Nanoporous graphene-based thin-film microelectrodes for in vivo high-resolution neural recording and stimulation.

One of the critical factors determining the performance of neural interfaces is the electrode material used to establish electrical communication with the neural tissue, which needs to meet strict electrical, electrochemical, mechanical, biological and microfabrication compatibility requirements. This work presents a nanoporous graphene-based thin-film technology and its engineering to form flexible neural interfaces. The developed technology allows the fabrication of small microelectrodes (25 µm diameter) while achieving low impedance (∼25 kΩ) and high charge injection (3-5 mC cm-2). In vivo brain recording performance assessed in rodents reveals high-fidelity recordings (signal-to-noise ratio >10 dB for local field potentials), while stimulation performance assessed with an intrafascicular implant demonstrates low current thresholds (<100 µA) and high selectivity (>0.8) for activating subsets of axons within the rat sciatic nerve innervating tibialis anterior and plantar interosseous muscles. Furthermore, the tissue biocompatibility of the devices was validated by chronic epicortical (12 week) and intraneural (8 week) implantation. This work describes a graphene-based thin-film microelectrode technology and demonstrates its potential for high-precision and high-resolution neural interfacing.

Neural substrates of cognitive impairment in a NMDAR hypofunction mouse model of schizophrenia and partial rescue by risperidone.

N-methyl D-aspartate receptor (NMDAR) hypofunction is a pathophysiological mechanism relevant for schizophrenia. Acute administration of the NMDAR antagonist phencyclidine (PCP) induces psychosis in patients and animals while subchronic PCP (sPCP) produces cognitive dysfunction for weeks. We investigated the neural correlates of memory and auditory impairments in mice treated with sPCP and the rescuing abilities of the atypical antipsychotic drug risperidone administered daily for two weeks. We recorded neural activities in the medial prefrontal cortex (mPFC) and the dorsal hippocampus (dHPC) during memory acquisition, short-term, and long-term memory in the novel object recognition test and during auditory processing and mismatch negativity (MMN) and examined the effects of sPCP and sPCP followed by risperidone. We found that the information about the familiar object and its short-term storage were associated with mPFC→dHPC high gamma connectivity (phase slope index) whereas long-term memory retrieval depended on dHPC→mPFC theta connectivity. sPCP impaired short-term and long-term memories, which were associated with increased theta power in the mPFC, decreased gamma power and theta-gamma coupling in the dHPC, and disrupted mPFC-dHPC connectivity. Risperidone rescued the memory deficits and partly restored hippocampal desynchronization but did not ameliorate mPFC and circuit connectivity alterations. sPCP also impaired auditory processing and its neural correlates (evoked potentials and MMN) in the mPFC, which were also partly rescued by risperidone. Our study suggests that the mPFC and the dHPC disconnect during NMDAR hypofunction, possibly underlying cognitive impairment in schizophrenia, and that risperidone targets this circuit to ameliorate cognitive abilities in patients.

Cardioembolic ischemic stroke associated with undertreated atrial fibrillation: an observational study / Accidente cerebrovascular isquémico cardioembólico asociado con fibrilación auricular no tratada: estudio observacional

Objectives: To describe the characteristics of patients and to determine the risk factors associated with second Emergency Department visits at 30 and 180 days in sick people admitted to the Emergency Department for cardioembolic stroke with a previous diagnosis of atrial fibrillation.Methods: Retrospective, observational study of adult patients admitted to the Emergency Department at our institution for cardioembolic stroke from January 1, 2019 to December 31, 2019. All study participants had a previous diagnosis of Atrial Fibrillation, CHADs2-VASc ≥2, and no contraindications for anticoagulants. The patients were retrospectively identified through a database search. A univariate analysis was performed to assess variables potentially associated with readmission (any cause) at 30 and 180 days. All variables with a p<0.2 were included in a multivariate analysis.Results: During the study period, 547 patients presented to the ED with ischemic stroke and 113 (20.6%) met the study inclusion criteria. Of these, 53 patients (46.9%) did not receive anticoagulant therapy before the stroke and 28 (24.7%) were taking doses lower than recommended in the technical data sheet. The pharmacological stroke prevention strategy was modified in 44 patients (38.9%) at discharge. On the multivariate analysis, diabetes was the only risk factor significantly associated with early readmission to the ED.Conclusions: Most patients (71.6%) with a previous diagnosis of AF who presented to the emergency department for cardioembolic stroke had not received optimal anticoagulant preventive treatment before the event. Diabetes was the only risk factor associated with early readmission to the Emergency Department. (AU)

