Women working as cleaners in Spain: working conditions and use of psychotropic drugs.

GOALS: To describe the exposure to psychosocial risks at work and the consumption of psychotropic drugs and opioids among women working as cleaners; and to analyse the association between their exposure to psychosocial risks and drug use. METHODS: Observational cross-sectional study based on an online survey (collected during April and May 2021) from the wage-earning population in Spain. In this study, only women working in manual occupations were included (n=3430). Working conditions and drug consumption of cleaning workers were compared with those of other manual workers through bivariate analysis. The adjusted prevalence ratios and the corresponding 95% CIs were estimated using Poisson regression models with robust variance. RESULTS: Cleaning workers were older and had more problems making ends meet than other manual workers and were significantly more exposed to low possibilities for development (85.2 (95% CI 81.8 to 88.0)), high strain (51.9 (95% CI 47.3 to 55.9)) and low social support from colleagues (72.0 (95% CI 68.1 to 75.7)) and supervisors (61.7 (95% CI 57.3 to 65.6)). They also scored higher prevalence rates for the use of tranquillisers (37.7 (95% CI 32.0 to 43.3)) and opioids (33.3 (95% CI 27.9 to 38.6)) consumption indicators. This consumption was associated significantly with high strain exposure and high insecurity over working conditions. DISCUSSION: Under the umbrella of the 2012 labour reform, cleaning companies shift the pressure and burden they have on ordinary cleaning staff in the form of low wages and precarious working conditions. Our results imply that addressing adverse working conditions, mainly high strain and insecurity over working conditions, may significantly contribute to reducing the gender and social inequalities among cleaning workers.

GEMA-Na and MELD 3.0 severity scores to address sex disparities for accessing liver transplantation: a nationwide retrospective cohort study.

Background: The Gender-Equity Model for liver Allocation corrected by serum sodium (GEMA-Na) and the Model for End-stage Liver Disease 3.0 (MELD 3.0) could amend sex disparities for accessing liver transplantation (LT). We aimed to assess these inequities in Spain and to compare the performance of GEMA-Na and MELD 3.0. Methods: Nationwide cohort study including adult patients listed for a first elective LT (January 2016-December 2021). The primary outcome was mortality or delisting for sickness within the first 90 days. Independent predictors of the primary outcome were evaluated using multivariate Cox's regression with adjusted relative risks (RR) and 95% confidence intervals (95% CI). The discrimination of GEMA-Na and MELD 3.0was assessed using Harrell c-statistics (Hc). Findings: The study included 6071 patients (4697 men and 1374 women). Mortality or delisting for clinical deterioration occurred in 286 patients at 90 days (4.7%). Women had reduced access to LT (83.7% vs. 85.9%; p = 0.037) and increased risk of mortality or delisting for sickness at 90 days (adjusted RR = 1.57 [95% CI 1.09-2.28]; p = 0.017). Female sex remained as an independent risk factor when using MELD or MELD-Na but lost its significance in the presence of GEMA-Na or MELD 3.0. Among patients included for reasons other than tumours (n = 3606; 59.4%), GEMA-Na had Hc = 0.753 (95% CI 0.715-0.792), which was higher than MELD 3.0 (Hc = 0.726 [95% CI 0.686-0.767; p = 0.001), showing both models adequate calibration. Interpretation: GEMA-Na and MELD 3.0 might correct sex disparities for accessing LT, but GEMA-Na provides more accurate predictions of waiting list outcomes and could be considered the standard of care for waiting list prioritization. Funding: Instituto de Salud Carlos III, Agencia Estatal de Investigación (Spain), and European Union.

Labour market participation after sickness absence due to cancer: a dynamic cohort study in Catalonia (Spain).

