Deep mutational scanning of hepatitis B virus reveals a mechanism for cis-preferential reverse transcription.

Hepatitis B virus (HBV) is a small double-stranded DNA virus that chronically infects 296 million people. Over half of its compact genome encodes proteins in two overlapping reading frames, and during evolution, multiple selective pressures can act on shared nucleotides. This study combines an RNA-based HBV cell culture system with deep mutational scanning (DMS) to uncouple cis- and trans-acting sequence requirements in the HBV genome. The results support a leaky ribosome scanning model for polymerase translation, provide a fitness map of the HBV polymerase at single-nucleotide resolution, and identify conserved prolines adjacent to the HBV polymerase termination codon that stall ribosomes. Further experiments indicated that stalled ribosomes tether the nascent polymerase to its template RNA, ensuring cis-preferential RNA packaging and reverse transcription of the HBV genome.

Structure of the interleukin-5 receptor complex exemplifies the organizing principle of common beta cytokine signaling.

Cytokines regulate immune responses by binding to cell surface receptors, including the common subunit beta (ßc), which mediates signaling for GM-CSF, IL-3, and IL-5. Despite known roles in inflammation, the structural basis of IL-5 receptor activation remains unclear. We present the cryo-EM structure of the human IL-5 ternary receptor complex, revealing architectural principles for IL-5, GM-CSF, and IL-3. In mammalian cell culture, single-molecule imaging confirms hexameric IL-5 complex formation on cell surfaces. Engineered chimeric receptors show that IL-5 signaling, as well as IL-3 and GM-CSF, can occur through receptor heterodimerization, obviating the need for higher-order assemblies of ßc dimers. These findings provide insights into IL-5 and ßc receptor family signaling mechanisms, aiding in the development of therapies for diseases involving deranged ßc signaling.

Selective treatment of clinical mastitis: Assessment of the Net Cash Impact on Dairy Farms Under Diverse Scenarios. A European Perspective.

Selective treatment of clinical mastitis (STCM) potentially reduces antimicrobial use without negative implications on cow's milk production or health. However, this approach comes with additional costs. The aim of this study was to evaluate the net cash impact (NCI) of implementing STCM compared with blanket treatment of clinical mastitis (BTCM) under different diagnostic-test turnaround times (24 h, 14 h, and 8 h) using a stochastic partial budget analysis with Monte Carlo simulation. The target population was European commercial dairy herds; therefore, the model inputs were primarily from European sources. Additionally, variables associated with dairy management programs were obtained from USDA sources, worldwide multisite clinical trials, and expert opinion. The output was calculated by subtracting the cost of STCM from the cost of BTCM and it represented the expected NCI if a herd switched from BTCM to STCM. Depending on the time-to-treatment efficiency and diagnostic-test turnaround time, the expected mean NCI, assuming that STCM has no impact on the cow's future health or production, ranged from +€8.7 to +€12.4 per case with 72.4% to 84.8% of the iterations being ≥ €0. Moreover, using the numerically favorable health and production effects of STCM reported in the literature, the expected mean NCI ranged from +€44.5 to +€48.1 per case with 93.6% to 95.4% of the iterations being ≥ €0. The variables with the greatest contribution to NCI variance were proportion of gram-positive cases (39.2% of the variance) and days out of the tank for treated cows (22.0%). However, if future cow's health and production were accounted for, culling risk (24.6%), recurrence risk (19.4%), and milk yield (10.6%) would have the greatest contribution to NCI. The sensitivity analysis indicated that farms with high clinical mastitis incidence, low proportion of gram-positive cases, large number of days out of the tank for treated cows, higher milking frequency or using automatic milking systems, not using the highest priced diagnostic tests, and having high antimicrobial treatment costs are the best candidates for STCM. Improving time-to-treatment efficiency, for example, by using a rapid diagnostic test, leads to a favorable NCI, while high daily milk yield and milk price enhances the NCI in already positive scenarios. Finally, the cash flow entirely depends on future cow's health and milk yield. In conclusion, results indicate that overall, STCM is a practice that positively impacts the NCI of many herds.

Essential Review of Oncological Emergencies.

