microRNA Expression Profile in Obesity-Induced Kidney Disease Driven by High-Fat Diet in Mice.

Obesity is one of the main causes of chronic kidney disease; however, the precise molecular mechanisms leading to the onset of kidney injury and dysfunction in obesity-associated nephropathy remain unclear. The present study aimed to unveil the kidney microRNA (miRNA) expression profile in a model of obesity-induced kidney disease in C57BL/6J mice using next-generation sequencing (NGS) analysis. High-fat diet (HFD)-induced obesity led to notable structural alterations in tubular and glomerular regions of the kidney, increased renal expression of proinflammatory and profibrotic genes, as well as an elevated renal expression of genes involved in cellular lipid metabolism. The miRNA sequencing analysis identified a set of nine miRNAs differentially expressed in the kidney upon HFD feeding, with miR-5099, miR-551b-3p, miR-223-3p, miR-146a-3p and miR-21a-3p showing the most significant differential expression between standard diet (STD) and HFD mice. A validation analysis showed that the expression levels of miR-5099, miR-551b-3p and miR-146a-3p were consistent with NGS results, while Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses revealed that these three validated miRNAs modulated target genes involved in metabolic and adipocytokine pathways, fatty acid and lipid metabolism, and inflammatory, senescence and profibrotic pathways. Our results suggest that differentially expressed miRNAs play pivotal roles in the intricate pathophysiology of obesity-associated kidney disease and could potentially create novel treatment strategies to counteract the deleterious effects of obesity on kidney function.

The extracellular matrix supports breast cancer cell growth under amino acid starvation by promoting tyrosine catabolism.

Breast tumours are embedded in a collagen I-rich extracellular matrix (ECM) network, where nutrients are scarce due to limited blood flow and elevated tumour growth. Metabolic adaptation is required for cancer cells to endure these conditions. Here, we demonstrated that the presence of ECM supported the growth of invasive breast cancer cells, but not non-transformed mammary epithelial cells, under amino acid starvation, through a mechanism that required macropinocytosis-dependent ECM uptake. Importantly, we showed that this behaviour was acquired during carcinoma progression. ECM internalisation, followed by lysosomal degradation, contributed to the up-regulation of the intracellular levels of several amino acids, most notably tyrosine and phenylalanine. This resulted in elevated tyrosine catabolism on ECM under starvation, leading to increased fumarate levels, potentially feeding into the tricarboxylic acid (TCA) cycle. Interestingly, this pathway was required for ECM-dependent cell growth and invasive cell migration under amino acid starvation, as the knockdown of p-hydroxyphenylpyruvate hydroxylase-like protein (HPDL), the third enzyme of the pathway, opposed cell growth and motility on ECM in both 2D and 3D systems, without affecting cell proliferation on plastic. Finally, high HPDL expression correlated with poor prognosis in breast cancer patients. Collectively, our results highlight that the ECM in the tumour microenvironment (TME) represents an alternative source of nutrients to support cancer cell growth by regulating phenylalanine and tyrosine metabolism.

Estandarización de la batería neuropsicológica de funciones ejecutivas y lóbulos frontales BaNFE-2 en muestra paraguaya con esclerosis múltiple tipo recaída remisión

Introducción: la esclerosis múltiple (EM), enfermedad crónica del sistema nervioso (SNC), compromete significativamente la cognición. Su prevalencia en Paraguay es 9,2/100.000 habitantes, 72% con recaída remisión (EMRR) e incidencia de 2-3mujeres/hombre, afecta más a personas en edad productiva, con altos costos económicos y afectivos. Objetivos: caracterizar al paciente con EMRR, evaluar sus funciones ejecutivas (FEs) con BaNFE-2; establecer valores de corte ajustados al país. Metodología: con fundamento en teoría de la neurociencia cognitiva, diseño no experimental, cuantitativo, descriptivo, empírico, retrospectivo y transversal; técnica psicométrica y entrevista neuropsicológica en una muestra por conveniencia de 40 pacientes, 82,5% mujeres y edad 25-55 años (37,78±7,89). Resultados: se reportaron datos demográficos y clínicos, se caracterizaron las escalas de BaNFE-2 cuya consistencia interna resultó significativa. Se obtuvo 52,5% de alteración en la escala prefrontal y 42,5% en FEs; relaciones significativas con escolaridad, discapacidad física (DF), cantidad de brotes y deterioro cognitivo (DC); diferencias significativas por sexo, escolaridad, DF y DC. Se calcularon puntuaciones tipificadas por escolaridad, z<-1 establece el corte entre normalidad y alteración. Conclusión: las pruebas de BaNFE-2 perfilan la afectación del tiempo de ejecución, atención, memoria de trabajo y FEs. Este estudio aporta baremos ajustados al país y abre una novedosa línea de investigación aplicando BaNFE-2 en EM.

