Primary Cutaneous Acral CD8-Positive Lymphoproliferative Disorder: A Case Report With Nonacral Presentation.

In this study, we describe a patient of primary cutaneous acral CD8-positive lymphoproliferative disorder located in a nonacral region. A 65-year-old male presented with an ill-defined lesion of rubbery consistency and a maximum diameter of 2.5 cm localized in the right thigh. Histologically, it was composed of a diffuse dermal infiltration of medium-sized atypical lymphocytes that expressed CD3, CD8, and TIA-1. In addition, a characteristic paranuclear positivity with CD68 was observed. During the follow-up, the patient had a recurrence of the disease in the abdomen with a lesion showing similar morphology and phenotype. To our knowledge, < 20 patients of primary cutaneous acral CD8-positive lymphoproliferative disorder with a nonacral presentation have been described in English literature. Although rare, its identification is essential to differentiate it from other T-cell lymphoma that express CD8 and cytotoxic markers, and whose clinical courses are very aggressive.

Transcription factors HB21/40/53 trigger inflorescence arrest through abscisic acid accumulation at the end of flowering.

Flowers, and hence, fruits and seeds, are produced by the activity of the inflorescence meristem after the floral transition. In plants with indeterminate inflorescences the final number of flowers produced by the inflorescence meristem is determined by the length of the flowering period, which ends with inflorescence arrest. Inflorescence arrest depends on many different factors, such as the presence of seeds, the influence of the environment, or endogenous factors such as phytohormone levels and age, which modulate inflorescence meristem activity. The FRUITFULL-APETALA2 (FUL-AP2) pathway plays a major role in regulating the end of flowering, likely integrating both endogenous cues and those related to seed formation. Among AP2 targets, HOMEOBOX PROTEIN21 (HB21) has been identified as a putative mediator of AP2 function in the control of inflorescence arrest. HB21 is a homeodomain leucine zipper transcription factor involved in establishing axillary bud dormancy. Here we characterized the role of HB21 in the control of the inflorescence arrest at the end of flowering in Arabidopsis (Arabidopsis thaliana). HB21, together with HB40 and HB53, are upregulated in the inflorescence apex at the end of flowering, promoting floral bud arrest. We also show that abscisic acid (ABA) accumulation occurs in the inflorescence apex in an HB-dependent manner. Our work suggests a physiological role of ABA in floral bud arrest at the end of flowering, pointing to ABA as a regulator of inflorescence arrest downstream of the HB21/40/53 genes.

Analysis of pea mutants reveals the conserved role of FRUITFULL controlling the end of flowering and its potential to boost yield.

Monocarpic plants have a single reproductive phase in their life. Therefore, flower and fruit production are restricted to the length of this period. This reproductive strategy involves the regulation of flowering cessation by a coordinated arrest of the growth of the inflorescence meristems, optimizing resource allocation to ensure seed filling. Flowering cessation appears to be a regulated phenomenon in all monocarpic plants. Early studies in several species identified seed production as a major factor triggering inflorescence proliferative arrest. Recently, genetic factors controlling inflorescence arrest, in parallel to the putative signals elicited by seed production, have started to be uncovered in Arabidopsis, with the MADS-box gene FRUITFULL (FUL) playing a central role in the process. However, whether the genetic network regulating arrest is also at play in other species is completely unknown. Here, we show that this role of FUL is not restricted to Arabidopsis but is conserved in another monocarpic species with a different inflorescence structure, field pea, strongly suggesting that the network controlling the end of flowering is common to other plants. Moreover, field trials with lines carrying mutations in pea FUL genes show that they could be used to boost crop yield.

Social participation, loneliness, and physical inactivity over time: evidence from SHARE.

