MEG3 Expression Indicates Lymph Node Metastasis and Presence of Cancer-Associated Fibroblasts in Papillary Thyroid Cancer.

Papillary thyroid cancer is the most common endocrine malignancy, occurring at an incidence rate of 12.9 per 100,000 in the US adult population. While the overall 10-year survival of PTC nears 95%, the presence of lymph node metastasis (LNM) or capsular invasion indicates the need for extensive neck dissection with possible adjuvant radioactive iodine therapy. While imaging modalities such as ultrasound and CT are currently in use for the detection of suspicious cervical lymph nodes, their sensitivities for tumor-positive nodes are low. Therefore, advancements in preoperative detection of LNM may optimize the surgical and medical management of patients with thyroid cancer. To this end, we analyzed bulk RNA-sequencing datasets to identify candidate markers highly predictive of LNM. We identified MEG3, a long-noncoding RNA previously described as a tumor suppressor when expressed in malignant cells, as highly associated with LNM tissue. Furthermore, the expression of MEG3 was highly predictive of tumor infiltration with cancer-associated fibroblasts, and single-cell RNA-sequencing data revealed the expression of MEG3 was isolated to cancer-associated fibroblasts (CAFs) in the most aggressive form of thyroid cancers. Our findings suggest that MEG3 expression, specifically in CAFs, is highly associated with LNM and may be a driver of aggressive disease.

Cross-cultural validity of the five items Mindful Attention Awareness Scale (MAAS-5) in Peru and Mexico during the COVID-19 pandemic.

The Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5) is a brief measure of the general tendency to be attentive and aware of experiences in the present moment during daily life. The MAAS-5 has been used in different countries; however, an assessment of its cross-cultural measurement invariance (MI) has not been conducted. Therefore, the study aimed to evaluate the cross-cultural measurement invariance of the MAAS-5 in university students from two countries: Peru and Mexico. A total of 1144 university students from Peru (N = 822) and Mexico (N = 322) responded online to the Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5). A multigroup confirmatory factor analysis was performed. Measurement invariance tests the hypothesis that the model behind a set of scores is comparable between groups. The results showed that the unidimensional structure of the MAAS-5 is the same between Peruvian and Mexican university students. Therefore, it is suggested that university students from both countries conceptualize the mindfulness in a similar way. As a result, the MAAS-5 can be used to compare differences between countries. No significant differences were observed in the MAAS-5 score between Peruvian and Mexican university students. The present study contributes to a better understanding of the psychometric properties of the MAAS-5 by presenting MI results in two Latin American countries. Implications of the findings are discussed, which will facilitate a more solid and reliable use of the MAAS-5 in future cross-cultural studies.

Dorsal Column Stimulation and Cannabinoids in the Treatment of Chronic Nociceptive and Neuropathic Pain: a Review of the Clinical and Pre-clinical Data.

PURPOSE OF REVIEW: The main objective of this review is to appraise the literature on the role of spinal cord stimulation (SCS), cannabinoid therapy, as well as SCS and cannabinoid combination therapy for the management of chronic neuropathic and nociceptive pain. Current research suggests that SCS reduces pain and increases functional status in carefully selected patients with minimal side effects. RECENT FINDINGS: As cannabinoid-based medications become a topic of increasing interest in pain management, data remains limited regarding the clinical efficacy of cannabinoids for pain relief. Furthermore, from a mechanistic perspective, although various pain treatment modalities utilize overlapping pain-signaling pathways, clarifying whether cannabinoids work synergistically with SCS via shared mechanisms remains to be determined. In considering secondary outcomes, the current literature suggests cannabinoids improve quality of life, specifically sleep quality, and that SCS decreases opioid consumption, increases functional capacity, and decreases long-term healthcare costs. These findings, along with the high safety profiles of SCS and cannabinoids overall, incentivize further exploration of cannabinoids as an adjunctive therapy to SCS in the treatment of neuropathic and nociceptive pain.

