PD-1 inhibits T cell actin remodeling at the immunological synapse independently of its signaling motifs.

Engagement of the receptor programmed cell death molecule 1 (PD-1) by its ligands PD-L1 and PD-L2 inhibits T cell-mediated immune responses. Blocking such signaling provides the clinical effects of PD-1-targeted immunotherapy. Here, we investigated the mechanisms underlying PD-1-mediated inhibition. Because dynamic actin remodeling is crucial for T cell functions, we characterized the effects of PD-1 engagement on actin remodeling at the immunological synapse, the interface between a T cell and an antigen-presenting cell (APC) or target cell. We used microscopy to analyze the formation of immunological synapses between PD-1+ Jurkat cells or primary human CD8+ cytotoxic T cells and APCs that presented T cell-activating antibodies and were either positive or negative for PD-L1. PD-1 binding to PD-L1 inhibited T cell spreading induced by antibody-mediated activation, which was characterized by the absence of the F-actin-dense distal lamellipodial network at the immunological synapse and the Arp2/3 complex, which mediates branched actin formation. PD-1-induced inhibition of actin remodeling also prevented the characteristic deformation of T cells that contact APCs and the release of cytotoxic granules. We showed that the effects of PD-1 on actin remodeling did not require its tyrosine-based signaling motifs, which are thought to mediate the co-inhibitory effects of PD-1. Our study highlights a previously unappreciated mechanism of PD-1-mediated suppression of T cell activity, which depends on the regulation of actin cytoskeleton dynamics in a signaling motif-independent manner.

Assessing complementarities between live performances and YouTube video streaming.

Digitization and increased accessibility to recorded music have made revenue-generating activities increasingly tied to live performances. In this context, identifying the full impact of concerts (namely capturing the value of activities that emerge as a consequence of them) is of primary interest to assess the sustainability of the different music ecosystems. This paper analyzes spillover effects from playing live to YouTube video streaming. A sample of 190 artists performing in two international music festivals in years 2016 to 2019 has been selected, and the temporal patterns of online video searches for each one have been collected. Using a regression discontinuity design, results show a discrete jump of the YouTube search index for the average performer in the sample after playing live. Furthermore, there is evidence of a gender-specific effect: female performers experience a greater increase in YouTube searches. Though exploratory, this gender bias is consistent with potential theoretical explanations to be explored. Overall, findings provide causal evidence of the effect of live performances on a related but different market (i.e., recorded music), which underlines how technological disruptions may enable alternative revenue sources for musicians.

Vitamin D and Risk of Obesity-Related Cancers: Results from the SUN ('Seguimiento Universidad de Navarra') Project.

Obesity is associated with a higher risk of several types of cancer, grouped as obesity-related cancers (ORC). Vitamin D deficiency is more prevalent in obese subjects, and it has been suggested to play a role in the association between obesity and cancer risk. The aim of the study was to analyze the association between vitamin D intake and the subsequent risk of ORC in a prospective Spanish cohort of university graduates. The SUN Project, initiated in 1999, is a prospective dynamic multipurpose cohort. Participants answered a 556-item lifestyle baseline questionnaire that included a validated food-frequency questionnaire. We performed Cox regression models to estimate the hazard ratios (HRs) of ORC according to quartiles of energy-adjusted vitamin D intake (diet and supplements). We included 18,017 participants (mean age = 38 years, SD = 12 years), with a median follow-up of 12 years. Among 206,783 person-years of follow-up, we identified 225 cases of ORC. We found no significant associations between vitamin D intake and ORC risk after adjusting for potential confounders: HRQ2vsQ1 = 1.19 (95% CI 0.81-1.75), HRQ3vsQ1 = 1.20 (95% CI 0.81-1.78), and HRQ4vsQ1 = 1.02 (95% CI 0.69-1.51). Dietary and supplemented vitamin D do not seem to be associated with ORC prevention in the middle-aged Spanish population.

LGB´s Arts Affinity: An Empirical Study of Theater Audiences Based on Motivations.

The extended belief of gay people being more creative and showing higher interest toward arts lacks robust empirical support. The pioneer study on this issue highlighted that LGB´s arts participation was mostly explained by demographic factors such as level of studies, residence and family situation, which suggests that differences due to sexual orientation tend to fade. In this paper, we put forward the hypothesis that sexual orientation influences motivations to participate, which emphasizes their role and heterogeneity. To do so, we conducted a survey on participants at an alternative performing arts festival collecting information on socio-demographics, including sexual orientation, motivations and other variables. Results show that being LGB increases the likelihood of attendance for emotional, social or political motives, and emphasize the heterogeneity that sexual orientation plays on cultural audiences. Particularly, we find evidence of gender differences in attendance goals within LGB performing arts consumers, supporting gender nonconformity.

