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1.
Proc Natl Acad Sci U S A ; 121(19): e2402550121, 2024 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-38691590

RESUMEN

Earlier sum frequency generation (SFG) experiments involve one infrared and one visible laser, and a measurement of the intensity of the response, yielding data on the surface sensitive properties of the sample. Recently, both the real and imaginary components of the susceptibility were measured in two different sets of experiments. In one set, a broadband infrared laser was used, permitting observations at very short times, while in another set the infrared laser was narrowband, permitting higher spectral resolution. The differences in the spectrum obtained by the two will be most evident in studying narrow absorption bands, e.g., the band due to dangling OH bonds at a water interface. The direct comparisons in the integrated amplitude (sum rule) of the imaginary part of the dangling OH bond region differ by a factor of 3. Due to variations in experimental setup and data processing, corrections were made for the quartz reference, Fresnel factors, and the incident visible laser wavelength. After the corrections, the agreement differs now by the factors of 1.1 within broadband and narrowband groups and the two groups now differ by a factor of 1.5. The 1.5 factor may arise from the extra heating of the more powerful broadband laser system on the water surface. The convolution from the narrowband SFG spectrum to the broadband SFG spectrum is also investigated and it does not affect the sum rule. Theory and narrowband experiments are compared using the sum rule and agree to a factor of 1.3 with no adjustable parameters.

2.
Am J Kidney Dis ; 2024 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-38640993

RESUMEN

In 1988, the American Board of Internal Medicine (ABIM) defined essential procedural skills in nephrology, and candidates for ABIM certification were required to present evidence of possessing the skills necessary for placement of temporary dialysis vascular access, hemodialysis, peritoneal dialysis, and percutaneous renal biopsy. In 1996, continuous renal replacement therapy was added to the list of nephrology requirements. These procedure requirements have not been modified since 1996 while the practice of nephrology has changed dramatically. In March 2021, the ABIM Nephrology Board embarked on a policy journey to revise the procedure requirements for nephrology certification. With the guidance of nephrology diplomates, training program directors, professional and patient organizations, and other stakeholders, the ABIM Nephrology Board revised the procedure requirements to reflect current practice and national priorities. The approved changes include the Opportunity to Train standard for placement of temporary dialysis catheters, percutaneous kidney biopsies, and home hemodialysis which better reflects the current state of training in most training programs, and the new requirements for home dialysis therapies training will align with the national priority to address the underuse of home dialysis therapies. This perspective details the ABIM process for considering changes to the certification procedure requirements and how ABIM collaborated with the larger nephrology community in considering revisions and additions to these requirements.

3.
J Affect Disord ; 351: 971-976, 2024 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-38346649

RESUMEN

BACKGROUND: Suicidal ideation is a major concern in clinical practice. Yet, little is known about prevalence rates of suicidal ideation in patients undergoing outpatient psychotherapeutic treatment. Therefore, the aim of the current study is to assess the prevalence of suicidal ideation in a large sample of psychotherapy outpatients in Germany. The data analyzed in this study is taken from the KODAP-project on the coordination of data collection and analysis at German university-based research and training outpatient clinics for psychotherapy. METHODS: A total of N = 10,357 adult outpatients (64.4 % female; age: M(SD) = 35.94 (13.54), range: 18-92 years of age) starting cognitive-behavioral therapy at one of 27 outpatient clinics in Germany were included in the current study. Prevalence of suicidal ideation was assessed with the Suicide Item (Item 9) of the Beck-Depression Inventory II. RESULTS: Suicidal ideation was reported by 36.7 % (n = 3795) of the participants. Borderline Personality Disorder, Posttraumatic Stress Disorder, and recurrent Major Depression were the diagnoses most strongly associated with the presence and severity of suicidal ideation. LIMITATION: Suicide ideation was assessed only with the respective item of the Beck Depression Inventory II. CONCLUSION: Suicidal ideation is very common among adult patients who start psychotherapy in Germany. A well-founded knowledge of risk assessment in suicidal patients and suicide-specific treatment options is therefore highly relevant.


