Evidence of Validity and Reliability for the Spanish Version of the Self-Identified Stage of Recovery.

BACKGROUND: The Self-Identified Stage of Recovery (SISR) () is a scale used to assess both the stage of recovery (SISR-A) and the components of the process of personal recovery (SISR-B). This study aimed to develop the Spanish version of the SISR and obtain evidence of validity and reliability in a sample of 230 users of community mental health services. METHOD: The Spanish version of the SISR was developed following the translation-back translation procedure, with the support of a committee of experienced experts. The SISR was examined in terms of dimensional structure, internal consistency, relationships with other variables (i.e., the Maryland Recovery Assessment Scale [MARS-12] and the Dispositional Hope Scale [DHS]), and temporal stability (n = 66). Differential item functioning (DIF) by gender was analysed. RESULTS: The study confirmed the unidimensionality of the SISR-B and suitable internal consistency of its scores (ω = .83, α = .83). Scores from both SISR-A and SISR-B showed good temporal stability and the SISR-B displayed strong correlations with the MARS-12 (rs = .78) and the DHS (rs = .67). No DIF was found. CONCLUSIONS: This study supports the validity and reliability of the scores of the Spanish version of the SISR.

Student-Led Webinar to Support LGBTQ+ Students Applying to Medical School During the COVID-19 Pandemic.

Lesbian, gay, bisexual, transgender, queer, intersex, asexual, non-binary, two-spirit, and other (LGBTQ+) students are a diverse group with unique and frequently overlooked needs in medical training. The present study was designed to understand the concerns of LGBTQ+ applicants to medical school and examine the effectiveness of a webinar in alleviating concerns. Sixty participants joined webinars discussing the medical school application process with particular attention to concerns pertinent to the LGBTQ+ population. Pre and post surveys were administered to examine webinar effectiveness and participant concerns. Results were analyzed using quantitative and qualitative methods. Pre-medical students reported that the webinar format was helpful for their application process. Specifically, pre- and post-test analyses revealed that the webinar increased both students' preparedness as well as their confidence in disclosing their LGBTQ+ identity or being "out" when applying to medical school. Student-led, online webinars increase LGBTQ+ students' confidence and help address SGM students' concerns about applying to medical school.

Evidence of Validity and Reliability for the Spanish Version of the Self-Identified Stage of Recovery / Evidencia de la Validez y Fiabilidad de la Versión en Español de la Etapa deRecuperación Autoidentificada

Background: The Self-Identified Stage of Recovery (SISR) (Andresen, 2007) is a scale used to assess both the stage of recovery (SISR-A) and the components of the process of personal recovery (SISR-B). This study aimed to develop the Spanish version of the SISR and obtain evidence of validity and reliability in a sample of 230 users of community mental health services. Method: The Spanish version of the SISR was developed following the translation–back translation procedure, with the support of a committee of experienced experts. The SISR was examined in terms of dimensional structure, internal consistency, relationships with other variables (i.e., the Maryland Recovery Assessment Scale [MARS-12] and the Dispositional Hope Scale [DHS]), and temporal stability (n = 66). Differential item functioning (DIF) by gender was analysed. Results: The study confirmed the unidimensionality of the SISR-B and suitable internal consistency of its scores (ω = .83, α = .83). Scores from both SISR-A and SISR-B showed good temporal stability and the SISR-B displayed strong correlations with the MARS-12 (rs = .78) and the DHS (rs = .67). No DIF was found. Conclusions: This study supports the validity and reliability of the scores of the Spanish version of the SISR.(AU)

