Long-term outcome of pediatric renal transplantation with donors younger than 6 years.

BACKGROUND: Renal transplantation is currently the best treatment option for patients with end-stage renal disease. However, the use of kidneys from donors under 6 years of age as a possibility to increase the organ pool in pediatric recipients remains a controversial matter. We aimed to investigate whether donor age is associated to the long-term functionality of the renal graft. Likewise, we analyzed the adaptation of the graft to the ascending functional requirements in the pediatric patient. METHODS: Retrospective study of the results obtained in pediatric recipients transplanted with grafts from donors between 3 and 6 years of age, comparing them with those of grafts from donors older than 6 years. Among the variables compared are cumulative graft survival, renal size, need for antiproteinuric therapy, GFR, incidence of rejection, pyelonephritis, renal failure and surgical or tumor complications. RESULTS: A total of 43 transplants were performed with donors aged 3-6 years, and 42 transplants with donors older than 6 years. Cumulative graft survival at 5 years was 81% for the younger donor group compared to 98% for the older donor group (p < .05). At 8 years, cumulative graft survival for donors <6 years was 74%. As for the mean estimated graft survival, it was 11.52 years for the younger donor group and 14.51 years for older donors. During follow-up, the younger donor group presented greater renal enlargement and need for antiproteinuric therapy. The older donors group had a higher GFR during the first year of follow-up, which then equalized in both groups. There were no statistically significant differences in the incidence of acute or chronic rejection, acute pyelonephritis, acute renal failure or surgical or tumor complications. CONCLUSIONS: Renal transplants of grafts equal to or less than 6 years old have good short-term and acceptable long-term results in pediatric patients.

Neutrophil-to-lymphocyte ratio as a predictor of primary vesicoureteral reflux evolution in children with associated acute pyelonephritis.

Background: Neutrophil-to-lymphocyte ratio (NLR) has been recently postulated as an inflammatory biomarker for the diagnosis of vesicoureteral reflux (VUR). The aim of this study is to determine the role of NLR as a predictor of evolution of primary VUR in patients with associated acute pyelonephritis (APN). Methods: A retrospective observational cohort study was performed in patients with APN episodes with associated primary VUR diagnosed between 2013-2020. Patients were divided into two groups according to VUR evolution after APN: group A [spontaneous resolution (SR)] and group B [VUR complications development (CD) during follow-up: new APN or renal function worsening]. Demographic, prenatal, laboratory, microbiological and radiological data were analysed. Sensitivity and specificity for CD of VUR was determined by receiver operating characteristic (ROC) curves. Results: A total of 1,146 episodes of APN were analysed of which 273 patients with APN and associated primary VUR were finally included (median age of 11 months at APN diagnosis). SR of VUR occurred in 169 patients (SR group), while CD were observed in the remaining 104 patients (CD group). No differences in demographic, prenatal, microbiological and radiological features were observed. CD patients had significantly higher levels of leukocytes, neutrophils, NLR, C-reactive protein and creatinine. NLR was the parameter with the highest area under the curve (AUC =0.966) for predicting the development of VUR complications (cut-off point =3.41) with a maximum sensitivity of 92.7% and specificity of 91.1% (P<0.001). Conclusions: NLR may be considered as a simple and cost-effective predictor of clinical outcome of VUR, which may correlate with the increased risk of developing complications of primary VUR after an episode of APN. Therefore, it should be included in the management algorithm for these patients, although future prospective studies are still required to confirm these results.

Simultaneous bladder augmentation and artificial urinary sphincter placement in children with neuropathic urinary incontinence. Is it safe to perform? Long-term results.

