No link between handedness and spatial navigation: evidence from over 400 000 participants in 41 countries.

There is an active debate concerning the association of handedness and spatial ability. Past studies used small sample sizes. Determining the effect of handedness on spatial ability requires a large, cross-cultural sample of participants and a navigation task with real-world validity. Here, we overcome these challenges via the mobile app Sea Hero Quest. We analysed the navigation performance from 422 772 participants from 41 countries and found no reliable evidence for any difference in spatial ability between left- and right-handers across all countries. A small but growing gap in performance appears for participants over 64 years old, with left-handers outperforming right-handers. Further analysis, however, suggests that this gap is most likely due to selection bias. Overall, our study clarifies the factors associated with spatial ability and shows that left-handedness is not associated with either a benefit or a deficit in spatial ability.

Cultural determinants of the gap between self-estimated navigation ability and wayfinding performance: evidence from 46 countries.

Cognitive abilities can vary widely. Some people excel in certain skills, others struggle. However, not all those who describe themselves as gifted are. One possible influence on self-estimates is the surrounding culture. Some cultures may amplify self-assurance and others cultivate humility. Past research has shown that people in different countries can be grouped into a set of consistent cultural clusters with similar values and tendencies, such as attitudes to masculinity or individualism. Here we explored whether such cultural dimensions might relate to the extent to which populations in 46 countries overestimate or underestimate their cognitive abilities in the domain of spatial navigation. Using the Sea Hero Quest navigation test and a large sample (N = 383,187) we found cultural clusters of countries tend to be similar in how they self-rate ability relative to their actual performance. Across the world population sampled, higher self-ratings were associated with better performance. However, at the national level, higher self-ratings as a nation were not associated with better performance as a nation. Germanic and Near East countries were found to be most overconfident in their abilities and Nordic countries to be most under-confident in their abilities. Gender stereotypes may play a role in mediating this pattern, with larger national positive attitudes to male stereotyped roles (Hofstede's masculinity dimension) associated with a greater overconfidence in performance at the national level. We also replicate, with higher precision than prior studies, evidence that older men tend to overestimate their navigation skill more than other groups. These findings give insight into how culture and demographics may impact self-estimates of our abilities.

New vegetable varieties of Brassica rapa and Brassica napus with modified glucosinolate content obtained by mass selection approach.

Background: Glucosinolates (GSLs) constitute a characteristic group of secondary metabolites present in the Brassica genus. These compounds confer resistance to pests and diseases. Moreover, they show allelopathic and anticarcinogenic effects. All those effects are dependent on the chemical structure of the GSL. The modification of the content of specific GSLs would allow obtaining varieties with enhanced resistance and/or improved health benefits. Moreover, the attainment of varieties with the same genetic background but with divergent GSLs concentration will prompt the undertaking of studies on their biological effects. Objective and Methods: The objective of this study was to evaluate the efficacy of two divergent mass selection programs to modify GSL content in the leaves of two Brassica species: nabicol (Brassica napus L.), selected by glucobrassicanapin (GBN), and nabiza (Brassica rapa L.), selected by gluconapin (GNA) through several selection cycles using cromatographic analysis. Results: The response to selection fitted a linear regression model with no signs of variability depletion for GSL modification in either direction, but with higher efficiency in reducing the selected GSL than in the increasing. The selection was also effective in other parts of the plant, suggesting that there is a GSL translocation in the plant or a modification in their synthesis pathway that is not-organ specific. There was an indirect response of selection in other GSL; thus this information should be considered when designing breeding programs. Finally, populations obtained by selection have the same agronomic performance or even better than the original population. Conclusion: Therefore, mass selection seems to be a good method to modify the content of specific GSL in Brassica crops.

Entropy and a sub-group of geometric measures of paths predict the navigability of an environment.

