Impact of Long SARS-CoV-2 Omicron Infection on the Health Care Burden: Comparative Case-Control Study Between Omicron and Pre-Omicron Waves.

BACKGROUND: Following the initial acute phase of COVID-19, health care resource use has escalated among individuals with SARS-CoV-2 infection. OBJECTIVE: This study aimed to compare new diagnoses of long COVID and the demand for health services in the general population after the Omicron wave with those observed during the pre-Omicron waves, using similar assessment protocols for both periods and to analyze the influence of vaccination. METHODS: This matched retrospective case-control study included patients of both sexes diagnosed with acute SARS-CoV-2 infection using reverse transcription polymerase chain reaction or antigen tests in the hospital microbiology laboratory during the pandemic period regardless of whether the patients were hospitalized. We included patients of all ages from 2 health care departments that cover 604,000 subjects. The population was stratified into 2 groups, youths (<18 years) and adults (≥18 years). Patients were followed-up for 6 months after SARS-CoV-2 infection. Previous vaccination, new diagnoses, and the use of health care resources were recorded. Patients were compared with controls selected using a prospective score matched for age, sex, and the Charlson index. RESULTS: A total of 41,577 patients with a history of prior COVID-19 infection were included, alongside an equivalent number of controls. This cohort encompassed 33,249 (80%) adults aged ≥18 years and 8328 (20%) youths aged <18 years. Our analysis identified 40 new diagnoses during the observation period. The incidence rate per 100 patients over a 6-month period was 27.2 for vaccinated and 25.1 for unvaccinated adults (P=.09), while among youths, the corresponding rates were 25.7 for vaccinated and 36.7 for unvaccinated individuals (P<.001). Overall, the incidence of new diagnoses was notably higher in patients compared to matched controls. Additionally, vaccinated patients exhibited a reduced incidence of new diagnoses, particularly among women (P<.001) and younger patients (P<.001) irrespective of the number of vaccine doses administered and the duration since the last dose. Furthermore, an increase in the use of health care resources was observed in both adult and youth groups, albeit with lower figures noted in vaccinated individuals. In the comparative analysis between the pre-Omicron and Omicron waves, the incidence of new diagnoses was higher in the former; however, distinct patterns of diagnosis were evident. Specifically, depressed mood (P=.03), anosmia (P=.003), hair loss (P<.001), dyspnea (<0.001), chest pain (P=.04), dysmenorrhea (P<.001), myalgia (P=.011), weakness (P<.001), and tachycardia (P=.015) were more common in the pre-Omicron period. Similarly, health care resource use, encompassing primary care, specialist, and emergency services, was more pronounced in the pre-Omicron wave. CONCLUSIONS: The rise in new diagnoses following SARS-CoV-2 infection warrants attention due to its potential implications for health systems, which may necessitate the allocation of supplementary resources. The absence of vaccination protection presents a challenge to the health care system.

Prostaglandin analogues signal detection by data mining in the FDA Adverse Event Reporting System database.

OBJECTIVE: This study aims to identify safety signals of ophthalmic prostaglandin analogues through data mining the Food and Drug Administration Adverse Event Reporting System (FAERS) database. METHODS: A data mining search by proportional reporting ratio, reporting OR, Bayesian confidence propagation neural network, information component 0.25 and χ2 for safety signals detection was conducted to the FAERS database for the following ophthalmic medications: latanoprost, travoprost, tafluprost and bimatoprost. RESULTS: 12 preferred terms were statistically associated: diabetes mellitus, n=2; hypoacusis, n=2; malignant mediastinal neoplasm, n=1; blood immunoglobulin E increased, n=1; cataract, n=1; blepharospasm, n=1; full blood count abnormal, n=1; skin exfoliation, n=1; chest discomfort, n=1; and dry mouth, n=1. LIMITATION OF THE STUDY: The FAERS database's limitations, such as the undetermined causality of cases, under-reporting and the lack of restriction to only health professionals reporting this type of event, could modify the statistical outcomes. These limitations are particularly relevant in the context of ophthalmic drug analysis, as they can affect the accuracy and reliability of the data, potentially leading to biased or incomplete results. CONCLUSIONS: Our findings have revealed a potential relationship due to the biological plausibility among malignant mediastinal neoplasm, full blood count abnormal, blood immunoglobulin E increased, diabetes mellitus, blepharospasm, cataracts, chest discomfort and dry mouth; therefore, it is relevant to continue investigating the possible drug-event association, whether to refute the safety signal or identify a new risk.