Asunto(s)
Trastorno Depresivo Mayor , Ideación Suicida , Adulto , Humanos , Femenino , Masculino , Pacientes Ambulatorios , Prevalencia , Trastorno Depresivo Mayor/epidemiología , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Mayor/diagnóstico , Psicoterapia , Factores de Riesgo
4.
J Sports Med Phys Fitness ; 64(2): 175-182, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38015478

RESUMEN

BACKGROUND: The diagnosis and treatment of relative energy deficiency in sport (RED-S) are challenging owing to variations in symptoms and the absence of specific guidelines. This study aimed to investigate differences in the diagnosis and follow-up of RED-S, its consequences, and related factors among sports medicine physicians with different backgrounds in Japan and the USA and examine the differences between the two countries. METHODS: An anonymous survey regarding the diagnosis and treatment processes of RED-S was distributed to sports medicine physicians via email. Respondents included 58 sports medicine physicians from the USA and 241 from Japan. RESULTS: The findings showed that 77.6% of the US physicians screened athletes for RED-S, whereas 17.5% of their Japanese counterparts did so. Moreover, 98.3% and 36.7% of the US and Japanese physicians, respectively, answered that they screened athletes for eating disorders upon suspicion of low energy availability. Logistic regression analysis revealed that the number of US sports medicine physicians who screened athletes for the female athlete triad (Triad) and RED-S (odds ratio [OR] = 12.78, P<0.001) and adhered to specific criteria for athlete suspension and return-to-play (OR=33.67, P<0.01) was higher than that of their Japanese counterparts. CONCLUSIONS: The prevalence of RED-S-related screening and treatment differed between US and Japanese sports medicine physicians. Educating sports medicine physicians about the diagnosis and treatment of athletes with possible signs of RED-S is important in treating female athletes and further investigations are required to identify why the physicians screened/not screened the athletes.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos , Síndrome de la Tríada de la Atleta Femenina , Humanos , Femenino , Estados Unidos , Japón , Síndrome de la Tríada de la Atleta Femenina/prevención & control , Encuestas y Cuestionarios , Atletas
6.
Cancers (Basel) ; 15(6)2023 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-36980752

RESUMEN

Kirsten rat sarcoma virus (KRAS)-mutant cancers are frequent, metastatic, lethal, and largely undruggable. While interleukin (IL)-1ß and nuclear factor (NF)-κB inhibition hold promise against cancer, untargeted treatments are not effective. Here, we show that human KRAS-mutant cancers are addicted to IL-1ß via inflammatory versican signaling to macrophage inhibitor of NF-κB kinase (IKK) ß. Human pan-cancer and experimental NF-κB reporter, transcriptome, and proteome screens reveal that KRAS-mutant tumors trigger macrophage IKKß activation and IL-1ß release via secretory versican. Tumor-specific versican silencing and macrophage-restricted IKKß deletion prevents myeloid NF-κB activation and metastasis. Versican and IKKß are mutually addicted and/or overexpressed in human cancers and possess diagnostic and prognostic power. Non-oncogene KRAS/IL-1ß addiction is abolished by IL-1ß and TLR1/2 inhibition, indicating cardinal and actionable roles for versican and IKKß in metastasis.

7.
Am J Med Qual ; 38(1): 47-56, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36472420

RESUMEN

The development of vaccines for SARS-CoV-2 has offered game-changing protection from severe disease and death from COVID-19. Despite efforts to vaccinate individuals in the ambulatory setting, a sizable minority of the US population remains unvaccinated for COVID-19. For unvaccinated patients, hospitalization for non-COVID-19 illness offers another opportunity for vaccination. In the summer of 2021, the authors noted that COVID-19 vaccination rate for medicine inpatients at their hospital had fallen to 5.3 vaccine doses administered per 4-week block. In response, they created Vax the Max, a gamification program of COVID-19 vaccination tasks where internal medicine resident teams were awarded points for completing these tasks. Residents were anonymously surveyed after participation. The hospital demonstrated higher rates of administering the initial COVID-19 vaccine dose and completing the vaccine series in the inpatient setting per 4-week plan-do-study-act cycle after implementation of Vax the Max (5.3 versus 8.8 doses per plan-do-study-act cycle). Among residents, 76.8% reported that Vax the Max spurred their COVID-19 task engagement, and 66% reported that a similar gamification model could be utilized for a different clinical task in the future. An increase was observed in the COVID-19 vaccination rate for medicine inpatients after launching the Vax the Max competition. This occurred in the setting of resident turnover every 4 weeks, which normally makes practice sustainment more challenging. Despite this, a high degree of engagement was produced by itinerant residents. There is potential to explore similar gamification approaches involving resident physicians in areas of quality improvement and patient safety.