Innovations in oncology have expanded treatment eligibility, leading to a rise in cancer patients requiring critical care. This necessitates that all critical care clinicians possess a fundamental knowledge of prevalent oncological conditions and identify emergent scenarios requiring immediate action. This article will explore key oncological complications and their management approaches.

Effectiveness of handheld near infrared spectrometer for traceability of Angus steaks.

The feasibility of Near Infrared Spectroscopy was assessed for aging traceability of steaks of Angus beef (Biceps femoris) individually vacuum-packaged, as well as for the prediction of the refrigeration storage time (0, 7, and 14 days). For this purpose, a total of 288 steaks homogeneously distributed among the sampling times were used. The model developed by Partial Least Squares-Discriminant Analysis offered high discrimination ability between aged beef vs. non-aged. The accuracy after external validation exceeded 90%. Regarding the predictive capacity of the storage time, it was greater on the set of aged samples, in which the accuracy achieved values higher than 96%, while the accuracy decreased to 75% for the non-aged samples. Results obtained support the ability of NIRS technology to be considered in any digital transformation strategy for traceability across the meat supply chain.

Acoustic Communication in Dendroctonus adjunctus Blandford (Curculionidae Scolytinae): Description of Calls and Sound Production Mechanism.

The acoustic communication system (ACS) in bark beetles has been studied mainly in species of the genera Dendroctonus, Ips and Polygraphus. Specifically, ACS of the roundheaded pine beetle, Dendroctonus adjunctus, has been little studied. In this study, we described the stridulatory apparatus of this beetle using optical and scanning electron microscopy and recorded the call types produced by males in three behavioral contexts: stress, female-male-, and male-male interactions. From the spectrograms and waveforms, call types, as well as temporal (tooth strike, tooth strike rate, and intertooth strike interval) and spectral features (minimum, maximum and dominant frequency), were determined. Males have a functional elytro-tergal stridulatory apparatus-females do not-consisting of a file for the pars stridens and two lobes for the plectrum. Most of spectro-temporal features were statistically different between single- and multi-noted calls and across the three behavioral contexts. In the male-male interaction, a new type of call named "withdrawal" was produced by the male withdrawing or fleeing. Our results suggest that the spectro-temporal features of single- and multiple-noted calls in the three behavioral conditions are specific and different from each other. Yet, the combination of single and multiple calls determines an overall calling pattern characteristic of the tested behaviors and, therefore, is species-specific.

Ground penetrating radar at work: A realistic perspective on utility surveying in the Netherlands through a comprehensive ground-truth dataset.

This dataset provides a comprehensive compilation of Ground Penetrating Radar (GPR) surveys across 125 utility surveying activities in the Netherlands. The dataset details the specific use of GPR in each authentic real-life utility surveying activity, whether employed independently or as a complementary tool alongside existing surveying methods, with or without post-processing. The dataset includes 959 radargrams, ground-truth information obtained from trial trenches, and an inventory of construction, geophysical, infrastructural, and technical features. The GPR utilised in all activities is an air-coupled radar with a 500 MHz frequency antenna, a GNSS RTK positioning system, and a measuring wheel encoder. This ground-truth dataset provides researchers with a valuable resource to further assess the practical efficacy of GPR as a utility surveying method, refine radargram processing algorithms and techniques, and explore the possibilities of predictive modelling.

Relation of changes in peak expiratory flow (PEF) and forced expiratory volume in 1 s (FEV1) during bronchoconstriction.

Diagnosis of asthma can be confirmed based on variability in peak expiratory flow (PEF) or changes in forced expiratory volume in 1 s (FEV1) measured with spirometry. Our aim was to use methacholine challenge as a model of induced airway obstruction to assess how well relative changes in PEF reflect airway obstruction in comparison to relative changes in FEV1. We retrospectively studied 878 patients who completed a methacholine challenge test. To assess congruency along with differences between relative changes in FEV1 and PEF during airway obstruction, a regression analysis was performed, and a Bland & Altman plot was constructed. ROC analysis, sensitivity, specificity, positive and negative predictive values and κ-coefficient were used to analyze how decrease in PEF predicts decrease of 10% or 15% in FEV1. The relative change in PEF was on average less than the relative change in FEV1. In the ROC analysis areas under the curve were 0.844 and 0.893 for PEF decrease to predict a 10% and 15% decrease in FEV1, respectively. The agreement between changes in PEF and FEV1 varied from fair to moderate. Airway obstruction detected by change in PEF was false in about 40% of cases when compared to change in FEV1. Change in PEF is not a very accurate measure of airway obstruction when compared to change in FEV1. Replacing peak flow metre with a handheld spirometer might improve diagnostic accuracy of home monitoring in asthma.

