Reliability of a Trunk Flexion and Extensor Muscle Strength Test with Hand-Held and Isokinetic Dynamometers in Female Athletes.

An accurate trunk muscle strength assessment seems very important to design and individualize training and rehabilitation programs in clinical and sport settings. Hand-held dynamometers (HHDs) are interesting alternatives to isokinetic dynamometers for assessing trunk isometric muscle strength because they are inexpensive instruments and easy to use. This cross-sectional observational study aimed to examine the reliability of two novel sitting tests for assessing trunk flexion and extension isometric strength using an HHD and their relationship with two other novel isometric tests that use an isokinetic dynamometer. Twenty-four female amateur athletes (age: 24.5 ± 2.64 years; body height: 164.45 ± 6.33 cm; body mass: 63.17 ± 10.35 kg) participated in this study. A test-retest design was carried out one-week apart to examine the reliability. The relationship and the degree of agreement between the HHD and the isokinetic dynamometer measurements were analysed using Pearson correlation and Bland-Altman analysis, respectively. In general, the reliability of all isometric strength tests was good, with ICCs ranging from 0.65 to 0.87 and typical error < 15%. Pearson correlations were moderate, with values of r = 0.47 (R2 = 0.22) and r = 0.42 (R2 = 0.18) for flexion and extension strength, respectively. Bland-Altman plots showed no agreement between HHDs and isokinetic measurements. All trunk isometric tests using both, an isokinetic dynamometer and HHDs, provide reliable measurements for assessing trunk flexion and extension strength. According to the comparative analysis, both measurement types are different and cannot be used interchangeably. Health and sport professionals should choose the test that best suits the biomechanical characteristics required for functional goals or success in a given sport.

Carotid-femoral pulse wave velocity score, an estimator of cognitive performance in the elderly: results from the Toledo Study for Healthy Aging.

Ageing-related changes in the vascular wall influence the function of different organs; for this reason, we assessed how arterial stiffness measured by carotid-femoral pulse wave velocity (cf-PWV) modulates: the basal cognitive performance and the change in cognitive performance over the follow-up time. We developed a prospective, population-based cohort study with 1581 participants aged > 65 years were obtained from the Toledo Study for Healthy Aging. Participants from the second wave (2011-2013) were selected for the cross-sectional analysis. Those who also performed the cognitive assessment in the third wave (2015-2017) were selected for the prospective analysis. Arterial stiffness was evaluated by cf-PWV. Multivariate segmented regression models were used to evaluate the association between cf-PWV scores and basal neuropsychological evaluation scores and change of neuropsychological evaluation scores along follow-up. Cross-sectional analysis showed that as cf-PWV grew within the cf-PWV (5- < 10) category an improvement was observed in 7-min test, free short-term memory, and hole peg test. Furthermore, in the cf-PWV (> 13-18) category a decrease was observed in total short-term memory, free long-term memory, and total long-term memory. Prospective analysis showed a progressive worsening of cognitive function as cf-PWV increases within the cf-PWV (> 13-18) category in 7-min test, object denomination, immediate and short-term memory, and hole peg test, while in the cf-PWV (5- < 10) category, there was observed a decrease in Cumulative Executive Dysfunction Index score and short-term memory. In conclusion, a higher cf-PWV score is associated with worse cognitive performance, and with a worse evolution, reinforcing the need to plan interventions to delay arterial stiffness and its consequences.

Higher Synovial Immunohistochemistry Reactivity of IL-17A, Dkk1, and TGF-ß1 in Patients with Early Psoriatic Arthritis and Rheumatoid Arthritis Could Predict the Use of Biologics.