Introduction: Multiple sclerosis (MS) is a chronic, neurodegenerative, inflammatory disease of the central nervous system (CNS) that significantly compromises cognitive functions. In Paraguay, it occurs with a prevalence of 9.2/100,000 inhabitants, 72% in the clinical form of relapsing remission (RRMS) and an incidence of 2 to 3 women/men, affecting more people of productive age with high economic and emotional costs. Objectives: To characterize the Paraguayan patient with RRMS, to assess the state of their executive functions (EFs) with the BaNFE-2 battery, and to establish cut-off values adjusted to the country. Methods: Research based on the theory of cognitive neuroscience of non-experimental, quantitative and descriptive design for analytical purposes. It is empirical, retrospective and cross-sectional. The psychometric technique and neuropsychological interview were used in a convenience sample of 40 patients aged 25 to 55 (37.78 ± 7.89) and 82.5% women. Results: Demographic and clinical data of the participants were reported. The BaNFE-2 coded and normalized scales were statistically characterized, the internal consistency of which was significant. 52.5% of the alteration was obtained in the anterior prefrontal scale and 42.5% in FEs; there are significant relationships with schooling, physical disability (PD), number of outbreaks and cognitive impairment (CI); there were also significant differences by sex, education, PD and CI. Standardized scores adjusted for schooling were calculated such that z<-1 establishes the cutoff between normality and abnormality. Conclusion: BaNFE-2 battery tests profile the affectation of execution time, attention, working memory, and FEs. This study provides the adjusted scales for the country and opens a new line of research applying the BaNFE-2 battery in people with MS.

"Fat but Fit" Paradox and Cardiometabolic Risk in Children: The Role of Physical Activity.

Background: The "fat but fit" paradigm suggests that high fitness levels counteract the negative consequences of obesity on cardiometabolic risk, nevertheless, this paradigm has been less studied in children. Objectives: To analyze the relationship between "fat but fit" categories and cardiometabolic risk factors in school children, and to examine whether the intensity of physical activity (PA) is related with the fat but fit (FF) category in which the child is classified. Methods: We analyzed the baseline measurements of 312 school children aged 9-11 years involved in the clinical trial MOVI-daFit!, including adiposity parameters (BMI, waist circumference, and body fat mass percentage), cardiorespiratory fitness (CRF), blood pressure parameters, PA, and biochemical parameters (blood lipid profile, insulin, C-reactive protein, and glycosylated hemoglobin). Results: The cluster analysis of body fat mass percentage and VO2 max estimate z-scores agreed with the four categories of the "fat but fit" paradigm: fat unfit (FU), unfat unfit (UU), FF, and unfat fit (UF). Analysis of variance (ANOVA) models indicated that children in the FF and UF clusters had better levels of biochemical parameters [high-density lipoprotein cholesterol (HDL-c), triglycerides (TG), TG/HDL-c, insulin], vigorous PA amount and metabolic syndrome (MetS) index than their peers in the FU and UU cluster categories (p < 0.05). Conclusions: Our results reinforce the "fat but fit" paradigm proving that CRF levels can counteract the effect of obesity on some cardiometabolic risk factors (HDL-c, TG, TG/HDL-c, insulin, PA, and MetS) in school children. ClinicalTrials.gov Identifier: NCT03236337.

Decrease in the prevalence of hypertension in Spanish schoolchildren from 2010 to 2017: Cuenca Study.