Malnutrition in Amyotrophic Lateral Sclerosis: Insights from Morphofunctional Assessment and Global Leadership Initiative on Malnutrition Criteria.

Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease frequently accompanied by malnutrition due to weight loss, increased energy expenditure, and muscle mass loss. This study aimed to evaluate morphofunctional assessment tools as predictors of malnutrition and to investigate their relationship with muscle status and disease severity in ALS patients. A cross-sectional study was conducted with 45 ALS patients at the San Cecilio University Hospital in Granada. Malnutrition was assessed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Morphofunctional assessment was performed using Bioimpedance Vectorial Analysis (BIVA), handgrip strength (HGS), and Short Physical Performance Battery (SPPB). Malnutrition prevalence was 38% according to GLIM criteria. Significant differences were observed between malnourished and non-malnourished groups in age (70 ± 9 vs. 62 ± 10 years, p = 0.01), sex (female prevalence: 58.8% vs. 25.0%, p = 0.02), dysphagia prevalence (83% vs. 29%, p < 0.001), PEG/PRG use (35.3% vs. 3.6%, p = 0.01), and ALSFRS-R scores (30 ± 12 vs. 34 ± 12, p = 0.02). Malnourished patients had lower values in anthropometric measurements, muscle mass obtained by BIVA, and phase angle (PA) (4.05 ± 0.8° vs. 5.09 ± 0.8°, p < 0.001). No significant differences were found in muscle strength or functional status. PA showed significant correlations with muscle strength (r = 0.52, p < 0.001) and muscle mass measures (r = 0.48, p < 0.001). Moreover, PA was associated with poorer disease progression and physical performance. In our sample, BIVA metrics such as PA (<4.3°), SPA (<-0.8), body cell mass (<9.2 kg/m), and extracellular water (>49.75%) were identified as malnutrition risk factors. The study underscores the critical importance of comprehensive morphofunctional assessment and the use of advanced diagnostic criteria, for early identification and intervention in malnutrition among people with ALS. Further research is warranted to validate these findings and develop targeted nutritional strategies into routine clinical practice.

Knowledge, Attitudes, and Perceptions of Maternity Care Providers on the Implementation of Calcium Supplementation during Pregnancy in Three Public Hospitals in Argentina: A Qualitative Study.

The aim of this study was to explore maternity care providers' knowledge, attitudes, and perceptions about the use of calcium supplements during pregnancy for the prevention of preeclampsia in three hospitals from Metropolitan Buenos Aires, Argentina. We conducted semi-structured interviews and followed a thematic analysis framework. Maternity care providers' knowledge, attitudes, and practices regarding calcium supplementation during pregnancy are linked to barriers to the potential implementation of calcium supplementation. Free provision of calcium supplements by the government, coupled with training that reinforces the scientific evidence supporting their use to prevent preeclampsia, along with documented recommendations from credible sources, would be crucial to ensure that health providers adopt the use of calcium supplements in antenatal care. Future studies should assess pregnant women and policymakers' perceptions about calcium supplementation during pregnancy, as well as local infrastructure to provide access to free-of-charge calcium supplements in antenatal care settings. Economic evaluation with local information could inform policymakers and advocate for the implementation of strategies to reduce preeclampsia.

An untargeted metabolomics approach applied to the study of the bioavailability and metabolism of three different bioactive plant extracts in human blood samples.

Advances in the understanding of bioavailability and metabolism of bioactive compounds have been achieved primarily through targeted or semi-targeted metabolomics approaches using the hypothesis of potential metabolized compounds. The recent development of untargeted metabolomics approaches can present great advantages in this field, such as in the discovery of new metabolized compounds or to study the metabolism of compounds from multiple matrices simultaneously. Thus, this study proposes the use of an untargeted metabolomics strategy based on HPLC-ESI-QTOF-MS for the study of bioavailability and metabolism of bioactive compounds from different vegetal sources. Specifically, this study has been applied to plasma samples collected in an acute human intervention study using three matrices (Hibiscus sabdariffa, Silybum marianum and Theobroma cacao). This approach allowed the selection of those significant variables associated with exogenous metabolites derived from the consumption of bioactive compounds for their subsequent identification. As a result, 14, 25 and 3 potential metabolites associated with supplement intake were significantly detected in the plasma samples from volunteers who ingested the H. sabdariffa (HS), S. marianum (SM) and T. cacao (TC) extracts. Furthermore, Tmax values have been computed for each detected compound. The results highlight the potential of untargeted metabolomics for rapid and comprehensive analysis when working with a wide range of exogenous metabolites from different plant sources in biological samples.