Antecedentes: La Self-Identified Stage of Recovery (SISR) (Andresen, 2007) es una escala que evalúa tanto la etapa de recuperación (SISR-A) como los componentes del proceso de recuperación personal (SISR-B). El objetivo del estudio fue desarrollar la versión en español de la SISR y obtener evidencias de validez y fiabilidad en una muestra de 230 usuarios de servicios comunitarios de salud mental. Método: La versión en español se desarrolló siguiendo el procedimiento de traducción-retrotraducción, con el apoyo de un comité de expertos por experiencia. Se examinó la estructura dimensional, consistencia interna, relaciones con otras variables (Escala de Evaluación de la Recuperación de Maryland [MARS-12] y Escala de Esperanza Disposicional [DHS]) y estabilidad temporal (n = 66). Se analizó el funcionamiento diferencial del ítem (DIF) por género. Resultados: El estudio confirmó la unidimensionalidad de la SISR-B y una adecuada consistencia interna de sus puntuaciones (ω = .83, α = .83). Las puntuaciones de la SISR-A y la SISR-B presentaron estabilidad temporal y la SISR-B mostró correlaciones elevadas con la MARS-12 (rs = .78) y la DHS (rs = .67). No se encontró DIF. Conclusiones: Este estudio apoya la validez y fiabilidad de las puntuaciones de la versión española de la SISR.(AU)

Control hospitalario de la diabetes y de la hiperglucemia: una auditoría en hospitales españoles / Inpatient management of diabetes and hyperglycemia: an audit of Spanish hospitals

Objetivos Evaluación de la calidad de la asistencia a los pacientes con diabetes mellitus ingresados en España. Métodos Estudio transversal que incluyó a 1.193 (26,7%) pacientes con diabetes tipo 2 o hiperglucemia de un total de 4.468 pacientes ingresados en los servicios de medicina interna de 53 hospitales (España). Se recogieron datos demográficos, adecuación de la monitorización de la glucemia capilar, tratamiento administrado durante el ingreso y terapia recomendada al alta. Resultados La edad mediana fue de 80 años (74-87), 561 (47%) pacientes eran mujeres, con un índice de Charlson de 4 (2-6) puntos, siendo clasificados frágiles 742 (65%). La mediana de glucemia al ingreso fue de 155 (119-213) mg/dL. Al tercer día de ingreso el número de glucemias capilares en objetivo (80-180mg/dL) fue de 792/1.126 (70,3%) en el predesayuno, 601/1.083 (55,4%) en la precomida, 591/1.073 (55,0%) en la precena y 317/529 (59,9%) durante la noche. Se observó hipoglucemia en 35 (0,9%) pacientes. El tratamiento durante el ingreso fue realizado con insulina en escala móvil en 352 (40,5%) pacientes, insulina basal y análogos de insulina rápida en 434 (50%) y dieta exclusivamente en 101 (9,1%). Un total de 735 (61,6%) pacientes disponían de un valor reciente de HbA1c. En el alta se incrementó el uso de iSGLT2 (30,1 vs. 21,6%; p<0,001) y el uso de insulina basal (25,3 vs. 10,1%; p<0,001). Conclusiones Existe un excesivo uso de insulina en escala móvil, una deficiente información de los valores de HbA1c y una prescripción aún deficiente de tratamientos con beneficio cardiovascular al alta (AU)

Objectives Evaluation of the quality of care for patients with diabetes mellitus admitted to hospitals in Spain. Methods Cross-sectional study in one day that included 1193 (26.7%) patients with type 2 diabetes or hyperglycemia out of 4468 patients admitted to the internal medicine departments of 53 hospitals in Spain. We collected demographic data, adequacy of capillary glycemic monitoring, treatment administered during admission, and recommended therapy at discharge. Results The median age of the patients was 80 years (74-87), of which 561 (47%) were women, with a Charlson index of 4 points (2-6), and 742 (65%) were fragile. Median blood glucose on admission was 155mg/dL (119-213). On the third day, the number of capillary blood glucose levels in target (80-180mg/dL) was pre-breakfast 792/1126 (70.3%), pre-lunch 601/1083 (55.4%), pre-dinner 591/1073 (55.0%) and night 317/529 (59.9%). A total of 35 patients (0.9%) were suffering from hypoglycemia. Treatment during hospitalization was performed with sliding scale insulin in 352 (40.5%) patients, with basal insulin and rapid insulin analogs in 434 (50%), or with diet exclusively in 101 (9.1%). A total of 735 (61.6%) patients had a recent HbA1c value. At the time of discharge, the use of iSGLT2 increased significantly (30.1% vs. 21.6%; p<0.001), as well as the use of basal insulin (25.3% vs. 10.1%; p<0.001). Conclusions There is an excessive use of insulin on a sliding scale as well as deficient information on HbA1c values and an even deficient prescription at the discharge of treatments with cardiovascular benefit (AU)

