Validation of the IberScore model in a primary care population.

BACKGROUND: This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting. METHODS: A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected. Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model. RESULTS: A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age. The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84-0.88) in men and 0.82 (95% CI 0.79-0.85) in women. CONCLUSION: IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.

Prevalence of familial hypercholesterolemia phenotype and ten-year risk of cardiovascular events in a working population in primary prevention: The ICARIA study.

BACKGROUND AND AIMS: We aimed to assess the prevalence of familial hypercholesterolaemia (FH) and to determine the incidence of cardiovascular events during a 10-year follow up in individuals with FH, compared to unaffected individuals in a working, middle-aged/young population. METHODS AND RESULTS: 576,724 active workers (36 ± 10 years-old, 70% men) without cardiovascular disease were given regular health check-ups and followed for a median of 8.5 years (i.e., 4,123,927 person-years). The FH phenotype was defined according to validated low-density lipoprotein-cholesterol thresholds, adjusted for age and sex. The primary outcome was a first cardiovascular event, whether fatal or non-fatal. We found that 707 workers (0.12% or 1 in 816 individuals) met the criteria for a heterozygous FH phenotype. During the follow-up, cardiovascular events occurred in 23 of 707 (3.25%) subjects with the FH phenotype and in 3297 of 576,017 (0.57%) subjects without the FH phenotype (p<0.001). The hazard ratio (HR, assessed with a Cox regression model) for the primary outcome was 5.7 (99% CI 3.33-9.78), before adjustments, and 4.7 (99% CI 2.62-8.58) after adjusting for sex, age, smoking, blood pressure, and diabetes. The HRs were significant for both men and women, but the magnitude of the effect was greater for men than for women. CONCLUSIONS: Our findings confirmed the high incidence of cardiovascular disease in individuals with untreated FH. We showed that regular health check-ups in an active, and mostly young, working population could contribute to the early identification of FH. Therefore, this approach may provide an opportunity for early treatment.

Prediction of fatal and non-fatal cardiovascular events in young and middle-aged healthy workers: The IberScore model.

AIMS: Our primary objective was to improve risk assessment for fatal and non-fatal cardiovascular events in a working population, mostly young and healthy. METHODS: We conducted a prospective cohort study to derive a survival model to predict fatal and non-fatal 10-year cardiovascular risk. We recruited 992,523 workers, free of diagnosed cardiovascular disease at entry, over six years, from 2004-2009. We divided the sample into two independent cohorts: a derivation one (626,515 workers; from 2004-2006) and a temporal validation one (366,008 workers; over 2007-2009). Then, we followed both cohorts over 10 years and registered all fatal and non-fatal cardiovascular events. We built a new risk calculator using an estimation of cardiovascular biological age as a predictor and named it IberScore. There were remarkable differences between this new model and Systematic Coronary Risk Evaluation (SCORE) (in both the specification and the equation). RESULTS: Over the 10-year follow-up, we found 3762 first cardiovascular events (6‰) in the derivation cohort. Most of them (80.3%) were non-fatal ischaemic events. If we had been able to use our model at the beginning of the study, we had classified in the 'high-risk' or 'very high-risk' groups 82% of those who suffered a cardiovascular event during the follow-up. All the post-estimation tests showed superior performance (true positive rate: 81.8% vs 11.8%), higher discrimination power and better clinical utility (standardised net benefit: 58% vs 13%) for IberScore when compared to SCORE. CONCLUSION: Risk assessment of fatal and non-fatal cardiovascular events in young and healthy workers was improved when compared to the previously used model (SCORE). The latter was not reliable to predict cardiovascular risk in our sample. The new model showed superior clinical utility and provided four useful measures for risk assessment. We gained valuable insight into cardiovascular ageing and its predictors.

Double-checking emotions: Valence and emotion category in contextual integration of facial expressions of emotion.