A Case Series of Patients With Complex Airway Disease and Large Thyroid Tumors Anterior to the Trachea Precluding Tracheostomy.

BACKGROUND: This case series explores the management of respiratory failure in patients with large anterior tracheal thyroid tumors where tracheostomy is not an option. To our knowledge, this study is the first to address the challenges associated with caring for such patients. CASE SUMMARY: We present the clinical courses of four intubated adults with advanced thyroid cancer and complex airway issues that preclude surgical tracheostomy. Interventions included custom airway stents, long-term intubation, and oncological therapies. Ethical quandaries around patient autonomy and capacity emerged, exacerbated by the absence of viable exit strategies for prolonged intubation, notably the performance of a tracheostomy, causing emotional distress in patients, families, and staff. CONCLUSIONS: This study showcases the multifaceted challenges in medical, ethical, and emotional domains associated with managing intubated patients with complex disease precluding tracheotomies. We advocate for a nuanced, multidisciplinary, and personalized approach to confront unique issues in airway management, ethical considerations, and disposition.

Mechanical Behaviour of As-Manufactured and Repaired Aligned Discontinuous Basalt Fibre-Reinforced Vitrimer Composites.

The aim of this research is to investigate basalt as a natural mineral-based fibre together with a vitrimeric resin as a sustainable alternative to standard composite materials. Vitrimers combine the properties of thermoset and thermoplastic polymers, enabling the repair of specimens and hence prolonging the lifetime of the composite material. The micro-mechanical characteristics between the basalt fibres and the vitrimer resin are reported and shown to match those of a standard Skyflex K51 epoxy resin. Discontinuous (4 mm) basalt fibres were employed to produce aligned discontinuous fibre-reinforced composites (ADFRCs) using the high-performance discontinuous fibre (HiPerDiF) technology. The mechanical characteristics of the laminates were investigated through tensile testing and the fracture zones were analysed under a scanning electron microscope. By normalising the results by their respective fibre volume fraction, it was discovered that the vitrimer-basalt ADFRCs exhibited, on average, a 4% higher strength and a 25% higher stiffness compared to their basalt epoxy counterparts. The repair potential of the vitrimer ADFRC specimens was explored during low-temperature compression repair. Two approaches were tested using double-sided local- and full-patch repair. Both successfully recovered a significant amount of their prime strength. In conclusion, the potential of the sustainable vitrimer-basalt composite is shown by its competitive mechanical performance. Combining this with the manufacturing flexibility, repair potential, and recyclability of the material, the vitrimer-basalt composite seems to be a competitive alternative to standard glass epoxies.

Water level drawdown induces a legacy effect on the seed bank and retains sediment chemistry in a eutrophic clay wetland.

The lack of extreme water level fluctuations in managed, non-peat forming wetland ecosystems can result in decreased productivity through the loss of heterogeneity of these ecosystems. Stochastic disruption, such as a water level drawdown, can effectively reverse this effect and return the wetland to a more productive state, associated with higher biodiversity through new vegetation development. Yet, aside from the effect on vegetation dynamics, little is known about longer-term effects (30 years) of a water level drawdown, hereafter referred to as legacy effects, and how this may impact future water level drawdowns. Here, we aim to unravel the legacy effects of a water level drawdown, stand alone and along a water level gradient, on seed bank properties and nutrient availability in a eutrophic clay wetland. To identify these, we studied the hydrologically managed nature reserve Oostvaardersplassen in the Netherlands. Here, one section was subjected to a multi-year water level drawdown and another section was kept inundated. We determined seed bank properties in both areas, spatially and along a soil elevation gradient (20 cm). Nutrient availability was measured by taking sediment samples along the water level gradient and through experimental manipulation of the water level in an indoor mesocosm experiment. Germination was higher in locations with a water level drawdown history, especially at relatively high elevations. Additionally, the proportion of pioneer species in the seed bank was higher in the water level drawdown area. Overall, nutrient concentrations were higher compared to other aquatic systems. Nutrient availability was higher in the inundated area and did not respond to the water level gradient. We conclude that 30 years after an induced water level drawdown there is no depletion of nutrients, while we still observe a legacy effect in the number of viable seeds in the seed bank.

