Precision Oncology and Systemic Targeted Therapy in Pseudomyxoma Peritonei.

PURPOSE: Pseudomyxoma peritonei (PMP) is a rare and poorly understood malignant condition characterized by the accumulation of intra-abdominal mucin produced from peritoneal metastases. Currently, cytoreductive surgery remains the mainstay of treatment but disease recurrence and death after relapse frequently occur in patients with PMP. New therapeutic strategies are therefore urgently needed for these patients. EXPERIMENTAL DESIGN: A total of 120 PMP samples from 50 patients were processed to generate a collection of 50 patient-derived organoid (PDO) and xenograft (PDX) models. Whole exome sequencing, immunohistochemistry analyses, and in vitro and in vivo drug efficacy studies were performed. RESULTS: In this study, we have generated a collection of PMP preclinical models and identified druggable targets, including BRAFV600E, KRASG12C, and KRASG12D, that could also be detected in intra-abdominal mucin biopsies of patients with PMP using droplet digital PCR. Preclinical models preserved the histopathological markers from the original patient sample. The BRAFV600E inhibitor encorafenib reduced cell viability of BRAFV600E PMP-PDO models. Proof-of-concept in vivo experiments showed that a systemic treatment with encorafenib significantly reduced tumor growth and prolonged survival in subcutaneous and orthotopic BRAFV600E-PMP-PDX mouse models. CONCLUSIONS: Our study demonstrates for the first time that systemic targeted therapies can effectively control PMP tumors. BRAF signaling pathway inhibition represents a new therapeutic opportunity for patients with BRAFV600E PMP who have a poor prognosis. Importantly, our present data and collection of preclinical models pave the way for evaluating the efficacy of other systemic targeted therapies toward extending the promise of precision oncology to patients with PMP.

Development of novel methods based on GC-HRMS and LC-HRMS for the determination of non-phthalate plasticizers in soil.

Non-phthalate plasticizers (NPPs) are a suitable alternative to phthalates, which are harmful compounds for human, animal health, and the environment. In this study, 28 commercial non-phthalate plasticizers (NPPs) from different families, including adipates, citrates, phosphates, sebacates, trimellitates, benzoates and cyclohexanoates, were determined. Two novel methods for determining these alternative compounds in soil were developed using gas chromatography coupled to high-resolution mass spectrometry (GC-HRMS-Q-Orbitrap) and liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS-Q-Orbitrap). Solid-liquid extraction (SLE) with ethyl acetate or acetonitrile, along with water as extraction solvents, were employed. In most cases, the GC method exhibited recoveries ranging from 84.9 % to 110.8 % at 20, 40 and 200 µg/kg, while the LC method achieved recoveries between 73.1 % and 115.4 % at 10, 20, 40 and 200 µg/kg. Most of the relative standard deviation (RSD) values were below 20 % for both methods. The validated methods were then applied to analyse soil samples collected from four different areas in Almeria. The results indicated that the compounds detected most frequently at high concentrations were 1-hydroxycyclohexyl phenyl ketone (HCPK) using GC, in the range 29.1-67.4 µg/kg and 2,2,4-trimethyl-1,3-pentanediol diisobutyrate (TXIB) using LC, in the range 39.9-51.5 µg/kg. Additionally, suspect and unknown analysis were carried out, and other plasticizers as phthalates, were also detected, in addition to other substances present in the analysed samples. All the soils exhibited the presence of a few plasticizers, either phthalic and/or non-phthalic.

Adaptation and Validation of the Falls Efficacy Scale-International (FES-I) in Community-Dwelling Older Mexican Adults.

The objective of this study was to evaluate the reliability and validity of the FES-I scale in community-dwelling older Mexican adults. Participants were 222 older adults, with a mean age of 70 years; 75% were women who completed a sociodemographic data sheet, a Spanish version of the FES-I scale, intended to explore measures of depression, quality of life, and instrumental activities of daily living. Discriminant validity was demonstrated for all items on the FES-I scale and when groups of older adults were compared according to age. Evidence of internal consistency was found in all the items of the FES-I scale (α = .91) and convergent and divergent validity of the FES-I scale with measures of depression and quality of life, except instrumental activities of daily living. The Confirmatory Factor Analysis shows that the FES-I scale partially retains its two-factor measurement properties since five items were removed from the model to fit the data. The FES-I scale is a valid and reliable measure for clinical evaluations of fear of falls in older Mexican adults in the community.

