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This study addresses the experiences of informal caregivers caring for elderly family members with Alzheimer's disease (AD) during the COVID-19 pandemic. The study includes a sample of eight informal caregivers who were evaluated through a semi-structured interview six months after the death of a loved one they cared for. A thematic content analysis was applied to the interviews and yielded two higher-order domains: (1) Experiencing the AD and the death of a family member and (2) The grieving process during the COVID-19 pandemic. The results provide valuable insights into family caregivers' experiences regarding the profound emotional impact of caregiving and grief during the COVID-19 pandemic. Caregivers maintain their identity even after loss, underscoring the enduring impact of caregiving. The identity as a caregiver impacted coping and grief responses, highlighting the need for tailored interventions.
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Menopause may negatively impact Quality of Life (QoL). Our study used a cross-sectional design and research participants were 99 women in natural menopause. In our study, we analyzed the relationship between age at menopause onset, hormone therapy use, duration of couple relationship, menopause duration, psychological morbidity, marital satisfaction, menopause representations, and QoL following the Wilson and Cleary Health-Related QoL conceptual model. The authors found that negative representations, lower marital satisfaction, psychological morbidity, and shorter duration of menopause contributed to lower QoL. Moreover, the authors found that psychological morbidity and menopause representations (identity and control/cure dimensions) had an indirect effect between marital satisfaction and vasomotor, psychosocial, and sexual QoL. Also, we found that age at the onset of menopause showed a moderating effect in the final model. Future studies should replicate these results in a longitudinal design and analyze how the variables that showed a moderating role and indirect effects will function as moderators and mediators, respectively, over time.
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OBJECTIVE: To explore patients' and healthcare professionals' (HPs') perspectives on the suitability/acceptability of a relaxation intervention, its effects on patients' well-being and diabetic foot ulcer (DFU) healing, and its incorporation into the multidisciplinary management of patients with diabetic foot. METHODS: This qualitative study was nested within a three-arm pilot randomized controlled trial. Patients with a chronic DFU received four relaxation sessions. Investigators then interviewed patients, physicians, and nurses involved with diabetic foot consultations. Interviews were audio-recorded, transcribed, and analyzed using thematic content analysis. RESULTS: Five themes emerged from patient's interviews about the suitability/acceptability of the relaxation intervention: perceptions regarding the psychological intervention, distress, the relaxation technique, changes in the patient's life, and changes in DFU/contribution to healing. Three themes emerged from interviews with HPs: perceptions regarding relaxation, changes in the patient, and changes in DFU/healing. Regarding the feasibility of the relaxation intervention, three themes emerged for both patients and HPs: suggested modifications, stressors/difficulties, and impact of COVID-19 pandemic. The utility theme emerged only in HP interviews, with subthemes of patients' distress, psychological interventions, relaxation intervention, and integration of the psychologist in the team. CONCLUSIONS: These findings provide evidence for the suitability/acceptability, feasibility, and utility of a relaxation intervention in diabetic foot consultations.
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COVID-19 , Diabetes Mellitus , Pie Diabético , Úlcera del Pie , Humanos , Pie Diabético/terapia , Pandemias , Cicatrización de HeridasRESUMEN
The purpose of this study was to investigate correlates of preterm (PT) infant's cortisol reactivity and the association to infant negative affect, during a mother-infant interaction procedure. Participants included 48 infants born prematurely (gestational age < 37 weeks) and their mothers, assessed when infants were 12 months old corrected for prematurity. The examined variables comprised both neonatal and environmental dimensions including maternal interactive behavior. Infant negative affect and maternal interactive behavior were assessed with a standardized mother-infant interaction task. A baseline infant saliva sample was collected before the interaction began, and a second sample after the interaction episodes ended. Results revealed that decrease of infant's cortisol concentration was significantly associated with the exposure to more sensitive, and less intrusive maternal behaviors. However, once controlled for neonatal risk, family SES and maternal psychological distress, the associations were rendered non-significant. Although the association between cortisol reactivity and negative affect trended toward significance, maternal intrusiveness was the only significant predictor of observed infant negative affect. Findings suggest the importance of primary relational experiences on PT infants' early regulatory competencies.