Evaluation of the effects of a gamified, fully immersive and stroke-specific virtual reality intervention for improving disability and quality of life in patients with stroke in the subacute phase: study protocol of the RESET randomised trial.

Stroke is the leading cause of disability and the second cause of death worldwide. The increasing burden of stroke underscores the importance of optimising rehabilitation protocols. Virtual reality (VR) can improve poststroke prognosis. A VR software combining gamification, full immersion and stroke specificity (ie, the Development and validation of a novel viRtual rEality software for improving diSability and quality of lifE in patients with sTroke (RESET) software) might substantially improve disability and quality of life (QoL). However, this technology is still very scarce. The RESET trial aims to assess the effects of an early 10-week gamified, fully immersive and stroke-specific VR intervention (ie, starting at week 3 poststroke) on disability and QoL in people with stroke in the subacute phase. People with ischaemic or haemorrhagic stroke (n=94) aged ≥ 18 years will be randomised to receive (1) usual care (UC), (2) commercial VR or (3) gamified, fully immersive and stroke-specific VR (RESET). The three groups will receive UC (ie, three sessions/week of 90 min of standard rehabilitation). The VR groups will additionally receive three VR sessions of 20 min per week. The outcome measures will be assessed at baseline (week 2 from stroke occurrence), week 13 (approximately 90 days from the event) and week 26 (approximately 6 months from the event). The primary outcome is disability measured with the Barthel Index. Secondary outcomes include QoL, upper-extremity and lower-extremity motor function, gross manual dexterity, handgrip strength and cognitive function. This study will unravel the effects of a gamified, fully immersive and stroke-specific VR software on disability and QoL in patients with stroke in the early subacute phase.Trial registration number: NCT06132399.

The invasive Aedes albopictus in the Doñana World Heritage Site.

BACKGROUND: Aedes albopictus is catalogued as one of the 100 most dangerous species worldwide. Native to Asia, the species has drastically increased its distribution range, reaching all continents except Antarctica. The presence of Ae. albopictus in Spain was first reported in 2004 in Cataluña (NE Spain), and it is spreading in the country. METHODS: We conducted an extensive mosquito monitoring study in the natural protected area of the Doñana National Park (SW Spain) in 2023. After identifying the presence of Ae. albopictus, a mosquito control strategy was developed and implemented to eradicate the species in the area. RESULTS: Overall, 12,652 mosquito females of 14 different species were captured at nine sites within the park. For the first time, the presence of Ae. albopictus was recorded in the area, despite intensive trapping performed at some localities since 2003. The presence of this invasive species in the park is most likely linked to human activities, potentially facilitated by daily car trips of personnel. Although larvae of Culex, Anopheles, and Culiseta mosquitoes were identified in these containers, the presence of Ae. albopictus larvae was not recorded in those locations. In spite of that, the biological larvicide Bacillus thuringiensis israelensis (Bti) was applied to artificial containers potentially used by Ae. albopictus as breeding sites. CONCLUSIONS: This work evidences the high capacity of Ae. albopictus to reach highly conserved natural areas far from urban foci. We discuss the implications of the presence of Ae. albopictus in this endangered ecosystem and the potential control measures necessary to prevent its reintroduction.

A baited trap for kissing bugs (Hemiptera: Reduviidae: Triatominae).