Despite extensive research on navigation, it remains unclear which features of an environment predict how difficult it will be to navigate. We analysed 478,170 trajectories from 10,626 participants who navigated 45 virtual environments in the research app-based game Sea Hero Quest. Virtual environments were designed to vary in a range of properties such as their layout, number of goals, visibility (varying fog) and map condition. We calculated 58 spatial measures grouped into four families: task-specific metrics, space syntax configurational metrics, space syntax geometric metrics, and general geometric metrics. We used Lasso, a variable selection method, to select the most predictive measures of navigation difficulty. Geometric features such as entropy, area of navigable space, number of rings and closeness centrality of path networks were among the most significant factors determining the navigational difficulty. By contrast a range of other measures did not predict difficulty, including measures of intelligibility. Unsurprisingly, other task-specific features (e.g. number of destinations) and fog also predicted navigation difficulty. These findings have implications for the study of spatial behaviour in ecological settings, as well as predicting human movements in different settings, such as complex buildings and transport networks and may aid the design of more navigable environments.

Mitochondrial Complex I Inhibition by Metformin: Drug-Exercise Interactions.

Metformin has antidiabetic, anticancer, and prolongevity effects, but seems to interfere with aerobic training mitochondrial adaptations. The primary mechanism of action has been suggested to be the inhibition of mitochondrial complex I. Recent papers (Wang et al. and Cameron et al.), however, provide evidence to deny the hypothesis of a direct action of metformin on complex I.

Low pre-transplant levels of mannose-binding lectin are associated with viral infections and mortality after haematopoietic allogeneic stem cell transplantation.

BACKGROUND: Mannose-binding lectin (MBL) is a key component of innate immunity. Low serum MBL levels, related to promoter polymorphism and structural variants, have been associated with an increased risk of infection. The aim of this work was to analyse the incidence and severity of infections and mortality in relation to the MBL2 genotype and MBL levels in patients underwent allogeneic haematopoietic stem cell transplantation (Allo-HSCT). RESULTS: This was a prospective cohort study of 72 consecutive patients underwent Allo-HSCT between January 2007 and June 2009 in a tertiary referral centre. Three periods were considered in the patients' follow-up: the early period (0-30 days after Allo-HSCT), the intermediate period (30-100 days after Allo-HSCT) and the late period (> 100 days after Allo-HSCT). A commercial line probe assay for MBL2 genotyping and an ELISA Kit were used to measure MBL levels. A total of 220 episodes of infection were collected in the 72 patients. No association between donor or recipient MBL2 genotype and infection was found. The first episode of infection presented earlier in patients with pre-transplant MBL levels of < 1000 ng/ml (median 6d vs 8d, p = 0.036). MBL levels < 1000 ng/ml in the pre-transplant period (risk ratio (RR) 2.48, 95% CI 1.00-6.13), neutropenic period (0-30 days, RR 3.28, 95% CI 1.53-7.06) and intermediate period (30-100 days, RR 2.37, 95% CI 1.15-4.90) were associated with increased risk of virus infection. No association with bacterial or fungal disease was found. Mortality was associated with pre-transplant MBL levels < 1000 ng/ml (hazard ratio 5.55, 95% CI 1.17-26.30, p = 0.03) but not with MBL2 genotype. CONCLUSIONS: Patients who underwent Allo-HSCT with low pre-transplant MBL levels presented the first episode of infection earlier and had an increased risk of viral infections and mortality in the first 6 months post-transplant. Thus, pre-transplant MBL levels would be important in predicting susceptibility to viral infections and mortality and might be considered a biomarker to be included in the pre-transplantation risk assessment.

Effects of 3-butenyl isothiocyanate on phenotypically different prostate cancer cells.

Isothiocyanates (ITCs) have gained increasing attention since they have been attributed the merits for the potential beneficial effects of cruciferous vegetable dietary consumption on cancer. The aim of the present study was to determine the cytotoxic effects of 3-butenyl ITC (3-BI) on prostate cancer (PC) cells under in vitro conditions. Two androgen-insensitive human PC cell lines, PC-3 and DU145, were assayed. Cells were cultured in the presence of increasing concentrations of 3-BI (5, 10, 30 and 50 µM) in the absence or presence of the chemotherapeutic drug docetaxel (DOCE) (1 and 2 nM). The cytotoxic effects of these compounds were analyzed using the trypan blue exclusion assay at 24, 48 and 72 h. Apoptosis and migration assays were also performed. The results showed that 3-BI induced a dose-dependent cytotoxic effect on PC-3 cells at 24, 48 and 72 h. These effects were significantly higher than those found with DOCE at 72 h of culture. Moreover, 3-BI also potentiated the effects of DOCE in a dose-dependent manner. Additionally, 3-BI showed inhibition of the migration of PC-3 cells. Nevertheless, 3-BI was not effective in the DU145 PC cell line. These results show a promising role for the 3-BI compound as a co-adjuvant agent in DOCE-based therapy in certain types of PC.