BACKGROUND: Delay in diagnosis and therapy in patients with arthritis commonly leads to progressive articular damage. The study aimed to investigate the immunohistochemical reactivity of synovial cytokines associated with inflammation and the bone erosives/neoformatives processes among individuals diagnosed with psoriatic arthritis (PsA), rheumatoid arthritis (RA), osteoarthritis (OA), and radiographic axial spondyloarthritis (r-axSpA), with the intention of identifying potential biomarkers. METHODS: Specimens were collected from the inflamed knee joints of patients referred for arthroscopic procedures, and the synovial tissue (ST) was prepared for quantifying protein expression through immunohistochemical analysis (% expressed in Ratio_Area-Intensity) for TGF-ß1, IL-17A, Dkk1, BMP2, BMP4, and Wnt5b. The collected data underwent thorough analysis and examination of their predictive capabilities utilising receiver operating characteristic (ROC) curves. RESULTS: Valid synovial tissue samples were acquired from 40 patients for IHC quantification analysis. Initially, these patients had not undergone treatment with biologics. However, after 5 years, 4 out of 13 patients diagnosed with PsA and two out of nine patients diagnosed with RA had commenced biologic treatments. Individuals with early PsA who received subsequent biologic treatment exhibited significantly elevated IHC reactivity in ST for TGF-ß1 (p = 0.015). Additionally, patients with both PsA and RA who underwent biologic therapy displayed increased IHC reactivity for IL-17A (p = 0.016), TGF-ß1 (p = 0.009), and Dkk1 (p = 0.042). ROC curve analysis of IHC reactivity for TGF-ß1, Dkk1, and IL-17A in the synovial seems to predict future treatment with biologics in the next 5 years with the area under the curve (AUC) of a combined sum of the three values: AUC: 0.828 (95% CI: 0.689-0.968; p 0.005) S 75% E 84.4%. CONCLUSIONS: Higher synovial immunohistochemistry reactivity of IL-17A, Dkk1, and TGF-ß1 in patients with early psoriatic arthritis and rheumatoid arthritis may serve as potential indicators for predicting the necessity of utilising biologic treatments.

The Role of Heparin in Postural Orthostatic Tachycardia Syndrome and Other Post-Acute Sequelae of COVID-19.

The therapeutic management and short-term consequences of the coronavirus disease 2019 (COVID-19) are well known. However, COVID-19 post-acute sequelae are less known and represent a public health problem worldwide. Patients with COVID-19 who present post-acute sequelae may display immune dysregulation, a procoagulant state, and persistent microvascular endotheliopathy that could trigger microvascular thrombosis. These elements have also been implicated in the physiopathology of postural orthostatic tachycardia syndrome, a frequent sequela in post-COVID-19 patients. These mechanisms, directly associated with post-acute sequelae, might determine the thrombotic consequences of COVID-19 and the need for early anticoagulation therapy. In this context, heparin has several potential benefits, including immunomodulatory, anticoagulant, antiviral, pro-endothelial, and vascular effects, that could be helpful in the treatment of COVID-19 post-acute sequelae. In this article, we review the evidence surrounding the post-acute sequelae of COVID-19 and the potential benefits of the use of heparin, with a special focus on the treatment of postural orthostatic tachycardia syndrome.

Biodiversity loss impacts top-down regulation of insect herbivores across ecosystem boundaries.

Biodiversity loss, as driven by anthropogenic global change, imperils biosphere intactness and integrity. Ecosystem services such as top-down regulation (or biological control; BC) are susceptible to loss of extinction-prone taxa at upper trophic levels and secondary 'support' species e.g., herbivores. Here, drawing upon curated open-access interaction data, we structurally analyze trophic networks centered on the fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae) and assess their robustness to species loss. Tri-partite networks link 80 BC organisms (invertebrate or microbial), 512 lepidopteran hosts and 1194 plants (including 147 cultivated crops) in the Neotropics. These comprise threatened herbaceous or woody plants and conservation flagships such as saturniid moths. Treating all interaction partners functionally equivalent, random herbivore loss exerts a respective 26 % or 108 % higher impact on top-down regulation in crop and non-crop settings than that of BC organisms (at 50 % loss). Equally, random loss of BC organisms affects herbivore regulation to a greater extent (13.8 % at 50 % loss) than herbivore loss mediates their preservation (11.4 %). Yet, under moderate biodiversity loss, (non-pest) herbivores prove highly susceptible to loss of BC organisms. Our topological approach spotlights how agriculturally-subsidized BC agents benefit vegetation restoration, while non-pest herbivores uphold biological control in on- and off-farm settings alike. Our work underlines how the on-farm usage of endemic biological control organisms can advance conservation, restoration, and agricultural sustainability imperatives. We discuss how integrative approaches and close interdisciplinary cooperation can spawn desirable outcomes for science, policy and practice.

