Balanced crystalloid solutions versus 0.9% saline for treating acute diarrhoea and severe dehydration in children.

BACKGROUND: Although acute diarrhoea is a self-limiting disease, dehydration may occur in some children. Dehydration is the consequence of an increased loss of water and electrolytes (sodium, chloride, potassium, and bicarbonate) in liquid stools. When these losses are high and not replaced adequately, severe dehydration appears. Severe dehydration is corrected with intravenous solutions. The most frequently used solution for this purpose is 0.9% saline. Balanced solutions (e.g. Ringer's lactate) are alternatives to 0.9% saline and have been associated with fewer days of hospitalization and better biochemical outcomes. Available guidelines provide conflicting recommendations. It is unclear whether 0.9% saline or balanced intravenous fluids are most effective for rehydrating children with severe dehydration due to diarrhoea. OBJECTIVES: To evaluate the benefits and harms of balanced solutions for the rapid rehydration of children with severe dehydration due to acute diarrhoea, in terms of time in hospital and mortality compared to 0.9% saline. SEARCH METHODS: We used standard, extensive Cochrane search methods. The latest search date was 4 May 2022. SELECTION CRITERIA: We included randomized controlled trials in children with severe dehydration due to acute diarrhoea comparing balanced solutions, such as Ringer's lactate or Plasma-Lyte with 0.9% saline solution, for rapid rehydration. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were 1. time in hospital and 2. MORTALITY: Our secondary outcomes were 3. need for additional fluids, 4. total amount of fluids received, 5. time to resolution of metabolic acidosis, 6. change in and the final values of biochemical measures (pH, bicarbonate, sodium, chloride, potassium, and creatinine), 7. incidence of acute kidney injury, and 8. ADVERSE EVENTS: We used GRADE to assess the certainty of the evidence. MAIN RESULTS: Characteristics of the included studies We included five studies with 465 children. Data for meta-analysis were available from 441 children. Four studies were conducted in low- and middle-income countries and one study in two high-income countries. Four studies evaluated Ringer's lactate, and one study evaluated Plasma-Lyte. Two studies reported the time in hospital, and only one study reported mortality as an outcome. Four studies reported final pH and five studies reported bicarbonate levels. Adverse events reported were hyponatremia and hypokalaemia in two studies each. Risk of bias All studies had at least one domain at high or unclear risk of bias. The risk of bias assessment informed the GRADE assessments. Primary outcomes Compared to 0.9% saline, the balanced solutions likely result in a slight reduction of the time in hospital (mean difference (MD) -0.35 days, 95% confidence interval (CI) -0.60 to -0.10; 2 studies; moderate-certainty evidence). However, the evidence is very uncertain about the effect of the balanced solutions on mortality during hospitalization in severely dehydrated children (risk ratio (RR) 0.33, 95% CI 0.02 to 7.39; 1 study, 22 children; very low-certainty evidence). Secondary outcomes Balanced solutions probably produce a higher increase in blood pH (MD 0.06, 95% CI 0.03 to 0.09; 4 studies, 366 children; low-certainty evidence) and bicarbonate levels (MD 2.44 mEq/L, 95% CI 0.92 to 3.97; 443 children, four studies; low-certainty evidence). Furthermore, balanced solutions likely reduces the risk of hypokalaemia after the intravenous correction (RR 0.54, 95% CI 0.31 to 0.96; 2 studies, 147 children; moderate-certainty evidence). Nonetheless, the evidence suggests that balanced solutions may result in no difference in the need for additional intravenous fluids after the initial correction; in the amount of fluids administered; or in the mean change of sodium, chloride, potassium, and creatinine levels. AUTHORS' CONCLUSIONS: The evidence is very uncertain about the effect of balanced solutions on mortality during hospitalization in severely dehydrated children. However, balanced solutions likely result in a slight reduction of the time in the hospital compared to 0.9% saline. Also, balanced solutions likely reduce the risk of hypokalaemia after intravenous correction. Furthermore, the evidence suggests that balanced solutions compared to 0.9% saline probably produce no changes in the need for additional intravenous fluids or in other biochemical measures such as sodium, chloride, potassium, and creatinine levels. Last, there may be no difference between balanced solutions and 0.9% saline in the incidence of hyponatraemia.

Problematic Internet Use among adolescents: Spanish validation of the Compulsive Internet Use Scale (CIUS). / Uso Problemático de Internet en adolescentes: Validación en español de la Escala de Uso Compulsivo de Internet (CIUS).