Asunto(s)
COVID-19 , Pacientes Internos , Humanos , Vacunas contra la COVID-19 , COVID-19/prevención & control , Gamificación , SARS-CoV-2 , Vacunación
8.
Rehabilitación (Madr., Ed. impr.) ; 56(4): 264-273, Oct-Dic. 2022. ilus, tab
Artículo en Español | IBECS | ID: ibc-210837

RESUMEN

Introducción y objetivo: Proponemos valorar el impacto del nivel educativo en las pruebas cognitivas al ingreso y al alta tras un periodo de rehabilitación cognitiva en los pacientes jóvenes tras un ictus isquémico. Materiales y métodos: Consideramos educación secundaria y superior (grupo A) y menos de 6 años de educación reglada (grupo B). Comparamos A y B mediante χ2 y Kruskal-Wallis. Estudiamos A y B como predictores de memoria verbal y de trabajo al alta. La memoria verbal y la memoria de trabajo las valoramos al ingreso y al alta mediante Rey Auditory Verbal Learning Test (RAVLT) y DIGITS del test Barcelona, espectivamente. Resultados: Analizamos n=277 pacientes (55% pertenecientes al grupo A, 51 años de edad media) ingresados a un centro especializado en España entre 2009 y 2019.Encontramos diferencias significativas (p<0,05) al ingreso, todas en favor del grupo A en las valoraciones de la atención, la inhibición, la visuopercepción, la visuoconstruccion, la fluencia verbal y la comprensión.En DIGITS y RAVLT-aprendizaje encontramos diferencias al ingreso. En DIGITS y RAVLT-reconocimiento encontramos diferencias al alta, todas en favor del grupo A. No encontramos diferencias en la edad, en la severidad, en el tiempo hasta el ingreso, ni en el tiempo de estadía ingresados.Tampoco encontramos diferencias en las ganancias cognitivas ni en la eficiencia del tratamiento en las pruebas de memoria.Los grupos A y B no predicen RAVLT (R2=0,53) ni DIGITS (R2=0,48). Conclusiones: El grupo A puntúa mejor en el 63% de las pruebas al ingreso y en el 75% de las pruebas al alta, los grupos A y B son similares en ganancias y eficiencia en las pruebas de memoria.(AU)


Introduction and objective: We propose to assess the impact of educational level on cognitive tests at admission and discharge after a period of cognitive rehabilitation in young patients after ischaemic stroke. Materials and methods: We considered secondary and higher education (group A) and less than 6 years of formal education (group B). We compared A and B using χ2 and Kruskal–Wallis. We studied A and B as predictors of verbal and working memory at discharge. Verbal and working memories were assessed at admission and discharge using Rey Auditory Verbal Learning Test (RAVLT) and DIGITS of the Barcelona Test respectively. Results: We analysed n=277 patients (55% belonging to A, mean age of 51 years) admitted to a specialised centre in Spain between 2009 and 2019.We found significant differences (P<.05) at admission, all in favour of A in the assessments of attention, inhibition, visuoperception, visuoconstruction, verbal fluency and comprehension.In DIGITS and RAVLT-learning we found differences at admission. In Digits and RAVLT-recognition we found differences at discharge, all in favour of A. We found no differences in age, severity, time at admission, or length of stay in hospital.Nor did we find differences in cognitive gains or treatment efficiency in memory tests.The groups A and B did not predict RAVLT (R2=.53) or DIGITS (R2=.48). Conclusions: A scores better in 63% of tests at admission and in 75% of tests at discharge, A and B are similar in gains and efficiency on memory tests.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Pacientes Internos , Accidente Cerebrovascular , Adolescente , Escolaridad , Rehabilitación de Accidente Cerebrovascular , Educación Primaria y Secundaria , 35174 , Rehabilitación , Cognición , Hospitalización , Memoria a Corto Plazo
9.
Eur J Heart Fail ; 24(8): 1327-1345, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35775383