Faces showing happy, angry or fearful expressions were presented in emotionally congruent or incongruent situational contexts (short sentences describing events that would usually provoke happiness, anger or fear). The participants were assigned the task of judging whether the expression was appropriate or not to the context (congruency judgment task). Effects of emotional congruency were observed at both the behavioral and electrophysiological levels. Behavioral results showed evidence of congruency effects based on specific emotion content (e.g., less accurate and slower responses to fear faces in angry contexts). Event-related-potentials (ERP) results also showed emotional congruency effects at different post-stimulus onset latencies, beginning with the face-sensitive N170 component. An effect of emotional congruency was also shown on the N400 component that is typically sensitive to semantic congruency. Finally, a late positive potential (LPP), appearing at 450-650 ms post-stimulus onset showed a complex pattern of effects with modulations driven by the different combinations of contexts and target expressions. These results are interpreted in terms of a double process of valence and emotion checking that is supposed to underlie affective processing and contextual integration of facial expressions of emotions.

Estimación del riesgo cardiovascular de por vida (IBERLIFERISK): una herramienta nueva en prevención primaria de las enfermedades cardiovasculares / Estimation of lifetime risk of cardiovascular disease (IBERLIFERISK): a new tool for cardiovascular disease prevention in primary care

Introducción y objetivos: Desarrollar una función predictiva del riesgo cardiovascular de por vida de eventos cardiovasculares, mortales y no mortales en población laboral española. Métodos: Estudio de cohortes retrospectivo. Se seleccionó a trabajadores de entre 18 y 65 años sin antecedentes de enfermedad cardiovascular que realizaron un examen de salud entre los años 2004 y 2007. El 70% de la cohorte se utilizó para desarrollar la ecuación de riesgo y el 30%, para validar la ecuación. Se construyeron 4 modelos de riesgos proporcionales de Cox en los que se utilizaron como variables dependientes la aparición de eventos cardiovasculares y la aparición de eventos competitivos; se usaron los mismos modelos en varones y mujeres. Los eventos mortales y no mortales se evaluaron hasta el año 2014. Resultados: Se incluyó a 762.054 sujetos, con una media de edad de 35,48 años (el 71,14% varones). Resultaron factores significativos en el modelo la ocupación manual, el tabaquismo, la diabetes mellitus, el tratamiento antihipertensivo, la presión arterial sistólica, el colesterol total, el colesterol unido a lipoproteínas de alta densidad y el tratamiento hipolipemiante; en varones, el consumo de alcohol, el índice de masa corporal, los antecedentes de enfermedad coronaria precoz en familiares de primer grado, la enfermedad renal y la presión arterial diastólica. El área bajo la curva c fue 0,84 (IC95%, 0,82-0,85) en varones y 0,73 (IC95%, 0,66-0,80) en mujeres. La calibración mostró una subestimación en los deciles de bajo riesgo y sobrestimación en los de alto riesgo. Conclusiones: El modelo de riesgo cardiovascular de por vida tiene una discriminación y una calibración satisfactorias, con mejores resultados para varones que para mujeres

Introduction and objectives: To develop a predictive function of lifetime cardiovascular risk, including morbidity and mortality, in a healthy working population in Spain. Methods: Retrospective cohort study. We selected healthy workers, aged 18 to 65 years, with no history of cardiovascular disease, who underwent a health assessment between 2004 and 2007. We used 70% of the cohort to develop the risk equation, and the remaining 30% to validate the equation. Four Cox proportional hazards models were constructed using cardiovascular events and competing events as dependent variables. The same models were replicated for men and women separately. Fatal and nonfatal events were assessed until 2014. Results: A total of 762 054 individuals were selected. The mean age was 35.48 years and 71.14% were men. Significant risk variables in the model included manual occupations, being a smoker or exsmoker, diabetes mellitus, antihypertensive treatment, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and lipid-lowering treatment; in men, the model also included alcohol consumption, body mass index, a family history of early coronary disease in first-degree relatives, renal failure, and diastolic blood pressure. The area under the curve receiver operating characteristic was 0.84 (95%CI, 0.82-0.85) in men and 0.73 (95%CI, 0.66-0.80) in women. Calibration showed underestimation in low-risk deciles and overestimation in high-risk deciles. Conclusions: The new lifetime cardiovascular risk model has satisfactory discrimination and calibration, with better results in men than in women

Joint Modulation of Facial Expression Processing by Contextual Congruency and Task Demands.