Cross-cultural validity of the five items Mindful Attention Awareness Scale (MAAS-5) in Peru and Mexico during the COVID-19 pandemic

The Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5) is a brief measure of the general tendency to be attentive and aware of experiences in the present moment during daily life. The MAAS-5 has been used in different countries; however, an assessment of its cross-cultural measurement invariance (MI) has not been conducted. Therefore, the study aimed to evaluate the cross-cultural measurement invariance of the MAAS-5 in university students from two countries: Peru and Mexico. A total of 1144 university students from Peru (N = 822) and Mexico (N = 322) responded online to the Spanish version of the 5-item Mindful Attention Awareness Scale (MAAS-5). A multigroup confirmatory factor analysis was performed. Measurement invariance tests the hypothesis that the model behind a set of scores is comparable between groups. The results showed that the unidimensional structure of the MAAS-5 is the same between Peruvian and Mexican university students. Therefore, it is suggested that university students from both countries conceptualize the mindfulness in a similar way. As a result, the MAAS-5 can be used to compare differences between countries. No significant differences were observed in the MAAS-5 score between Peruvian and Mexican university students. The present study contributes to a better understanding of the psychometric properties of the MAAS-5 by presenting MI results in two Latin American countries. Implications of the findings are discussed, which will facilitate a more solid and reliable use of the MAAS-5 in future cross-cultural studies. (AU)

Trace elements under the spotlight: A powerful nutritional tool in cancer.

Cancer is the second leading cause of death worldwide. Research on the relationships between trace elements (TE) and the development of cancer or its prevention is a field that is gaining increasing relevance. This review provides an evaluation of the effects of TE (As, Al, B, Cd, Cr, Cu, F, I, Pb, Li, Mn, Hg, Mo, Ni, Se, Si, Sn, V and Zn) intake and supplementation in cancer risk and prevention, as well as their interactions with oncology treatments. Advancements in the knowledge of TE, their dietary interactions and their main food sources can provide patients with choices that will help them to improve their quality of life and therapy outcomes. This approach could open new opportunities for treatments based on the integration of conventional therapies (chemotherapy, radiotherapy, and immunotherapy) and dietary interventions that provide advanced personalized treatments.

Could pulmonary low-dose radiation therapy be an alternative treatment for patients with COVID-19 pneumonia? Preliminary results of a multicenter SEOR-GICOR nonrandomized prospective trial (IPACOVID trial).

PURPOSE: To evaluate the efficacy and safety of lung low-dose radiation therapy (LD-RT) for pneumonia in patients with coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: Inclusion criteria comprised patients with COVID-19-related moderate-severe pneumonia warranting hospitalization with supplemental O2 and not candidates for admission to the intensive care unit because of comorbidities or general status. All patients received single lung dose of 0.5 Gy. Respiratory and systemic inflammatory parameters were evaluated before irradiation, at 24 h and 1 week after LD-RT. Primary endpoint was increased in the ratio of arterial oxygen partial pressure (PaO2) or the pulse oximetry saturation (SpO2) to fractional inspired oxygen (FiO2) ratio of at least 20% at 24 h with respect to the preirradiation value. RESULTS: Between June and November 2020, 36 patients with COVID-19 pneumonia and a mean age of 84 years were enrolled. Seventeen were women and 19 were men and all of them had comorbidities. All patients had bilateral pulmonary infiltrates on chest X­ray. All patients received dexamethasone treatment. Mean SpO2 pretreatment value was 94.28% and the SpO2/FiO2 ratio varied from 255 mm Hg to 283 mm Hg at 24 h and to 381 mm Hg at 1 week, respectively. In those who survived (23/36, 64%), a significant improvement was observed in the percentage of lung involvement in the CT scan at 1 week after LD-RT. No adverse effects related to radiation treatment have been reported. CONCLUSIONS: LD-RT appears to be a feasible and safe option in a population with COVID-19 bilateral interstitial pneumonia in the presence of significant comorbidities.

Prediction model of rhomboid major and pleura depth based on anthropometric features to decrease the risk of pneumothorax during dry needling.

