Predictors of damage accrual and its impact on health-related quality of life of thrombotic antiphospholipid syndrome: Independent validation of the damage index for antiphospholipid syndrome (DIAPS).

OBJECTIVES: We aim to independently assess the validity of the damage index for antiphospholipid syndrome (DIAPS) in thrombotic antiphospholipid syndrome (APS) patients by exploring the prevalence and risk factors of organ damage and evaluating its impact on health-related quality of life (HR-QoL). METHODS: Cross-sectional study including all thrombotic APS patients (Sydney criteria) attending a Portuguese tertiary centre. Damage was assessed using the DIAPS, and HR-QoL using the 3- and 5-level EuroQol HR-QoL (EQ-D5-3L and 5L), and Visual Analogue Scale (VAS) applied via a phone questionnaire. Spearman's correlation between DIAPS and the HR-QoL scales was performed. Risk factors for damage accrual and HR-QoL impairment were explored using univariate and multivariate logistic regression. RESULTS: Among the 108 patients (female, 65.7%; white, 90.7%; primary APS, 75.9%; median disease duration, 6 years), damage (DIAPS≥1) developed in 48.2% of patients (mean ± SD DIAPS, 3.08 ± 1.83). DIAPS's neuropsychiatric domain was the most affected (24.2%), followed by the peripheral vascular domain (20.3%). No clinical, demographic nor laboratory parameters were significantly associated with damage. Regarding HR-QoL, pain/discomfort, anxiety/depression and usual activities domains were the most frequently impaired in both scales. DIAPS's domains correlated similarly with the EQ-5D-3L and 5L scales' individual domains. Female sex, medical disorders, secondary APS and type of presenting thrombosis (arterial) increased the risk of HR-QoL impairment. Total DIAPS was associated with higher odds of mobility, self-care and pain/discomfort impairment in both EQ-5D-3L and 5L scales but lost its independent risk in multivariable analysis. CONCLUSION: This external validation of DIAPS reinforces the ability of the score to correlate with HR-QoL while also highlighting risk factors for HR-QoL impairment other than damage accrual.

Epidemiology of antiphospholipid syndrome: macro- and microvascular manifestations.

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic and non-thrombotic macro- and microvascular manifestations and pregnancy complications in the setting of persistent antiphospholipid antibodies (aPL), namely anticardiolipin antibodies, anti-ß2 glycoprotein-I antibodies and lupus anticoagulant. Four decades after its first description, APS prevalence and incidence are still not completely understood due to the limited number of well-designed, population-based multi-ethnic studies. Furthermore, despite decades of efforts to standardise aPL immunoassays, considerable intraassay and interlaboratory variances in aPL measures still exist. Large multicentre APS cohorts have shown a 10-year survival of ∼91% and the presence of catastrophic APS occurs in about 1% of the entire population, associated with a 50% mortality rate. Clinically, any organ can be affected in the context of large, medium or small vessel (artery and/or vein) thrombosis. Macrovascular thrombosis is the hallmark of the disease and veins are more frequently affected than arteries. Deep vein thrombosis/pulmonary embolism thromboembolic disease is the most common APS manifestation, while stroke and transient ischaemic attack are the most frequent arterial thrombosis events. Myocardial infarction can also occur and contributes to increased mortality in APS. A minority of patients present with thrombosis affecting the intraabdominal organs, including the liver, spleen, small and large bowel, and the kidneys. Microvascular thrombosis, including APS nephropathy, chronic skin ulcers and livedoid vasculopathy represent a diagnostic challenge requiring histologic confirmation. In this narrative review we summarize the available evidence on APS epidemiology, focusing on the description of the prevalence of macro- and microvascular manifestations of the disease.

Bleeding events in thrombotic antiphospholipid syndrome: prevalence, severity, and associated damage accrual.