OBJECTIVES: We aimed to explore the reciprocal effects of social participation, loneliness, and physical inactivity over a period of 6 years in a representative sample of European adults over 50 years old. DESIGN: A longitudinal study with a six-year follow-up period was conducted. SETTING: Four waves of the Survey of Health, Ageing and Retirement in Europe project were used. PARTICIPANTS: This study includes 64,887 participants from Europe and Israel, who were aged 50 or older at the first time. MEASUREMENTS: The relationship between participation in social activities, loneliness and physical inactivity was analyzed, controlling for age, gender, and disability. A series of cross-lagged panel models (CLPMs) were applied to analyze the relationships among these variables. RESULTS: A CLPM with equal autoregressive cross-lagged effects across waves was the best fit to the data (χ2 = 7137.8, CFI = .972, RMSEA = .049, SRMR = .036). The autoregressive effects for the three variables showed high stability across waves, and all the cross-lagged effects in the model were statistically significant. Social activity and physical inactivity maintained a strong negative cross-lagged effect, while their cross-lagged effects on loneliness were comparatively smaller. Social activity had a positive cross-lagged effect on loneliness, while physical inactivity had a negative cross-lagged effect on loneliness. CONCLUSIONS: These findings highlight the importance of promoting physical activity and social participation and addressing loneliness through targeted interventions in older adults.

Sudden cardiac death triggered by minimal alcohol consumption in the context of novel PPA2 mutations in 2 unrelated families.

Biallelic variants in PPA2 gene cause a rare but lethal mitochondrial disorder. We describe the first four cases reported in Spain of PPA2 disease in two unrelated families. We have conducted a revision of the clinical history, necropsies, and postmortem genetic testing from probands, and clinical evaluation, genetic testing and blood transcript analysis in family members. All the cases harbored biallelic PPA2 variants in compound heterozygous status. Two brothers from family 1 suffered sudden death after a small first intake of alcohol in 2013 and 2022. The sister remains alive but affected with cardiomyopathy, extensive scar on cardiac imaging, and high sensitivity to alcohol intake. The three siblings carried PPA2 c.290A > G (p.Glu97Gly) novel missense variant and PPA2 c.513C > T (p.Cys171 = ) altering splicing site variant, both probably leading to mRNA degradation based on in-silico and transcript analyses. A teenager from family 2 suffered sudden death after a small intake of alcohol in 2018 and carried PPA2 c.683C > T (p.Pro228Leu) missense and PPA2 c.980_983del (p.Gln327fs) novel frameshift variant, both probably leading to abnormal protein structure. All cases were asymptomatic until adolescence. Furthermore, the sister in family 1 has survived as an asymptomatic adult. PPA2 disease can manifest as cardiac arrest in the young, especially after alcohol exposure. Our results show that PPA2 deficiency can be related to different pathogenicity mechanisms such as abnormal protein structure but also mRNA decay caused by synonymous or missense variants. Strict avoidance of alcohol consumption and early defibrillator implantation might prevent lethal arrhythmias in patients at risk.

A Review of Current Approaches to Evaluating and Reimbursing New Medicines in a Subset of OECD Countries.

OBJECTIVES: The aim of this study was to review the current evaluation and funding processes for new drugs in different developed countries, to provide a comparative framework with detailed, homogeneous, and up-to-date information. METHODS: Scientific publications, reports and websites were reviewed between July and December 2021 using PubMed, Google Scholar, and grey literature sources. The main items searched were actors and processes, including timelines, characteristics of clinical and economic evaluations, participation of stakeholders, elements of price and reimbursement decisions, cost-effectiveness thresholds and specific funds. The analysed 13 countries were Australia, Canada, England, France, Germany, Italy, Japan, the Netherlands, Portugal, Scotland, South Korea, Spain and Sweden. RESULTS: Eight countries perform the assessment process separated from the pricing decision. Countries measure each drug's added therapeutic value through multi-attribute value scales, algorithms, non-prescriptive lists of criteria, or quality-adjusted life years (QALYs). Health technology assessment (HTA) methodologies differ in their outcome measures, elicitation techniques, comparators, and perspectives. The criteria used for pricing and reimbursement include humanistic, clinical, and economic aspects. Only Scotland, England, the Netherlands, Canada and Portugal use explicit efficiency thresholds. Health care professionals participate in all assessment committees, and patients are becoming increasingly involved in most countries. The official time from marketing authorisation to the completion of the evaluation and pricing processes varied from 126 to 540 days. CONCLUSIONS: Most analysed countries show a trend towards value-based approaches that consider value for money to society, but also other economic, clinical, and humanistic criteria. Good practices included robustness, transparency, independence, and participation.