Genotypification of the MSP3 Gene in patients with complicated Malaria / Genotypification of the MSP3 Gene in patients with complicated Malaria

Objetivo. Se estudió la diversidad genética de las poblaciones naturales de parásitos de Plasmodium vivax mediante el estudio de la región variable del gen Pvmsp-3α. Materiales y métodos. Se realizó PCR-RFLP en 29 muestras de pacientes con malaria por P. vivax con complicaciones (PC) y 32 pacientes con malaria por P. vivax sin complicaciones (PNC), todos los pacientes provenientes de la región Bajo-Córdoba-Uraba, zona altamente endémica para malaria. Fueron colectadas muestras de sangre total para la extracción de DNA utilizando la tecnica saponina/chelex-100. Se usó la tecnica de RFLP usando las enzimas de restricción HhAI y AluI. Diez patrones de restricción fácilmente distinguibles, se detectaron después que los productos de la PCR fueron digeridos con la enzima Alu I y 9 con la enzima Hha I. Resultados. El gen Pvmsp-3α exhibió gran polimorfismo y los resultados sugieren que este gen puede ser utilizado en Colombia como un marcador molecular epidemiológico para el genotipado de P. vivax, ademas el patron PH1con la enzima AluI mostró mayor frecencia en los pacientes complicados. Conclusiones. El gen Pvmsp3α puede ser un marcador genetico de variabilidad en las cepas circulantes de P. vivax y el PH1 sugiere ser un marcador para predecir una complicación en pacientes con malaria vivax.

Objective. The genetic diversity of the natural populations of Plasmodium vivax parasites was studied by studying the variable region ofthe Pvmsp-3α gene. Materials and methods. PCR-RFLP was performed in 29 samples of patients with P. vivax malaria with complications (PC) and 32 patients with P. vivax malaria with out complications (PNC), all patients from the Bajo-Córdoba-Uraba region, Highly endemicto malaria. Total blood samples were collected for DNA extraction using the saponin /chelex-100 technique. The RFLP technique was used using there striction en zymes HhA Iand AluI. Teneasily distinguis hablere striction patterns were detected after the PCR products were digested with the enzyme Alu I and 9 with the enzyme Hha I. Results. The Pvmsp-3α gene exhibited large polymorphismand the results suggest that this gene can be used in Colombia asa moleculare pidemiological marker for the genotypin go fP. vivax. Further more, the PH1 pattern with the AluIen zyme showed higher frequency in the complicated patients. Conclusions. The Pvmsp3 gene may be agenetic marker of variability in the circulating strain so fP. vivax and the PH1 suggest samarker for predicting a complication in patients with vivax malaria.

Methylmercury reduces synaptic transmission and neuronal excitability in rat hippocampal slices.

In a previous study, we pointed out that the neurotoxic action evoked by methylmercury (MeHg), a potent environmental pollutant responsible for fatal food poisoning, is associated with alterations of cellular excitability by irreversible blockade of sodium and calcium currents. Here, we investigated the MeHg effects on synaptic transmission and neuronal plasticity using extracellular field recording in CA1 area of rat hippocampal slices. MeHg caused a fast and drastic depression of evoked field excitatory postsynaptic potentials (fEPSPs) in a concentration-dependent manner with an IC50 of 25.7 µM. This depression was partially caused by the irreversible reduction of axon recruitment deduced from the decrement of the fiber volley (FV) amplitude. Nevertheless, this MeHg-induced synaptic depression represents a true reduction of synaptic efficacy, as judged by input/output curves. In addition, a reduction on presynaptic release of glutamate was detected with the paradigm of paired-pulse facilitation during MeHg application. Moreover, MeHg also reduced population spike (PS) ampxlitude, and this effect was more prominent when the PS was evoked by ortodromic stimulation than by antidromic stimulation. Interestingly, despite these strong effects of MeHg on synaptic transmission and excitability, this compound did not modify the induction of long-term synaptic potentiation (LTP). The effects described here for MeHg were irreversible or very slowly reversible after drug wash-out. In summary, the blockade of sodium and calcium channels by MeHg affects synaptic transmission and cellular excitability but not synaptic plasticity.

