Long COVID among Brazilian Adults and Elders 12 Months after Hospital Discharge: A Population-Based Cohort Study.

The persistence of symptoms for more than three months following infection with severe acute respiratory syndrome coronavirus 2 is referred to as "Long COVID". To gain a deeper understanding of the etiology and long-term progression of symptoms, this study aims to analyze the prevalence of Long COVID and its associated factors in a cohort of Brazilian adults and elders, twelve months after hospital discharge. An observational, prospective, and follow-up study was performed with a cohort of adults and older adults diagnosed with COVID-19 in 2020 in the State of Paraná, Brazil. Twelve months after hospital discharge, patients answered a phone questionnaire about the persistence of symptoms after three levels of exposure to COVID-19's acute phase (ambulatory, medical ward, and intensive care unit). According to the characteristics of participants, the prevalence of Long COVID-19 was calculated, and logistic regression analyses were conducted. We analyzed data from 1822 participants (980 adults [≥18-<60 years] and 842 older people [≥60 years]) across three exposure levels. The overall Long COVID prevalence was 64.2%. Long COVID was observed in 646 adults (55%; of which 326 were women) and 523 older people (45%; of which 284 were women). Females had a higher prevalence of long-term symptoms (52%) compared with men. The most common post-COVID-19 conditions in the 12-month follow-up were neurological (49.8%), followed by musculoskeletal (35.1%) and persistent respiratory symptoms (26.5%). Male individuals were less likely to develop Long COVID (aOR = 0.50). Other determinants were also considered risky, such as the presence of comorbidities (aOR = 1.41). Being an adult and having been hospitalized was associated with the development of Long COVID. The risk of developing Long COVID was twice as high for ward patients (aOR = 2.53) and three times as high for ICU patients (aOR = 3.56) when compared to non-hospitalized patients. Presenting clinical manifestations of digestive (aOR = 1.56), endocrine (aOR = 2.14), cutaneous (aOR = 2.51), musculoskeletal (aOR = 2.76) and psychological systems (aOR = 1.66) made adults more likely to develop Long COVID. Long COVID was present in a large proportion of people affected by the SARS-CoV-2 infection. Presence of Long COVID symptoms displayed a dose-response relationship with the level of disease exposure, with a greater prevalence of symptoms associated with the severe form in the acute period.

Challenges of nursing research with immigrant and refugee populations: methodological and pragmatic considerations.

The objective of the study was to identify the main challenges in conducting research with immigrants and refugees and to provide seven methodological and pragmatic strategies. The analyses presented, based on the Theory of Culture Care Diversity and Universality, are extracted from insights of the authors' experiences as researchers and the literature. The main challenges are related to cultural, moral, political, and educational differences between researcher and researched; identification of the universe and sampling; access to informants through the barrier of distrust; and communication and language difficulties. Strategies to make research more successful involve: developing a thorough research protocol; creatively recruiting participants; developing strategies to facilitate communication; having a sensitive look; offering a structure of reciprocity; increasing trust, and triangulating research. The main methodological and pragmatic issues in studies with immigrants and refugees were explored, providing valuable guidance for future projects. However, in different migration situations, researchers must be aware of the possibility of other challenges arising during the investigative process.

Cognitive Impairment Related to Chronic Kidney Disease Is Associated with a Decreased Abundance of Membrane-Bound Klotho in the Cerebral Cortex.

Cognitive impairment (CI) is a complication of chronic kidney disease (CKD) that is frequently observed among patients. The aim of this study was to evaluate the potential crosstalk between changes in cognitive function and the levels of Klotho in the brain cortex in an experimental model of CKD. To induce renal damage, Wistar rats received a diet containing 0.25% adenine for six weeks, while the control group was fed a standard diet. The animals underwent different tests for the assessment of cognitive function. At sacrifice, changes in the parameters of mineral metabolism and the expression of Klotho in the kidney and frontal cortex were evaluated. The animals with CKD exhibited impaired behavior in the cognitive tests in comparison with the rats with normal renal function. At sacrifice, CKD-associated mineral disorder was confirmed by the presence of the expected disturbances in the plasma phosphorus, PTH, and both intact and c-terminal FGF23, along with a reduced abundance of renal Klotho. Interestingly, a marked and significant decrease in Klotho was observed in the cerebral cortex of the animals with renal dysfunction. In sum, the loss in cerebral Klotho observed in experimental CKD may contribute to the cognitive dysfunction frequently observed among patients. Although further studies are required, Klotho might have a relevant role in the development of CKD-associated CI and represent a potential target in the management of this complication.