Latent trajectories of recent and delayed memory and their predictors: evidence from SHARE.

OBJECTIVES: Cognitive decline is common in the old age, but some evidence suggests it may already occur during adulthood. Previous studies have linked age, gender, educational attainment, depression, physical activity, and social engagement to better cognitive performance over time. However, most studies have used global measures of cognition, which could mask subtle changes in specific cognitive domains. The aim of this study is to examine trajectories of recent and delayed memory recall from a variable-centered perspective, in order to elucidate the impact of age, gender, educational attainment, depression, physical activity, and social engagement on recent and delayed memory both at initial time and across a 10-year period. DESIGN AND PARTICIPANTS: The sample was formed by 56,616 adults and older adults that participated in waves 4 to 8 of the Survey of Health, Aging and Retirement in Europe (SHARE). ANALYSES: We used latent growth modeling to establish latent recent and delayed memory trajectories, and then tested the effects of the aforementioned covariates on the latent intercept and slopes. RESULTS: Results showed that both recent and delayed recall display a quadratic trajectory of decline. All covariates significantly explained initial levels of immediate and delayed recall, but only a few had statistically significant effects on the slope terms. CONCLUSIONS: We discuss differences between present results and those previously reported in studies using a person-centered approach. This study provides evidence of memory decline during adulthood and old adulthood. Further, results provide support for the neural compensation reserve theory.

CD61 identifies a superior population of aged murine HSCs and is required to preserve quiescence and self-renewal.

ABSTRACT: Aging leads to a decline in function of hematopoietic stem cells (HSCs) and increases susceptibility to hematological disease. We found CD61 to be highly expressed in aged murine HSCs. Here, we investigate the role of CD61 in identifying distinct subpopulations of aged HSCs and assess how expression of CD61 affects stem cell function. We show that HSCs with high expression of CD61 are functionality superior and retain self-renewal capacity in serial transplantations. In primary transplantations, aged CD61High HSCs function similarly to young HSCs. CD61High HSCs are more quiescent than their CD61Low counterparts. We also show that in aged bone marrow, CD61High and CD61Low HSCs are transcriptomically distinct populations. Collectively, our research identifies CD61 as a key player in maintaining stem cell quiescence, ensuring the preservation of their functional integrity and potential during aging. Moreover, CD61 emerges as a marker to prospectively isolate a superior, highly dormant population of young and aged HSCs, making it a valuable tool both in fundamental and clinical research.

Evolución del riesgo y protección en la infancia y la adolescencia

(analítico) Los factores de riesgo y protección pueden ser utilizados para evaluar, prevenir e intervenir en el maltrato infantil. El objetivo de este estudio es analizar longitudinalmente el riesgo en la infancia y la adolescencia, para determinar qué factores pueden ser empleados como indicadores de evolución. Se empleó una muestra de 102 niños, niñas y adolescentes que participaban en el sistema de bienestar infantil español, en tres momentos temporales. Los resultados indicaron que existe una evolución del riesgo, con una tendencia general de disminución de riesgos e incremento de elementos protectores. Nuestros hallazgos identificaron la existencia de factores dinámicos y estáticos. Este estudio pone de manifiesto la relevancia de la atención e intervención continuada y a largo plazo para fortalecer los factores de protección y disminuir los de riesgo en niños, niñas y adolescentes.

(analytical) Risk and protective factors can be used for risk and needs assessments, prevention, and intervention in cases involving mistreatment of children. The aim of this study is to provide a longitudinal analysis of risks and vulnerabilities in childhood and adolescence, with the goal of determining which factors can be used as indicators for progress with cases. A sample of 102 children and adolescents supported by the child welfare system in Spain was used along with measurements based on three different points in time. The study's results indicated that there is a change in risk levels, with a general trend of decreasing risk and increasing protective elements. The study's findings identified the existence of a group of dynamic factors and another group of static factors. This study highlighted the relevance of continuous and long-term care and intervention in order to strengthen protection and decrease risks for children.