INTRODUCTION: Simultaneous performance of artificial urinary sphincter (AUS) placement and bladder augmentation (BA) in patients with neuropathic bladder is currently controversial. OBJECTIVE: The aim of this study is to describe our very long-term results after a median follow-up of 17 years. STUDY DESIGN: A retrospective single-center case-control study was performed in patients with neuropathic bladder treated in our institution between 1994 and 2020, in whom AUS placement and BA were performed simultaneously (SIM group) or sequentially at different times (SEQ group). Demographic variables, hospital length of stay (LOS), long-term outcomes and postoperative complications were compared between both groups. RESULTS: A total of 39 patients (21 males, 18 females) were included, with a median age of 14.3 years. BA and AUS were performed simultaneously at the same intervention in 27 patients, and sequentially in different interventions in 12 cases, with a median of 18 months between both surgeries. No demographics differences were observed. SIM group had a shorter median LOS when compared to SEQ group, considering the two sequential procedures (10 vs. 15 days; p = 0.032). Median follow-up was 17.2 years (interquartile range 10.3-23.9). Four postoperative complications were reported, 3 patients in SIM group and 1 case in SEQ group, with no statistically significant differences between them (p = 0.758). Adequate urinary continence was achieved in more than 90% of patients in both groups. DISCUSSION: There are scarce recent studies comparing the combined performance of simultaneous or sequential AUS and BA in children with neuropathic bladder. The results of our study show a much lower postoperative infection rate than previously reported in the literature. It is a single-center analysis with a relatively small sample of patients although it is among the largest series published so far, and presents the longest long-term follow-up with more than 17 years of median follow-up time. CONCLUSION: Simultaneous BA and AUS placement appears safe and efficacious in children with neuropathic bladder, with shorter LOS and no differences in postoperative complications or long-term outcomes when compared to performing the two procedures sequentially at different times.

Disconnected Out of Passion: Relationship Between Social Alienation and Obsessive Passion.

Violent radicalization continues to be a global problem. One of the main proposals for understanding radicalization and support for political violence is based on social alienation as a trigger. That is, individuals who feel alienated from society try to get out of this situation by using violence, if necessary. However, social alienation alone is not enough to explain radicalization. Therefore, we propose that social alienation interacts with other factors to foster radicalization. Particularly, we propose that obsessive passion, an internal compulsion that leads a person to engage in an activity even when they should not, is one of the interacting factors. Following previous literature, we hypothesized that higher social alienation predicts support for political violence to a greater extent the higher the obsessive passion. To test this hypothesis, we performed two studies in which the cause of passion varied (religion: N = 652 and family: N = 873). Both studies assessed social alienation, harmonious and obsessive passion, and support for political violence. The results showed a significant increase in the effect of social alienation on support for political violence when obsessive passion was higher, even controlling by harmonious passion. These results highlight the importance of considering other variables related to social alienation that could facilitate radicalization processes, particularly maintaining an obsessive passion for a cause when one feels a social disconnection. The theoretical and practical implications of these results are discussed given their contributions to prevention based on work on feelings of social disconnection and harmonization of causes.

Development and Validation of SERR Scale for Detecting Extremism and Religious Radicalism.

BACKGROUND: In line with the growing religious, political and social violence around the world, this study evaluates the psychometric properties of a new scale for Detecting Extremism and Religious Radicalism (SERR), a self-report measure of extremism and religious radicalism. METHOD: Factor analyses, validity and reliability data were collected using a sample of 1985 participants from 58 different cities around Spain who self-identified as actively practicing their religion. RESULTS: Statistical analyses of SERR scores yielded acceptable internal consistency scores (ω > .74) and confirmed key factors associated with radicalism and extremism. The structure of the scale was confirmed as two-dimensional (χ2(64) = 361.22, p < .001, CFI = 0.976, TLI = 0.970, RMSEA (90% CI) = 0.089 (0.080 - 0.098), SRMR = 0.064). Scores for the extremism dimension correlated significantly and positively with scores for the same factor on the Activism and Radicalism Intention Scales (r = .32, p < .001, n = 139). CONCLUSIONS: The SERR demonstrates adequate reliability and validity for evaluating the degree of extremism and radicalism in Christian/Catholic and Muslim believers.