Challenges of nursing research with immigrant and refugee populations: methodological and pragmatic considerations / Desafíos de la investigación en enfermería con poblaciones inmigrantes y refugiadas: consideraciones metodológicas y pragmáticas / Desafios da pesquisa em enfermagem com populações imigrantes e refugiadas: considerações metodológicas e pragmáticas

ABSTRACT The objective of the study was to identify the main challenges in conducting research with immigrants and refugees and to provide seven methodological and pragmatic strategies. The analyses presented, based on the Theory of Culture Care Diversity and Universality, are extracted from insights of the authors' experiences as researchers and the literature. The main challenges are related to cultural, moral, political, and educational differences between researcher and researched; identification of the universe and sampling; access to informants through the barrier of distrust; and communication and language difficulties. Strategies to make research more successful involve: developing a thorough research protocol; creatively recruiting participants; developing strategies to facilitate communication; having a sensitive look; offering a structure of reciprocity; increasing trust, and triangulating research. The main methodological and pragmatic issues in studies with immigrants and refugees were explored, providing valuable guidance for future projects. However, in different migration situations, researchers must be aware of the possibility of other challenges arising during the investigative process.

RESUMEN El objetivo del estudio fue identificar los principales desafíos al realizar investigaciones con inmigrantes y refugiados y proporcionar siete estrategias metodológicas y pragmáticas. Los análisis presentados, basados en la Teoría de Diversidad y Universalidad de la Atención Cultural, se extraen de insights de las experiencias de los autores como investigadores y de la literatura. Los principales desafíos están relacionados con las diferencias culturales, morales, políticas y educativas entre investigador e investigado; identificación del universo y muestreo; acceso a informantes a través de la barrera de la desconfianza; y dificultades de comunicación y lenguaje. Las estrategias para lograr que la investigación sea más exitosa implican: desarrollar un protocolo de investigación exhaustivo; reclutar participantes de forma creativa; desarrollar estrategias para facilitar la comunicación; tener una mirada sensible; ofrecer una estructura de reciprocidad; aumentar la confianza y triangular la investigación. Se exploraron las principales cuestiones metodológicas y pragmáticas en los estudios con inmigrantes y refugiados, proporcionando una valiosa orientación para proyectos futuros. Sin embargo, en diferentes situaciones migratorias, los investigadores deben ser conscientes de la posibilidad de que surjan otros desafíos durante el proceso de investigación.

RESUMO O objetivo do estudo foi identificar os principais desafios na condução de pesquisas com imigrantes e refugiados e fornecer sete estratégias metodológicas e pragmáticas. As análises apresentadas, embasadas na Teoria da Diversidade e Universalidade do Cuidado Cultural, são extraídas de insights das experiências dos autores enquanto pesquisadores e da literatura. Os principais desafios relacionam-se a diferenças culturais, morais, políticas e educacionais entre pesquisador e pesquisado; identificação do universo e amostragem; acesso aos informantes pela barreira da desconfiança; e dificuldade de comunicação e idioma. As estratégias para tornar a pesquisa mais exitosa envolvem: desenvolver um minucioso protocolo de pesquisa; recrutar participantes de forma criativa; elaborar estratégias para facilitar a comunicação; ter olhar sensível; oferecer uma estrutura de reciprocidade; ampliar a confiança e triangular a pesquisa. Foram exploradas as principais questões metodológicas e pragmáticas nos estudos com imigrantes e refugiados, fornecendo orientações valiosas para projetos futuros. Entretanto, em diferentes situações de migração, os pesquisadores devem atentar-se para a possibilidade de surgirem outros desafios durante o processo investigativo.

VALIDACIÓN DE LA VERSIÓN EN ESPAÑOL DE LA ESCALA PERSPECTIVA ESPIRITUAL DE P. REED EN PERSONAS MAYORES, CHILE / VALIDATION OF THE SPANISH VERSION OF P. REED'S SPIRITUAL PERSPECTIVE SCALE IN OLDER PEOPLE IN CHILE

El envejecimiento global es uno de los grandes desafíos sanitarios del siglo XXI, el 2030 una de cada seis personas tendrá ≥ 60 años. En Chile se proyecta un 32,1% para el 2050. Esta realidad demográfica desafía a la enfermería en el abordaje multidimensional del envejecimiento. La espiritualidad como atributo de la autotrascendencia es un factor condicionante de acciones promotoras de salud en las personas mayores. Desde la perspectiva de la Dra. Reed, se presentan los resultados de validación de su Escala de Perspectiva Espiritual. La población fue de 202 personas mayores en promedio de 71 años (D.E.= 8,2338). El método utilizado fue diseño psicométrico y corte transversal. La escala general presentó; α de Cronbach=0,92; dimensiones prácticas espirituales α de Cronbach= 0,822; dimensión creencias espirituales α de Cronbach=0,914. El análisis de modelo de un factor (CFI=0,956, RMSEA=0,167 IC95% [0,147 - 0,188] y un c2=232,762; p=0,000), como de dos factores coherentes con la estructura teórica propuesta por Reed (CFI=0,984; RMSEA=0,102 IC95% [0,081 ­ 0,125] y c2=105,890; p=0,000), presentaron cargas factoriales altas y relativamente homogéneas. La escala general y las subescalas de creencias y prácticas espirituales mostraron adecuada confiabilidad. El análisis de modelos anidados mostró un mejor ajuste del modelo de dos factores. Los resultados suman para afirmar que la Escala de Perspectiva Espiritual, contribuye a la precisión empírica, potencial heurístico y verificabilidad de la Teoría de Transcendencia de Reed. Se vislumbra que la espiritualidad es un factor mediador en la relación entre la vulnerabilidad, autotrascendencia y bienestar de la persona mayor.