RESUMEN

Patients with heart failure with preserved ejection fraction (HFpEF) universally complain of exercise intolerance and dyspnoea as key clinical correlates. Cardiac as well as extracardiac components play a role for the limited exercise capacity, including an impaired cardiac and peripheral vascular reserve, a limitation in mechanical ventilation and/or gas exchange with reduced pulmonary vascular reserve, skeletal muscle dysfunction and iron deficiency/anaemia. Although most of these components can be differentiated and quantified through gas exchange analysis by cardiopulmonary exercise testing (CPET), the information provided by objective measures of exercise performance has not been systematically considered in the recent algorithms/scores for HFpEF diagnosis, by neither European nor US groups. The current clinical consensus statement by the Heart Failure Association (HFA) and European Association of Preventive Cardiology (EAPC) of the European Society of Cardiology (ESC) aims at outlining the role of exercise testing and its pathophysiological, clinical and prognostic insights, addressing the implications of a thorough functional evaluation from the diagnostic algorithm to the pathophysiology and treatment perspectives of HFpEF. Along with these goals, we provide a specific analysis of the evidence that CPET is the standard for assessing, quantifying, and differentiating the origin of dyspnoea and exercise impairment and even more so when combined with echocardiography and/or invasive haemodynamic evaluation. This will lead to improved quality of diagnosis when applying the proposed scores and may also help to implement the progressive characterization of the specific HFpEF phenotypes, a critical step toward the delivery of phenotype-specific treatments.


Asunto(s)
Cardiología , Insuficiencia Cardíaca , Disnea/diagnóstico , Disnea/etiología , Prueba de Esfuerzo , Tolerancia al Ejercicio/fisiología , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Humanos , Volumen Sistólico/fisiología
10.
Front Microbiol ; 13: 861855, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35531282

RESUMEN

In this chapter, we review single-molecule observations of rotary motors, focusing on the general theme that their mechanical motion proceeds in substeps with each substep described by an angle-dependent rate constant. In the molecular machine F1-ATPase, the stepping rotation is described for individual steps by forward and back reaction rate constants, some of which depend strongly on the rotation angle. The rotation of a central shaft is typically monitored by an optical probe. We review our recent work on the theory for the angle-dependent rate constants built to treat a variety of single-molecule and ensemble experiments on the F1-ATPase, and relating the free energy of activation of a step to the standard free energy of reaction for that step. This theory, an elastic molecular transfer theory, provides a framework for a multistate model and includes the probe used in single-molecule imaging and magnetic manipulation experiments. Several examples of its application are the following: (a) treatment of the angle-dependent rate constants in stalling experiments, (b) use of the model to enhance the time resolution of the single-molecule imaging apparatus and to detect short-lived states with a microsecond lifetime, states hidden by the fluctuations of the imaging probe, (c) treatment of out-of-equilibrium "controlled rotation" experiments, (d) use of the model to predict, without adjustable parameters, the angle-dependent rate constants of nucleotide binding and release, using data from other experiments, and (e) insights obtained from correlation of kinetic and cryo-EM structural data. It is also noted that in the case where the release of ADP would be a bottleneck process, the binding of ATP to another site acts to accelerate the release by 5-6 orders of magnitude. The relation of the present set of studies to previous and current theoretical work in the field is described. An overall goal is to gain mechanistic insight into the biological function in relation to structure.