Background: Life-long anticoagulation increases bleeding risk in patients with antiphospholipid syndrome (APS). The Damage Index for Antiphospholipid Syndrome does not include bleeding events in damage accrual. Objectives: We aimed to characterize the prevalence, severity, and damage associated with bleeding events in patients with APS. Methods: This was a single-center retrospective analysis of patients with thrombotic APS (2006 Sydney criteria). Bleeding events were reviewed up to 43 years and classified according to the ISTH definitions into 2 groups: 1) major bleedings and 2) nonmajor bleedings (minor bleedings and clinically relevant nonmajor bleedings). Damage events were recorded as bleeding events a) resulting in permanent (>6 months) decrease in organ function and b) complicated by total/partial organ resection. Results: Among 197 patients (2412 patient-years [PYs] of follow-up), all of whom had been exposed to antithrombotic therapy, 40.6% experienced 167 bleedings (6.9 events per 100 PYs), of whom 61.3% had nonmajor bleedings (77.2% of bleedings: 42.6% minor, 57.4% clinically relevant nonmajor) and 38.8% had major bleedings (22.8% of bleedings; 1.6 events per 100 PYs). Soft/connective tissue was affected in 44.3% of bleedings, and 94.6% were nonmajor bleedings. Central nervous system was affected in 20.9% of bleedings, and 62.9% were major bleedings. Bleeding events were spontaneous in 90.4% of cases, and thrombocytopenia was likely involved in 62.2% of bleedings. Damage occurred in 11.4% of bleedings and affected 7.6% of patients. Most of the damage was associated with central nervous system events (8.4% of all bleedings). Conclusion: Approximately 40% of patients experienced at least 1 bleeding, and almost 8% of patients were left with organ damage not recognized by the current version of the Damage Index for Antiphospholipid Syndrome.

Efectos de un programa de ejercicio físico con enfoque sanológico en universitarios / Effects of a physical exercise program with a sanological approach in university students / Efeitos de um programa de exercícios físicos com abordagem saudável em estudantes universitários

Objetivo: identificar el efecto del programa de ejercicio físico del proyecto institucionalUSCO saludable con enfoque sanológico en 40 jóvenes universitarios con sobrepeso. Metodología: se plantea un estudio mixto el cual utiliza metodología cuantitativa y cualitativa. En específico, se desarrolló un estudio cuasiexperimental de un solo grupo con valoración antes y después, los datos se tomaron de la revisión de historias clínicosanológicas del programa de ejercicio físico, de la dimensión actividad física. Del proyecto USCO Saludable, se seleccionaron 40 estudiantes con un índice de masa muscular (IMC) entre los rangos de 25 a 30 kg/m2. Se utilizó un instrumento denominado historia clínico-sanológica, esta fue diseñada, ajustada y estandarizada por los investigadores Pedro Reyes Gaspar y Dolly Arias Torres. Los datos se trabajaron a través de entrevista semiestructurada, mediante la creación de códigos y categorías con el programa ATLAS. ti 6.0. Para la comparación del IMC se empleó la prueba de Wilcoxon y el tamaño del efecto por medio de la g de Hedges en el programa SPSS versión 24. Resultados: después de la intervención, en el grupo de estudiantes universitarios con sobrepeso se observaron cambios importantes en la comprensión del concepto de salud, salud actual y del ejercicio físico como herramienta de cuidado de la salud y la vejez. Además, se identificó un cambio significativo en el IMC de la población. Conclusiones: la estrategia de ejercicio físico desde un enfoque sanológico es factible y eficaz, debido a los cambios significativos en el pensamiento y comportamiento en la salud de estudiantes universitarios con sobrepeso.

Objective: to identify the effect of the physical exercise program, of the healthy USCO institutional project with a sanological approach, on 40 overweight university students. Methodolgy: a mixed study is proposed using quantitative and qualitative methodology. Specifically, a quasiexperimental study of a single group was developed with evaluation before and after, the data was taken from the review of clinical-sanological histories of the physical exercise program, of the physical activity dimension, of the Healthy USCO project, 40 students with BMI (body mass index) between the ranges of 25 to 30 kg/ m2 were selected. An instrument called clinical-sanological history was used, it was designed, adjusted, and standardized by researchers Pedro Reyes Gaspar and Dolly Arias Torres. The data was processed through a semi-structured interview through the creation of codes, and categories with the ATLAS.ti 6.0 software, for the comparison of the BMI the Wilcoxon test was used and the effect size through Hedges' G in the SPSS program version 24. Results: after the intervention, important changes were observed in the understanding of the concept of health, current health, and physical exercise as a tool for health care and old age in a group of overweight university students. Furthermore, a significant change in the BMI of the population was identified. Conclusions: the strategy of physical exercise from a sanological approach is feasible and effective due to the significant changes in the thinking and behavior in the health of overweight university students.