BACKGROUND: Although most common adverse events associated with dry needling can be considered minor, serious adverse events including induced pneumothorax cannot be excluded, and safety instructions for reducing the risk of pleura puncture are needed. OBJECTIVE: To investigate if anthropometric features can predict the rhomboid major muscle and pleura depth in a sample of healthy subjects to avoid the risk of pneumothorax during dry needling. METHODS: A diagnostic study was conducted on 59 healthy subjects (52.5% male) involving a total of 236 measurements (both sides in maximum inspiration and expiration), to calculate the accuracy of a prediction model for both pleura and rhomboid depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), breathing and chest circumference. A correlation matrix and a multiple linear regression analyses were used to detect those variables contributing significantly to the variance in both locations. RESULTS: Men showed greater height, weight, BMI, thorax circumference and skin-to-rhomboid, rhomboid-to-pleura and skin-to-pleura distances (P < .001). Sex, BMI, and thorax circumference explained 51.5% of the variance of the rhomboid (P < .001) and 69.7% of pleura (P < .001) depth limit. In general, inserting a maximum length of 19 mm is recommended to reach the deep limit of rhomboid major decreasing the risk of passing through the pleura. CONCLUSION: This study identified that gender, BMI and thorax circumference can predict both rhomboid and pleura depth, as assessed with ultrasonography, in healthy subjects. Our findings could assist clinicians in the needle length election in avoiding the risk of induced pneumothorax during dry needling.

Factorial validity and invariance analysis of the five items version of Mindful Awareness Attention Scale in older adults.

Objective: Mindfulness or the full attention state is a factor that contributes to the successful process of aging. This study aims to evaluate the evidence of validity, on the basis of the internal structure, convergent and discriminant validity, reliability and factorial invariance across gender, for the five items Mindful Attention Awareness Scale (MAAS-5) within a sample of older adults.Methods: The participants were 323 Peruvian older adults, consisting of 160 women and 163 men, whose average ages were 68.58 (S.D = 7.23) and 68.91 years (S.D = 7.12), respectively. In addition to the MAAS-5, the Satisfaction with Life Scale and the Patient Health Questionnaire-2 were administered.Results: The Confirmatory Factor Analysis indicates that the one-factor structure of the MAAS-5 presents adequate fit for the total sample (χ2 = 11.24, df = 5, χ2/df = 2.25, CFI = .99, RMSEA = .06 [90%CI: .01, .11]; and SRMR = .025), as well as for the sub-samples of men and women. This one-factor solution presents adequate internal consistency (ω = 80 [95%CI: .76 - .82]) and it is invariant across gender. Regarding convergent validity, high scores in the MAAS are associated with a greater satisfaction with life (r = .88, p< .01 [95%CI: .85, .95]) and less depression (r = -.56, p< .01 [95%CI: -.48, -.77]) in older adults.Conclusions: The preliminary results back the use of the MAAS-5 as a self-report measure of mindfulness that has an adequate unifactorial structure that is reliable and invariant across gender for measuring the full attention state in elderly Peruvians.

Lethality and characteristics of deaths due to COVID-19 in Rondônia: an observational study. / Letalidade e características dos óbitos por COVID-19 em Rondônia: estudo observacional.

OBJECTIVE: To describe the characteristics of deaths due to COVID-19 in the state of Rondônia. METHODS: This was a descriptive study, with data from the Brazilian National Health System Epidemiological Surveillance System Computerization Strategy (E-SUS-VE, notified between January 1 and August 20, 2020. Statistical tests (Chi-square and Marascuilo procedure) were applied, where differences were considered to be significant when p< 0.05. RESULTS: 184,146 suspected cases were reported, of which 49,804 were confirmed as COVID-19, and 1,020 died (lethality 2.1%). Statistically significant differences were observed between age groups and lethality (p-value <0.001); lethality was greater as age increased (Marascuilo procedure, significant in the comparison between the over 60s and the other age groups); death was higher among males (2.7% lethality); and lethality was higher among Black people (3.0%). CONCLUSION: Lethality was greater among the elderly, males and people of brown and black skin color in Rondônia.

Metabolome and proteome changes in skeletal muscle and blood of pre-weaning calves fed leucine and threonine supplemented diets.