[Patients with COPD hospitalized due to COVID-19 in Spain: a comparison between the first and second wave]. / Pacientes con EPOC hospitalizados por COVID-19 en España: comparación entre la primera y la segunda ola.

Objective: This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave. Material and methods: This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed. Results: Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1,128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy. Conclusions: Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it.

Pacientes con EPOC hospitalizados por COVID-19 en España: comparación entre la primera y la segunda ola / Patients with COPD hospitalized due to COVID-19 in Spain: a comparison between the first and second wave

Objetivo Comparar las características, evolución y pronóstico de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) hospitalizados por COVID-19 en España en la primera ola con los de la segunda ola. Material y métodos Estudio observacional de los pacientes hospitalizados en territorio español con diagnóstico de EPOC incluidos en el registro SEMI-COVID-19. Se compararon los antecedentes, la clínica, los resultados analíticos y radiológicos, el tratamiento y la evolución de los pacientes con EPOC hospitalizados en la primera ola (desde marzo hasta junio del 2020 [OLA1]) frente a los que fueron ingresados en la segunda ola (desde julio hasta diciembre del 2020 [OLA2]). Se analizaron los factores de mal pronóstico, definidos como mortalidad por todas las causas y un evento combinado que incluía mortalidad, oxigenoterapia con alto flujo, ventilación mecánica e ingreso en la unidad de cuidados intensivos (UCI). Resultado De 21.642 pacientes del registro SEMI-COVID-19, están diagnosticados de EPOC 6,9%, 1.128 (6,8%) en la OLA1 y 374 (7,7%) en la OLA2 (p = 0,04). Los pacientes de la OLA2 presentan menos tos seca, fiebre y disnea, hipoxemia (43 vs. 36%, p < 0,05) y condensación radiológica (46 vs. 31%, p < 0,05) que los de la OLA1. La mortalidad es menor en la OLA2 (35 vs. 28,6%, p = 0,01). En el global de pacientes la mortalidad y la variable combinada de mal pronóstico fue menor entre aquellos que recibieron tratamiento inhalador. Conclusiones Los pacientes con EPOC con ingreso hospitalario por COVID-19 en la segunda ola presentan menos insuficiencia respiratoria y menor afectación radiológica, con mejor pronóstico. Estos deben recibir tratamiento broncodilatador si no hay contraindicación para el mismo (AU)

Objective This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave. Material and methods This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed. Results Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1,128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy. Conclusions Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it (AU)

Patients with COPD hospitalized due to COVID-19 in Spain: a comparison between the first and second wave.

OBJECTIVE: This work aimed to compare the characteristics, progress, and prognosis of patients with COPD hospitalized due to COVID-19 in Spain in the first wave with those of the second wave. MATERIAL AND METHODS: This is an observational study of patients hospitalized in Spain with a diagnosis of COPD included in the SEMI-COVID-19 registry. The medical history, symptoms, analytical and radiological results, treatment, and progress of patients with COPD hospitalized in the first wave (from March to June 2020) versus those hospitalized in the second wave (from July to December 2020) were compared. Factors associated with poor prognosis, defined as all-cause mortality and a composite endpoint that included mortality, high-flow oxygen therapy, mechanical ventilation, and ICU admission, were analyzed. RESULTS: Of the 21,642 patients in the SEMI-COVID-19 Registry, 6.9% were diagnosed with COPD: 1128 (6.8%) in WAVE1 and 374 (7.7%) in WAVE2 (p = 0.04). WAVE2 patients presented less dry cough, fever and dyspnea, hypoxemia (43% vs 36%, p < 0.05), and radiological condensation (46% vs 31%, p < 0.05) than WAVE1 patients. Mortality was lower in WAVE2 (35% vs 28.6%, p = 0.01). In the total sample, mortality and the composite outcome of poor prognosis were lower among patients who received inhalation therapy. CONCLUSIONS: Patients with COPD admitted to the hospital due to COVID-19 in the second wave had less respiratory failure and less radiological involvement as well as a better prognosis. These patients should receive bronchodilator treatment if there is no contraindication for it.