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Hidrocortisona , Recien Nacido Prematuro , Lactante , Femenino , Recién Nacido , Humanos , Recien Nacido Prematuro/psicología , Relaciones Madre-Hijo/psicología , Madres/psicología , AfectoRESUMEN
Understanding the correct interaction among the different components of the endocannabinoid (eCB) system is fundamental for a proper assessment of the function of eCBs as signaling molecules. The knowledge of how the membrane environment modulates the intracellular trafficking of the eCB system and its interacting proteins holds a huge potential in unraveling new mechanisms of its modulation. This chapter deals with the application of fluorescence resonance energy transfer technique to measure the binding affinity of eCB proteins to model membranes (i.e., large unilamellar vesicles, LUVs). In particular, we describe in detail the paradigmatic example of the interaction of rat recombinant fatty acid amide hydrolase with LUVs constituted of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine.
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Endocannabinoides , Liposomas Unilamelares , Animales , Transferencia Resonante de Energía de Fluorescencia , Unión Proteica , Ratas , Liposomas Unilamelares/metabolismoRESUMEN
Abstract Focal Adhesion Kinase (FAK) protein participates in proliferation, migration, cell survival, and apoptosis process. It has been described as overexpressed in several neoplasms being a promising target for therapy. BCR-ABL negative chronic Myeloproliferative Neoplasms (MPN) are clonal disorders characterized by the excess of proliferation and apoptosis resistance. The identification of the acquired JAK2 V617F mutation in MPN patients allowed a better understanding of pathogenesis. However, there is still no pharmacological treatment that leads all patients to molecular remission, justifying new studies. The present study aimed to evaluate FAK involvement in the viability and apoptosis of HEL and SET-2 cells, both JAK2 V617F positive cell lines. The FAK inhibitor PF 562,271 was used. Cell viability was determined using MTT assay and apoptosis verified by cleaved PARP, cleaved Caspase 3 and Annexin-V/PI staining detection. FAK inhibition significantly reduced HEL and SET-2 cells viability and induced apoptosis. Considering the role of JAK/STAT pathway in MPN, further investigation of FAK participation in the MPN cells proliferation and apoptosis resistance, as well as possible crosstalk between JAK and FAK and downstream pathways may contribute to the knowledge of MPN pathophysiology, the discovery of new molecular targets, and JAK inhibitors resistance mechanisms.
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Apoptosis , Proteína-Tirosina Quinasas de Adhesión Focal/análisis , Janus Quinasa 2/efectos adversos , Pacientes/clasificación , Línea Celular/clasificación , Neoplasias/patologíaRESUMEN
The fishery industry generates large amounts of waste (20-75% (w/w) of the total caught fish weight). The recovery of bioactive compounds from residues and their incorporation in cosmetics represents a promising market opportunity and may contribute to a sustainable valorisation of the sector. In this work, protein-rich extracts obtained by high-pressure technologies (supercritical CO2 and subcritical water) from sardine (Sardina pilchardus) waste and codfish (Gadus morhua) frames were characterized regarding their cosmeceutical potential. Antioxidant, anti-inflammatory and antibacterial activities were evaluated through chemical (ORAC assay), enzymatic (inhibition of elastase and tyrosinase), antimicrobial susceptibility (Klebsiella pneumoniae, Staphylococcus aureus and Cutibacterium acnes) and cell-based (in keratinocytes-HaCaT) assays. Sardine extracts presented the highest antibacterial activity, and the extract obtained using higher extraction temperatures (250 °C) and without the defatting step demonstrated the lowest minimum inhibitory concentration (MIC) values (1.17; 4.6; 0.59 mg/mL for K. pneumoniae, S. aureus and C. acnes, respectively). Codfish samples extracted at lower temperatures (90 °C) were the most effective anti-inflammatory agents (a concentration of 0.75 mg/mL reduced IL-8 and IL-6 levels by 58% and 47%, respectively, relative to the positive control). Threonine, valine, leucine, arginine and total protein content in the extracts were highlighted to present a high correlation with the reported bioactivities (R2 ≥ 0.7). These results support the potential application of extracts obtained from fishery industry wastes in cosmeceutical products with bioactive activities.