Faces showing expressions of happiness or anger were presented together with sentences that described happiness-inducing or anger-inducing situations. Two main variables were manipulated: (i) congruency between contexts and expressions (congruent/incongruent) and (ii) the task assigned to the participant, discriminating the emotion shown by the target face (emotion task) or judging whether the expression shown by the face was congruent or not with the context (congruency task). Behavioral and electrophysiological results (event-related potentials (ERP)) showed that processing facial expressions was jointly influenced by congruency and task demands. ERP results revealed task effects at frontal sites, with larger positive amplitudes between 250-450 ms in the congruency task, reflecting the higher cognitive effort required by this task. Effects of congruency appeared at latencies and locations corresponding to the early posterior negativity (EPN) and late positive potential (LPP) components that have previously been found to be sensitive to emotion and affective congruency. The magnitude and spatial distribution of the congruency effects varied depending on the task and the target expression. These results are discussed in terms of the modulatory role of context on facial expression processing and the different mechanisms underlying the processing of expressions of positive and negative emotions.

Estimation of Lifetime Risk of Cardiovascular Disease (IBERLIFERISK): A New Tool for Cardiovascular Disease Prevention in Primary Care.

INTRODUCTION AND OBJECTIVES: To develop a predictive function of lifetime cardiovascular risk, including morbidity and mortality, in a healthy working population in Spain. METHODS: Retrospective cohort study. We selected healthy workers, aged 18 to 65 years, with no history of cardiovascular disease, who underwent a health assessment between 2004 and 2007. We used 70% of the cohort to develop the risk equation, and the remaining 30% to validate the equation. Four Cox proportional hazards models were constructed using cardiovascular events and competing events as dependent variables. The same models were replicated for men and women separately. Fatal and nonfatal events were assessed until 2014. RESULTS: A total of 762 054 individuals were selected. The mean age was 35.48 years and 71.14% were men. Significant risk variables in the model included manual occupations, being a smoker or exsmoker, diabetes mellitus, antihypertensive treatment, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, and lipid-lowering treatment; in men, the model also included alcohol consumption, body mass index, a family history of early coronary disease in first-degree relatives, renal failure, and diastolic blood pressure. The area under the curve receiver operating characteristic was 0.84 (95%CI, 0.82-0.85) in men and 0.73 (95%CI, 0.66-0.80) in women. Calibration showed underestimation in low-risk deciles and overestimation in high-risk deciles. CONCLUSIONS: The new lifetime cardiovascular risk model has satisfactory discrimination and calibration, with better results in men than in women.

Influence of emotional contexts on facial emotion attribution in schizophrenia.

Recent emotion recognition studies in schizophrenia have reported misattribution of emotional content to emotionally neutral faces. While in these studies faces are presented in the absence of any contextual reference, in daily life facial expressions are typically perceived within a specific situational context. However, there is no evidence on the possible modulatory role of contextual aids on emotion attribution to neutral faces. We address this issue in the present study. Thirty schizophrenia patients and thirty paired controls performed an emotion categorization task (by choosing one among six labels of emotions) with neutral target faces that were superimposed on affectively positive, negative or neutral scenes. In presence of positive contexts, patients categorized neutral faces as happy and fearful more frequently than controls. When negative contexts were present, patients also categorized neutral faces as fearful more frequently than controls. However, in the presence of neutral contexts patients and controls did not differ in their categorization pattern. These results suggest that explicit presence of a neutral context seems to compensate for the bias showed by patients. With the purpose of correcting emotion misattribution in schizophrenia, emotionally neutral contexts might be incorporated to treatments aimed at improving social cognition performance in this patient population.

Socioeconomic context of the community and chronic child malnutrition in Colombia.

OBJECTIVE: To analyze the influence of the socioeconomic context of the community on chronic child malnutrition in Colombia. METHODS: We estimated multilevel logistic models using data from the National Demographic and Health Survey in Colombia in 2010. The final sample included 11,448 children under the age of five gathered in 3,528 communities. In addition, we used the Principal Component Analysis with polychoric correlations for the construction of composed indicators of wealth, autonomy of the woman, and the use and access to the health system. RESULTS: The average level of community wealth was significantly and independently associated with chronic malnutrition in early childhood, more than the socioeconomic status of the household itself. At the individual and household level, the probability of chronic malnutrition was higher for children from mothers with low levels of autonomy and use and access to the health system, mothers who had their first child in adolescence, and mothers who live in homes in the lowest wealth quintiles. In contrast, children from mothers with a body mass index > 25 and with at least secondary education (versus no education) were less likely to suffer from chronic malnutrition. CONCLUSIONS: Research, programs, and interventions need to take into account the physical, economic, and social context of communities to contribute with the improvement of the nutritional status of early childhood in Colombia.