Desert dust intrusions and their incidence on airborne biological content. Review and case study in the Iberian Peninsula.

Desert dust intrusions cause the transport of airborne particulate matter from natural sources, with important consequences for climate regulation, biodiversity, ecosystem functioning and dynamics, human health, and socio-economic activities. Some effects of desert intrusions are reinforced or aggravated by the bioaerosol content of the air during these episodes. The influence of desert intrusions on airborne bioaerosol content has been very little studied from a scientific point of view. In this study, a systematic review of scientific literature during 1970-2021 was carried out following the standard protocol Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). After this literature review, only 6% of the articles on airborne transport from desert areas published in the last 50 years are in some way associated with airborne pollen, and of these, only a small proportion focus on the study of pollen-related parameters. The Iberian Peninsula is affected by Saharan intrusions due to its proximity to the African continent and is seeing an increasing trend the number of intrusion events. There is a close relationship among the conditions favouring the occurrence of intrusion episodes, the transport of particulate matter, and the transport of bioaerosols such as pollen grains, spores, or bacteria. The lack of linearity in this relationship and the different seasonal patterns in the occurrence of intrusion events and the pollen season of most plants hinders the study of the correspondence between both phenomena. It is therefore important to analyse the proportion of pollen that comes from regional sources and the proportion that travels over long distances, and the atmospheric conditions that cause greater pollen emission during dust episodes. Current advances in aerobiological techniques make it possible to identify bioaerosols such as pollen and spores that serve as indicators of long-distance transport from remote areas belonging to other bioclimatic and biogeographical units. A greater incidence of desert intrusion episodes may pose a challenge for both traditional systems and for the calibration and correct validation of automatic aerobiological monitoring methods.

Perceptions of change in the environment caused by the COVID-19 pandemic: Implications for environmental policy.

COVID-19 lockdown measures have impacted the environment with both positive and negative effects. However, how human populations have perceived such changes in the natural environment and how they may have changed their daily habits have not been yet thoroughly evaluated. The objectives of this work were to investigate (1) the social perception of the environmental changes produced by the COVID-19 pandemic lockdown and the derived change in habits in relation to i) waste management, energy saving, and sustainable consumption, ii) mobility, iii) social inequalities, iv) generation of noise, v) utilization of natural spaces, and, vi) human population perception towards the future, and (2) the associations of these potential new habits with various socio-demographic variables. First, a SWOT analysis identified strengths (S), weaknesses (W), opportunities (O), and threats (T) generated by the pandemic lockdown measures. Second, a survey based on the aspects of the SWOT was administered among 2370 adults from 37 countries during the period from February to September 2021. We found that the short-term positive impacts on the natural environment were generally well recognized. In contrast, longer-term negative effects arise, but they were often not reported by the survey participants, such as greater production of plastic waste derived from health safety measures, and the increase in e-commerce use, which can displace small storefront businesses. We were able to capture a mismatch between perceptions and the reported data related to visits to natural areas, and generation of waste. We found that age and country of residence were major contributors in shaping the survey participants ´answers, which highlights the importance of government management strategies to address current and future environmental problems. Enhanced positive perceptions of the environment and ecosystems, combined with the understanding that livelihood sustainability, needs to be prioritized and would reinforce environmental protection policies to create greener cities. Moreover, new sustainable jobs in combination with more sustainable human habits represent an opportunity to reinforce environmental policy.