Objetivo: identificar o efeito do programa de exercícios físicos do projeto institucional USCO saudável com enfoque saudável em 40 universitários com excesso de peso. Metodologia: propõe-se um estudo misto que utiliza metodologia quantitativa e qualitativa. Especificamente, foi desenvolvido um estudo quase-experimental de grupo único com avaliação antes e depois, os dados foram retirados da revisão dos registros clínico-saúde do programa de exercício físico, da dimensão atividade física. Do projeto USCO Healthy, foram selecionados 40 alunos com índice de massa muscular (IMC) entre 25 e 30 kg/m2. Foi utilizado um instrumento denominado histórico clínico-saúde, desenhado, ajustado e padronizado pelos pesquisadores Pedro Reyes Gaspar e Dolly Arias Torres. Os dados foram trabalhados por meio de entrevista semiestruturada, mediante criação de códigos e categorias com o programa ATLAS.ti 6.0. Para a comparação do IMC foi utilizado o teste de Wilcoxon e o tamanho do efeito por meio do g de Hedges no programa SPSS versão 24. Resultados: após a intervenção, no grupo de universitários com excesso de peso, foram observadas mudanças importantes na compreensão do conceito de saúde, saúde atual e exercício físico como ferramenta de cuidado à saúde e à velhice. Além disso, foi identificada uma alteração significativa no IMC da população. Conclusões: a estratégia de exercício físico sob uma abordagem de saúde é viável e eficaz, devido às mudanças significativas no pensamento e no comportamento de saúde de estudantes universitários com excesso de peso

The pupillary dilation reflex to a nociceptive stimulus as a tool for analgesia management: A diagnostic study.

BACKGROUND: More than 70% of patients demonstrate pain after endotracheal aspiration. Tools are needed to objectify the need for analgesia in non-communicative critically ill patients. OBJECTIVE: The objective of this study was to identify the lowest intensity electrical stimulus for detecting pain before daily care interventions. METHODS: Study of diagnostic tests to assess pupillometry to detect pain through the pupillary dilation response to noxious stimuli versus the Behavioural Pain Scale. Patients older than 18 years, under analgosedation, subjected to invasive ventilation, baseline Behavioural Pain Scale of 3, and Richmond Agitation-Sedation Scale between -1 and -4 were studied. We assessed the Behavioural Pain Scale and the pupillary dilation response to 10, 20, 30, and 40 mA stimuli. We studied the diagnostic performance based on sensitivity and specificity, negative predictive value, positive predictive value, and accuracy of the selected points after the different stimulations. AlgiScan® Pupillometer measured the pupillary dilation response. The presence of pain was considered as a Behavioural Pain Scale score of ≥4. Significance was defined as p <0.05. RESULTS: Measurements were performed on 31 patients. In the 20 mA stimulus, we found an area under the curve of 0.85 (0.69-1.0). The cut-off point of pupillary dilation was 11.5%, with a sensitivity of 100% (34.2-100) and a specificity of 75.9% (57.9-87.8). This point had an accuracy of 77.4 (60.2-88.6) and a Youden's Index of 0.8. CONCLUSIONS: Pupillary variation measurement during a 20 mA stimulus could help assess the need for analgesia before potentially painful interventions. Further studies are needed to confirm this. REGISTRATION: Phase 1 of the project PUPIPAIN ClinicalTrials.gov Identifier: NCT04078113.

Pupillary dilation reflex and behavioural pain scale: Study of diagnostic test.

BACKGROUND: The objective of this study was to assess the value of the pupillary dilation reflex as an assessment pain tool in critically ill patients. It is important to continue working for the well-being and security of critically ill patients. METHODS: We studied the diagnostic accuracy of the pupillary dilation reflex against the Behavioral Pain Scale. Inclusion criteria were: age greater than 18, receiving mechanical ventilation, with a basal score of the Behavioural Pain Scale of three and a Richmond Agitation and Sedation score between -1 and -4. We studied the responses to a non-painful stimulus, four calibrated stimuli, after a tracheal aspiration and with and without pain. The receiver operating curve was plotted and we calculated the area under the curve. We identified the cut-off points showing the highest sensitivity and specificity and studied diagnostic performance based on negative predictive value, positive predictive value, and accuracy. These were reported with their 95% confidence intervals. RESULTS: 183 measurements were performed. An AUC of 0.88(95% CI 0.83-0.94) was obtained. The pupillary dilation reflex of 11.5% had a sensitivity of 89.8%(95% CI 78.2-95.6) and a specificity of 78.4%(95% CI 70.6-84.5) with an accuracy of 81.4(75.2-86.4). The pupillary dilation reflex detected nociceptive pain response in 15.8% of the measurements that did not show pain according to the Behavioural Pain Scale. CONCLUSIONS: Pupillometry may be a valid alternative for identifying pain in critically ill patients.

