Incidence, treatment, and factors associated with survival of out-of-hospital cardiac arrest attended by Spanish emergency services: report from the Out-of-Hospital Spanish Cardiac Arrest Registry for 2022. / Incidencia, tratamiento y factores asociados con la supervivencia de la parada cardiaca extrahospitalaria atendida por los servicios de emergencias en España: informe 2022 del registro OHSCAR.

SUMMARY: Out-of-hospital cardiac arrest is a serious public health problem worldwide. The annual incidence is estimated at around 400 000 cases in Europe and the United States, and survival rates scarcely reach 10%. However, there is considerable variation between countries and even between regions that share a similar health care system within a single country. Information recorded by the Out-of-Hospital Spanish Cardiac Arrest Registry (OHSCAR) provides information on care provided by emergency ambulance services, final health outcomes after cardiac arrest cases (including variations), the possibility of organ donation, and the impact of the COVID-19 pandemic. This paper presents the OHSCAR report for Spanish emergency services for the year 2022.

RESUMEN: La parada cardiorrespiratoria extrahospitalaria (PCREH) es un grave problema de salud pública mundial, con una incidencia anual estimada entorno a entorno a los 350.000 y 400.000 casos de PCERH en Europa y Estados Unidos, respectivamente. La supervivencia final se sitúa en porcentajes que apenas alcanzan el 10%, aunque existe una importante variabilidad entre países e incluso entre regiones del mismo país con modelos de atención similares. En España, el Registro Español de Parada Cardiaca Extrahospitalaria (acrónimo OHSCAR) ha ofrecido información sobre la asistencia a la PCRE prestada por los servicios de emergencias (SEM) y sus resultados finales en salud, así como sobre variabilidad, posibilidades de programas de donación o impacto de la pandemia COVID-19. A continuación se presenta el informe OHSCAR correspondiente a la asistencia a la PCRE por los SEM españoles durante el año 2022.

Ambulatory blood pressure monitoring. Current status and future perspectives. / Monitorización ambulatoria de la presión arterial. Situación actual y perspectivas futuras.

Ambulatory Blood Pressure Monitoring (ABPM) is considered the best method for obtaining a reliable estimation of the true blood pressure. Average values obtained during the whole 24-hour period, or during daytime and nighttime periods are better correlated with the risk of mortality and cardiovascular disease compared to clinic or office blood pressure. Indeed, nighttime blood pressure, a measure only obtained through ABPM, is the most powerful risk predictor. ABPM is complementary to clinic blood pressure measurement and allows the definition of blood pressure phenotypes, such as "white-coat or masked hypertension, when clinic and ABPM measurements show discrepancy in normal values. Additional potentially relevant features include blood pressure variability, such as nocturnal blood pressure decline, morning surge or short-term variability, as determined by standard deviation or the coefficient of variation.

Glycemic variability in diagnosis of gestational diabetes as predictor of pharmacological treatment.

INTRODUCTION: To establish whether glycemic variability (GV) parameters used when gestational diabetes mellitus (GDM) has been diagnosed could help predict the probability that a patient will need pharmacological treatment, and to analyze the link of these parameters to the development of maternal-fetal complications. MATERIALS AND METHODS: A prospective study of 87 women with GDM who underwent retrospective continuous glucose monitoring (CGM) for six days between weeks 26 and 32 of gestation, following diagnosis. The mean glycemia levels and GV variables were analyzed together with their link to maternal-fetal complications, and the need for pharmacological treatment. ROC (receiver operating characteristic) curves were developed to determine validity to detect the need for pharmacological treatment. RESULTS: Patients with higher mean glycemia (p < 0.001) and continuous overlapping of net glycemic action in a period of n-hours (CONGAn) (p = 0.001) required pharmacological treatment. The ROC curves showed cut-off points of 98.81 mg/dL for mean glycemia, and 86.70 mg/dL for CONGAn, with 83.3% sensitivity and 67.8% specificity for both parameters. No relation between the GV parameters and development of maternal-fetal complications was observed. CONCLUSIONS: The use of CGM, once GDM is diagnosed, enables us to identify those patients who would benefit from closer monitoring during gestation, and facilitate a speedier take-up of pharmacological treatment. However, prospective studies involving a higher number of patients are needed, as well as a cost assessment for recommending the use of CGM following GDM diagnosis.

Thrombotic risk assessed by PAI-1 in patients with COVID-19: The influence of hyperglycemia and diabetes mellitus.

OBJECTIVE: To assess thrombotic risk with PAI-1 levels in patients with COVID-19, to evaluate PAI-1 differences between hyperglycemic and/or Type 2 Diabetes Mellitus (T2DM) versus non-hyperglycemic patients, and to analyze the association of plasminogen activator inhibitor-1 (PAI-1) with hyperglycemia and T2DM. METHODS: A cross-sectional study carried out in 181 patients hospitalized for COVID-19. Two groups were formed: the patients with hyperglycemia at admission and/or previously diagnosed T2DM group and the non-hyperglycemic group. Fibrinolysis was assessed by measuring PAI-1 levels by ELISA. RESULTS: The mean age was 59.4±16.1 years; 55.8% were male 54.1% of patients presented obesity, 38.1% had pre-existing T2DM and 50.8% had admission hyperglycemia and/or pre-existing T2DM. The patients with admission hyperglycemia and/or preexisting T2DM had higher PAI-1 compared with non-hyperglycemic patients [197.5 (128.8-315.9) vs 158.1 (113.4-201.4) ng/mL; p=0.031]. The glucose levels showed a positive correlation with PAI-1 levels (r=0.284, p=0.041). A multivariate logistic regression analysis showed association of PAI-1 level and hyperglycemia and pre-existing T2DM with severity of COVID-19. CONCLUSION: Patients hospitalized for COVID-19 infection with preexisting T2DM or hyperglycemia detected during their hospitalization presented a greater increase in PAI-1 levels, which suggests that hyperglycemia contributes directly to the hypercoagulable state and probably a worse outcome from the patients.