Factores psicosociales y sociodemográficos asociados con el desgaste profesional en médicos residentes de Sonora (México) / Psychosocial and Sociodemographic Factors Associated with Burnout among Medical Residents of Sonora ­ Mexico / Fatores psicossociais e sociodemográficos associados ao burnout em médicos residentes de Sonora, México

Introducción: la simultaneidad de actividades entre las exigencias académicas y el adiestramiento médico durante las residencias provoca un elevado riesgo de desarrollar un desgaste profesional (o síndrome de burnout [SB]) en los médicos residentes. El objetivo fue identificar los factores psicosociales y socio- demográficos asociados al SB en médicos residentes. Materiales y métodos: estudio transversal y correlacional. Participaron 47 médicos residentes de un hospital público. Se aplicaron la Escala de Desgaste Ocupacional (EDO), el Inventario Multifásico de la Personalidad Minnesota-2 Forma Reestructurada (MMPI2-Rf) y un cuestionario sociodemográfico. Los datos se analizaron mediante la prueba de correlación no paramétrica de Spearman. Resultados: el 25.6 % de los participantes mostró burnout alto, y el 51 %, un agotamiento emocional alto. Respecto a los factores de personalidad y sociodemográficos asociados, solo mostraron relación significativa (p < 0.05) la escala de impulsividad (r = 0.341, p = 0.019) y las horas de ejercicio en la semana (r = −0.414, p = 0.004). Al segmentar por sexo, solo en los hombres del estudio existió una relación entre SB y psicoticismo (r = 0.468, p = 0.018), la disminución de la actividad física (r = −0.620, p = 0.001) y primeros años de residencia (r = −0.396, p = 0.050). Conclusiones: el alto agotamiento emocional de los residentes está asociado con problemas en el manejo de impulsos, distorsiones de la realidad (debido al psicoticismo), pertenecer a los primeros años de residencia y falta de ejercicio físico. Se requiere especial atención a la salud física y mental de estos profesionales

Introduction: The simultaneity of activities between academic demands and medical training during residencies is a high risk of developing burnout syndrome (BS) among resident physicians, which decreases their quality of life. This study aimed to identify the psychosocial and sociodemographic factors associated with BS among resident physicians from a public hospital. Materials and methods: This cross-sectional and correlational study involved 47 resident physicians. The Occupational Burnout Scale (EDO), the Minnesota Multiphasic Personality Inventory-2 Restructured Form, and a sociodemographic questionnaire were applied. The data were analyzed by using nonparametric Spearman's correlation test. Results: We found that 25.6% of the participants had a high level of burnout, while 51% showed a high level of emotional exhaustion. Regarding personality and sociodemographic factors associated with BS, only the impulsivity scale (r = 0.341; p = 0.019) and the hours of exercise performed in a week (r = −0.414; p = 0.004) showed a significant relationship (p < 0.05). When segmented by sex, a relationship between BS and psychoticism (r = 0.468; p = 0.018), decreased physical activity (r = −0.620; p = 0.001), and first years of residence (r = −0.396; p = 0.050) were noted only in men. Conclusions: A high level of emotional exhaustion was evidenced among the medical residents in relation to the development of their activities, which were associated with problems in the management of impulses, distortions of reality (due to psychoticism), belonging to the first years of residency, and the lack of physical exercise. Hence, special attention must be given to the physical and mental health of medical residents

Introdução: a simultaneidade de atividades entre as demandas acadêmicas e ao mesmo tempo a formação médica durante as residências acarreta alto risco de desenvolvimento da Síndrome de Burnout (SB) nos médicos residentes, diminuindo sua qualidade de vida. O objetivo da pesquisa foi identificar os fatores psicossociais e sociodemográficos associados à SB em médicos residentes. Materiais e métodos: estudo transversal e correlacional. Participaram 47 médicos residentes de um hospital público. Aplicou-se a Escala de Desgaste Ocupacional (EDO), o Inventário Multifásico da Personalidade Minnesota-2 Forma Reestruturada (MMPI2-Rf) e adicionalmente um questionário sociodemográfico. Os dados foram analisados por meio do teste de correlação não paramétrica de Spearman. Resultados: 25,6% dos participantes apresentaram alto burnout e 51% alto nível de exaustão emocional. Em relação aos fatores de personalidade e sociodemográficos associados à SB, apenas a escala de impulsividade (r = 0,341; p = 0,019) e as horas de exercício por semana (r = −0,414; p = 0.004) apresentaram relação significativa (p < 0,05). Quando segmentado por sexo, apenas nos homens do estudo houve relação entre SB e psicoticismo (r = 0,468; p = 0,018), diminuição da atividade física (r = −0,620; p = 0,001) e primeiros anos de residência (r = −0,396; p = 0,050). Conclusões: destaca-se o elevado desgaste emocional vivenciado pelos residentes no desenvolvimento das suas atividades, que se associa a problemas na gestão dos impulsos, distorções da realidade (devido ao psicoticismo), estar nos primeiros anos de residência e falta de exercício físico. É necessária atenção especial à saúde física e mental desses profissionais

Efficacy of a transdiagnostic guided internet-delivered intervention for emotional, trauma and stress-related disorders in Mexican population: study protocol for a randomized controlled trial.