AIMS: To examine the secular trends in blood pressure measurements and normal or high blood pressure classification among Spanish schoolchildren from 2010 to 2017, to analyze the persistence in the blood pressure category reported in 2017 compared with 2013 in those children born in 2007-08 and to compare in this cohort the prevalence of high blood pressure using both definitions, the 2004 and 2017 guidelines. METHODS AND RESULTS: The data for the prevalence/trend analysis were obtained from cross-sectional analyses conducted in 2010, 2013, and 2017 of 2709 schoolchildren aged 4-6 and 8-11 years from 22 schools in the province of Cuenca, Spain. The data for the longitudinal analysis were obtained from cross-sectional analyses of measurements gathered in 2013 and 2017 in the same cohort of children (n = 275). The prevalence of normal blood pressure increased by 5.4% in children aged 4-6 years from 2013 to 2017 and by 2.2% in children aged 8-11 from 2010 to 2017. This increase was mainly driven by a decrease in the children classified in any stage of hypertension by 4.2% and 2.3% in each age range, respectively. In the same birth cohort, there was an increase of 7.6% in normal blood pressure prevalence. CONCLUSION: The high blood pressure prevalence in Spanish children has clearly decreased over the last decade, but is still important to detect this condition to design specific school-based interventions and the evaluation of children classified as hypertensive who might need medical supervision and treatment.

Periarticular injection and hamstring block versus placebo for pain control in anterior cruciate ligament reconstruction: A randomized controlled trial.

PURPOSE: To study the effectiveness of periarticular infiltration (PI), including the proximal donor site vs. placebo in anterior cruciate ligament (ACL) reconstruction. METHOD: A total of 44 patients were randomized in two groups assigned to receive PI or placebo. The perioperative protocol was the same for both groups. The principal outcome was pain measured at 8 and 24 h by a visual analog scale (VAS). The pain was registered in the knee and the proximal donor site. Pain scores were also assessed to determine whether the VAS improvement would reach the threshold values reported for the minimal clinically significant difference. The secondary outcome was the need for opioid rescue medication. RESULTS: Patients receiving PI exhibited lower pain values in the knee at 8 h (mean PI 35.00 ± 5.76 vs. placebo 60.23 ± 4.52 p = 0.01) and at 24 h (mean PI 37.23 ± 5.62 vs. placebo 55.55 ± 3.41 p = 0.008). These results were above the threshold for clinical significance. No improvements were found in proximal donor site pain and consumption of opioid rescue medication. Complications were comparable between the two groups. CONCLUSION: PI significantly reduced pain in the knee vs. placebo after ACL reconstruction with hamstring autograft at 8 and 24 h after surgery. The instillation of part of the mixture in the proximal hamstring stump did not result in any improvement LEVEL OF EVIDENCE I: Level I, randomized controlled trial.

Evaluación del dolor neonatal y opinión de los profesionales sobre el uso de un sistema automático para su valoración / Evaluation of neonatal pain and opinion of professionals regarding the use of an automatic assessment system

Objetivo: conocer las características de la evaluación del dolor neonatal en las unidades neonatales (UCIN) y la opinión de los profesionales sobre el uso de un sistema automático de valoración. Método: estudio transversal (2017). Población: enfermeras y médicos de UCIN de hospitales españoles. Recogida de datos mediante cuestionario online que incluía variables del perfil del profesional, frecuencia de evaluación del dolor, escala de valoración utilizada, formación recibida, dificultades percibidas para valorar el dolor, opinión sobre la evaluación del dolor y sobre el uso de un sistema automático de evaluación. Análisis estadístico descriptivo. Programa Jamovi 1.2.7®. Resultados: 133 respuestas. El 83,5% fueron mujeres, edad media de 40 años (9,43). El 88% de hospitales fueron de tercer nivel, 44,1% profesionales de Enfermería, 72% con experiencia en UCIN superior a seis años. El 66,9% valora según el estado del neonato, el 29,3% con escala propia de la unidad, el 72,6% considera que existe un componente subjetivo en la valoración, el 48,1% no recibió formación para valorar dolor. El 93,2% encontró útil un sistema automático, para el 36,1% no sería fiable. El 23,3% opina que un sistema automático no puede sustituir la percepción humana. Conclusiones: no se aplica un protocolo consensuado para la evaluación del dolor en neonatos, existe variabilidad, a veces no se mide por falta de tiempo y cuando se mide el dato puede ser subjetivo. La mayoría considera que el uso de un sistema automático de evaluación del dolor neonatal puede resultar útil, aunque algunos dudan de su fiabilidad por desconocimiento de la tecnología aplicada actual.(AU)