RhoA/rho kinase pathway activation in age-associated endothelial cell dysfunction and thrombosis.

The small GTPase RhoA and the downstream Rho kinase (ROCK) regulate several cell functions and pathological processes in the vascular system that contribute to the age-dependent risk of cardiovascular disease, including endothelial dysfunction, excessive permeability, inflammation, impaired angiogenesis, abnormal vasoconstriction, decreased nitric oxide production and apoptosis. Frailty is a loss of physiological reserve and adaptive capacity with advanced age and is accompanied by a pro-inflammatory and pro-oxidative state that promotes vascular dysfunction and thrombosis. This review summarises the role of the RhoA/Rho kinase signalling pathway in endothelial dysfunction, the acquisition of the pro-thrombotic state and vascular ageing. We also discuss the possible role of RhoA/Rho kinase signalling as a promising therapeutic target for the prevention and treatment of age-related cardiovascular disease.

Single-cell dissection of the human motor and prefrontal cortices in ALS and FTLD.

Amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) share many clinical, pathological, and genetic features, but a detailed understanding of their associated transcriptional alterations across vulnerable cortical cell types is lacking. Here, we report a high-resolution, comparative single-cell molecular atlas of the human primary motor and dorsolateral prefrontal cortices and their transcriptional alterations in sporadic and familial ALS and FTLD. By integrating transcriptional and genetic information, we identify known and previously unidentified vulnerable populations in cortical layer 5 and show that ALS- and FTLD-implicated motor and spindle neurons possess a virtually indistinguishable molecular identity. We implicate potential disease mechanisms affecting these cell types as well as non-neuronal drivers of pathogenesis. Finally, we show that neuron loss in cortical layer 5 tracks more closely with transcriptional identity rather than cellular morphology and extends beyond previously reported vulnerable cell types.

Metabolic Recovery with the Persistence of Proinflammatory Leucocyte Dysfunction After Bariatric Intervention for Obesity.

PURPOSE: A suitable option for severe obesity treatment is a surgical approach. After surgery, metabolic markers and weight frequently return to adequate values; however, concerning systemic inflammatory mediators, the results are inconsistent. Furthermore, it has been suggested that leucocyte function may be affected even after weight normalization. This study aimed to determine if the surgical treatment of obesity influences the production of cytokines by LPS-stimulated as a function of leucocytes. MATERIALS AND METHODS: We performed a cross-sectional study that investigated the production of cytokines in response to lipopolysaccharide (LPS) along a kinetic of simulation by leucocytes recovered from individuals with normal weight (NW, n = 8), persons living with obesity (Ob, n = 7), persons living with obesity and diabetes mellitus (Ob-DM, n = 17), and persons that used to live with obesity who underwent bypass surgery (fOb + bypass, n = 8) and recover normal weigh. RESULTS: IL-6 levels were significantly higher in the Ob and fOb + bypass groups than in NW (p = 0.043). IL-10 secretion without LPS was significantly higher in the NW group than in the other groups explored (p < 0.05). When exposed to LPS, the IL-10 levels increased in all groups except the NW group. As also observed for IL-18 and IL-33, the secretion curve of the fOb + bypass group was more similar to the Ob group, even when they had reached normal weight, as opposed to the NW group. CONCLUSION: Our results show that in patients with fOb + bypass, inflammatory and anti-inflammatory cytokine production dynamics remain disrupted even with improved metabolic control and normal weight recovery.