Objetivos: Describir las características de los pacientes y determinar los factores de riesgo asociados a las segundas visitas al Servicio de Urgencias a los 30 y 180 días en los enfermos ingresados en el Servicio de Urgencias por ictus isquémico cardioembólico con diagnóstico previo de fibrilación auricular.Métodos: Estudio retrospectivo y observacional de pacientes adultos ingresados en el Servicio de Urgencias del Hospital de la Santa Creu i Sant Pau (HSP) por un ictus cardioembólico desde el 1 de enero de 2019 hasta el 31 de diciembre de 2019. Todos los participantes en el estudio tenían un diagnóstico previo de fibrilación auricular, CHADs2-VASc ≥2, y no tenían contraindicaciones para los anticoagulantes. Los pacientes fueron identificados retrospectivamente mediante una búsqueda en una base de datos del hospital. Se realizó un análisis univariante para evaluar las variables potencialmente asociadas al reingreso (cualquier causa) a los 30 y 180 días. Todas las variables con una p <0,2 se incluyeron en un análisis multivariante.Resultados: Durante el periodo de estudio, 547 pacientes acudieron a urgencias con ictus isquémico y 113 (20,6%) cumplieron los criterios de inclusión del estudio. De ellos, 53 pacientes (46,9%) no recibían tratamiento anticoagulante antes del ictus y 28 (24,7%) tomaban dosis inferiores a las recomendadas en la ficha técnica. La estrategia de prevención farmacológica del ictus se modificó en 44 pacientes (38,9%) al alta. En el análisis multivariante, la diabetes fue el único factor de riesgo que se asoció significativamente con el reingreso temprano en urgencias.Conclusiones: La mayoría de los pacientes (71,6%) con diagnóstico previo de FA que acudieron a urgencias por ictus cardioembólico no habían recibido un tratamiento preventivo anticoagulante óptimo antes del evento. La diabetes fue el único factor de riesgo asociado al reingreso temprano en el servicio de urgencias. (AU)

Reversible Photocontrol of Dopaminergic Transmission in Wild-Type Animals.

Understanding the dopaminergic system is a priority in neurobiology and neuropharmacology. Dopamine receptors are involved in the modulation of fundamental physiological functions, and dysregulation of dopaminergic transmission is associated with major neurological disorders. However, the available tools to dissect the endogenous dopaminergic circuits have limited specificity, reversibility, resolution, or require genetic manipulation. Here, we introduce azodopa, a novel photoswitchable ligand that enables reversible spatiotemporal control of dopaminergic transmission. We demonstrate that azodopa activates D1-like receptors in vitro in a light-dependent manner. Moreover, it enables reversibly photocontrolling zebrafish motility on a timescale of seconds and allows separating the retinal component of dopaminergic neurotransmission. Azodopa increases the overall neural activity in the cortex of anesthetized mice and displays illumination-dependent activity in individual cells. Azodopa is the first photoswitchable dopamine agonist with demonstrated efficacy in wild-type animals and opens the way to remotely controlling dopaminergic neurotransmission for fundamental and therapeutic purposes.

Postnatal environmental enrichment enhances memory through distinct neural mechanisms in healthy and trisomic female mice.