Ligand-dependent Hedgehog pathway activation in Rhabdomyosarcoma: the oncogenic role of the ligands.

BACKGROUND: Rhabdomyosarcoma (RMS) is the most common type of soft tissue sarcoma in children. The Hedgehog (HH) pathway is known to develop an oncogenic role in RMS. However, the molecular mechanism that drives activation of the pathway in RMS is not well understood. METHODS: The expression of HH ligands was studied by qPCR, western blot and immunohistochemistry. Functional and animal model studies were carried out with cells transduced with shRNAs against HH ligands or treated with HH-specific inhibitors (Vismodegib and MEDI-5304). Finally, the molecular characterisation of an off-target effect of Vismodegib was also made. RESULTS: The results showed a prominent expression of HH ligands supporting an autocrine ligand-dependent activation of the pathway. A comparison of pharmacologic Smoothened inhibition (Vismodegib) and HH ligand blocking (MEDI-5304) is also provided. Interestingly, a first description of pernicious off-target effect of Vismodegib is also reported. CONCLUSIONS: The clarification of the HH pathway activation mechanism in RMS opens a door for targeted therapies against HH ligands as a possible alternative in the future development of better treatment protocols. Moreover, the description of a pernicious off-target effect of Vismodegib, via unfolded protein response activation, may mechanistically explain its previously reported inefficiency in several ligand-dependent cancers.

Exactitud y concordancia entre glucómetros: un estudio en condiciones habituales de práctica clínica / Accuracy and reliability between glucose meters: a study under normal clinical practice conditions

Introducción. Los glucómetros demuestran habitualmente una gran exactitud, y en la práctica, la glucemia capilar y la glucemia plasmática (GP) son utilizadas indistintamente. Sin embargo, numerosas variables pueden afectar la validez de estos aparatos. El objetivo de este estudio fue conocer la exactitud y la concordancia de 3 glucómetros utilizados en las consultas de un EAP. Material y métodos. De 59 participantes se obtuvieron una muestra de sangre venosa y una gota de sangre capilar, que fue analizada en 3 glucómetros: 2 FreeStyle® Optium (OP1 y OP2) y un Accu-Chek® Aviva. El valor de referencia fue la GP y fueron analizados asimismo el hematocrito y los niveles plasmáticos de urea, bilirrubina, ácido úrico y triglicéridos. Se utilizaron la regresión de Passing-Bablok para la exactitud, y el coeficiente de correlación intraclase y el método Bland-Altman para la concordancia. Se ha considerado el estándar actual (American Diabetes Association) de un error tolerado de±5%. Resultados. La diferencia de medias±desviación estándar (mg/dL) y el error sistemático fueron: 5,8±7 y 5,8% (OP1); 6,2±8 y 5,9% (OP2); 8,3±8 y 6,3% (Accu-Chek®). El par más concordante fue OP1/OP2, con un coeficiente de correlación intraclase=0,97, sesgo=−0,4mg/dL y una amplitud de los límites de acuerdo con el 95%=28,6mg/dL. Se observaron los mayores grados de exactitud y de concordancia en rangos glucémicos elevados (GP≥126mg/dL). Conclusiones. Aunque mostraron una diferencia de medias clínicamente aceptable respecto a la GP, los 3 glucómetros incumplieron el estándar actual de la American Diabetes Association. Es recomendable la realización periódica de controles de calidad de estos dispositivos (AU)

Introduction. The glucose meters usually show a high accuracy, and in clinical practice, capillary and plasma glucose (PG) are used interchangeably. However, many variables can affect the validity of these devices. The aim of this study was to determine the accuracy and reliability of 3 glucose meters that are currently used in a primary care centre. Material and methods. A sample of venous blood and a drop of capillary blood were obtained from 59 participants. The drop was analysed in 3 glucose meters: 2 FreeStyle® Optium (OP1 and OP2), and one Accu-Chek® Aviva. The PG acted as the reference value, and the haematocrit and plasma levels of urea, bilirubin, uric acid and triglycerides were also analysed. We used the Passing-Bablok regression for accuracy and the intraclass correlation coefficient and the Bland-Altman method for reliability. The current American Diabetes Association standard of a total error of±5% was applied. Results. Differences in mean±standard deviation (mg/dL) and the systematic error were 5.8±7 and 5.8% (OP1); 6.2±8 and 5.9% (OP2); 8.3±8 and 6.3% (Accu-Chek®). The OP1/OP2 pair showed the highest level of reliability, with an intraclass correlation coefficient=0.97, bias=−0.4mg/dL, and a width of the 95% limits of agreement of 28.6mg/dL. The highest levels of accuracy and reliability were observed in high glucose ranges (PG≥126mg/dL). Conclusions. Despite their clinically acceptable mean difference compared to the PG, the 3 glucose meters did not fulfill the current American Diabetes Association standard. The regular performance of quality control tests of these devices is recommended (AU)