11.
Appl Neuropsychol Adult ; : 1-14, 2022 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-35196474

RESUMEN

OBJECTIVES: To assess the usefulness of a computerized tasks module designed for the rehabilitation of social cognition (SC) in acquired brain injury. METHODS: Quasi-randomized controlled trial (ClinicalTrials.gov:NCT03479970) involving 45 patients with moderate-severe traumatic brain injury (TBI) in a subacute inpatient rehabilitation hospital. The experimental group (n = 28) received treatment with a computerized SC module in combination with a non-SC module. The control group (n = 26) only received a treatment with non-SC module. RESULTS: Intragroup comparisons showed that the experimental group had better results for all SC measures, except for International Affective Picture System (IAPS). The control group improved for Facial Expressions of cEmotion-Stimuli and Tests (FEEST) and Moving Shapes Paradigm (MSP), showing no changes with respect to pretreatment in IAPS, MSP and Reading the Mind in the Eyes Test (RMET). Intergroup comparisons did not present differences between the two groups for pretreatment measures. Post-treatment comparison showed that the experimental group obtained better results for RMET than the control group. CONCLUSION: The computerized SC module was useful for the rehabilitation of SC in patients with moderate-severe TBI in the subacute phase. The group that received combined rehabilitative treatment (SC + non-SC) obtained better results for SC than the group that received treatment intended only for non-SC.

12.
Rev. neurol. (Ed. impr.) ; 74(3): 69-77, Feb 1, 2022. ilus, tab
Artículo en Inglés, Español | IBECS | ID: ibc-217568

RESUMEN

Introducción: El papel del género en la independencia funcional en las actividades de la vida diaria tras un ictus isquémico es aún controvertido. Proponemos: a) comparar características clínicas de hombres y mujeres en el momento del ingreso a rehabilitación hospitalaria; b) comparar su independencia funcional en el ingreso y en el alta, y c) identificar predictores de independencia funcional. Materiales y métodos: Estudio de cohortes retrospectivo observacional. Se incluyeron variables descritas en estudios previos en comparaciones ingreso-alta y en regresión lineal multivariante de la Functional Independence Measure (FIM) en el momento del alta, la ganancia, la eficiencia y la efectividad. Resultados: Se estudió a 144 pacientes (33%, mujeres) admitidos a rehabilitación en un centro español (= 3 semanas tras un ictus isquémico). Los hombres eran mayores (p = 0,003), un 19,6% diabéticos (un 6,4% de las mujeres; p = 0,03) y un 52,6% fumadores (un 72,3% de las mujeres; p = 0,02). No observamos diferencias significativas en la FIM en el momento del ingreso, del alta, la ganancia, la eficiencia ni la efectividad (FIM total, motora ni cognitiva). El análisis de regresión identificó el sexo (beta = –0,13), la gravedad (beta = –0,25) y la FIM total en el momento el ingreso (beta = –0,69) como predictores de la ganancia de la FIM total (R2 = 0,42). Las mismas variables predicen la FIM total en el alta: género (beta = –0,12), gravedad (beta = –0,23) y FIM total en el ingreso (beta = 0,59) (R2 = 0,51). La FIM en el ingreso (beta = –0,64), la gravedad (beta = –0,24), la edad (beta = –0,17) y el tiempo de estancia hospitalaria (beta = –0,45) predicen la eficiencia de la FIM total (R2 = 39,9). El modelo de efectividad de la FIM explica únicamente el 13,5% de la varianza. Conclusiones: No encontramos diferencias funcionales entre hombres y mujeres. El sexo es un predictor significativo, pero no explica la mitad de la varianza.(AU)


Introduction: The role of gender in functional independence for activities of daily living after ischemic stroke is still controversial. We aim to a) compare clinical characteristics of men and women at inpatient rehabilitation admission b) compare their functional independence at admission and discharge c) identify predictors of functional independence. Materials and methods: Retrospective observational cohort study. State-of-the-art variables were used for admission and discharge comparisons and to predict total FIM (Functional Independence Measure) at discharge, FIM gain, FIM efficiency and FIM effectiveness using multivariate linear regressions. Results: 144 patients (33% women) admitted to inpatient rehabilitation in a Spanish specialized center, with less than 3 weeks since ischemic stroke onset were included. Men were older (p = 0.039), 19.6% of men had diabetes mellitus (6.4% of women) (p = 0.038), with 52.6% of men being non-smokers (72.3% of women) (p = 0.022). No significant differences were observed in FIM at admission, discharge, FIM gain, efficiency or effectiveness (total, motor either cognitive FIM). Regression analysis identified sex (b = –0.13), stroke severity (b = –0.25) and admission total FIM (b = –0.69) as significant predictors of total FIM gain (R2 = 0.42). The same variables predicted discharge total FIM: sex (b = –0.12), severity (b = –0.23) and admission total FIM (b = 0.59) (R2 = 0.51). FIM efficiency was predicted by admission total FIM (b = –0.64), severity (b = –0.24), age (b = –0.17) and length of stay (b = –0.45) (R2 = 39.9%). FIM effectiveness model explained only 13.5% of the variance. Conclusions: No functional differences between men and women in any independence measure were found. Sex was a significant predictor but leaving half of the variance unexplained.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Perspectiva de Género , Accidente Cerebrovascular , Rehabilitación , Actividades Cotidianas , Neurología , Estudios de Cohortes , Estudios Retrospectivos
13.
J Sports Med Phys Fitness ; 62(9): 1184-1190, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35084164