Effects of affective and emotional congruency on facial expression processing under different task demands.

Contextual influences on responses to facial expressions of emotion were studied using a context-target paradigm that allowed distinguishing the effects of affective congruency (context and target of same/different valence: positive or negative) and emotional congruency (context and target representing the same/different emotion: anger, fear, happiness). Sentences describing anger, fear or happiness-inducing events and faces expressing each of these emotions were used as contexts and targets, respectively. While between-valence comparisons (context and target of similar/different valence) revealed affective congruency effects, within-valence comparisons (context and target of similar valence and same/different emotion) revealed emotional congruency effects. In Experiment 1 no evidence of emotional congruency and limited evidence of affective congruency were found with an evaluative task. In Experiment 2 effects of both affective and emotional congruency were observed with an emotion recognition task. In this case, angry and fearful faces were recognized faster in emotionally congruent contexts. In Experiment 3 the participants were asked explicitly to judge the emotional congruency of the target faces. Emotional congruency effects were again found, with faster judgments of angry and fearful faces in the corresponding emotional contexts. Moreover, judgments of angry expressions were faster and more accurate in happy than in anger contexts. Thus, participants found easier to decide that angry faces did not match a happy context than to judge that they did match an anger context. These results suggest that there are differences in the way that facial expressions of positive and negative emotions are discriminated and integrated with their contexts. Specifically, compared to positive expressions, contextual integration of negative expressions seems to require a double check of the valence and the specific emotion category of the expression and the context.

Comparative myology of the ankle of Leopardus wiedii and L. geoffroyi (Carnivora: Felidae): functional consistency with osteology, locomotor habits and hunting in captivity.

Leopardus wiedii (margay) is the only arboreal Neotropical felid able to climb head-first down trees, due to its ability to rotate its tarsal joint 180°. A closely related, similar-sized species, L. geoffroyi (Geoffroy's cat) exhibits more typical terrestrial habits and lacks the arboreal capabilities of L. wiedii. There is osteological evidence that supports a mechanical specialization of L. wiedii's tarsal joint for inversion, but there have been no studies on the myology of this specialization. Based on comparative gross-anatomy dissections of zeugo- and autopodial muscles related to the ankle joint of one margay specimen and two Geoffroýs cats, we identified myological specializations of L. wiedii that support its arboreal abilities. In addition, we documented both species hunting the same prey (domestic pigeon Columba livia, Aves: Columbidae) in captivity, to complement. We report differences in the origin, insertion and belly in 8 of the 10 dissected muscles. At least 3 of these interspecific variations can be associated with strengthening of the main muscles that command inversion/eversion movements of the tarsal joint and support the body weight in the head-down climbing position typical of L. wiedii. Frame-by-frame video reconstructions depict the sequence of movements in these species while hunting and highlight the advantages of the arboreal abilities of L. wiedii.

Socioeconomic context of the community and chronic child malnutrition in Colombia / Contexto socioeconómico de la comunidad y desnutrición crónica infantil en Colombia

ABSTRACT OBJECTIVE To analyze the influence of the socioeconomic context of the community on chronic child malnutrition in Colombia. METHODS We estimated multilevel logistic models using data from the National Demographic and Health Survey in Colombia in 2010. The final sample included 11,448 children under the age of five gathered in 3,528 communities. In addition, we used the Principal Component Analysis with polychoric correlations for the construction of composed indicators of wealth, autonomy of the woman, and the use and access to the health system. RESULTS The average level of community wealth was significantly and independently associated with chronic malnutrition in early childhood, more than the socioeconomic status of the household itself. At the individual and household level, the probability of chronic malnutrition was higher for children from mothers with low levels of autonomy and use and access to the health system, mothers who had their first child in adolescence, and mothers who live in homes in the lowest wealth quintiles. In contrast, children from mothers with a body mass index > 25 and with at least secondary education (versus no education) were less likely to suffer from chronic malnutrition. CONCLUSIONS Research, programs, and interventions need to take into account the physical, economic, and social context of communities to contribute with the improvement of the nutritional status of early childhood in Colombia.