Osseous metaplasia of the endometrium: A multicenter retrospective study.

OBJECTIVE: To describe clinical and demographic characteristics, ultrasound appearance, and hysteroscopic outcomes of patients with endometrial osseous metaplasia. STUDY DESIGN: We conducted a multicenter retrospective study. We retrospectively reviewed the medical records of all consecutive patients who were referred for hysteroscopy at fourteen institutions in Venezuela, Spain, Morocco, India, Ukraine, Argentina, the United States, and Italy between 1994 and 2018. We identified and included all patients who had a diagnosis of osseous metaplasia at the pathologic report, and data were retrieved from the medical records. RESULTS: Between January 1st, 1994, and December 31st, 2018, 63 patients out of a total of 419,673 women who underwent hysteroscopy had a diagnosis of osseous metaplasia (0.015%). Most patients were 31-40 years old (53.7%), were Caucasian or Hispanic (95.5%), and had at least one previous pregnancy (86.9%). Forty-one out of 63 patients (65.1%) had at least one miscarriage before the index hysteroscopy. Dysmenorrhea, abnormal uterine bleeding, and infertility were reported by 34.9%, 27.0%, and 23.8% of patients. 14.3% of women were asymptomatic. Preoperative transvaginal ultrasound was available and identified a hyperechoic area of variable size with posterior acoustic shadowing in all cases. Hysteroscopy was successful without complications in all 63 cases. Follow-up data were available in 30.2% of patients: 69.2% of patients were infertile, and 44.4% of them conceived and achieved a live birth; all other symptoms improved after hysteroscopic treatment in all patients. CONCLUSIONS: Osseous metaplasia appears associated with multiple unspecific gynecologic symptoms without the predominant role of infertility, as previously suggested. Although endometrial osseous metaplasia is rare, gynecologists should consider this pathologic condition when the characteristic ultrasound appearance is detected, being hysteroscopic treatment effective.

Where Did All the Sport Go? Negative Impact of COVID-19 Lockdown on Life-Spheres and Mental Health of Spanish Young Athletes.

During the 2020, the pandemic caused by the massive spread of the SARS-CoV-2 coronavirus (COVID-19) resulted in a global crisis. In Spain, the COVID-19 pandemic caused a lockdown for almost 100 days and forced the sudden stop of sport practices and competitions. This interruption had a negative impact on high-level athletes' mental health. However, its impact on young athletes, who are intrinsically developing a high-demanding dual career, remains unclear. Therefore, this study aimed at (1) describing and characterizing the general impact that COVID-19 lockdown had on Spanish young athletes' life-spheres and mental health, and (2) identifying different profiles of athletes regarding life-conditions and sport-related variables. A sample of 544 young athletes (M = 15.9; SD = 1.51) participated in this study. Measures included life-conditions and sport-related information along with the Holistic Monitoring Questionnaire (HMQ) and the General Health Questionnaire (GHQ-12). After the screening and description of the data, profiles were defined using a two-level cluster analysis using HMQ and GHQ-12 subscales. We explored differences in demographic and sports information between profiles using MANOVA and subsequent ANOVA. Results suggest a general negative impact of COVID-19 on young athletes' life-spheres and mental health, but with three different clusters regarding the degree of such impact. Cluster 1 grouped the 54.78% of the sample and exhibited a low negative impact of COVID-19 lockdown on life-spheres and few mental health issues. Cluster 2 grouped a 29.96% of the participants who reported a medium negative impact on life-spheres and moderate mental health issues. Cluster 3 represented 15.26% of the sample including participants who showed a high negative impact of the COVID-19 lockdown with high mental health issues. The paradigmatic participant in this third group would be a female student-athlete from a medium or low socioeconomic status with high academic demands and poor or inexistent training conditions during lockdown. Current findings emphasize the need to pay attention to young athletes' mental health and suggest possible influencing contextual variables. We suggest some applied recommendations aimed at helping clubs and sports institutions to mitigate the negative effects of such difficult circumstances on athletes' mental health.

Trends analysis of specialized palliative care services in 51 countries of the WHO European region in the last 14 years.