Problematic use of the Internet among adolescents has risen in the last decade. The Compulsive Internet Use Scale (CIUS) is one of the most frequently internationally-used tools developed to assess Problematic Internet Use (PIU). However, evidence concerning its validity and reliability in its Spanish version for the adolescent population is currently lacking. Thus, the main goal of the present study was to analyse the psychometric properties of CIUS scores in a large sample of Spanish adolescents. The sample consisted of 1,790 participants (53.7% female, mean age = 15.70 years old, SD = 1.26). The one-dimensional model displayed appropriate goodness of fit indices after error covariance of five items were allowed to correlate. Strong measurement invariance was found for the one-dimensional model across age and gender. The McDonald's Omega coefficient for the total score was 0.91. Furthermore, PIU was positively associated with different indicators of poor wellbeing and psychological difficulties and negatively associated with prosocial behaviour, self-esteem and sense of belonging to the educational centre. The study provided evidence of validity for the CIUS, confirming its utility for screening PIU in non-clinical adolescents.

La Escala de Uso Compulsivo de Internet (Compulsive Internet Use Scale, CIUS) es uno de los instrumentos más empleados a nivel internacional para evaluar el Uso Problemático de Internet (UPI). Sin embargo, no existen evidencias de validez y fiabilidad de las puntuaciones de la versión española en población adolescente. Por ello, el principal objetivo de este estudio fue analizar las propiedades psicométricas de las puntuaciones de la CIUS en una muestra representativa de adolescentes españoles. La muestra contó con 1.790 participantes (53,7% mujeres, edad media = 15,70 años, DT = 1,26). El análisis de la estructura interna del instrumento mostró unos índices de bondad de ajuste apropiados para el modelo unidimensional después de que se permitiera correlacionar la covarianza de errores de cinco ítems. Se encontró invarianza de medición fuerte para el modelo unidimensional en las variables de edad y género. El coeficiente Omega de McDonald para la puntuación total fue 0,91. Además, el UPI se asoció positivamente con diferentes indicadores de malestar y dificultades psicológicas y negativamente con el comportamiento prosocial, la autoestima y el sentido de pertenencia al centro educativo. Este estudio arroja evidencias de validez de la CIUS, y sugiere que puede ser una herramienta apropiada para medir el UPI en adolescentes de la población general.

Relationship between substance use and schizotypal traits in school-aged adolescents. / Relación entre consumo de sustancias y rasgos esquizotípicos en adolescentes escolarizados.

GOAL: The main goal of the present study was to analyze the relationship between substance use (tobacco, alcohol, cannabis) and schizotypal traits in a representative sample of school-aged adolescents from the general population. METHOD: cross-sectional, descriptive survey 1,588 students (M = 16.13 years, SD = 1.36), 739 male (46.5%), selected by random stratified cluster sampling, participated in the study. The instruments administered were the Oviedo Questionnaire for Schizotypy Assessment, the Modified Substance Use Questionnaire, the Strengths and Difficulties Questionnaire, the Penn Matrix Reasoning Test, the Family Affluence Scale-II, and the Oviedo Infrequency Scale. RESULTS: Controlling for the effects of multiple covariates (gender, age, IQ, socio-economic level, psychopathology and consumption), the results showed that compared with non-users, alcohol drinkers reported higher average scores in the Social Disorganization dimension. Cigarette smokers, differentiated by frequency, reported higher average scores in the Anhedonia and Social Disorganization dimensions than non-smokers. No statistically significant differences between users and non-users of cannabis were found in terms of schizotypal traits. CONCLUSION: controlling for the effects of multiple covariates, adolescents who use tobacco and alcohol reported higher scores - depending on frequency of use - in schizotypal traits. Future studies should continue to analyze the role of substance use in individuals at risk of psychosis and determine its role in the transition to serious mental disorders using new methodologies such as ambulatory assessment.

Objetivo: analizar la posible relación entre el consumo de sustancias psicoactivas (en concreto, tabaco, alcohol y cannabis) y los rasgos esquizotípicos en una muestra representativa de adolescentes escolarizados de la población general.  Método: diseño transversal descriptivo tipo encuesta. La muestra se compuso por 1.588 estudiantes (M = 16,13 años; DT = 1,36; 739 varones, 46,5%), seleccionados mediante muestreo aleatorio estratificado por conglomerados. Los instrumentos administrados fueron el Cuestionario Oviedo para la Evaluación de la Esquizotipia, el Cuestionario de Consumo de Sustancias Modificado, el Cuestionario de Capacidades y Dificultades, el Penn Matrix Reasoning Test, la Family Affluence Scale-II y la Escala Oviedo de Infrecuencia de Respuesta. Resultados: una vez controlado el efecto de múltiples covariables (género, edad, cociente intelectual, nivel socio-económico, psicopatología previa y consumo de sustancias), los consumidores de alcohol comparados con los no consumidores, informaron de mayores puntuaciones medias en la dimensión Desorganización Social. Los consumidores de tabaco comparados con los no consumidores, informaron de mayores puntuaciones medias en las dimensiones de esquizotipia de Anhedonia y Desorganización Social. Con respecto al consumo de cannabis, no se hallaron diferencias estadísticamente significativas entre consumidores y no consumidores en las dimensiones esquizotípicas. Conclusiones: controlando el efecto de múltiples variables de confundido, los adolescentes consumidores de tabaco y alcohol ­según su frecuencia­ informaron de mayores puntuaciones en rasgos esquizotípicos. Futuros estudios podrían continuar analizando el papel del consumo de sustancias en la aparición de trastornos mentales, como la psicosis, mediante nuevas metodologías como la evaluación ambulatoria.