Optimized Placement of Frost-Measuring Sensors in Heat Exchangers via Image Processing of Frost Formation Pattern.

Heat exchangers (HXs) play a critical role in maintaining human thermal comfort and ensuring product safety and quality in various industries. However, the formation of frost on HX surfaces during cooling operations can significantly impact their performance and energy efficiency. Traditional defrosting methods primarily rely on time-based control of heaters or HX operation, overlooking the actual frost formation pattern across the surface. This pattern is influenced by ambient air conditions (humidity and temperature) and surface temperature variations. To address this issue, frost formation sensors can be strategically placed within the HX. However, the non-uniform frost pattern poses challenges in sensor placement. This study proposes an optimized sensor placement approach using computer vision and image processing techniques to analyze the frost formation pattern. Through creating a frost formation map and evaluating various sensor locations, frost detection can be optimized to control defrosting operations with higher accuracy, thereby enhancing the thermal performance and energy efficiency of HXs. The results demonstrate the effectiveness of the proposed method in accurately detecting and monitoring frost formation, providing valuable insights for sensor placement optimization. This approach presents significant potential in enhancing the overall performance and sustainability of the operation of HXs.

A Chromatic Enzymatic Time-Temperature Integrator Device Based on the Degradation of Phenolic Compounds for the Real-Time Prediction of the Quality and Shelf Life of Cherries.

The particular characteristics of cherries, such as color, firmness, and palate increase their demand, as does, among other things, their antioxidant properties that benefit human health. However, their high perishability leads to a reduced shelf life and consequently generates undesirable changes in the cherry flow chain. To ensure food quality and safety and prevent food waste, a smart device prototype is proposed. The concepts related to the formulation and design of the enzymatic-type chromatic time-temperature integrator (TTI) device used to monitor the real-time quality of cherries are described. The kinetic parameters for thermal inactivation of cultivar Santina cherries were determined based on the degradation of phenolic compounds that are substrates of the polyphenol oxidase enzyme, whose hydroxylation reaction of a monophenol to o-diphenol leads to the oxidation in o-quinone. The proposed device concept aims to help retailers and consumers decide upon selling and buying according to the remaining shelf life, thus promoting sustainability related to food processes.

Predictors of Long-COVID-19 and its Impact on Quality of Life: Longitudinal Analysis at 3, 6 and 9 Months after Discharge from a Portuguese Centre.

INTRODUCTION: Long-COVID-19 impacts health-related quality of life (HR-QoL) but data is scarce. The aim of this study was to describe and prospectively assess the prevalence and risk factors for long-COVID-19 after hospital discharge, and to evaluate its impact on patient HR-QoL. MATERIAL AND METHODS: Single-centre longitudinal study including all COVID-19 patients discharged between December 2020 and February 2021. Patients were contacted remotely at three, six and nine months. Data were collected as follows: 1) Long-COVID-19 symptoms were self-reported; 2) HRQoL were assessed using the 3-level EuroQoL-5D (EQ-5D-3L) questionnaire. Pregnant women, demented, bedridden, and non-Portuguese-speaking patients were excluded. RESULTS: The three-, six- and nine-month assessments were completed by 152, 117 and 110 patients (median age: 61 years; male sex: 56.6%). Long-COVID-19 (≥ 1 symptom) was reported by 66.5%, 62.4% and 53.6% of patients and HR-QoL assessment showed impairment of at least some domain in 65.8%, 69.2% and 55.4% of patients at three, six and nine months, respectively. Fatigue was the most common long-COVID-19 symptom. Anxiety/depression domain was the most frequently affected in all three time-points, peaking at six months (39%), followed by pain/discomfort and mobility domains. Long-COVID-19 was associated with the impairment of all EQ-5D-3L domains except for self-care domain at each time-point. Neither intensive care unit admission nor disease severity were associated with long-COVID-19 nor with impairment of any EQ-5D-3L domain. After adjusting for sex, age, frailty status, and comorbid conditions, long-COVID-19 remained significantly associated with HR-QoL impairment at three (OR 4.27, 95% CI 1.92 - 9.52, p < 0.001), six (OR 3.46, 95% CI 1.40 - 8.57, p = 0.007) and nine months (OR 4.13, 95% CI 1.62 - 10.55, p = 0.003) after hospital discharge. In a longitudinal analysis, patients reporting long-COVID-19 at three months had an EQ-5D-3L index value decreased by 0.14 per visit (p < 0.001) compared to those without long-COVID-19 and both groups had a non-significant change in mean EQ-5D-3L index over the nine-month period (time-point assessment, Z = 0.91, p = 0.364). CONCLUSION: Clinical sequelae associated with long-COVID-19 can persist for at least nine months after hospital discharge in most patients and can impair long-term HR-QoL in more than half of patients regardless of disease severity, and clinicodemographic characteristics.