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Background: Hemodialysis patients have high-risk of severe SARS-CoV-2 infection but were unrepresented in randomized controlled trials evaluating the safety and efficacy of COVID-19 vaccines. We estimated the real-world effectiveness of COVID-19 vaccines in a large international cohort of hemodialysis patients. Methods: In this historical, 1:1 matched cohort study, we included adult hemodialysis patients receiving treatment from December 1, 2020, to May 31, 2021. For each vaccinated patient, an unvaccinated control was selected among patients registered in the same country and attending a dialysis session around the first vaccination date. Matching was based on demographics, clinical characteristics, past COVID-19 infections and a risk score representing the local background risk of infection at vaccination dates. We estimated the effectiveness of mRNA and viral-carrier COVID-19 vaccines in preventing infection and mortality rates from a time-dependent Cox regression stratified by country. Results: In the effectiveness analysis concerning mRNA vaccines, we observed 850 SARS-CoV-2 infections and 201 COVID-19 related deaths among the 28110 patients during a mean follow up of 44 ± 40 days. In the effectiveness analysis concerning viral-carrier vaccines, we observed 297 SARS-CoV-2 infections and 64 COVID-19 related deaths among 12888 patients during a mean follow up of 48 ± 32 days. We observed 18.5/100-patient-year and 8.5/100-patient-year fewer infections and 5.4/100-patient-year and 5.2/100-patient-year fewer COVID-19 related deaths among patients vaccinated with mRNA and viral-carrier vaccines respectively, compared to matched unvaccinated controls. Estimated vaccine effectiveness at days 15, 30, 60 and 90 after the first dose of a mRNA vaccine was: for infection, 41.3%, 54.5%, 72.6% and 83.5% and, for death, 33.1%, 55.4%, 80.1% and 91.2%. Estimated vaccine effectiveness after the first dose of a viral-carrier vaccine was: for infection, 38.3% without increasing over time and, for death, 56.6%, 75.3%, 92.0% and 97.4%. Conclusion: In this large, real-world cohort of hemodialyzed patients, mRNA and viral-carrier COVID-19 vaccines were associated with reduced COVID-19 related mortality. Additionally, we observed a strong reduction of SARS-CoV-2 infection in hemodialysis patients receiving mRNA vaccines.
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Dropping out of university studies is one of the current problems of Higher Education; the increased rates during the first year of the study programme is considerable around the world. Dropping out has negative social implications that are reflected at the personal, family, institutional, and educational levels. The aim of this study was to evaluate a predictive model considering the mediation of university social satisfaction and perceived academic performance within the relations between perceived social support, social self-efficacy and academic purposes with career satisfaction and dropout intention in Chilean university students. A non-experimental explanatory design of latent and observed variables was used. Structural equation analyses with Mplus software were performed. The sample consisted of 956 first year university students. The study complied with the ethical requirements for research with human subjects. As a result, a predictive model with adequate adjustment indexes was obtained. When evaluating the explanatory capacity through the coefficient of determination (R2 ), it was observed that it explains 38.9 and 27.4% of the variance of the dropout intention and career satisfaction, respectively. This percentage of explanation indicates a large effect size in Social Sciences; therefore, they are considered adequate predictive models. The mediation of university social satisfaction on the relationships between social support, social self-efficacy, and academic purposes with academic adjustment and dropout intention was, respectively, confirmed. The perception of academic performance has less influence on dropout intention and on career satisfaction among first-year students. The model obtained allows explaining the dropout intention and career satisfaction in first year students. In addition, it is composed of variables that can potentially be modified in the interaction of students and professors.