Psychotic-like experiences and cannabis use in adolescents from the general population. / Experiencias psicóticas atenuadas y consumo de cannabis en adolescentes de la población general.

The purpose of this study was to analyze the relationship between psychotic-like experiences and cannabis use in a representative sample of adolescents from the general population. A total of 1,588 students (M=16.13 years, SD = 1.36), 739 men (46.5%), selected by stratified random sampling by conglomerates from 98 classes in 34 schools participated in the survey. The instruments used were the Prodromal Questionnaire-Brief, the Strengths and Difficulties Questionnaire, the Modified Substance Use Questionnaire, the Penn Matrix Reasoning Test, the Family Affluence Scale-II, and the Oviedo Infrequency Scale. Results showed that a percentage of adolescents reported psychotic-like experiences and/or cannabis use. Prior to controlling for multiple confounders (gender, age, socio-economic level, alcohol use, smoking, emotional and behavioral problems, and IQ), cannabis use was associated with psychotic-like experiences. After adjustment for confounders, psychotic-like experiences were not seen to be associated with cannabis use. Mediational analyses showed that emotional and behavioral problems mediate the relationship between cannabis use and risk of psychosis. It seems that once the effect of multiple confounding variables is controlled for, the use of cannabis increases the risk of comorbid psychopathology and this in turn increases the risk of psychosis. These results suggest that the relationships established between psychotic experiences and cannabis are complex and mediated by relevant variables. Further studies should examine this relationship in follow-up studies and gene-environmental designs.

El propósito de este estudio fue analizar la relación entre las experiencias psicóticas atenuadas y el consumo de cannabis en una muestra representativa de adolescentes de la población general. Un total de 1,588 estudiantes (M=16,13 años; DT = 1,36), 739 eran hombres (46,5%), pertenecientes a 34 escuelas y 98 aulas, seleccionados mediante muestreo aleatorio estratificado por conglomerados, fueron encuestados. Los instrumentos administrados fueron el Cuestionario de Pródromos de Psicosis-Breve, el Cuestionario de Capacidades y Dificultades, el Cuestionario de Consumo de Sustancias Modificado, el Penn Matrix Reasoning Test (PMRT), la Family Affluence Scale-II y la Escala Oviedo de Infrecuencia de Respuesta. Los resultados mostraron que un porcentaje de adolescentes informaron de experiencias psicóticas atenuadas y/o consumo de cannabis. Antes de controlar el efecto de múltiples covariables (género, edad, nivel socio-económico, consumo de tabaco, problemas emocionales y CI), los jóvenes consumidores de cannabis informaron de un mayor riesgo teórico de psicosis. Cuando se controló el efecto de las covariables, las experiencias psicóticas no se asociaron con el consumo de cannabis. El análisis mediacional indicó que los problemas en el ajuste emocional y comportamental mediaban en la relación entre consumo de cannabis y experiencias psicotiformes. Parece ser que, una vez controlado el efecto de las múltiples variables de confundido, el uso de cannabis aumenta el riesgo de psicopatología comórbida y esta a su vez el riesgo de psicosis (mayor frecuencia de experiencias psicóticas). Estos resultados sugieren que la relación que se establece entre las experiencias psicóticas y el cannabis es compleja y se encuentra mediada por variables relevantes. Futuros estudios deberán examinar las interacciones Gen x Ambiente en estudios longitudinales.

Cell therapy for spinal cord injury with olfactory ensheathing glia cells (OECs).

The prospects of achieving regeneration in the central nervous system (CNS) have changed, as most recent findings indicate that several species, including humans, can produce neurons in adulthood. Studies targeting this property may be considered as potential therapeutic strategies to respond to injury or the effects of demyelinating diseases in the CNS. While CNS trauma may interrupt the axonal tracts that connect neurons with their targets, some neurons remain alive, as seen in optic nerve and spinal cord (SC) injuries (SCIs). The devastating consequences of SCIs are due to the immediate and significant disruption of the ascending and descending spinal pathways, which result in varying degrees of motor and sensory impairment. Recent therapeutic studies for SCI have focused on cell transplantation in animal models, using cells capable of inducing axon regeneration like Schwann cells (SchCs), astrocytes, genetically modified fibroblasts and olfactory ensheathing glia cells (OECs). Nevertheless, and despite the improvements in such cell-based therapeutic strategies, there is still little information regarding the mechanisms underlying the success of transplantation and regarding any secondary effects. Therefore, further studies are needed to clarify these issues. In this review, we highlight the properties of OECs that make them suitable to achieve neuroplasticity/neuroregeneration in SCI. OECs can interact with the glial scar, stimulate angiogenesis, axon outgrowth and remyelination, improving functional outcomes following lesion. Furthermore, we present evidence of the utility of cell therapy with OECs to treat SCI, both from animal models and clinical studies performed on SCI patients, providing promising results for future treatments.