From Chalcogen Bonding to S-π Interactions in Hybrid Perovskite Photovoltaics.

The stability of hybrid organic-inorganic halide perovskite semiconductors remains a significant obstacle to their application in photovoltaics. To this end, the use of low-dimensional (LD) perovskites, which incorporate hydrophobic organic moieties, provides an effective strategy to improve their stability, yet often at the expense of their performance. To address this limitation, supramolecular engineering of noncovalent interactions between organic and inorganic components has shown potential by relying on hydrogen bonding and conventional van der Waals interactions. Here, the capacity to access novel LD perovskite structures that uniquely assemble through unorthodox S-mediated interactions is explored by incorporating benzothiadiazole-based moieties. The formation of S-mediated LD structures is demonstrated, including one-dimensional (1D) and layered two-dimensional (2D) perovskite phases assembled via chalcogen bonding and S-π interactions, through a combination of techniques, such as single crystal and thin film X-ray diffraction, as well as solid-state NMR spectroscopy, complemented by molecular dynamics simulations, density functional theory calculations, and optoelectronic characterization, revealing superior conductivities of S-mediated LD perovskites. The resulting materials are applied in n-i-p and p-i-n perovskite solar cells, demonstrating enhancements in performance and operational stability that reveal a versatile supramolecular strategy in photovoltaics.

Ejercicio físico y disminución del peso y el índice de masa corporal en la cirugía bariátrica: una revisión sistemática / Physical exercise and loss of weight and body mass index in bariatric surgery: a systematic review

Introducción: la cirugía bariátrica se considera exitosa cuando el porcentaje de pérdida de peso es igual o superior al 25 % o bien cuando el porcentaje de pérdida de índice de masa corporal ocurre por encima del 50 % a largo plazo. Objetivo: analizar el efecto del ejercicio físico en el peso corporal y el índice de masa corporal antes y después de la cirugía bariátrica. Metodología: se buscaron artículos registrados en las bases de datos de PudMed, Scopus y Web of Science, de artículos originales con acceso abierto en inglés y español que compararan uno o varios programas de ejercicio físico como tratamiento antes y/o después de la cirugía bariátrica, con resultados de peso e índice de masa corporal inicial y final, masa muscular y masa grasa, de enero a abril de 2021. Resultados: se obtuvieron en total 730 artículos de las diferentes bases de datos y solo 7 se seleccionaron para el análisis. El ejercicio aerobio combinado con el entrenamiento de resistencia mostró una mayor disminución del porcentaje de peso perdido (% PP) y del porcentaje perdido de índice de masa corporal (% PIMC). Conclusiones: el ejercicio físico aerobio, en combinación con el entrenamiento de resistencia, es el programa más aplicado a los sujetos con cirugia bariátrica y los efectos más importantes son el aumento del porcentaje de pérdida de peso y la disminución del índice de masa corporal (AU)

Introduction: bariatric surgery is considered successful when the percentage of weight loss is equal to or higher than 25 %, or when the percentage loss of body mass index occurs above 50 % long-term. Objective: to analyze the effect of physical exercise on body weight and body mass index before and/or after bariatric surgery. Methodology: articles registered in the PudMed, Scopus and Web of Science databases were searched for original papers with open access in English and Spanish that compared one or more physical exercise programs as treatment before and/or after bariatric surgery, with results on initial and final weight and body mass index, muscle mass, and fat mass from January to April 2021. Results: a total of 730 articles were obtained in the different databases and only 7 were selected for the analysis. Aerobic exercise combined with resistance training showed a greater decrease in the percentage of weight loss (% PP) and the percentage of loss of body mass index (% PBMI). Conclusions: aerobic physical exercise in combination with endurance training is the most applied program in subjects with bariatric surgery, and the most important effects are an increase in percentage of weight loss and a decrease in body mass index (AU)

Tumoración subungueal, no siempre son partes blandas / Subungual tumor, not always soft tissue