Chagas disease is a key vector-borne disease. This illness is caused by Trypanosoma cruzi Chagas, which is transmitted by triatomine bugs. Largely, the control of this disease relies on reducing such contact. We optimized the performance of a box trap in laboratory conditions to capture four triatomine species: Triatoma pallidipennis (Stål), Triatoma infestans Klug, Triatoma phyllosoma (Burmeister), and Rhodnius prolixus Stål. We varied four components for a box trap: material, color, height, and bait attractants. All species were captured more in corrugated cardboard traps than in other trap material. Moreover, T. infestans and R. prolixus were also captured in plywood traps. T. pallidipennis preferred traps of 15 × 15 × 4 cm and 20 × 20 × 4 cm, while T. phyllosoma and T. infestans were more captured in traps of 10 × 10 × 4 cm, and 15 × 15 × 4 cm. Rhodnius prolixus was more captured to 10 × 10 × 4 cm traps. T. pallidipennis was trapped with traps of any color tested, T. phyllosoma and T. infestans were captured more in red and yellow traps, and R. prolixus was mostly captured in blue, violet, and yellow traps. Triatoma pallidipennis was captured at any height above the ground, while T. phyllosoma, T. infestans, and R. prolixus were mostly captured 50, 100, and 150 cm above the ground. Regarding the lure, T. pallidipennis was trapped with four aldehydes + lactic acid + ammonia; T. infestans and R. prolixus were trapped with a blend of four aldehydes + lactic acid, a blend of the four aldehydes + ammonia, and a blend of four aldehydes + lactic acid + ammonia. Triatoma phyllosoma was trapped with any lure tested. These results showed that the trap boxes offer an alternative method for controlling Chagas disease.

New gel from a water-soluble Carboxymethyl chitosan-Cinnamaldehyde Schiff base derivative as an effective preservative against soft rot in ginger.

Ginger, valued for its culinary and medicinal properties, suffers substantial production loss-up to 90 %-due to fungal soft rot. To combat this, we have developed an environmentally sustainable antifungal polysaccharide gel derived from a water-soluble Schiff base of O-carboxymethyl chitosan (CMC) and cinnamaldehyde (CIN). Terpene incorporation was confirmed via various characterization techniques, including Fourier transform infrared (FT-IR), pH-dependent release, solubility, thermogravimetric analysis, and UV-vis spectra. Results showed successful grafting of CIN onto the polysaccharide, at a CIN:CMC ratio of 120 mg/g. In vitro evaluation demonstrated significant antifungal activity against F. oxysporum, with a MIC value of 159.25 µg/mL. Application of the CMC=CIN gel to ginger rhizomes inhibited spore germination in all evaluated wounds, enhancing gloss and appearance. These findings validate the efficacy of this novel, environmentally friendly gel in preventing ginger loss caused by fungal infections.

The Transcription Factor TCF21 is necessary for adoption of cell fates by Foxd1+ stromal progenitors during kidney development.

Normal kidney development requires coordinated interactions between multiple progenitor cell lineages. The Foxd1+ stromal progenitors are critical for normal nephrogenesis and their heterogeneity is increasingly appreciated. However, the molecular mechanisms and trajectories that drive the differentiation of Foxd1+ cells toward the renal stroma, capsule, mesangial cells, renin cells, pericytes, and vascular smooth muscle cells (VSMCs) are poorly understood. Recent work has implicated Tcf21, a mesoderm-specific bHLH transcription factor critical for embryogenesis, in the development of the kidney stroma and perivascular cells. To investigate the role of Tcf21 in Foxd1+ cells, we performed single-cell RNA sequencing (scRNA-seq) on GFP+ cells from E14.5 Foxd1 Cre/+ ;Rosa26 mTmG ;Tcf21 f/f kidneys ( Tcf21 -cKO) and controls. Clustering of the entire dataset identified a large stromal population and a smaller representation of non-stromal lineages. Subclustering of stromal cells identified seven populations: medullary/perivascular stroma, proliferating stroma, stroma of the differentiating nephron, nephrogenic zone-associated, collecting duct-associated, and ureteric stroma. Loss of Tcf21 resulted in a dramatic reduction in the medullary/perivascular stroma, proliferating stroma, stroma of the nephrogenic zone, and collecting duct-associated stromal subpopulations. Immunostaining confirmed that Tcf21 -cKO has a severe constriction of the medullary and collecting duct-associated stromal space. We identified a cluster unique to Tcf21 -cKO kidneys exhibiting mosaic expression of genes from stromal pogenitors, proliferating, and perivascular cells spanning across all pseudotime, suggesting cells halted in the midst of differentiation. These findings underscore a critical role for Tcf21 in the emergence of Foxd1+ derivatives, with loss of Tcf21 leading to a shift in stromal cell fates that results in abnormal kidney development. NEW & NOTEWORTHY: The mechanisms responsible for the emergence of renal stromal heterogeneity has been unknown. Using scRNA-seq on Foxd1+ enriched cells from E14.5 kidneys, we identified seven molecularly distinct stromal populations and their regional association. The data suggest that the transcription factor Tcf21 regulates the adoption of fates by Foxd1+ cells that is required to form the normal milieu of stromal derivatives for the development of a kidney of normal size and function.

