The Rheb GTPase promotes pheromone blindness via a TORC1-independent pathway in the phytopathogenic fungus Ustilago maydis.

The target of the rapamycin (TOR) signaling pathway plays a negative role in controlling virulence in phytopathogenic fungi. However, the actual targets involved in virulence are currently unknown. Using the corn smut fungus Ustilago maydis, we tried to address the effects of the ectopic activation of TOR on virulence. We obtained gain-of-function mutations in the Rheb GTPase, one of the conserved TOR kinase regulators. We have found that unscheduled activation of Rheb resulted in the alteration of the proper localization of the pheromone receptor, Pra1, and thereby pheromone insensitivity. Since pheromone signaling triggers virulence in Ustilaginales, we believe that the Rheb-induced pheromone blindness was responsible for the associated lack of virulence. Strikingly, although these effects required the concourse of the Rsp5 ubiquitin ligase and the Art3 α-arrestin, the TOR kinase was not involved. Several eukaryotic organisms have shown that Rheb transmits environmental information through TOR-dependent and -independent pathways. Therefore, our results expand the range of signaling manners at which environmental conditions could impinge on the virulence of phytopathogenic fungi.

Incompatibility between proliferation and plant invasion is mediated by a regulator of appressorium formation in the corn smut fungus Ustilago maydis.

Plant pathogenic fungi often developed specialized infection structures to breach the outer surface of a host plant. These structures, called appressoria, lead the invasion of the plant by the fungal hyphae. Studies in different phytopathogenic fungi showed that appressorium formation seems to be subordinated to the cell cycle. This subordination ensures the loading in the invading hypha of the correct genetic information to proceed with plant infection. However, how the cell cycle transmits its condition to the genetic program controlling appressorium formation and promoting the plant's invasion is unknown. Our results have uncovered how this process occurs for the appressorium of Ustilago maydis, the agent responsible for corn smut disease. Here, we described that the complex Clb2-cyclin-dependent kinase (Cdk)1, one of the master regulators of G2/M cell cycle progression in U. maydis, interacts and controls the subcellular localization of Biz1, a transcriptional factor required for the activation of the appressorium formation. Besides, Biz1 can arrest the cell cycle by down-regulation of the gene encoding a second b-cyclin Clb1 also required for the G2/M transition. These results revealed a negative feedback loop between appressorium formation and cell cycle progression in U. maydis, which serves as a "toggle switch" to control the fungal decision between infecting the plant or proliferating out of the plant.

Spatial distribution patterns of tick community structure in sympatric jaguars (Panthera onca) and pumas (Puma concolor) from three ecoregions in Mexico.

We examined tick communities on wild felid hosts in three ecoregions of Mexico. We collected 186 ticks of 7 species from 10 pumas (Puma concolor) and 9 jaguars (Panthera onca). Tick community composition varied across the ecoregions, and across host species within each region. Overall, Ixodes affinis, Amblyomma ovale, and Amblyomma tenellum were the most abundant species; however, only the latter two ticks were distributed across all three ecoregions, while I. affinis, along with Ixodes spinipalpis, Amblyomma inornatum, and Amblyomma parvum were restricted to more limited geographical regions. Ixodes affinis occurred strictly in southern tropical rainforest ecoregions and was significantly more abundant in Selva Lacandona compared with the Yucatán Peninsula. Amblyomma ovale was significantly more common in the tropical dry forest in the Pacific coastal ecoregion. Amblyomma tenellum abundance tended to be higher on jaguars, while I. affinis abundance was higher on pumas. Regional distribution patterns of some tick species (e.g., I. affinis and I. spinipalpis) may be determined by off-host environmental conditions rather than host factors. In contrast, at the local scale, occurrence and abundance of some tick species (e.g., A. tenellum, A. ovale and Rhipicephalus microplus) might be driven by ecological-host factors, such as habitat use or predator-prey relationships.

Association study of dietary non-enzymatic antioxidant capacity (NEAC) and colorectal cancer risk in the Spanish Multicase-Control Cancer (MCC-Spain) study.