BACKGROUND: The consequences of cancer on working until retirement age remain unclear. This study aimed to analyse working life considering all possible labour market states in a sample of workers after sickness absence (SA) due to cancer and to compare their working life paths to those of a sample of workers without SA and with an SA due to other diseases. METHODS: This was a retrospective dynamic cohort study among social security affiliates in Catalonia from 2012-2018. Cases consisted of workers with an SA due to cancer between 2012-2015 (N = 516) and were individually age- and sex-matched with those of affiliates with an SA due to other diagnoses and workers without an SA. All workers (N = 1,548, 56% women) were followed up from entry into the cohort until the end of 2018 to characterise nine possible weekly labour states. Sequence analysis, optimal matching, and multinomial logistic regression were used to identify and assess the probability of future labour market participation patterns (LMPPs). All analyses were stratified by sex. RESULTS: Compared with workers with an SA due to cancer, male workers with no SA and SA due to other causes showed a lower probability of being in the LMPP of death (aRRR 0.02, 95% CI: 0.00‒0.16; aRRR 0.17, 95% CI: 0.06‒0.46, respectively) and, among women, a lower probability of permanent disability and death (aRRR 0.24, 95% CI: 0.10‒0.57; aRRR 0.39, 95% CI: 0.19‒0.83, respectively). Compared to workers with SA due to cancer, the risk of early retirement was lower among workers with no SA (women, aRRR 0.60, 95% CI: 0.22‒1.65; men, aRRR 0.64, 95% CI: 0.27‒1.52), although these results were not statistically significant. CONCLUSIONS: Workplaces, many of which have policies common to all diagnoses, should be modified to the needs of cancer survivors to prevent an increasing frequency of early retirement and permanent disability when possible. Future studies should assess the impact of cancer on premature exit from the labour market among survivors, depending on cancer localisation and type of treatment.

Extreme temperatures and sickness absence in the Mediterranean province of Barcelona: An occupational health issue.

Objectives: This study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics. Methods: Ecological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of sickness absence. Results: The study included 42,744 salaried workers and 97,166 episodes of sickness absence. The risk of sickness absence increased significantly between 2 and 6 days after the cold day. For hot days there was no association with risk of sickness absence. Women, young, non-manual and workers in the service sector had a higher risk of sickness absence on cold days. The effect of cold on sickness absence was significant for respiratory system diseases (RR: 2.16; 95%CI: 1.68-2.79) and infectious diseases (RR: 1.31; 95%CI: 1.04-1.66). Conclusion: Low temperatures increase the risk of having a new episode of sickness absence, especially due to respiratory and infectious diseases. Vulnerable groups were identified. These results suggest the importance of working in indoor and possibly poorly ventilated spaces in the spread of diseases that eventually lead to an episode of sickness absence. It is necessary to develop specific prevention plans for cold situations.

Informal Employment, Working Conditions, and Self-Perceived Health in 3098 Peruvian Urban Workers.

Peru has one of the highest informal employment rates in Latin America (73%). Previous studies have shown a higher prevalence of poor self-perceived health (P-SPH) in informal than in formal workers. The aim of this study was to analyze the role of working conditions in the association between informality and SPH in an urban working population in Peru. We conducted a cross-sectional study based on 3098 workers participating in the working conditions survey of Peru 2017. The prevalence of P-SPH and exposure to poor working conditions were calculated separately for formal and informal employment and were stratified by sex. Poisson regression models were used to assess the association between P-SPH and informal employment, with crude and adjusted prevalence ratios (PR) for working conditions. Informal employment affected 76% of women and 66% of men. Informal workers reported higher exposition to poor working conditions than formal workers and reported worse SPH. Informal workers had a higher risk of P-SPH than formal workers: PR 1.38 [95% CI: 1.16-1.64] in women and PR 1.27 [95% CI: 1.08-1.49] in men. Adjustment by working conditions weakened the association in both sexes. In women, this association was only partially explained by worse working conditions; PR 1.23 [95% CI: 1.04-1.46]. Although some of the negative effect of informal employment on workers´ health can be explained by the characteristics of informality per se, such as poverty, a substantial part of this effect can be explained by poor working conditions.

Returning to work after a sickness absence due to cancer: a cohort study of salaried workers in Catalonia (Spain).

Cancer incidence and survival rates have increased in the last decades and as a result, the number of working age people diagnosed with cancer who return to work. In this study the probability of accumulating days of employment and employment participation trajectories (EPTs) in a sample of salaried workers in Catalonia (Spain) who had a sickness absence (SA) due to cancer were compared to salaried workers with SA due to other diagnoses or without SA. Each individual with SA due to cancer between 2012 and 2015 was matched by age, sex, and onset of time at risk to a worker with SA due to other diagnoses and another worker without SA. Accumulated days of employment were measured, and negative binomial models were applied to assess differences between comparison groups. Latent class models were applied to identify EPTs and multinomial regression models to analyse the probability of belonging to one EPT of each group. Men and women without SA or with SA due to other diagnoses had at least a 9% higher probability of continuing in employment compared to workers who had a SA due to cancer, especially among men without SA (adjusted IRR 1.27, 95% CI 1.06‒1.53). Men without SA had the highest probability of having high stable EPT compared to workers who had a SA due to cancer (adjusted RRR 3.21, 95% CI 1.87‒5.50). Even though workers with SA due to cancer continue working afterwards, they do it less often than matched controls and with a less stable employment trajectory. Health and social protection systems should guaranty cancer survivors the opportunity to continue voluntary participation in the labour market.