RESUMEN

BACKGROUND: Intensive training without appropriate recovery can predispose athletes to injury. Balancing these two facets - training and recovery - is crucial for keeping athletes at their highest possible performance level while lowering their risk of training-related injury. Cultural differences may also affect athletes' training and daily routines, but research investigating the effects of cultural background on female track and field athletes is lacking. METHODS: In total, 49 Japanese and 28 American track and field athletes competing at the national level were included in this study. Their body composition was evaluated and eating attitudes test (EAT-26) and a survey regarding training schedules, recovery practices, and performance levels were conducted. RESULTS: Compared with the Japanese athletes, the American athletes had significantly higher height, weight, and Body Mass Index measurements, although their performance levels did not differ. Japanese athletes trained for significantly longer hours both on school days and non-school days and spent significantly fewer days per week on weight training. The Japanese athletes slept, on average, for 1 hour less per day than the American athletes, and their EAT-26 scores were significantly higher than those of the American athletes (both P<0.01). The number of days off per week was positively correlated with performance, but training hours on school days and fat mass percentage were negatively correlated with performance (P<0.05). Further, days off per week and nationality were correlated with EAT-26 scores (both P<0.05). CONCLUSIONS: The American and Japanese athletes performed similarly, but the Japanese athletes were achieving their performance level with less sleep, longer training hours, and a higher risk of developing an eating disorder.


Asunto(s)
Atletismo , Atletas , Composición Corporal , Femenino , Humanos , Japón , Sueño
14.
Rev Neurol ; 74(3): 69-77, 2022 02 01.
Artículo en Inglés, Español | MEDLINE | ID: mdl-35084731

RESUMEN

INTRODUCTION: The role of gender in functional independence for activities of daily living after ischemic stroke is still controversial. We aim to a) compare clinical characteristics of men and women at inpatient rehabilitation admission b) compare their functional independence at admission and discharge c) identify predictors of functional independence. MATERIALS AND METHODS: Retrospective observational cohort study. State-of-the-art variables were used for admission and discharge comparisons and to predict total FIM (Functional Independence Measure) at discharge, FIM gain, FIM efficiency and FIM effectiveness using multivariate linear regressions. RESULTS: 144 patients (33% women) admitted to inpatient rehabilitation in a Spanish specialized center, with less than 3 weeks since ischemic stroke onset were included. Men were older (p = 0.039), 19.6% of men had diabetes mellitus (6.4% of women) (p = 0.038), with 52.6% of men being non-smokers (72.3% of women) (p = 0.022). No significant differences were observed in FIM at admission, discharge, FIM gain, efficiency or effectiveness (total, motor either cognitive FIM). Regression analysis identified sex (ß = -0.13), stroke severity (ß = -0.25) and admission total FIM (ß = -0.69) as significant predictors of total FIM gain (R2 = 0.42). The same variables predicted discharge total FIM: sex (ß = -0.12), severity (ß = -0.23) and admission total FIM (ß = 0.59) (R2 = 0.51). FIM efficiency was predicted by admission total FIM (ß = -0.64), severity (ß = -0.24), age (ß = -0.17) and length of stay (ß = -0.45) (R2 = 39.9%). FIM effectiveness model explained only 13.5% of the variance. CONCLUSIONS: No functional differences between men and women in any independence measure were found. Sex was a significant predictor but leaving half of the variance unexplained.