Objective: to understand the characteristics of the evaluation of neonatal pain in Neonatal Intensive Care Units (NICUs) and the opinion of professionals about the use of an automatic assessment system. Method: a cross-sectional study (2017). Population: NICU nurses and doctors from Spanish hospitals. Data collection through online questionnaire which included variables of the professional profile, frequency of pain assessment, evaluation scale used, training received, difficulties perceived to assess pain, opinion about pain evaluation and about the use of an automatic assessment system. Descriptive statistical analysis; Jamovi 1.2.7® program. Results: there were 133 answers: 83.5% were women, with a mean age of 40 (9.43) years. 88% from tertiary level hospitals; 44.1% were Nursing professionals, and 72% with >6 years’ experience at the NICU. Of these respondents, 66.9% assessed pain according to the status of the newborn, 29.3% with a scale specific to the unit, 72.6% considered that there was a subjective component in the assessment, 48.1% did not receive any training to assess pain. An automatic system was regarded as useful by 93.2%, but for 36.1% it would not be reliable, and 23.3% reckoned that an automatic system could not replace human perception. Conclusions: no protocol by consensus was applied for pain assessment in newborns, there was variability, sometimes it was not measured due to lack of time, and when it was measured, data could be subjective. The majority considered that the use of an automatic pain assessment system could be useful, although some doubted its reliability due to lack of knowledge of the technology currently applied.(AU)

Comparative effectiveness and safety of homologous two-dose ChAdOx1 versus heterologous vaccination with ChAdOx1 and BNT162b2.

Small trials have suggested that heterologous vaccination with first-dose ChAdOx1 and second-dose BNT162b2 may generate a better immune response than homologous vaccination with two doses of ChAdOx1. In this cohort analysis, we use linked data from Catalonia (Spain), where those aged <60 who received a first dose of ChAdOx1 could choose between ChAdOx1 and BNT162b2 for their second dose. Comparable cohorts were obtained after exact-matching 14,325/17,849 (80.3%) people receiving heterologous vaccination to 14,325/149,386 (9.6%) receiving homologous vaccination by age, sex, region, and date of second dose. Of these, 464 (3.2%) in the heterologous and 694 (4.8%) in the homologous groups developed COVID-19 between 1st June 2021 and 5th December 2021. The resulting hazard ratio (95% confidence interval) is 0.66 [0.59-0.74], favouring heterologous vaccination. The two groups had similar testing rates and safety outcomes. Sensitivity and negative control outcome analyses confirm these findings. In conclusion, we demonstrate that a heterologous vaccination schedule with ChAdOx1 followed by BNT162b2 was more efficacious than and similarly safe to homologous vaccination with two doses of ChAdOx1. Most of the infections in our study occurred when Delta was the predominant SARS-CoV-2 variant in Spain. These data agree with previous phase 2 randomised trials.

Robust and bias-free localization of individual fixed dipole emitters achieving the Cramér Rao bound for applications in cryo-single molecule localization microscopy.

Single molecule localization microscopy (SMLM) has the potential to resolve structural details of biological samples at the nanometer length scale. Compared to room temperature experiments, SMLM performed under cryogenic temperature achieves higher photon yields and, hence, higher localization precision. However, to fully exploit the resolution it is crucial to account for the anisotropic emission characteristics of fluorescence dipole emitters with fixed orientation. In case of slight residual defocus, localization estimates may well be biased by tens of nanometers. We show here that astigmatic imaging in combination with information about the dipole orientation allows to extract the position of the dipole emitters without localization bias and down to a precision of 1 nm, thereby reaching the corresponding Cramér Rao bound. The approach is showcased with simulated data for various dipole orientations, and parameter settings realistic for real life experiments.

Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review.

INTRODUCTION: The main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life. METHODS AND ANALYSIS: The literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined. ETHICS AND DISSEMINATION: In this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.The results will be published in a peer-reviewed journal.