BACKGROUND: Emotional and stress-related disorders show high incidence, prevalence, morbidity, and comorbidity rates in Mexico. In recent decades, research findings indicate that cognitive behavioral interventions, from a disorder-specific perspective, are the effective front-line treatment for anxiety and depression care. However, these treatments are not often used. Reasons include limited access and low availability to effective interventions and comorbidity between mental disorders. Emotional deregulation of negative affectivity has been found to be a mediating factor in addressing emotional disorders from a transdiagnostic perspective, aimed at two or more specific disorders. In addition, technological advancement has created alternatives for psychological assistance, highlighting the possibilities offered by technologies since Internet-supported intervention programs have been empirically tested for effectiveness, efficiency and efficacy and can be key to ensuring access to those who are inaccessible. The aim of the study is to evaluate the efficacy, moderators of clinical change and acceptability of a transdiagnostic guided Internet-delivered intervention versus a transdiagnostic self-guided Internet-delivered intervention for emotional, trauma and stress-related disorders, and waiting list in community sample. METHODS: A three-armed, parallel group, superiority randomized controlled clinical trial with repeated measurements at four times: pretest, posttest, follow-up at 3, 6 and 12 months. Outcomes assessor, participant, care provider and investigator will be blinded. Participants aged 18 to 70 years will be randomly allocated 1:1:1 to one of three study arms: a) Transdiagnostic guided internet-delivered intervention with synchronous assistance, b) Transdiagnostic self-guided internet-delivered intervention, c) Waiting list group. Based on sample size estimation, a minimum of 207 participants (69 in each intervention group) will be included. DISCUSSION: The study could contribute to improving the efficacy of transdiagnostic internet-delivered interventions to promote the dissemination of evidence-based treatments and eventually, to decrease the high prevalence of emotional and trauma-related disorders in the Mexican population. TRIAL REGISTRATION: ClinicalTrial.gov: NCT05225701 . Registered February 4, 2022.

Appropriateness of radiological diagnostic tests in otolaryngology.

OBJECTIVE: To evaluate the appropriateness of imaging tests associated with radiation in the field of otolaryngology according to the available recommendations, and to estimate the effective radiation dose associated. METHOD: Cross-sectional epidemiological study of the totality of the imaging test requests carried out by two Spanish hospitals (n = 1931). We collected the following information: patient demographic data, type of imaging test, imaging tests referred in the previous 12 months, referrer department and diagnostic suspicion. In accordance with the available guidelines, we considered the requests: (a) Appropriate; (b) Inappropriate; (c) Not adequately justified; (d) Not included in the guidelines. We calculated the prevalence of each category and their variation according to the different variables. Collective and per capita effective dose were calculated for each category. RESULTS: Of the 538 requests, 42% were considered appropriate, 34.4% inappropriate, 11.9% not adequately justified and 11.7% not included in the guidelines. Imaging tests requested by general partitioners (aOR: 0.18; 95% CI: 0.06-0.50) and clinical departments (aOR: 0.27; 95% CI: 0.11-0.60) were less likely to be considered appropriate than those requested by the Otolaryngology department. Patients with a diagnosis suspicion of tumour pathology were more likely to have a requested imaging test classified as appropriate (aOR: 7.12; 95% CI: 3.25-15.61). The cumulative effective dose was 877.8 mSv, of which 40% corresponded to tests classified as inappropriate. CONCLUSIONS: A high percentage of imaging tests are considered as inappropriate in the field of otolaryngology, with a relevant frequency of associated effective radiation dose. Type of department, the diagnostic suspicion and the type of imaging tests were variables associated to the inappropriateness of the test.