Effectiveness of a recovery workshop implemented in community mental health services in Catalonia (Spain): study protocol for a non-randomized controlled trial.

BACKGROUND: Many countries today are undergoing a paradigm shift in mental health policies towards a recovery-oriented and rights-based approach. From this perspective, self-determination and self-management are fundamental factors for recovery. Despite this shift, there is still a lack of evidence on the effectiveness of training programmes aimed at promoting self-determination and self-management in recovery processes implemented in southern European or Spanish-speaking countries. The aim of this paper is to present a study protocol that evaluates the effectiveness of a 12-session recovery workshop implemented in community mental health services in Catalonia (Spain). METHODS/DESIGN: This is a 12-week follow-up multi-centre non-randomized controlled trial design. At least 160 users will be recruited from 13 Community Rehabilitation Services (CRS) in Catalonia. Eligible participants are adult (≥ 18 years old) users of a CRS, who sign a written consent to participate. The experimental group participates in a recovery workshop, in which people learn to develop and implement their own plan of personal recovery, which includes a Wellness Toolbox, a Maintenance Toolkit, a Personal Growth Plan, a Mirror of Relapses, a Crisis Plan, and a Learning Agenda. The control group participates in the usual activities of the CRS. Data is collected using a questionnaire of sociodemographic characteristics, personal recovery, empowerment, hope and perceived social support. The users' measurements are taken at the baseline and one week after the end of the workshop. The primary outcome measures include the Self-Identified Stage of Recovery and the Maryland Assessment of Recovery in Serious Mental Illness Scale (short version). The secondary outcome measures include the Netherlands Empowerment List, Dispositional Hope Scale, and Multidimensional Scale of Perceived Social Support. Descriptive statistics for characterizing the sample size will be performed. Multivariate analyses for repeated measures designs will be used to evaluate the primary and secondary outcomes. Between-group and within-subject comparisons will be conducted. DISCUSSION: The results of the study will provide information on the usefulness of recovery workshops in a Mediterranean cultural context. Additionally, if this workshop is effective, it will be proposed for inclusion within the portfolio of community mental health services in Catalonia. TRIAL REGISTRATION: ISRCTN11695542 (Registration date: 5 July 2022).

Proyecto Kairós. Monitorización ambulatoria de la presión arterial en farmacia comunitaria: hipertensión no controlada enmascarada en pacientes con diabetes e hipertensión / Kairos Project. Ambulatory blood pressure monitoring in community pharmacies: masked uncontrolled hypertension in patients with diabetes and hypertension

JUSTIFICACIÓN: entre un 18,8-33 % de pacientes con diabetes sufre hipertensión no controlada enmascarada. Se diagnostica por cifras de presión arterial (PA) inferiores a 135/85 mmHg en medida aislada farmacia comunitaria (MAFC) y Monitorización Ambulatoria de la PA (MAPA) de 24 h ≥ 130/80 mmHg y/o ≥ 135/85 mmHg en MAPA actividad y/o ≥ 120/70 mmHg en MAPA nocturno. Adultos con diabetes tratados con antihipertensivos que presentan hipertensión no controlada enmascarada (“masked uncontrolled hypertensión” ó MUCH) tienen mayor riesgo vascular (RV) y probabilidad de daño de órgano diana.OBJETIVOS: 1.Identificación de MUCH en pacientes con diabetes e hipertensión mediante la realización de MAPA en farmacia comunitaria (FC) y posterior valoración por el médico de Atención Primaria.2. Determinación de PA nocturna y definición del perfil circadiano en pacientes con MUCH. 3. Identificación de factores de RV asociados a la población con MUCH.MATERIAL Y MÉTODOS: se realizó un muestreo consecutivo de los pacientes con tratamiento antihipertensivo atendidos en dos farmacias comunitarias desde Enero 2013 hasta Septiembre de 2021. Se excluyó aquellos con fibrilación auricular y/o intolerancia al monitor. Se realizó MAFC y MAPA de un mínimo de 24 h. Se envió informe de resultados al médico para su posterior valoración. Los datos se expresan como media± desviación estándar.RESULTADOS: la muestra resultante estuvo formada por 212 pacientes (39 % mujeres, edad 69±8,5 años) 56 de esos pacientes (26 % del total) tenían hipertensión tratada y controlada según MAFC (PA < 135/85). 21 pacientes con hipertensión tratados controlados según MAFC (10 % del total) tuvieron cifras de PA ≥ 130/80 en MAPA24 h, y/o ≥135/85 en MAPAactividad y/o ≥120/70 MAPAnocturna, considerándose pacientes con MUCH. (AU)