Development and Validation of SERR Scale for Detecting Extremism and Religious Radicalism / Desarrollo y Validación de la Escala SERR para la Detección del Extremismo y Radicalismo Religioso

Background: In liiine with the growing religious, political and social violence around the world, this study evaluates the psychometric properties of a new scale for Detecting Extremism and Religious Radicalism (SERR), a self-report measure of extremism and religious radicalism. Method: Factor analyses, validity and reliability data were collected using a sample of 1985 participants from 58 different cities around Spain who self-identified as actively practicing their religion. Results: Statistical analyses of SERR scores yielded acceptable internal consistency scores (ω > .74) and confirmed key factors associated with radicalism and extremism. The structure of the scale was confirmed as two dimensional (χ²(64) = 361.22, p < .001, CFI = 0.976, TLI = 0.970, RMSEA (90% CI) = 0.089 (0.080 - 0.098), SRMR = 0.064). Scores for the extremism dimension correlated significantly and positively with scores for the same factor on the Activism and Radicalism Intention Scales (r = .32, p < .001, n = 139). Conclusions: The SERR demonstrates adequate reliability and validity for evaluating the degree of extremism and radicalism in Christian/Catholic and Muslim believers.(AU)

Antecedentes: en consonancia con la creciente violencia religiosa, política y social en todo el mundo, este estudio evalúa las propiedades psicométricas de la escala para la detección del extremismo y el radicalismo religioso (SERR), una medida de autoinforme del extremismo y el radicalismo religioso. Método: los análisis factoriales y las evidencias de validez y fiabilidad se recopilaron utilizando una muestra de 1985 participantes de 58 ciudades distintas de España que se identificaron a sí mismos como practicantes activos de su religión. Resultados: los análisis estadísticos de las puntuaciones SERR arrojaron puntuaciones de consistencia interna aceptables (ω > .74) y confirmaron los factores clave asociados con el radicalismo y el extremismo. La estructura de la escala se confirmó como bidimensional (χ²(64) = 361.22, p < .001, CFI = 0.976, TLI = 0.970, RMSEA (90% CI) = 0.089 (0.080 - 0.098), SRMR = 0.064). Las puntuaciones de la dimensión de extremismo se correlacionaron significativa y positivamente con las puntuaciones del mismo factor en la Escala de Intención de Activismo y Radicalismo (r = 0,32, p < 0.001, n = 139). Conclusiones: los autores concluyen que el SERR muestra una fiabilidad y validez adecuadas para evaluar el grado de extremismo y radicalismo en creyentes cristianos/católicos y musulmanes.(AU)

Evidence of Psychological Manipulation in the Process of Violent Radicalization: An Investigation of the 17-A Cell.

Introduction: Radicalization leading to violence is a complex social process that frequently targets young people. In this study, we examine the 17-A cell, which carried out terrorist attacks in the Spanish cities of Barcelona and Cambrils on August 17, 2017. We focus on the psychological manipulation techniques used to radicalized members of the cell. Methods: Using deductive content analysis, we examined the judicial order of the National High Court related to "Operation Ramblas" and the police proceedings of Cuerpo de Mossos d'Esquadra (CME) associated with the Barcelona and Cambrils attacks. Our goal was to determine whether psychological manipulation was used on the cell members and, if so, how frequently. Results: Our results suggest that different psychological manipulation techniques were used on the 17-A cell members to facilitate their use of ideological violence. The most frequent strategies were cognitive control (control of attention, group identification, and denigration of critical thinking), environmental control (control of information), and emotional control (authoritarian leadership). Conclusions: This study provides evidence that psychological manipulation techniques were used in the radicalization of 17-A cell members. The results are discussed in the context of previous research on the psychology of violent extremism and terrorism. We highlight the need for prevention and psychosocial interventions to steer young people away from violent extremism.

Artificial urinary sphincter in congenital neuropathic bladder: Very long-term outcomes.