BACKGROUND: Service provision is a key domain to assess national-level palliative care development. Three editions of the European Association for Palliative Care (EAPC) Atlas of Palliative Care monitored the changes in service provision across Europe since 2005. AIM: To study European trends of specialized service provision at home care teams, hospital support teams, and inpatient palliative care services between 2005 and 2019. DESIGN: Secondary analysis was conducted drawing from databases on the number of specialized services in 2005, 2012, and 2019. Ratios of services per 100,000 inhabitants and increase rates on number of services for three periods were calculated. Analysis of variance (ANOVA) analyses were conducted to determine significant changes and chi-square to identify countries accounting for the variance. Income-level and sub-regional ANOVA analysis were undertaken. SETTING: 51 countries. RESULTS: Forty-two countries (82%) increased the number of specialized services between 2005 and 2019 with changes for home care teams (104% increase-rate), inpatient services (82%), and hospital support teams (48%). High-income countries showed significant increase in all types of services (p < 0.001), while low-to-middle-income countries showed significant increase only for inpatient services. Central-Eastern European countries showed significant improvement in home care teams and inpatient services, while Western countries showed significant improvement in hospital support and home care teams. Home care was the most prominent service in Western Europe. CONCLUSION: Specialized service provision increased throughout Europe, yet ratios per 100,000 inhabitants fell below the EAPC recommendations. Western Europe ratios' achieved half of the suggested services, while Central-Eastern countries achieved only a fourth. High-income countries and Western European countries account for the major increase. Central-Eastern Europe and low-to-middle-income countries reported little increase on specialized service provision.

Mapping Pediatric Palliative Care Development in the WHO-European Region: Children Living in Low-to-Middle-Income Countries Are Less Likely to Access It.

CONTEXT: Approximately 170,000 children in need of palliative care die every year in Europe without access to it. This field remains an evolving specialty with unexplored development. OBJECTIVES: To conduct the first regional assessment of pediatric palliative care (PPC) development and provision using data from the European Association for Palliative Care atlas of palliative care 2019. METHODS: Two surveys were conducted. The first one included a single question regarding PPC service provision and was addressed by European Association for Palliative Care atlas informants. The second one included 10 specific indicators derived from an open-ended interview and rating process; a specific network of informants was enabled and used as respondents. Data were analyzed and presented in the map of the figure. RESULTS: Data on PPC service provision were gathered from 51 of 54 (94%) European countries. Additional data were collected in 34 of 54 (62%) countries. A total of 680 PPC services were identified including 133 hospices, 385 home care services, and 162 hospital services. Nineteen countries had specific standards and norms for the provision of PPC. Twenty-two countries had a national association, and 14 countries offered education for either pediatric doctors or nurses. In seven countries, specific neonatal palliative care referral services were identified. CONCLUSION: PPC provision is flourishing across the region; however, development is less accentuated in low-to-middle-income countries. Efforts need to be devoted to the conceptualization and definition of the models of care used to respond to the unmet need of PPC in Europe. The question whether specialized services are required or not should be further explored. Strategies to regulate and cover patients in need should be adapted to each national health system.

Niveles de ansiedad y estilos de afrontamiento en función de las características perceptivo-motoras del deporte / Anxiety levels and coping styles depending on the perceptual-motor skills of the sport / Níveis de ansiedade e estilos de coping, dependendo das habilidades percetivas-motoras do desporto

Afrontar las propias emociones supone una de las demandas más importantes del deporte formativo, existiendo importantes diferencias en función de las características del deporte practicado. Algunas de estas diferencias (e.g., deporte individual o de equipo) han sido extensamente estudiadas en la literatura previa. En cambio, otras características como el tipo de habilidades perceptivo-motoras (i.e., deportes de habilidad abierta o cerrada) han recibido escasa atención. Centrándonos en esta distinción, el objetivo de este estudio fue el de explorar las posibles diferencias en los niveles de ansiedad rasgo competitiva y los estilos de afrontamiento en función de si el deporte practicado requiere de habilidades abiertas o cerradas. Para ello, un total de 804 deportistas (M = 15.59; DE = 1.97) que practicaban deportes de habilidad abierta (n = 593) y cerrada (n = 211) completaron medidas de ansiedad competitiva y afrontamiento. Tras realizarse un análisis de invariancia para comprobar la comparabilidad de los grupos, se efectuaron un total de cinco modelos de regresión para las subescalas de ansiedad competitiva y afrontamiento. Además del tipo de deporte, se incluyeron el género y edad como variables predictoras de los modelos. Los resultados obtenidos muestran mayores niveles de ansiedad somática para el grupo de habilidad cerrada y mayores niveles de ansiedad cognitiva (i.e., preocupación y desconcentración) para el grupo de habilidad abierta. Por su parte, el afrontamiento mostró valores equivalentes entre ambos grupos respecto al uso del estilo de afrontamiento orientado a la tarea, y un mayor uso del estilo de afrontamiento orientado a la resignación en los deportes de habilidad abierta. En conjunto, los resultados observados constituyen respuestas psicológicas coherentes con la mayor inmediatez de rendimiento exigida en los deportes de habilidad cerrada y con la menor previsibilidad de los deportes de habilidad abierta