[Accuracy and reliability between glucose meters: A study under normal clinical practice conditions]. / Exactitud y concordancia entre glucómetros: un estudio en condiciones habituales de práctica clínica.

INTRODUCTION: The glucose meters usually show a high accuracy, and in clinical practice, capillary and plasma glucose (PG) are used interchangeably. However, many variables can affect the validity of these devices. The aim of this study was to determine the accuracy and reliability of 3 glucose meters that are currently used in a primary care centre. MATERIAL AND METHODS: A sample of venous blood and a drop of capillary blood were obtained from 59 participants. The drop was analysed in 3 glucose meters: 2 FreeStyle® Optium (OP1 and OP2), and one Accu-Chek® Aviva. The PG acted as the reference value, and the haematocrit and plasma levels of urea, bilirubin, uric acid and triglycerides were also analysed. We used the Passing-Bablok regression for accuracy and the intraclass correlation coefficient and the Bland-Altman method for reliability. The current American Diabetes Association standard of a total error of±5% was applied. RESULTS: Differences in mean±standard deviation (mg/dL) and the systematic error were 5.8±7 and 5.8% (OP1); 6.2±8 and 5.9% (OP2); 8.3±8 and 6.3% (Accu-Chek®). The OP1/OP2 pair showed the highest level of reliability, with an intraclass correlation coefficient=0.97, bias=-0.4mg/dL, and a width of the 95% limits of agreement of 28.6mg/dL. The highest levels of accuracy and reliability were observed in high glucose ranges (PG≥126mg/dL). CONCLUSIONS: Despite their clinically acceptable mean difference compared to the PG, the 3 glucose meters did not fulfill the current American Diabetes Association standard. The regular performance of quality control tests of these devices is recommended.

Quenched Magnon excitations by oxygen sublattice reconstruction in (SrCuO2)n/(SrTiO3)2 superlattices.

The recently discovered structural reconstruction in the cuprate superlattice (SrCuO2)n/(SrTiO3)2 has been investigated across the critical value of n = 5 using resonant inelastic x-ray scattering (RIXS). We find that at the critical value of n, the cuprate layer remains largely in the bulk-like two-dimensional structure with a minority of Cu plaquettes being reconstructed. The partial reconstruction leads to quenching of the magnons starting at the Γ-point due to the minority plaquettes acting as scattering points. Although comparable in relative abundance, the doped charge impurities in electron-doped cuprate superconductors do not show this quenching of magnetic excitations.

Fiabilidad en la evaluación radiológica de la calcificación aórtica abdominal mediante la escala de 24 puntos / Reliability of radiologic evaluation of abdominal aortic calcification using the 24-point scale

Objetivo. La calcificación de la aorta abdominal se asocia a un incremento en el riesgo de morbilidad cardiovascular, y disponer de un método de cuantificación de la misma es clínicamente trascendente. La escala de 24 puntos (AAC-24) es el método estándar para su evaluación en la radiología simple lateral de columna lumbar. El objetivo del estudio ha sido conocer el nivel de acuerdo intra e interobservador que aporta esta escala, teniendo en cuenta la heterogeneidad de la distribución de las calcificaciones en el diseño del análisis estadístico. Material y métodos. Se analizó la concordancia intraobservador (sobre radiografías de 81 pacientes, con una separación de 4 años) y la concordancia interobservador (sobre radiografías de 100 pacientes, con tres evaluadores), utilizando simultáneamente la correlación intraclase y el método gráfico de Bland-Altman. Resultados. El coeficiente de correlación intraclase fue de 0,93 (intervalo de confianza al 95% [IC95%]: 0,6-0,9) y 0,91 (IC95%: 0,8-0,9), intra e interobservador, respectivamente, con un incremento del coeficiente en el tercil de mayor discrepancia. La diferencia de medias osciló entre 0,3 y-1,2 puntos. La amplitud entre los límites de acuerdo, entre 4,7 y 9,4 puntos. Se observó un aumento significativo de las diferencias en relación con el aumento progresivo de la calcificación. Conclusiones. La valoración de la calcificación de la aorta abdominal en radiología simple lateral de columna lumbar mediante la escala AAC-24 es un método fiable y reproducible, observándose un mayor grado de concordancia intra e interobservador en las fases iniciales de la calcificación (AU)