Mapping mad maps and recovery tools developed by mental health service users and survivors of psychiatry: a scoping review.

BACKGROUND: Since 1997, several tools based on the experiences of users and survivors of psychiatry have been developed with the goal of promoting self-determination in recovery, empowerment and well-being. OBJECTIVES: The aims of this study were to identify these tools and their distinctive features, and to know how they were created, implemented and evaluated. METHOD: This work was conducted in accordance with a published Scoping Review protocol, following the Arksey and O'Malley approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. Five search strategies were used, including contact with user and survivor networks, academic database searching (Cochrane, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PsycARTICLES, SCOPUS, PubMed and Web of Science), grey literature searching, Google Scholar searching and reference harvesting. We focused on tools, elaborated by users and survivors, and studies reporting the main applications of them. The searches were performed between 21 July and 22 September 2022. Two approaches were used to display the data: descriptive analysis and thematic analysis. RESULTS: Six tools and 35 studies were identified, most of them originating in the USA and UK. Thematic analysis identified six goals of the tools: improving wellness, navigating crisis, promoting recovery, promoting empowerment, facilitating mutual support and coping with oppression. Of the 35 studies identified, 34 corresponded to applications of the Wellness Recovery Action Plan (WRAP). All of them, but one, evaluated group workshops implementations. The most common objective was to evaluate symptom improvement. Only eight studies included users and survivors as part of the research team. CONCLUSIONS: Only the WRAP has been widely disseminated and investigated. Despite the tools were designed to be implemented by peers, it seems they have been usually implemented without them as trainers. Even when these tools are not aimed to promote clinical recovery, in practice the most disseminated recovery tool is being used in this way.

Methods for interpolating missing data in aerobiological databases.

Missing data is a common problem in scientific research. The availability of extensive environmental time series is usually laborious and difficult, and sometimes unexpected failures are not detected until samples are processed. Consequently, environmental databases frequently have some gaps with missing data in it. Applying an interpolation method before starting the data analysis can be a good solution in order to complete this missing information. Nevertheless, there are several different approaches whose accuracy should be considered and compared. In this study, data from 6 aerobiological sampling stations were used as an example of environmental data series to assess the accuracy of different interpolation methods. For that, observed daily pollen/spore concentration data series were randomly removed, interpolated by using different methods and then, compared with the observed data to measure the errors produced. Different periods, gap sizes, interpolation methods and bioaerosols were considered in order to check their influence in the interpolation accuracy. The moving mean interpolation method obtained the highest success rate as average. By using this method, a success rate of the 70% was obtained when the risk classes used in the alert systems of the pollen information platforms were taken into account. In general, errors were mostly greater when there were high oscillations in the concentrations of biotic particles during consecutive days. That is the reason why the pre-peak and peak periods showed the highest interpolation errors. The errors were also higher when gaps longer than 5 days were considered. So, for completing long periods of missing data, it would be advisable to test other methodological approaches. A new Variation Index based on the behaviour of the pollen/spore season (measurement of the variability of the concentrations every 2 consecutive days) was elaborated, which allows to estimate the potential error before the interpolation is applied.

Effects of mesoporous SiO2-CaO nanospheres on the murine peritoneal macrophages/Candidaalbicans interface.