Coping with emotions represents one of the most important demands of youth sport, yet existing important differences depending on the characteristics of each sport. Some of these characteristics (e.g., individual or team sport) have been comprehensively studied in previous literature. In contrast, other characteristics such as perceptive-motor skills required by each sport (i.e., open versus closed skill sports) have received less attention. Focusing on this specific characteristic, this study aimed to explore the possible differences in trait competitive anxiety levels and coping usage depending on whether practised sport required an opened or closed skill. Within this purpose, 804 athletes (M = 15.59; SD = 1.97) who practised an open (n = 593) and closed (n = 211) skill sports participated in this study. Participants completed competitive anxiety and coping measures. Once invariance analysis showed the equivalence among groups, we made a regression analysis for each competitive anxiety and coping subscale. We also included gender and age as predictive variables of the models. Results showed higher somatic anxiety levels in open skills sports and higher levels of cognitive anxiety (i.e., worry and concentration disruption) in closed skill sports. Regarding coping, results suggested equivalent levels of task-oriented coping usage; and higher disengagement-oriented coping usage in open skills sports. These results are coherent with the performance immediacy requested in closed skill sports, and the low predictability of open skill sports

Enfrentar as emoções representa uma das demandas mais importantes do desporto juvenil, mas existem diferenças, na função das características do deporto praticado. Algumas dessas características (por exemplo, desporto individual ou em equipa) foram amplamente estudadas na literatura anterior. Em contraste, outras características desportivas, como habilidades percetivas-motoras requeridas (i.e., desportos abertos contra fechados) receberam menos atenção. Com foco nessa característica específica, este estudo teve como objetivo explorar as possíveis diferenças nos níveis de ansiedade competitiva e no uso de estratégias de coping, dependendo se o desporto praticado exige habilidades abertas ou fechadas. Nesse sentido, um total de 804 desportistas (M = 15,59; DE = 1,97) praticam desportos de habilidade aberta (n = 593) e fechada (n = 211), participaram deste estudo. Os participantes completaram medidas de ansiedade competitiva e coping. Uma vez que a análise de invariância mostrou a comparabilidade entre os grupos, fizemos um modelo de regressão para competitiva de ansiedade e coping. Além disso, ou desporto, inclua o género e idade como variáveis preditivas dos modelos preditivos. Os resultados obtidos mostraram níveis mais altos de ansiedade somática em desportos de habilidades abertas e níveis mais altos de ansiedade cognitiva (i.e., preocupação e desconcentração) para o grupo de habilidades fechadas. As escalas de coping mostram valores iguais para ambos os grupos, como o estilo de coping orientado a tarefas, e um prefeito usa o coping orientado a resignação nos desportos de habilidade aberta. No conjunto, os resultados observados constituem as questões psicológicas coerentes com o desempenho imediato, exigindo o retorno dos desportos de habilidades fechadas e com a menor previsibilidade dos desportos de habilidades abertas

Consensus Building on Health Indicators to Assess PC Global Development With an International Group of Experts.

CONTEXT: International consensus on indicators is necessary to standardize the global assessment of palliative care (PC) development. OBJECTIVES: To identify the best indicators to assess current national-level PC development. METHODS: Experts in PC development were invited to rate 45 indicators organized by domains of the World Health Organization Public Health Strategy in a two-round RAND/UCLA-modified Delphi process. In the first round, experts rated indicators by relevance, measurability, and feasibility (1-9). Ratings were used to calculate a global score (1-9). Indicators scoring >7 proceeded to the second round for fine-tuning of global scores. Median, confidence interval, Content Validity Index, and Disagreement Index were calculated. Indicators scoring a lower limit 95% confidence interval of ≥7 and a Content Validity Index of ≥0.30 were selected. RESULTS: 24 experts representing five continents and several organizations completed the study. 25 indicators showed a high content validity and level of agreement. Policy indicators (n = 8) included the existence of designated staff in the National Ministry of Health and the inclusion of PC services in the basic health package and in the primary care level list of services. Education indicators (n = 4) focused on processes of official specialization for physicians, inclusion of teaching at the undergraduate level, and PC professorship. Use of medicines indicators (n = 4) consisted of opioid consumption, availability, and prescription requirements. Services indicators (n = 6) included number and type of services for adults and children. Additional indicators for professional activity (n = 3) were identified. CONCLUSION: The first list including 25 of the best indicators to evaluate PC development at a national level has been identified.

CFD modelling of air quality in Pamplona City (Spain): Assessment, stations spatial representativeness and health impacts valuation.

A methodology based on CFD-RANS simulations (WA CFD-RANS, Weighted Averaged Computational Fluid Dynamic-Reynolds-Averaged Navier-Stokes simulations) which includes appropriate modifications, has been applied to compute the annual, seasonal, and hourly average concentration of NO2 and NOX throughout the city of Pamplona (Spain) at pedestrian level during 2016. The results have been evaluated using measurements provided both by the city's network of air quality monitoring stations and by a network of mobile microsensors carried around by cyclists during their daily commutes, obtaining a maximum relative error lower than 30% when computing NO2 annual average concentrations. The model has taken into account the actual city layout in three dimensions, as well as the traffic emissions. The resulting air pollution maps provided information critical for studying the traffic-related health effects of NO2 and their associated external costs in the city of Pamplona and the spatial representativeness of the current network of air quality monitoring stations (it has not been carried out for an entire city to date). The developed methodology can be applied to similar cities, providing useful information for the decision-makers.

