El abrazo, de las bases a su expresión en la vida y el arte / The embrace of the people to their expression in life and art

Resumen: El confinamiento y aislamiento social durante la pandemia por COVID-19 limitaron el contacto físico estrecho, en especial los de cercanía, del que destacan los abrazos. El impacto social del vacío y aislamiento afectivo aún perdura. El abrazo es una respuesta innata afectiva del ser humano que se expresa en diferentes circunstancias. Tiene su origen en diferentes regiones cerebrales, que van de las límbicas a las corticales, en las que se entrelaza una compleja interacción entre aferencias, sistemas de señalización y neurotransmisores que condicionan una respuesta neurohormonal con impacto multisistémico. El abrazo va más allá de este complejo sustrato, representa la sublimación de lo meramente anatómico y fisiológico, a la manifestación afectiva del espíritu humano. El objetivo de este breve ensayo es poner a su consideración las bases neurocientíficas del abrazo y su expresión en la complejidad de la vida y el arte.

Abstract: Confinement and social isolation during the COVID-19 pandemic limited close physical contact, especially close ones, of which hugs stand out. The social impact of emptiness and affective isolation still endures. The hug is an innate affective response of the human being that is expressed in different circumstances. It originates from different brain regions, ranging from limbic to cortical, in which a complex interaction between afferents, signaling systems, and neurotransmitters is intertwined, conditioning a neurohormonal response with multisystem impact. The hug goes beyond this complex substrate, it represents the sublimation of the merely anatomical and physiological, to the affective manifestation of the human spirit. The objective of this brief essay is to put to your consideration the neuroscientific bases of the hug and its expression in the complexity of life and art.

HUG: A Compassionate Approach to Designing for Wellbeing in Dementia Care.

Design can improve the quality of life of people living with dementia but creating successful design solutions is not simple, due to the complexity of the medical condition, and the ethical considerations of including those affected in design research and evaluation. This article describes research involving an interactive product, 'HUG', developed from academic research, to support the wellbeing of people living with advanced dementia, which is now commercially available. People affected by dementia were included at every stage in the design research process. The evaluation of HUG took place in both hospital and care home contexts with 40 participants living with dementia. In this paper, a qualitative hospital study is described, in which patients received a HUG on prescription. Findings reveal that although HUG was rejected by some, those patients who did accept it benefitted significantly. Not only did the device reduce distress, anxiety and agitation but it also helped with patient compliance in medical procedures, aspects of daily care and enhanced communication and socialisation. The Alzheimer's Society's accelerator partnership funding has enabled this product to be manufactured and made commercially available so that the benefits of this academic design research can be made more widely available to people living with dementia.

Monocytosis in the acute phase of SARS-CoV-2 infection predicts the presence of anosognosia for cognitive deficits in the chronic phase.

Reduced awareness of neuropsychological disorders (i.e., anosognosia) is a striking symptom of post-COVID-19 condition. Some leukocyte markers in the acute phase may predict the presence of anosognosia in the chronic phase, but they have not yet been identified. This study aimed to determine whether patients with anosognosia for their memory deficits in the chronic phase presented specific leukocyte distribution in the acute phase, and if so, whether these leukocyte levels might be predictive of anosognosia. First, we compared the acute immunological data (i.e., white blood cell differentiation count) of 20 patients who displayed anosognosia 6-9 months after being infected with SARS-CoV-2 (230.25 ± 46.65 days) versus 41 patients infected with SARS-Cov-2 who did not develop anosognosia. Second, we performed an ROC analysis to evaluate the predictive value of the leukocyte markers that emerged from this comparison. Blood circulating monocytes (%) in the acute phase of SARS-CoV-2 infection were associated with long-term post-COVID-19 anosognosia. A monocyte percentage of 7.35% of the total number of leukocytes at admission seemed to predict the presence of chronic anosognosia 6-9 months after infection.

Effect of Short-Term Deep-Pressure Portable Seat on Behavioral and Biological Stress in Children with Autism Spectrum Disorders: A Pilot Study.