OBJECTIVE: Artificial urinary sphincter has been used to treat urinary incontinence in children with neuropathic bladder, although there are few studies reporting very long-term results. We assess our experience over the last 27 years in the management of artificial urinary sphincter. METHODS: A retrospective study was performed in patients with neuropathic bladder in whom an artificial urinary sphincter was placed in our institution between 1994 and 2020. Demographic variables, pre- and post-artificial urinary sphincter implantation urodynamic studies, long-term outcomes, and postoperative complications were collected. RESULTS: An artificial urinary sphincter was implanted in 71 patients (median age 14.5; interquartile range 12.8-15.9), with a median follow-up time of 17.2 years (interquartile range 9.8-23.9 years). Thirty-nine patients underwent enterocystoplasty combined with artificial urinary sphincter placement and 32 underwent artificial urinary sphincter implantation alone, of whom 12 patients (16.9%) eventually required an enterocystoplasty because of unexpected bladder behavior changes, usually within 3 years of artificial urinary sphincter implantation. Adequate urinary continence was reported in 90.1% of patients, nine void their bladders spontaneously, and 62 need clean intermittent catheterization. Eighteen mechanical malfunctions occurred in 15 patients (21.1%), with an average artificial urinary sphincter working life of 15.1 ± 1.3 years. In five patients artificial urinary sphincter was removed due to infection or erosion. In 12 patients (30.8%), a continent catheterizable stoma was made (before or during the follow-up) because of problems with clean intermittent catheterization through the urethra. CONCLUSION: The very long-term results of this study demonstrate that artificial urinary sphincter is an effective treatment for urinary incontinence in neuropathic bladder patients. Long-term follow-up is important to identify potential unexpected changes in bladder behavior in these patients.

Buried penis surgical treatment in children: Dorsal dartos flap VS. Fascia fixation. A retrospective cohort study.

INTRODUCTION: Several surgical techniques for buried penis (BP) treatment have been described, although there is not a reference pattern for it. In our institution, we have traditionally performed penis fixation to Buck's fascia at 3 points. In 2014 we introduced a dorsal dartos flap technique, fixed at both sides of the penis base. OBJETIVE: To compare both techniques and their long-term outcomes. METHODS: A retrospective cohort study was conducted on consecutive patients with BP who underwent surgery between 2010 and 2018. They were divided according to surgical technique performed: group A (fascia fixation) and B (dorsal dartos flap). Demographic variables, surgical time and postoperative complications were analyzed. Long-term cosmetic outcomes were evaluated through a telephone survey to patients parents. RESULTS: Thirty-five patients were included (16 group A; 19 group B). Median age at intervention was 9.7 years in group A, with no statistical differences with group B (7.3 years; p = 0.071). No statistically significant differences were observed in mean surgical time or postoperative complications between both groups. Cosmetic outcomes (Table 2) were significantly better in group B, which presented higher percentages of satisfaction with the outcomes (95% vs. 64%; p = 0.02) and age at intervention (89% vs. 59%; p = 0.032), higher perception of the procedure as "minimally invasive" (100% vs. 71%; p = 0.013) and higher recommendation rate of the intervention (95% vs. 57%; p = 0.029). CONCLUSIONS: Dorsal dartos flap is a reproducible, minimally invasive technique with minimal adverse effects and satisfactory long-term results. It has fewer postoperative complications and more satisfactory cosmetic results compared to fascia fixation.

Social inclusion level of Spanish and foreign adolescents: Proposal for an evaluation instrument.

Social exclusion is one of the most complex and sensitive social problems nowadays. Of all social groups, adolescents are among the most vulnerable to social exclusion, which can interfere with their social development. Consequently, the evaluation of this construct in adolescents is an important matter. The aim of this investigation was to develop the Social Inclusion for Adolescents Scale (SIAS). Firstly, five psychosocial factors were proposed, which potentially contribute to social inclusion: (1) covered needs, (2) self-efficacy, (3) social support, (4) job training, and (5) social integration. From these five factors, a set of items was created and reduced using qualitative evaluations. The final set of items was used in three studies, with a Spanish population (N = 1540) and a foreign population (N = 460), to test the psychometric properties of the scale, its dimensional structure, the measurement invariance between Spanish and foreign people, the reliability of the instrument and the evidence of the validity of its measurements. The results indicate that this scale is psychometrically reliable enough to assess social inclusion in adolescents. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-020-01201-5.