Global aging is one of the great health challenges of the 21st century. By 2030, one in six people will be ≥60 years of age, with 32.1% projected for Chile by 2050. This demographic reality challenges nursing in the multidimensional approach to aging. The dimension of spirituality as an attribute of self-transcendence is a conditioning factor of health promoting actions in the elderly. The validation results of Dr. Reed's Spiritual Perspective Scale are presented. The population included 202 people older than 71 years on average (SD= 8.2338). The method used was a psychometric and cross-sectional design. The general scale presented Cronbach's α=0.92; spiritual practical dimension, Cronbach's α=0.822; spiritual beliefs dimension, Cronbach's α=0.914. The analysis of a one-factor model (CFI=.956, RMSEA=0.167 IC95% [0.147-0.188] and c2=232.762; p=0.000), as two factors consistent with the theoretical structure proposed by Reed (CFI=0.984; RMSEA=0.102 IC95% [0.081-0.125] and c2=105.890; p=0.000), presented high and relatively homogeneous factorial loads. The general scale and the subscales of spiritual beliefs and practices showed adequate reliability. The analysis of nested models showed a better adjustment of the two-factor model. The results collectively affirm that the Spiritual Perspective Scale contributes to the empirical precision, heuristic potential, and verifiability of Reed's Theory of Transcendence. It is observed that spirituality is a mediating factor in the relationship between vulnerability, self-transcendence, and well-being of humans.

A selenoureido-iminoglycolipid transported by zeolitic-imidazolate framework nanoparticles: a novel antioxidant therapeutic approach.

A selenium-containing metal-organic framework with remarkable antioxidant capacity and ROS-scavenging activity was constructed by a controlled de novo encapsulation approach of a glycoconjugate mimetic, specifically a sp2-iminoglycolipid bearing a selenoureido fragment (DSeU), within a zeolitic-imidazolate framework exoskeleton. Biocompatible and homogeneous nanosized particles of ∼70 nm (DSeU@ZIF8) were obtained, which could be efficiently internalized in cells, overcoming the poor solubility in biological media and limited bioavailability of glycolipids. The ZIF-particle served as nanocarrier for the intracellular delivery of the selenocompound to cells, promoted by the acidic pH inside endosomes/lysosomes. As demonstrated by in vitro studies, the designed DSeU@ZIF8 nanoparticles displayed a high antioxidant activity at low doses; lower intracellular ROS levels were observed upon the uptake of DSeU@ZIF8 by human endothelial cells. Even more interesting was the finding that these DSeU@ZIF8 particles were able to reverse to a certain level the oxidative stress induced in cells by pre-treatment with an oxidizing agent. This possibility of modulating the oxidative stress in living cells may have important implications in the treatment of diverse pathological complications that are generally accompanied with elevated ROS levels.

Uremic Toxins Induce THP-1 Monocyte Endothelial Adhesion and Migration through Specific miRNA Expression.

Atherosclerosis is initiated by the activation of endothelial cells that allows monocyte adhesion and transmigration through the vascular wall. The accumulation of uremic toxins such as indoxyl sulphate (IS) and p-cresol (PC) has been associated with atherosclerosis. Currently, miRNAs play a crucial role in the regulation of monocyte activation, adhesion, and trans-endothelial migration. The aim of the present study is to evaluate the effect of IS and PC on monocyte adhesion and migration processes in monocytes co-cultured with endothelial cells as well as to determine the underlying mechanisms. The incubation of HUVECs and THP-1 cells with both IS and PC toxins resulted in an increased migratory capacity of THP-1 cells. Furthermore, the exposure of THP-1 cells to both uremic toxins resulted in the upregulation of BMP-2 and miRNAs-126-3p, -146b-5p, and -223-3p, as well as the activation of nuclear factor kappa B (NF-κB) and a decrease in its inhibitor IĸB. Uremic toxins, such as IS and PC, enhance the migratory and adhesion capacity of THP-1 cells to the vascular endothelium. These toxins, particularly PC, contribute significantly to uremia-associated vascular disease by increasing in THP-1 cells the expression of BMP-2, NF-κB, and key miRNAs associated with the development of atherosclerotic vascular diseases.