Is lower fetal heart rate variability a susceptibility marker to the impact of negative coparenting on infant regulatory capacity?

Lower fetal heart rate variability (FHRV) may be a prenatal endophenotypic susceptibility marker and increase the impact of both positive and negative coparenting on infant regulatory capacity. This study analyzed the moderator role of FHRV in the association between positive and negative coparenting and infant regulatory capacity at 3 months. The sample comprised 86 first-born infants and their mothers and fathers recruited at a public Health Service in Northern Portugal. FHRV was recorded during routine cardiotocography examination at the third trimester of gestation. Mothers and fathers reported on coparenting and infant regulatory capacity at 2 weeks and 3 months postpartum. FHRV moderated the association between mother's and father's negative coparenting at 2 weeks postpartum and infant regulatory capacity at three months. Infants with low FHRV presented higher regulatory capacity when mothers or fathers reported less negative coparenting, while lower regulatory capacity when mothers or fathers reported more negative coparenting, than infants with high FHRV. Findings suggested lower FHRV as a prenatal endophenotypic susceptibility marker that increases the impact of negative coparenting on infant regulatory capacity.

La más baja variabilidad del pulso cardíaco fetal (FHRV) pudiera ser un marcador determinante de la susceptibilidad endofenotípica prenatal y aumentar el impacto de la crianza compartida tanto positiva como negativa sobre la capacidad regulatoria del infante. Este estudio analizó el papel moderador de FHRV en la asociación entre la positiva y negativa crianza compartida y la capacidad regulatoria del infante a los tres meses. El grupo muestra estaba compuesto de 86 infantes primerizos y sus mamás y papás. Se grabó la FHRV durante una examinación de cardiotocografía de rutina en el tercer trimestre de la gestación. Las mamás y los papás reportaron acerca de la crianza compartida y la capacidad regulatoria del infante a las dos semanas y a los tres meses después del parto. La FHRV moderó la asociación entre la crianza compartida negativa de la mamá y del papá a las dos semanas después del parto y la capacidad regulatoria del infante a los tres meses. Los infantes con baja FHRV presentaron una capacidad regulatoria más alta cuando las mamás o los papás reportaron una crianza compartida menos negativa, mientras que la capacidad regulatoria más baja se dio cuando las mamás o los papás reportaron una crianza compartida más negativa, que los infantes con una FHRV alta. Los resultados señalan la más baja FHRV como un marcador determinante de la susceptibilidad endofenotípica prenatal que aumenta el impacto de la crianza compartida negativa sobre la capacidad regulatoria del infante. Los infantes con baja FHRV pueden ser aquellos que mejor desarrollan mecanismos de autorregulación en la presencia de una crianza compartida menos negativa, mientras que están bajo alto riesgo de problemas regulatorios en la presencia de una crianza compartida más negativa.

Une variabilité de la fréquence cardiaque fœtale (VFCF) plus basse pourrait être un marqueur de sensibilité endophénotypique prénatale et augmenter l'impact du coparentage positif et négatif sur la capacité régulatoire du nourrisson. Cette étude a analysé le rôle modérateur de la VFCF dans le lien entre le coparentage positif et négatif et la capacité régulatoire du nourrisson à trois mois. Cet échantillon a inlu 86 nourrisson premiers nés et leurs mères et pères. La VFCF a été enregistrée penfdant un examen de cardiotocographie de routine au troisième trimestre de la grossesse. Les mères et les pères ont fait état de leur coparentage et de la capacité régulatoire du nourrisson à deux semaines et à trois mois postpartum. La VFCF a modéré le lien entre le coparentage négatif de la mère et du père à deux mois postpartum et la capacité régulatoire du nourrisson à trois mois. Les nourrissons avec une VFCF basse ont présenté une capacité régulatoire plus élevée lorsque les mères ou les pères ont signalé moins de coparentage négatif, alors qu'ils ont présenté une capacité régulatoire plus basse lorsque les mères ou les pères ont signalé un coparentage plus négatif, que les nourrissons avec une VFCF élevée. Les résultats ont suggéré une VFCF plus basse comme un marqueur de sensibilité endophénotypique prénatale qui augmente l'impact de coparentage négatif sur la capacité régulatoire du nourrisson. Les enfants avec une VFCF basse peuvent être ceux qui développent mieux leurs mécanismes auto-régulatoires en présence de moins de coparentage négatif, tout en étant à haut risque de problèmes régulatoires en présence de plus de coparentage négatif.

Psychophysiological reactions during the trauma-film paradigm and their predictive value for intrusions.

Background: Adequate adaptation of the autonomic nervous system (ANS) is crucial in potentially life-threatening situations. The defence cascade provides a descriptive model of progressing dominant physiological reactions in such situations, including cardiovascular parameters and body mobility. The empirical evidence for this model is scarce, and the influence of physiological reactions in this model for predicting trauma-induced intrusions is unresolved.Objectives: Using a trauma-film paradigm, we aimed to test physiological reactions to a highly stressful film as an analogue to a traumatic event along the defence cascade model. We also aimed to examine the predictive power of physiological activity for subsequent intrusive symptoms.Method: Forty-seven healthy female participants watched a stressful and a neutral film in randomized order. Heart rate (HR), heart rate variability (HRV), and body sway were measured. Participants tracked frequency, distress, and quality of subsequent intrusions in a diary for 7 consecutive days.Results: For the stressful film, we observed an initial decrease in HR, followed by an increase, before the HR stabilized at a high level, which was not found during the neutral film. No differences in HRV were observed between the two films. Body sway and trembling frequency were heightened during the stressful film. Neither HR nor HRV predicted subsequent intrusions, whereas perceived distress during the stressful film did.Conclusions: Our results suggest that the physiological trauma-analogue response is characterized by an orientation response and subsequent hyperarousal, reaching a high physiological plateau. In contrast to the assumptions of the defence cascade model, the hyperarousal was not followed by downregulation. Potential explanations are discussed. For trauma-associated intrusions in the subsequent week, psychological distress during the film seems to be more important than physiological distress. Understanding the interaction between physiological and psychological responses during threat informs the study of ANS imbalances in mental disorders such as post-traumatic stress disorder.