Olfactory Ensheathing Cell-Conditioned Medium Reverts Aß25-35-Induced Oxidative Damage in SH-SY5Y Cells by Modulating the Mitochondria-Mediated Apoptotic Pathway.

Olfactory ensheathing cells (OECs) are a type of glia from the mammalian olfactory system, with neuroprotective and regenerative properties. ß-Amyloid peptides are a major component of the senile plaques characteristic of the Alzheimer brain. The amyloid beta (Aß) precursor protein is cleaved to amyloid peptides, and Aß25-35 is regarded to be the functional domain of Aß, responsible for its neurotoxic properties. It has been reported that Aß25-35 triggers reactive oxygen species (ROS)-mediated oxidative damage, altering the structure and function of mitochondria, leading to the activation of the mitochondrial intrinsic apoptotic pathway. Our goal is to investigate the effects of OECs on the toxicity of aggregated Aß25-35, in human neuroblastoma SH-SY5Y cells. For such purpose, SH-SY5Y cells were incubated with Aß25-35 and OEC-conditioned medium (OECCM). OECCM promoted the cell viability and reduced the apoptosis, and decreased the intracellular ROS and the lipid peroxidation. In the presence of OECCM, mRNA and protein levels of antioxidant enzymes (SOD1 and SOD2) were upregulated. Concomitantly, OECCM decreased mRNA and the protein expression levels of cytochrome c, caspase-9, caspase-3, and Bax in SH-SY5Y cells, and increased mRNA and the protein expression level of Bcl-2. However, OECCM did not alter intracellular Ca2+ concentration in SH-SY5Y cells. Taken together, our data suggest that OECCM ameliorates Aß25-35-induced oxidative damage in neuroblastoma SH-SY5Y cells by inhibiting the mitochondrial intrinsic pathway. These data provide new insights into the functional actions of OECCM on oxidative stress-induced cell damage.

A pilot study on feasibility, acceptance and effectiveness of metacognitive-oriented social skills training in schizophrenia.

BACKGROUND: In preparation for a randomized controlled trial, a pilot study was conducted to investigate the feasibility, acceptability and effectiveness of a psychotherapy group based on metacognitive-oriented social skills training (MOSST). METHODS: Twelve outpatients with schizophrenia were offered 16 group-sessions of MOSST. Effect sizes were calculated for changes from baseline to treatment end for both psychosocial functioning and metacognitive abilities measured by the Personal and Social Performance Scale (PSP) and the Metacognition Assessment Scale-Abbreviated (MAS-A) respectively. RESULTS AND DISCUSSION: Ten patients finished the full treatment protocol and nonsignificant moderate effect sizes were obtained on PSP and MAS-A scores. To date, this is the first study in Spain to suggest that outpatients with schizophrenia will accept metacognitive therapy for social skills training and evidence improvements in psychosocial functioning and metacognition. CONCLUSION: Despite limitations inherent in a pilot study, including a small sample size and the absence of a control group, sufficient evidence of effectiveness was found to warrant further investigation. TRIAL REGISTRATION: ISRCTN10917911 . Retrospectively registered 30 November 2016.

Assessing self-reported clinical high risk symptoms in community-derived adolescents: A psychometric evaluation of the Prodromal Questionnaire-Brief.

BACKGROUND: The reliable early identification of individuals at risk for psychosis requires well-validated screening measures. To date, there is little information about the psychometric properties of the screening measures for psychosis risk in nonclinical adolescents. The main purpose of the present study was to validate the Prodromal Questionnaire-Brief (PQ-B) in a community sample of non-clinical Spanish adolescents. We also analyzed the prevalence, factorial validity, and reliability of the PQ-B scores as well as the relationship between self-reported clinical high risk symptoms and schizotypal traits. METHOD: Four hundred and forty-nine high-school students participated in a cross-sectional survey. The PQ-B and the Oviedo Schizotypy Assessment Questionnaire (ESQUIZO-Q) were used. RESULTS: Although 85.1% of the total sample reported at least one clinical high risk symptom, only 16% of the adolescents scored above the standardized cut-off. The PQ-B revealed an essentially unidimensional structure. The internal consistency of the PQ-B total score was 0.93. Pearson correlation coefficients indicated a high degree of overlap between self-reported clinical high risk symptoms and Positive and Disorganized schizotypal traits. A Canonical correlation between the PQ-B total score and ESQUIZO-Q dimensions showed that the associated variance between both sets of variables was 45.4% (adjusted R(2)=0.45). CONCLUSIONS: The PQ-B is a brief, easy, and reliable tool for screening self-reported clinical high risk symptoms in adolescents from the general population. These results also indicated that self-reported clinical high risk symptoms and schizotypal traits are closely associated at the subclinical level. The assessment of psychosis risk symptoms and their relationship with other distal risk factors, in a close-in strategy, may enhance the early identification of individuals at heightened risk for psychosis spectrum disorders.