Intervenciones para la promoción de actividad física basadas en la teoría de la autodeterminación: Una revisión narrativa (2011-2016) / Lessons from self-determination interventions to promote physical activity: A Narrative review (2011-2016)

El objetivo del presente estudio es revisar intervenciones recientes orientadas a la promoción de la actividad física mediante un enfoque basado en la Teoría de la Autodeterminación (SDT). Así, presentamos ideas apoyadas por la evidencia que los investigadores pueden utilizar para desarrollar sus futuros programas. Nuestro estudio incluye artículos publicados entre 2011 y 2016 que cumplen los siguientes criterios de inclusión: (a) SDT como principal marco teórico, (b) participantes sanos con edades ≥ 12 años, y (c) foco en la promoción de la actividad física y/o variables relacionadas. Presentamos los resultados en tres categorías: (a) estructura, enfoque teórico y aspectos generales, (b) desarrollo, y (c) evaluación. En relación con la estructura, encontramos dos tipos de intervención: aquellas desarrolladas en un contexto existente, donde los profesionales responsables reciben una formación específica que puede influir indirectamente en los estudiantes/pacientes, e intervenciones desarrolladas desde cero, dónde los participantes reciben la formación o información directamente. Los resultados muestran que el enfoque más habitual para desarrollar la intervención es el apoyo y la satisfacción de la autonomía. En cuanto al desarrollo de la intervención, es crucial entender las necesidades de la población diana y aplicar intervenciones hechas a medida que incluyan la SDT no solo como conceptos a explicar sino también como una manera de guiar el desarrollo de la intervención. Por último, para la evaluación de la intervención destacamos: (a) utilizar métodos mixtos, (b) evaluar medidas objetivas y autopercepciones, y (c) medir la satisfacción de los participantes con la intervención (AU)

The purpose of the present study is to review recent interventions aimed at promoting physical activity using self-determination theory (SDT) framework. We present evidence-based proposals that researchers could find useful to develop their own interventions. Our narrative review includes journal articles published between 2011 that meet the following inclusion criteria: (a) using SDT as reference framework, (b) targeting healthy participants with age ≥ 12 years old, and (c) pursuing a main goal of promoting physical activity or related variables. Results are presented in three categories: (a) structure, theoretical approach and general aspects of the intervention, (b) development, and (c) assessment. Regarding the structure, two types of interventions emerged: those conducted within an existing setting, where professionals in charge receive specific training that is expected to indirectly affect their students/patients; and interventions developed from zero, where participants receive direct training or information. Results showed that the most common background to develop SDT interventions is autonomy support and autonomy satisfaction. Concerning the development of the intervention, it appears essential to understand the needs of the target population and to develop tailored interventions that consider SDT not only as concepts to explain but also as a way of thinking that guides the development of the interventions. Regarding the assessment of the intervention, researchers could consider (a) using mixed-methods approach, (b) including objective and self-reported measures and (c) measuring participants’ satisfaction with the intervention (AU)

Evaluación del grado de formación del personal que elabora las nutriciones parenterales en los Servicios de Farmacia / Training degree assessment of staff producing parenteral nutrition in Pharmacy Services

Objetivo: Evaluar el grado de formación del personal que elabora nutrición parenteral en los Servicios de Farmacia. Material y métodos: Se diseñó una encuesta on-line con 17 preguntas en la que se incluyeron los puntos más importantes en la elaboración de nutriciones parenterales. Para el diseño de la encuesta y el análisis posterior se utilizó la aplicación informática Survey monkey®. Resultados: Se obtuvieron un total de 135 respuestas. En el 95% de los Servicios de Farmacia existían normas escritas de elaboración. El 67% contestó que el fosfato se debía añadir cuando se empiezan a añadir los electrolitos y el 34% que no se realizaba la validación de la técnica aséptica de elaboración. En cuanto a la formación, el 19% no la había recibido, considerando necesario recibirla el 99%. Conclusiones: El personal encuestado presenta un grado de formación aceptable, pero son necesarios los cursos de formación que se deben fomentar desde los Servicios de Farmacia (AU)

Objective: To assess the level of expertise of Pharmacy personnel in the manufacturing of total parenteral nutrition. Material and methods: An on-line survey including 17 questions concerning key aspects of TPN manufacturing was designed. Survey monkey software was used to create the survey and to analize its results. Results: 135 answers were received. 95% of the participant Pharmacy services had written standard manufacturing procedures. 67% answered that phosphate salts should be the first electrolite to be additioned into the total parenteral nutrition and 34% affirmed that validation of the aseptic manufacturing technique was not performed. As far as personnel training was concerned, 19% of respondents had not received any specific training, although 99% considered it would be necessary to receive it. Conclusions: The polled personell has an acceptable level of expertise but adequate training courses are still necessary and should be promoted from Pharmacy services (AU)

[Training degree assessment of staff producing parenteral nutrition in Pharmacy Services]. / Evaluación del grado de formación del personal que elabora las nutriciones parenterales en los Servicios de Farmacia.