We used a trauma-film analogue to examine the defence cascade model and to investigate the influence of psychophysiological response on subsequent intrusions.While we found an orientation phase, upregulation phase, and coactivation indicated by heart rate, no downregulation phase was observed.None of the physiological parameters examined predicted subsequent intrusions, whereas subjective distress during the film did.

Concordancia inter e intraobservador en la medida de los agujeros maculares por tomografía de coherencia óptica / Inter- and intra-observer agreement in the measurement of macular holes by optical coherence tomography

Antecedentes y objetivo El agujero macular de espesor completo (AMEC) es una lesión foveal causada por un defecto del espesor completo de la retina neurosensorial. En su diagnóstico y en la indicación de tratamiento quirúrgico se tiene en cuenta la medida del agujero según la herramienta proporcionada por la OCT. Dicha medida puede ser realizada por varios oftalmólogos a lo largo del seguimiento de un paciente. El objetivo de este estudio es averiguar si existe variabilidad intraindividual e interindividual en dichas mediciones. Material y métodos Revisión retrospectiva de imágenes de b-scans de OCT con diagnóstico de AMEC. Se realizaron mediciones del diámetro mínimo del AMEC mediante la herramienta manual disponible en el DRI-Triton (Topcon, Japón) en las escalas 1:1 y 1:2, en días diferentes, por 2 especialistas en retina y 2 residentes. Se compararon dichas mediciones para valorar la correspondencia interobservador e intraobservador Resultados Se analizan 34 imágenes. Para la variabilidad intraobservador se obtuvo un índice de correlación superior a 0,98 en todos los casos. Para la variabilidad interobservador, el coeficiente de correlación intraclase fue de 0,94 (IC del 95%, 0,91-0,97) para la escala 1:1, y de 0,94 (IC del 95%, 0.91-0,97) para la escala 1:2. Conclusiones Los valores del tamaño de los AMEC medidos por OCT son reproducibles entre oftalmólogos especialistas y residentes y son independientes de la escala de la imagen en la que se realice dicha medición (AU)

Background and objective A full-thickness macular hole (FTMH) is a foveal lesion caused by a defect in the full thickness of the neurosensory retina. Its diagnosis and the indication for surgical treatment take into account the measurement of the hole according to the tool provided by the OCT. This measurement can be performed by several ophthalmologists during the follow-up of a patient. The aim of this study is to find out whether there is intra-individual and inter-individual variability in these measurements. Material and methods Retrospective review of OCT b-scan images with a diagnosis of FTMH. Measurements of the minimum diameter of the FTMH were performed using the hand-held tool available on the DRI-Triton (Topcon, Japan) at 1:1 and 1:2 scales, on different days, by 2retina specialists and 2residents. These measurements were compared to assess inter-observer and intra-observer correspondence. Results Thirty-four images were analysed. For intra-observer variability, a correlation index higher than 0.98 was obtained in all cases. For inter-observer variability, the intra-class correlation coefficient was 0.94 (95% CI: 0.91-0.97) for the 1:1 scale, and 0.94 (95% CI: 0.91-0.97) for the 1:2 scale. Conclusions OCT-measured AMEC size values are reproducible between ophthalmic specialists and residents and are independent of the imaging scale at which the measurement is made (AU)

Selection of planning unit size in dynamic management strategies to reduce human-wildlife conflict.

Conservation planning traditionally relies upon static reserves; however, there is increasing emphasis on dynamic management (DM) strategies that are flexible in space and time. Due to its novelty, DM lacks best practices to guide design and implementation. We assessed the effect of planning unit size in a DM tool designed to reduce entanglement of protected whales in vertical ropes of surface buoys attached to crab traps in the lucrative U.S. Dungeness crab (Metacarcinus magister) fishery. We conducted a retrospective analysis from 2009 to 2019 with modeled distributions of blue (Balaenoptera musculus) and humpback (Megaptera novaeangliae) whales and observed fisheries effort and revenue to evaluate the effect of 7 planning unit sizes on DM tool performance. We measured performance as avoided whale entanglement risk and protected fisheries revenue. Small planning units avoided up to $47 million of revenue loss and reduced entanglement risk by up to 25% compared to the large planning units currently in use by avoiding the incidental closure of areas with low biodiversity value and high fisheries revenue. However, large planning units were less affected by an unprecedented marine heat wave in 2014-2016 and by delays in information on the distributions of whales and the fishery. Our findings suggest that the choice of planning unit size will require decision-makers to navigate multiple socioecological considerations-rather than a one-size-fits-all approach-to separate wildlife from threats under a changing climate.

Selección del tamaño de la unidad de planeación en las estrategias dinámicas de manejo para reducir el conflicto humano-fauna Resumen La planeación de la conservación depende por tradición de las reservas estáticas; sin embargo, cada vez hay más énfasis en estrategias de manejo dinámico (MD) que son flexibles con el tiempo y el espacio. Ya que es novedoso, el MD carece de buenas prácticas que guíen el diseño y la implementación. Analizamos el efecto del tamaño de la unidad de planeación en una herramienta de MD diseñada para reducir el número de ballenas que se enredan en las cuerdas verticales de las boyas amarradas a las trampas para cangrejos de la pesquería lucrativa del cangrejo Dungeness (Metacarcinus magister) en los Estados Unidos. Realizamos un análisis retrospectivo de 2009 a 2019 con modelos de distribución de la ballena azul (Balaenoptera musculus) y la ballena jorobada (Megaptera novaeangliae) y observamos los esfuerzos y ganancias de la pesquería para evaluar el efecto del tamaño de siete unidades de planeación sobre el desempeño de una herramienta de MD. Medimos el desempeño como el riesgo de enredamiento evitado y los ingresos protegidos de la pesquería. Las unidades pequeñas de planeación evitaron hasta $47 millones de ingresos perdidos y redujeron el riesgo de enredamiento hasta en 25% en comparación con las unidades grandes que se usan actualmente al evitar el cierre indirecto de áreas con un valor bajo de biodiversidad e ingresos elevados para la pesquería. Sin embargo, las unidades grandes de planeación estuvieron menos afectadas por una ola de calor marino sin precedentes entre 2014 y 2016 y por los retrasos en la información sobre la distribución de las ballenas y la pesquería. Nuestros hallazgos sugieren que la selección del tamaño de la unidad de planeación requerirá que el órgano decisorio navegue múltiples consideraciones socio-ecológicas-en lugar de un enfoque de un-tamaño-para-todos-para separar a la fauna de las amenazas bajo el clima cambiante.

Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement.

INTRODUCTION: Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness. METHODS: We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas. RESULTS: Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas. CONCLUSIONS: Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.

Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement / Correlación entre hiperconectividad de la corteza auditiva antes del tratamiento con estimulación magnética transcraneal repetitiva y mejoría de los acúfenos

Introduction: Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness. Methods: We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas. Results: Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas. Conclusions: Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.(AU)

Introducción: La estimulación magnética transcraneal repetitiva (EMTr) se ha utilizado como posible tratamiento para los acúfenos, aunque su efectividad es variable e impredecible. Planteamos la hipótesis de que existe una correlación entre la conectividad funcional en estado de reposo antes de aplicar EMTr y la efectividad de dicho tratamiento. Métodos: Aplicamos EMTr a 1 Hz sobre la corteza auditiva primaria (A1) y la corteza prefrontal dorsolateral (CPFDL) izquierdas de 10 pacientes con acúfenos y 10 controles del mismo rango de edad. Se realizaron estudios de resonancia magnética funcional (RMF) en estado de reposo de todos los pacientes aproximadamente una semana antes de la EMTr. En cada caso, se construyó un mapa de conectividad basado en las ROIs, en el que las ROIs eran las áreas que se tratarían con la EMTr. Resultados: La región temporal superior izquierda mostró una conectividad positiva significativamente mayor con el área A1 izquierda y mayor conectividad negativa con la CPFDL izquierda en los pacientes con acúfenos que en los controles. Además, las áreas frontoparietal izquierda y cerebelar derecha mostraron una conectividad negativa significativamente superior con el área A1 izquierda y mayor conectividad positiva con la CPFDL izquierda. La hiperconectividad de las ROIs se correlacionó con mejoría de los acúfenos según las puntuaciones pre-EMTr y 2 semanas post-EMTr en la escala Tinnitus Handicap Inventory. La mejoría de los acúfenos se correlacionó de manera significativa con la hiperconectividad del área A1 izquierda; sin embargo, no se encontró correlación con la conectividad de la CPFDL izquierda. El resultado favorable del tratamiento con EMTr se asocia con una mayor conectividad positiva en áreas temporales superiores de ambos hemisferios y con mayor conectividad negativa en áreas frontales bilaterales...(AU)

Pérdida de células endoteliales después de cirugía de catarata por facoemulsificación

Objetivo: Determinar la pérdida celular endotelial corneal posterior a la cirugía de catarata por técnica de facoemulsificación. Métodos: Se realizó un estudio descriptivo de intervención prospectivo y longitudinal. Se estudiaron 51 ojos operados de catarata por la técnica de facochop. Se les realizó microscopia endotelial pre- y posoperatoria a los tres y seis meses de la intervención. También se estudiaron los parámetros facodinámicos. Resultados: La edad promedio fue de 66,7 ± 11,7 años, predominó el sexo femenino (53,7 %). Se observó una disminución significativa de los valores promedios de densidad celular y hexagonalidad a los tres y seis meses posteriores a la operación de catarata. El porcentaje de pérdida de células endoteliales posterior a la intervención fue de 19,6 ± 0,8 %. El tiempo total de ultrasonido medio fue de 11,8 ± 4,5 seg mientras el tiempo efectivo de facoemulsificación tuvo una media de 0,008 ± 0,001 seg. Conclusiones: El recuento de células endoteliales corneales muestra una disminución significativa de los valores promedios de densidad celular y hexagonalidad a los tres y seis meses posteriores a la operación de catarata, el porcentaje de pérdida de células endoteliales corneales a los seis meses posterior está dentro de los límites normales y se observa relación de dependencia entre el tiempo efectivo de facoemulsificación y el porcentaje de pérdida de células endoteliales.

Objective: To determine the loss of corneal endothelial cell after cataract surgery by the phacoemulsification technique. Methods: A prospective, longitudinal, descriptive and interventional study was conducted. Fifty-one eyes operated on for cataract by the phacoemulsification technique were studied. Preoperative, as well as postoperative endothelial microscopy at three and six months after the cataract surgery, was performed. Phacodynamic parameters were also studied. Results: The mean age was 66.7 ± 11.7 years and there was a predominance of the female sex (53.7%). A significant decrease in the mean values of cell density and hexagonality was observed at three and six months after the cataract surgery. The percentage of endothelial cell loss after surgery was 19.6% ± 0.8%. The mean total ultrasound time was 11.8 ± 4.5 secs, while the effective phacoemulsification time had a mean of 0.008 ± 0.001 secs. Conclusions: The count of corneal endothelial cell shows a significant decrease in the mean values of cell density and hexagonality at three and six months after the cataract surgery; the percentage of corneal endothelial cell loss at six months is within normal limits; and a dependent relationship is observed between the effective phacoemulsification time and the percentage of endothelial cell loss.

Parental sensitivity, family alliance and infants' vagal tone: Influences of early family interactions on physiological emotion regulation.