New approaches on the study of the psychometric properties of the STAI.

INTRODUCTION: The main purpose of this study was to analyze the psychometric properties of the State-Trait Anxiety Inventory (STAI1). Previous studies have indicated different factor solutions. Nevertheless, there is still a lack of consensus about the best dimensional model of STAI scores. METHOD: The sample consisted of 417 participants, composed of 387 (29.71% male) healthy participants (comparison group: M=35.5 years; SD=8.40), and 30 (36.66% male) patient (clinical group M=35.8 years; SD=12.94). RESULTS: The internal consistency evaluated through Ordinal Alpha was good, 0.98 and 0.94 in the non-clinical and the clinical samples, respectively. Test-retest reliability (two weeks) for Total Score was 0.81 for the non-clinical subsample, and 0.93 for the clinical subsample. Confirmatory factor analyses supported both a four factor model and bifactor model. Also, STAI scores showed statistically significant correlations with Burns Anxiety Inventory (Burns-A) scores. Furthermore, results showed statistically significant differences in the mean scores of the STAI between the clinical and the non-clinical subsamples. CONCLUSIONS: The psychometric properties of the STAI were adequate. The present study contributes to better understand the STAI structure through the comparison of new approaches in the study of the STAI internal structure. The results found may contribute in the efforts to improve the evaluation and identification of anxiety symptoms and disorders.

Psychotic-like Experiences and Substance Use in College Students. / Experiencias psicóticas atenuadas y consumo de sustancias en universitarios.

Psychotic disorders, as well as psychotic-like experiences and substance use, have been found to be associated. The main goal of the present study was to analyse the relationship between psychoticlike experiences and substance use in college students. The simple comprised a total of 660 participants (M = 20.3 years, SD = 2.6). The results showed that 96% of the sample reported some delusional experience, while 20.3% reported at least one positive psychotic-like experience. Some substance use was reported by 41.1% of the sample, differing in terms of gender. Substance users reported more psychoticlike experiences than non-users, especially in the positive dimension. Also, alcohol consumption predicted in most cases extreme scores on measures of delusional ideation and psychotic experiences. The association between these two variables showed a differentiated pattern, with a stronger relationship between substance use and cognitive-perceptual psychotic-like experiences. To some extent, these findings support the dimensional models of the psychosis phenotype and contribute a better understanding of the links between psychoticlike experiences and substance use in young adults. Future studies should further explore the role of different risk factors for psychotic disorders and include models of the gene-environment interaction.

Los trastornos del espectro esquizofrénico, así como las experiencias psicóticas, se han asociado con un mayor consumo de sustancias. El objetivo de este trabajo fue analizar la relación entre las experiencias psicóticas atenuadas y el consumo de sustancias en adultos jóvenes. La muestra la formaron un total de 660 participantes universitarios (M = 20,3 años; DT = 2,6). Los resultados mostraron que un 96% de la muestra informó de alguna experiencia de ideación delirante, mientras que el 20,3% informó de, al menos, una experiencia atenuada de tipo cognitivo-perceptual. El 41,1% de la muestra refirió algún consumo de sustancias, encontrándose diferencias en función del género. Los participantes consumidores informaron de un mayor número de experiencias psicóticas, sobre todo de tipo positivo. Asimismo, el consumo de alcohol predijo, en la mayoría de los casos, las puntuaciones extremas en las medidas de ideación delirante y experiencias pseudopsicóticas. La asociación entre estas dos variables parece mostrar un patrón diferenciado, encontrándose el consumo de sustancias más relacionado con las experiencias pseudo-psicóticas de tipo cognitivoperceptual. Estos hallazgos parecen apoyar los modelos dimensionales del fenotipo psicótico y permiten mejorar la comprensión de la relación entre las experiencias psicóticas atenuadas y el consumo de sustancias en adultos jóvenes. Futuros estudios deberían seguir analizando el papel de los factores de riesgo a los trastornos psicóticos, así como incorporar modelos de interacción gen x ambiente.