Intervención multidisciplinaria en pacientes con diabetes mellitus tipo 2 en comunidades rurales: un estudio piloto / Multidisciplinary intervention in patients with type 2 diabetes mellitus in rural communities: a pilot study

Resumen Objetivo: Evaluar los efectos de una intervención multidisciplinaria, para mejorar la adhesión al tratamiento en diabetes mellitus tipo 2 (DM2) de comunidades rurales. Materiales y Métodos: Participaron 26 pacientes (15 mujeres) con DM2 (M edad = 60 DT = 12) de dos comunidades rurales del noroeste de México. Se aplicaron los inventarios de Depresión y Ansiedad de Beck y el Inventario de Calidad de Vida y Salud. Se midió la glucosa en el ayuno y la hemoglobina glicosilada antes y después de la intervención. Resultados: La intervención mostró una disminución en depresión y ansiedad, así como una mejor calidad de vida. También se detectó una disminución de la glucosa en ayuno. Se calculó la prueba t de Student para examinar las diferencias en las variables señaladas tomadas en dos momentos, antes de iniciar el programa y al finalizar el programa. Se observaron menores niveles de sintomatología depresiva, ansiedad y mayores niveles de calidad de vida al finalizar el programa. Además, el nivel de glucosa en sangre descendió de manera significativa. Conclusiones: Se analizaron las implicaciones de intervenciones de este tipo en comunidades rurales, detectándose la necesidad de implementar políticas públicas que permitan mejorar condiciones en población vulnerable.

Abstract Objective: To evaluate the effects of a multidisciplinary intervention in patients with type 2 Diabetes Mellitus from rural communities. Materials and methods: Twenty-six patients (15 women and 11 men) with DM2 from two rural communities in northwestern Mexico participated. The average age was 60 years. The Beck Depression and Anxiety Inventory and Inventario de Calidad de Vida y Salud were applied, in addition to fasting glucose and glycosylated hemoglobin before and after the intervention. Results: Statistically significant pretest-postest changes were detected in depression and anxiety (p=.006 y p=.002 respectively). by Student's t for related samples and the size of the median and large effect by Cohen's d in the psychological variables. In fasting blood glucose changes were detected between the first and last sessions. However in glycosylated hemoglobin only 6 patients decreased their levels. Conclusions: Future studies involving community members to support the behavioral change of patients with DM2 are proposed.

[Perceived stressors associated with the presence of burnout in resident physicians]. / Estresores percibidos asociados a la presencia de burnout en médicos residentes.

Background: Scientific research has reported various stressors that could be related to the development of burnout in resident physicians. Objective: To identify the perceived stressors associated with burnout in residents of various medical specialties in Mexico's northwest. Material and methods: A cross-sectional, explanatory, observational, and analytical study was carried out. The sampling was non-probabilistic. Resident physicians from two hospitals in southern Sonora participated. The Occupational Burnout Scale (OED) and the Stressors Check List with intensity were used. Results: 189 resident physicians were included. 87% presented high levels of burnout. Specifically, the work overload and job dissatisfaction stressors were the ones with the greatest predictive power of burnout and dissatisfaction with achievement in resident physicians. By dimensions, physical problems were predictors of the pain dimension in the occupational burnout state. Professional exercise and physical problems predicted burnout in occupational burnout state. And physical problems were predictors for the presence of depression. Conclusions: The data obtained confirm the need to attend physical and mental health of resident doctors, and promote optimal work environments that have a positive impact on the well-being of their members.

Introducción: la investigación científica ha reportado diversos estresores que podrían estar relacionados con el desarrollo del burnout en médicos residentes. Objetivo: identificar los estresores percibidos asociados con burnout en residentes de diversas especialidades médicas en el noroeste de México. Material y métodos: se realizó un estudio analítico, observacional, explicativo y transversal. El muestreo fue no probabilístico. Participaron médicos residentes de dos hospitales del sur de Sonora. Se utilizó la Escala de desgaste ocupacional (EDO) y la Lista de chequeo de estresores con intensidad. Resultados: se incluyeron 189 médicos residentes. El 87% presentó altos niveles de burnout. Específicamente los estresores sobrecarga laboral e insatisfacción laboral tuvieron mayor poder predictivo del agotamiento y la insatisfacción de logro en los médicos residentes. Por dimensiones, los problemas físicos fueron predictores de la dimensión de dolor en el estado de desgaste ocupacional. Asimismo, el ejercicio profesional y los problemas físicos predijeron el agotamiento en el estado de desgaste ocupacional. Y los problemas físicos fueron predictores para la presencia de depresión. Conclusiones: los datos obtenidos confirman la necesidad de atender la salud física y mental de los médicos residentes, así como promover ambientes laborales óptimos que tengan un impacto positivo en el bienestar de sus integrantes.