Confirmatory Factor Analysis and Gender Invariance of the Coping Strategies Inventory in Academic University Stress / [Análisis factorial confirmatorio e invarianza de género del Inventario de Estrategias de Afrontamiento (CSI) en estrés académico universitario]

Background: Though the Spanish version of the Coping Strategies Inventory (CSI) is frequently used, it has not been subjected to any significant re-evaluation from a psychometric perspective. Method: We analysed CSI data that was focused on an academic stress situation, using a university sample of 874 participants, 50% of each gender. We conducted reliability, confirmatory factor, and factorial invariance across gender analyses. Results: The first-order factorial structure was confirmed, showing an adequate fit for the eight-factor coping strategies model with good reliability indices. Neither the second-order (problem-centred vs. emotion-centred) nor third-order (engagement vs. disengagement) strategies showed an adequate fit. Factorial invariance for gender was confirmed. Conclusions: The theoretical and applied implications of the results are discussed.(AU)

Antecedentes: Aunque la versión española del del Inventario de Estrategias de Afrontamiento (CSI) se usa frecuentemente, no se ha sometido a reevaluación psicométrica. Método: Analizamos datos del CSI aplicados a situaciones de estrés académico utilizando una muestra universitaria de 874 participantes, 50% de cada género. Llevamos a cabo análisis de fiabilidad, confirmatorios y de invarianza factorial por género. Resultados: Se confirmó la estructura factorial de primer orden, mostrando un ajuste adecuado el modelo de 8 estrategias de afrontamiento, con buenos índices de fiabilidad. No mostraron un ajuste adecuado las factorizaciones de segundo orden (centrado en el problema o en la emoción) ni de tercer orden (compromiso o retirada). Se confirmó la invarianza factorial por género. Conclusiones: Se discuten las implicaciones teóricas y aplicadas de los resultados.(AU)

Validez en la predicción de riesgo de la escala SCORE en una población mediterránea con hipertensión arterial / Predictive validity of the risk SCORE model in a Mediterranean population with arterial hypertension

Introducción y objetivos: La hipertensión arterial es el factor de riesgo más prevalente a nivel global. Se recomienda el cálculo del riesgo cardiovascular en pacientes hipertensos antes del inicio del tratamiento. Este estudio tuvo como objetivo evaluar el valor predictivo y la utilidad clínica de la escala SCORE para prevenir eventos cardiovasculares y mortalidad por todas las causas en los pacientes con hipertensión arterial. Métodos: Se incluyeron los pacientes con hipertensión arterial de la cohorte ESCARVAL-RISK. El riesgo cardiovascular se calculó mediante la escala SCORE. Todas las muertes y eventos cardiovasculares se registraron durante un periodo de 5 años de seguimiento. Se calculó la sensibilidad, la especificidad y los valores predictivos para diferentes puntos de corte, y se evaluó el efecto de diferentes factores de riesgo sobre la exactitud diagnóstica de las gráficas SCORE. Resultados: En una cohorte final de 9.834 pacientes, hubo 555 eventos cardiovasculares y 69 muertes. El valor de riesgo recomendado para iniciar tratamiento farmacológico (5%) presentó una especificidad del 92% para la muerte y del 91% para los eventos cardiovasculares, y una sensibilidad del 20% para la muerte y del 22% para los eventos cardiovasculares. Además, la escala clasificó al 80,4% de los pacientes que sufrieron un evento cardiovascular, y al 78,3% de los que murieron, como de bajo riesgo. La edad, el índice de masa corporal, la retinopatía y el tratamiento anticoagulante se asociaron con una reducción en la capacidad predictiva de la escala SCORE, mientras que ser mujer se asoció con mejor predicción de riesgo. Conclusiones: La capacidad predictiva de la escala SCORE para la enfermedad cardiovascular y la mortalidad total en los pacientes con hipertensión arterial es limitada.(AU)