La exostosis subungueal es un tipo de tumor óseo benigno, muy infrecuente en la infancia, que se localiza habitualmente en la falange distal del primer dedo del pie. Se presenta como una tumoración dolorosa que afecta a la uña y a los tejidos blandos periungueales. En su diagnóstico diferencial se incluyen lesiones dermatológicas como la verruga vulgar o el granuloma piogénico, y tumores óseos como el osteocondroma. El diagnóstico definitivo se basa en los hallazgos radiológicos e histopatológicos. Su tratamiento es la exéresis quirúrgica y suele tener buen pronóstico (AU)

Subungual exostosis is a benign bone tumor, very unusual in childhood, which is usually located in the distal phalanx of the first toe. It presents as a painful tumoration that affects the overlying nail and the periungual soft tissues. The differential diagnosis includes dermatological lesions such as common warts or pyogenic granuloma, and bone tumors such as osteochondroma. The final diagnosis is based on the radiological and histopathological findings. The treatment is surgical excision and the outcome is usually favourable. (AU)

Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias I. Protocolo / Pharmacovigilance of COVID-19 vaccines in community pharmacies I. Protocol

INTRODUCCIÓN: la aprobación en tiempo récord de las vacunas frente a la COVID-19 hace necesario implementar acciones de farmacovigilancia, tanto de reacciones infrecuentes, como a medio o largo plazo, con el fin de completar su perfil de seguridad.OBJETIVOS: colaborar en la evaluación de la seguridad de las vacunas, mediante la detección y seguimiento de sospechas de reacciones adversas en los usuarios de las farmacias.MATERIAL Y MÉTODOS. Diseño: estudio observacional prospectivo, en farmacias comunitarias de Ourense y Pontevedra, a partir de la administración de las vacunas frente al SARS-CoV-2 en febrero de 2021.Sujetos: usuarios de la farmacia que hayan recibido la vacuna, mayores de edad, y que firmen el consentimiento informado. Variables principales: número y porcentaje de sujetos que presentan al menos una reacción adversa en relación al número de pacientes incorporados al estudio; su número, tipo y frecuencia. Repercusión en su vida diaria. Procedimiento: oferta de participación en el estudio, entrevista en la zona de atención personalizada. Recogida de datos en un cuaderno de registro cumplimentado por el farmacéutico junto con el paciente. Seguimiento decenal presencial o telefónico después de la primera y segunda dosis de vacuna recibidas y mensual a partir del segundo mes de la segunda dosis. A los pacientes vacunados con una reacción considerada leve tras su evaluación, se recomendarán medidas no farmacológicas convenientes y si es necesario, se les indicará un medicamento sin receta adecuado para la resolución o alivio del problema de salud originado por la reacción. Tamaño muestral: para una precisión del 5,0 % en la estimación de una proporción mediante un intervalo de confianza al 95 % bilateral, asumiendo que el porcentaje de sujetos con al menos una reacción adversa sería del 20,0 %, resultó necesario incluir 246 participantes. (AU)

Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias II. Reacciones adversas en farmacéuticos y personal auxiliar / Pharmacovigilance of COVID-19 vaccines in community pharmacies II. Adverse reactions in pharmacists and auxiliary personnel