RESUMEN OBJETIVO Analizar la influencia del contexto socioeconómico de la comunidad sobre la desnutrición infantil crónica en Colombia. MÉTODOS Utilizando datos de la Encuesta Nacional de Demografía y Salud en Colombia en 2010, se estimaron modelos logísticos multinivel. La muestra final incluyó 11.448 niños menores de cinco años anidados en 3.528 comunidades. Además, se utilizó el Análisis de Componentes Principales usando correlaciones policóricas para la construcción de indicadores compuestos de riqueza, autonomía de la mujer y el uso y acceso al sistema de salud. RESULTADOS El nivel de riqueza promedio de la comunidad resultó significativa e independientemente asociado con la desnutrición crónica en la primera infancia, por encima y más allá del propio estatus socioeconómico del hogar. A nivel individual y del hogar, la probabilidad de desnutrición crónica fue mayor para niños de madres con bajos niveles de autonomía y uso y acceso al sistema de salud, que han tenido su primer hijo en la adolescencia y que viven en hogares en los quintiles más bajos de riqueza. En contraste, niños de madres con un índice de masa corporal > 25 y con al menos educación secundaria (versus sin educación) tuvieron menor probabilidad de padecer desnutrición crónica. CONCLUSIONES Investigaciones, programas e intervenciones que tengan en cuenta el contexto físico, económico y social de las comunidades son necesarias para contribuir a mejorar el estado nutricional de la primera infancia en Colombia.

Discrimination of face gender and expression under dual-task conditions.

In order to test whether expression and gender can be attended to simultaneously without a cost in accuracy four experiments were carried out using a dual gender-expression task with male and female faces showing different emotional expressions that were backward masked by emotionally neutral faces. In the dual-facial condition the participants had to report both the gender and the expression of the targets. In two control conditions the participant reported either the gender or the expression of the face and indicated whether a surrounding frame was continuous or discontinuous. In Experiments 1-3, with angry and happy targets, asymmetric interference was observed. Gender discrimination, but no expression discrimination, was impaired in the dual-facial condition compared to the corresponding control. This effect was obtained with a between-subjects design in Experiment 1, with a within-subjects design in Experiment 2, and with androgynous face masks in Experiment 3. In Experiments 4a and 4b different target combinations were tested. No decrement of performance in the dual-facial task was observed for either gender or expression discrimination with fearful-disgusted (Experiment 4a) or fearful-happy faces (Experiment 4b). We conclude that the ability to attend simultaneously to gender and expression cues without a decrement in performance depends on the specific combination of expressions to be differentiated between. Happy and angry expressions are usually directed at the perceiver and command preferential attention. Under conditions of restricted viewing such as those of the present study, discrimination of these expressions is prioritized leading to impaired discrimination of other facial properties such as gender.

Facial affect recognition in early and late-stage schizophrenia patients.

Prior studies have shown deficits in social cognition and emotion perception in first-episode psychosis (FEP) and multi-episode schizophrenia (MES) patients. These studies compared patients at different stages of the illness with only a single control group which differed in age from at least one clinical group. The present study provides new evidence of a differential pattern of deficit in facial affect recognition in FEP and MES patients using a double age-matched control design. Compared to their controls, FEP patients only showed impaired recognition of fearful faces (p=.007). In contrast to this, the MES patients showed a more generalized deficit compared to their age-matched controls, with impaired recognition of angry, sad and fearful faces (ps<.01) and an increased misattribution of emotional meaning to neutral faces. PANSS scores of FEP patients on Depressed factor correlated positively with the accuracy to recognize fearful expressions (r=.473). For the MES group fear recognition correlated positively with negative PANSS factor (r=.498) and recognition of sad and neutral expressions was inversely correlated with disorganized PANSS factor (r=-.461 and r=-.541, respectively). These results provide evidence that a generalized impairment of affect recognition is observed in advanced-stage patients and is not characteristic of the early stages of schizophrenia. Moreover, the finding that anomalous attribution of emotional meaning to neutral faces is observed only in MES patients suggests that an increased attribution of salience to social stimuli is a characteristic of social cognition in advanced stages of the disorder.