Neck Circumference as a Valuable Tool to Identify the Risk of Metabolic Syndrome in Mexican Children.

BACKGROUND/OBJECTIVES: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was to estimate the association between NC and indicators of Metabolic Syndrome (MS) to subsequently estimate its capacity to identify the risk of MS compared to waist circumference (WC) and Body Mass Index (BMI). METHODS: A cross-sectional study was carried out with a sample of 286 children 6-9 years old who attended six public primary schools in Jalisco, Mexico. Pearson's correlation coefficients along with sensitivity and specificity tests were performed to analyze the relationship between NC and MS indicators. Odds ratio (OR) and concordance analyses were performed considering the Kappa index. RESULTS: NC showed statistically significant correlations with all MS indicators except for LDL cholesterol and total cholesterol. The cut-off points of NC to identify MS according to sex was >27.4 cm for girls and >29.8 cm for boys. The association of NC with values above the cutoff point and the presence of MS was OR: 21.6 (CI: 7.11-65.74). CONCLUSIONS: NC represents a simple and cost-effective alternative to identify children at risk of MS when compared to BMI and WC.

How Does Nerve Mechanical Interface Treatment Impact Pre-Surgical Carpal Tunnel Syndrome Patients? A Randomized Controlled Trial.

BACKGROUND: Carpal tunnel syndrome (CTS) presents a high burden on the healthcare system. However, no alternative treatments are provided during the waiting period. In addition, the incidence of severe patients with comorbidities is underestimated. The aim of this study was to determine whether nerve mechanical interface treatment improves the symptoms, function, and quality of life in pre-surgical CTS patients. METHODS: A randomized controlled trial and intention-to-treat analysis were carried out. Forty-two patients with an electrodiagnosis of carpal tunnel syndrome, included on the surgery waiting list of a public healthcare system, were analyzed. The intervention group (n = 20) received a 45 min session/per week of instrument-assisted manual therapy (diacutaneous fibrolysis) for 3 weeks. The Boston Carpal Tunnel Questionnaire (BCTQ) was the primary outcome. The symptoms, mechanical threshold, grip strength, mechanosensitivity of the median nerve, quality of life, and patient satisfaction were included as secondary outcomes. The control group (n = 22) remained on the waiting list. RESULTS: The intervention seems to be beneficial for the BCTQ score (function and symptoms scale), pain, and mechanosensitivity after treatment, at the 3 and 6 months follow-up (p < 0.05). Kinesiophobia was improved at 6 months (p = 0.043; η2 = 0.10) and the mechanical threshold at the 3-month follow-up (p = 0.048; η2 = 0.10). No differences were identified for grip strength. At 6 months, the intervention group patients were satisfied (100%), as opposed to the controls, who felt that they had experienced a worsening of their condition (50.1%). CONCLUSIONS: Nerve mechanical interface treatment improved the symptoms, function, and quality of life in pre-surgical CTS patients. One hundred percent of the treated patients, characterized as moderate and severe CTS with associated comorbidities, were satisfied.

Tracking the brain signature of (mis)spelled logotypes via letter transpositions and replacements.

All leading models of visual word recognition assume a hierarchical process that progressively converts the visual input into abstract letter and word representations. However, the results from recent behavioral studies suggest that the mental representations of words with a highly consistent visual format, such as logotypes, may comprise not only purely abstract information but also perceptual information. This hypothesis would explain why participants often misperceive transposed-letter misspellings with the original base words to a larger degree in logotypes (e.g., SASMUNG, but not SARVUNG, is perceived as SAMSUNG) than in common words. The present experiment examined the electrophysiological signature behind the identification of correctly spelled and misspelled logotypes (via letter transposition or replacement) in an ERP go/no-go semantic categorization experiment. Results showed that N400 amplitudes for transposed-letter misspelled logotypes (SASMUNG) and intact logotypes (SAMSUNG) did not differ significantly across various time windows (until 600 ms), whereas replacement-letter misspelled logotypes (SARVUNG) yielded consistently larger N400 amplitudes. These findings reveal that the mental representations of logotypes are particularly resistant to minor orthographic changes, which has important theoretical and applied (e.g., marketing) implications.

Digital solutions in paediatric sepsis: current state, challenges, and opportunities to improve care around the world.