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Preeclampsia , Disfunción Ventricular Izquierda , Factor Natriurético Atrial , Biomarcadores , Femenino , Atrios Cardíacos , Humanos , Péptido Natriurético Encefálico , Preeclampsia/diagnóstico , Embarazo , Disfunción Ventricular Izquierda/diagnóstico por imagen , Disfunción Ventricular Izquierda/etiologíaRESUMEN
BACKGROUND: Dropout in higher education is a concern for students, families, educational institutions, and society. Tertiary education is an important mechanism for empowering people and STEM courses are vital to countries' development. METHOD: The study combined quantitative and qualitative data. Step 1 was an analysis of personal and contextual variables in a comprehensive examination of dropout in a sample of 1,016 engineering students. In step 2 a short interview by telephone were conducted with 82 students who dropped out, identifying their reasons and their academic/professional situation. In step 3 in-depth interviews were conducted with six students in order to understand the dynamic process of their decisions to leave. RESULTS: The academic/professional situations of students who dropped out were quite varied, for example the same course or a different course at another institution, starting a job, not working or studying, or attending another level of professional training. There were three main reasons for dropping: vocational, learning process and achievement, and reconciling roles. CONCLUSIONS: Engineering student dropout is related to vocational and academic achievement. This should be considered in the implementation of programs to reduce the rate of dropout.
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Abandono Escolar , Universidades , Logro , Escolaridad , Humanos , EstudiantesRESUMEN
The valorization of Atlantic cod (Gadus morhua) frames from a filleting industry was investigated using subcritical water extraction and hydrolysis (SBW) at different temperatures (90, 140, 190 and 250 °C) and 100 bar to obtain extracts rich in proteins, peptides and amino acids. Up to 57.7 g of extract per 100 g of codfish frames were obtained, with nearly total recovery of the protein fraction. At each temperature, protein extracts of decreasing molecular weight were obtained, according to SEC-GPC results. Most of the protein present in the raw material and extracts was collagen and collagen fragments, as suggested by the amino acid profile. Codfish SBW extracts did not show cytotoxicity in the range of concentrations tested and the protein extract obtained at the lowest temperature (90 °C) showed the highest anti-inflammatory potential in human intestinal epithelium cell model. The mineralized residue left after SBW treatment of cod frames was identified as practically pure, crystalline, hydroxyapatite, that may find applications in biomedical field and hard-tissue engineering. This study shows the possible valorization of cod frames using green extraction methods such as SBW process to obtain protein extracts for food and nutraceutical applications.
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OBJECTIVES: Studies of cardiovascular function in pregnancy have shown inconsistent and, in some cases, contradictory results, particularly regarding cardiac output. While some studies report preeclampsia associated with high cardiac output, other studies suggest that preeclampsia should be further subdivided into women with high or low cardiac output. This study was conducted to examine the NT-proBNP levels in preeclampsia, intrauterine growth restriction, and hypertensive pregnancies without preeclampsia. We also examined N-terminal pro-B natriuretic peptide (NT-proBNP) levels three to four months after delivery, in preeclamptic women as well as the prediction of delivery within 10 days. In a reduced number of preeclamptic women and controls we performed echocardiograms to study their diastolic function. METHODS: We investigated the NT-proBNP levels in 213 subjects with preeclampsia only, 73 with intrauterine growth restriction, 44 with preeclampsia and intrauterine growth restriction, 211 who were hypertensive and 662 unaffected pregnancies (controls). We also performed echocardiograms on 36 preeclampsia and 19 controls before delivery and three to five months after delivery. RESULTS: NT-proBNP levels are higher in early onset preeclampsia than in late onset preeclampsia. Intrauterine growth restriction pregnancies showed a NT-proBNP levels similar to hypertensive and unaffected pregnancies. Compared with healthy pregnancies, women with preterm preeclampsia (<37 gestational weeks) had altered left atrial segments. CONCLUSIONS: We observed that NT-proBNP levels are higher in early onset preeclampsia than in late onset. Moreover, diastolic dysfunction is higher in early onset than in late-onset term preeclampsia. An NT-proBNP value >136 pg/mL has a high positive predictive value for an imminent delivery within 10 days.