In this study, we investigated the influence of parental sensitivity and family alliance on infants' vagal tone, considered as a physiological indicator of emotion regulation. Studies on mother-infant interactions have shown that vagal tone can be influenced by the quality of the interaction, such as interacting with a sensitive mother. To date, no study has investigated the influence of paternal sensitivity or family alliance on infants' vagal tone. We hypothesized that maternal sensitivity, paternal sensitivity, and family alliance would be associated with infants' vagal tone during dyadic and triadic interactions. We also explored if family alliance would act as a moderator on the association between parental sensitivity and vagal tone and if the sensitivity of both parents would act as a moderator on the association between family alliance and vagal tone. This study took place in Switzerland and included 82 families with their 3-4-month-old infants. Results showed that maternal sensitivity and family alliance were associated with infants' vagal tone, but paternal sensitivity was not. We found no significant moderation effect. However, result tendencies suggested that the contribution of paternal sensitivity to infants' emotion regulation could be influenced by family alliance, whereas maternal sensitivity and family alliance have a unique contribution.

En este estudio, investigamos la influencia de la sensibilidad del progenitor y la alianza de familia sobre el tono vagal del infante, considerado como un indicador fisiológico de regulación de la emoción. Los estudios acerca de las interacciones madre-infante han demostrado que el tono vagal puede ser influido por la calidad de la interacción, tal como el interactuar con una mamá sensible. Hasta hoy, ningún estudio ha investigado la influencia de la sensibilidad paterna o la alianza de familia sobre el tono vagal del infante. Nuestra hipótesis es que la sensibilidad materna, la sensibilidad paterna y la alianza de familia estaban asociadas con el tono vagal del infante durante las interacciones diádicas y triádicas. También exploramos si la alianza de familia actuaba como moderadora en la asociación entre la sensibilidad paterna y el tono vagal y si la sensibilidad de ambos progenitores actuaba como moderadora en la asociación entre la alianza de familia y el tono vagal. Este estudio se llevó a cabo en Suiza e incluyó a 82 familias con sus infantes de 3-4 meses de edad. Los resultados muestran que la sensibilidad materna y la alianza de familia estaban asociadas con el tono vagal del infante, pero que la sensibilidad paterna no lo estaba. No encontramos ningún efecto de moderación significativo. Sin embargo, las tendencias del resultado sugieren que la contribución de la sensibilidad paterna a la regulación de la emoción puede ser influida por la alianza de familia, mientras que la sensibilidad materna y la alianza de familia tienen una contribución particularmente única.

Dans cette étude nous nous sommes penchés sur l'influence de la sensibilité paternelle et de l'alliance de la famille sur le tonus vagal des nourrissons, considéré comme étant un indicateur physiologique de la régulation de l'émotion. Les études sur les interactions mère-nourrisson ont montré que le tonus vagal peut être influencé par la qualité de l'interaction, comme l'interaction avec une mère sensible. Jusqu'à présent aucune étude n'a porté sur l'influence de la sensibilité paternelle ou l'alliance familiale sur le tonus vagal des nourrissons. Nous avons fait l'hypothèse que la sensibilité maternelle, la sensibilité paternelle, et l'alliance familiale peuvent être liées au tonus vagal des nourrissons durant les interactions dyadiques et triadiques. Nous avons également exploré si l'alliance familiale pourrait agir comme modératrice sur le lien entre la sensibilité parentale et le tonus vagal et si la sensibilité des deux parents pourrait agir comme modérateur du lien entre l'alliance familiale et le tonus vagal. Cette étude s'est faite en Suisse et a inclus 82 familles avec des bébés de 3-4 mois. Les résultats ont montré que la sensibilité maternelle et l'alliance familiale étaient liées au tonus vagal des bébés mais la sensibilité de l'était pas. Nous n'avons trouvé aucun effet de modération important. Cependant les tendances des résultats ont suggéré que la contribution de la sensibilité paternelle à la régulation de l'émotion des nourrissons pourrait être influencée par l'alliance familiale alors que la sensibilité maternelle et l'alliance familiale a une contribution unique.

Experiencia Emocional y sus Fundamentos Biológicos: Mejorando el Estado Emocional a Través del Tono Vagal / Emotional Experience and its Biological Underpinnings: Improving Emotional Well-Being Through Vagal Tone

El objetivo principal de este trabajo es el de recopilar conocimiento sobre la base de los fundamentos biológicosde la experiencia emocional y sobre la posibilidad de mejora del bienestar emocional a través del aumento deltono vagal. El tono vagal es considerado un indicador de la experiencia emocional. Y la experiencia emocional esconcebida como un proceso dinámico donde interaccionan la propia reacción emocional y la capacidad de regularla reacción emocional. Mediante las intervenciones en biorretroalimentación de la variabilidad de la frecuenciacardíaca centradas en la respiración y mediante la neuroestimulación transauricular del nervio vago es posibleaumentar el tono vagal de forma que se mejora el estado emocional.(AU)

The main objective of this study is to present knowledge on the biological underpinnings of emotional experience andon the possibility of improving emotional well-being by increasing vagal tone. Vagal tone is considered an indicatorof emotional experience. An emotional experience is conceived as a dynamic process in which an emotional reactionand the ability to regulate the emotional reaction interact. Through heart rate variability biofeedback interventionsfocusing on breathing and through transauricular vagus nerve stimulation, it is possible to increase the vagal tone ina way that improves the emotional state.(AU)

Reactividad Cardiaca ante Evocación de Eventos Estresantes en Población Universitaria / Cardiac Reactivity to Evocation of Stressful Events in a University Population

Resumen La variabilidad de la frecuencia cardiaca (VFC) se utiliza como una señal fisiológica para evaluar la reactividad psicofisiológica al estrés. El análisis en el dominio de la frecuencia de esta señal se ha usado para describir el papel del sistema nervioso autónomo en los procesos de adaptación al estrés. Sin embargo, el uso de medidas de tendencia central para reportar los resultados de distintas poblaciones desestima las diferencias individuales en la reacción frente al estrés. El objetivo de esta investigación fue caracterizar la reactividad cardiaca ante la evocación de eventos estresantes en población universitaria. Participaron 94 estudiantes de nuevo ingreso a la carrera de psicología, de dos universidades de México. Los resultados indican un decremento consistente en la banda de alta frecuencia ante la evocación de eventos estresantes, en comparación con la banda de baja frecuencia. La caracterización de la respuesta autonómica al estrés presenta dos subgrupos acoplados (co-activación y co-inhibición); y uno desacoplado. Nuestros hallazgos, ratifican la viabilidad de la banda de frecuencia alta de la VFC como un indicador estable de reactividad al estrés, y resaltan la importancia de las diferencias específicas de la actividad autonómica en la caracterización de la respuesta fisiológica al estrés.