OBJECTIVE: To assess the level of expertise of Pharmacy personnel in the manufacturing of total parenteral nutrition. MATERIAL AND METHODS: An on-line survey including 17 questions concerning key aspects of TPN manufacturing was designed. Survey monkey software was used to create the survey and to analize its results. RESULTS: 135 answers were received. 95% of the participant Pharmacy services had written standard manufacturing procedures. 67% answered that phosphate salts should be the first electrolite to be additioned into the total parenteral nutrition and 34% affirmed that validation of the aseptic manufacturing technique was not performed. As far as personnel training was concerned, 19% of respondents had not received any specific training, although 99% considered it would be necessary to receive it. CONCLUSIONS: The polled personell has an acceptable level of expertise but adequate training courses are still necessary and should be promoted from Pharmacy services.

Objetivo: Evaluar el grado de formación del personal que elabora nutrición parenteral en los Servicios de Farmacia. Material y métodos: Se diseñó una encuesta on-line con 17 preguntas en la que se incluyeron los puntos más importantes en la elaboración de nutriciones parenterales. Para el diseño de la encuesta y el análisis posterior se utilizó la aplicación informática Survey monkey®. Resultados: Se obtuvieron un total de 135 respuestas. En el 95% de los Servicios de Farmacia existían normas escritas de elaboración. El 67% contestó que el fosfato se debía añadir cuando se empiezan a añadir los electrolitos y el 34% que no se realizaba la validación de la técnica aséptica de elaboración. En cuanto a la formación, el 19% no la había recibido, considerando necesario recibirla el 99%. Conclusiones: El personal encuestado presenta un grado de formación aceptable, pero son necesarios los cursos de formación que se deben fomentar desde los Servicios de Farmacia.

Living at a Geographically Higher Elevation Is Associated with Lower Risk of Metabolic Syndrome: Prospective Analysis of the SUN Cohort.

Living in a geographically higher altitude affects oxygen availability. The possible connection between environmental factors and the development of metabolic syndrome (MetS) feature is not fully understood, being the available epidemiological evidence still very limited. The aim of the present study was to evaluate the longitudinal association between altitude and incidence of MetS and each of its components in a prospective Spanish cohort, The Seguimiento Universidad de Navarra (SUN) project. Our study included 6860 highly educated subjects (university graduates) free from any MetS criteria at baseline. The altitude of residence was imputed with the postal code of each individual subject residence according to the data of the Spanish National Cartographic Institute and participants were categorized into tertiles. MetS was defined according to the harmonized definition. Cox proportional hazards models were used to assess the association between the altitude of residence and the risk of MetS during follow-up. After a median follow-up period of 10 years, 462 incident cases of MetS were identified. When adjusting for potential confounders, subjects in the highest category of altitude (>456 m) exhibited a significantly lower risk of developing MetS compared to those in the lowest tertile (<122 m) of altitude of residence [Model 2: Hazard ratio = 0.75 (95% Confidence interval: 0.58-0.97); p for trend = 0.029]. Living at geographically higher altitude was associated with a lower risk of developing MetS in the SUN project. Our findings suggest that geographical elevation may be an important factor linked to metabolic diseases.

Electroforesis horizontal en geles de poliacrilamida en la detección y tipificación del virus de papiloma humano / Horizontal electrophoresis in polyacrylamide gels in the detection and typing of human papillomavirus