Objective. Calcification of the abdominal aorta is associated with increased cardiovascular morbidity, so a reliable method to quantify it is clinically transcendent. The 24-point scale (AAC-24) is the standard method for assessing abdominal aortic calcification on lateral plain films of the lumbar spine. The aim of this study was to determine the intraobserver and interobserver agreements for the AAC-24, taking into account the heterogeneity of the distribution of the calcifications in the design of the statistical analysis. Material and methods. We analyzed the intraobserver agreement (in plain films from 81 patients, with a four-year separation between observations) and the interobserver agreement (in plain films from 100 patients, with three observers), using both intraclass correlation and Bland-Altman plots. Results. The intraobserver intraclass correlation coefficient was 0.93 (95% confidence interval [CI95%]: 0.6-0.9), and the interobserver intraclass correlation coefficient was 0.91 (CI95%: 0.8-0.9) with an increase in the coefficient in the tercile with the greatest discrepancy. The difference in means ranged from 0.3 to 1.2 points, and the distance between the limits of agreement ranged from 4.7 to 9.4 points. These differences increased significantly as the calcification progressed. Conclusions. Using the AAC-24 on lateral plain films of the lumbar spine is a reliable and reproducible method of assessing calcification of the abdominal aorta; both intraobserver and interobserver agreement are higher during the initial phases of calcification (AU)

Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults.

UNLABELLED: Vitamin D insufficiency is very common among Spanish community-dwelling adult subjects. A threshold of serum 25(OH)D around 30 ng/ml would be necessary for the prevention of secondary hyperparathyroidism and hip bone loss in our population, regardless of the dairy calcium ingestion. INTRODUCTION: This study aims to assess 25-hydroxyvitamin D-25(OH)D-status in Spanish adult subjects and to analyze its relationships with serum PTH levels, calcium intake, and bone mineral density (BMD). METHODS: A total of 1811 individuals (1154 postmenopausal women and 657 men) aged 44-93 years participated in the study. Serum 25(OH)D, intact parathyroid hormone (PTH), aminoterminal propeptide of type I collagen (P1NP), and C-terminal telopeptide of type I collagen (ß-CTX) levels were measured by electrochemiluminescence. BMD was determined by dual x-ray absorptiometry (DXA) at lumbar spine, femoral neck, and total hip. RESULTS: Serum 25(OH)D levels were below 10, 20, and 30 ng/ml in 5, 40, and 83 % of participants, respectively. There was a significant seasonal difference in mean serum 25(OH)D, with higher levels in summer-autumn. In multivariate analysis, 25(OH)D levels were negatively correlated with age, serum PTH and creatinine, body mass index, smoking, alcohol intake, and a number of chronic diseases, but positively with dairy calcium intake. The magnitude of the difference in serum PTH according to 25(OH)D quartiles was not influenced by calcium intake. A threshold of serum 25(OH)D around 30 ng/ml was observed for serum PTH and hip BMD. CONCLUSIONS: Vitamin D insufficiency is very common among Spanish community-dwelling adult subjects. A threshold of serum 25(OH)D around 30 ng/ml would be necessary for the prevention of secondary hyperparathyroidism and hip bone loss in our population, regardless of the dairy calcium ingestion. Programs to improve vitamin D status may be required in our country.

Reliability of radiologic evaluation of abdominal aortic calcification using the 24-point scale.