PURPOSE: Studies attempting to link dietary non-enzymatic antioxidant activity (NEAC) and colorectal cancer (CRC) risk have reported mixed results. We examined this association in the Spanish Multicase-Control Study considering the likely influence of coffee and other dietary factors. METHODS: 1718 CRC cases and 3312 matched-controls provided information about diet through a validated 140-item food frequency questionnaire. Dietary NEAC was estimated for three methods [total radical-trapping antioxidant parameters (TRAP), ferric reducing/antioxidant power (FRAP) and TEAC-ABTS] using published values of NEAC content in food, with and without coffee's NEAC. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated through unconditional logistic regression models adjusted for lifestyle and dietary factors. RESULTS: Overall dietary intake of NEAC was significantly lower in cases compared to controls and associated with a significantly reduced CRC risk, in both men (ORQ5vsQ1 = 0.67, 95% CI 0.47-0.96 for FRAP) and women (ORQ5vsQ1 = 0.53, 95% CI 0.32-085 for FRAP), in multivariate models with and without the antioxidant contribution from coffee. The effect was similar for all the NEAC methods evaluated and for both colon and rectum. The association between dietary NEAC and CRC risk became non-significant when adjusting for fiber intake. However, intakes of NEAC and fiber were correlated. CONCLUSION: This study indicates that intake of an antioxidant-rich plant-based diet, both with and without NEAC from coffee, is associated with decreased CRC risk.

Protein Phosphatase Ppz1 Is Not Regulated by a Hal3-Like Protein in Plant Pathogen Ustilago maydis.

Ppz enzymes are type-1 related Ser/Thr protein phosphatases that are restricted to fungi. In S. cerevisiae and other fungi, Ppz1 is involved in cation homeostasis and is regulated by two structurally-related inhibitory subunits, Hal3 and Vhs3, with Hal3 being the most physiologically relevant. Remarkably, Hal3 and Vhs3 have moonlighting properties, as they participate in an atypical heterotrimeric phosphopantothenoyl cysteine decarboxylase (PPCDC), a key enzyme for Coenzyme A biosynthesis. Here we identify and functionally characterize Ppz1 phosphatase (UmPpz1) and its presumed regulatory subunit (UmHal3) in the plant pathogen fungus Ustilago maydis. UmPpz1 is not an essential protein in U. maydis and, although possibly related to the cell wall integrity pathway, is not involved in monovalent cation homeostasis. The expression of UmPpz1 in S. cerevisiae Ppz1-deficient cells partially mimics the functions of the endogenous enzyme. In contrast to what was found in C. albicans and A. fumigatus, UmPpz1 is not a virulence determinant. UmHal3, an unusually large protein, is the only functional PPCDC in U. maydis and, therefore, an essential protein. However, when overexpressed in U. maydis or S. cerevisiae, UmHal3 does not reproduce Ppz1-inhibitory phenotypes. Indeed, UmHal3 does not inhibit UmPpz1 in vitro (although ScHal3 does). Therefore, UmHal3 might not be a moonlighting protein.

Virulence-specific cell cycle and morphogenesis connections in pathogenic fungi.

To initiate pathogenic development, pathogenic fungi respond to a set of inductive cues. Some of them are of an extracellular nature (environmental signals), while others are intracellular (developmental signals). These signals must be integrated into a single response whose major outcome is changes in the morphogenesis of the fungus. The regulation of the cell cycle is pivotal during these cellular differentiation steps; therefore, cell cycle regulation would likely provide control points for infectious development by fungal pathogens. Here, we provide clues to understanding how the control of the cell cycle is integrated with the morphogenesis program in pathogenic fungi, and we review current examples that support these connections.

Patient-Reported Mobility: A Systematic Review.