Evaluation of comparative scenarios from different sites of chestnut production using life cycle assessment (LCA): Case study in the Beira Interior region of Portugal.

The evaluation of the environmental impacts of chestnut production in the Beira Interior region (Portugal) is accessed. The comparative life cycle assessment (LCA) was performed with the use of openLCA software with 16 Environmental Footprint (EF) impact categories retrieved from the AGRIBALYSE database. The system boundary was from "cradle-to-farm gate" and the functional unit was 1 ton of chestnut delivered to consumers (only wholesale buyers). The processes model for the production of agricultural machinery, pesticides, fertilizers, and materials was modeled based on surveys and existing literature. The data was gathered from four different production areas: Serra da Estrela, Malcata, Gardunha, and Plateau area. Each site has two selected representative producers inner 250 km2 square radius environment. The results showed that the average GHG emissions in the low-input group (Estrela and Gardunha) were 1.83 kg CO2-eq/ton with the energy burden (80-89%) as main contribution emissions and in the intensive-input group (Malcata and Plateau) were 2.61 kg CO2-eq/ton with the main contribution source of emissions are fertilizer (76-83%). Sensitivity analysis results indicate shift input material and cultivation activities in chestnut production systems can be possible for all study areas without reducing yield production. The suggestions in this article can be used by farmers, policymakers, and other stakeholders to adopt new alternative production scenarios.

Innovative processes in smart packaging. A systematic review.

Smart packaging provides one possible solution that could reduce greenhouse gas emissions. In comparison with traditional packaging, which aims to extend the product's useful life and to facilitate transport and marketing, smart packaging allows increased efficiency, for example by ensuring authenticity and traceability from the product's origin, preventing fraud and theft, and improving security. Consequently, it may help to reduce pollution, food losses, and waste associated with the food supply chain. However, some questions must be answered to fully understand the advantages and limitations of its use. What are the most suitable smart packaging technologies for use in agro-industrial subsectors such as meat, dairy, fruits, and vegetables, bakery, and pastry? What are the opportunities from a perspective of life extension, process optimization, traceability, product quality, and safety? What are the future challenges? An up-to-date, systematic review was conducted of literature relevant to the application of indicator technologies, sensors, and data carriers in smart packaging, to answer these questions. © 2022 Society of Chemical Industry.

What is the role of active packaging in the future of food sustainability? A systematic review.

Nowadays, the strong increase in products consumption, the purchase of products on online platforms as well as the requirements for greater safety and food protection are a concern for food and packaging industries. Active packaging brings huge advances in the extension of product shelf-life and food degradation and losses reduction. This systematic work aims to collect and evaluate all existing strategies and technologies of active packaging that can be applied in food products, with a global view of new possibilities for food preservation. Oxygen scavengers, carbon dioxide emitters/absorbers, ethylene scavengers, antimicrobial and antioxidant active packaging, and other active systems and technologies are summarized including the products commercially available and the respective mechanisms of action. © 2022 Society of Chemical Industry.

A one-point increase in the Damage Index for Antiphospholipid Syndrome (DIAPS) predicts mortality in thrombotic antiphospholipid syndrome.