(analítico) Os factores de risco e protecção podem ser utilizados para avaliar, prevenir e intervir em casos de maustratos a crianças. O objectivo deste estudo é analisar o risco na infância e adolescência longitudinalmente, a fim de determinar que factores podem ser utilizados como indicadores de evolução. Uma amostra de 102 crianças e adolescentes participantes no sistema espanhol de bem-estar infantil foi utilizada em três pontos no tempo. Os resultados indicaram que existe uma evolução do risco, com uma tendência geral de diminuição do risco e aumento dos elementos protectores. Os nossos resultados identificaram a existência de factores dinâmicos e estáticos. Este estudo destaca a relevância dos cuidados e intervenções contínuos e a longo prazo para reforçar os factores de protecção e diminuir os factores de risco nas crianças.

Genetic and Phenotypic Analyses of Carpel Development in Arabidopsis.

Carpels are the female reproductive organs of the flower, organized in a gynoecium, which is likely the most complex organ of the plant. The gynoecium provides protection for the ovules, helps to discriminate between male gametophytes, and facilitates successful pollination. After fertilization, it develops into a fruit, a specialized organ for seed protection and dispersal. To carry out all these functions, coordinated patterning and tissue specification within the developing gynoecium has to be achieved. In this chapter, we provide different methods to characterize defects in carpel morphogenesis and patterning associated with developmental mutations, as well as a list of reporter lines that can be used to facilitate genetic analyses.

Influencia de la pandemia COVID-19 sobre la epidemiología de la bronquiolitis aguda / Influence of the COVID-19 pandemic on the epidemiology of acute bronchiolitis

Introducción: La pandemia COVID-19ha modificado la propagación de ciertos virus respiratorios causantes de bronquiolitis aguda. Analizamos la epidemiología de los ingresos por bronquiolitis durante la pandemia COVID-19 en comparación con ocho temporadas epidémicas anteriores. Métodos: Estudio observacional ambispectivo, que incluyó lactantes con bronquiolitis ingresados en un hospital terciario durante dos períodos: pandemia COVID-19 (15 de marzo de 2020 a 31 de agosto de 2021) y pre-pandemia (1 de septiembre de 2012 a 14 de marzo de 2020). Se recogieron características demográficas, clínicas y etiología. Resultados: Ingresaron 510 pacientes por bronquiolitis: 486 en el período pre-pandemia con una media de 61 ingresos por temporada vs. 24 durante la pandemia, observándose una reducción de ingresos del 60,7%. Durante la pandemia, el brote epidémico se inició con retraso abarcando la primavera-verano de 2021. El virus respiratorio sincitial fue el agente etiológico más frecuente en ambos períodos. Conclusiones: Observamos un cambio estacional de la bronquiolitis durante la pandemia COVID-19, probablemente influenciado por las medidas de control frente a SARS-CoV-2.(AU)

Introduction: The COVID-19 pandemic has changed the circulation of some viruses associated with acute bronchiolitis. We analyzed the epidemiology of bronchiolitis admissions during the COVID-19 pandemic compared with 8 previous epidemic seasons. Methods: An observational and ambispective study was performed, including infants admitted with bronchiolitis in a tertiary hospital during 2 periods: COVID-19 pandemic (15th March 2020 to 3rd August 2021) and pre-pandemic (1st September 2012 to 14th March 2020). Demographic, clinical data and etiologies were collected. Results: Five hundred ten patients were hospitalized with bronchiolitis: 486 in the pre-pandemic period with an average of 61 admissions per season vs. 24 during the pandemic, observing a 60.7% reduction in bronchiolitis admissions. During the pandemic, bronchiolitis outbreak was delayed until spring–summer 2021. Respiratory syncytial virus was the most frequent etiological agent in both periods. Conclusion: We observed a change in the seasonality of bronchiolitis during the pandemic COVID-19, possibly influenced by control measures against SARS-CoV-2..(AU)

A deficient immune response to SARS-CoV-2 in the nasopharynx is associated with severe COVID-19 pneumonia.