Comparison of application of different methods to estimate lifetime cardiovascular risk.

BACKGROUND: Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain. DESIGN: National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests. METHODS: Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK. RESULTS: Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk. CONCLUSIONS: Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.

Judging emotional congruency: Explicit attention to situational context modulates processing of facial expressions of emotion.

The influence of explicit evaluative processes on the contextual integration of facial expressions of emotion was studied in a procedure that required the participants to judge the congruency of happy and angry faces with preceding sentences describing emotion-inducing situations. Judgments were faster on congruent trials in the case of happy faces and on incongruent trials in the case of angry faces. At the electrophysiological level, a congruency effect was observed in the face-sensitive N170 component that showed larger amplitudes on incongruent trials. An interactive effect of congruency and emotion appeared on the LPP (late positive potential), with larger amplitudes in response to happy faces that followed anger-inducing situations. These results show that the deliberate intention to judge the contextual congruency of facial expressions influences not only processes involved in affective evaluation such as those indexed by the LPP but also earlier processing stages that are involved in face perception.

Patterns of Emotion Attribution are Affected in Patients with Schizophrenia.

Deficits in facial affect recognition have been repeatedly reported in schizophrenia patients. The hypothesis that this deficit is caused by poorly differentiated cognitive representation of facial expressions was tested in this study. To this end, performance of patients with schizophrenia and controls was compared in a new emotion-rating task. This novel approach allowed the participants to rate each facial expression at different times in terms of different emotion labels. Results revealed that patients tended to give higher ratings to emotion labels that did not correspond to the portrayed emotion, especially in the case of negative facial expressions (p < .001, η 2 = .131). Although patients and controls gave similar ratings when the emotion label matched with the facial expression, patients gave higher ratings on trials with "incorrect" emotion labels (p s < .05). Comparison of patients and controls in a summary index of expressive ambiguity showed that patients perceived angry, fearful and happy faces as more emotionally ambiguous than did the controls (p < .001, η 2 = .135). These results are consistent with the idea that the cognitive representation of emotional expressions in schizophrenia is characterized by less clear boundaries and a less close correspondence between facial configurations and emotional states.

Patterns of emotion attribution are affected in patients with schizophrenia

Deficits in facial affect recognition have been repeatedly reported in schizophrenia patients. The hypothesis that this deficit is caused by poorly differentiated cognitive representation of facial expressions was tested in this study. To this end, performance of patients with schizophrenia and controls was compared in a new emotion-rating task. This novel approach allowed the participants to rate each facial expression at different times in terms of different emotion labels. Results revealed that patients tended to give higher ratings to emotion labels that did not correspond to the portrayed emotion, especially in the case of negative facial expressions (p < .001, η2 = .131). Although patients and controls gave similar ratings when the emotion label matched with the facial expression, patients gave higher ratings on trials with "incorrect" emotion labels (ps < .05). Comparison of patients and controls in a summary index of expressive ambiguity showed that patients perceived angry, fearful and happy faces as more emotionally ambiguous than did the controls (p < .001, η2 = .135). These results are consistent with the idea that the cognitive representation of emotional expressions in schizophrenia is characterized by less clear boundaries and a less close correspondence between facial configurations and emotional states (AU)

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Roturas dentales debidas a accidentes de trabajo en España / Dental fractures due to occupational accidents in Spain