Abstract Heart rate variability (HRV) is used as a reliable physiological signal to assess psychophysiological reactivity to stress. Frequency-domain mathematical analysis of the HRV signal provides metrics that are associated with the performance of the autonomic nervous system. However, the use of measures of central tendency to report global results in different populations underestimates individual differences in the way people react to stress and the clinical importance of this response. The objective of this research was to characterize cardiac reactivity to the evocation of stressful events in a university population. The participants were 94 new psychology students from two universities in Mexico. A psychophysiological stress assessment was performed to estimate cardiac reactivity; the evaluation consisted of the following conditions: 1) Baseline; 2) Evocation of stress; and 3) Recovery. The participants were sitting with their eyes closed and without moving during every single one of the conditions. Four subgroups were created depending on the type of cardiac reactivity to stress. The results indicate a significant consistent decrease in the high-frequency band when evoking stressful events, compared to the low-frequency band. Similar responses were observed between the low-frequency band and the high-frequency band in 60.6% of the cases, suggesting that the antagonistic autonomic balance between the two divisions of the ANS was scarce. According to the autonomic space model and the type of stress reactivity of each student, there were two subgroups characterized by co-activation and co-inhibition modes; and one subgroup characterized by uncoupled response mode. Our findings confirm the viability of the high-frequency band of HRV as a stable indicator of stress reactivity. Likewise, evidence is generated in favor of using evocative stress stimuli to assess physiological reactivity like more personal stressors. Lastly, the importance of specific differences in autonomic activity to characterize the physiological response to stress and its possible clinical utility to propose interventions and select techniques that most effectively benefit vulnerable populations are highlighted.

Faster-acting insulin aspart reduces glycaemic variability in sensor-augmented pump treated type 1 diabetes patients.

AIM: To evaluate the effect of faster aspart over glycaemic variability in type 1 diabetes (T1D) patients treated with sensor-augmented pump (SAP) in a real-world scenario. METHODS: Observational study with SAP-treated adult T1D patients treated with faster aspart for three months. The primary endpoint was the mean amplitude of glucose excursions (MAGE). RESULTS: Fifty patients were treated with faster aspart. Eleven patients (23%) withdrew during the follow-up mainly due to worsening of diabetes control (9 patients). Mean age was 41.2 yrs. (range 21-59) and T1D duration 22.4±10.0 yrs. Mean SAP treatment duration was 3.6±3.1 yrs. We detected a reduction of -7.0 (95% CI -1.1, -12.9; p=0.021) in MAGE at the end of the study. Other glycemic variability indices were also improved: standard deviation of mean interstitial glucose (-3mg/dl; 95% CI, -1, -5; p=0.01), CONGA4 (-2.2; 95% CI -0.3, -4.2; p=0.029), CONGA6 (-2.6; 95% CI -0.6, -4.6; p=0.011), GRADE (-0.5; 95% CI -0.1, -0.9; p=0.022), HBGI (-0.7; 95% CI -0.2, -1.3; p=0.013), J-index (-2.9; 95% CI -0.7, -5.0; p=0.011) and MODD (-5.7; 95% CI -1.7, -9.7; p=0.006). A slight reduction in mean glucose management indicator was also detected (-0.14%; 95% CI, -0.02, -0.27; -1.4mmol/mol; 95% CI -0.1, -3.3; p=0.03). CONCLUSIONS: In SAP-treated T1D patients, faster aspart insulin was associated with reduced glycaemic variability, but also a high percentage of dropouts due to worsened glycaemic control. NCT04233203.

Evaluación de cultivares de arroz (Oryza sativa L.) de Vietnam, para su introducción en Cuba

Con el objetivo de evaluar la diversidad fenotípica de ocho cultivares de arroz (Oryza sativa L.) procedentes de Vietnam, para su introducción en los programas de mejora y en la producción en Cuba, apoyados en caracteres morfoagronómicos y técnicas de análisis multivariado, fue desarrollado este trabajo en la Unidad Científico Tecnológica de Base "Los Palacios", perteneciente al Instituto Nacional de Ciencias Agrícolas de Cuba. Los cultivares vietnamitas se sembraron en campo junto a los comerciales INCA LP-5 e INCA LP-7, para ser caracterizados agronómicamente con la utilización de 29 descriptores cualitativos y 22 cuantitativos. Los resultados mostraron que 16 caracteres cualitativos resultaron homogéneos para los ocho cultivares procedentes de Vietnam y los dos cultivares comerciales cubanos, la asociación entre varios caracteres cuantitativos reafirma la influencia que ejercen algunos componentes sobre el rendimiento, los que son considerados como marcadores para la selección, tres cultivares de procedencia vietnamita (GL301, LCG3-4 y DS1) no pueden ser utilizados en la producción arrocera en Cuba, por su susceptibilidad a Tagosodes. Todos los cultivares mostraron resistencia a Rhizoctonia solani y Sarocladium oryzae y dos (GL 301 y LTH 31) fueron susceptibles a Pyricularia grisea. Los cultivares OM6976, OM5451 y OM8087 alcanzaron valores altos de rendimiento, por lo que pudieran ser utilizados, como progenitores en los programas de mejora, así como cultivares comerciales.