Oxytocin Administration in Low-Risk Women, a Retrospective Analysis of Birth and Neonatal Outcomes.

BACKGROUND: In recent years, higher than the recommended rate of oxytocin use has been observed among low-risk women. This study examines the relationship between oxytocin administration and birth outcomes in women and neonates. METHODS: A retrospective analysis of birth and neonatal outcomes for women who received oxytocin versus those who did not. The sample included 322 women with a low-risk pregnancy. RESULTS: Oxytocin administration was associated with cesarean section (aOR 4.81, 95% CI: 1.80-12.81), instrumental birth (aOR 3.34, 95% CI: 1.45-7.67), episiotomy (aOR 3.79, 95% CI: 2.20-6.52) and length of the second stage (aOR 00:18, 95% CI: 00:04-00:31). In neonatal outcomes, oxytocin in labor was associated with umbilical artery pH ≤ 7.20 (OR 3.29, 95% CI: 1.33-8.14). Admission to neonatal intensive care unit (OR 0.56, 95% CI: 0.22-1.42), neonatal resuscitation (OR 1.04, 95% CI: 0.22-1.42), and Apgar score <7 (OR 0.48, 95% CI: 0.17-1.33) were not associated with oxytocin administration during labor. CONCLUSIONS: Oxytocin administration during labor for low-risk women may lead to worse birth outcomes with an increased risk of instrumental birth and cesarean, episiotomy and the use of epidural analgesia for pain relief. Neonatal results may be also worse with an increased proportion of neonates displaying an umbilical arterial pH ≤ 7.20.

Relationship between exclusive breastfeeding and brain-derived neurotrophic factor in children.

OBJECTIVE: A positive relationship between breastfeeding and brain-derived neurotrophic factor (BDNF) in infants has been suggested due to the presence of BDNF in human milk. This study aimed to determine the relationship between exclusive breastfeeding and BDNF serum levels in Spanish schoolchildren. METHODS: A cross-sectional analysis including 202 schoolchildren, aged eight to 11 years, from Cuenca, Spain, was conducted. Information on sociodemographic and anthropometric variables, sexual maturation, birth weight and exclusive breastfeeding ('no exclusive breastfeeding', and exclusive breastfeeding for ≤6 and >6 months), and BDNF serum levels using an ELISA method were obtained. Covariance analyses (ANCOVA) were conducted to examine the relationship between serological BDNF and exclusive breastfeeding after controlling for potential confounders. RESULTS: ANCOVA models showed no significant differences in BDNF levels between children who were exclusively breastfed for more than six months versus those who were not (p > 0.05). No significant differences were observed by age group (eight to nine years versus 10 to 11 years; p > 0.05). Additionally, no clear negative trend in BDNF serum levels according to sexual maturation categories was found (p > 0.05). CONCLUSION: These findings suggest that exclusive breastfeeding does not have a significant positive association on BDNF from eight to 11 years, since children who were exclusively breastfed did not have significantly higher BDNF levels than those who were not exclusively breastfed. Likewise, BDNF levels were not found to be negatively affected by hormonal development. Future research should examine the influence of exclusive breastfeeding on BDNF over the different developmental stages.

APANICU 1.0: sistema automático para la valoración del dolor en las unidades de cuidados intensivos neonatales / APANICU 1.0: an automatic system for pain assessment at neonatal intensive care units