Estresores percibidos asociados a la presencia de burnout en médicos residentes / Perceived stressors associated with the presence of burnout in resident physicians

Introducción: la investigación científica ha reportado diversos estresores que podrían estar relacionados con el desarrollo del burnout en médicos residentes. Objetivo: identificar los estresores percibidos asociados con burnout en residentes de diversas especialidades médicas en el noroeste de México. Material y métodos: se realizó un estudio analítico, observacional, explicativo y transversal. El muestreo fue no probabilístico. Participaron médicos residentes de dos hospitales del sur de Sonora. Se utilizó la Escala de desgaste ocupacional (EDO) y la Lista de chequeo de estresores con intensidad. Resultados: se incluyeron 189 médicos residentes. El 87% presentó altos niveles de burnout. Específicamente los estresores sobrecarga laboral e insatisfacción laboral tuvieron mayor poder predictivo del agotamiento y la insatisfacción de logro en los médicos residentes. Por dimensiones, los problemas físicos fueron predictores de la dimensión de dolor en el estado de desgaste ocupacional. Asimismo, el ejercicio profesional y los problemas físicos predijeron el agotamiento en el estado de desgaste ocupacional. Y los problemas físicos fueron predictores para la presencia de depresión. Conclusiones: los datos obtenidos confirman la necesidad de atender la salud física y mental de los médicos residentes, así como promover ambientes laborales óptimos que tengan un impacto positivo en el bienestar de sus integrantes

Background: Scientific research has reported various stressors that could be related to the development of burnout in resident physicians. Objective: To identify the perceived stressors associated with burnout in residents of various medical specialties in Mexico's northwest. Material and methods: A cross-sectional, explanatory, observational, and analytical study was carried out. The sampling was non-probabilistic. Resident physicians from two hospitals in southern Sonora participated. The Occupational Burnout Scale (OED) and the Stressors Check List with intensity were used. Results: 189 resident physicians were included. 87% presented high levels of burnout. Specifically, the work overload and job dissatisfaction stressors were the ones with the greatest predictive power of burnout and dissatisfaction with achievement in resident physicians. By dimensions, physical problems were predictors of the pain dimension in the occupational burnout state. Professional exercise and physical problems predicted burnout in occupational burnout state. And physical problems were predictors for the presence of depression. Conclusions: The data obtained confirm the need to attend physical and mental health of resident doctors, and promote optimal work environments that have a positive impact on the well-being of their members

The Geriatric Depression Scale (GDS-15): Validation in Mexico and Disorder in the State of Knowledge.

The objective of this study was to evaluate the reliability and validity of the Geriatric Depression Scale in its 15-item version (GDS-15) in Mexican older adults. Participants included 1178 older adults between the ages of 60 and 94 (M = 69.16, SD = 7.69); 53.9% were women and 55.8% were married or with a partner. They completed the GDS-15, a subjective well-being scale, and a quality-of-life questionnaire. A Kuder-Richardson coefficient of .80 was obtained, which indicates an acceptable internal consistency of the GDS-15, as well as evidence of divergent validity with significant correlations of -.783 with subjective well-being and -.569 with quality of life, in addition to concurrent validity when discriminating between participants with low scores from those with high scores of depressive symptoms. The need for a simple screening tool such as the GDS-15 that helps in the identification of depressive symptoms in Mexican older adults is underlined.

High-extinction ratio polarization splitter based on an asymmetric directional coupler and on-chip polarizers on a silicon photonics platform.

A high performance compact silicon photonics polarization splitter is proposed and demonstrated. The splitter is based on an asymmetric directional coupler. High extinction ratios at the through and drop ports of the polarization splitter are achieved by using an on-chip TE-pass polarizer and a TM-pass polarizer, respectively. The splitter, implemented on a silicon-on-insulator platform with a 220 nm-thick silicon device layer, has a measured insertion loss lower than 1 dB (for both TE and TM modes) and extinction ratio greater than 25 dB (for TM mode) and greater than 36 dB (for TE mode), in the wavelength range from 1.5 µm to 1.6 µm. The footprint of the device is 12 µm × 15 µm.