In pre-weaning calves, both leucine and threonine play important roles in growth and muscle metabolism. In this study, metabolomics, proteomics and clinical chemistry were used to assess the effects of leucine and threonine supplementation added to milk replacer on 14 newborn Holstein male calves: 7 were fed a control diet (Ctrl) and 7 were fed the Ctrl diet supplemented with 0.3% leucine and 0.3% threonine (LT) from 5.6 days of age to 53.6 days. At this time, blood and semitendinosus muscle biopsies were collected for analysis. Integrated metabolomics and proteomics showed that branched-chain amino acids (BCAA) degradation and mitochondrial oxidative metabolism (citrate cycle and respiratory chain) were the main activated pathways in muscle because of the supplementation. BCAA derivatives and metabolites related to lipid mobilization showed the major changes. The deleterious effects of activated oxidative phosphorylation were balanced by the upregulation of antioxidant proteins. An increase in protein synthesis was indicated by elevated aminoacyl-tRNA biosynthesis and increased S6 ribosomal protein phosphorylation in skeletal muscle. In conclusion, LT group showed greater BCAA availability and mitochondrial oxidative activity; as the muscle cells undergo greater aerobic metabolism, antioxidant defenses were activated to compensate for possible cell damage. Data are available via ProteomeXchange (PXD016098). SIGNIFICANCE: Leucine and threonine are essential amino acids for the pre-weaning calf, being of high importance for growth. In this study, we found that leucine and threonine supplementation of milk replacer to feed pre-weaning calves led to differences in the proteome, metabolome and clinical chemistry analytes in skeletal muscle and plasma, albeit no differences in productive performance were recorded. This study extends our understanding on the metabolism in dairy calves and helps optimizing their nutritional status.

Supervivencia a largo plazo de los fármacos biológicos anti-TNF subcutáneos administrados durante los años 2008-2012 en una cohorte de pacientes con artritis reumatoide / Long-term survival of subcutaneous anti-tumor necrosis factor biological drugs administered between 2008 and 2012 in a cohort of rheumatoid arthritis patients

Objetivo: Comparar la supervivencia de los anti-TNF subcutáneos utilizados durante el periodo 2008-2012 según práctica clínica. Material y métodos: Estudio observacional retrospectivo de todos los pacientes diagnosticados de AR que habían iniciado tratamiento con un anti-TNF subcutáneo y mantenido durante al menos 6 meses. Los datos fueron analizados mediante SPSS V17,0. Resultados: Cuarenta y nueve pacientes con AR iniciaron tratamiento con anti-TNF subcutáneo (32 con etanercept y 17 con adalimumab). La media de edad fue de 45,94 años (75,5% mujeres). La media de duración de la enfermedad previa al inicio del anti-TNF fue de 2,67 años. La media de edad al inicio del tratamiento fue de 51,84 años, índice de actividad de la enfermedad en 28 articulaciones medio de 4,93. La supervivencia media del tratamiento anti-TNF fue de 8,40 años, mostrando una mayor supervivencia etanercept. La principal razón de discontinuación fue por fallo secundario (90,9%). Conclusión: En la práctica clínica habitual, la supervivencia a largo plazo de los tratamientos anti-TNF subcutáneos fue elevada e independiente de que tuvieran o no tratamiento inmunosupresor concomitante

Objective:To compare the survival of subcutaneous anti-tumor necrosis factor (TNF) drugs used between 2008 and 2012 prescribed in accordance with clinical practice. Material and methods:Retrospective, observational study of the patients in our center diagnosed with rheumatoid arthritis (RA). We included patients who had received a subcutaneous anti-TNF agent for at least 6 months. The data were analyzed using the SPSS V17.0 statistical package. Results:Forty-nine RA patients started subcutaneous biological treatment with an anti-TNF agent (32 with etanercept and 17 with adalimumab). The mean age was 45.94 years (75.5% female). The mean disease duration prior to starting anti-TNF administration was 2.67 years. The mean age at the start of treatment was 51.84 years, and the average Disease Activity Score 28 was 4.93. The median survival of the anti-TNF treatment was 8.40 years; the survival of etanercept was the longer of the two. The main reason for discontinuation was secondary failure (90.9%). Conclusions:In routine clinical practice, the survival of subcutaneous anti-TNF treatment was extensive and was independent of whether or not the patients received concomitant immunosuppressive therapy

Translation and content validity of a brief scale of mindfulness for Peruvian adolescents. / Traducción y validez de contenido de una escala breve de mindfulness para adolescentes peruanos.