The digitisation of health care is offering the promise of transforming the management of paediatric sepsis, which is a major source of morbidity and mortality in children worldwide. Digital technology is already making an impact in paediatric sepsis, but is almost exclusively benefiting patients in high-resource health-care settings. However, digital tools can be highly scalable and cost-effective, and-with the right planning-have the potential to reduce global health disparities. Novel digital solutions, from wearable devices and mobile apps, to electronic health record-embedded decision support tools, have an unprecedented opportunity to transform paediatric sepsis research and care. In this Series paper, we describe the current state of digital solutions in paediatric sepsis around the world, the advances in digital technology that are enabling the development of novel applications, and the potential effect of advances in artificial intelligence in paediatric sepsis research and clinical care.

Development of Chitosan Polysaccharide-Based Magnetic Gel for Direct Red 83:1 Removal from Water.

Water pollution caused by dyes is a significant environmental issue, necessitating the development of effective, cost-efficient decolorization methods suitable for industrial use. In this study, a Chitosan-Fe polymeric gel was synthesized, characterized, and tested for removing the azo dye Direct Red 83:1 from water. The polymeric magnetic chitosan was analyzed using various techniques: Field Emission Scanning Electron Microscopy (FE-SEM) revealed a porous structure, Differential Scanning Calorimetry (DSC) and Thermal Gravimetric Analysis (TGA) demonstrated the thermal stability, Infrared Spectrophotometry (IR) indicated the successful coordination of iron at the C3 position, and X-ray Powder Diffraction (XRD) confirmed the crystalline nature of the polymeric structure. Optimal conditions for kinetic and isotherm models were found at 1 g and pH 7.0. Adsorption behavior of Direct Red 83:1 onto magnetic chitosan gel beads was studied through kinetic tests and isotherm curves. The maximum adsorption capacity was 17.46 mg/g (qmax). The adsorption process followed pseudo-second-order kinetics (R2 = 0.999) and fit the Temkin isotherm (R2 = 0.946), suggesting heterogeneous surface adsorption. The newly synthesized Chitosan-Fe polymeric gel demonstrated good adsorption properties and facilitated easy separation of purified water.

Sensors Based on Molecularly Imprinted Polymers in the Field of Cancer Biomarker Detection: A Review.

Biomarkers play a pivotal role in the screening, diagnosis, prevention, and post-treatment follow-up of various malignant tumors. In certain instances, identifying these markers necessitates prior treatment due to the complex nature of the tumor microenvironment. Consequently, advancing techniques that exhibit selectivity, specificity, and enable streamlined analysis hold significant importance. Molecularly imprinted polymers (MIPs) are considered synthetic antibodies because they possess the property of molecular recognition with high selectivity and sensitivity. In recent years, there has been a notable surge in the investigation of these materials, primarily driven by their remarkable adaptability in terms of tailoring them for specific target molecules and integrating them into diverse analytical technologies. This review presents a comprehensive analysis of molecular imprinting techniques, highlighting their application in developing sensors and analytical methods for cancer detection, diagnosis, and monitoring. Therefore, MIPs offer great potential in oncology and show promise for improving the accuracy of cancer screening and diagnosis procedures.

Comparing temporal changes and predictors of different types of mental health and socio-emotional wellbeing outcomes during COVID-19: an overlapping panel study of Spanish residents.

OBJECTIVES: Few panel studies have investigated how different types of mental health (MH) and socio-emotional wellbeing (SEW) outcomes have changed during the pandemic and if their burden has been equally distributed at the population-level. We aimed to examine temporal changes in these outcomes and their socio-ecological predictors using panel data. STUDY DESIGN: Longitudinal population-based survey with overlapping panels. METHODS: Analyses were carried out using four measurements of data from the Health and Social Survey (April 2020 to April 2021). Participants included Andalusian (Spanish) residents aged 16 years or older who participated in all four measurements (n = 1223). Seven dichotomous MH and SEW outcomes, as well as several socio-ecological predictors informed by a conceptual model, were examined in descriptive and multivariate analyses. RESULTS: Unadjusted odds of regular/bad perceived mental health (vs. excellent/very good/good), low socio-emotional wellbeing (vs. regular), low happiness (vs. regular), and feeling anxious (vs. not feeling anxious) decreased significantly from the first to the second measurement; however, in the fourth, low socio-emotional wellbeing significantly increased while low optimism decreased. Considering varying coefficients, objectively measured COVID-19 status and self-reported severity levels of the infection were statistically significant. Health status, social support, and household financial difficulty predicted higher adjusted odds in most of the seven assessed outcomes. CONCLUSIONS: Significant temporal variations in MH and SEW outcomes, along with their predictors, were observed during the first year of the pandemic. Some of these outcomes worsened as the pandemic progressed, whereas others improved. Findings also suggest that some individuals such as those experiencing poor health, limited social support, and low socioeconomic status are disproportionately impacted.