The use of nanoparticles for intracellular drug delivery could reduce the toxicity and side effects of the drug but, the uptake of these nanocarriers could induce adverse effects on cells and tissues after their incorporation. Macrophages play a central role in host defense and are responsible for in vivo nanoparticle trafficking. Assessment of their defense capacity against pathogenic micro-organisms after nanoparticle uptake, is necessary to prevent infections associated with nanoparticle therapies. In this study, the effects of hollow mesoporous SiO2-CaO nanospheres labeled with fluorescein isothiocyanate (FITC-NanoMBGs) on the function of peritoneal macrophages was assessed by measuring their ability to phagocytize Candidaalbicans expressing a red fluorescent protein. Two macrophage/fungus ratios (MOI1 and MOI5) were used and two experimental strategies were carried out: a) pretreatment of macrophages with FITC-NanoMBGs and subsequent fungal infection; b) competition assays after simultaneous addition of fungus and nanospheres. Macrophage pro-inflammatory phenotype markers (CD80 expression and interleukin 6 secretion) were also evaluated. Significant decreases of CD80+ macrophage percentage and interleukin 6 secretion were observed after 30 min, indicating that the simultaneous incorporation of NanoMBG and fungus favors the macrophage non-inflammatory phenotype. The present study evidences that the uptake of these nanospheres in all the studied conditions does not alter the macrophage function. Moreover, intracellular FITC-NanoMBGs induce a transitory increase of the fungal phagocytosis by macrophages at MOI 1 and after a short time of interaction. In the competition assays, as the intracellular fungus quantity increased, the intracellular FITC-NanoMBG content decreased in a MOI- and time-dependent manner. These results have confirmed that macrophages clearly distinguish between inert material and the live yeast in a dynamic intracellular incorporation. Furthermore, macrophage phagocytosis is a critical determinant to know their functional state and a valuable parameter to study the nanomaterial / macrophages / Candida albicans interface.

Predicting the Olea pollen concentration with a machine learning algorithm ensemble.

Air pollution in large cities produces numerous diseases and even millions of deaths annually according to the World Health Organization. Pollen exposure is related to allergic diseases, which makes its prediction a valuable tool to assess the risk level to aeroallergens. However, airborne pollen concentrations are difficult to predict due to the inherent complexity of the relationships among both biotic and environmental variables. In this work, a stochastic approach based on supervised machine learning algorithms was performed to forecast the daily Olea pollen concentrations in the Community of Madrid, central Spain, from 1993 to 2018. Firstly, individual Light Gradient Boosting Machine (LightGBM) and artificial neural network (ANN) models were applied to predict the day of the year (DOY) when the peak of the pollen season occurs, resulting the estimated average peak date 149.1 ± 9.3 and 150.1 ± 10.8 DOY for LightGBM and ANN, respectively, close to the observed value (148.8 ± 9.8). Secondly, the daily pollen concentrations during the entire pollen season have been calculated using an ensemble of two-step GAM followed by LightGBM and ANN. The results of the prediction of daily pollen concentrations showed a coefficient of determination (r2) above 0.75 (goodness of the model following cross-validation). The predictors included in the ensemble models were meteorological variables, phenological metrics, specific site-characteristics, and preceding pollen concentrations. The models are state-of-the-art in machine learning and their potential has been shown to be used and deployed to understand and to predict the pollen risk levels during the main olive pollen season.

Mapping mental health recovery tools developed by mental health service users and ex-users: protocol for a scoping review.