Metacognitive abilities in adults with substance abuse treated in therapeutic community. / Habilidades metacognitivas en adultos con abuso de sustancias bajo tratamiento en comunidad terapéutica.

BACKGROUND: The term metacognition reflects a spectrum of psychological activities that allows people to form and integrate representations about their own mental states and those of others. The main goal of this study was to examine whether people with substance abuse disorders (SUDs), and treated in therapeutic community regime, displayed specific patterns of metacognitive deficits on Self-reflectivity, Understanding others’ mind, Decentration, and Mastery, comparing their scores with two clinical groups of patients with schizophrenia spectrum disorders (SSDs) and anxiety disorders. METHOD: A mixed-methods (qualitative-quantitative) study was designed. Two hundred and sixteen adults aged 18-65 with principal diagnoses of SUDs (n = 52), SSDs (n = 49), and anxiety disorders (n = 115) were recruited. Qualitative data were obtained with the Metacognition Assessment Interview, which was then rated using a quantitative scale, the Metacognition Assessment Scale-Abbreviated (MAS-A). RESULTS: The anxiety disorders group had significantly higher MAS-A total scores than the SUDs group, and the SUDs group obtained significantly higher MAS-A total scores than the SSDs group. Concerning the MAS-A subscale scores, the SUDs group displayed significantly lower scores only on the Mastery subscale compared to the anxiety disorders group, with the SUDs and SSDs groups obtaining equivalent Mastery scores. CONCLUSIONS: According to these findings, current interventions for addiction should focus more specifically on improving metacognitive Mastery.

Antecedentes: El término de metacognición hace referencia al conjunto de procesos psicológicos que permiten a los individuos desarrollar e integrar representaciones sobre los estados mentales propios y de los demás. El objetivo principal de este estudio fue examinar si los pacientes bajo tratamiento por consumo de sustancias, en régimen de comunidad terapéutica, presentan un perfil específico de déficits metacognitivos en las áreas de Autorreflexividad, Diferenciación, Descentramiento y Dominio, comparando sus puntuaciones con las obtenidas por dos muestras clínicas de pacientes con trastornos del espectro esquizofrénico y trastornos de ansiedad. Método: Se diseñó un estudio con metodología mixta (cualitativa-cuantitativa). Se seleccionaron un total de 216 participantes con diagnósticos principales por consumo de sustancias (n = 52), espectro esquizofrénico (n = 49) y trastornos de ansiedad (n = 115). Los datos cualitativos se obtuvieron con la Entrevista de Evaluación de la Metacognición (MAI) y, posteriormente, estos fueron cuantificados con la Escala Abreviada de Evaluación de la Metacognición (MAS-A). Resultados: Las puntuaciones totales en la MAS­A del grupo con trastornos de ansiedad fueron estadísticamente superiores a las del grupo con trastornos por consumo de sustancias (TCS), y éstas, a su vez, fueron significativamente superiores a las del grupo con trastornos del espectro esquizofrénico. Por subescalas de la MAS-A, sólo hubo diferencias estadísticamente significativas entre las puntuaciones de Dominio del grupo con ansiedad y TCS, obteniendo el grupo con TCS puntuaciones estadísticamente equivalentes a las del grupo con trastornos del espectro esquizofrénico. Conclusiones: De acuerdo con estos resultados, los programas actuales de intervención en drogadicción deberían orientarse más específicamente a mejorar las habilidades metacognitivas de Dominio.

The WIF domain of the human and Drosophila Wif-1 secreted factors confers specificity for Wnt or Hedgehog.

The Hedgehog (Hh) and Wnt signaling pathways are crucial for development as well as for adult stem cell maintenance in all organisms from Drosophila to humans. Aberrant activation of these pathways has been implicated in many types of human cancer. During evolution, organisms have developed numerous ways to fine-tune Wnt and Hh signaling. One way is through extracellular modulators that directly interact with Wnt or Hh, such as the Wnt inhibitory factor (Wif-1) family of secreted factors. Interestingly, Wif-1 family members have divergent functions in the Wnt and Hh pathways in different organisms. Whereas vertebrate Wif-1 blocks Wnt signaling, Drosophila Wif-1 [Shifted (Shf)] regulates only Hh distribution and spreading through the extracellular matrix. Here, we investigate which parts of the Shf and human Wif-1 (WIF1) proteins are responsible for functional divergence. We analyze the behavior of domain-swap (the Drosophila and human WIF domain and EGF repeats) chimeric constructs during wing development. We demonstrate that the WIF domain confers the specificity for Hh or Wg morphogen. The EGF repeats are important for the interaction of Wif-1 proteins with the extracellular matrix; Drosophila EGF repeats preferentially interact with the glypican Dally-like (Dlp) when the WIF domain belongs to human WIF1 and with Dally when the WIF domain comes from Shf. These results are important both from the evolutionary perspective and for understanding the mechanisms of morphogen distribution in a morphogenetic field.