Vanadium oxide and a sharp onset of cold-trapping on a giant exoplanet.

The abundance of refractory elements in giant planets can provide key insights into their formation histories1. Owing to the low temperatures of the Solar System giants, refractory elements condense below the cloud deck, limiting sensing capabilities to only highly volatile elements2. Recently, ultra-hot giant exoplanets have allowed for some refractory elements to be measured, showing abundances broadly consistent with the solar nebula with titanium probably condensed out of the photosphere3,4. Here we report precise abundance constraints of 14 major refractory elements on the ultra-hot giant planet WASP-76b that show distinct deviations from proto-solar and a sharp onset in condensation temperature. In particular, we find nickel to be enriched, a possible sign of the accretion of the core of a differentiated object during the evolution of the planet. Elements with condensation temperatures below 1,550 K otherwise closely match those of the Sun5 before sharply transitioning to being strongly depleted above 1,550 K, which is well explained by nightside cold-trapping. We further unambiguously detect vanadium oxide on WASP-76b, a molecule long suggested to drive atmospheric thermal inversions6, and also observe a global east-west asymmetry7 in its absorption signals. Overall, our findings indicate that giant planets have a mostly stellar-like refractory elemental content and suggest that temperature sequences of hot Jupiter spectra can show abrupt transitions wherein a mineral species is either present or completely absent if a cold trap exists below its condensation temperature8.

Efecto mediador de la motivación a buscar venganza en la relación de la ansiedad y la evitación en el apego con la calidad de vida / Mediating effect of revenge-seeking motivation on the relationship of attachment anxiety and avoidance to quality of life

OBJETIVO: Determinar el efecto mediador de la motivación a buscar venganza en la relación de la ansiedad y la evitación en el apego con la calidad de vida. METODOLOGÍA: estudio transversal correlacional. La muestra estuvo constituida por 558 personas de 18 a 65 años de la ciudad de Antofagasta, Chile. Fueron utilizados los instrumentos: Cuestionario WHOQoL-Bref; Experiencia en Relaciones Cercanas; y Motivación a buscar venganza. Se realizó un modelo de ecuaciones estructurales que consideró efectos directos, indirectos y totales. RESULTADOS: Del total de participantes, 289 (51,8%) fueron hombres. Las edades fluctuaron entre 18 y 65 años (M=39,7; ±13,42). Se encontraron efectos significativos en la relación entre la ansiedad y evitación en el apego en los dominios físico, psicológico y social-relacional de la calidad de vida. La motivación a buscar venganza tiene efecto de mediación total en la relación entre evitación en el apego y el dominio físico, y efecto de mediación parcial de la evitación en el apego sobre el dominio psicológico de la calidad de vida. CONCLUSIÓN: ansiedad y evitación en el apego disminuyen la calidad de vida y la motivación a buscar venganza media parcial o totalmente la relación entre la evitación en el apego sobre los dominios físico y psicológico de la calidad de vida.

OBJECTIVE: To determine the mediating effect of revenge-seeking motivation on the relationship between anxiety and avoidance in attachment and quality of life. METHODOLOGY: cross-sectional correlational study. The sample consisted of 558 people aged 18 to 65 years from the city of Antofagasta, Chile. The following instruments were used: WHOQoL-Bref Questionnaire; Experience in Close Relationships; and Motivation to seek revenge. Structural equation modeling was performed considering direct, indirect and total effects. RESULTS: Of the total number of participants, 289 (51.8%) were male. Ages ranged from 18 to 65 years (M=39.7; ±13.42). Significant effects were found in the relationship between anxiety and avoidance on attachment in the physical, psychological, and social-relational domains of quality of life. Revenge-seeking motivation has full mediation effect on the relationship between attachment avoidance and the physical domain, and partial mediation effect of attachment avoidance on the psychological domain of quality of life. CONCLUSION: Anxiety and attachment avoidance decrease quality of life, and revenge-seeking motivation partially or fully mediates the relationship between attachment avoidance and the physical and psychological domains of quality of life.