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Hipertensión , Preeclampsia , Biomarcadores , Femenino , Retardo del Crecimiento Fetal , Humanos , Recién Nacido , Péptido Natriurético Encefálico , Fragmentos de Péptidos , Preeclampsia/diagnóstico , EmbarazoRESUMEN
The objective of this study was to evaluate the effects of relative humidity (RH) and different dry aging methods on the quality of beef. Sixteen loins, from eight carcasses, were used in this experiment. Each pair of loin was cut into eight sections with equal size, which were evenly assigned to eight treatments, by the combination of two dry aging methods (traditional and highly moisture-permeable special bag), two relative humidity (65 and 85% RH) and two aging times (21 and 42 days). At 85% RH, neither special bag nor the traditional dry aging methods were viable, since samples presented high microbiological counts, mucus and bad odor. At 65% RH, Enterobacteriaceae and lactic acid bacteria were not detected in any treatment. The highest aerobic plate count and psychrotrophic count were observed in the samples of the traditional dry-aged process whereas the special bag showed the greatest mold and yeast count. Regarding dry aging in special bag, there was a reduction in the weight loss (P < 0.05) and no change in the physical-chemical characteristics (P > 0.05) compared to traditional dry aging. The values of pH, moisture and Warner-Bratzler shear force were not affected (P > 0.05) by aging method and relative humidity. Thus, the results indicate that high RH should be avoided for both dry aging methods. Furthermore, the special bag dry aging can be considered an alternative to produce dry-aged beef, as it reduces weight losses even at conditions of lower relative humidity.
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Manipulación de Alimentos , Animales , Bovinos , HumedadRESUMEN
OBJECTIVES: To evaluate whether the use of exogenous melatonin affects sleep, reduces the prevalence of delirium, and decreases the need for analgosedation and to assess whether serum melatonin indices correlate with exogenous administration in critically ill patients. DESIGN: Double-blind, randomized, placebo-controlled study. SETTING: Multicenter ICUs of two tertiary hospitals. PATIENTS: A total of 203 adult patients who were admitted to the ICU and administered with analgesics and/or sedatives. INTERVENTIONS: Oral melatonin (10 mg) or placebo for up to seven consecutive nights. MEASUREMENTS AND MAIN RESULTS: The number of observed sleeping hours at night was assessed by the bedside nurse. Sleep quality was evaluated using the Richards Campbell Questionnaire Sleep (RCSQ). The prevalence of delirium, pain, anxiety, adverse reactions, duration of mechanical ventilation, length of ICU and hospital stays, and doses of sedative and analgesic drugs administered were recorded. The use of analgesics and sedatives was assessed daily. Melatonin levels were determined by enzyme-linked immunosorbent assay. Based on the RCSQ results, sleep quality was assessed to be better in the melatonin group than that in the placebo group with a mean (SD) of 69.7 (21.2) and 60.7 (26.3), respectively (p = 0.029). About 45.8% and 34.4% of participants in the melatonin and placebo groups had very good sleep (risk ratio, 1.33; 95% CI, 0.94-1.89), whereas 3.1% and 14.6% had very poor sleep (risk ratio, 0.21; 95% CI, 0.06-0.71), respectively. No significant difference was observed regarding the days free of analgesics or sedatives, the duration of night sleep, and the occurrence of delirium, pain, and anxiety. Melatonin serum peak levels at 2 AM were 150 pg/mL (range, 125-2,125 pg/mL) in the melatonin group and 32.5 pg/mL (range, 18.5-35 pg/mL) in the placebo group (p < 0.001). CONCLUSIONS: Melatonin was associated with better sleep quality, which suggests its possible role in the routine care of critically ill patients in the future.