Introduction and objectives: Hypertension is the most prevalent risk factor globally. Calculation of cardiovascular risk in hypertensive patients before initiation of treatment is recommended. This study aimed to assess the predictive value and clinical utility of the SCORE scale in preventing cardiovascular events and all-cause mortality in patients with hypertension. Methods: Patients with hypertension from the ESCARVAL-RISK cohort were included. Cardiovascular risk was calculated using the SCORE scale. All deaths and cardiovascular events were recorded during a 5-year follow-up period. Sensitivity, specificity and predictive values were calculated for different cut-off points and the effect of different risk factors on the diagnostic accuracy of SCORE charts were assessed. Results: In a final cohort of 9834 patients, there were 555 cardiovascular events and 69 deaths. The recommended risk value for initiating drug treatment (5%) had a specificity of 92% for death and 91% for cardiovascular events, and a sensitivity of 20% for death and 22% for cardiovascular events. In addition, the scale classified 80.4% of patients who experienced a cardiovascular event and 78.3% of those who died as low risk. Age, body mass index, retinopathy and anticoagulant therapy were associated with reduced predictive ability of the SCORE scale, while being female was associated with better risk prediction. Conclusions: The predictive ability of the SCORE scale for cardiovascular disease and total mortality in patients with hypertension is limited.(AU)

Trunk muscle activation in prone plank exercises with different body tilts.

BACKGROUND: Body tilt changes could affect the intensity/difficulty of core stability exercises, but there is still a lack of knowledge about its impact. OBJECTIVE: To analyse the trunk muscles activation during prone plank exercises at different body tilts. METHODS: Twenty-four young adults who performed recreational gymnastic activities participated in this study. Electromyography activity of the rectus abdominis (RA), external oblique (EO), internal oblique (IO) and erector spinae (ES) was recorded during the performance of six variations of the prone plank exercise (planking with feet supported on the ground [conventional horizontal position] and planking with feet supported on wall bars at five different heights increasing the angle tilt) and an inverted position exercise. RESULTS: The RA, EO and IO activation in all prone plank variations were higher than those observed in the conventional prone plank. In addition, the coefficient of variation of the muscle activation increased with the declination angle, reaching the highest values in the inverted position for the RA and ES muscles. CONCLUSION: The results seem to indicate that the body tilt variation could be used as an easy and inexpensive strategy for modulating the neuromuscular demands and the motor control challenge during planking exercises.

Trunk postural control during unstable sitting among individuals with and without low back pain: A systematic review with an individual participant data meta-analysis.

INTRODUCTION: Sitting on an unstable surface is a common paradigm to investigate trunk postural control among individuals with low back pain (LBP), by minimizing the influence lower extremities on balance control. Outcomes of many small studies are inconsistent (e.g., some find differences between groups while others do not), potentially due to confounding factors such as age, sex, body mass index [BMI], or clinical presentations. We conducted a systematic review with an individual participant data (IPD) meta-analysis to investigate whether trunk postural control differs between those with and without LBP, and whether the difference between groups is impacted by vision and potential confounding factors. METHODS: We completed this review according to PRISMA-IPD guidelines. The literature was screened (up to 7th September 2023) from five electronic databases: MEDLINE, CINAHL, Embase, Scopus, and Web of Science Core Collection. Outcome measures were extracted that describe unstable seat movements, specifically centre of pressure or seat angle. Our main analyses included: 1) a two-stage IPD meta-analysis to assess the difference between groups and their interaction with age, sex, BMI, and vision on trunk postural control; 2) and a two-stage IPD meta-regression to determine the effects of LBP clinical features (pain intensity, disability, pain catastrophizing, and fear-avoidance beliefs) on trunk postural control. RESULTS: Forty studies (1,821 participants) were included for the descriptive analysis and 24 studies (1,050 participants) were included for the IPD analysis. IPD meta-analyses revealed three main findings: (a) trunk postural control was worse (higher root mean square displacement [RMSdispl], range, and long-term diffusion; lower mean power frequency) among individuals with than without LBP; (b) trunk postural control deteriorated more (higher RMSdispl, short- and long-term diffusion) among individuals with than without LBP when vision was removed; and (c) older age and higher BMI had greater adverse impacts on trunk postural control (higher short-term diffusion; longer time and distance coordinates of the critical point) among individuals with than without LBP. IPD meta-regressions indicated no associations between the limited LBP clinical features that could be considered and trunk postural control. CONCLUSION: Trunk postural control appears to be inferior among individuals with LBP, which was indicated by increased seat movements and some evidence of trunk stiffening. These findings are likely explained by delayed or less accurate corrective responses. SYSTEMATIC REVIEW REGISTRATION: This review has been registered in PROSPERO (registration number: CRD42021124658).