OBJETIVO: conocer tipo y frecuencia de las sospechas de reacciones adversas (RA) experimentadas entre los farmacéuticos comunitarios (FC) y personal auxiliar de las farmacias de Pontevedra con la primera dosis de la vacuna y su repercusión laboral y personal.MÉTODOS . Diseño: estudio observacional transversal, febrero-abril de 2021.Sujetos: farmacéuticos, técnicos y auxiliares de la provincia de Pontevedra que ejercen en contacto con los pacientes, vacunados con la primera dosis frente al SARS-CoV-2, que dieron su consentimiento explícito. Variables: número, tipo y frecuencia de RA, repercusión. Procedimiento: se habilitó un formulario en la web del Colegio de Farmacéuticos de Pontevedra. Se anunció a los FC colegiados de la provincia su existencia y la conveniencia de cumplimentarlo. Tamaño muestral: teniendo en cuenta la metodología de incorporación al estudio, mediante cumplimentación voluntaria del cuestionario, no se consideró procedente. Análisis de resultados: test de chi- cuadrado para el análisis de variables cualitativas, t de Student y Mann-Whitney para cuantitativas. La normalidad comprobada mediante Kolmogorov-Smirnov con corrección de Lilliefors. Significación estadística p<0,05.Resultados 153 participantes manifestaron síntomas compatibles con reactividad a la vacuna, 122 (93,1 %) mujeres y 31 (86,1 %) hombres. 146 (95,4 %) que recibieron Vaxzevria® (VZ), 116 (79,4 %) mujeres y 30 (20,6 %) hombres, y 7 (4,6 %) Comirnaty® Pfizer-BioNtech (CO), 6 (85,7 %) mujeres y 1 (14,3 %) hombres. Se comunicaron 823 RA, 811 (98,5 %) con VZ y 12 (1,5 %) con CO. Reacciones más frecuentes: dolor en punto de inyección, 128 (87,7 %); escalofríos, 107 (73,3 %); dolor muscular, 106 (72,6 %). El número máximo de RA manifestadas por un participante fue 12. (AU)

Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias III. Primera dosis / Pharmacovigilance of COVID-19 vaccines in community pharmacies III. First dose

OBJETIVO: conocer tipo y frecuencia de sospechas de reacciones adversas (RA) experimentadas por la población general tras la primera dosis de la vacuna frente a COVID-19 y la repercusión sobre su actividad diaria.MÉTODOS: se describen detalladamente en el protocolo del Proyecto. Procedimiento: en un cuaderno de recogida de datos ad hoc se registraron datos demográficos, sospechas de RA y demás circunstancias referidas por los encuestados.RESULTADOS: colaboraron 10 farmacias de la provincia de Pontevedra y 2 de Ourense que incorporaron 781 casos válidos, 488 (62,5 %) mujeres y 293 (37,5 %) hombres. Media de edad 56,8 (DE=17,9) (rango=18-97) años. 389 (49,8 %) estaban incluidos en grupos de riesgo: edad ≥65 años 271 (34,7 %), 219 hipertensión arterial, 148 dislipemias, 105 neuropsiquiátricas, 88 cardiológicas, 75 diabetes, 62 EPOC/problemas respiratorios. 119 (15,2 %) anticoagulados. 64 (8,2 %) habían pasado la enfermedad.445 (57,0 %) recibieron Comirnaty® Pfizer-BioNtech (CO), 190 (24,3 %) Vaxzevria® (VZ), 104 (13,3 %) Spikevax® Moderna (SP) y 42 (5,4 %) COVID-19 Vaccine Janssen (JA). La mayoría, 491 (62,9 %) en los “vacunódromos”. 204 (26,1 %) utilizaron medicamentos como profilaxis de posibles RA. 165 (80,1 %) paracetamol.495 (63,4 %) vacunados, 321 mujeres (65,8 %) y 174 (59,4 %) hombres (diferencia no significativa), refirieron al menos una RA: 236 (53,0 %) CO, 157 (82,6 %) VZ, 69 (66,3 %) SP y 33 (80,5 %) JA. El número de RA manifestadas por los encuestados fue 1.419, con máximo de 13 por persona, resultando las más prevalentes, afectando a >10 % de los vacunados: dolor en el punto de inyección 375 (48,0 %), cansancio/fatiga 170 (21,8 %), escalofríos 118 (15,1 %), cefalea 117 (15,0 %), dolor muscular 112 (14,3 %) y fiebre 98 (12,5 %). (AU)

Farmacovigilancia de las vacunas frente a la COVID-19 en farmacias comunitarias IV. Segunda dosis / Pharmacovigilance of COVID-19 vaccines in community pharmacies IV. Second dose