Intervención telefónica para mejorar adherencia terapéutica en niños con enfermedad renal / Telephone intervention to improve therapeutic adherence in children with kidney disease / Intervenção telefônica para melhorar a adesão terapêutica em crianças com doença renal / Intervention téléphonique pour améliorer lobservance thérapeutique chez les enfants atteints dune maladie rénale

Resumen Objetivo Evaluar los efectos de una intervención cognitivo conductual vía telefónica sobre la adherencia terapéutica de niños con insuficiencia renal crónica (IRC) y sus cuidadores. Materiales y Métodos El estudio utilizó un diseño de caso único con línea base múltiple. Se aplicó la intervención vía telefónica con dos sesiones presenciales: al principio y al final. Resultados Se observó una tendencia a disminuir el olvido en los medicamentos, reducción del consumo de líquidos con alto contenido de azúcar y un incremento clínicamente significativo en las estrategias de solución de problemas por parte del cuidador. Conclusiones El cuidador percibió beneficios en el niño tales como mayor comprensión de la enfermedad y la importancia de los medicamentos, mayor frecuencia de actitudes positivas del niño hacia los tratamientos orales y mayor autocontrol en el consumo de alimentos y líquidos no saludables. La intervención se distingue por enfocarse en el niño y su cuidador y por aplicarse vía telefónica. La aplicación de un protocolo de intervención facilita que la efectividad del programa no se encuentre directamente relacionada con las habilidades terapéuticas del aplicador. Se recomienda llevar a cabo estudios con mayor cantidad de participantes para evaluar su eficacia.

Abstract Objective Evaluate the effects of a cognitive behavioral intervention by phone on the therapeutic adherence of children with chronic kidney failure (CRF) and their caregivers. Material and Methods The study used a single case design with multiple baseline. The intervention was applied by phone with two face- to-face sessions at the beginning and end. Results There was a tendency to decrease forgetfulness in the medications, reduction of the consumption of liquids with high sugar content and a clinically significant increase in the strategies of solution of problems by the caregiver. Conclusions The caregiver perceived benefits in the child such as greater understanding of the disease and the importance of the medications, more frequent positive attitudes of the child towards oral treatments and greater self-control in them consumption of unhealthy foods and liquids. The intervention is distinguished by focusing on the child and their caregiver and it being applied by telephone. The application of an intervention protocol facilitates that the effectiveness of the program is not directly related to the therapeutic abilities of the applicator. It is recommended to conduct studies with a larger number of participants to evaluate their effectiveness.

Resumo Objetivo Avaliar os efeitos de uma intervenção cognitivo-comportamental via telefone na adesão terapêutica de crianças com insuficiência renal crônica (IRC) e seus cuidadores. Materiais e Métodos O estudo utilizou um design de caso único com múltiplas linhas de base. A intervenção foi aplicada por telefone com duas sessões presenciais: no início e no final. Resultados Houve tendência a diminuir o esquecimento dos medicamentos, a redução no consumo de líquidos com alto teor de açúcar e um aumento clinicamente significativo nas estratégias de solução de problemas por parte do cuidador. Conclusões O cuidador percebeu benefícios na criança, como maior entendimento da doença e importância dos medicamentos, maior frequência de atitudes positivas da criança em relação aos tratamentos orais e maior autocontrole no consumo de alimentos e líquidos não saudáveis. A intervenção é diferenciada, concentrando-se na criança e seu cuidador e aplicando por telefone. A aplicação de um protocolo de intervenção facilita que a eficácia do programa não esteja diretamente relacionada às habilidades terapêuticas do candidato. Recomenda- se a realização de estudos com mais participantes para avaliar sua eficácia.

Résumé Objectif Évaluez les effets de l'intervention cognitive comportementale par téléphone sur l'observance thérapeutique des enfants atteints d'une déficience rénale chronique (MCK) et de leurs soignants. Matériaux et méthodes L'étude a utilisé une seule conception de cas avec une base de référence multiple. L'intervention téléphonique a été appliquée avec deux séances en face-à-face : au début et à la fin. Résultats On a observé une tendance à diminuer l'oubli des médicaments, à réduire la consommation de liquides à teneur élevée en sucre et à augmenter cliniquement considérablement les stratégies de résolution de problèmes des soignants. Conclusions L'aidant percevait des avantages chez l'enfant, comme une meilleure compréhension de la maladie et l'importance des médicaments, une fréquence accrue des attitudes positives de l'enfant à l'égard des traitements oraux et une plus grande maîtrise de soi dans la consommation alimentaire et fluides malsains. L'intervention se distingue en mettant l'accent sur l'enfant et son aidant et en s'appliquant par téléphone. L'application d'un protocole d'intervention facilite le fait que l'efficacité du programme n'est pas directement liée aux compétences thérapeutiques de l'applicateur. Il est recommandé de mener des études avec plus de participants afin d'en évaluer l'efficavacité.

Author Correction: Optical fibre Fabry-Pérot interferometer based on inline microcavities for salinity and temperature sensing.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Heterozygous rare genetic variants in non-syndromic early-onset obesity.