Validation of a Psychosocial Intervention on Body Image in Older People: An Experimental Design.

For most people, body satisfaction is crucial to develop both a positive self-concept and self-esteem, and therefore, it can influence mental health and well-being. This idea has been tested with younger people, but no studies explore whether body image interventions are useful when people age. This research validates a specific program designed for older people (IMAGINA Specific Body Image Program). This is done by employing a mixed experimental design, with between-subject and within-subject comparisons that focus on body satisfaction before and after experimental treatment, comparing two groups. Using this experimental methodology makes it possible to identify the effect of the intervention in a group of 176 people. The score obtained with the Body Shape Questionnaire (BSQ) was the dependent variable, and the IMAGINA program was the independent one. As for age, gender, relationship status, season, and residence environment, these were controlled variables. There were significant differences in body satisfaction between the two programs, obtaining better results with IMAGINA. The controlled variables had a much less significant effect than the treatment. Therefore, it is possible to improve body satisfaction in older adults through interventions similar to the one presented here.

Exploring language dominance through code-switching: intervocalic voiced stop lenition in Afrikaans-Spanish bilinguals.

The present study examines the relationship between the two grammars of bilingual speakers, the linguistic ecologies in which the L1 and L2 become active, and how these topics can be explored in a bilingual community undergoing L1 attrition. Our experiment focused on the production of intervocalic phonemic voiced stops for L1-Afrikaans/L2-Spanish bilinguals in Patagonia, Argentina. While these phonemes undergo systematic intervocalic lenition in Spanish (e.g., /b d É¡/ > [ß ð É£]), they do not in Afrikaans (e.g., /b d/ > [b d]). The bilingual participants in our study produced target Afrikaans and Spanish words in unilingual and code-switched speaking contexts. The results show that: (i) the participants produce separate phonetic categories in Spanish and Afrikaans; (ii) code-switching affects the production of the target sounds asymmetrically, such that L1 Afrikaans influences the production of L2 Spanish sounds but not vice versa; and (iii) this L1-to-L2 influence remains robust despite the instability of the L1 itself. Altogether, our findings speak to the persistence of a bilingual's L1 phonological grammar despite cross-generational L1 attrition.

Dataset of factors impacting second language learning from Teachers' experience.

Developing an accurate second language competence different from the mother tongue has become an essential skill in today's globalized world, and therefore it is a highly valued and demanded learning among the main educational institutions and models. However, it is a complex process that is influenced by numerous and, in many cases, unknown factors, which are not usually taken into consideration when designing second language learning processes, which tend to lead to inadequate teaching and may lead to school failure that could have been avoided. 216 in-service teachers from all non-university educational stages of the Community of Madrid, Spain, evaluate the significance of 44 factors traditionally associated with second language learning, which are grouped into four general categories (factors linked to students; factors linked to teachers; learning structure and organisation; and learning environment) through a five-point Likert scale. The data were collected using a Google Forms questionnaire through the research described in Arigita-García et al. (2021) [1]. The sample is heterogeneous concerning different attribute variables such as age, teaching experience, gender, school ownership, and the language in which classes are taught. The sample was obtained through social networks and teacher forums. The data collection offers essential information to better understand the process of second language learning, as it gathers the experience and learning accumulated by the teachers who took part in this work, which implies direct information from the educational reality that they are intended to improve.

Pre-eminence of determining factors in second language learning: An educator's perspective from Spain.