Objetivo: comprobar la conectividad del prototipo APANICU 1.0 (Automatic Pain Assessment in Neonatal Intensive Care Units) y el software de la unidad para valorar el dolor en neonatos, y determinar la concordancia en la valoración del dolor cuando se usa APANICU 1.0 frente a escalas validadas.Método: pilotaje del prototipo (APANICU) que combina y analiza parámetros conductuales y fisiológicos del neonato, adquiere datos del monitor de constantes y registra la actividad del bebé con cámara y micrófono, calculando una cifra de dolor en tiempo real. El estudio se realizó en la Unidad de Cuidados Intensivos Neonatales del Hospital Universitario Joan XXIII (Tarragona). Dos observadores (A y B) valoraron el dolor del neonato usando las escalas Premature Infant Pain Profile (PIPP) y Susan Givens Bell (SGB), simultáneamente al volcado de APANICU. Se valoró la concordancia intraobservador mediante el coeficiente de correlación intraclase y concordancia entre instrumentos mediante el coeficiente de correlación Rho de Sperman.Resultados: 11 neonatos, edad gestacional media (DE) 32 (7,23) semanas. Coeficiente de correlación intraclase (IC 95%) entre A y B con PIPP fue 0,516 (- 0,800; 0,870), con SGB fue 0,079 (- 2,422; 0,752). Coeficiente de correlación de Spearman entre PIPP (A) y APANICU fue -0,144 (p= 0,67); entre SGB (A) y APANICU fue 0,115 (p= 0,74); entre PIPP (B) y APANICU fue 0,435 (p= 0,18), entre SGB (B) y APANICU fue de 0,077(p= 0,82).Conclusión: APANICU 1.0 emite una cifra de dolor, pero necesita perfeccionarse, ya que los valores obtenidos no se correlacionaron adecuadamente. Se propone mejorar el software creando una versión 2.0.(AU)

Objective: to test the connectivity of the APANICU 1.0 (Automatic Pain Assessment in Neonatal Intensive Care Units) prototype and the software used in the unit to assess pain in newborns, and to determine the consistency in pain assessment when using APANICU 1.0 vs. validated scales.Method: pilot test of the prototype (APANICU) that combines and analyzes behavioral and physiological parameters of the newborn, obtains data from the vital signs monitor, and records the activity of the baby with camera and microphone, calculating a pain figure in real time. The study was conducted in the Neonatal Intensive Care Unit of the Hospital Universitario Joan XXIII (Tarragona). Two observers (A and B) assessed the pain of the newborn using the Premature Infant Pain Profile (PIPP) and Susan Givens Bell (SGB) scales, simultaneously with APANICU data dump. Consistency between observers was assessed through the coefficient of intra-class correlation, and consistency between instruments through the Spearman’s Rho coefficient of correlation.Results: eleven (11) newborns, with mean gestational age (SD): 32 (7.23) weeks. The coefficient of intra-class correlation (CI 95%) between A and B with PIPP was 0.516 (- 0.800; 0.870): and 0.079 (- 2.422; 0.752) with SGB. The Spearman’s Coefficient of Correlation between PIPP (A) and APANICU was -0.144 (p= 0.67); between SGB (A) and APANICU: 0.115 (p= 0.74); between PIPP (B) and APANICU: 0.435 (p= 0.18), and between SGB (B) and APANICU: 0.077 (p= 0.82).Conclusion: APANICU 1.0 issues a pain figure, but it needs improvement, because the values obtained were not adequately correlated. The proposal is to improve the software by creating a 2.0 version.(AU)

The Spanish Version of the Fear of Kidney Failure Questionnaire: Validity, Reliability, and Characterization of Living Donors With the Highest Fear of Kidney Failure.

BACKGROUND: Measures of fear of progression or recurrence of illnesses have been criticized for neglecting cross-cultural validity. Therefore, we assessed the psychometric properties of the Spanish version of the Fear of Kidney Failure Questionnaire (FKFQ), to determine whether postdonation fear of kidney failure (FKF) influenced the donors' psychosocial status, and define variables that characterized donors with high FKFQ scores. METHODS: We included 492 participants (211 donors) in a multicenter, 11-year, retrospective, cross-sectional study. Donors were classified with a Latent Class Analysis of the FKFQ-item scores and characterized with a multivariable logistic regression analysis. We calculated the risk ratio based on predicted marginal probabilities. RESULTS: The Spanish version of the FKFQ showed acceptable psychometric properties. FKF was uncommon among donors, but we detected a small subgroup (n = 21, 9.9%) with high FKF (mean FKFQ score = 14.5, 3.1 SD). Compared with other donors, these donors reported higher anxiety and depression (38% and 29% of potential anxiety and depressive disorders), worse quality of life, and less satisfaction with the donation. Donors with high FKFQ scores were characterized by higher neuroticism combined with postdonation physical symptoms that interfered with daily activities. CONCLUSIONS: The FKFQ was cross-culturally valid, and thus, it may be used to assess the FKF in Spanish-speaking donors. New interventions that promote positive affectivity and evidence-based treatments for worry could be adapted for treating FKF.