Cost-effectiveness analysis of zinc supplementation for treatment of acute diarrhea in children younger than 5 years in Colombia.

OBJECTIVE: The objective of this study was to determine the cost-effectiveness of zinc supplementation for the treatment of acute diarrhea (AD) in children younger than 5 years in Colombia. METHODS: The cost-effectiveness analysis was performed from the perspective of the Colombian health system. The standard treatment with the addition of zinc was compared with the standard treatment without zinc in children younger than 5 years. The time horizon was 1 month. Effectiveness was extracted from a systematic review of literature. The specific data for Colombia were taken from local databases and observational studies. To determine the costs, a typical case was constructed by reviewing guidelines and medical records and validated by experts. To evaluate the resources consumed, Colombian tariff manuals were used. Costs were stated in Colombian pesos (COP) and US dollar (USD) for 2010. Deterministic sensitivity analysis was performed to evaluate the impact of changes in cost and effectiveness of the strategies on the results from the model. RESULTS: The results from the model indicate that zinc supplementation is a dominant strategy; it is less costly and more effective than standard treatment without zinc (reduction of $15,210 COP [8.14 USD] per child). The results are sensitive to changes in the probability of hospitalization and of persistent diarrhea. CONCLUSIONS: Zinc for the treatment of AD is a highly cost-effective strategy and is recommended for inclusion in the benefit plan of the Colombian health system. This intervention is more cost-effective in children with a higher risk of persistent diarrhea and hospitalization.

New evidence of factor structure and measurement invariance of the SDQ across five European nations.

The main purpose of the present study was to analyse the internal structure and to test the measurement invariance of the Strengths and Difficulties Questionnaire (SDQ), self-reported version, in five European countries. The sample consisted of 3012 adolescents aged between 12 and 17 years (M = 14.20; SD = 0.83). The five-factor model (with correlated errors added), and the five-factor model (with correlated errors added) with the reverse-worded items allowed to cross-load on the Prosocial subscale, displayed adequate goodness of-fit indices. Multi-group confirmatory factor analysis showed that the five-factor model (with correlated errors added) had partial strong measurement invariance by countries. A total of 11 of the 25 items were non-invariant across samples. The level of internal consistency of the Total difficulties score was 0.84, ranging between 0.69 and 0.78 for the SDQ subscales. The findings indicate that the SDQ's subscales need to be modified in various ways for screening emotional and behavioural problems in the five European countries that were analysed.

Screening mental health problems during adolescence: psychometric properties of the Spanish version of the Strengths and Difficulties Questionnaire.

The main purpose of the present study was to test the psychometric properties of the Strength and Difficulties Questionnaire (SDQ), self-reported version, in Spanish adolescents, introducing a five-point Likert response scale. The sample consisted of 1474 adolescents with a mean age of 15.92 years (SD = 1.18). The level of internal consistency of the SDQ Total score was .75, ranging from .56 to .71 for the subscales. Results from exploratory factor analysis revealed a three-factor structure as the most satisfactory. Confirmatory factor analyses showed that the five-factor model (with modifications) displayed better goodness of-fit indices than the other hypothetical dimensional models tested. Furthermore, strong measurement invariance by age and partial measurement invariance by gender was supported. The study of the psychometric properties confirms that the Spanish version of the SDQ, self-reported form, is a useful tool for the screening of emotional and behavioural problems in adolescents.

Altered subcellular localization of IL-33 leads to non-resolving lethal inflammation.

Non-resolving inflammation is a major contributor to chronic disease pathogenesis, including that of cancer, chronic obstructive pulmonary disease, asthma, arthritis, inflammatory bowel disease, multiple sclerosis and obesity. Some cytokines, such as IL-1α and IL-33, may act as endogenous alarmins that contribute to non-resolving inflammation. These cytokines are constitutively expressed in the nucleus and are thought to promote inflammation only upon release during tissue damage or cell necrosis. However, the importance of their nuclear localization in immune homeostasis is not fully understood. We describe herein a novel mouse model in which the nuclear localization signal of IL-33 is abolished and demonstrate for the first time that, alone, altered subcellular localization of IL-33 dramatically affects immune homeostasis. Heterozygous IL33(tm1/+) mice display elevated serum IL-33 levels, indicating that IL-33 is constitutively released when not actively targeted to the nucleus. IL33(tm1/+) mice succumb to lethal inflammation characterized by eosinophil-dominated immune cell infiltration of multiple organs. The profound inflammatory phenotype is dependent on mediators downstream of ST2 as ST2-null mice are protected in spite of high serum IL-33 levels. Importantly, IL-33 transcript levels in this knock-in mouse model remain under endogenous control. We adopt the term "nuclear alarmin" to describe a danger signal that is primarily regulated by nuclear compartmentalization in this fashion.