OBJECTIVES: To identify the self-administered instruments to assess mobility in adults with disability, to link the mobility assessed by these instruments to the International Classification of Functioning, Disability and Health (ICF), and to evaluate their methodological quality. DATA SOURCES: Scopus, Science Direct, and Web of Science were systematically searched up to July 2015. STUDY SELECTION: Studies on the development and validation of self-administered questionnaires in which at least half of the items were related to movement or mobility were included. DATA EXTRACTION: The mobility assessed by the instruments was classified according to the ICF categories. The methodological quality was assessed according to the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. DATA SYNTHESIS: Of 5791 articles, 34 studies were eligible for inclusion. Only 10 of the instruments contained items that exclusively assessed mobility. The most frequently linked ICF categories were "changing basic body position" (19.4%), "walking" (14.8%), and "moving around" (13.5%). Measurement properties evaluated included internal consistency (5 studies), reliability (5 studies), measurement error (1 study), content validity (9 studies), structural validity (4 studies), hypotheses testing (6 studies), and responsiveness (1 study). Only content validity obtained the highest quality, probably because the studies included in the review reported the development and initial validation of the instruments. CONCLUSIONS: Self-administered mobility questionnaires published in the scientific literature assess mobility activities rather than functions related to movement, and do so from the perspective of disability, frequently including self-care and domestic life as domains for assessment. The instruments that presented the highest methodological quality were the Outpatient Physical Therapy Improvement in Movement Assessment Log, the Movement Ability Measure, and the Mobility Activities Measure for Inpatient Rehabilitation Settings.

[Impact of the COVID-19 pandemic on cannabis use in young adults and general population: a systematic review]. / Impacto de la pandemia por la COVID-19 en el consumo de cannabis en jóvenes y población general: una revisión sistemática.

OBJECTIVE: The first COVID-19 lockdown was a very restrictive situation that may have impacted on the prevalence and patterns of cannabis use. The aim of this systematic review was to assess the evidence on cannabis use and reasons for use in different countries during first lockdown in young adults and general population. METHODS: This study followed PRISMA guidelines, and the review protocol was registered in PROSPERO (registration CRD42022303181). The search was carried out in PubMed, Scopus, Web of Science y Embase databases. Inclusion criteria were: cross-sectional or cohort studies; population ≥16 years; exploring cannabis use during lockdown; and English or Spanish language. RESULTS: Thirty studies, conducted in European countries (n=17), North America (n=12) and rest of the world (n=1), were analysed. The overall prevalence of cannabis use was found to be largely unchanged, but regular users tended to maintain (between 39.5% and 96.8% of the sample) or increase cannabis use (between 2.9% and 51.6%). The main decreases were among occasional users. Some reasons for the increase were boredom, loneliness, stress, coping and depressive symptoms. In addition, young people were the heaviest users, and being younger, live without family, financial problems and a low educational level were significantly (p-value<0.05) associated with increased use. CONCLUSIONS: Most regular users maintained or slightly increased their use, with young people being the main users. Concerning reasons for use like coping and depressive symptoms were found. Cannabis use needs to be addressed with strategies focused on the young population, considering occasional and regular use, as well as motivations.

OBJETIVO: El primer confinamiento por la COVID-19 fue una situación muy restrictiva que pudo haber impactado sobre la prevalencia y los patrones de consumo de cannabis. El objetivo de esta revisión sistemática fue evaluar la evidencia sobre el consumo y los motivos de consumo de cannabis en diferentes países durante el primer confinamiento en adultos jóvenes y población general. METODOS: Este estudio siguió las directrices PRISMA y el protocolo de revisión se registró en PROSPERO (registro CRD42022303181). Se realizó una búsqueda en las bases de datos PubMed, Scopus, Web of Science y Embase en julio de 2023. Los criterios de inclusión fueron: estudios transversales o de cohortes; población con edad igual o mayor de 16 años; explorar el consumo durante el confinamiento; e idioma inglés o español. RESULTADOS: Se analizaron treinta estudios, realizados en países europeos (n=17), norteamericanos (n=12) y resto del mundo (n=1). Se observó que la prevalencia global de consumo de cannabis no experimentó grandes cambios, pero los consumidores regulares tendieron a mantener (entre el 39,5% y el 96,8% de la muestra) o a incrementar el consumo (entre el 2,9% y el 51,6%). Las principales disminuciones se dieron en consumidores ocasionales. Algunos motivos para el aumento fueron aburrimiento, soledad, estrés, afrontamiento y síntomas depresivos. Además, los jóvenes fueron los mayores consumidores y ser más joven, vivir sin la familia, los problemas financieros y un bajo nivel de estudios se asociaron significativamente (p-valor menor de 0,05) con el aumento del consumo. CONCLUSIONES: La mayor parte de consumidores regulares mantuvieron o aumentaron ligeramente su consumo, siendo los jóvenes los principales consumidores. Se encontraron motivos de consumo alarmantes como el afrontamiento y los síntomas depresivos. Es necesario que el consumo de cannabis se aborde con estrategias enfocadas en la población joven, considerando el consumo ocasional y regular, así como las motivaciones.