With the objective of evaluating the phenotypic diversity of eight rice cultivars (Oryza sativa L.) from Vietnam, for their introduction in breeding programs and production in Cuba, supported by morphoagronomic characters and multivariate analysis techniques, this work was developed in Scientific and Technological Base Unit belonging to the National Agricultural Sciences Institute of Cuba. The Vietnamese cultivars were planted in the field together with the commercial cultivars INCA LP-5 and INCA LP-7, to be characterized agronomically with the use of 29 qualitative and 22 quantitative descriptors. The results showed that 16 qualitative characters were homogeneous for the eight cultivars from Vietnam and the two Cuban commercial cultivars, the association between various quantitative characters reaffirms the influence exerted by some components on yield, which are considered as markers for selection. Three cultivars of Vietnamese origin (GL301, LCG3-4 and DS1) cannot be used in Cuban rice production, due to their susceptibility to Tagosodes. All cultivars showed resistance to Rhizoctonia solani and Sarocladium oryzae and two (GL 301 and LTH 31) were susceptible to Pyricularia grisea. The OM6976, OM5451 and OM8087 cultivars reached high yield values, so they could be used as parents in breeding programs, as well as commercial cultivars.

Habilidad combinatoria de los caracteres relacionados con la producción de habichuela (Phaseolus vulgaris L.)

Las variedades de habichuela cultivadas en Colombia presentan un bajo potencial de producción, por lo que se hace necesario adelantar programas de mejoramiento, cuya ejecución depende del conocimiento de la habilidad combinatoria de los cultivares disponibles. Con el objetivo de evaluar la acción génica predominante en caracteres de importancia económica, se evaluaron 15 híbridos directos y seis progenitores. Las habilidades combinatorias general (HCG) y específica (HCE), se estimaron con el Método 2 modelo 1 de Griffing, que considera a los progenitores y sus cruzamientos directos. Se midieron los caracteres: número de vainas y producción por planta, peso promedio y longitud de la vaina. Los resultados indicaron efectos genéticos aditivos para longitud de la vaina; por el contrario, el número de vainas y producción por planta, se vieron influenciados por efectos genéticos no aditivos, mientras que el peso promedio de la vaina fue controlado por efectos genéticos, tanto aditivos como no aditivos. Los progenitores 1 y 6 mostraron efectos positivos más altos de HCG, para el peso promedio y longitud de la vaina, mientras los progenitores 5 y 6, lo fueron para la producción de vainas por planta y los progenitores 4 y 5, para el número de vainas por planta. La estimación de HCE más alta para todos los caracteres, se presentó en el hibrido 1x2, siendo la más adecuada para mejorar la producción de la habichuela.

Green bean varieties grown in Colombia have low production potential, therefore it is necessary to carry out plant breeding programs, which execution depends on the knowledge of the combinatorial ability of the available cultivars. To evaluate the predominant gene action in economically important traits 15 direct hybrids and six parents were evaluated. General combining ability (GCA) and specific combining ability (SCA) were estimated with Griffing's Method 2 model 1, which considers parents and their direct crosses. The characters: number of pods and yield per plant, average weight and pod length were measured. The results indicated additive genetic effects for pod length. In contrast, pod number and yield per plant were influenced by non-additive genetic effects, while average pod weight was controlled by both additive and non-additive genetic effects. Parents 1 and 6 showed higher positive effects of HCG for average pod weight and pod length, while parents 5 and 6 for pod yield per plant and parents 4 and 5 for number of pods per plant. The highest ECGH estimation for all traits was found in the 1x2 hybrid, being the most suitable for improving bean production.

Respuestas autonómicas y análisis de la carga interna mediante la evaluación aguda de la variabilidad de la frecuencia cardíaca tras una sesión de entrenamiento funcional de alta intensidad / Autonomic responses and internal load analysis through acute assessment of heart rate variability after a high-intensity functional training session

Backgroud: Heart rate variability (HRV) measurement is an important tool that may help indicate possible physiological changes, and HRV monitorization could be a great strategy for clinical analysis (autonomic control) and performance (internal load).Objective: The aim of the present study was to evaluate autonomic responses and internal load through HRV during a higintensity functional training (HIFT) session.Material and method: Thirty-three individuals (22 men and 11 women) participated in the study (Age: Mean = 34.9 ± 7.2years; Weight: Mean = 72.3 ± 13.7 kg; Height: Mean = 1.72 ± 0.1 m; BMI: Mean = 24.4 ± 3.0 kg/m²). All participants engaged ina 60-to-90-minute HIFT session. HRV analysis was performed during the specific warm-up period (targeted warm-up or skilltraining that followed the general mobility and light cardiovascular warm-up), during exercise (approximately 50 minutes),and in the recovery phase (10 minutes post-training). A Polar H10 heart rate monitor chest strap (Kempele, Finland®) wasused to collect HRV and was connected to the Elite HRV mobile application. The data were further transferred to Kubios HRVStandart software, version 3.3.1, in order to process the acquired data.Results: For isolated analyzes (pre- and post-), differences were found for SDNN (P<0.001), RMSSD (P<0.001) and HF(P=0.041), yet not for LF / HF (P=0.483). In the analysis of HRV kinetics, significant results were found between momentsfor RR, SDNN, RMSSD, LF and HF (P<0.05). In the analysis of the internal load, the highest level of stress was identified in 40(P=0.010) and 50 minutes of exercise (P=0.001), as well as in recovery (P<0.001), this assessment being carried out throughHRV through the LnRMSSD index. A negative correlation was observed between maximum heart rate (HRmax) and LnRMSSDat 40 (r=-0.51) and 50 minutes of exercise (r=-0.58). In recovery, the correlation was positive, yet insignificant (r=0.032)...(AU)