BACKGROUND: Obesity is a very heterogeneous disorder at both the clinical and molecular levels and with high heritability. Several monogenic forms and genes with strong effects have been identified for non-syndromic severe obesity. Novel therapeutic interventions are in development for some genetic forms, emphasizing the importance of determining genetic contributions. OBJECTIVE: We aimed to define the contribution of rare single-nucleotide genetic variants (RSVs) in candidate genes to non-syndromic severe early-onset obesity (EOO; body mass index (BMI) >+3 standard deviation score, <3 years). METHODS: Using a pooled DNA-sequencing approach, we screened for RSVs in 15 obesity candidate genes in a series of 463 EOO patients and 480 controls. We also analysed exome data from 293 EOO patients from the "Viva la Familia" (VLF) study as a replication dataset. RESULTS: Likely or known pathogenic RSVs were identified in 23 patients (5.0%), with 7 of the 15 genes (BDNF, FTO, MC3R, MC4R, NEGR1, PPARG and SIM1) harbouring RSVs only in cases (3.67%) and none in controls. All were heterozygous changes, either de novo (one in BDNF) or inherited from obese parents (seven maternal, three paternal), and no individual carried more than one variant. Results were replicated in the VLF study, where 4.10% of probands carried RSVs in the overrepresented genes. RSVs in five genes were either absent (LEP) or more common in controls than in cases (ADRB3, LEPR, PCSK1 and PCSK2) in both obese datasets. CONCLUSIONS: Heterozygous RSVs in several candidate genes of the melanocortin pathway are found in ~5.0% patients with EOO. These results support the clinical utility of genetic testing to identify patients who might benefit from targeted therapeutic intervention.

Tailoring the visible light photoactivity of un-doped defective TiO2 anatase nanoparticles through a simple two-step solvothermal process.

Anatase TiO2 has become a material of great interest for photocatalytic production of hydrogen, environmental purification and solar energy conversion. Among the key parameters boosting the photocatalytic efficiency of the anatase nanoparticles, an increased light absorption to expand its optical response to the visible region, together with an improved charge separation of the photo-generated electrons and holes, can be enumerated. In this work, yellow-coloured, single-phase anatase nanoparticles have been obtained using a simple two-step solvothermal routine which requires no external addition of dopants, nor the use of a harassing/aggressive synthesis atmosphere. The obtained powders display a lowered bandgap (<3.0 eV) and significantly reduce the recombination processes, eventually leading to an improved photocatalytic performance under visible light, as exemplified by an enhanced degradation of phenol. This exceptional response is linked to the presence of intrinsic defects in the yellowish particles and, hence, the specific conditions of the proposed methodology become crucial to produce a propitious TiO2-defective nanomaterial capable of photo-degrade the phenol molecule, in contrast with the lack of photocatalytic activity currently exhibited by commercial photocatalysts under visible light.

Evaluation of an Age-Friendly City and Its Effect on Life Satisfaction: A Two-Stage Study.

Due to the ageing of the world's population, age-friendly cities are emerging to promote active ageing by optimising opportunities for health, participation and safety, in order to improve the quality of life of older people. Despite initiatives in different countries, there is a lack of empirical research exploring their impact on older people. The objective of this study is to evaluate an age-friendly city by analysing its relationship with life satisfaction, taking into account the age cohort variables of the elderly and whether they live alone or with someone else. A two-stage study, in which 66 subjects participated in the qualitative analysis (focus groups) in Stage I and 203 of the quantitative analysis (survey methodology) or Stage II. Despite the differences found in the different groups of elderly persons, for all of them the domains of outdoor spaces and buildings, and community support and health services, are significantly related to life satisfaction, with the latter showing itself to be a predictor of such satisfaction. It is important to take into account the different groups of elderly persons, so as to be able to establish suitable specific actions. This study aims to make a contribution to the development of public policies that influence the life satisfaction of the elderly.

Substance use and antisocial behavior: criterion-related validity of the Antisocial Process Screening Device in Mexican adolescents / Uso de sustancias y comportamiento antisocial: validez de criterio del Test de Tamizaje del Proceso Antisocial en adolescentes mexicanos

Abstract Introduction Adolescents who use drugs present several health problems, including criminal behavior. The Antisocial Process Screening Device (APSD) is a test that evaluates current conduct disorders in adolescents. Objective This research carried out a cross-cultural adaptation of the APSD on Mexican population. Method The original version of the APSD was translated into Mexican Spanish. The final version was administered to 1 070 adolescents (958 students, 72 with minor faults, and 40 with criminal behavior) who completed the APSD and the ENCODE, the National survey on drug use. We computed correlations and regression models between APSD and ENCODE. We carried out a multivariate analysis to compare samples and quantity of drugs. Finally, we fitted the two-and three-factor models of the APSD with a CFA. Results The APSD scores correlated significantly with all of the ENCODE variables. In the multivariate analysis, the variable quantity of drugs was significant to rise the APSD score (F [3 847] = 7.53, p = .000). The CFA with three factors had the best fit. Reliability analysis suggests acceptable internal consistency (α = .79). Discussion and conclusion Our results confirmed that the Mexican Spanish version of the APSD has good psychometric properties to be used in future research.