Differences in the Interleukin Profiles in Inattentive ADHD Prepubertal Children Are Probably Related to Conduct Disorder Comorbidity.

Inflammatory cytokines are involved in attention deficit hyperactivity disorder (ADHD), a highly prevalent neurodevelopmental disorder. To quantify the baseline levels of pro- and anti-inflammatory cytokines and their changes after methylphenidate (MPH), a total of 31 prepubertal children with ADHD were recruited and subclassified into only two ADHD presentations-ADHD attention deficit (n = 13) or ADHD combined (n = 18). The children were also screened for oppositional defiant conduct disorder (ODCD) and anxiety disorder. Blood samples were drawn at 09:00 and after 4.63 ± 1.87 months of treatment. Four pro-inflammatory cytokines (interleukin-1beta (IL-1ß), IL-5, IL-6, tumor necrosis factor-alpha (TNF-α)) and three anti-inflammatory cytokines (IL-4, IL-10, IL-13) were measured using a Luminex® assay. For statistics, a factorial analysis was performed in Stata 15.1. Overall, there were no statistically significant differences in the interleukin (IL) values induced by treatment. When grouped by presentation, the differences were present almost exclusively in ADHD-AD, usually with a profile opposite to that observed in ADHD-C, and with interactions between comorbid factors, with IL-1ß (p = 0.01) and IL-13 (p = 0.006) being the ones reaching the greatest statistical significance. These differences are probably related to the ODCD factor, and they disappear after treatment. In conclusion, the changes observed in cytokine levels in prepubertal children only in the ADHD-AD presentation are probably related to comorbidities (specifically ODCD) and are mitigated after treatment.

Agreement for Recovery: First Spanish Consensus on the Concept of Alcohol Addiction Recovery.

INTRODUCTION: Current literature does not dispose from a widely accepted definition of recovery in alcohol use disorder (AUD), and most proposals originate from anglophone countries. This study introduces a pioneering consensus in Spain on the definition of recovery in AUD. METHOD: The Delphi method was used. The expert panel, comprising 54 multidisciplinary professionals from the Community of Madrid. RESULTS: A high level of consensus (≥80% agreement) was reached for 45% of the items and majority (≥60%) for 84%. Recovery is understood as a dynamic, personalized, and voluntary process, potentially enduring throughout one's lifespan. It entails a transformative lifestyle shift aimed at achieving a significant improvement in overall quality of life, encompassing physical and mental health, interpersonal relationships, and environmental factors. The journey of recovery is marked by heightened psychological well-being, is characterized by empowerment, personal growth, existential purpose, and positive identity reconstruction. Recovery is supported by substance use management, requires proactive individual agency and involves both personal and societal responsibilities. CONCLUSIONS: This study represents a milestone as it is the first consensus in the Community of Madrid on the meaning of recovery in AUD. The proposed definition of recovery could be a potential reference for similar regions within Spain or even for other countries with cultural similarities. The elucidation of a clear framework of recovery provides a solid basis for future research efforts and clinical interventions in the Spanish AUD landscape.

How can we optimize the diagnostic and therapeutic approach to pneumonia? Expert opinion-based recommendations.

Pneumonia continues to be one of the most frequent infectious syndromes and a relevant cause of death and health resources utilization. The OPENIN ("Optimización de procesos clínicos para el diagnóstico y tratamiento de infecciones") Group is composed of Infectious Diseases specialists and Microbiologists and aims at generating recommendations that can contribute to improve the approach to processes with high impact on the health system. Such task relies on a critical review of the available scientific evidence. The first Group meeting (held in October 2023) aimed at answering the following questions: Can we optimize the syndromic and microbiological diagnosis of pneumonia? Is it feasible to safely shorten the length of antibiotic therapy? And, is there any role for the immunomodulatory strategies based on the adjuvant use of steroids, macrolides or immunoglobulins? The present review summarizes the literature reviewed for that meeting and offers a series of expert recommendations.