Sequencing by avidity enables high accuracy with low reagent consumption.

We present avidity sequencing, a sequencing chemistry that separately optimizes the processes of stepping along a DNA template and that of identifying each nucleotide within the template. Nucleotide identification uses multivalent nucleotide ligands on dye-labeled cores to form polymerase-polymer-nucleotide complexes bound to clonal copies of DNA targets. These polymer-nucleotide substrates, termed avidites, decrease the required concentration of reporting nucleotides from micromolar to nanomolar and yield negligible dissociation rates. Avidity sequencing achieves high accuracy, with 96.2% and 85.4% of base calls having an average of one error per 1,000 and 10,000 base pairs, respectively. We show that the average error rate of avidity sequencing remained stable following a long homopolymer.

Exercise Intensity Progressions and Criteria to Prescribe Core Stability Exercises in Young Physically Active Men: A Smartphone Accelerometer-Based Study.

ABSTRACT: Heredia-Elvar, JR, Juan-Recio, C, Prat-Luri, A, Barbado, D, Ríos-Calonge, Jdl, and Vera-Garcia, FJ. Exercise intensity progressions and criteria to prescribe core stability exercises in young physically active men: a smartphone accelerometer-based study. J Strength Cond Res 38(2): 266-273, 2024-The establishment of core stability (CS) exercise intensity progressions in sport and clinical settings is normally based on subjective criteria. Therefore, this study aimed to develop exercise intensity progressions for some of the most common CS exercises through smartphone accelerometry and to analyze the effect of the subjects' lumbopelvic postural control on these progressions. Fifty-seven healthy young physically active male students performed 7 isometric variations of front bridge, back bridge, side bridge, and bird-dog exercises with a smartphone accelerometer placed on the pelvis. Mean pelvic accelerations were calculated during each variation to evaluate the lumbopelvic postural control challenge imposed on the subjects as an index of exercise intensity of difficulty. For the bridge exercises, long bridging produced higher pelvic accelerations than short bridging, bridging with single-leg support was more intense than bridging with double-leg support (even with both legs on a hemisphere ball for the back and front bridge), and the most difficult variations were those performed on a Swiss ball, mainly the variations with single-leg support. For the bird-dog exercise, the 2-point positions were more intense than the 3-point positions, the variations performed with a knee on the hemisphere ball produced higher pelvic accelerations than similar variations performed with the forearm on the hemisphere ball, and the variations with limb motions generated higher pelvic accelerations than similar variations performed without limb motions. Although the CS exercise progressions were very similar across subjects, our results showed the need to individualize the prescription of the CS exercise progressions based on the subjects' lumbopelvic postural control level.

How cognitive performance changes according to the ankle-brachial index score in an elderly cohort? Results from the Toledo Study of Healthy Ageing.

In the ageing process, the vascular system undergoes morphological and functional changes that may condition brain functioning; for this reason, the aims of this study were to assess the effect of vascular function indirectly measured by ankle-brachial index (ABI) on both cognitive performance at baseline and change in cognitive performance at end of follow-up. We developed a prospective, population-based, cohort study with 1147 participants aged > 65 years obtained from the Toledo Study for Healthy Ageing who had cognitive assessment and measured ABI in the first wave (2006-2009) were selected for the cross-sectional analysis. Those participants who also performed the cognitive assessment in the second wave (2011-2013) were selected for the prospective analysis. Cognitive impairment diagnosis and symptoms and/or history of cardio/neurovascular disease were used as exclusion criteria. Multivariate segmented regression model was used to assess the associations between ABI and cognitive performance in both the cross-sectional and prospective analyses. As ABI score decreased from 1.4, the cross-sectional analysis showed a higher decrease in cognitive performance and the prospective analysis showed a higher degree of worsening in cognitive performance. Our findings suggest that the ABI, a widespread measure of vascular health in primary care, may be a useful tool for predicting cognitive performance and its evolution.