Leisure-time physical activity and gastric cancer risk: A pooled study within the Stomach cancer Pooling (StoP) Project.

BACKGROUND: Although physical activity (PA) has been recognized as a favourable factor in the prevention of various diseases, including certain forms of cancer, the relationship between PA and gastric cancer (GC) is not yet fully understood. This study aims to provide data from a pooled analysis of case-control studies within the Stomach cancer Pooling (StoP) Project to estimate the association between leisure-time PA and the occurrence of GC. METHODS: Six case-control studies from StoP project collected data on leisure-time PA, for a total of 2,343 cases and 8,614 controls. Subjects were classified into three leisure-time PA categories, either none/low, intermediate or high, based on study-specific tertiles. We used a two-stage approach. Firstly, we applied multivariable logistic regression models to obtain study-specific odds ratios (ORs) and corresponding 95% confidence intervals (CIs) then, we used a random-effect models to obtain pooled effect estimates. We performed stratified analyses according to demographic, lifestyle and clinical covariates. RESULTS: The meta-analysis showed ORs of GC with no significant differences between intermediate vs low and high vs low PA level (OR 1.05 [95%CI 0.76-1.45]; OR 1.23 [95%CI 0.78-1.94], respectively). GC risk estimates did not strongly differ across strata of selected covariates except for age ≤ 55 years old (high vs low level: OR 0.72 [95%CI 0.55-0.94]) and for control population-based studies (high vs low level: OR 0.79 [95%CI 0.68-0.93]). CONCLUSIONS: No association was found between leisure time PA and GC, apart from a slight suggestion of decreased risk below age 55 and in control population-based studies. These results may reflect specific characteristics of GC at a younger age, or the presence of a cohort effect mediating and interacting with socioeconomic determinants of GC The different distribution of PA levels among hospitalized controls could have led to an underestimated effect of PA on GC risk.

[Municipal distribution and trend of the incidence of stomach cancer in the health area of León, Spain (1994-2008)]. / Tendencia y distribución municipal de la incidencia de cáncer de estómago en el área de salud de León (1994-2008).

BACKGROUND: Stomach cancer is common and has a high mortality rate. The aim of this study was to analyze the incidence and trend of gastric cancer in the health area of León. METHODS: We designed an observational descriptive study that included patients enrolled in the Hospital Tumor Registry of the Centro Asistencial Universitario de León with a diagnosis of malignant neoplasm of the stomach (ICD 9-151, ICD10-C16) between 01/01/1994 and 12/31/2008 and resident in the health area of León. The population supplied by Spain's National Institute of Statistics was used as the denominator. The time trend was evaluated with a Poisson regression model. To study the spatial distribution, we estimated municipal relative risks (RR) smoothed by fitting the Besag, York and Mollié model and the posterior probability (PP) of RR>1 using bayesian methods. RESULTS: A total of 1680 cases were included. The average crude incidence rate was 40.0 new cases per 100,000 in men and 23.5 for women. The incidence decreased by 1.4% per year (men: 1.2%, women: 1.8%). The age adjusted rates (European standard population) decreased from 26.9 (1994-6) to 22.2 (2006-8) new cases per 100,000 population in men and from 13.3 to 9.5 in women. Three geographical areas showed a RR excess with a PP higher than 0.9. CONCLUSIONS: The observed rates are among the highest in Spain and their declining trend is lower than expected. Some municipalities had an excess risk.