OBJECTIVES: To determine whether early damage and its kinetics measured by the Damage Index for Antiphospholipid Syndrome (DIAPS) predicts mortality. METHODS: We carried out a single-centre retrospective analysis of thrombotic APS patients (2006 Sydney criteria), using the DIAPS for damage assessment. Early damage was considered to be at six months after disease onset; early damage increase (delta-DIAPS) was deemed to be at least a one-point rise in DIAPS within the first five years of illness. Groups were compared using appropriate statistical tests. Survival was analysed by the Kaplan-Meier method. Cox regression analysis was performed to investigate predictors of mortality. RESULTS: A total of 197 patients (71.1% female; 65.9% primary APS; 72.4% Caucasian) were followed for up to 43 years (median 10). Damage developed in 143 (73.6%) patients. Twenty-three patients (12%) died. Secondary APS (HR 3.07, 95%CI 1.32-7.12, p=0.009), male sex (HR 3.14, 95%CI 1.35-7.33, p=0.008) and age at APS onset ≥40 years (HR 5.34, 95%CI 1.96-14.53, p=0.001) were risk factors for death. Early damage (n=69, 35.0%) was not associated with death (p=0.231). Having a first arterial event was associated with early damage (p<0.001), but not with delta-DIAPS (p=0.539) nor with the risk of death (p=0.151). Delta-DIAPS (n=53/181, 29.3%) predicted mortality (HR 5.40, 95%CI 2.33-12.52, p<0.001), even after adjusting individually for APS category (secondary), sex (male), early damage and age at APS onset (≥40 years) (all p<0.005). CONCLUSIONS: Evolving damage in the first five years of illness, but not early damage, predicted mortality regardless of the nature of the first thrombotic event, sex, APS category and age.

Perfil del estilo de vida en docentes y administrativos de una universidad / Profile of the lifestyle in professors and administrators of a university / Perfil do estilo de vida em professores e administradores de uma universidade

Objetivo: Determinar los comportamientos del estilo de vida en docentes y administrativos de una universidad pública de Colombia. Materiales y métodos: Investigación cuantitativa descriptiva de corte trasversal. El tamaño de la muestra fue de 178 docentes y administrativos, mediante un muestreo aleatorio simple. Se aplicó un cuestionario auto diligenciado compuesto por una ficha sociodemográfica y el instrumento fantástico, diseñado por el Departamento de Medicina Familiar de la Universidad McMaster de Canadá, ajustado por el investigador Pedro Reyes Gaspar, obteniendo un Alfa de Cronbach, de 0,706, y un coeficiente de Spearman Brown r=0,616 y la correlación dos mitades de Guttman r=0,615. Los datos se trabajaron a través del programa SPSS versión 24, mediante análisis estadístico descriptivo univariado de frecuencias y tablas de contingencia. Resultados: El 40% de la población no es activa físicamente, más de la mitad de los docentes y administrativos aseguran que no ingieren una dieta adecuada, el 26% casi nunca duermen bien y se sienten descansados, el 29% algunas veces duerme bien y descansa. El 50% algunas veces es capaz de hacer frente al estrés en sus vidas y 10% casi nunca puede manejar el estrés. Se identificó riesgo en salud en los docentes en las dimensiones de actividad física, nutrición, sueño y estrés (p.000) en comparación con los administrativos. Conclusiones: Se halló que el perfil de estilo de vida en docentes y administrativos de una universidad pública de Colombia se caracteriza por la inactividad física, una mala alimentación, un mal manejo del estrés y trastornos del sueño.

Objective: To determine the behaviors of the lifestyle in teachers and administrators of a public university in Colombia. Materials and methods: cross-sectional descriptive quantitative research. The sample size was 178 teachers and administrators, using simple random sampling. A self-completed questionnaire was applied, consisting of a sociodemographic record and the fantastic instrument, designed by the Department of Family Medicine of the McMaster University of Canada, adjusted by the researcher Pedro Reyes Gaspar, obtaining a Cronbach's Alpha of 0.706, and a coefficient Spearman Brown r=0.616 and Guttman's twohalf correlation r=0.615. The data was worked through the SPSS version 24 program, through univariate descriptive statistical analysis of frequencies and contingency tables. Results: 40% of the population is not physically active, more than half of teachers and administrators say they do not eat a proper diet, 26% almost never sleep well and feel rested, 29% sometimes sleep well and rest. 50% are sometimes able to cope with stress in their lives and 10% can hardly ever handle stress. Health risk was identified in teachers in the dimensions of physical activity, nutrition, sleep and stress (p.000) compared to administrative staff. Conclusions:it was found that the lifestyle profile of teachers and administrators at a public university in Colombia is characterized by physical inactivity, poor nutrition, poor stress management and sleep disorders.