[Predictive validity of the risk SCORE model in a Mediterranean population with arterial hypertension]. / Validez en la predicción de riesgo de la escala SCORE en una población mediterránea con hipertensión arterial.

INTRODUCTION AND OBJECTIVES: Hypertension is the most prevalent risk factor globally. Calculation of cardiovascular risk in hypertensive patients before initiation of treatment is recommended. This study aimed to assess the predictive value and clinical utility of the SCORE scale in preventing cardiovascular events and all-cause mortality in patients with hypertension. METHODS: Patients with hypertension from the ESCARVAL-RISK cohort were included. Cardiovascular risk was calculated using the SCORE scale. All deaths and cardiovascular events were recorded during a 5-year follow-up period. Sensitivity, specificity and predictive values were calculated for different cut-off points and the effect of different risk factors on the diagnostic accuracy of SCORE charts were assessed. RESULTS: In a final cohort of 9834 patients, there were 555 cardiovascular events and 69 deaths. The recommended risk value for initiating drug treatment (5%) had a specificity of 92% for death and 91% for cardiovascular events, and a sensitivity of 20% for death and 22% for cardiovascular events. In addition, the scale classified 80.4% of patients who experienced a cardiovascular event and 78.3% of those who died as low risk. Age, body mass index, retinopathy and anticoagulant therapy were associated with reduced predictive ability of the SCORE scale, while being female was associated with better risk prediction. CONCLUSIONS: The predictive ability of the SCORE scale for cardiovascular disease and total mortality in patients with hypertension is limited.

Acceptance and Commitment Therapy for Chronic Pain: An Overview of Systematic Reviews with Meta-Analysis of Randomized Clinical Trials.

This overview of reviews aimed to summarize the evidence from systematic reviews and meta-analyses of randomized clinical trials of the efficacy of acceptance and commitment therapy (ACT) for adults with chronic pain in relation to pain intensity, pain-related functioning, quality of life, and psychological factors. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, PubMed, and the Cochrane Library databases were searched from inception to July 2, 2023. AMSTAR 2 was used to assess the methodological quality of systematic reviews. The overlap among reviews was calculated. Nine reviews comprising 84 meta-analyses of interest were included. At post-treatment, some meta-analyses mainly showed that ACT can reduce depression symptoms, anxiety symptoms, psychological inflexibility, and pain catastrophizing; and can improve mindfulness, pain acceptance, and psychological flexibility. At three-month follow-up, ACT can reduce depression symptoms and psychological inflexibility, as well as improve pain-related functioning and psychological flexibility. At six-month follow-up, ACT can improve mindfulness, pain-related functioning, pain acceptance, psychological flexibility, and quality of life. At six-twelve-month follow-up, ACT can reduce pain catastrophizing and can improve pain-related functioning. Some methodological and clinical issues are identified in the reviews, such as a very high overlap between systematic reviews, the fact that the certainty of the evidence is often not rated and specific details needed to replicate the interventions reviewed are often not reported. Overall, however, randomized clinical trials and systematic reviews show that ACT can improve outcomes related to chronic pain (eg, pain-related functioning). Future systematic reviews should address the methodological and clinical concerns identified here to produce higher-quality findings. PERSPECTIVE: Despite certain methodological and clinical issues, randomized clinical trials and systematic reviews of ACT appear to show that it can improve outcomes related to chronic pain (eg, psychological factors).

Preliminary Validation and Gender Invariance of the Technology Anxiety Scale in Older Spanish Adults / Validación preliminar e invarianza de género de la Escala de Ansiedad Tecnológica en mayores españoles

Background: Technology anxiety is more prevalent in older people and can compromise their functionality in an increasingly techno-dependent world. There are no validated instruments to assess it in older Spanish people. Method: A technology anxiety scale was cross-culturally adapted and applied to 355 Spaniards (66% women, M = 78.63, SD = 6.77). Two models were tested by confirmatory factor analysis: a one-dimensional model (technology anxiety) and a model with two correlated factors (fear and confidence in technology, respectively). Results: Both showed an adequate fit, although higher in the two-factor correlated model (χ2 = 243.797, df = 26, CFI = .969, TLI = .945, SRMR = .039). Concurrent validity was confirmed through correlations with psychological well-being, quality of life, and health satisfaction. Configural, metric, and scalar factorial gender invariance were also verified. Conclusion: Our data support the preliminary validity of the Technology Anxiety Scale in older Spanish men and women. (AU)