[Municipal distribution and trends in the incidence of colorectal cancer in the health area of Leon (1994-2008)]. / Tendencia y distribución municipal de la incidencia de cáncer colorrectal en el área de salud de León (1994-2008).

BACKGROUND: There is an excess incidence of colorectal cancer (CRC) and mortality from this disease in the health area of Leon. The aim of the present study was to determine trends in CRC and its geographical distribution. METHODS: Cases included in the Hospital Registry of Tumors of the Centro Asistencial Universitario de León from 1994-2008 and occurring in patients residing in the health area of Leon were studied. Time trends were evaluated with a Poisson regression model. To analyze geographical distribution, the smoothed relative risks (RR) of the municipalities adjusted by the Besag, York and Mollié model were calculated, and their subsequent probability of an RR>1 (PP) was calculated using Bayesian methods. RESULTS: A total of 4,136 cases were included. Rates standardized to the European standard population ranged from 49.6 (1994-6) to 63.5 new cases per 100,000 inhabitants in men (2006-8) and from 29.6 to 33.8 in women. An annual 2% increase was found for all localizations, ranging from 1.8% in the rectum to 3.6% in the proximal colon. In all localizations, the increase was greater in men than in women. Several municipalities in the health area of Leon showed an excess risk. The geographical pattern observed was due especially to the distribution of colon cancer. CONCLUSIONS: The incidence rates observed were high and were increasing. Special attention should be paid to CRC in the health area of Leon, mainly in the municipalities with excess risk.

Robust Cre recombinase activity in the biotrophic smut fungus Ustilago maydis enables efficient conditional null mutants in planta.

Site-specific recombinases have been used in higher eukaryotes, especially in animals, for a broad range of applications, including chromosomal translocations, large deletions, site-specific integration, and tissue-specific as well as conditional knock-outs. The application of site-specific recombination has also been demonstrated in simple eukaryotes like fungi and protozoa. However, its use in fungal research, especially in phytopathogenic fungi, has often been limited to "recycle" the marker genes used in transformation experiments. We show that Cre recombinase can be used for conditional gene deletions in the phytopathogenic fungus Ustilago maydis. Conditional gene knock-outs can be generated via the transcriptional control of the recombinase by U. maydis promoters specifically activated during the biotrophic phase of fungal growth, enabling gene deletions at defined developmental stages inside the plant tissue. Also, we show that a tamoxifen-activated Cre-recombinase allows the tight control necessary for the induced deletion of essential genes by the addition of tamoxifen. These tools will be helpful to address the function of genes under both axenic and in planta conditions for the U. maydis-maize pathosystem and should pave the way for similar approaches in other plant pathosystems.

Relationship between Aldehyde Dehydrogenase, PD-L1 and Tumor-Infiltrating Lymphocytes with Pathologic Response and Survival in Breast Cancer.

Aldehyde dehydrogenase 1A1 (ALDH1A1) is a cancer stem cell (CSC) marker related to clinical outcomes in breast cancer (BC). The aim of this study was to analyze the relationship between ALDH1A1, programmed death ligand 1 (PD-L1) and tumor-infiltrating lymphocytes (TILs) in triple negative (TN) and human epidermal growth factor receptor 2-positive (HER2+) BC tumors, and its association with clinicopathological characteristics and outcomes. A retrospective, historical cohort study of patients diagnosed with early or locally advanced BC treated with neoadjuvant chemotherapy was conducted. ALDH1A1, PD-L1 expression and TILs were assessed using immunohistochemistry. A total of 75 patients were analyzed (42.7% TN, 57.3% HER2+ tumors). ALDH1A1+ was related to HTILs (p = 0.005) and PD-L1+ tumors (p = 0.004). ALDH1A1+ tumors presented higher CD3+ (p = 0.008), CD4+ (p = 0.005), CD8+ (p = 0.003) and CD20+ (p = 0.006) TILs. ALDH1A1+ (p = 0.018), PD-L1+ (p = 0.004) and HTILs (p < 0.001) were related to smaller tumors. ALDH1A1+ was related to pathologic complete response (pCR) (p = 0.048). At the end of the follow-up (54.4 [38.3−87.6] months), 47 patients (62.7%) remained disease-free, and 20 (26.7%) had died. HTILs were related to improved disease-free survival (p = 0.027). ALDH1A1+ was related to PD-L1+ and HITLs, that might be related to higher pCR rates with neoadjuvant therapy.