Stimulating lifestyles have powerful effects on cognitive abilities, especially when they are experienced early in life. Cognitive therapies are widely used to improve cognitive impairment due to intellectual disability, aging, and neurodegeneration, however the underlying neural mechanisms are poorly understood. We investigated the neural correlates of memory amelioration produced by postnatal environmental enrichment (EE) in diploid mice and the Ts65Dn mouse model of Down syndrome (trisomy 21). We recorded neural activities in brain structures key for memory processing, the hippocampus and the prefrontal cortex, during rest, sleep and memory performance in mice reared in non-enriched or enriched environments. Enriched wild-type animals exhibited enhanced neural synchrony in the hippocampus across different brain states (increased gamma oscillations, theta-gamma coupling, sleep ripples). Trisomic females showed increased theta and gamma rhythms in the hippocampus and prefrontal cortex across different brain states along with enlarged ripples and disrupted circuit gamma signals that were associated with memory deficits. These pathological activities were attenuated in their trisomic EE-reared peers. Our results suggest distinct neural mechanisms for the generation and rescue of healthy and pathological brain synchrony, respectively, by EE and put forward hippocampal-prefrontal hypersynchrony and miscommunication as major targets underlying the beneficial effects of EE in intellectual disability.

Impacto de la infección materna asintomática por SARS-CoV-2 sobre el crecimiento fetal / Impact of asymptomatic maternal SARS-CoV-2 infection on foetal growth

Introducción: La repercusión de la infección asintomática por SARS-CoV-2 sobre el crecimiento fetal no ha sido bien establecida. El objetivo de este estudio fue determinar si existe un incremento del riesgo de retraso de crecimiento intrauterino en gestaciones con una infección asintomática por SARS-CoV-2 durante el embarazo. Material y métodos: Estudio retrospectivo caso-control en gestantes con feto pequeño para la edad gestacional o restricción del crecimiento intrauterino. Los grupos se constituyeron según el percentil de peso al nacimiento. El antecedente de infección por SARS-CoV-2 ha sido definido por la presencia de IgG en el momento del ingreso hospitalario para el parto. Resultados: No se encontraron diferencias significativas entre el grupo control y el grupo caso en cuanto a anticuerpos IgG positivos (11,5 vs. 8,8%). Tampoco se registraron diferencias en la prematuridad ni el tipo de parto. Conclusiones: La infección asintomática por SARS-CoV-2 durante el embarazo no parece afectar al crecimiento fetal.(AU)

Introduction: The impact of asymptomatic infection by SARs-CoV-2 on foetal growth has not been described. The purpose of our study is to determine whether there is an increased risk of foetal growth restriction in pregnancies in which asymptomatic or mild infection by SARS-CoV-2 has been detected. Material and methods: Retrospective case-control study with a subset of pregnant women with a small for gestational age foetus. Groups were established according to birth weight percentile. Previous SARS-CoV-2 infection was defined by positive antibodies obtained on admission to hospital for delivery. Results: No statistically significant differences between controls and cases were recorded in terms of positive IgG antibodies (11.5 vs. 8.8%). There were no premature births or significant differences in the date or type of delivery. Conclusions: Asymptomatic infection by SARs-CoV-2 during pregnancy does not seem to affect foetal growth.(AU)

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey.

AIMS: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS: 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS: 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS: Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.

[Impact of asymptomatic maternal SARS-CoV-2 infection on foetal growth]. / Impacto de la infección materna asintomática por SARS-CoV-2 sobre el crecimiento fetal.

Introduction: The impact of asymptomatic infection by SARs-CoV-2 on foetal growth has not been described. The purpose of our study is to determine whether there is an increased risk of foetal growth restriction in pregnancies in which asymptomatic or mild infection by SARS-CoV-2 has been detected. Material and methods: Retrospective case-control study with a subset of pregnant women with a small for gestational age foetus. Groups were established according to birth weight percentile. Previous SARS-CoV-2 infection was defined by positive antibodies obtained on admission to hospital for delivery. Results: No statistically significant differences between controls and cases were recorded in terms of positive IgG antibodies (11.5 vs. 8.8%). There were no premature births or significant differences in the date or type of delivery. Conclusions: Asymptomatic infection by SARs-CoV-2 during pregnancy does not seem to affect foetal growth.

Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic.

Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.

Atypical, but Not Typical, Antipsychotic Drugs Reduce Hypersynchronized Prefrontal-Hippocampal Circuits during Psychosis-Like States in Mice: Contribution of 5-HT2A and 5-HT1A Receptors.

Neural synchrony and functional connectivity are disrupted in schizophrenia. We investigated changes in prefrontal-hippocampal neural dynamics during psychosis-like states induced by the NMDAR antagonist phencyclidine and subsequent rescue by two atypical antipsychotic drugs (AAPDs), risperidone and clozapine, and the classical APD haloperidol. The psychotomimetic effects of phencyclidine were associated with prefrontal hypersynchronization, hippocampal desynchronization, and disrupted circuit connectivity. Phencyclidine boosted prefrontal oscillatory power at atypical bands within delta, gamma, and high frequency ranges, while irregular cross-frequency and spike-LFP coupling emerged. In the hippocampus, phencyclidine enhanced delta rhythms but suppressed theta oscillations, theta-gamma coupling, and theta-beta spike-LFP coupling. Baseline interregional theta-gamma coupling, theta phase coherence, and hippocampus-to-cortex theta signals were redirected to delta frequencies. Risperidone and clozapine, but not haloperidol, reduced phencyclidine-induced prefrontal and cortical-hippocampal hypersynchrony. None of the substances restored hippocampal and circuit desynchronization. These results suggest that AAPDs, but not typical APDs, target prefrontal-hippocampal pathways to elicit antipsychotic action. We investigated whether the affinity of AAPDs for serotonin receptors could explain their distinct effects. Serotonin 5-HT2AR antagonism by M100907 and 5-HT1AR agonism by 8-OH-DPAT reduced prefrontal hypersynchronization. Our results point to fundamentally different neural mechanisms underlying the action of atypical versus typical APDs with selective contribution of serotonin receptors.

Magnetic double-J stent: Evaluation of tolerance and impact on quality of life compared to traditional double-J stent.

INTRODUCTION: The placement of a ureteral stent is one of the most widely performed procedures in urology. It can have a negative impact on the patients' quality of life, requiring a cystoscopy for its removal. The objective of this study is to evaluate the symptoms and impact on quality of life derived from the use of a magnetic double-J stent (Black Star®) and compare them to those presented in patients with a traditional double-J stent (OptiMed®). MATERIAL AND METHODS: We conducted a comparative, prospective, randomized study in 46 patients who underwent ureterorenoscopy with double-J stent placement between August 2019 and June 2020. Of all patients included, 23 had a traditional double-J stent placed (group A) and 23 had a magnetic double-J stent (group B) placed. We evaluated the results of the Ureteral Stent Symptom Questionnaire (USSQ) in both groups, assessed the technical difficulty related to stent removal and the pain during the procedure using the Visual Analogue Scale (VAS). We also reviewed the need for medical attention due to problems related to the stent or after its removal. RESULTS: There were no statistically significant differences between groups regarding the answers in the USSQ and the complications related to the use of the stent. Group B showed less pain (1.52 vs. 4, VAS, p = 0.001) and less difficulty during removal (1.61 vs. 3, p < 0.001) associated with a shorter procedure duration (11.65 min vs. 22.17 min p < 0.001). CONCLUSIONS: The tolerance shown by the use of magnetic double-J is comparable to the tolerance of traditional stent, since it does not cause an increase in urinary symptoms nor worsens the quality of life of patients during its use.