Second language acquisition as a process is subject to factors related to the student, the teacher, the learning structure and learning organisation, and also to the learning environment. The research hereby presented aims to establish the relevance of the above-mentioned factors in the process of second language learning. The study addresses the point of view of teachers, as their perspective concerning the learning process is privileged. If it were not to be included in a scientific process, this detailed and contextual knowledge would not be able to contribute to the improvement of teaching. The data obtained will allow for the designing of teaching strategies focused on learners' needs and requirements. This is a descriptive, observational and cross-sectional study with the participation of 216 practicing teachers within the Community of Madrid in Spain. The information was collected through an online questionnaire using the Google Drive tool Google Forms. Then, it was analysed and validated with IBM SPSS Statistics 25.0. The outcomes of the study show that the factors linked to the teacher are the most dominant for those educators in the Community of Madrid. Regarding the teacher-student relationship, the use of teaching resources and materials adequate for learning, together with the communication, strategies used, the linguistic input received by the students and the planning of lessons, are factors showing the greatest capacity to determine the process of teaching and learning a second language.

Association between early working life patterns, in publicly and privately owned companies, and the course of future sickness absence due to mental disorders: a cohort study in Catalonia (Spain).

OBJECTIVES: To assess the relationship between early working life patterns, at privately and publicly held companies, and the course of sickness absence (SA) due to mental disorders. METHODS: Cohort study of workers aged 18-28 years, affiliated with the Spanish social security system, living in Catalonia, who had at least one episode of SA due to mental disorders between 2012 and 2014. Individual prior working life trajectories were reconstructed through sequence analysis. Optimal matching analysis was performed to identify early working life patterns by clustering similar individual trajectories. SA trajectories were identified using latent class growth modelling analysis. Finally, the relationship between early working life patterns and subsequent SA trajectories was assessed via multinomial logistic regression models. RESULTS: Among both men and women, four labour market participation (LMP) patterns were identified: stable permanent employment (reference group), increasing permanent employment, fluctuating employment and delayed employment. Among women, an increasing permanent employment pattern in early working life was related to a decrease of accumulated SA days over time (adjusted OR (aOR) 2.08; 95% CI 1.18 to 3.66). In men, we observed a trend towards a middle stable accumulation of SA days in those with fluctuating employment (aOR 1.25, 95% CI 0.57 to 2.74) or delayed employment (aOR 1.79; 95% CI 0.59 to 5.41). In both men and women, an early working life in big companies was related to a more favourable SA trajectory. CONCLUSIONS: Early LMP patterns characterised by an increasing stability-decreased number of transitions between temporary contracts and lack of social security coverage towards permanent contracts-were related to a better future SA course due to mental diagnosis.

Online Explorative Study on the Learning Uses of Virtual Reality Among Early Adopters.

Virtual reality (VR) has shown great educational potential because it makes it possible to simulate any desired situation or event, thus playing an important role in addressing current educational challenges. Despite the unlimited learning possibilities that VR may offer, unless users are willing to apply virtual devices to education, the investment of time, money, and effort will be fruitless. It is therefore crucial to assess the educational interest of the first generation of VR users and to identify their current needs. To this end, in this study we designed an online questionnaire and applied it through the SaaS (Software as a service) of a private server. The sample consisted of 117 early VR adopters recruited via a main portal of communication and information technologies in Spain. In order to engage participants, we posted a thread in the main forum, which is dedicated to the advances and potential uses of VR. Once the responses were gathered, we analyzed the relationship between 12 variables (mean contrasts with Snedecor's F, and contingency analysis with chi-square and Sommer's d). The results showed that the current profile of a VR user is a male over 35 years old, with university studies, and who has purchased his viewer recently (<1 year). As for the learning and teaching applications that these users were interested in, only 13.7% of the participants in this study use VR for educational purposes, although 28.2% were interested, indicating that perhaps the lack of applications or learning experiences may be hampering the use of VR within education. Almost half of the early adopters surveyed would like to learn using VR technology and are somehow optimistic about the relationship between VR and education, particularly those who are younger.

Measurement of different types of intelligence (general, verbal vs. non-verbal, multiple), academic performance and study habits of secondary students at a Music Integrated Centre.