Adaptation, validity, and reliability of the Interaction with Disabled Persons Scale in Spanish population.

PURPOSE: To adapt the Interaction with Disabled Persons Scale (IDP) into Spanish and examine its factor structure. METHODS: A forward and back translation of the IPD was performed by professional translators of scholarly articles. Spanish-speaking professional translators provided modifications in order to develop the final version of the scale. Participants filled in the Spanish version of the IDP, Positive and Negative Affect Schedule (PANAS), Multidimensional Attitudes Scale toward persons with disabilities (MAS), and Semantic Differential Technique (SDT). RESULTS: A total of 523 persons (62.6% women), with a mean age of 29.22 (SD = 14.03) ranking from 18 to 81. The confirmatory factor analysis showed a reliable brief version of the IDP with adequate psychometric properties and two factors: (χ(19)2=28.98, p < 0.001, CFI = 0.94, TLI = 0.91, RMSEA (90% IC)=0.05 (0.01, 0.08), SRMR = 0.06). The first factor solution was Coping/Succumbing Framework and the second factor was Discomfort in Social Interaction. The internal consistency reliability for the first factor was 0.63 and for the second 0.66. CONCLUSIONS: Our findings provide evidence of the psychometric properties of the IDP as a brief measure of attitude toward individual with special needs in Spanish population.Implications for rehabilitationThe Interaction with Disabled Persons Scale (IDP) was successfully translated into Spanish language.The Spanish version of IDP Scale has a good acceptability, acceptable internal consistency, and high test-retest reliability.The Spanish version of IDP can been used to assist the clinicians, educators, and researchers in identifying the attitudes of the Spanish population toward persons with functional diversity in Spanish.Identifying the attitudes will permit to improve the inclusion polity and to design social programs toward greater inclusion.

Adaptation and validation into Spanish of the Workplace Dignity Scale / Adaptación y validación al español de la Escala Dignidad en el Trabajo

Abstract Introduction and objective: Workers contend with many threats while performing their daily routine that could undermine their dignity, such as denigrating comments from supervisors or co-workers. Denying workers' dignity constitutes a direct threat towards their well-being. The aim of this paper is to adapt and validate the Spanish version of the Workplace Dignity Scale (WDS). Method: An instrumental design was executed in order to adapt the scale to Spanish with a Mexican population (N = 588). Following back-translation, three studies were conducted in which confirmatory factor analysis, correlations, regressions, and invariance analysis were applied. Results: The results showed that the Spanish adaptation conforms to the six-factor structure of the original scale and that organisational dehumanisation and workers' self-objectification predicted dignity at work; with workers' self-objectification being the variable that most strongly predicted workers' dignity. Finally, we also evaluated measurement invariance comparing our data with the results of the original scale. In general, results indicated that even when the Spanish version of the WDS presented an adequate factor structure, its measurement presented different factor loadings and slopes compared with the measurement of the original scale. Conclusions: In general, we have an instrument adapted to the Mexican context that allows us to evaluate workers' sense of dignity in the workplace.