Predictores demográficos y psicosociales de salud fisica percibida por migrantes colombianos y peruanos en chile

Objetivo: Identificar la capacidad predictiva de variables demográficas y psicosociales en el autorreporte de la salud física de migrantes colombianos y peruanos en Chile. Material y Método: Diseño no experimental de tipo transversal, correlacional, con muestreo intencional. Participaron 853 inmigrantes (51,7% colombianos y 48,3% peruanos; 51% mujeres) entre 18 a 71 años. Se evaluó el autorreporte del estado de salud física, variables sociodemográficas, síntomas ansiosos y depresivos, estrés por aculturación, apoyo social percibido, autoestima individual, entre otros, los que fueron analizados mediante regresión múltiple. Resultados: La población colombiana reportó un mejor estado de salud física. En ambos grupos, los síntomas ansiosos y depresivos fueron importantes predictores del estado de salud física. Otras variables predictivas fueron en peruanos: ingresos económicos, distancia con el país origen y años de permanencia en Chile, en tanto en colombianos: autoestima individual, discriminación y rechazo, y estado de salud actual en comparación con el que tenían en su país. En colombianos, el modelo explica el 14,7% de la varianza, en peruanos un 28,9%. Conclusiones: En ambas poblaciones los síntomas ansiosos y depresivos, y el estrés por aculturación resultaron ser importantes predictores del autorreporte de la salud física, aportando evidencia a que el proceso migratorio afecta el estado de salud mental del migrante y este, a su vez, puede afectar su estado de salud física.

Objective: To identify the predictive capacity of demographic and psychosocial variables in the self-reported physical health of Colombian and Peruvian migrants in Chile. Materials and Methods: Non-experimental, cross-sectional, correlational design using intentional sampling. A total of 853 immigrants (51.7% Colombians and 48.3% Peruvians; 51% women) between 18 and 71 years of age participated. Self-reported physical health status, sociodemographic variables, anxious and depressive symptoms, acculturation stress, perceived social support, individual self-esteem, among others, were evaluated and analyzed using multiple regression. Results: The Colombian population reported a better state of physical health. In both groups, anxious and depressive symptoms were important predictors of the physical health status. Other predictive variables were among Peruvians: income, distance from country of origin and years of permanence in Chile, while among Colombians: individual self-esteem, discrimination and rejection, and current health status compared to the one they had in their country. Among Colombians, the model explains 14.7% of the variance, whereas among Peruvians it accounts for 28.9%. Conclusions: In both populations, anxious and depressive symptoms, as well as acculturation stress turned out to be important predictors of self-reported physical health, providing evidence that the migratory process affects the migrant's mental health status, and this in turn can affect their physical health status.

Objetivo: Identificar a capacidade preditiva das variáveis demográficas e psicossociais na saúde física autorreferida de migrantes colombianos e peruanos no Chile. Material e Método: Desenho não experimental, transversal e correlacional com amostragem intencional. Participaram 853 imigrantes (51,7% colombianos e 48,3% peruanos; 51% mulheres) entre 18 e 71 anos. O estado de saúde física autorreferido, variáveis sociodemográficas, sintomas ansiosos e depressivos, estresse de aculturação, apoio social percebido, auto-estima individual, entre outros, foram avaliados e analisados por meio de regressão múltipla. Resultados: A população colombiana relatou um melhor estado de saúde física. Em ambos os grupos, sintomas ansiosos e depressivos foram importantes preditores do estado de saúde física. Outras variáveis preditoras foram entre os peruanos: renda económica, distância do país de origem e anos de permanência no Chile, enquanto nos colombianos: auto-estima individual, discriminação e rejeição, e estado de saúde atual em comparação ao que tinham em seu país. Entre os colombianos, o modelo explica 14,7% da variância, entre os peruanos ele representa 28,9%. Conclusões: Em ambas as populações, os sintomas ansiosos e depressivos e o estresse de aculturação revelaram-se importantes preditores da saúde física autorreferida, evidenciando que o processo migratório afeta o estado de saúde mental do migrante, e este, por sua vez, pode afetar seu estado de saúde física.

Passage Number-Induced Replicative Senescence Modulates the Endothelial Cell Response to Protein-Bound Uremic Toxins.

Endothelial aging may be induced early in pathological situations. The uremic toxins indoxyl sulfate (IS) and p-cresol (PC) accumulate in the plasma of chronic kidney disease (CKD) patients, causing accelerated endothelial aging, increased cardiovascular events and mortality. However, the mechanisms by which uremic toxins exert their deleterious effects on endothelial aging are not yet fully known. Thus, the aim of the present study is to determine the effects of IS and PC on endothelial damage and early senescence in cultured human umbilical vein endothelial cells (HUVECs). Hence, we establish an in vitro model of endothelial damage mediated by different passages of HUVECs and stimulated with different concentrations of IS and PC to evaluate functional effects on the vascular endothelium. We observe that cell passage-induced senescence is associated with apoptosis, ROS production and decreased endothelial proliferative capacity. Similarly, we observe that IS and PC cause premature aging in a dose-dependent manner, altering HUVECs' regenerative capacity, and decreasing their cell migration and potential to form vascular structures in vitro. In conclusion, IS and PC cause accelerated aging in HUVECs, thus contributing to endothelial dysfunction associated with CKD progression.

Ethnic Identity and Well-Being of Andean Indigenous People: The Effect of Individualistic and Collectivist Value Orientations.