OBJECTIVE: Calcification of the abdominal aorta is associated with increased cardiovascular morbidity, so a reliable method to quantify it is clinically transcendent. The 24-point scale (AAC-24) is the standard method for assessing abdominal aortic calcification on lateral plain films of the lumbar spine. The aim of this study was to determine the intraobserver and interobserver agreements for the AAC-24, taking into account the heterogeneity of the distribution of the calcifications in the design of the statistical analysis. MATERIAL AND METHODS: We analyzed the intraobserver agreement (in plain films from 81 patients, with a four-year separation between observations) and the interobserver agreement (in plain films from 100 patients, with three observers), using both intraclass correlation and Bland-Altman plots. RESULTS: The intraobserver intraclass correlation coefficient was 0.93 (95% confidence interval [CI95%]: 0.6-0.9), and the interobserver intraclass correlation coefficient was 0.91 (CI95%: 0.8-0.9) with an increase in the coefficient in the tercile with the greatest discrepancy. The difference in means ranged from 0.3 to 1.2 points, and the distance between the limits of agreement ranged from 4.7 to 9.4 points. These differences increased significantly as the calcification progressed. CONCLUSIONS: Using the AAC-24 on lateral plain films of the lumbar spine is a reliable and reproducible method of assessing calcification of the abdominal aorta; both intraobserver and interobserver agreement are higher during the initial phases of calcification.

Hypoglycaemic episodes in patients with type 2 diabetes--risk factors and associations with patient-reported outcomes: The PANORAMA Study.

AIM: To explore the frequency of hypoglycaemic episodes, their risk factors, and associations with patient-reported outcomes in patients with type 2 diabetes enrolled in the PANORAMA cross-sectional study. METHODS: Five thousand seven hundred and eighty-three patients aged ≥ 40 years with type 2 diabetes duration ≥ 1 year were recruited in nine European countries. Patients reported severe and non-severe hypoglycaemic episodes during the past year at a single study visit. Patient-reported outcomes were measured by the Audit of Diabetes-Dependent Quality of Life, Diabetes Treatment Satisfaction Questionnaires, Hypoglycaemia Fear Survey-II, and EQ-5D Visual Analog Scale. RESULTS: During the previous year, 4.4% of the patients experienced ≥ 1 severe hypoglycaemic episode; among those without severe hypoglycaemia, 15.7% experienced ≥ 1 non-severe episode. Patients experiencing any hypoglycaemic episode reported a greater negative impact of diabetes on quality of life, greater fear of hypoglycaemia, less treatment satisfaction and worse health status than those with no episodes. In multivariate analyses hypoglycaemia was significantly associated with longer diabetes duration; presence of microvascular and, to a lesser extent, macrovascular complications; treatment with insulin, glinides or sulfonylureas; and use of self-monitoring blood glucose. CONCLUSION: In patients with type 2 diabetes, severe hypoglycaemic episodes were not uncommon and one in five experienced some form of hypoglycaemia during the previous year. Hypoglycaemia was associated with more negative patient-reported outcomes. The risk of hypoglycaemia increased with diabetes duration, presence of diabetes-related complications, use of self-monitoring blood glucose, insulin secretagogues, and insulin treatment.

Prevalencia y factores asociados a la adherencia al tratamiento no farmacológico en pacientes con hipertensión y diabetes en servicios de baja complejidad / Prevalence and factors associated with adherence to non-pharmacological treatment of hypertensive and diabetic patients at low complexity services / Prevalência e fatores associados à aderência ao tratamento não-farmacológico em pacientes com hipertensão e diabete em serviços de baixa complexidade