Children with autism spectrum disorder (ASD) have challenging behaviors, which are associated with difficulties in parenting. Deep pressure is a therapeutic modality in occupational therapy, and it was reported to produce a calming effect. This study aimed to determine whether the short-term use of an autism hug machine portable seat (AHMPS) improves behavioral and neurobiological stress in children with ASD, and to determine whether AHMPS with an inflatable wrap or manual pull is more effective. This study enrolled children with ASD who were administered with the inflatable wrap (group I) and manual pull (group II) for 20 min twice a week for 3 weeks. Conners' Parent Rating Scale-48 (CPRS-48) was used to rate behavioral improvements, and galvanic skin response (GSR) was used to measure sympathetic stress response. A total of 20 children with ASD (14 boys and 6 girls; aged 7-13 years) were included. CPRS-48 presented conduct problems: behavior was significantly decreased in the inflatable group (p = 0.007) compared to the manual pull group. The GSR captured a significant reduction in sympathetic response (p = 0.01) only in group I. Neurobiological stress was reduced in children who were wearing the AHMPS inflatable wrap; therefore, AHMPS inflatable wrap is an effective method to reduce emotional arousal.

Prenatal education program decreases postpartum depression and increases maternal confidence: A longitudinal quasi-experimental study in urban Japan.

BACKGROUND: Mothers in urban Japan are at high risk for postpartum depression. Previous research indicates that parents who understand their baby's behavior may have lower risks for postpartum depression. HUG Your Baby helps parents understand their baby's behavior. AIM: The purpose of this longitudinal study was to determine whether mothers receiving prenatal HUG Your Baby teaching would have better outcomes than a control group with respect to postpartum depression and related factors. METHODS: Pregnant women, after thirty weeks' gestation, were recruited to either the intervention or the control group. The intervention group received HUG Your Baby education, which teaches how to recognize and respond to a baby's behavior. The control group received a leaflet and regular, prenatal treatment. Participants completed the Edinburgh Postnatal Depression Scale, Karitane Parenting Confidence Scale, and three other scales at one and three months, postpartum. Questions about knowledge of baby's behavior was administered prenatally, and at one and three months, postpartum. FINDINGS: Data derived from 221 mothers (Control 100, Intervention 121) were included in the analysis. Researchers found significant differences regarding postpartum depression at one and three months and parenting confidence at one month. Scores were favorable for the intervention group. CONCLUSIONS: The HUG Your Baby program has a positive impact on preventing postpartum depression and increasing parenting confidence. It warrants wider implementation and evaluation in prenatal programs.

The influence of duration, arm crossing style, gender, and emotional closeness on hugging behaviour.

Hugging is one of the most common types of affective touch encountered in everyday life. However, little is known about the factors that influence hugging evaluation and behaviour. Here, we aimed to assess how different hugs would be evaluated and whether they can affect mood. Furthermore, we aimed to investigate what kind of arm crossing is common in a naturalistic setting and whether arm crossing style could be predicted from gender, emotional closeness, and the height difference of huggers. We conducted two studies addressing these questions. In study 1, participants hugged a confederate for 1 second (s), 5 s or 10 s with two different arm crossing styles and reported how pleasant, arousing and under control the touch felt. Additionally, participants were asked about their mood ("self-ratings") immediately after, 3 minutes (min) after and 6 min after each hug. In study 2, participants were approached on campus and asked to share a hug, with arm crossing style being the dependent variable. The height difference, gender and self-rated emotional closeness to the hug partner were recorded as possible predictors for arm crossing style. Results from study 1 indicate that duration matters more than arm crossing style for hug pleasure, arousal, and control, with 1 s hugs being rated as least pleasant and under control than 5 s and 10 s hugs. Accordingly, 1 s hugs also resulted in lower pleasure self-ratings immediately post hug than 5 s and 10 s hugs. Arousal self-ratings were higher immediately post hug than several minutes after a hug. In study 2, gender was linked to arm crossing style, with male-male hug dyads exhibiting a different hugging style from female-female dyads. These findings are discussed in relation to previous hug research and gender differences in touch behaviour.

Combined clinical test and magnetic resonance imaging have similar diagnostic values in the diagnosis of subscapularis tear.