OBJECTIVES: We analyzed the expression of inflammatory and antiviral genes in the nasopharynx of SARS-CoV-2 infected patients and their association with the severity of COVID-19 pneumonia. METHODS: We conducted a cross-sectional study on 223 SARS-CoV-2 infected patients. Clinical data were collected from medical records, and nasopharyngeal samples were collected in the first 24 hours after admission to the emergency room. The gene expression of eight proinflammatory/antiviral genes (plasminogen activator urokinase receptor [PLAUR], interleukin [IL]-6, IL-8, interferon [IFN]-ß, IFN-stimulated gene 15 [ISG15], retinoic acid-inducible gene I [RIG-I], C-C motif ligand 5 [CCL5], and chemokine C-X-C motif ligand 10 [CXCL10]) were quantified by real-time polymerase chain reaction. Outcome variables were: (i) pneumonia; (ii) severe pneumonia or acute respiratory distress syndrome. Statistical analysis was performed using multivariate logistic regression analyses. RESULTS: We enrolled 84 mild, 88 moderate, and 51 severe/critical cases. High expression of PLAUR (adjusted odds ratio [aOR] = 1.25; P = 0.032, risk factor) and low expression of CXCL10 (aOR = 0.89; P = 0.048, protective factor) were associated with pneumonia. Furthermore, lower values of ISG15 (aOR = 0.88, P = 0.021), RIG-I (aOR = 0.87, P = 0.034), CCL5 (aOR = 0.73, P <0.001), and CXCL10 (aOR = 0.84, P = 0.002) were risk factors for severe pneumonia/acute respiratory distress syndrome. CONCLUSION: An unbalanced early innate immune response to SARS-CoV-2 in the nasopharynx, characterized by high expression of PLAUR and low expression of antiviral genes (ISG15 and RIG-I), and chemokines (CCL5 and CXCL10), was associated with COVID-19 severity.

The Impact of COVID-19 on the Academic Life of Social Work Students: Resilience as a Mediating Variable.

PURPOSE: The aim of this study is to analyze the relationship between emotions and concerns stemming from COVID-19 and the academic engagement of social work students, taking into account the mediating role played by resilience. METHOD: We carried out a cross-cutting quantitative study by means of an online questionnaire. The participants comprised a total of 474 students currently enrolled on the Degree in Social Work at the University of Valencia (Spain). RESULTS: The results show that the effects of emotions and concerns stemming from COVID-19 on student engagement were fully mediated by resilience. Indeed, positive emotions and concerns about the future had a positive impact on student engagement through resilience. DISCUSSION: Resilience stands as a potential protective factor against the social and academic challenges generated by COVID-19. The pandemic could therefore be seen as a real opportunity for sweeping change in the teaching and practice of social work.

Effects of stone-made wind shelter structures over an arid nebkha foredune.

Beach users often use a range of strategies to shelter from the wind and blown sand. This involves building structures made of stacking stones. Different from other portable wind blockers, stone-made wind shelters can remain in the landscape for a long time. The process of stone removal from their original place and stone-stacking at another location has well-known effects on rock-dwelling wildlife. Less known are the impacts of stone wind shelters on biogeomorphological processes of beach-dune systems, especially those in arid coastlines, where foredunes formed by nebkhas are naturally discontinuous. This is the case of Playa del Inglés beach (Gran Canaria, Spain), the main sediment input to the Maspalomas dunefield, where the presence of stone wind shelters (goros) made by users has increased in recent decades following an increase of visitors. This research aims to investigate the effects of stone wind shelters on the dynamics of an arid beach-dune system at various spatiotemporal scales. The methodology includes the use of aerial photography to study the appearance and evolution of stone shelters in Playa del Inglés and some of their long-term effects on the foredune. Field data was also collected to investigate the effects that stone shelters have over a representative foredune nebkha in detail, by monitoring the changes (topography, airflow, and vegetation) of an individual landform as we progressively remove pebbles from a previously built stone shelter. Results show that stone stacking has an impact on airflow and sediment transport dynamics around landforms, limiting sediment accumulation inside nebkhas and therefore arid foredune growth. Stone stacking also constrict vegetation growth and its ability to retain sediment. The impacts of these artificial structures can be reverted following their removal but that the process of dismantling stones must be carefully planned. We elaborate some recommendations here to do it avoid damaging foredune vegetation.