INTRODUCTION: Since the emergence in 1997 of the Wellness Recovery Action Plan, a number of other tools developed by users and/or ex-users of mental health services have been published and implemented. All these tools aim to promote self-determination in mental health recovery processes. A scoping review will be carried out in order to (1) identify existing tools, (2) describe their distinctive characteristics and (3) examine how they have been implemented and evaluated. METHODS AND ANALYSIS: The scoping review will be guided by the methodological framework proposed by Arksey and O'Malley and expanded by Levac et al. It will involve, primarily, a literature search of the following electronic databases: Cochrane database, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, PsycArticles, Scopus, PubMed and Web of Science. In addition, the search process will consider grey literature databases. Users, ex-users and survivors organisations and networks will be contacted in order to identify any relevant material. The reference lists of the articles identified through the literature search will be inspected. Finally, hand searches of journals will be conducted in order to increase the confidence in the search. Two main approaches will be used to present the charted data: a descriptive analysis and a thematic analysis. The study will be performed between April and December 2020. The results will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. ETHICS AND DISSEMINATION: This study does not require ethical approval because the data used are from publicly available materials. The study results will be disseminated through an article submitted for publication to a scientific journal and presented at relevant conferences. The results will also be shared in future workshops and seminars as part of continuing education programmes for mental health professionals.

Clinical characteristics of patients hospitalized with COVID-19 in Spain: Results from the SEMI-COVID-19 Registry. / Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19.

BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.

Carcinoma medular de tiroides asociado a una mutación del protooncogén RET con presentación y evolución poco frecuente / Medullary thyroid carcinoma associated with a RET protooncogene mutation with an infrequent presentation and evolution

El carcinoma medular de tiroides (CMT) es un tumor derivado de las células parafoliculares de la glándula tiroides productoras de calcitonina. Es una neoplasia muy infrecuente en niños y adolescentes. La calcitonina es un marcador tumoral fundamental en el diagnóstico y el seguimiento de estos tumores. Sin embargo, se han descrito algunos casos de CMT no productores de calcitonina, hecho que dificulta el manejo de estos pacientes. Presentamos el caso de un CMT en una paciente portadora de una mutación en el protooncogén RET de riesgo moderado, según la clasificación de la Asociación Americana de Tiroides de 2015. Se trata de una presentación más precoz y agresiva de lo que cabría esperar, con la peculiaridad añadida de que los marcadores tumorales estaban dentro de los límites de la normalidad. Además, realizamos una revisión del tema y analizamos las posibles causas descritas para este caso, así como formas alternativas para el manejo de estos pacientes

Medullary thyroid carcinoma (MTC) is a malignant tumor of the parafollicular C cells of the thyroid, which produces calcitonin (CT). It's very infrequent in children and adolescents. CT is a well-recognized tool in the diagnosis and the follow up of these tumors. However, few cases of CT-negative MTCs have been reported in literature. This fact makes more difficult to manage these patients. We present a patient with a moderate risk mutation in RET protoncogene, according to the ATA classification of 2015 who develops a MCT. This case is more precocious and aggressive than what we would normally expect, and it has the peculiarity that tumor markers were between normal limits. We review the literature and analyze possible causes for this event. We also show alternative ways to manage these kind of patients

[Clinical characteristics of patients hospitalized with COVID-19 in Spain: Results from the SEMI-COVID-19 Registry]. / Características clínicas de los pacientes hospitalizados con COVID-19 en España: resultados del Registro SEMI-COVID-19.

BACKGROUND: Spain has been one of the countries most affected by the COVID-19 pandemic. OBJECTIVE: To create a registry of patients with COVID-19 hospitalized in Spain, in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease. METHODS: A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. RESULTS: Up to June 30th 2020, 15,111 patients from 150 hospitals were included. Their median age was 69.4 years (range: 18-102 years) and 57.2% were male. Prevalences of hypertension, dyslipidemia, and diabetes mellitus were 50.9%, 39.7%, and 19.4%, respectively. The most frequent symptoms were fever (84.2%) and cough (73.5%). High values of ferritin (73.5%), lactate dehydrogenase (73.9%), and D-dimer (63.8%), as well as lymphopenia (52.8%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.6%) and lopinavir/ritonavir (61.4%); 33.1% developed respiratory distress. Overall mortality rate was 21.0%, with a marked increase with age (50-59 years: 4.7%, 60-69 years: 10.5%, 70-79 years: 26.9%, ≥ 80 years: 46.0%). CONCLUSIONS: The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress and one in five patients died. These findings confirm a close relationship between advanced age and mortality.