PURPOSE: The aim of the present study was to compare the diagnostic values of clinical tests and magnetic resonance imaging (MRI) which used for the diagnosis of subscapularis (SSc) tears in the patients who underwent arthroscopic rotator cuff surgery. METHODS: Two-hundred and nine consecutive patients who underwent arthroscopic rotator cuff surgery between 2015 and 2019 were analyzed. The lift-off test, belly-press test and bear-hug test were performed preoperatively. 1.5 T MRI scans of all patients were evaluated for SSc integrity. The diagnostic values of both clinical tests and MRI were calculated. SSc tears were graded according to Fox and Romeo. Arthroscopic findings were used as the gold standard for diagnosis of SSc tears. RESULTS: There were 54 SSc tears accounting for an prevalence of 29%. The BHT showed the greatest sensitivity for both type II-II-IV (73.3%) and all types of (68.5%) SSc tears. The sensitivity and specificity of the combined test and MRI were 91.1-87.2% and 93.3-90.8% in Type II-III-IV SSc tears, respectively, and 81.5-88.6% and 88.9-94.7% in all SSc tears, respectively. There were no statistically significant difference between combined test and MRI in terms of sensitivity and specificity (n.s.). CONCLUSION: The present study is the first that compared both clinical tests and MRI with arthroscopic findings in terms of sensitivity and specificity in the same patient group. A combination of clinical tests increases their diagnostic values and shows similar sensitivity and specificity as MRI. LEVEL OF EVIDENCE: I.

Thoracic flexion provokes circumferential dysesthesia: A symptom of thoracic cord lesions in MS.

Thoracic flexion, a rapid forward flexion at the waist, can elicit a circumferential electrical sensation in some patients with multiple sclerosis. The clinical and radiographic features of this phenomenon are described here. This symptom is typically a sensory band around the T6-T7 dermatomes and is usually associated with recent thoracic cord lesions. It is clinically independent of cervical pathology and Lhermitte's sign. Similar to the vertical radiation of symptoms upon neck flexion due to cervical cord lesions, this sign may help localize MS plaques to the thoracic cord, even when thoracic MRI is negative.

Comparative Effect of Mother's Hug and Massage on Neonatal Pain Behaviors Caused by Blood Sampling: A Randomized Clinical Trial.

BACKGROUND: The early experience of pain can lead to complications such as tachycardia, tachypnea and increased metabolic needs of the body, thereby exacerbation of the behavioral and physiological responses to pain in neonates. The current study aimed to compare the effect of a mother's hug and massage on pain behaviors during and after blood sampling in neonates. METHOD: This study was a randomized clinical trial. A total of 135 healthy full-term neonates were selected by convenience sampling method. Samples were randomly assigned to a mother's hug group, massage group or control group. In all three groups, the behavioral responses of the neonate were measured and recorded before, immediately and 5 min after blood sampling by Neonatal Infant Pain Scale. Heart rate, respiratory rate and blood oxygen saturation were recorded with pulse oximetry, and the crying period was measured from start to silence using a stopwatch. RESULTS: The results showed that after 5 min, the pain and heart rate in the mother's hug group decreased significantly compared to the massage and control groups (p < 0.001). There were no significant changes in the respiratory rate and blood oxygen saturation level in any of the newborns during blood sampling (p > 0.05). The duration of crying in the mother's hug group had more reduction than that of the massage and control groups (p < 0.001). CONCLUSION: The placement of the baby in the mother's hug during painful procedures is recommended due to the reduction of pain, the improvement of physiological symptoms and the promotion of neonatal health.

Four novel biomarkers for bladder cancer identified by weighted gene coexpression network analysis.

Bladder cancer (BC) is one of the most malignancies in terms of incidence and recurrence worldwide. The aim of this study is to find out novel and prognostic biomarkers for patients with BC. First, we identified 258 differentially expressed genes by using GSE19915 from Gene Expression Omnibus database. Second, a total of 33 modules were identified by constructing a coexpression network by using weighted gene coexpression network analysis and yellow module was regarded as the key module. Furthermore, by constructing protein-protein interaction networks, we preliminarily picked out 13 genes. Among them, four hub genes (CCNB1, KIF4A, TPX2, and TRIP13) were eventually identified by using five different methods (survival analysis, one-way analysis of variance, the Spearman correlation analysis, receiver operating characteristic curve, and expression value comparison), which were significantly correlated with the prognosis of BC. The validation of transcriptional and translational levels made sense (based on Oncomine and The Human Protein Atlas database). Moreover, functional enrichment analysis suggested that all the hub genes played crucial roles in chromosome segregation, sister chromatid segregation, nuclear chromosome segregation, mitotic nuclear division, nuclear division, and organelle fission during cell mitosis. In addition, three of the hub genes (KIF4A, TPX2, and TRIP13) might be potential targets of cancer drugs according to the results of the genetical alteration. In conclusion, this study indicates that four hub genes have great predictive value for the prognosis of BC, and may contribute to the exploration of the further and more in-depth research of BC.