OBJETIVOS: El objetivo de este estudio fue caracterizar las roturas dentales debidas a accidentes de trabajo. Material y MÉTODOS: Estudio observacional retrospectivo de 1.081 sujetos con roturas dentales de origen laboral pertenecientes a la población protegida de una mutua de accidentes de trabajo y enfermedades profesionales. Se seleccionaron todos los casos del periodo 2000-2010 con un diagnóstico único de rotura dental. Se realizaron análisis descriptivos y bivariados de las principales variables demográficas, laborales y clínicas. RESULTADOS: Las roturas dentales resultaron más frecuentes entre los hombres (9:1), en trabajadores menores de 40 años (74,2%) y con ocupaciones manuales (9:1). La causa más común fueron golpes al manipular piezas o herramientas durante la realización de una tarea manual (72,8%). Muchos de tales accidentes se produjeron con herramientas poco sofisticadas (llaves 18,9%; martillos 4%). Las causas de accidente variaron en función del sexo, edad y nivel ocupacional (p < 0,001). Entre los hombres, los trabajadores más jóvenes y con ocupaciones manuales, los accidentes durante la manipulación de piezas y herramientas u operaciones de carga y descarga fueron los más frecuentes. Entre las mujeres, trabajado res de mayor edad o con ocupaciones no manuales, la variedad de causas fue mayor. CONCLUSIONES: La mejora del entrenamiento en el uso de herramientas y de los equipos de protección individual, la formación acerca de los factores de riesgo y la inspección y mantenimiento de los equipos parecen ser aspectos esenciales para la prevención de este tipo de lesiones

OBJECTIVES: The aim of this study was to characterize dental fractures due to work accidents. MATERIAL AND METHODS: Observational retrospective study of 1,081 subjects with work-related dental fractures that were selected from the insured population of a Spanish Mutual Insurance Company for Accidents at Work and Professional Illnesses. All the cases from 2000 to 2010 with the only diagnosis of traumatic dental fracture were selected. Descriptive and bivariate analysis on demographic, work related and clinical variables were performed. RESULTS: Dental fractures were more frequent among males (9:1), younger than 40 years-old (74.2%) and blue-collar vs. white-collar workers (9:1). The most common cause of dental fractures in work-related accidents were bumps when manipulating components or tools (72.8%) and many of these events involved low-sophisticated tools (wrenches 18.9%; hammers 4%). Causes of the accidents significantly differed according to sex, age and occupational level (p < 0.001). Among men, younger and blue-collar workers, work accidents involving manipulation of components and tools and loading maneuvers accounted for the majority of the injuries. On the other hand, women, older and white-collar workers showed a greater variety of causes. CONCLUSIONS: Improved training on the use of tools and individual protective equipment, education on risk factors, and inspection and maintenance practices appear to be essential for prevention

Estimating the glomerular filtration rate in the Spanish working population: chronic kidney disease prevalence and its association with risk factors.

OBJECTIVE: This study aims to investigate the influence of estimated glomerular filtration rate (eGFR) with two equations (and by one or two separate measurements), on the prevalence of chronic kidney disease (CKD) and its association with blood pressure, and cardiovascular and metabolic risk factors. METHODS: Between January 2010 and October 2011, the Ibermutuamur CArdiovascular RIsk Assessment project included 128 588 workers (77.2% men, mean age 39.3 years, range 16-75), who underwent two consecutive yearly medical check-ups and had information for eGFR according to the MDRD-IDMS and CKD-EPI equations (serum creatinine was measured by a isotope-dilution mass spectrometry traceable method in a single central laboratory). CKD was defined by an eGFR less than 60 ml/min per 1.73 m. Subclinical (occult) renal disease was defined as an eGFR less than 60 ml/min per 1.73 m in patients with serum creatinine below 1.3 mg/dl and below 1.2 mg/dl in men and women, respectively. RESULTS: In this working population, prevalence of CKD was very low, but two to six times lower when two separate eGFRs below 60 ml/min per 1.73 m were used. The prevalence of CKD was significantly lower with the CKD-EPI compared to the MDRD-IDMS equation. The same applies to occult CKD. In male workers, occult CKD was practically nonexistent.Multivariate analyses show that blood pressure, total serum cholesterol, and serum glucose (positively), and high-density lipoprotein and low-density lipoprotein (negatively) were associated with CKD, with both equations. Another metabolic factor (waist circumference) was only associated (positively) with CKD defined by the CKD-EPI equation, which appears to be associated with most components of the metabolic syndrome. CONCLUSIONS: The CKD-EPI formula, calculated on the basis of two reported blood samples, may provide the most specific definition of CKD.