TITLE: Rehabilitación en régimen de ingreso en adultos en edad laboral tras un ictus isquémico: análisis clinicofuncional desde una perspectiva de género.Introducción. El papel del género en la independencia funcional en las actividades de la vida diaria tras un ictus isquémico es aún controvertido. Proponemos: a) comparar características clínicas de hombres y mujeres en el momento del ingreso a rehabilitación hospitalaria; b) comparar su independencia funcional en el ingreso y en el alta, y c) identificar predictores de independencia funcional. Materiales y métodos. Estudio de cohortes retrospectivo observacional. Se incluyeron variables descritas en estudios previos en comparaciones ingreso-alta y en regresión lineal multivariante de la Functional Independence Measure (FIM) en el momento del alta, la ganancia, la eficiencia y la efectividad. Resultados. Se estudió a 144 pacientes (33%, mujeres) admitidos a rehabilitación en un centro español (= 3 semanas tras un ictus isquémico). Los hombres eran mayores (p = 0,003), un 19,6% diabéticos (un 6,4% de las mujeres; p = 0,03) y un 52,6% fumadores (un 72,3% de las mujeres; p = 0,02). No observamos diferencias significativas en la FIM en el momento del ingreso, del alta, la ganancia, la eficiencia ni la efectividad (FIM total, motora ni cognitiva). El análisis de regresión identificó el sexo (beta = ­0,13), la gravedad (beta = ­0,25) y la FIM total en el momento el ingreso (beta = ­0,69) como predictores de la ganancia de la FIM total (R2 = 0,42). Las mismas variables predicen la FIM total en el alta: género (beta = ­0,12), gravedad (beta = ­0,23) y FIM total en el ingreso (beta = 0,59) (R2 = 0,51). La FIM en el ingreso (beta = ­0,64), la gravedad (beta = ­0,24), la edad (beta = ­0,17) y el tiempo de estancia hospitalaria (beta = ­0,45) predicen la eficiencia de la FIM total (R2 = 39,9). El modelo de efectividad de la FIM explica únicamente el 13,5% de la varianza. Conclusiones. No encontramos diferencias funcionales entre hombres y mujeres. El sexo es un predictor significativo, pero no explica la mitad de la varianza.


Asunto(s)
Accidente Cerebrovascular Isquémico , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Actividades Cotidianas , Adulto , Evaluación de la Discapacidad , Femenino , Humanos , Pacientes Internos , Tiempo de Internación , Masculino , Recuperación de la Función , Estudios Retrospectivos , Resultado del Tratamiento
15.
Rehabilitacion (Madr) ; 56(4): 264-273, 2022.
Artículo en Español | MEDLINE | ID: mdl-34702593

RESUMEN

INTRODUCTION AND OBJECTIVE: We propose to assess the impact of educational level on cognitive tests at admission and discharge after a period of cognitive rehabilitation in young patients after ischaemic stroke. MATERIALS AND METHODS: We considered secondary and higher education (group A) and less than 6 years of formal education (group B). We compared A and B using χ2 and Kruskal-Wallis. We studied A and B as predictors of verbal and working memory at discharge. Verbal and working memories were assessed at admission and discharge using Rey Auditory Verbal Learning Test (RAVLT) and DIGITS of the Barcelona Test respectively. RESULTS: We analysed n=277 patients (55% belonging to A, mean age of 51 years) admitted to a specialised centre in Spain between 2009 and 2019. We found significant differences (P<.05) at admission, all in favour of A in the assessments of attention, inhibition, visuoperception, visuoconstruction, verbal fluency and comprehension. In DIGITS and RAVLT-learning we found differences at admission. In Digits and RAVLT-recognition we found differences at discharge, all in favour of A. We found no differences in age, severity, time at admission, or length of stay in hospital. Nor did we find differences in cognitive gains or treatment efficiency in memory tests. The groups A and B did not predict RAVLT (R2=.53) or DIGITS (R2=.48). CONCLUSIONS: A scores better in 63% of tests at admission and in 75% of tests at discharge, A and B are similar in gains and efficiency on memory tests.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Isquemia Encefálica/complicaciones , Cognición , Hospitalización , Humanos , Persona de Mediana Edad , Accidente Cerebrovascular/complicaciones
16.
Appl Neuropsychol Adult ; 29(5): 1039-1048, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-33174449