OBJETIVO: estandarizar el uso de electroforesis horizontal en poliacrilamida como un método rápido de fácil implementación y de alta sensibilidad para la detección y tipificación del virus del papiloma humano por reacción en cadena de la polimerasa-polimorfismos de longitud de fragmentos de restricción con la enzima HpyCH4V como única enzima de restricción. MÉTODOS: Se utilizó el ácido desoxirribonucleico de 17 tipos de virus del papiloma humano, clonados en la colección del Laboratorio de Biología y Medicina Experimental (LABIOMEX-ULA), para la amplificación de la región flanqueada por los oligonucleótidos MY09/ MY11, los amplificados obtenidos se sometieron a digestión enzimática con la enzima HpyCH4V. El producto se corrió en geles de poliacrilamida de rápida polimerización en equipos de electroforesis horizontales. El ácido desoxirribonucleico se tiñó con bromuro de etidio y fueron fotografiados con la utilización de un trans-iluminador de luz ultravioleta. RESULTADOS: Se corrieron muestras de 17 tipos diferentes de virus del papiloma humano en geles de poliacrilamida en electroforesis horizontal sudmarina. Se observaron patrones de digestión, con la enzima de restricción HpyCH4V, bien definidos y distintos para 15 tipos diferentes. Se presentó una coincidencia de patrón polimorfismos de longitud de fragmentos de restricción para los tipos 45 y 52 ambos de alto riesgo. Se obtuvo una excelente resolución en corridas de 2,5 cm de longitud para cualquier patrón polimorfismos de longitud de fragmentos de restricción de los 17 tipos de virus del papiloma humano analizados. CONCLUSIÓN: El análisis de las corridas permitió una eficiente caracterización de los 17 tipos virales. La comparación del índice de movilidad relativa con polimorfismos de longitud de fragmentos de restricción virtual de los fragmentos amplificados presentó diferencias mínimas, el análisis de la movilidad en agarosa y poliacrilamida se ajustaron perfectamente permitiendo la sustitución de la agarosa por la poliacrilamida.

OBJECTIVE: to standardize the use of horizontal electrophoresis in polyacrylamide as a quick method of easy implementation and high sensitivity for the detection and typing of Human Papillomavirus by PCR-FRLP with HpyCH4V enzyme as unique restriction enzyme. METHODS: DNA from 17 Human Papillomavirus types, cloned in the collection of the Laboratory of Experimental Biology and Medicine, for amplification of the region flanked by the MY09/ MY11 oligonucleotides were used, the amplified obtained were subjected to enzymatic digestion with the enzyme HpyCH4V. The product was run on polyacrylamide gels rapid polymerization horizontal electrophoresis equipment. Stained with ethidium bromide and were photographed with the use of a trans-illuminating UV. RESULTS: Samples of 17 different Human Papillomavirus types polyacrylamide gel electrophoresis were run horizontally. Digestion patterns were observed with the restriction enzyme HpyCH4V, well-defined and different for different types 15. A pattern match for RFLP types 45 and 52 both high risk presented. Excellent resolution on runs of 2.5 cm in length for any RFLP pattern of the 17 Human Papillomavirus types analyzed was obtained. CONCLUSION: The analysis of the runs allows efficient characterization of the 17 Human Papillomavirus types. Comparing the relative mobility rate with the virtual RFLP of amplified fragments present minimal differences, analyzing mobility in agarose and polyacrylamide perfectly adjusted allowing for substitution of agarose by polyacrylamide.

[Applying standards of pharmaceutical practice in nutritional therapy cancer patient]. / Aplicación de los estándares de práctica del farmacéutico en terapia nutricional al paciente oncológico.

Malnutrition in cancer patients is associated with a poor prognosis, weight loss being an important predictor of mortality. The cancer and its treatment have a great impact on nutritional status, so by applying nutritional therapy can improve quality of life, prognosis and functional status. The application of standards of practice this therapy in cancer patients can reduce variability of interventions and promote efficient, safe and quality use. Being the hospital pharmacist as part of the nutritional support team a key in optimizing nutrition therapy through four strategic partner roles: clinical, technical, operational and manager.

Aplicación de los estándares de práctica del farmacéutico en terapia nutricional al paciente oncológico / Applying standards of pharmaceutical practice in nutritional therapy cancer patient

La desnutrición en el paciente oncológico se asocia con un mal pronóstico, siendo la pérdida de peso un importante predictor de mortalidad. El cáncer y su tratamiento tienen un gran impacto en el estado nutricional, por lo que mediante la aplicación de la terapia nutricional podemos mejorar la calidad de vida, el pronóstico y el estado funcional. La aplicación de estándares de práctica a esta terapia en el paciente oncológico puede reducir la variabilidad de las intervenciones y favorecer su uso eficiente, seguro y de calidad. Siendo el farmacéutico de hospital como parte del equipo de soporte nutricional un socio estratégico clave en la optimización de la terapia nutricional a través de cuatro roles: clínico, técnico, operativo y gestor (AU)

Malnutrition in cancer patients is associated with a poor prognosis, weight loss being an important predictor of mortality. The cancer and its treatment have a great impact on nutritional status, so by applying nutritional therapy can improve quality of life, prognosis and functional status. The application of standards of practice this therapy in cancer patients can reduce variability of interventions and promote efficient, safe and quality use. Being the hospital pharmacist as part of the nutritional support team a key in optimizing nutrition therapy through four strategic partner roles: clinical, technical, operational and manager (AU)