[Prevalence of microbiologically-confirmed influenza in patients with influenza-like illness in primary care and clinical and epidemiological characteristics]. / Prevalencia de gripe confirmada microbiológicamente en pacientes con síntomas gripales en atención primaria y características clínico-epidemiológicas.

OBJECTIVE: We evaluated the prevalence of microbiologically-confirmed influenza infection among patients with influenza-like symptoms and compared the clinical and epidemiological characteristics of patients with and without influenza infection. METHODS: Retrospective study of a cohort of patients with influenza-like symptoms from 2016 to 2018 who participated in a clinical trial in thirteen urban primary centres in Catalonia. Different epidemiological data were collected. Patients rated the different symptoms and signs on a Likert scale (absent, little problem, moderate problem and severe problem) and self-reported the measure of health status with the EuroQol visual analogue scale. A nasopharyngeal swab was taken for microbiological isolation of influenza and other microorganisms. RESULTS: A total of 427 patients were included. Microbiologically confirmed influenza was found in 240 patients (56.2%). The percentage of patients with moderate-to-severe cough, muscle aches, tiredness and dizziness was greater among patients with microbiologically confirmed influenza. The self-reported health status was significantly lower among patients with true flu infection (mean of 36.3 ± 18.2 vs 41.7 ± 17.8 in patients without influenza; p<0.001). CONCLUSIONS: Clinical findings are not particularly useful for confirming or excluding the diagnosis of influenza when intensity is not considered. However, the presence of moderate-to-severe cough, myalgias, tiredness and dizziness along with a poor health status is more common in patients with confirmed flu infection.

Catéter doble J magnético: evaluación de la tolerancia e impacto en la calidad de vida en comparación con el catéter doble J tradicional / Magnetic double-J stent: evaluation of tolerance and impact on quality of life compared to traditional double-J stent

Introducción: La colocación de un catéter doble J (DJ) es uno de los procedimientos más realizados en urología. Puede causar un impacto negativo en la calidad de vida, siendo necesaria una cistoscopia para su extracción. El objetivo de este estudio es evaluar la sintomatología e impacto en la calidad de vida derivados del uso del catéter DJ magnético (Black Star®) y compararla con la del DJ tradicional (OptiMed®).Material y métodosRealizamos un estudio comparativo, prospectivo y aleatorizado en 46 pacientes sometidos a ureterorrenoscopia (URS) en quienes se colocó un DJ entre agosto del 2019 y junio del 2020. De los pacientes incluidos, 23 llevaron un DJ tradicional (grupo A) y 23 un DJ magnético (grupo B). Valoramos en ambos grupos los resultados del cuestionario de síntomas de catéter ureteral (USSQ). Evaluamos el dolor de la extracción mediante la escala visual analógica (EVA) y la dificultad de la retirada. Revisamos la necesidad de atención médica por problemas relacionados con el catéter o surgidos tras la extracción.ResultadosNo observamos diferencias estadísticamente significativas en el cuestionario USSQ, ni en las complicaciones. El grupo B presentó: menor dolor de la extracción (EVA de 1,52 vs. 4, p = 0,001), menor dificultad en la retirada (1,61 vs. 3, p < 0,001) y menor tiempo de extracción (11,65 vs. 22,17 min p < 0,001).ConclusionesEl DJ magnético es un catéter ureteral que presenta una tolerancia equiparable a los tradicionales, ya que no genera un incremento de la sintomatología urinaria ni empeora la calidad de vida de los pacientes durante su uso. (AU)