RESUMEN

OBJECTIVES: The first aim was to study the relationship between Social Cognition (SC) and nonsocial Cognition (n-SC) measures in a group of patients with moderate or severe traumatic brain injury (TBI) to assess the dependence or independence of both types of cognition. The second aim was to explore the relationships between SC measures and generate a model based on the results of these relationships. METHODS AND PROCEDURES: Forty-three subacute patients with TBI were included in the study. They were administered a SC battery and n-SC battery. SC battery included the following measures: International Affective Picture System (IAPS); Facial Expressions of Emotion-Stimuli Test (FEEST); Moving Shapes Paradigm (MSP); Reading the Mind in the Eyes Test- Revised Version (RMET); Social Decision Making Task (SDMT). n-SC battery included Digit Span Forwards and Backwards; Trail Making Test (Part A); Rey's Auditory Verbal Learning Test; Letter-Number Sequencing; and verbal fluency test (PMR). RESULTS: FEEST, MSP and RMET were related to n-SC measures. The exploratory factor analysis shows a two-factor SC structure: Factor 1: Emotional recognition and mentalization (FEEST, MSP and RMET) and Factor 2: Acquisition and contextualization (IAPS and SDMT). CONCLUSION: The performance of subjects with moderate-to-severe TBI in the SC measures is related, at least partially, by the performance in the n-SC measures. Our SC model shows a two-factor structure characterized by a first factor that brings together SC measures that are highly related to n-SC domains and a second factor that brings together measures whose performance is not influenced by n-SC domains.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Trastornos del Conocimiento , Lesiones Traumáticas del Encéfalo/complicaciones , Lesiones Traumáticas del Encéfalo/psicología , Cognición , Trastornos del Conocimiento/psicología , Emociones , Humanos , Pruebas Neuropsicológicas
17.
EMBO Mol Med ; 14(2): e13631, 2022 02 07.
Artículo en Inglés | MEDLINE | ID: mdl-34898002

RESUMEN

Malignant pleural mesothelioma (MPM) arises from mesothelial cells lining the pleural cavity of asbestos-exposed individuals and rapidly leads to death. MPM harbors loss-of-function mutations in BAP1, NF2, CDKN2A, and TP53, but isolated deletion of these genes alone in mice does not cause MPM and mouse models of the disease are sparse. Here, we show that a proportion of human MPM harbor point mutations, copy number alterations, and overexpression of KRAS with or without TP53 changes. These are likely pathogenic, since ectopic expression of mutant KRASG12D in the pleural mesothelium of conditional mice causes epithelioid MPM and cooperates with TP53 deletion to drive a more aggressive disease form with biphasic features and pleural effusions. Murine MPM cell lines derived from these tumors carry the initiating KRASG12D lesions, secondary Bap1 alterations, and human MPM-like gene expression profiles. Moreover, they are transplantable and actionable by KRAS inhibition. Our results indicate that KRAS alterations alone or in accomplice with TP53 alterations likely play an important and underestimated role in a proportion of patients with MPM, which warrants further exploration.


Asunto(s)
Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Neoplasias Pleurales , Proteínas Proto-Oncogénicas p21(ras) , Animales , Humanos , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Mesotelioma/genética , Mesotelioma/patología , Mesotelioma Maligno/genética , Mesotelioma Maligno/patología , Ratones , Neoplasias Pleurales/genética , Neoplasias Pleurales/patología , Proteínas Proto-Oncogénicas p21(ras)/genética , Proteínas Proto-Oncogénicas p21(ras)/metabolismo , Transducción de Señal , Proteínas Supresoras de Tumor/genética , Proteínas Supresoras de Tumor/metabolismo , Ubiquitina Tiolesterasa/genética , Ubiquitina Tiolesterasa/metabolismo
18.
Chemphyschem ; 22(16): 1656-1657, 2021 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-34409719

RESUMEN

The front cover artwork is provided by Wei-Chen Chen and Rudolph A. Marcus. The image shows an electron undergoing backscattering in a disordered solid, a phenomenon commonly described using the Drude-Smith equation represented by the damping curve. Read the full text of the Article at 10.1002/cphc.202100299.

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