Validación de un instrumento para medir experiencias infantiles adversas en estudiantes universitarios colombianos / Validation of an instrument to measure adverse child experiences in Colombian university students / Validação de um instrumento para medir as experiências adversas de crianças em universitários colombianos

El objetivo del presente estudio fue adaptar culturalmente y desarrollar la versión colombiana del test Adverse Childhood Experiences y explorar sus propiedades psicométricas. Metodología: participaron cinco jueces expertos para validar el contenido de la versión adaptada y 100 estudiantes universitarios para realizar la confiabilidad y validez del constructo. Resultados: El instrumento Adverse Childhood Experiences versión Colombia es autoaplicable de 16 ítems y mide cuatro factores o Subsescalas: violencia sociopolítica y desastres naturales, abusos, desafíos domésticos, y negligencia física y emocional. Esta versión mostro una muy buena validez de contenido (k=0,83-1,00), una consistencia interna fuerte y perfecta (0,95) y una validez de constructo que muestra un contenido discriminante importante de las cuatro Subsescalas o factores con el 57% de la varianza. Conclusiones: el Adverse Childhood Experiences versión colombiana es confiable para medir experiencias traumáticas en la infancia y eventos traumáticos por violencia sociopolítica y desastres naturales en población universitaria colombiana.

Objective: The objective of the present study was to culturally adapt and develop the colombi-an version of the Adverse Childhood Experiences test and explore its psychometric properties. Methodology: five expert judges participated to validate the content of the adapted version and 100 university students to perform the reliability and validity of the construct. Results: The Adverse Childhood Experiences instrument, colombia version, is self-applied with 16 items and measures four factors or Subscales: sociopolitical violence and natural disasters, abuse, domestic challenges, and physical and emotional neglect. This version showed a very good content validity (k = 0.83-1.00), a strong and perfect internal consistency (0.95) and a construct validity that shows an important discriminant content of the four subscales or factors with 57% of the variance. Conclusions: The Adverse Childhood Experiences Colombian version is reli-able to measure traumatic experiences in childhood and traumatic events due to socio-political violence and natural disasters in Colombian university population

Objetivo: O objetivo deste estudo foi adaptar culturalmente e desenvolver a versão colombiana do teste Adverse Childhood Experiences e explorar suas propriedades psicométricas. Metodolo-gia: participaram cinco juízes especialistas para validar o conteúdo da versão adaptada e 100 uni-versitários para realizar a confiabilidade e validade do construto. Resultados: A versão colombi-ana do instrumento Adverse Childhood Experiences é autoaplicável com 16 itens e mede quatro fatores ou subescalas: violência sociopolítica e desastres naturais, abuso, desafios domésticos e negligência física e emocional. Esta versão apresentou uma validade de conteúdo muito boa (k=0,83-1,00), uma consistência interna forte e perfeita (0,95) e uma validade de construto que mostra um conteúdo discriminante importante das quatro subescalas ou fatores com 57% da variância. Conclusões: a versão colombiana das Experiências Adversas da Infância é confiável para medir experiências traumáticas na infância e eventos traumáticos devido à violência socio-política e desastres naturais na população universitária colombiana

Development of an mHealth Platform for Adolescent Obesity Prevention: User-Centered Design Approach.

Obesity is a chronic condition that influences the quality of life of patients and families while increasing the economic burden for the world population. Multidisciplinary prevention programs are crucial to address it, allowing an early introduction of healthy behaviors into daily habits. Mobile health interventions provide adequate support for these programs, especially considering the gamification techniques used to promote users' engagement. TeenPower is a multidisciplinary mHealth intervention program conducted in Portugal during 2018 to empower adolescents, promoting healthy behaviors while preventing obesity. An agile software development process was applied to the development of the digital platform that holds a web-based application and a mobile application. We also propose a model for future developments based on the user-centered design approach adopted for this development and the assessment conducted in each phase. The user-centered design approach model proposed has three distinct phases: (1) design study; (2) pre-production usability tests; and (3) post-production data. Phase 1 allowed us to obtain the high-fidelity version of the graphical user interfaces (n = 5). Phase 2 showed a task completion success rate of 100% (n = 5). Phase 3 was derived from statistical analysis of the usage of the platform by real end users (n = 90). We achieved an average retention rate of 35% (31 out of 90 participants). Each technique has provided input for the continuous design and improvement of the platform. This allowed the creation of a tailored platform that could meet users' expectations. Nevertheless, the retention rate decreased significantly over a short period of time, revealing the need for further work in the improvement of the gamification experience.

Cognitive reserve and mental health in cognitive frailty phenotypes: Insights from a study with a Portuguese sample.