Introduction: The placement of a ureteral stent is one of the most widely performed procedures in urology. It can have a negative impact on the patients’ quality of life, requiring a cystoscopy for its removal. The objective of this study is to evaluate the symptoms and impact on quality of life derived from the use of a magnetic double-J stent (Black Star ®) and compare them to those presented in patients with a traditional double-J stent (OptiMed®).Material and methodsWe conducted a comparative, prospective, randomized study in 46 patients who underwent ureterorenoscopy with double-J stent placement between August 2019 and June 2020. Of all patients included, 23 had a traditional double-J stent placed (group A) and 23 had a magnetic double-J stent (group B) placed. We evaluated the results of the Ureteral Stent Symptom Questionnaire (USSQ) in both groups, assessed the technical difficulty related to stent removal and the pain during the procedure using the Visual Analogue Scale (VAS). We also reviewed the need for medical attention due to problems related to the stent or after its removal.ResultsThere were no statistically significant differences between groups regarding the answers in the USSQ and the complications related to the use of the stent. Group B showed less pain (1,52 vs. 4, VAS, p = 0.001) and less difficulty during removal (1,61 vs. 3, p < 0,001) associated with a shorter procedure duration (11,65 min vs. 22,17 min p < 0,001).ConclusionsThe tolerance shown by the use of magnetic double-J is comparable to the tolerance of traditional stent, since it does not cause an increase in urinary symptoms nor worsens the quality of life of patients during its use. (AU)

Psychometric design and validation of a tool to assess the medication administration process through simulation in undergraduate nursing students.

BACKGROUND: Medication errors account for 38% of adverse events reported among undergraduate nursing students. Simulation provides training for nursing students in the medication administration process. However, there is a lack of reliable and valid instruments to measure its assessment. OBJECTIVES: To design and validate a new tool (MEDICORRECT) to assess undergraduate nursing students in the medication administration process using a high-fidelity simulation scenario. DESIGN AND METHODS: Study participants were fourth year undergraduate nursing students at the University of Barcelona. Phase 1 consisted of tool design and drafting, and content validity and feasibility analyses. Phase 2 covered construct validity and interrater reliability. A factor analysis was conducted, involving a principal component analysis and varimax rotation. FINDINGS: Of 21 initial items, 11 were eliminated because of low content validity ratio, 4 of which assessed cognitive skills such as administering the right medicine at the right dose, which were impossible to observe in the simulation scenario. The final version of MEDICORRECT contained 10 items. The exploratory factor analysis identified a four-factorial model explaining 67.3% of the variance. Interrater agreement measured with Kappa was greater than 0.70 for 80% of items. CONCLUSIONS: The 10 items in MEDICORRECT are relevant and feasible, have suitable psychometric properties and reflect the practical skills identified in the medication administration process. The tool excludes cognitive skills, which should be included and assessed during prebriefing.

Trombo en tránsito en paciente con neumonía por COVID-19 / Thrombus in transit in patient with COVID-19 pneumonia

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Prefrontal-hippocampal functional connectivity encodes recognition memory and is impaired in intellectual disability.

Down syndrome (DS) is the most common form of intellectual disability. The cognitive alterations in DS are thought to depend on brain regions critical for learning and memory such as the prefrontal cortex (PFC) and the hippocampus (HPC). Neuroimaging studies suggest that increased brain connectivity correlates with lower intelligence quotients (IQ) in individuals with DS; however, its contribution to cognitive impairment is unresolved. We recorded neural activity in the PFC and HPC of the trisomic Ts65Dn mouse model of DS during quiet wakefulness, natural sleep, and the performance of a memory test. During rest, trisomic mice showed increased theta oscillations and cross-frequency coupling in the PFC and HPC while prefrontal-hippocampal synchronization was strengthened, suggesting hypersynchronous local and cross-regional processing. During sleep, slow waves were reduced, and gamma oscillations amplified in Ts65Dn mice, likely reflecting prolonged light sleep. Moreover, hippocampal sharp-wave ripples were disrupted, which may have further contributed to deficient memory consolidation. Memory performance in euploid mice correlated strongly with functional connectivity measures that indicated a hippocampal control over memory acquisition and retrieval at theta and gamma frequencies, respectively. By contrast, trisomic mice exhibited poor memory abilities and disordered prefrontal-hippocampal functional connectivity. Memory performance and key neurophysiological alterations were rescued after 1 month of chronic administration of a green tea extract containing epigallocatequin-3-gallate (EGCG), which improves executive function in young adults with DS and Ts65Dn mice. Our findings suggest that abnormal prefrontal-hippocampal circuit dynamics are candidate neural mechanisms for memory impairment in DS.