Resumen Introducción y objetivo: Los trabajadores pueden enfrentar muchas amenazas mientras realizan su rutina diaria que podrían socavar su dignidad, como comentarios denigrantes de supervisores o compañeros de trabajo. Negar la dignidad de los trabajadores constituye una amenaza directa para su bienestar. El objetivo de este artículo fue adaptar y validar la versión en español de la Workplace Dignity Scale (WDS). Método: Se realizó un diseño instrumental con el fin de adaptar la escala al español con población mexicana (N = 588). Después de realizar una traducción inversa, se realizaron tres estudios donde se aplicaron análisis factoriales confirmatorios, correlaciones, regresiones y un análisis de invarianza. Resultados: Los resultados mostraron que la adaptación al español se ajusta a la estructura de seis factores de la escala original y que la deshumanización organizacional y la auto-objetivación de los trabajadores predecían la dignidad en el trabajo; siendo la auto-objetivación de los trabajadores la variable que predecía en mayor medida la dignidad de los trabajadores. Finalmente, también se evaluó la invariancia de medición comparando nuestros datos con los resultados de la escala original. En general, los resultados indicaron que aun cuando la versión en español de la WDS presentaba una estructura factorial adecuada, su medición presentaba cargas factoriales y pendientes diferentes en comparación con la medición de la escala original. Conclusiones: En general, contamos con un instrumento adaptado al contexto mexicano que nos permite evaluar el sentido de dignidad de los trabajadores en el lugar de trabajo.

Spanish adaptation of the Ambivalent Classism Inventory (ACI) / Adaptación del Inventario de Clasismo Ambivalente (ICA) para hispanohablantes

Abstract Introduction: Hostile and benevolent classism influence the derogation of poor people and groups, with negative consequences. The present study aims to adapt and validate the Ambivalent Classism Inventory (ACI) to obtain an adequate tool for expanding research on this topic among the Spanish-speaking population. Method: Toward this end, the researchers back-translated the ACI version originally developed for English speakers. Exploratory and confirmatory analyses verify the ACI's reliability and factor structure with a sample of Mexican participants. Results: The results demonstrated that the adapted scale's psychometric properties are acceptable. Its original and factor structure are similar to those of the original scale: hostile classism (12 items), protective paternalism (4 items), and complementary class differentiation (4 items). Furthermore, the study tests the convergent and divergent validity of the scale´s sub-dimensions concerning other ideological and socioeconomic variables. Conclusion: The proposed ACI adaptation should contribute to understanding attitudes toward the poor as well as their consequences among Spanish speakers.

Resumen Introducción: El clasismo hostil y benevolente contribuye a la discriminación de las personas y grupos pobres, lo que implica consecuencias negativas para estos individuos. Este artículo tiene como objetivo adaptar y validar el Inventario de Clasismo Ambivalente (ACI) para obtener una herramienta adecuada que sea útil para expandir la investigación sobre este tema entre la población hispanohablante. Método: Con este fin, se tradujo al español la versión del ACI desarrollada originalmente para angloparlantes, y esta versión en español fue a su vez traducida al inglés. Tras la aplicación de la escala en español, se llevaron a cabo análisis exploratorios y confirmatorios para verificar la confiabilidad y la estructura factorial del ACI en una muestra de participantes mexicanos. Resultados: Los resultados demostraron que las propiedades psicométricas de la escala adaptada son aceptables. Su estructura original y factorial son similares a las de la escala original: clasismo hostil (12 ítems), paternalismo protector (4 ítems) y diferenciación de clases complementarias (4 ítems). Además, el estudio confirmó la validez convergente y divergente de las subdimensiones de la escala en relación con otras variables ideológicas y socioeconómicas. Conclusión: La adaptación propuesta de ACI contribuirá a comprender las actitudes hacia los pobres y sus consecuencias entre los hispanohablantes.

Creation of Tissue-Engineered Urethras for Large Urethral Defect Repair in a Rabbit Experimental Model.