Comparación de los libros de historia de vida digitales y convencionales sobre el estado de ánimo, la comunicación, la cognición y la calidad de vida en personas con demencia en residencias: un estudio piloto / Comparison of digital and conventional life story books on mood, communication, cognition and quality of life in people with dementia in nursing homes: A pilot study

Introducción: La atención centrada en la persona (ACP) incluye la historia de vida, una forma de terapia de reminiscencia que puede ser útil en el tratamiento de la demencia. Comparamos la eficacia de usar un libro de historia de vida (LHV) digital o convencional sobre los síntomas depresivos, la comunicación, la cognición y la calidad de vida. Material y métodos: Treinta y una personas con demencia que viven en 2 centros residenciales que siguen un modelo ACP fueron aleatorizadas para recibir terapia de reminiscencia basada en el LHV digital NeuralActions (n=16) o un LHV convencional (n=15). Ambos grupos realizaron 2 sesiones semanales de 45 minutos durante 5 semanas y fueron evaluadas inmediatamente antes y después de la intervención. Los síntomas depresivos se evaluaron con la escala de Cornell (CSDD); la comunicación con la escala de Holden (HCS), la cognición con el Mini Mental State Examination (MMSE) y la calidad de vida con la escala de calidad de vida para el Alzheimer (QoL-AD). Los resultados se analizaron mediante ANOVA de medidas repetidas con el programa jamovi 2.3. Resultados: Ambos LHV mejoraron las capacidades de comunicación (η2=0,115; p <0,001), sin diferencias entre grupos. No se encontraron efectos sobre la calidad de vida, la cognición, o el estado de ánimo. Conclusiones: En centros que siguen un modelo ACP, los LVH digitales o convencionales pueden ser útiles en el tratamiento de personas con demencia facilitando la comunicación. Su papel sobre la calidad de vida, cognición o estado de ánimo es incierto. (AU)

Introduction: Person-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life. Material and methods: Thirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n=16) or a conventional LSB (n=15). Both groups performed 2 weekly sessions of 45min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program. Results: Both LSB improved communication skills (η2=0.115; p<0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found. Conclusions: In PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain. (AU)

mRNA-1273 boost after BNT162b2 vaccination generates comparable SARS-CoV-2-specific functional responses in naïve and COVID-19-recovered individuals.

Introduction: COVID-19 vaccines based on mRNA have represented a revolution in the biomedical research field. The initial two-dose vaccination schedule generates potent humoral and cellular responses, with a massive protective effect against severe COVID-19 and death. Months after this vaccination, levels of antibodies against SARS-CoV-2 waned, and this promoted the recommendation of a third vaccination dose. Methods: We have performed an integral and longitudinal study of the immunological responses triggered by the booster mRNA-1273 vaccination, in a cohort of health workers previously vaccinated with two doses of the BNT162b2 vaccine at University Hospital La Paz located in Madrid, Spain. Circulating humoral responses and SARS-CoV-2-specific cellular reactions, after ex vivo restimulation of both T and B cells (cytokines production, proliferation, class switching), have been analyzed. Importantly, all along these studies, the analyses have been performed comparing naïve and subjects recovered from COVID-19, addressing the influence of a previous infection by SARS-CoV-2. Furthermore, as the injection of the third vaccination dose was contemporary to the rise of the Omicron BA.1 variant of concern, T- and B-cell-mediated cellular responses have been comparatively analyzed in response to this variant. Results: All these analyses indicated that differential responses to vaccination due to a previous SARS-CoV-2 infection were balanced following the boost. The increase in circulating humoral responses due to this booster dropped after 6 months, whereas T-cell-mediated responses were more stable along the time. Finally, all the analyzed immunological features were dampened in response to the Omicron variant of concern, particularly late after the booster vaccination. Conclusion: This work represents a follow-up longitudinal study for almost 1.5 years, analyzing in an integral manner the immunological responses triggered by the prime-boost mRNA-based vaccination schedule against COVID-19.