An Open-Label Uncontrolled Trial of the Efficacy and Safety of a Hug with Singing and Rocking for Promotion of Relaxation in Pediatric Patients with Severe Motor and Intellectual Disabilities: Study Protocol.

Children with severe motor and intellectual disabilities (SMID) are continually exposed to stress due to their need to receive daily care. In particular, chronic physical and acute mental stress derived from daily medical care due to unstable health status are issues specific to SMID children. Therefore, it is important to approach these issues for the maintenance of their lives and quality of life. Seventeen children with a SMIDmedical care dependent group (SMID-MCDG) score of 25 or more will be enrolled in this study. Intervention by a hug while singing and rocking will be performed once a week for 24 weeks. The practitioner will sing, and slowly rock the child back and forth. Primary endpoint is high-frequency component of heart rate variability by frequency analysis. Secondary endpoints are low-frequency/high-frequency components of heart rate variability by frequency analysis, activity of salivary amylase, the incidence of adverse events, and changes in appearance. Frequency analysis of heart beat changes and salivary amylase activity are used as physiological indexes for assessing response to being held while singing and rocking. In this study, we will examine the efficacy and safety of hugging while singing and rocking as a practice of Ryouiku to promote relaxation in SMID-MCDG children.

Building Local Capacity in Hand-Rub Solution Production during the 2014-2016 Ebola Outbreak Disaster: The Case of Liberia and Guinea.

BACKGROUND: During the 2014-2015 Ebola outbreak in West Africa, the lack of infection prevention and control (IPC) measures in health care facilities amplified human-to-human transmission and contributed to the magnitude of this humanitarian disaster.Case ReportIn the summer of 2014, the Geneva University Hospitals (HUG; Geneva, Switzerland) conducted an IPC assessment and developed a project based on the local needs and their expertise with the support of the Swiss Agency for Development and Cooperation and the Humanitarian Aid Unit (SDC/HA; Bern, Switzerland). The project consisted of building local capacity in the production of alcohol-based hand-rub solution (ABHRS) based on the World Health Organization (WHO; Geneva, Switzerland) formula in non-Ebola health facilities at the peak of the outbreak in Liberia (Fall 2014) and during recovery in Guinea (September 2015) to promote safer care. Twenty-one pharmacists in Liberia and 22 in Guinea were trained and one years' worth of laboratory equipment, chemical products, containers for personal use, and bioethanol were delivered to 10 hospitals per country with more than 8,000 100 ml bottles of solution produced at the end of the project.DiscussionHand hygiene using hand-rub solution is a critical component of safer care, especially in health care settings lacking runnable water. Throughout the Ebola outbreak, it was a timely moment to promote hand-rub solution and to reinforce IPC measures in non-Ebola health facilities. During the project implementation, a substantial challenge was the unavailability of bioethanol in Liberia and Guinea. In the long run, sustainability of the production can become an issue as it depends heavily on the local government's financial and political commitment, the capacity to create an on-going demand for hand-rub solution in health facilities, the local purchase and replacement of the materials and chemical products, as well as the availability of continuous local partners' support. CONCLUSION: The project demonstrated that it was feasible to build local capacity in ABHRS production during an emergency and in limited-resource settings when materials and training are provided. Future programs in similar contexts should identify and address the factors of sustainability during the implementation phase and provide regular, long-term technical support. Jacquerioz BauschFA, HellerO, BengalyL, Matthey-KhouityB, BonnabryP, TouréY, KervillainGJ, BahEI, ChappuisF, HagonO. Building local capacity in hand-rub solution production during the 2014-2016 Ebola outbreak disaster: the case of Liberia and Guinea.. Prehosp Disaster Med. 2018;33(6):660-667.

Bodily-Contact Communication Medium Induces Relaxed Mode of Brain Activity While Increasing Its Dynamical Complexity: A Pilot Study.