A workflow for sizing oligomeric biomolecules based on cryo single molecule localization microscopy.

Single molecule localization microscopy (SMLM) has enormous potential for resolving subcellular structures below the diffraction limit of light microscopy: Localization precision in the low digit nanometer regime has been shown to be achievable. In order to record localization microscopy data, however, sample fixation is inevitable to prevent molecular motion during the rather long recording times of minutes up to hours. Eventually, it turns out that preservation of the sample's ultrastructure during fixation becomes the limiting factor. We propose here a workflow for data analysis, which is based on SMLM performed at cryogenic temperatures. Since molecular dipoles of the fluorophores are fixed at low temperatures, such an approach offers the possibility to use the orientation of the dipole as an additional information for image analysis. In particular, assignment of localizations to individual dye molecules becomes possible with high reliability. We quantitatively characterized the new approach based on the analysis of simulated oligomeric structures. Side lengths can be determined with a relative error of less than 1% for tetramers with a nominal side length of 5 nm, even if the assumed localization precision for single molecules is more than 2 nm.

Well-being status and post-traumatic stress symptoms in health workers attending mindfulness sessions during the early stage of the COVID-19 epidemic in Mexico / Alteraciones en el bienestar y síntomas de estrés postraumático en trabajadores de la salud mexicanos que participaron en sesiones virtuales de atención plena durante la etapa inicial de la epidemia de COVID-19

Abstract Introduction In Mexico, a National Mental Health Strategy was implemented to identify and attend the mental health repercussions of the COVID-19 pandemic. It included the creation of five virtual clinics for health workers, being the Burnout, Post-traumatic Stress and Compassion Fatigue clinic one of them. Objective To describe the basal sociodemographic and psychological characteristics of health workers attending online mindfulness sessions as part of the treatment of the aforementioned clinic. Method This is a cross-sectional report part of a major nationwide and longitudinal project. All attendants responded to digital sociodemographics and COVID-19 questionnaires, the Extended Physician Well-Being Index (EPWBI), and the Post-traumatic Stress Disorder (PTSD) TOP-8 index. Results Of the 507 health workers that participated, 70.02% of them were at risk of burnout according to the Extended Well-Being Index and 57.31, 7.91 and 2.77% had a mild, moderate, and severe risk of PTSD, respectively. The most affected were the female health workers, from metropolitan or central areas of the country, and those diagnosed with COVID-19 or exposed to a person with the diagnosis. Discussion and conclusion Mexican health workers attending mindfulness sessions presented high frequencies of PTSD symptoms and burnout. Female workers at urban hospitals could be at a special risk for developing PTSD or Well-ness alterations, and thus, they must be cared for closely, particularly those having direct contact with COVID 19 positive persons. The early participation in mental health strategies might lessen the immediate and long-term pandemic effects.

Resumen Introducción En México se crearon cinco clínicas virtuales de salud mental para los trabajadores de la salud como parte de la respuesta nacional de salud mental ante la pandemia por COVID-19. La clínica de desgaste, estrés postraumático y fatiga por compasión es una de ellas. Objetivo Describir las características sociodemográficas y psicológicas basales de los trabajadores de la salud que asistieron a las sesiones virtuales de atención plena, que constituyeron una de las estrategias de atención en la clínica. Método Estudio transversal, parte de un proyecto nacional y longitudinal. Los participantes contestaron un cuestionario digital con preguntas sociodemográficas y sobre la situación actual del COVID-19, el Índice Extendido de Bienestar Médico y la escala TOP-8 de estrés postraumático. Resultados De los 507 trabajadores de la salud que participaron, 70.02% presentaron riesgo de desgaste según el Índice de Bienestar Extendido, y 57.31, 7.91 y 2.77% de riesgo leve, moderado y grave en el TOP-8, respectivamente. Las mujeres, los habitantes de la zona metropolitana o del centro del país, aquellos con diagnóstico de COVID-19 y los expuestos a personas con dicho diagnóstico fueron los más afectados. Discusión y conclusión Los participantes de las sesiones de atención plena presentaron altas frecuencias de síntomas de estrés postraumático y desgaste (burnout). Como las trabajadoras de zonas urbanizadas podrían correr un riesgo especial, debería dárseles un seguimiento especial, en particular a aquellas en contacto directo con personas positivas al COVID-19. La participación temprana en estrategias de salud mental podría amortiguar los efectos inmediatos y de largo plazo de la pandemia.