OBJECTIVE: To translate into Spanish and analyze the evidence of validity based on the content of the items in the brief version of the Mindful Attention Awareness Scale of 5 items (MAAS-5). METHOD: An instrumental study that involved the translation to Spanish of the items of the short version of the MAAS-5 scale, using the back-translation procedure. We analyzed the evidence of validity based on the test content, with the participation of a total of 14 expert judges. The degree of clarity, coherence and relevance of the items was quantified using the Aiken V coefficient and their 95% confidence intervals using an ad hoc template developed in the MS Excel program. RESULTS: The items of the MAAS-5 show favourable evaluations of their clarity, coherence and relevance, where all the values of V were statistically significant and greater than 0.70. On the other hand, the lower limit of 95% confidence intervals of all the items satisfies the criterion at population level (Li˃0.59). CONCLUSION: The empirical evidence of validity based on the test content of the MAAS-5 reports that all are sufficiently relevant, coherent and clear to adequately represent the construct mindfulness, both at sample and population level. This suggests that the MAAS-5 can be a brief and useful measure to assess mindfulness. On the other hand we suggest carrying out further studies that analyze other sources of evidence of validity of the MAAS-5.

Evidencias psicométricas de una medida breve de resiliencia en adultos mayores peruanos no institucionalizados / Psychometric evidence of a brief measure of resilience in non-institutionalized Peruvian older adults

La resiliencia es comprendida como el dominio de recursos personales y factores contextuales que permiten un afrontamiento exitoso y el logro de una adaptación positiva ante los diferentes estresores que aparecen a lo largo de la vida, siendo así importante dentro del proceso de envejecimiento saludable y exitoso. En la actualidad se han desarrollado instrumentos breves para la medición de la resiliencia como la escala breve de resiliencia (BRCS - Brief Resilient Coping Scale) que evalúa la capacidad de los individuos para hacer frente al estrés de manera adaptativa. En este sentido, el estudio ofrece evidencia de validez y fiabilidad de la BRCS en adultos mayores no institucionalizados peruanos. Se contó con la participación de 236 adultos mayores con una edad promedio de 72.8 años (DT = 6.90) de los cuales el 78.4% eran mujeres y el 21.6% hombres, quienes respondieron la versión en español del BRCS y otras escalas para medir la satisfacción con la vida, humor como afrontamiento y depresión. Mediante el análisis factorial confirmatorio se corrobora la estructura unidimensional de la BRCS. Los coeficientes de consistencia interna alfa de Cronbach y omega indicaron una adecuada fiabilidad de la BRCS. Tanto los índices de ajuste del modelo como los valores de los coeficientes de fiabilidad fueron mejores en comparación con los reportados en la literatura. La BRCS mostró una correlación positiva significativa con la satisfacción con la vida y el humor como afrontamiento (p < .01). Asimismo, se observó una correlación negativa significativa con depresión (p < .01). Los resultados muestran que la BRCS cuenta con evidencias de validez y fiabilidad que avala su empleo como medida breve de la resiliencia en adultos mayores peruanos

Resilience is understood as the domain of personal resources and contextual factors that allow for a successful coping and enhance positive adaptation to the different stressors during the lifespan, thereby being important for a healthy and successful aging. Nowadays, several brief instruments have been developed to measure resilience, such as the Brief Resilient Coping Scale (BRCS), an instrument that measures the ability of people to confront stress in an adaptive way. In this vein, the study provides evidence of the validity and reliability of the BRCS in non-institutionalized older adults in Peru. Two hundred thirty-six elderly people of both genders, 78.4% women and 21.6% men, with a mean age of 72.8 years (SD = 6.90), who answered the Spanish version of the BRCS and other scales to measure satisfaction with life, humor as coping, and depression. Confirmatory factor analysis corroborates the one-dimensional structure of the BRCS. The coefficients of internal consistency, Chronbach's alpha and omega, indicated an adequate reliability of the BRCS. Both the adjustment indices of the model and the values of the coefficients of reliability were higher compared to those reported in the literature. The BRCS showed positive and significant correlations with satisfaction with life and humor as coping (p < .01). Likewise, negative and significant correlations were observed with depression (p < .01). The results show that the BRCS has proved valid and reliable, supporting its use as a short measure of resilience in older Peruvians

Cuantificación de la efectividad de una intervención terapéutica en geriatría: aportes a Folch et al / Quantification of the effectiveness of a therapeutic intervention in geriatrics: Contributions by Folch et al

No disponible

Automated pollen identification using microscopic imaging and texture analysis.