[Comparison of digital and conventional life story books on mood, communication, cognition and quality of life in people with dementia in nursing homes: A pilot study]. / Comparación de los libros de historia de vida digitales y convencionales sobre el estado de ánimo, la comunicación, la cognición y la calidad de vida en personas con demencia en residencias: un estudio piloto.

INTRODUCTION: Person-centered care (PCC) includes life story, a form of reminiscence therapy that can be useful in the treatment of dementia. We compared the efficacy of using a digital or conventional life story book (LSB) on depressive symptoms, communication, cognition, and quality of life. MATERIAL AND METHODS: Thirty one persons with dementia living in 2 PCC nursing homes were randomly assigned to receive reminiscence therapy based on the Neural Actions digital LSB (n=16) or a conventional LSB (n=15). Both groups performed 2 weekly sessions of 45min for 5 weeks. Depressive symptoms were evaluated with the Cornell scale (CSDD); communication with the Holden scale (HCS), cognition with the Mini Mental State Examination (MMSE) and quality of life with the quality of life scale for Alzheimer's (QoL-AD). The results were analyzed using ANOVA of repeated measures with the jamovi 2.3 program. RESULTS: Both LSB improved communication skills (η2=0.115; p<0.001), with no differences between groups. No effects on quality of life, cognition, or mood were found. CONCLUSIONS: In PCC centres digital or conventional LSB can be useful in the treatment of people with dementia by facilitating communication. Its role on quality of life, cognition or mood is uncertain.

Implementación del protocolo ERAS en ancianos sometidos a resección hepática / Implementation of an ERAS protocol on elderly patients in liver resection

Introducción: El aumento en la calidad de vida, la mejora en los cuidados perioperatorios, la aplicación del concepto de fragilidad y un mayor desarrollo de técnicas quirúrgicas permite a pacientes ancianos el acceso a la cirugía hepática. Sin embargo, la edad sigue siendo limitante para la implementación de protocolos ERAS en este grupo. El objetivo del estudio es evaluar la implementación del protocolo ERAS en pacientes ancianos (≥70años) sometidos a resecciones hepáticas. Métodos: Estudio de cohorte prospectivo que incluye pacientes intervenidos de resección hepática durante diciembre de 2017 a diciembre de 2019 sometidos a un programa ERAS, comparando los resultados de pacientes ≥70años (G≥70) frente a <70años (G<70). La fragilidad se midió con el score Physical Frailty Phenotype. Resultados: Se incluyeron 101 pacientes, de los que 32 (31,6%) correspondieron a G≥70. El 90% de ambos grupos verificaron realizar >70% del ERAS. Se encontraron diferencias a favor del G<70 en el inicio de tolerancia y la movilización activa el primer día postoperatorio. La estancia postoperatoria fue superponible (3,07días vs 2,7días). La morbimortalidad fue similar; ClavienI-II (G≥70: 41% vs G<70: 30,5%) y ≥III (G≥70: 6% vs G<70: 8,5%), al igual que los reingresos. La mortalidad global fue <1%. El cumplimiento del ERAS se asoció a un descenso en las complicaciones (ERAS <70%: 80% vs ERAS >90%: 20%; p=0,02) y de la gravedad de las mismas en la serie global y en ambos grupos a estudio. El 6% del G≥70 presentó fragilidad; el único paciente fallecido alcanzó un índice de fragilidad de 4. Conclusión: Los pacientes ancianos son candidatos a entrar en protocolo ERAS obteniendo una rápida recuperación, sin aumentar la morbimortalidad ni los reingresos. (AU)