Toenail zinc as a biomarker: Relationship with sources of environmental exposure and with genetic variability in MCC-Spain study.

BACKGROUND: Toenails are commonly used as biomarkers of exposure to zinc (Zn), but there is scarce information about their relationship with sources of exposure to Zn. OBJECTIVES: To investigate the main determinants of toenail Zn, including selected sources of environmental exposure to Zn and individual genetic variability in Zn metabolism. METHODS: We determined toenail Zn by inductively coupled plasma mass spectrometry in 3,448 general population controls from the MultiCase-Control study MCC-Spain. We assessed dietary and supplement Zn intake using food frequency questionnaires, residential proximity to Zn-emitting industries and residential topsoil Zn levels through interpolation methods. We constructed a polygenic score of genetic variability based on 81 single nucleotide polymorphisms in genes involved in Zn metabolism. Geometric mean ratios of toenail Zn across categories of each determinant were estimated from multivariate linear regression models on log-transformed toenail Zn. RESULTS: Geometric mean toenail Zn was 104.1 µg/g in men and 100.3 µg/g in women. Geometric mean toenail Zn levels were 7 % lower (95 % confidence interval 1-13 %) in men older than 69 years and those in the upper tertile of fibre intake, and 9 % higher (3-16 %) in smoking men. Women residing within 3 km from Zn-emitting industries had 4 % higher geometric mean toenail Zn levels (0-9 %). Dietary Zn intake and polygenic score were unrelated to toenail Zn. Overall, the available determinants only explained 9.3 % of toenail Zn variability in men and 4.8 % in women. DISCUSSION: Sociodemographic factors, lifestyle, diet, and environmental exposure explained little of the individual variability of toenail Zn in the study population. The available genetic variants related to Zn metabolism were not associated with toenail Zn.

Acute heart failure in subtropical climates: clinical characteristics, management, and outcomes in the Canary Islands versus continental Spain - the CANAR-ICA study results. / Características clínicas, asistenciales y evolutivas de la insuficiencia cardiaca aguda en el clima subtropical: resultados del estudio CANAR-ICA.

OBJECTIVES: To determine whether there are differences in the clinical characteristics, management, and outcome of episodes of acute heart failure (AHF) in residents of the Canary Islands, where the climate is subtropical, and episodes in continental Spain. MATERIAL AND METHODS: Cases were identified in the registry for Epidemiology of Acute Heart Failure in Emergency Departments and categorized as in the Canary Islands or continental Spain. Data for 38 demographic, baseline, clinical, and therapeutic variables were extracted. We analyzed statistics for in-hospital and 30-day mortality, long hospital stay (more than 7 days), and a composite outcome after discharge (revisits or death within 30 days). The results for island and continental patients were compared and adjusted for between-group differences. RESULTS: A total of 18 390 patients were studied, 697 islanders (3.8%) and 17 673 continental patients (96.2%). Comparisons showed that the islanders were younger; more often women; and more likely to have hypertension, diabetes, and a prior AHF episode. Their New York Heart Association functional class was also likely to be higher. However, their rates of dyslipidemia, valve disease, and functional dependence were lower, and they were also less likely to be on reninangiotensin system blockers. Although the severity of cardiac decompensation was similar in island and continental patients, the islanders received more intravenous treatments in the emergency department and were admitted less often. The adjusted risk of a long hospital stay was higher for the islanders (odds ratio [OR], 2.36; 95% CI, 1.52-3.02) but their risk for mortality and the composite outcome did not differ: in-hospital mortality, OR 0.97 (95% CI, 0.68-1.37); 30-day mortality, OR, 0.9 (95% CI, 0.67-1.27); and the post-discharge composite, OR, 1.19 (95% CI, 0.93-1.53). CONCLUSION: Baseline patient characteristics and clinical management of AHF episodes differ between the subtropical region and those in southern continental Europe. Hospitalization was required less often, but hospital stays were longer.