OBJETIVO: determinar la prevalencia y los factores relacionados con la adherencia no farmacológica en pacientes con hipertensión arterial (HTA) y diabetes mellitus (DM). METODOLOGIA: estudio observacional transversal en pacientes adultos mayores de 35 años con diagnóstico de HTA o DM, atendidos en un programa de Renoprotección en cuidado primario en Cali, Colombia. Se excluyeron aquellos pacientes con enfermedad renal crónica en estadío KDOQI 4-5, los que presentaran comorbilidades adicionales que deterioraran la función renal o con trastornos neuropsiquiátricos diagnosticados previamente. La adherencia no farmacológica se determinó mediante un cuestionario de autoreporte y los factores asociados a la misma se determinaron mediante regresión de Poisson con varianza robusta. RESULTADOS : la prevalencia de la adherencia no farmacológica fue de 9,4%. La inactividad física estuvo presente en 75% de los pacientes, y más del 19% de la población consumía sal frecuentemente. Entre los diabéticos, 18% consumía carbohidratos con frecuencia. Los hombres mostraron ser menos adherentes que las mujeres (RP: 0,21; p = 0,002). Los factores asociados positivamente con la adherencia no farmacológica fueron: estar estudiando, desempleado o pensionado (RP: 4,42; p = 0,019), recibir apoyo del equipo de salud (RP: 3,17; p = 0,032), tener diagnóstico de diabetes (RP: 7,79; p = 0,000) y la función renal en KDOQI-3 (RP: 5,14; p = 0,008). CONCLUSION: la adherencia no farmacológica fue muy baja en la población de estudio, en particular en relación con la inactividad física. Los factores asociados positivamente a la adherencia fueron el sexo femenino, tener una ocupación diferente al hogar, diagnostico de diabetes, enfermedad renal en KDOQI-3 y contar con apoyo del equipo de salud.

OBJECTIVE: To determine the prevalence and factors associated with adherence to non-pharmacological treatment in patients with high blood pressure (HBP) and diabetes mellitus (DM). METHODOLOGY: A cross-sectional and observational study conducted with adult patients older than 35, diagnosed with HBP or DM and receiving health care in a primary care renal protection program in Cali, Colombia. Patients with chronic kidney disease at the KDOQI 4-5 stage, additional comorbidities which impair the renal function or with previously diagnosed neuropsychiatric disorders were excluded. Adherence to non-pharmacological treatment was determined using a self-report questionnaire. Factors associated with adherence were obtained through a Poisson regression with robust variance. RESULTS : The prevalence of patient adherence was 9.4%.Physical inactivity was present in 75% of the patients and 19% of the population often consumed salt. Among the diabetics, 18% often consumed carbohydrates. Men showed less adherence than women (RP: 0.21; p = 0.002). Factors positively associated with adherence to non-pharmacological treatment were: being a student, unemployed or retired(RP: 4.42; p = 0.019), getting help from the health care team (RP: 3.17; p = 0.032), being diagnosed with diabetes (RP: 7.79; p = 0.000) and having the renal function in the KDOQI-3 stage (RP: 5.14; p = 0.008). CONCLUSION: Adherence to non-pharmacological treatment was very low in the studied population, particularly in relation to physical inactivity. The factors positively associated with treatment adherence were being female, not being a housewife, having diabetes, having a renal disease at the KDOQI-3 stage and having the support of a health care team.

OBJETIVO: Determinar a prevalência e os fatores ligados à aderência não-farmacológica em pacientes com hipertensão arterial (HTA) e diabetes mellitus (DM). METODOLOGIA: Estudo observacional transversal em pacientes adultos maiores de 35 anos com diagnóstico de HTA ou DM, atendidos em um programa de Renoproteção em cuidado primário em Cali, Colômbia.Foram excluídos aqueles pacientes com doença renal crônica em etapa KSOQI 4-5, aqueles com comorbilidades adicionais que deterioram a função renal ou com transtornos neuropsiquiátricos diagnosticados previamente.A aderência não farmacológica foi determinada por meio de um questionário de auto-relato e os fatores associados a ela foram determinados por meio de regressão de poisson com variância robusta. RESULTADOS: A prevalência da aderência não farmacológica foi de 9.4%.A inatividade física esteve presente em 75% dos pacientes e mais de 19% da população consumia sal frequentemente.Entre os diabéticos 18% consumia frequentemente carboidratos. Os homens mostraram ser menos aderentes do que as mulheres (RP: 0,21; p = 0,002). Os fatores associados positivamente à aderência não farmacológica foram os fatos de estarem estudando, desempregados ou aposentados(RP: 4,42; p = 0,019), receber apoio da equipe de saúde (RP: 3,17; p = 0,032), ter diagnóstico de diabetes (RP: 7,79; p = 0,000) e a função renal em KDOQI-3 (RP: 5,14; p = 0,008). CONCLUSÃO: Aderência não farmacológica foi muito baixa na população analisada, em particular em relação com a atividade física.Os fatores associados positivamente à aderência foram o gênero feminino, ter uma ocupação diferente do lar, diagnóstico de diabetes, doença renal em KDOQI-3 e contar com apoio da equipe de saúde.