Historical Perspective about ISSP from 1968-1985 and the Presidency of Bob Singer (1985-1993) / Perspectiva histórica de la ISSP desde 1968 hasta 1985, y presidencia de Bob Singer (1985-1993) / Perspetiva històrica da issp (1968 até 1985) e presidéncia de bob singer (1985-1993)

The functioning of the ISSP Managing Council (MC) during the early years was influenced to some degree by the Cold War. MC members were determined according to their acknowledged expertise and reputation, but also in respect to their country and political representation. Bob Singer was elected to be a member of the MC in 1977 at the congress in Prague. It was the first time that voting at the general assembly meeting was agreed upon for nominating and voting for MC members together with those members designated by the former MC. In 1985 he was elected as the third president of ISSP. A new phase in ISSP started and new goals were established. A more democratic style of communication and interactions among MC members were stimulated, agendas for the MC meetings were well organized, promotion of the ISSP’s mission all over the world was developed, new publications were produced, and new relations with other parts of the world as well as with other organizations were promoted

El funcionamiento del Managing Council (MC) de la ISSP durante sus primeros años se hallaba influenciado por la Guerra Fría. Los miembros del MC se designaban de acuerdo a su reputación y sus conocimientos, pero también según su procedencia y su representación política. Bob Singer fue elegido como miembro del MC en 1977 en el congreso de Praga. Fue la primera vez que se acordó que la votación de la Asamblea General sirviera para nombrar a los miembros del MC, junto con aquellos designados por el anterior MC. En 1985 fue elegido como el tercer residente de la ISSP, iniciándose una nueva fase y se fijaron nuevos objetivos. Se estimuló un estilo más democrático de comunicación e interacción entre los miembros del MC, hubo una mejora organizativa de las agendas de las reuniones del MC, se promocionó la misión de la ISSP alrededor del mundo, se editaron nuevas publicaciones, y se fomentaron nuevas relaciones con otras organizaciones y partes del mundo

O funcionamento do Managing Council(MC) da ISSP durante os primeiros anos da Sociedade foi, em parte, influenciado pela Guerra Fria.Os membros do MC eram escolhidos em função do facto de serem especialistas internacionalmente reconhecidos e reputados, mas também com o ob-jectivo de uma representatividade nacional e política. Bob Singer foi eleito para membro do MC em 1977, no congresso de Praga. Essa foi a primeiravez que houve uma votação em Assembleia Geral para os membros do MC, para além da designação de elementos por parte do MC cessante. Em 1985Singer foi eleito terceiro Presidente da ISSP. Começou, então, uma nova fase da Organização, tendo sido estabelecidos novos objectivos. Foi estimuladoum estilo mais democrático de comunicação e interacção entre os membros do MS, as agendas de trabalho para as reuniões de trabalho passaram a serbem organizadas, a missão da ISSP no mundo foi promovida, foram produzidas novas publicações, e estabeleceram-se relações internacionais e comoutras organizações

Incorporación de una rutina para la optimización del rendimiento deportivo / Routine incorporaton for the optimization of sport performance

El objetivo del estudio fue la evaluación del impacto de la incorporación de una rutina en el rendimiento de un joven futbolista, en cuanto a la ejecución de libres directos. Con base en el abordaje Five-step Approach (Singer, 2000) se llevó a cabo una intervención individualizada, dirigida al aprendizaje y sistematización de una rutina, utilizando estrategias destinadas a la preparación física, técnica y mental del atleta. Los resultados indican que después de la intervención el rendimiento del deportista mejoró significativamente, lo que demuestra la influencia positiva de la incorporación de rutinas, de forma similar a los resultados obtenidos en estudios previos (e.g. Ajamil, Pascual, Idiakez y Echevarría, 2011; Czech, Ploszay y Burke, 2004; Lidor y Mayan, 2005; Singer, 2002). Las conclusiones de este estudio poseen importantes implicaciones prácticas para todos los intervinientes en el contexto del deporte. Además de contribuir a un enfoque eficaz en la respuesta a esta necesidad específica, se enfatiza la importancia de la incorporación de estrategias psicológicas en el ámbito del entrenamiento deportivo (AU)

The aim of the study was to assess the impact of the inclusion of a routine in the performance of a young player, in terms of direct free execution. Based on the Five-step Approach (Singer, 2000) an individualized intervention directed towards the learning and systematization of a routine was conducted, using strategies for physical, technical and mental preparation of the athlete. The results indicate that after the intervention the athlete’s performance improved significantly, demonstrating the positive impact of incorporating routines, similar to results of previous studies (e.g. Ajamil, Pascual, Idiakez and Echevarria, 2011; Czech, Ploszay and Burke, 2004; Lidor and Mayan, 2005; Singer, 2002). The findings of this study have important practical implications for all those involved in the sports context. As well as contributing to an effective approach in response to this specific need, it emphasizes the importance of incorporating psychological strategies in the field of athletic training (AU)