OBJETIVO: Investigar si existen diferencias clínicas, asistenciales y evolutivas entre los episodios de insuficiencia cardiaca aguda (ICA) desarrollados en residentes en las Islas Canarias (CAN), de clima subtropical, y en los del territorio español continental (CON). METODO: . Los pacientes con ICA incluidos en el registro EAHFE se dividieron en CAN o CON. Se recogieron 38 variables demográficas, de estado clínico basal, clínicas y terapéuticas. Se analizó la mortalidad intrahospitalaria y a los 30 días, la hospitalización prolongada (> 7 días) y el evento combinado post-alta (reconsulta o muerte a 30 días). Se compararon los pacientes CAN y CON, ajustando los resultados por las diferencias entre grupos. RESULTADOS: Se incluyeron 18.390 pacientes: CAN = 697 (3,8%), CON = 17.673 (96,2%). Tras el ajuste, los CAN eran más jóvenes, más frecuentemente mujeres, tenían más antecedentes de hipertensión, diabetes e ICA previa, y estaban en clase funcional más avanzada, pero tenían menos dislipemia, valvulopatías y dependencia funcional, y recibían menos frecuentemente inhibidores del eje renina-angiotensina. Aunque la gravedad del episodio de descompensación fue similar, los CAN recibían más tratamientos endovenosos en urgencias y se hospitalizaban menos. El riesgo ajustado de hospitalización prolongada en los CAN resultó incrementado (OR 2,36; IC 95%:1,52-3,02), pero no hubo diferencias en la mortalidad intrahospitalaria (OR 0,97; IC 95%: 0,68-1,37), a 30 días (OR 0,9; IC 95%: 0,67-1,27) o en los eventos combinados post-alta a los 30 días (OR 1,19; IC 95%: 0,93-1,53). CONCLUSIONES: Existen diferencias tanto en las características basales como en el manejo clínico de los episodios de insuficiencia cardiaca en los residentes de una región subtropical respecto a los de una zona meridional europea. Además, tienen menor necesidad de hospitalización, aunque estas son más prolongadas.

Reliability and Validity of a Questionnaire for Assessing Self-Perceived Health-Related Fitness in Spanish Children.

There is a need for developing tools aimed at assessing fitness in children, due to its relationship with health. This study is aimed at testing the reliability and the validity of a questionnaire designed for assessing self-perceived health-related fitness in Spanish children. The questionnaire was created based on the model of physical self-concept developed by Fox and Corbin (1989) who conceived four sub-domains: Sport competence, attractive body, strength and physical condition. A total of 283 children (mean age: 10.80 ± 0.69 years; 45.6% girls) answered the questionnaire twice, in order to determine its test-retest reliability. The results obtained in the International Fitness Scale (IFIS) and on a fitness battery were used to determine its validity evidence based on relations to other variables. Exploratory and factorial analyses were performed to check its validity evidence based on internal structure. The obtained results indicated that the questionnaire showed an accurate validity evidence based on internal structure and a very good test-retest reliability, Intraclass correlation coefficient: .88; 95% CI [.84, .90]. The questionnaire established moderate correlations with the IFIS questionnaire (ρ = -.51 to -.68) and the fitness level showed by the children (ρ = -.53). These findings indicate that the questionnaire can be a useful research tool for assessing self-perceived health-related fitness in children.

Analysis of Killer Immunoglobulin-Like Receptor Genes in Colorectal Cancer.