Background: The increase of quality of life, the improvement in the perioperative care programs, the use of the frailty index, and the surgical innovation has allowed to access of complex abdominal surgery for elderly patients like liver resection. Despite of this, in patients aged 70 or older there is a limitation for the implementation ERAS protocols. The aim of this study is to evaluate the implementation ERAS protocol on elderly patients (≥70years) undergoing liver resection. Methods: A prospective cohort study of patients who underwent liver resection from December 2017 to December 2019 with an ERAS program. We compare the outcomes in patients ≥70years (G≥70) versus <70years (G<70). The frailty was measured with the Physical Frailty Phenotype score. Results: A total of 101 patients were included; 32 of these (31.6%) were patients ≥70years. 90% of the both groups had performed >70% of the ERAS. Oral diet tolerance and mobilization on the first postoperative day were quicker in <70years group. The hospital stay was similar in both groups (3.07days/2.7days). Morbidity and mortality were similar; ClavienI-II (G≥70: 41% vs G<70: 30.5%) and Clavien ≥III (G≥70: 6% vs G<70: 8.5%), like hospital readmissions. Mortality was <1%. ERAS protocol compliance was associated with a decrease in complications (ERAS <70%: 80% vs ERAS >90%: 20%; p=0.02) and decrease in severity of complications in both study groups. Frailty was found in 6% of the elderly group; the only patient who died had a frailty index of 4. Conclusion: Implementation of ERAS protocol for elderly patients is possible, with major improvements in perioperative outcomes, without an increase in morbidity, mortality neither readmissions. (AU)

Spanish adaptation of the Burden Assessment Scale in family caregivers of people diagnosed with borderline personality disorder.

BACKGROUND: Caregiving is a strong source of stress and leads the family caregiver to experience the burden of being responsible for the care of a severely mentally ill family member. The Burden Assessment Scale (BAS) assesses burden in family caregivers. This study aimed to analyze the psychometric properties of the BAS in a sample of family caregivers of people diagnosed with Borderline Personality Disorder (BPD). METHODS: Participants were 233 Spanish family caregivers (157 women and 76 men aged between 16-76 years old, M = 54.44, SD = 10.09) of people diagnosed with BPD. The BAS, the Multicultural Quality of Life Index, and the Depression Anxiety Stress Scale-21 were used. RESULTS: An exploratory analysis resulted in a three-factor 16-item model (Disrupted Activities; Personal and Social Dysfunction; Worry, Guilt, and Being Overwhelmed) with an excellent fit (χ2(101) = 56.873, p = 1.000, CFI = 1.000, TLI = 1.000, RMSEA = .000, SRMR = .060), good internal consistency (ω = .93), a negative correlation with quality of life, and a positive correlation with anxiety, depression, and stress. CONCLUSION: The model obtained for the BAS is a valid, reliable, and useful tool for assessing burden in family caregivers of relatives diagnosed with BPD.

Analysis of centrosomal area actin reorganization and centrosome polarization upon lymphocyte activation at the immunological synapse.

T cell receptor (TCR) and B cell receptor (BCR) stimulation of T and B lymphocytes, by antigen presented on an antigen-presenting cell (APC) induces the formation of the immunological synapse (IS). IS formation is associated with an initial increase in cortical filamentous actin (F-actin) at the IS, followed by a decrease in F-actin density at the central region of the IS, which contains the secretory domain. This is followed by the convergence of secretion vesicles towards the centrosome, and the polarization of the centrosome to the IS. These reversible, cortical actin cytoskeleton reorganization processes occur during lytic granule secretion in cytotoxic T lymphocytes (CTL) and natural killer (NK) cells, proteolytic granules secretion in B lymphocytes and during cytokine-containing vesicle secretion in T-helper (Th) lymphocytes. In addition, several findings obtained in T and B lymphocytes forming IS show that actin cytoskeleton reorganization also occurs at the centrosomal area. F-actin reduction at the centrosomal area appears to be associated with centrosome polarization. In this chapter we deal with the analysis of centrosomal area F-actin reorganization, as well as the centrosome polarization analysis toward the IS.