The aim of this research was to evaluate the mediating effect of the value orientations of collectivism and individualism on the relationship between ethnic identity and well-being, the latter conceived from the worldview of Andean natives. For this purpose, under an observational and cross-sectional design, 395 Lickan-Antay adults (57% women) living in areas of indigenous development and in two cities in northern Chile were surveyed. We used the Lickan-Antay BLA32 well-being scale, a short version of the Portrait 21 Values Questionnaire to measure individualistic and collectivistic values, and an adapted version of the Ethnic Identity Scale. The results show that ethnic identity had a direct positive effect on all three dimensions of well-being (harmony with community life, ethnic harmony and harmony with nature), and total indirect effects on all five dimensions of well-being, one of them originating mainly from collectivist orientations. Individualistic orientations also showed a positive, though less intense, mediating effect on well-being. We conclude that collectivist and individualistic motivational patterns coexist in Lickan-Antay natives and explain an important part of the relationship between ethnic identity and well-being. Finally, we discuss our results and suggest replication of this study in other ethnic contexts to assess the generalizability of these findings to other native peoples of the Andean region of South America.

Compasión, celos y envidia: emociones sociales y cyberbullying entre adolescentes / Compassion, jealousy and envy: social emotions and cyberbullying among adolescents

Las emociones cumplen un papel fundamental en la capacidad de acción de los seres humanos, razón por la cual es indispensable estudiarlas para entender los fenómenos sociales contemporáneos en los que participan los adolescentes. Esta investigación tiene como objetivo comprender las experiencias de la compasión, los celos y la envidia de los adolescentes implicados en situaciones de cyberbullying en los roles de espectadores y agresores. Se trata de una investigación con diseño cualitativo en la que se entrevistó a 31 adolescentes entre los 12 y 17 años (M=15,23, DS=1,6) que participaron de situaciones de cyberbullying como espectadores y/o agresores. Los resultados indican que la compasión adquiere la forma de tristeza y rabia, especialmente entre los espectadores de cyberbullying. Por otra parte, los celos son un motivo que justifica la agresión a otros a través de Internet, y una forma de gestionar las tensiones en los vínculos sexo-afectivos. El uso de redes sociales digitales y la participación en escenarios presenciales en los que se disputan posiciones a nivel académico favorece el proceso de comparación social vinculado a la envidia que está en la base del cyberbullying. Finalmente, este estudio es una invitación para padres, docentes e institucionales estatales a que acompañen a los adolescentes a gestionar sus conflictos sin que las agresiones presenciales y online medien en sus interacciones

Emotions play a fundamental role in the capacity for action of human beings, which is why it is essential to study them in order to understand contemporary social phenomena in which adolescents participate. This research aims to understand the experiences of compassion, jealousy and envy of adolescents involved in cyberbullying situations in the roles of bystanders and aggressors. This is a qualitative design research in which 31 adolescents between the ages of 12 and 17 (M=15.23, SD=1.6) who participated in cyberbullying situations as bystanders and aggressors were interviewed. The results indicate that compassion takes the form of sadness and anger, especially among cyberbullying bystanders. On the other hand, jealousy is a motive that justifies aggression to others through the Internet, and a way of managing tensions in sex-affective bonds. The use of digital social networks and participation in face-to-face scenarios in which positions are disputed at the academic level, favours the process of social comparison linked to envy that is at the basis of cyberbullying. Finally, this study is an invitation for parents, teachers and state institutions to accompany adolescents in managing their conflicts without face-to-face and online aggressions mediating their interactions.

Inflammation, Senescence and MicroRNAs in Chronic Kidney Disease.

BACKGROUND: Patients with chronic kidney disease (CKD) show a chronic microinflammatory state that promotes premature aging of the vascular system. Currently, there is a growth interest in the search of novel biomarkers related to vascular aging to identify CKD patients at risk to develop cardiovascular complications. METHODS: Forty-five CKD patients were divided into three groups according to CKD-stages [predialysis (CKD4-5), hemodialysis (HD) and kidney transplantation (KT)]. In all these patients, we evaluated the quantitative changes in microRNAs (miRNAs), CD14+C16++ monocytes number, and microvesicles (MV) concentration [both total MV, and monocytes derived MV (CD14+Annexin V+CD16+)]. To understand the molecular mechanism involved in senescence and osteogenic transdifferentation of vascular smooth muscle cells (VSMC), these cells were stimulated with MV isolated from THP-1 monocytes treated with uremic toxins (txMV). RESULTS: A miRNA array was used to investigate serum miRNAs profile in CKD patients. Reduced expression levels of miRNAs-126-3p, -191-5p and -223-3p were observed in CKD4-5 and HD patients as compared to KT. This down-regulation disappeared after KT, even when lower glomerular filtration rates (eGFR) persisted. Moreover, HD patients had higher percentage of proinflammatory monocytes (CD14+CD16++) and MV derived of proinflammatory monocytes (CD14+Annexin V+CD16+) than the other groups. In vitro studies showed increased expression of osteogenic markers (BMP2 and miRNA-223-3p), expression of cyclin D1, ß-galactosidase activity and VSMC size in those cells treated with txMV. CONCLUSION: CKD patients present a specific circulating miRNAs expression profile associated with the microinflammatory state. Furthermore, microvesicles generated by monocytes treated with uremic toxins induce early senescence and osteogenic markers (BMP2 and miRNA-223-3p) in VSMC.