Pollen identification is required in different scenarios such as prevention of allergic reactions, climate analysis or apiculture. However, it is a time-consuming task since experts are required to recognize each pollen grain through the microscope. In this study, we performed an exhaustive assessment on the utility of texture analysis for automated characterisation of pollen samples. A database composed of 1800 brightfield microscopy images of pollen grains from 15 different taxa was used for this purpose. A pattern recognition-based methodology was adopted to perform pollen classification. Four different methods were evaluated for texture feature extraction from the pollen image: Haralick's gray-level co-occurrence matrices (GLCM), log-Gabor filters (LGF), local binary patterns (LBP) and discrete Tchebichef moments (DTM). Fisher's discriminant analysis and k-nearest neighbour were subsequently applied to perform dimensionality reduction and multivariate classification, respectively. Our results reveal that LGF and DTM, which are based on the spectral properties of the image, outperformed GLCM and LBP in the proposed classification problem. Furthermore, we found that the combination of all the texture features resulted in the highest performance, yielding an accuracy of 95%. Therefore, thorough texture characterisation could be considered in further implementations of automatic pollen recognition systems based on image processing techniques.

Respiratory physiotherapy can increase lower esophageal sphincter pressure in GERD patients.

BACKGROUND: Inspiratory muscle training (IMT) has been shown to increase diaphragm thickness. We evaluated the effect of IMT on mid-respiratory pressure (MRP) in patients with gastroesophageal reflux disease (GERD) and hypotensive lower esophageal sphincter (LES), and compared the results with a sham group. METHODS: Twenty consecutive patients (progressive loading group) and 9 controls (sham group) were included. All patients had end expiratory pressure (EEP) between 5 and 10 mmHg, underwent esophageal manometry and pulmonary function tests before and after 8 weeks of training, and used a threshold IMT twice daily. The threshold IMT was set at 30% of the maximal inspiratory pressure for the progressive loading group; while, the threshold for sham-treated patients was set at 7 cmH(2)O for the whole period. RESULTS: There was an increase in MRP in 15 (75%) patients in the progressive loading group, with an average gain of 46.6% (p < 0.01), and in six (66%) patients in the sham group with a mean increase of 26.2% (p < 0.01). However, there was no significant difference between the groups (p = 0.507). The EEP also increased compared with measurements before training (p < 0.01), but it did not differ between groups (p = 0.727). CONCLUSION: IMT increased LES pressure in patients with GERD, in both the treatment and sham groups, after an eight-week program. Although there was no statistically significant difference between groups, suggesting the pressure increase in LES occurs regardless of the resistance load of the threshold IMT. These findings need to be confirmed in further studies with a larger sample. REGISTRATION NUMBER: 0922/09.

[The effect of alternative therapies on symptoms of patients with functional chest pain--pilot study with Johrei healing technique]. / Rola niekonwencjonalnych metod w leczeniu bólu czynnosciowego w klatce piersiowej--doswiadczenia wlasne z wykorzystaniem energii Johrei.

AIM OF THE STUDY: was to determine the efficacy of Johrei as compared to wait-list in improving symptoms of FCP patients. MATERIAL AND METHODS: Patients with chest pain of noncardiac origin for at least 3 months were enrolled into the study. All patients had to have negative upper endoscopy, pH testing and oesophageal manometry prior to randomization. Subsequently, patients were randomized to either Johrei or wait-list control. Patients received 18 Johrei sessions from a Johrei practitioner for 6 weeks. RESULTS: A total of 21 FCP patients enrolled into the Johrei group and 18 into the wait-list group. There was no difference in symptom intensity score between Johrei group and wait-list group at baseline (20.28 vs. 23.06, P = N.S.). However, there was a significant pre- and post-treatment reduction in symptom intensity in the Johrei group (20.28 vs. 7.0, P = 0.0023). There was no significant reduction in symptom intensity score between baseline and at the end of the study in the wait-list group (23.06 vs. 20.69, P = N.S.). CONCLUSION: This pilot study shows that Johrei may have a role in improving FCP symptoms; however, future studies are needed to compare Johrei treatment with sham Johrei or supportive care.