The accuracy of toe brachial index and ankle brachial index in the diagnosis of lower limb peripheral arterial disease: A systematic review and meta-analysis.

BACKGROUND AND AIMS: We aimed to compare the diagnostic accuracy of ankle brachial index (ABI) and toe brachial index (TBI) for peripheral arterial disease (PAD) in a wide spectrum of PAD populations and reference standard tests, and to examine variables influencing heterogeneity in the estimates. METHODS: Systematic searches in EMBASE, MEDLINE, Web of Science and the Cochrane Library databases were performed, from inception to January 2020. Hierarchical summary receiver operating characteristic curves (HSROC) were used to summarize the pooled test performance. RESULTS: Thirty five (patient-level: 1318 patients, limb-level: 5637 limbs) and nine studies (patient-level: 294 patients, limb-level: 826 limbs) were included in ABI and TBI meta-analyses, respectively. The QUADAS-2 tool identified many studies with high risk of bias, especially in the "patient selection" domain. Pooled estimates for ABI in detecting 50% or greater stenosis were sensitivity = 61% (95% CI: 55-69), specificity = 92% (95% CI: 89-95) and dOR = 16.5 (95% CI: 11.5-23.6). Similarly, TBI yielded sensitivity = 81% (95% CI: 70-94), specificity = 77% (95% CI: 66-90) and dOR = 13.1 (95% CI: 7.0-24.8). In a direct comparison of seven studies jointly analyzing ABI and TBI, TBI showed better overall diagnostic accuracy (16.4 vs 11.0 in dOR) at the expense of sensitivity (82% vs 52%), while specificity (77% vs 94%) performed worse in TBI than ABI. Heterogeneity was large in sensitivity for ABI, with variables as different reference standard tests, smoking habit and PAD prevalence accounting for such variability. Similarly, gender, different index test cut-offs and sample size influenced the heterogeneity in TBI specificity. CONCLUSIONS: Though ABI and TBI showed similar diagnostic performance to diagnose PAD, TBI showed far better sensitivity than ABI, especially in "challenging populations", as those exhibiting calcification.

Obesity and thinness prevalence trends in Spanish schoolchildren: are they two convergent epidemics?

BACKGROUND: The objective of this study was to analyse the secular trends in body composition variables and weight status among Spanish schoolchildren from 1992 to 2017, and to examine the persistence in the same weight status category from 2013 to 2017 of the birth cohort in 2007-08. METHODS: The data for the prevalence/trend analysis were taken from cross-sectional analyses conducted in 1992 (n = 308), 1996 (n = 307), 1998 (n = 275), 2004 (n = 1119), 2010 (n = 912), 2013 (n = 352) and 2017 (n = 275) using similar procedure methods among schoolchildren (aged 4-6 y and 8-11 years) from 22 public schools in the province of Cuenca, Spain. The data for the longitudinal analysis were obtained from cross-sectional analyses of measurements gathered in 2013 and 2017 in the same cohort of children (n = 275) born in 2007 and 2008. Weight, height, body fat percentage (by electronic bioimpedance) and waist circumference were measured by trained personnel. Weight status was defined according to the BMI cut-offs proposed by the International obesity task force (IOTF) criteria. RESULTS: In schoolchildren, the overall prevalence of thinness increased from 5.9% in 1992 to 14.5% in 2017, P < 0.001. Whereas, the overall prevalence of obesity/overweight remained relatively steady between the same time period (from 25.2% to 26.9%), P = 0.599. In relation to the longitudinal analyses, we observed that 70.9% of schoolchildren in 2017 remained in the same weight status category as in 2013. CONCLUSIONS: The child obesity epidemic in Spain has remained relatively stable over the last two decades. However, the prevalence of thinness shows a worrying upward trend.