Introducción: La medición de la variabilidad de la frecuencia cardiaca (HRV) es una herramienta importante que puedeayudar a indicar posibles cambios fisiológicos. La monitorización de la HRV podría ser una gran estrategia para el análisisclínico (control autonómico) y el rendimiento (carga interna).Objetivo: El objetivo del presente estudio fue evaluar las respuestas autonómicas y la carga interna a través de la VFC duranteuna sesión de entrenamiento funcional de alta intensidad (HIFT).Material y método: Treinta y tres individuos (22 hombres y 11 mujeres) participaron en el estudio (Edad: Media = 34,9 ±7,2 años; Peso: Media = 72,3 ± 13,7 kg; Altura: Media = 1,72 ± 0,1 m; IMC: Media = 24,4 ± 3,0 kg / m²). Todos los participantesparticiparon en una sesión HIFT de 60 a 90 minutos. El análisis de la VFC se realizó durante el periodo de calentamiento específico (calentamiento dirigido o entrenamiento de habilidades que seguía al calentamiento cardiovascular ligero y demovilidad general), durante el ejercicio (aproximadamente 50 minutos) y en la fase de recuperación (10 minutos despuésdel entrenamiento). Se utilizó una banda de pecho con pulsómetro Polar H10 (Kempele, Finlandia®) para recoger la VFC y seconectó a la aplicación móvil Elite HRV. Los datos se transfirieron posteriormente al software Kubios HRV Standart, versión3.3.1, para procesar los datos adquiridos.Resultados: En los análisis aislados (pre y post), se encontraron diferencias para SDNN (p <0,001), RMSSD (p <0,001) y HF(p = 0,041), pero no para LF / HF (p = 0,483). En el análisis de la cinética de la VFC, se encontraron resultados significativos entremomentos para RR, SDNN, RMSSD, LF y HF (p <0,05). En el análisis de la carga interna, el mayor nivel de estrés se identificóen 40 (p = 0,010) y 50 minutos de ejercicio (p = 0,001), así como en la recuperación (p <0,001), realizándose esta valoración...(AU)

The long-term impact of early adverse experience on adaptive functioning: a pilot study integrating measures of mental status, nonverbal communication, and heart rate variability.

Background: Childhood maltreatment (CM) can disrupt the development of behavioural and physiological systems, increasing the risk of physical and psychological adverse outcomes across the lifespan. CM may cause interpersonal dysfunctions that impair social communication and lead to dysfunctional activation of the autonomic nervous system. The present exploratory study analyzed the long-term impact of CM from an integrated perspective through the simultaneous assessment of psychological symptoms, social and behavioural communication, and physiological regulation.Methods: Participants were 55 healthy university students (9 males and 46 females; mean age ± SD = 25.26 ± 2.83 years), who filled out a battery of questionnaires to assess the presence of CM (Childhood Trauma Questionnaire) and psychopathological symptoms (Symptom Check-List-90 Item Revised). Participants were then subjected to a videotaped interview for the assessment of non-verbal behaviour (Ethological Coding System for Interviews) and measurement of tonic heart rate variability (HRV), a measure of physiological adaptability to the environment. We performed Pearson's correlation analysis to evaluate the associations between non-verbal behaviour, HRV, and CM variables. Multiple regression analysis was used to evaluate the independent associations between CM variables on HRV and nonverbal behaviour.Results: We found an association between more severe CM, increased symptoms-related distress (ps < .001), less submissive behaviour (ps < .018), and decreased tonic HRV (ps < .028). As a result of multiple regression analysis, participants with a history of emotional abuse (R² = .18, p = .002) and neglect (R² = .10, p = .03) were more likely to display decreased submissive behaviour during the dyadic interview. Moreover, early experience of emotional (R² = .21, p = .005) and sexual abuse (R² = .14, p = .04) was associated with decreased tonic HRV.Conclusion: Our preliminary findings show the utility of analyzing the long-term effects of adverse early experiences at different levels of 'adaptive functioning' (the capabilities needed to respond effectively to environmental demands).

Substantial traumatic experiences during childhood, such as emotional abuse, emotional neglect, and sexual abuse were associated with lower heart rate variability levels in a sample of young adults.Young adults with a history of emotional abuse and neglect were more likely to display decreased submissive behaviour (ethological behaviour) during the dyadic interview.Severe childhood maltreatment was associated with increased symptoms-related distress, less submissive behaviour (ethological behaviour), and decreased tonic heart rate variability in young adults.

Beyond hyperglycemia: glycaemic variability as a prognostic factor after acute ischemic stroke.

INTRODUCTION: Glycaemic variability (GV) refers to variations in blood glucose levels, and may affect stroke outcomes. This study aims to assess the effect of GV on acute ischaemic stroke progression. METHODS: We performed an exploratory analysis of the multicentre, prospective, observational GLIAS-II study. Capillary glucose levels were measured every 4 hours during the first 48 hours after stroke, and GV was defined as the standard deviation of the mean glucose values. The primary outcomes were mortality and death or dependency at 3 months. Secondary outcomes were in-hospital complications, stroke recurrence, and the impact of the route of insulin administration on GV. RESULTS: A total of 213 patients were included. Higher GV values were observed in patients who died (n = 16; 7.8%; 30.9 mg/dL vs 23.3 mg/dL; p = 0.05). In a logistic regression analysis adjusted for age and comorbidity, both GV (OR = 1.03; 95% CI, 1.003-1.06; p = 0.03) and stroke severity (OR = 1.12; 95% CI, 1.04-1.2; p = 0.004) were independently associated with mortality at 3 months. No association was found between GV and the other outcomes. Patients receiving subcutaneous insulin showed higher GV than those treated with intravenous insulin (38.95 mg/dL vs 21.34 mg/dL; p < 0.001). CONCLUSIONS: High GV values during the first 48 hours after ischaemic stroke were independently associated with mortality. Subcutaneous insulin may be associated with higher VG levels than intravenous administration.