According to many relevant scientific researches conducted in the last few years [1-3], the study of music-related subjects implies greater development of both intellectual and executive functions of students. Those functions comprise musical intelligence [4] and the rest of multiple intelligences [5], as well as the general and factorial intelligence [6]. The present research may help students organise and plan their studies with an improvement of their study habits, thus better self-organising their daily work. Unfortunately, the percentage of secondary students at Music Integrated Centres is less than 0.01% of the total centres; indeed, there are only 10 centres in Spain out of 34,149 total number of non-university education centres of this type [7]. Hence, the sample obtained from this data collection is a rara avis of a great scientific value [8,9]. In this study, a sample of 28 first-year secondary students at a Music Integrated Centre has been collected. In Music Integrated Centres, learners simultaneously study the General Education System and music-related courses from their third year of Primary Education until the second year of Baccalaureate. In order to obtain the data, several measurement tests have been conducted, namely general and factorial intelligence, multiple intelligence and study habits. Moreover, the study collects the academic performance of students in two evaluations carried out the school year 2017-2018 of the general courses on Spanish Language (mother tongue of the students), Mathematics, Social Sciences, Natural Sciences and English as a Foreign Language, as well as the music-related subjects, in particular Musical Language, Instrument and Choir. The data gathered for this field study can be useful if related to other researches on students belonging to other levels and modalities at Secondary Education with a focus on multiple intelligences and learning strategies, among others.

Early virtual reality adopters in Spain: sociodemographic profile and interest in the use of virtual reality as a learning tool.

This study describes the social and demographic profile of the first generation of users of marketed virtual reality (VR) viewers in Spain and, subsequently, it assesses the interest in its use as a learning tool. For that purpose, an online questionnaire created ad hoc was administered to a sample of 117 participants. The relationship between twelve variables was analysed comparing means through the Snedecor's F distribution and the contingency tables through the Chi-squared test and Somers' D. Among other issues, it was concluded that the virtual reality user profile at present corresponds to a person older than 36, mainly men, with higher education and having acquired their viewer no longer than one year ago. Concerning the interests of virtual reality users as a learning tool, only a few of them currently use virtual reality for this aim, but they mainly show an interest in using the virtual reality as a learning method and they feel optimism regarding the future use of this technology as a learning tool. However, this is not the case among users of video game consoles (PSVR), who are mainly men not interested in their use as a learning tool at present. Finally, it can be stated that current use as a learning tool among teachers and students is occasional and preferably via smartphones.

Improvement of Body Satisfaction in Older People: An Experimental Study.

Aging typically manifests itself in a variety of physical and cognitive alterations and challenges that are not always easily accepted. Feeling dissatisfied with these changes can also affect the mood and self-esteem of older people causing body image problems. The present study focuses on body satisfaction in Spanish older people (176 participants; M and SD = 64.03 ± 1 8.06; age range 50 to over 75) by employing experimental research to test whether psychosocial interventions may have a positive impact. Our aims are threefold: (1) To describe the body satisfaction of older people considering intervening variables, such as age, gender, having a stable partner, time of the year, and place of residence; (2) to compare body satisfaction improvement in older people participating in a specific body satisfaction program designed for this purpose versus a non-specific program run by the Spanish Red Cross; and (3) to examine the relationship between age, gender, having a stable partner, time of the year, place of residence, body satisfaction and participating in the experimental condition. The IMAGINA specific body image program yielded a significant improvement in body satisfaction when compared with the non-specific program in both men and women regardless of marital status and in some age groups: 50 to 54 years old, 60 to 64 years old, and 65 to 69. Male participants, as well as singles, were more satisfied with their bodies, and the contrary was true for divorced and separated. The IMAGINA program was particularly useful in participants with more body image problems. As shown, the pressure to fit beauty standards and related problems do not go away with age, a fact that is embodied and experienced differently in men and women.

Demographic data, habits of use and personal impression of the first generation of users of virtual reality viewers in Spain.

Taking into account that the first virtual reality viewers started to be marketed in Spain at the end of 2016 (Gadelha, 2018; Parong and Mayer, 2018; Rizzo and Koenig, 2017) [1], [2], [3], a questionnaire was designed in order to show the social and demographic profile of this first generation of users of virtual reality experiences, itemising their ages, genders, educational level, professional field and present work status. Furthermore, the participants' habits of use, interests, attitudes, assessments about the future potential of virtual reality in a range of areas and their preferences in this area are shown through the other items of the questionnaire. A wide sample of 117 participants, who were early adopters of virtual reality viewers, was obtained posting a new thread in the virtual reality forum of the Internet website 'Elotrolado.net'. The data were collected by means of an online questionnaire hosted at the private servers of 'Encuestafacil.com'. The sample did not undergo any pre-treatment and the obtained data were not altered.

Hypoxia Reduces the Pathogenicity of Pseudomonas aeruginosa by Decreasing the Expression of Multiple Virulence Factors.