We present the results of the analysis of the effect of a bodily-contact communication medium on the brain activity of the individuals during verbal communication. Our results suggest that the communicated content that is mediated through such a device induces a significant effect on electroencephalogram (EEG) time series of human subjects. Precisely, we find a significant reduction of overall power of the EEG signals of the individuals. This observation that is supported by the analysis of the permutation entropy (PE) of the EEG time series of brain activity of the participants suggests the positive effect of such a medium on the stress relief and the induced sense of relaxation. Additionally, multiscale entropy (MSE) analysis of our data implies that such a medium increases the level of complexity that is exhibited by EEG time series of our participants, thereby suggesting their sustained sense of involvement in their course of communication. These findings that are in accord with the results reported by cognitive neuroscience research suggests that the use of such a medium can be beneficial as a complementary step in treatment of developmental disorders, attentiveness of schoolchildren and early child development, as well as scenarios where intimate physical interaction over distance is desirable (e.g., distance-parenting).

Diagnostic performance of clinical tests for subscapularis tendon tears.

PURPOSE: Tears of the subscapularis (SSC) tendon constitute a diagnostic challenge. The purpose of the present study was to evaluate the diagnostic capabilities of five clinical SSC tests. METHODS: Five established clinical tests were evaluated in 106 consecutive patients prior to shoulder arthroscopy. The tests included the Lift Off Test, Internal Rotation Lag Sign, Belly Press Test, Belly Off Sign, and Bear Hug Test. The integrity of the SSC tendon at surgery was used as the gold standard. Lesions to the SSC were graded according to Fox and Romeo. RESULTS: There were 32 SSC lesions accounting for an incidence of 30.2%. The sensitivity for all tests was 0.66, while the specificity was 0.82. For all tests, positive tests results were found to be dependent on subscapularis integrity (p < 0.001, respectively). The sensitivity for any type of SSC lesion for the Lift Off Test, Internal Rotation Lag Sign, Belly Press Test, Belly Off Sign, and Bear Hug Test was 0.35, 0.41, 0.34, 0.31, and 0.52, respectively. Specificity was found to be 0.98, 0.91, 0.96, 0.97, and 0.85, respectively. If only grade 2-4 tears were analysed, sensitivity was 0.32, 0.42, 0.37, 0.37, and 0.72 and specificity 0.94, 0.86, 0.92, 0.94, and 0.84. A positive correlation was found between the number of positive tests and the severity of the SSC lesions. CONCLUSION: In the present study, the Bear Hug Test was found to have the highest sensitivity of all tests studied, especially for tears of the upper tendon border. It appears advisable to perform more than one clinical subscapularis test to further improve sensitivity. Nevertheless, SSC tears may still escape clinical recognition. Therefore, a high index of suspicion has to be maintained in order not to miss SSC tears. LEVEL OF EVIDENCE: Diagnostic study, Level I.

Effect of shoulder flexion angle and exercise resistance on the serratus anterior muscle activity during dynamic hug exercise.

[Purpose] The primary aim of this study was to determine the effect of shoulder flexion angle and exercise resistance on the serratus anterior muscle during dynamic hug exercise. [Subjects] Ten men aged 22-32 years were recruited. [Methods] The subjects performed dynamic hug exercise at different shoulder flexion angles and under resistance weight conditions. Serratus anterior muscle activities were measured by using the surface electromyographic system during the dynamic hug exercises. After performing the exercise, each subject described the exercise intensity by using the Borg rating of perceived exertion (RPE) scale. [Results] The normalized serratus anterior muscle activity increased significantly in the order of Conditions 1 and 4 < Condition 3 < Condition 2. The Borg RPE scale increased significantly in the order of Condition 1 < Condition 2 < Condition 3 < Condition 4. [Conclusion] The results suggest that dynamic hug exercise with the use of a multi-air-cushion biofeedback device is an effective scapular stability exercise.

Giant inguinal hernia: the challenging hug technique.