Introduction: Tissue engineering is a potential source of urethral substitutes to treat severe urethral defects. Our aim was to create tissue-engineered urethras by harvesting autologous cells obtained by bladder washes and then using these cells to create a neourethra in a chronic large urethral defect in a rabbit model. Methods: A large urethral defect was first created in male New Zealand rabbits by resecting an elliptic defect (70 mm2) in the ventral penile urethra and then letting it settle down as a chronic defect for 5-6 weeks. Urothelial cells were harvested noninvasively by washing the bladder with saline and isolating urothelial cells. Neourethras were created by seeding urothelial cells on a commercially available decellularized intestinal submucosa matrix (Biodesign® Cook-Biotech®). Twenty-two rabbits were divided into three groups. Group-A (n = 2) is a control group (urethral defect unrepaired). Group-B (n = 10) and group-C (n = 10) underwent on-lay urethroplasty, with unseeded matrix (group-B) and urothelial cell-seeded matrix (group-C). Macroscopic appearance, radiology, and histology were assessed. Results: The chronic large urethral defect model was successfully created. Stratified urothelial cultures attached to the matrix were obtained. All group-A rabbits kept the urethral defect size unchanged (70 ± 2.5 mm2). All group-B rabbits presented urethroplasty dehiscence, with a median defect of 61 mm2 (range 34-70). In group-C, five presented complete correction and five almost total correction with fistula, with a median defect of 0.3 mm2 (range 0-12.5), demonstrating a significant better result (p = 7.85 × 10-5). Urethrography showed more fistulas in group-B (10/10, versus 5/10 in group-C) (p = 0.04). No strictures were found in any of the groups. Group-B histology identified the absence of ventral urethra in unrepaired areas, with squamous cell metaplasia in the edges toward the defect. In group-C repaired areas, ventral multilayer urothelium was identified with cells staining for urothelial cell marker cytokeratin-7. Conclusions: The importance of this study is that we used a chronic large urethral defect animal model and clearly found that cell-seeded transplants were superior to nonseeded. In addition, bladder washing was a feasible method for harvesting viable autologous cells in a noninvasive way. There is a place for considering tissue-engineered transplants in the surgical armamentarium for treating complex urethral defects and hypospadias cases.

The role of vulnerable environments in support for homegrown terrorism: Fieldwork using the 3N model.

The 3N model of radicalization proposes that violent radicalization is the result of the contribution of needs, networks, and narratives. Although research has mainly been supportive of this perspective, a substantial amount of ground remains uncovered regarding the network component of the model. Within this framework, we examine why individuals living in certain social environments tend to harbor more positive attitudes toward homegrown terrorism than others. Building on prior research, we hypothesized that individuals living in social environments known to be vulnerable (vs. less vulnerable) are more likely to experience a sense of significance loss (i.e., lack of social integration, perceived conflicts between religious groups), find solace in religious social networks (i.e., mosques), and thus adhere to radical narratives (i.e., legitimization of terrorism). A study with 365 young Muslims from different cities in Spain (Almería, Barcelona, Ceuta, and Melilla)supported these predictions. Theoretical and practical implications for the study of violent extremism are discussed.

Upside-down kidney placement: An alternative in pediatric renal transplantation.

PURPOSE: "Upside-down" kidney placement has been reported as an acceptable alternative in cases of technical difficulty in kidney transplantation but there are few reports in the pediatric population. The aim of our study is to analyze whether the placement of the upside-down kidney could affect graft outcome or produce more complications. MATERIALS AND METHODS: A retrospective study was conducted of pediatric kidney transplants performed in our center between 2005 and 2017 with at least 6 months' follow-up. Epidemiological and anthropometric data, type of donor (deceased/living), graft position (normal/upside-down), reason for the upside-down placement, early, medium and long-term complications and renal function were analyzed and compared with patients transplanted in the same period with a normal graft placement. RESULTS: From 181 transplants, 167 grafts were placed in a normal position (mean age: 10 y and mean weight: 30 kg) and 14 were placed upside-down (10 y, 37 kg) mainly because of vessel shortness after laparoscopic nephrectomy. Male predominance was observed in both groups. 57% of grafts from the control group and 64% of those from study group came from a living donor. Four vascular and two ureteral re-anastomoses were recorded in the control group and two vascular and one ureteral re-anastomosis in the study group (p > 0.05). In the latter group, no grafts have been lost due to vascular or urological causes and no patients have required dialysis. CONCLUSIONS: When necessary, an upside-down placement for the renal graft is a safe alternative in the pediatric population. LEVEL OF EVIDENCE: Level III.