Background: Research on prevalence of cognitive frailty phenotypes in community-dwelling older adults in different countries is important to estimate their prevalence and to determine the influence of cognitive reserve and mental health in order to prevent frailty. The aims of this study were to estimate the prevalence of reversible and potentially reversible cognitive frailty (R-CF, PR-CF) in a Portuguese sample of old adults and explore the associations between these phenotypes and demographic, comorbidity, social support, cognitive reserve and mental health factors. Methods: We assessed frailty (Fried criteria) in 250 community-dwelling older adults (179 women) aged 60 years or over (mean 71.04 years) without dementia, neurological or psychiatric disorders. Subjective cognitive decline and Mild cognitive impairment were diagnosed according to standard criteria. The questionnaires Charlson Index, Medical Outcomes Study Social Support, Cognitive Reserve Index and General Health were used for assessing comorbidity, social support, cognitive reserve and mental health, respectively. Results: Prevalence of R-CF was 14%, and that of PR-CF, 15.2%. Cognitive frailty profiles differed significantly in relation to education, comorbidity, mental health, and cognitive reserve, but not in age or sex. Multivariate logistic regression showed that age, sex, comorbidity, social support, mental health, and cognitive reserve together predicted R-CF and PR-CF (90% specificity 75% sensitivity) with significant OR for mental health and cognitive reserve. Discussion: Cognitive reserve and mental health are important factors predicting R-CF and PR-CF. We recommend assessing these factors for early detection of cognitive frailty and promoting psychological well-being and lifestyles that increase cognitive reserve in adults.

Embodiment Comfort Levels During Motor Imagery Training Combined With Immersive Virtual Reality in a Spinal Cord Injury Patient.

Brain-machine interfaces combining visual, auditory, and tactile feedback have been previously used to generate embodiment experiences during spinal cord injury (SCI) rehabilitation. It is not known if adding temperature to these modalities can result in discomfort with embodiment experiences. Here, comfort levels with the embodiment experiences were investigated in an intervention that required a chronic pain SCI patient to generate lower limb motor imagery commands in an immersive environment combining visual (virtual reality -VR), auditory, tactile, and thermal feedback. Assessments were made pre-/ post-, throughout the intervention (Weeks 0-5), and at 7 weeks follow up. Overall, high levels of embodiment in the adapted three-domain scale of embodiment were found throughout the sessions. No significant adverse effects of VR were reported. Although sessions induced only a modest reduction in pain levels, an overall reduction occurred in all pain scales (Faces, Intensity, and Verbal) at follow up. A high degree of comfort in the comfort scale for the thermal-tactile sleeve, in both the thermal and tactile feedback components of the sleeve was reported. This study supports the feasibility of combining multimodal stimulation involving visual (VR), auditory, tactile, and thermal feedback to generate embodiment experiences in neurorehabilitation programs.

Análisis de concordancia inter-jueces para medir factores protectores en salud en universitarios / Análise de concordância entre jurados para mensurar os fatores protetores em saúde de universitários / Analysis of inter-judge agreement to measure protective factors in health in university students

Objetivo: Realizar el análisis de concordancia mediante el juicio de expertos de un instrumento de medición para detectar factores protectores de enfermedades no transmisibles en jóvenes universitarios. Materiales y método: Estudio psicométrico de validez de contenido, en el que participaron cuatro expertos que evaluaron cada ítem, se determinó el nivel de concordancia entre jueces con el coeficiente Kappa de Fleiss. Resultados: se observa fuerza de concordancia para el total de los ítems del instrumento, como muy buena, en cuanto a los criterios para todos la significancia estadísticas fue de p: 0,000, se ajustaron algunos ítems en redacción, contenido y se incorporaron algunos teniendo en cuenta las observaciones cualitativas de los expertos. Conclusión: El instrumento representa un avance en la medición del autocuidado de la salud en estudiantes Universitarios, que permitirá definir acciones para mejorar el estilo de vida en esta población.

Objetivo: realizar a analise de concordância entre expertos de um instrumento de medição para detectar fatores protetores de doenças no transmissíveis em jovens universitários. Materiais e métodos: estudo psicométrico de validez de conteúdo com a participação de quatro expertos que avaliaram cada item. Determinou-se o nível de concordância entre expertos empregando o Kappa de Fleiss. Resultados: houve força de concordância para o total dos itens do instrumento como muito boa. Os critérios para significância estatística foi de p=0,000. Foram ajustados itens em redação e conteúdo, posteriormente se incorporaram alguns tendo em consideração as observações qualitativas dos expertos. Conclusão: o instrumento representa o avanço na medição do autocuidado da saúde de jovens estudantes universitários, que permitirá definir ações para o melhoramento do estilo de vida dessa população.