Role of endothelial microvesicles released by p-cresol on endothelial dysfunction.

Protein bound uremic toxins, such as p-cresol, cannot be effectively removed by conventional dialysis techniques and are accumulated in plasma, thus contributing to progression of both chronic kidney disease (CKD) and cardiovascular disease (CVD). Pathological effects of uremic toxins include activation of inflammatory response, endothelial dysfunction and release of endothelial microvesicles. To date, the role of p-cresol in endothelial microvesicles formation has not been analyzed. The aim of the present study was evaluate the effects of endothelial microvesicles released by p-cresol (PcEMV) on endothelial dysfunction. An in vitro model of endothelial damage mediated by p-cresol was proposed to evaluate the functional effect of PcEMV on the endothelial repair process carried out by endothelial cells and microRNA (miRNA) that could be involved in this process. We observed that p-cresol induced a greater release of microvesicles in endothelial cells. These microvesicles altered regenerative capacity of endothelial cells, decreasing their capacity for cell migration and their potential to form vascular structures in vitro. Moreover, we observed increased cellular senescence and a deregulation of miRNA-146b-5p and miRNA-223-3p expression in endothelial cells treated with endothelial microvesicles released by p-cresol. In summary our data show that microvesicles generated in endothelial cells treated with p-cresol (PcEMV) interfere with the endothelial repair process by decreasing the migratory capacity, the ability to form new vessels and increasing the senescence of mature endothelial cells. These alterations could be mediated by the upregulation of miRNA-146b-5p and miRNA-223-3p.

Mechanical tricuspid balloon 'valvuloplasty' in a prohibitive risk patient with cardiogenic shock: a case report.

BACKGROUND: We present a complex case of a failing tricuspid mechanical valve prosthesis in a patient with refractory cardiogenic shock at prohibitive risk for surgery in whom balloon 'valvuloplasty' resulted in immediate haemodynamic improvement in valve function. CASE SUMMARY: A 67-year-old woman with remote history of endocarditis s/p tricuspid valve repair and mechanical aortic valve replacement was referred for second opinion and management of new severe symptomatic tricuspid valve stenosis resulting in progressive debilitating congestive heart failure (HF). The patient was approved by the heart team to undergo redo open heart for surgical repair of the tricuspid valve. Intraoperative technical challenges were met to repair the tricuspid valve. In turn, the native valve was resected and a 33 mm On-X mechanical valve prosthesis. The patient's post-operative course was complicated by recurrent haemoptysis, prolonged mechanical respiratory support, acute kidney injury, and cardiogenic shock. Surgical re-exploration to address the dysfunctional mechanical tricuspid valve was felt to be prohibitive. Structural heart team was consulted. Cardiac catheterization was recommended to ascertain and confirm findings. The patient was transferred to the cardiac catheterization laboratory. Initial fluoroscopic examination of the heart confirmed the echocardiographic results of an immobile septal leaflet of the recently implanted mechanical tricuspid valve. An 8 × 40 mm Mustang OTW angioplasty balloon was then advanced across the mechanical valve and inflated gradually at nominal pressure. A single inflation resulted in successful restoration of valve leaflet function. DISCUSSION: To the best of our knowledge, this is the first balloon 'valvuloplasty' on a mechanical On-X valve in the tricuspid position.

Validación de la versión en español de la escala Perspectiva Espiritual de P. Reed / Validation of the Spanish Version of Reed's Spiritual Perspective Scale

Introducción: La espiritualidad es un fenómeno complejo, que en su concepción y experimentación está determinada por múltiples factores, lo cual complejiza el ejercicio de su evaluación en diferentes contextos. Objetivo: Analizar la estructura factorial de la versión en español de la Escala de Perspectiva Espiritual de Reed (1987) en una muestra chilena de adultos. Métodos: Investigación cuantitativa, evaluación psicométrica de un instrumento. El estudio se realizó durante el año 2016 en la ciudad de Antofagasta, Chile. Se realizó un análisis factorial confirmatorio, se utilizó el método de Máxima Verosimilitud Robusto. La muestra estuvo constituida por 174 adultos, cuyo promedio de edad fue de 23,3 años (DS = 5,003). Resultados: Se revela una estructura de dos factores: creencias y prácticas espirituales. Al liberar los errores de medición, los índices de bondad de ajuste dan cuenta de un ajuste excelente del modelo. Conclusiones: La escala de perspectiva espiritual de Reed (versión en español) entrega puntuaciones válidas al medir el nivel de espiritualidad en adultos, evaluando dos factores de la espiritualidad(AU)