Our understanding of how the course of opportunistic bacterial infection is influenced by the microenvironment is limited. We demonstrate that the pathogenicity of Pseudomonas aeruginosa strains derived from acute clinical infections is higher than that of strains derived from chronic infections, where tissues are hypoxic. Exposure to hypoxia attenuated the pathogenicity of strains from acute (but not chronic) infections, implicating a role for hypoxia in regulating bacterial virulence. Mass spectrometric analysis of the secretome of P. aeruginosa derived from an acute infection revealed hypoxia-induced repression of multiple virulence factors independent of altered bacterial growth. Pseudomonas aeruginosa lacking the Pseudomonas prolyl-hydroxylase domain-containing protein, which has been implicated in bacterial oxygen sensing, displays reduced virulence factor expression. Furthermore, pharmacological hydroxylase inhibition reduces virulence factor expression and pathogenicity in a murine model of pneumonia. We hypothesize that hypoxia reduces P. aeruginosa virulence at least in part through the regulation of bacterial hydroxylases.

Nonfluoroscopic Catheter Ablation. Results From a Prospective Multicenter Registry.

INTRODUCTION AND OBJECTIVES: Nonfluoroscopic catheter ablation is feasible in most procedures. The aim of our registry was to evaluate the safety and feasibility of a zero-fluoroscopic approach to catheter ablation in several Spanish centers. METHODS: Eleven centers prospectively included a minimum of 20 patients. Patients with an arrhythmic substrate deemed suitable by the operator for a zero-fluoroscopic approach throughout the procedure were recruited. Patients with intracardiac devices were not included. Attending electrophysiologists, fellows, and resident physicians participated in each procedure, as in usual care. RESULTS: The study included 247 patients. Ablation was performed in 235 patients (95.2%). In 2 patients, who were not included in the analysis, fluoroscopy was performed as the first-line treatment. The arrhythmic substrate was located in the right chambers in most of the procedures (231 of 233 [99.15%]). Fluoroscopy was used in 24 procedures (10.3%). Catheter ablation was successful in 96.4% of the procedures and severe complications occurred in 2 patients (0.85%). Two variables were related to the need for fluoroscopy: the performing center (minimum 0% vs maximum 30.3%; P=.001) and procedural failure (13% vs 2.4%; P<.05). CONCLUSIONS: The Spanish multicenter registry reveals that a zero-fluoroscopic approach is feasible in most right-sided catheter ablation procedures. Randomized trials are necessary to confirm the safety of this approach. The need for fluoroscopy was related to procedural failure, with significant differences among performing centers.

The role of N-glycosylation in kiwi allergy.

The physical, biochemical, and immunological characteristics of plant allergens have been widely studied, but no definite conclusion has been reached about what actually makes a protein an allergen. In this sense, N-glycosylation is an exclusive characteristic of plant allergens not present in mammals and it could be implied in allergenic sensitization. With this aim, we evaluated and compared the allergenic activity of the protein fraction and the N-glycan fraction of the thaumatin-like protein and the main kiwi allergen, Act d 2. The natural allergen, Act d 2, was deglycosylated by trifluoromethanesulfonic acid treatment; the N-glycan fraction was obtained by extended treatment with proteinase K. N-glycan- and protein- fractions were recognized by specific IgE of kiwi-allergic patients. By contrast, the sugar moiety showed a reduced capacity to activate basophils and T cells, but not dendritic cells derived from patients' monocytes. Related to this, the production of cytokines such as IL6 and IL10 was increased by the incubation of dendritic cells with sugar moiety. Thus, the sugar moiety plays a significant role in sensitization, inducing the activation of antigen-presenting cells, but it is the protein fraction that is responsible for the allergic reactions.

Alt a 1 from Alternaria interacts with PR5 thaumatin-like proteins.

Alt a 1 is a protein found in Alternaria alternata spores related to virulence and pathogenicity and considered to be responsible for chronic asthma in children. We found that spores of Alternaria inoculated on the outer surface of kiwifruits did not develop hyphae. Nevertheless, the expression of Alt a 1 gene was upregulated, and the protein was detected in the pulp where it co-localized with kiwi PR5. Pull-down assays demonstrated experimentally that the two proteins interact in such a way that Alt a 1 inhibits the enzymatic activity of PR5. These results are relevant not only for plant defense, but also for human health as patients with chronic asthma could suffer from an allergic reaction when they eat fruit contaminated with Alternaria.