OBJETIVO: conocer tipo y frecuencia de sospechas de reacciones adversas (RA) experimentadas por la población general con la segunda dosis de la vacuna frente a COVID-19 y la repercusión sobre su actividad diaria.MÉTODOS: se describen detalladamente en el protocolo del Proyecto. Procedimiento: Seguimiento de los participantes incorporados al estudio tras la 2ª dosis, registrándose las nuevas sospechas de RA experimentadas. Resultados10 farmacias de la provincia de Pontevedra y 2 de Ourense incorporaron vacunados. Tras la 2ª dosis se redujeron en 88 (11,3 %): 43 habían recibido COVID-19 Vaccine Janssen® (JA), 39 se habían contagiado entre dosis, 1 no quiso vacunarse por RA de la 1ª dosis y con 5 no se pudo contactar. Quedaron 693 participantes, 441 (63,6 %) mujeres y 252 (36,4 %) hombres. Media de edad 57,8 (DE=18,0) (rango=18-97). 416 (60,0 %) recibieron Comirnaty® Pfizer- BioNtech (CO), 177 (25,5 %) Vaxzevria® (VZ) y 100 (14,5 %) Spikevax® Moderna (SP). 175 (25,2 %) utilizaron medicamentos como profilaxis de posibles RA. 145 (82,9 %) paracetamol.312 (45,0 %) vacunados, 218 mujeres (49,4 %) y 94 (37,1 %) hombres (p<0,01) refirieron al menos una reacción adversa: 183 (43,9 %) CO, 66 (37,3 %) VZ y 63 (63,0 %) SP. El número de reacciones adversas manifestadas por los encuestados fue de 971, con un máximo de 11 por vacunado, resultando las más prevalentes, que afectaron a >10 % de estos: dolor en punto de inyección 197 (28,4 %), cansancio/fatiga 141 (20,3 %), dolor muscular 111 (16,0 %), cefalea 95 (13,7 %) y fiebre 84 (12,1 %). (AU)

Evaluación de conocimientos y autonomía para la transición de adolescentes hacia la atención de adultos / Assessment of knowledge and autonomy for the transition from adolescent toward adult care

INTRODUCCIÓN: Cada vez más niños con enfermedades complejas logran sobrevivir requiriendo el paso de una atención pediátrica a una de adultos. Es fundamental contar con herramientas que permitan conocer el grado de preparación del paciente para este traslado. OBJETIVO: Crear un cuestionario local para medir el estado de preparación para la transición de adolescentes con enfermedad crónica y someterlo a pruebas de validación. PACIENTES Y MÉTODO: Basado en cuestionarios internacionales se diseñó un instrumento de auto-reporte que se sometió a validez de contenido por expertos, y luego a pruebas de comprensión y factibilidad en grupo piloto. Posteriormente se realizó validación de constructo y fiabilidad utilizando análisis factorial tras ser aplicado en adolescentes con enfermedad crónica. RESULTADOS: Tras el análisis por 11 expertos y piloto de 8 pacientes se obtuvo un instrumento que fue respondido en forma completa por 168 adolescentes. Edad promedio 14,4 años. Tras la validación de constructo se genera un instrumento de 24 ítems de alta relevancia clínica, con 9 ítems con resultados psicométricos aceptables, los que se destacan en el cuestionario final. CONCLUSIÓN: Se presenta un cuestionario de auto-reporte para medir el estado de preparación de los adolescentes para la transición a servicios de adultos. Las propiedades psicométricas del instrumento resultaron insuficientes para su validación, ya que sólo se comprueba la validez de constructo y confiabilidad para 9 de los 24 ítems.

INTRODUCTION: In the last decades more and more children survive with complex health conditions, requiring a transition from pediatric to adult care. It is essential to have instruments that provide information on the level of preparation of patients for this process. OBJECTIVE: To create and validate a questionnaire to measure the readiness status of adolescent patients with chronic diseases in the transition process. PATIENTS AND METHOD: Based on international questionnaires, a self-report instrument was designed which was subjected to content validity by experts, and then to comprehension and feasibility tests in a pilot group. Subsequently, construct and reliability validation were performed through a factorial analysis after applied it to adolescents living with a chronic illness. RESULTS: After the analysis made by 11 experts and the pilot group with 8 patients, we obtained an instrument that was fully answered by 168 teenagers (Average age 14.4 years). After construct validation, a 24-items instrument of high clinical relevance was developed, with 9 items with acceptable psychometric properties, which were highlighted in the final questionnaire. CONCLUSION: a self-report instrument aimed to measure the readiness of adolescents during the transition process to adult care is presented. The reported psycho metric properties of the instrument were insufficient to consider it validated since the construct vali dity and reliability were only checked for 9 of the 24 items.