Kogan's Attitude toward Old People scale revisited: Psychometric properties and recommendations.

Population ageing is one of the present and future challenges in the European context. In addition to age-related changes, negative and judicious attitudes by society are also prevalent. Therefore, there is a need for reliable instruments to evaluate attitudes toward ageing. In this vein, the present research aims to provide a reliable version of the Kogan's Attitudes toward Older People scale adapted to the Spanish context. In a sample from the academic community (N = 163), we evaluated the reliability, the psychometric properties, and the internal consistency of a version of Kogan's scale translated into Spanish. The results showed a reliable short version of the scale with adequate psychometric properties and two factors: positive and negative. Moreover, the correlates with similar measures of attitude toward older people proved external validity measures by the short scale. The implications and contributions to the geriatric population are discussed.

Long-term outcomes of adult-size and size-matched kidney transplants in small pediatric recipients.

INTRODUCTION: Adult-size kidneys are usually used for kidney transplantation in small pediatric recipients, but the influence of graft size in transplant outcome remains controversial. Our aim is to compare long-term transplant outcomes of using adult-size and size-matched kidneys in small pediatric recipients. MATERIALS AND METHODS: Since 1999, 61 of 226 kidney transplants were achieved in recipients weighing <20 kg with 5 years of follow-up. Patients were analyzed according to the graft size received: (group-A) adult-size (n = 32), (group-B) size-matched (n = 29). Kidney size (KS), glomerular filtration rate (GFR) proteinuria and rejection were compared between groups at transplant time (T0), at one (T1), two (T2), five years (T5), and at the end of the follow-up (TF) (median follow-up 8.47(0-17) years). Graft and patient survival were determined and compared between groups. RESULTS: Mean KS was significantly different between groups at T0 (A:11.3 ± 1.1 cm, B:8.8 ± 0.9 cm), (pT0<0.01), group-B evidenced graft growth, reaching similar sizes to group-A at T5 (A:11.7±1 cm, B:11.2±1 cm; pT5 = 0.13) and TF (A:12.2 ± 1.1 cm, B:12.4 ± 1.2 cm; pTF = 0.63), and group-A had a slight graft growth at TF (pT0-TF<0.01). Mean Schwartz-GFR at T0 was greater in group-A (138 ± 33 ml/min/1.73 m2) than group-B (109 ± 34 mL/min/1.73 m2) (pT0 = 0.01); during follow-up, it evidenced a reduction in group-A (T5:90 ± 27, TF:71 ± 24 mL/min/1.73 m2; pT0-T5<0.01; pT0-TF<0.01), meanwhile in group-B was stable until T5 (104 ± 33 mL/min/1.73 m2; pT0-T5 = 0.54), declining at TF (76 ± 31 mL/min/1.73 m2; pT0-TF<0.01); with no significant differences at T1, T2, T5, and TF between groups. Similar results were observed in mean Filler-GFR of both groups (Figure). Proteinuria and episodes of rejection were no significantly different between groups during the follow-up (p > 0.01; p = 0.23). Graft and patient survival at 5 and 10 years did not show significant differences (p = 0.45; p = 0.10). DISCUSSION: Despite the initial kidney size difference between groups, we have demonstrated that they tended to the same size during the follow-up. Adult-size kidneys presented a slight size increase in the long-term, suggesting that they have some growth potential in small recipients, in contrast to previous literature. Mean GFR between groups showed no significant differences in the long-term, suggesting that optimal graft perfusion and function can be achieved despite the size of the graft. We have demonstrated that there were no significant differences in long-term graft and patient survival; this results were similar to the most recent literature about this topic and different from the 90-2000s decades literature. CONCLUSIONS: Adult-size kidneys may be transplanted to small recipients (<20 kg) with comparable outcomes to size-matched kidneys, with no significant differences in long-term KS, GFR, proteinuria, rejection, graft or patient survival.