PURPOSE: Giant inguinoscrotal hernia are a real challenge for every kind of surgeon. The technique that we adopt is suggested as a good option to deal with this cases. We report our experience in five cases of giant inguinoscrotal hernia with loss of domain from 2005 to 2012. METHOD: Five patients with hernia that descended below the knees in the standing position, with an anteroposterior diameter not inferior to 30 cm and a laterolateral diameter of about 50 cm. Penis was not visible. We did the same procedure for all the five patients: single pararectus incision extended to groin region until proximal half of scrotum, isolation of the entire large sac out of the scrotal cavity, paying attention to not opening it, progressive reduction of the viscera without opening the sac with the hug technique, as shown in the video, placement of a heavyweight polypropylene meshes in the preperitoneal space, scrotal skin reductive plastic. In three of our five cases we obtained restoration of herniated viscera without resection of them. Orchiectomy was performed in all cases. RESULTS: No general neither wound complications were recorded. Long term follow up ranges from 8 years to 18 months: we did not record recurrence or chronic groin pain and scrotal size is normal in each patient. CONCLUSION: The technique proposed permits to treat with success giant inguinaoscrotal hernia, avoiding the use of further specific procedure such as the preoperative progressive pneumoperitoneum. All our patients were satisfied with the surgeries and their quality of daily life had definitely improved.

Effect of a Multi-Air-Cushion Biofeedback Device (MABD) on Shoulder Muscles during the Dynamic Hug Exercise.

[Purpose] We developed a multi-air-cushion biofeedback device (MABD) to assist the dynamic hug exercise, and investigated the effects of MABD on the shoulder muscles during the dynamic hug exercise. [Subjects] Twelve males aged 22-32 years were recruited. [Methods] We measured the right side serratus anterior, lower trapezius, and upper trapezius muscle activities during the dynamic hug exercise with and without MABD. [Results] The serratus anterior and lower trapezius muscles activities significantly increased during the dynamic hug exercise with MABD compared to without it. The upper trapezius muscle significantly decreased during the dynamic hug exercise with MABD compared to without it. [Conclusion] The results suggest that the dynamic hug exercise with MABD is an effective scapular stability exercise.

Cytoplasmic localization of Hug1p, a negative regulator of the MEC1 pathway, coincides with the compartmentalization of Rnr2p-Rnr4p.

The evolutionarily conserved MEC1 checkpoint pathway mediates cell cycle arrest and induction of genes including the RNR (Ribonucleotide reductase) genes and HUG1 (Hydroxyurea, ultraviolet, and gamma radiation) in response to DNA damage and replication arrest. Rnr complex activity is in part controlled by cytoplasmic localization of the Rnr2p-Rnr4p subunits and inactivation of negative regulators Sml1p and Dif1p upon DNA damage and hydroxyurea (HU) treatment. We previously showed that a deletion of HUG1 rescues lethality of mec1Δ and suppresses dun1Δ strains. In this study, multiple approaches demonstrate the regulatory response of Hug1p to DNA damage and HU treatment and support its role as a negative effector of the MEC1 pathway. Consistent with our hypothesis, wild-type cells are sensitive to DNA damage and HU when HUG1 is overexpressed. A Hug1 polyclonal antiserum reveals that HUG1 encodes a protein in budding yeast and its MEC1-dependent expression is delayed compared to the rapid induction of Rnr3p in response to HU treatment. Cell biology and subcellular fractionation experiments show localization of Hug1p-GFP to the cytoplasm upon HU treatment. The cytoplasmic localization of Hug1p-GFP is dependent on MEC1 pathway genes and coincides with the cytoplasmic localization of Rnr2p-Rnr4p. Taken together, the genetic interactions, gene expression, and localization studies support a novel role for Hug1p as a negative regulator of the MEC1 checkpoint response through its compartmentalization with Rnr2p-Rnr4p.

Supporting Fathers in a NICU: Effects of the HUG Your Baby Program on Fathers' Understanding of Preterm Infant Behavior.

Fathers of preterm babies in a neonatal intensive care unit (NICU) are under stress. Lack of knowledge about a preterm infant's behavior challenges new fathers who may be required to make decisions about the hospitalized infant, to update concerned family and friends, and to provide support to the mother while she recovers from giving birth. The NICU nurses have the opportunity to support and guide these new fathers, although no previous research has confirmed how to do so effectively. This study confirmed that using The HUG Your Baby DVD and family-friendly educational program with fathers of preterm babies in a NICU increased fathers' knowledge of infant behavior and, as previous research suggests, is likely to boost fathers' confidence and to promote the parent-child relationship and strengthen the family unit.