Natural killer cells (NK cells) play a major role in the immune response to cancer. An important element of NK target recognition is the binding of human leucocyte antigen (HLA) class I molecules by killer immunoglobulin-like receptors (KIRs). Colorectal carcinoma (CRC) is one of the most common types of inflammation-based cancer. The purpose of the present study was to investigate the presence of KIR genes and HLA class I and II alleles in 1074 CRC patients and 1272 controls. We imputed data from single-nucleotide polymorphism (SNP) Illumina OncoArray to identify associations at HLA (HLA-A, B, C, DPB1, DQA1, DQB1, and DRB1) and KIRs (HIBAG and KIR*IMP, respectively). For association analysis, we used PLINK (v1.9), the PyHLA software, and R version 3.4.0. Only three SNP markers showed suggestive associations (p < 10-3; rs16896742, rs28367832, and rs9277952). The frequency of KIR2DS3 was significantly increased in the CRC patients compared to healthy controls (p < 0.005). Our results suggest that the implication of NK cells in CRC may not act through allele combinations in KIR and HLA genes. Much larger studies in ethnically homogeneous populations are needed to rule out the possible role of allelic combinations in KIR and HLA genes in CRC risk.

Menstrual Problems and Lifestyle among Spanish University Women.

Menstrual problems affect many young women worldwide, conditioning both their academic performance and quality of life. This study sought to analyse the prevalence of menstrual problems and their possible relationship with lifestyle among Spanish university women, as part of a research project (UniHcos Project) involving a cohort of 11 Spanish universities with 7208 university students. A descriptive analysis was performed using the bivariate chi-square test and the Student's t-test together with a binary logistic regression, in which the dependent variable was 'suffering from menstrual problems'. Menstrual problems were identified in 23.8% of the students, representing women who paid more visits to the doctor and to emergency rooms, and who consumed more painkillers and contraceptives. In relation to dietary preferences, menstrual problems were 1.39 (CI 95% 1.22-1.61; p = 0.000) times more likely among women classified as high-risk alcohol users according to the AUDIT questionnaire, and 1.187 (CI 95% 1.029-1.370; p = 0.019) times greater among those who consumed sweets daily, 1.592 (CI 95% 1.113-2.276; p = 0.011) times more frequent among those who eat fish daily, and 1.199 (CI 95% 1.004-1.432; p = 0.045) times greater among those who were dieting. Menstrual problems affect many college students and potentially modifiable lifestyle variables exist which may influence their prevalence. It would be interesting to develop programmes to promote women's health in the university context.

Dietary Constituents: Relationship with Breast Cancer Prognostic (MCC-SPAIN Follow-Up).

The aim of this study was to characterize the relationship between the intake of the major nutrients and prognosis in breast cancer. A cohort based on 1350 women with invasive (stage I-IV) breast cancer (BC) was followed up. Information about their dietary habits before diagnosis was collected using a semi-quantitative Food Frequency Questionnaire. Participants without FFQ or with implausible energy intake were excluded. The total amount consumed of each nutrient (Kcal/day) was divided into tertiles, considering as "high intakes" those above third tertile. The main effect studied was overall survival. Cox regression was used to assess the association between death and nutrient intake. During a median follow-up of 6.5 years, 171 deaths were observed. None of the nutrients analysed was associated with mortality in the whole sample. However, in normal-weight women (BMI 18.5-25 kg/m2) a high intake of carbohydrates (≥809 Kcal/day), specifically monosaccharides (≥468 Kcal/day), worsened prognostic compared to lowest (≤352 Kcal/day). Hazard Ratios (HRs) for increasing tertiles of intake were HR:2.22 95% CI (1.04 to 4.72) and HR:2.59 95% CI (1.04 to 6.48), respectively (p trend = 0.04)). Conversely, high intakes of polyunsaturated fats (≥135 Kcal/day) improved global survival (HR: 0.39 95% CI (0.15 to 1.02) p-trend = 0.05) compared to the lowest (≤92.8 kcal/day). In addition, a protective effect was found substituting 100 kcal of carbohydrates with 100 kcal of fats in normal-weight women (HR: 0.76 95% CI (0.59 to 0.98)). Likewise, in premenopausal women a high intake of fats (≥811 Kcal/day) showed a protective effect (HR:0.20 95% CI (0.04 to 0.98) p trend = 0.06). Finally, in Estrogen Receptors (ER) negative tumors, we found a protective effect of high intake of animal proteins (≥238 Kcal/day, HR: 0.24 95% CI (0.06 to 0.98). According to our results, menopausal status, BMI and ER status could play a role in the relationship between diet and BC survival and must be taken into account when studying the influence of different nutrients.