Standardized language systems for the design of high-fidelity simulation scenarios: A Delphi study.

PURPOSE: This study aimed to identify which of the standardised Nursing Interventions Classification (NIC) activities should be used in the design of clinical cases with high fidelity simulation for educational preparation of undergraduate nursing students in non-technical skills. DESIGN AND METHODS: A three-round Delphi study was carried out: the first round with taxonomy experts, the second round with academic and clinical lecturers with limited experience in the simulation-based learning methodology, and the third round with academic and clinical lecturers having at least two years of simulation experience. The NIC interventions were grouped into two levels of competence in accordance with the undergraduate nursing degree curriculum (1st- and 2nd-year students, the "novice" level; 3rd- and 4th-year students, the "advanced" level). The NIC allows the description of nurse student competencies in multiple clinical scenarios and throughout various contexts: theory, clinical practice and simulation. FINDINGS: The experts identified 163 interventions in 8 areas as relevant and feasible, selecting 42 for the "novice" students, in Nursing Fundamentals (13) and Adult Nursing Care 1 (29), and 97 for the "advanced" students: Maternity Care and Child Health Nursing (18), Mental Health (13), Nursing Care of Older People (12), Community Health Nursing (20) and Adult Nursing Care 2 (34). In addition, 24 interventions were identified as cross-cutting, with training to be provided across all four years of the degree. CONCLUSION: A total of 163 interventions of the NIC list were selected by experts as being both relevant and feasible to nursing undergraduate education. This creates the favourable framework to design high-fidelity scenarios for the training of non-technical skills according to the competences required and in line with the health care reality. Therefore, enabling an optimal combination of theoretical education by academic lecturers with practical training by clinical lecturers and staff nurses.

Serotonin 5-HT1A, 5-HT2A and dopamine D2 receptors strongly influence prefronto-hippocampal neural networks in alert mice: Contribution to the actions of risperidone.

Atypical antipsychotic drugs (APDs) used to treat positive and negative symptoms in schizophrenia block serotonin receptors 5-HT2AR and dopamine receptors D2R and stimulate 5-HT1AR directly or indirectly. However, the exact cellular mechanisms mediating their therapeutic actions remain unresolved. We recorded neural activity in the prefrontal cortex (PFC) and hippocampus (HPC) of freely-moving mice before and after acute administration of 5-HT1AR, 5-HT2AR and D2R selective agonists and antagonists and atypical APD risperidone. We then investigated the contribution of the three receptors to the actions of risperidone on brain activity via statistical modeling and pharmacological reversal (risperidone + 5-HT1AR antagonist WAY-100635, risperidone + 5-HT2A/2CR agonist DOI, risperidone + D2R agonist quinpirole). Risperidone, 5-HT1AR agonism with 8-OH-DPAT, 5-HT2AR antagonism with M100907, and D2R antagonism with haloperidol reduced locomotor activity of mice that correlated with a suppression of neural spiking, power of theta and gamma oscillations in PFC and HPC, and reduction of PFC-HPC theta phase synchronization. By contrast, activation of 5-HT2AR with DOI enhanced high-gamma oscillations in PFC and PFC-HPC high gamma functional connectivity, likely related to its hallucinogenic effects. Together, power changes, regression modeling and pharmacological reversals suggest an important role of 5-HT1AR agonism and 5-HT2AR antagonism in risperidone-induced alterations of delta, beta and gamma oscillations, while D2R antagonism may contribute to risperidone-mediated changes in delta oscillations. This study provides novel insight into the neural mechanisms for widely prescribed psychiatric medication targeting the serotonin and dopamine systems in two regions involved in the pathophysiology of schizophrenia.