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Depresores del Sistema Nervioso Central/uso terapéutico , Unidades de Cuidados Intensivos , Melatonina/uso terapéutico , Sueño/efectos de los fármacos , Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/sangre , Método Doble Ciego , Femenino , Humanos , Tiempo de Internación , Masculino , Melatonina/administración & dosificación , Melatonina/sangre , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
OBJECTIVE: The Spanish registry of Covid-19 in Spanish pregnant women, made up of 100 centers, is created in response to the need to know the morbidity that Covid-19 generates in pregnant women and their newborns, to know the real incidence of the disease in this population group and to establish and monitor the package of measures to improve their care. The aim of this paper was the creation of a registry of pregnant women with Covid-19 infection in order to establish the interventions and measures necessary to improve the care of these patients during hospital admission. METHODS: To prepare the registry, the main researcher of each center collected weekly / biweekly the number of total pregnant women screened, as well as the total number of positive and negative, sending these data to the responsible researchers so that it could be available in real time of the percentage of infected asymptomatic pregnant population and the evolution by weeks in the centers of each participating province. The data were analyzed using the linear regression test and the Mantel test. RESULTS: As of May 31stsup> 2020, 16,308 screening tests were carried out in these hospitals, in which 338 pregnant women were positive, which translates into 2.07% (95% Confidence Interval: 1.86-2.30) of the asymptomatic pregnant women we attended in our centers were carriers of the virus and could develop the disease in subsequent days. CONCLUSIONS: The Spanish epidemiological registry allows us to know the incidence of infection in pregnant women attended in the Spanish delivery centers, as well as the weekly and / or fortnightly evolution of the same, observing a significant decrease in the proportion of positive pregnant women over the total of screenings throughout this period, with an average of 6.5% in early April 2020 to an average of 0.93% positive in late May 2020.
OBJETIVO: El registro español de Covid-19 en embarazadas españolas, integrado por 100 centros, surge en respuesta a la necesidad de conocer la morbilidad que la Covid-19 genera en las gestantes y sus recién nacidos, de conocer la incidencia real de la enfermedad en este grupo poblacional y de establecer y monitorizar el paquete de medidas para mejorar su atención. El objetivo de este estudio fue la creación de un registro de gestantes con infección por Covid-19 con la finalidad de establecer y monitorizar las intervenciones y medidas necesarias para mejorar la atención de estas pacientes durante el ingreso hospitalario. METODOS: Para la elaboración del registro, el investigador principal de cada centro recogió con carácter semanal/quincenal el número de gestantes totales cribadas, así como el total de positivas y negativas, remitiendo a los investigadores responsables estos datos de manera que se pudiera disponer a tiempo real del porcentaje de población gestante asintomática infectada y de la evolución por semanas en los centros de cada provincia participante. Los datos fueron analizados mediante el Test de regresión lineal y test de Mantel. RESULTADOS: A día 31 de mayo de 2020, se realizaron en estos hospitales 16.308 test de cribado, en los cuales 338 gestantes resultaron positivas, lo que se traduce en que un 2,07% (Intervalo de Confianza del 95%: 1,86-2,30) de las gestantes asintomáticas que atendimos en nuestros centros eran portadoras del virus y podían desarrollar la enfermedad en días posteriores. CONCLUSIONES: El registro epidemiológico español permite conocer la incidencia de infección en gestantes atendidas en los paritorios españoles, así como la evolución semanal y/o quincenal de la misma, observándose un descenso significativo de la proporción de gestantes positivas sobre el total de cribadas a lo largo de este periodo, con una media del 6,5% a principios de abril de 2020 hasta una media del 0,93% de positivas a finales de mayo de 2020.
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Betacoronavirus , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Tamizaje Masivo , Neumonía Viral/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Sistema de Registros , Adulto , Enfermedades Asintomáticas , Betacoronavirus/aislamiento & purificación , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico/métodos , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Femenino , Humanos , Incidencia , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/terapia , SARS-CoV-2 , España/epidemiologíaRESUMEN
The general objective of this study is to analyze student satisfaction with the use of virtual campuses in university teaching in order to discover the main variables influencing the overall online teaching-learning process that give quality to the virtual educational process. To this end, an ex-post-facto research methodology was applied to 1084 university students, who completed an ad hoc designed questionnaire, which allowed us to carry out descriptive analysis, classification trees and fuzzy inference systems using SPSS and Matlab software. The results suggest that four variables predominantly influence the quality of the teaching-learning processes in virtual campuses: satisfactory teacher responses to student questions and observations, the positive attitude of teachers towards the use of information and communication technologies, students having appropriate digital skills, and activities that encourage ideas and debate.