Introduction: Spirituality is a complex phenomenon, which is, in its conception and experimentation, determined by multiple factors, which complicates the exercise of its evaluation in different settings. Objective: To analyze the factor structure of the Spanish version of the Spiritual Perspective Scale (Reed 1987) in a Chilean sample of adults. Methods: Quantitative research, psychometric evaluation of an instrument. The study was conducted during 2016 in the city of Antofagasta, Chile. Confirmatory factor analysis was used, together with the robust maximum likelihood method. The sample consisted of 174 adults, whose average age was 23.3 years (SD=5.003). Results: A structure of two factors is revealed: spiritual beliefs and practices. On releasing the measurement errors, the indices of goodness of fit show an excellent fit of the model. Conclusions: The Spanish version of Read's Spiritual Perspective Scale delivers valid scores upon measuring the level of spirituality in adults, evaluating two spirituality factors(AU)

Gas Accretion within the Dust Cavity in AB Aur.

AB Aur is a Herbig Ae star hosting a well-known transitional disk. Because of its proximity and low inclination angle, it is an excellent object to study planet formation. Our goal is to investigate the chemistry and dynamics of the molecular gas component in the AB Aur disk, and its relation with the prominent horseshoe shape observed in continuum mm emission. We used the NOEMA interferometer to map with high angular resolution the J = 3-2 lines of HCO+ and HCN. By combining both, we can gain insight into the AB Aur disk structure. Chemical segregation is observed in the AB Aur disk: HCO+ shows intense emission toward the star position, at least one bright molecular bridge within the dust cavity, and ring-like emission at larger radii, while HCN is only detected in an annular ring that is coincident with the dust ring and presents an intense peak close to the dust trap. We use HCO+ to investigate the gas dynamics inside the cavity. The observed bright HCO+ bridge connects the compact central source with the outer dusty ring. This bridge can be interpreted as an accretion flow from the outer ring to the inner disk/jet system proving gas accretion through the cavity.

Pancreatic autoantibodies and CD14+CD16+ monocytes subset are associated with the impairment of ß-cell function after simultaneous pancreas-kidney transplantation.

Pancreatic autoantibodies (AAb) has been associated with a worse pancreas graft survival after simultaneous pancreas-kidney transplantation (SPK). However, due to the variable time for AAb to become positive and the lack of early biomarkers suggesting such autoimmune activation, the mechanisms leading ß-cell destruction remain uncertain. The present study aimed to evaluate the association between post-transplant AAb and the functional impairment of the pancreatic ß-cell and also the association of such AAb with inflammation after SPK. In a longitudinal study, we analyzed the impact of post-transplant glutamic acid decarboxylase (GAD-65) and the insulinoma-associated autoantigen 2 (IA-2) AAb on pancreas graft function. Serum Hb1Ac and C-peptide (C-pep) were longitudinally compared between a group with positive posttransplant AAb (AAb+; n = 40) and another matched group with negative AAb (AAb-; n = 40) until the fifth year following seroconversion. In the cross-sectional analysis, we further evaluated the systemic signatures of inflammation by measuring pro-inflammatory CD14+CD16+ monocytes by flow-cytometry and interleukin 17-A serum levels in 38 SPK recipients and ten healthy controls. In the longitudinal study, patients with AAb+ showed higher levels of Hb1Ac (p<0.001) and lower C-pep levels (p<0.001) compared to those who remained AAb- throughout the follow-up. In the cross-sectional study, AAb+ patients showed a higher percentage of CD14+CD16+ monocytes compared with those with AAb- and the healthy controls (6.70±4.19% versus 4.0±1.84% and 3.44±0.93%; p = 0.026 and 0.009 respectively). Also, CD14+CD16+ monocytes correlated with Hb1Ac and C-pep serum levels. Multivariate logistic regression showed that posttransplant AAb+ was independently associated with a higher percentage of pro-inflammatory monocytes (adjusted-OR 1.59, 95%CI 1.05-2.40, p = 0.027). The group of patients with positive AAb also showed higher levels of IL17A as compared with the other groups (either healthy control or the negative AAb subjects). In conclusion, pancreatic AAb+ after SPK were not only associated with higher Hb1Ac and lower c-peptide serum levels but also with an increased percentage of CD14+CD16+ monocytes and higher levels of circulating IL17-A.