Resumen Introducción Los adolescentes que consumen drogas presentan varios problemas de salud, incluida la conducta delictiva. El Test de Tamizaje de Proceso Antisocial (APSD, por sus siglas en inglés) es una prueba que evalúa los trastornos de conducta actual en adolescentes. Objetivo Esta investigación realizó una adaptación intercultural de la APSD en población mexicana. Método La versión original del APSD fue traducida al español de México. La versión final se administró a 1 070 adolescentes (958 estudiantes, 72 con delitos menores y 40 con conducta delictiva) que completaron el APSD y la Encuesta Nacional de Consumo de Drogas en Estudiantes (ENCODE). Calculamos correlaciones y modelos de regresión entre APSD y ENCODE. Realizamos un análisis multivariado para comparar muestras y cantidad de drogas consumidas. Finalmente, ajustamos los modelos de dos y tres factores del APSD con un CFA. Resultados Las puntuaciones APSD se correlacionaron significativamente con todas las variables ENCODE. En el análisis multivariado, la variable cantidad de drogas consumida fue significativa para incrementar el puntaje en APSD (F [3 847] = 7.53, p = .000). El CFA con tres factores tuvo el mejor ajuste. El análisis de confiabilidad sugiere una consistencia interna aceptable (α = .79). Discusión y conclusión Nuestros resultados confirmaron que la versión mexicana en español del APSD tiene adecuadas propiedades psicométricas para su utilización en futuras investigaciones.

Silicon photonics waveguide array sensor for selective detection of VOCs at room temperature.

We report on the fabrication and characterization of a volatile organic compound sensor architecture addressing common drawbacks of photonic integrated sensors such as reusability and specificity. The proposed sensor, built on a silicon-on-insulator platform and based on arrayed waveguide interference, has a chemically selective polydimethylsiloxane polymer cladding, which encapsulates the waveguides and provides an expandable and permeable low refractive index material. This cladding material acts as the chemical transducer element, changing its optical properties when in contact with specific volatile organic compounds, whose presence in the context of environmental and public health protection is important to monitor. The sensor operates at room temperature and its selectivity was confirmed by multiple tests with water, toluene, chlorobenzene, and hexane, through which the sturdiness of the sensor was verified. A maximum spectral shift of about 22.8 nm was measured under testing with chlorobenzene, at a central wavelength of 1566.7 nm. In addition, a sensitivity of 234.8 pm/% was obtained for chlorobenzene mass percent concentrations, with a limit of detection of 0.24%m/m. The thermal sensitivity of the sensor has been found to be 0.9 nm/°C.

Genetic factors contributing to autism spectrum disorder in Williams-Beuren syndrome.

BACKGROUND: The hallmark of the neurobehavioural phenotype of Williams-Beuren syndrome (WBS) is increased sociability and relatively preserved language skills, often described as opposite to autism spectrum disorders (ASD). However, the prevalence of ASD in WBS is 6-10 times higher than in the general population. We have investigated the genetic factors that could contribute to the ASD phenotype in individuals with WBS. METHODS: We studied four males and four females with WBS and a confirmed diagnosis of ASD by the Autism Diagnostic Interview-Revised. We performed a detailed molecular characterisation of the deletion and searched for genomic variants using exome sequencing. RESULTS: A de novo deletion of 1.55 Mb (6 cases) or 1.83 Mb (2 cases) at 7q11.23 was detected, being in 7/8 patients of paternal origin. No common breakpoint, deletion mechanism or size was found. Two cases were hemizygous for the rare T allele at rs12539160 in MLXIPL, previously associated with ASD. Inherited rare variants in ASD-related or functionally constrained genes and a de novo nonsense mutation in the UBR5 gene were identified in six cases, with higher burden in females compared with males (p=0.016). CONCLUSIONS: The increased susceptibility to ASD in patients with WBS might be due to additive effects of the common WBS deletion, inherited and de novo rare sequence variants in ASD-related genes elsewhere in the genome, with higher burden of deleterious mutations required for females, and possible hypomorphic variants in the hemizygous allele or cis-acting mechanisms on imprinting.