The assessment of positive dimension of the psychosis phenotype in college students.

The Wisconsin Schizotypy Scales are one of the most used measuring instruments for the assessment of psychometric risk for psychosis. The main goal of the present study was to analyze the reliability of the scores and to provide new sources of validity evidence for the brief version of the Magical Ideation Scale (MIS-B) and the Perceptual Aberration Scale (PAS-B). The final sample was comprised of a total of 1349 university students divided into two subsamples (n1=710; M=19.8 years; n2=639; M=21.2 years). Results show that both measurement instruments have adequate psychometric properties under Classical Test Theory and Item Response Theory. Internal structure analysis of MIS-B and PAS-B, through exploratory and confirmatory factor analysis, yielded an essentially one-dimensional solution. Cronbach's alpha coefficient for the total score of MIS-B ranged between 0.86 and 0.87, whereas for the PAS-B it ranged between 0.78 and 0.89. A total of 5 items showed a differential functioning for sex. The results indicate that the MIS-B and PAS-B are brief measurement instruments with adequate psychometric properties for the assessment of the positive dimension of the psychosis phenotype and could be used as screening tools in the detection of individuals at risk for psychosis in the general population.

Dispatched mediates Hedgehog basolateral release to form the long-range morphogenetic gradient in the Drosophila wing disk epithelium.

Hedgehog (Hh) moves from the producing cells to regulate the growth and development of distant cells in a variety of tissues. Here, we have investigated the mechanism of Hh release from the producing cells to form a morphogenetic gradient in the Drosophila wing imaginal disk epithelium. We describe that Hh reaches both apical and basolateral plasma membranes, but the apical Hh is subsequently internalized in the producing cells and routed to the basolateral surface, where Hh is released to form a long-range gradient. Functional analysis of the 12-transmembrane protein Dispatched, the glypican Dally-like (Dlp) protein, and the Ig-like and FNNIII domains of protein Interference Hh (Ihog) revealed that Dispatched could be involved in the regulation of vesicular trafficking necessary for basolateral release of Hh, Dlp, and Ihog. We also show that Dlp is needed in Hh-producing cells to allow for Hh release and that Ihog, which has been previously described as an Hh coreceptor, anchors Hh to the basolateral part of the disk epithelium.

Generation of functional neurons from adult human mucosal olfactory ensheathing glia by direct lineage conversion.

A recent approach to promote central nervous system (CNS) regeneration after injury or disease is direct conversion of somatic cells to neurons. This is achieved by transduction of viral vectors that express neurogenic transcription factors. In this work we propose adult human mucosal olfactory ensheathing glia (hmOEG) as a candidate for direct reprogramming to neurons due to its accessibility and to its well-characterized neuroregenerative capacity. After induction of hmOEG with the single neurogenic transcription factor NEUROD1, the cells under study exhibited morphological and immunolabeling neuronal features, fired action potentials and expressed glutamatergic and GABAergic markers. In addition, after engraftment of transduced hmOEG cells in the mouse hippocampus, these cells showed specific neuronal labeling. Thereby, if we add to the neuroregenerative capacity of hmOEG cultures the conversion to neurons of a fraction of their population through reprogramming techniques, the engraftment of hmOEG and hmOEG-induced neurons could be a procedure to enhance neural repair after central nervous system injury.

An assessment of priorities in handling climate change impacts on infrastructures.

Climate change (CC) will likely significantly impact the world's infrastructure significantly. Rising temperatures, increased precipitation, and rising sea levels are all likely to stress critical infrastructures (CI). Rising temperatures can lead to infrastructure damage from extreme heat events. This can cause roads and bridges to buckle or crack, leading to costly repairs and potential traffic disruptions. In addition, heat waves can damage vital electrical infrastructure, leading to widespread power outages. In light of this context, this article reports on a study which examined the connections and impacts of CC on infrastructure. The study employed a mixed-method approach, combining bibliometric analysis for the period 1997-2022 with a series of relevant case studies from the five continents to offer insight into the impact of CC on infrastructure. The article fills a research gap in respect of assessments of the extent to which climate change (CC) negative influences the infrastructure, with a special focus on developing countries. It also showcases CI projects and adaptation measures being currently deployed, to address CC. The results show that the current infrastructure is vulnerable to CC. The selected case studies on CI adaptation show that in developing and industrialised countries, there is a perceived need to understand better the connections and potential impacts of CC on critical areas such as transport, settlements, and coastal infrastructure. In order to protect infrastructure from CC impacts, governments need to invest in measures such as flood control, early warning systems, and improved building codes. Additionally, they need to work to reduce greenhouse gas emissions more actively, which are the primary cause of CC.