Introducción: La ansiedad tecnológica es más prevalente en mayores y puede dificultar su funcionalidad en un mundo cada vez más tecnodependiente. No hay instrumentos validados para evaluarla en mayores españoles. Método: Se adaptó transculturalmente una escala de ansiedad tecnológica y se aplicó a 355 españoles (66% mujeres, M = 78,63, DT = 6,77). Se testaron dos modelos mediante análisis factorial confirmatorio: un modelo unidimensional (ansiedad tecnológica) y un modelo con dos factores correlacionados (miedo a la tecnología y confianza en la misma). Resultados: Ambos mostraron un ajuste adecuado, aunque mayor en el modelo de dos factores correlacionados (χ2 = 243,797, gl = 26, CFI = .969, TLI = .945, SRMR = .039). La validez concurrente se confirmó mediante correlaciones con bienestar psicológico, calidad de vida y satisfacción con la salud. También se verificó la invarianza de género configural, métrica y escalar. Conclusión: Los resultados confirman la validez preliminar de la Escala de Ansiedad Tecnológica en hombres y mujeres mayores españoles. (AU)

Information in feedback ratchets.

Feedback control uses the state information of the system to actuate on it. The information used implies an effective entropy reduction of the controlled system, potentially increasing its performance. How to compute this entropy reduction has been formally shown for a general system and has been explicitly computed for spatially discrete systems. Here, we address a relevant example of how to compute the entropy reduction by information in a spatially continuous feedback-controlled system. Specifically, we consider a feedback flashing ratchet, which constitutes a paradigmatic example for the role of information and feedback in the dynamics and thermodynamics of transport induced by the rectification of Brownian motion. A Brownian particle moves in a periodic potential that is switched on and off by a controller. The controller measures the position of the particle at regular intervals and performs the switching depending on the result of the measurement. This system reaches a long-time dynamical regime with a nonzero mean particle velocity, even for a symmetric potential. Here, we calculate the efficiency at maximum power in this long-time regime, computing all the required contributions. We show how the entropy reduction can be evaluated from the entropy of the non-Markovian sequence of control actions, and we also discuss the required sampling effort for its accurate computation. Moreover, the output power developed by the particle against an external force is investigated, which-for some values of the system parameters-is shown to become larger than the input power provided by the switching of the potential. The apparent efficiency of the ratchet thus becomes higher than one, if the entropy reduction contribution is not considered. This result highlights the relevance of including the entropy reduction by information in the thermodynamic balance of feedback-controlled devices, specifically when writing the second principle. The inclusion of the entropy reduction by information leads to a well-behaved efficiency over all the range of parameters investigated.

Rotation of the c-Ring Promotes the Curvature Sorting of Monomeric ATP Synthases.

ATP synthases are proteins that catalyse the formation of ATP through the rotatory movement of their membrane-spanning subunit. In mitochondria, ATP synthases are found to arrange as dimers at the high-curved edges of cristae. Here, a direct link is explored between the rotatory movement of ATP synthases and their preference for curved membranes. An active curvature sorting of ATP synthases in lipid nanotubes pulled from giant vesicles is found. Coarse-grained simulations confirm the curvature-seeking behaviour of rotating ATP synthases, promoting reversible and frequent protein-protein contacts. The formation of transient protein dimers relies on the membrane-mediated attractive interaction of the order of 1.5 kB T produced by a hydrophobic mismatch upon protein rotation. Transient dimers are sustained by a conic-like arrangement characterized by a wedge angle of θ ≈ 50°, producing a dynamic coupling between protein shape and membrane curvature. The results suggest a new role of the rotational movement of ATP synthases for their dynamic self-assembly in biological membranes.