Detecting Oxygenator Thrombosis in ECMO: A Review of Current Techniques and an Exploration of Future Directions.

Extracorporeal membrane oxygenation (ECMO) is a life-support technique used to treat cardiac and pulmonary failure, including severe cases of COVID-19 (coronavirus disease 2019) involving acute respiratory distress syndrome. Blood clot formation in the circuit is one of the most common complications in ECMO, having potentially harmful and even fatal consequences. It is therefore essential to regularly monitor for clots within the circuit and take appropriate measures to prevent or treat them. A review of the various methods used by hospital units for detecting blood clots is presented. The benefits and limitations of each method are discussed, specifically concerning detecting blood clots in the oxygenator, as it is concluded that this is the most critical and challenging ECMO component to assess. We investigate the feasibility of solutions proposed in the surrounding literature and explore two areas that hold promise for future research: the analysis of small-scale pressure fluctuations in the circuit, and real-time imaging of the oxygenator. It is concluded that the current methods of detecting blood clots cannot reliably predict clot volume, and their inability to predict clot location puts patients at risk of thromboembolism. It is posited that a more in-depth analysis of pressure readings using machine learning could better provide this information, and that purpose-built imaging could allow for accurate, real-time clotting analysis in ECMO components.

Perspectives on technology - prostate cancer: is local anaesthetic transperineal prostate biopsy really better than transrectal biopsy?

For many years, transrectal ultrasound-guided (TRUS) prostate biopsies have been performed to establish a histological diagnosis of prostate cancer. This has been the recommended standard of care procedure, but has always carried risks, in particular the risk of post-procedural sepsis, and the associated antibiotic burden and risk of development of antibiotic resistance. Transperineal (TP) prostate biopsies performed under local anaesthetic (LA) have been proposed as a possible solution to these issues, with potentially lower infectious complications, and avoidance of need for antibiotic prophylaxis. The European Association of Urology produced guidance in 2023 with 'weak' recommendations in favour of LATP biopsy as a new standard of care, citing its safety profile. Both the National Institute for Health and Care Excellence in the UK, and the American Urological Association in the United States, have concluded for now that the body of evidence is inadequate and not offered a similar recommendation. We discuss the available evidence, pros and cons of each technique, and the status of current trials in the field. We believe that clinical equipoise remains necessary, given the disparity in national and international guidelines highlighting the need for large randomised controlled trials to answer the question: is LATP biopsy really better than TRUS biopsy?

Skin electronics from scalable fabrication of an intrinsically stretchable transistor array.

Skin-like electronics that can adhere seamlessly to human skin or within the body are highly desirable for applications such as health monitoring, medical treatment, medical implants and biological studies, and for technologies that include human-machine interfaces, soft robotics and augmented reality. Rendering such electronics soft and stretchable-like human skin-would make them more comfortable to wear, and, through increased contact area, would greatly enhance the fidelity of signals acquired from the skin. Structural engineering of rigid inorganic and organic devices has enabled circuit-level stretchability, but this requires sophisticated fabrication techniques and usually suffers from reduced densities of devices within an array. We reasoned that the desired parameters, such as higher mechanical deformability and robustness, improved skin compatibility and higher device density, could be provided by using intrinsically stretchable polymer materials instead. However, the production of intrinsically stretchable materials and devices is still largely in its infancy: such materials have been reported, but functional, intrinsically stretchable electronics have yet to be demonstrated owing to the lack of a scalable fabrication technology. Here we describe a fabrication process that enables high yield and uniformity from a variety of intrinsically stretchable electronic polymers. We demonstrate an intrinsically stretchable polymer transistor array with an unprecedented device density of 347 transistors per square centimetre. The transistors have an average charge-carrier mobility comparable to that of amorphous silicon, varying only slightly (within one order of magnitude) when subjected to 100 per cent strain for 1,000 cycles, without current-voltage hysteresis. Our transistor arrays thus constitute intrinsically stretchable skin electronics, and include an active matrix for sensory arrays, as well as analogue and digital circuit elements. Our process offers a general platform for incorporating other intrinsically stretchable polymer materials, enabling the fabrication of next-generation stretchable skin electronic devices.

Mortality, Functional Status, and Quality of Life after 5 Years of Patients Admitted to Critical Care for Spontaneous Intracerebral Hemorrhage.

BACKGROUND: The objective of this study was to assess long-term outcome in patients with spontaneous intracerebral hemorrhage admitted to the intensive care unit. METHODS: Mortality and Glasgow Outcome Scale, Barthel Index, and 5-level EQ-5D version (EQ-5D-5L) scores were analyzed in a multicenter cohort study of three Spanish hospitals (336 patients). Mortality was also analyzed in the Medical Information Mart for Intensive Care III (MIMIC-III) database. RESULTS: The median (25th percentile-75th percentile) age was 62 (50-70) years, the median Glasgow Coma Score was 7 (4-11) points, and the median Acute Physiology and Chronic Health disease Classification System II (APACHE-II) score was 21 (15-26) points. Hospital mortality was 54.17%, mortality at 90 days was 56%, mortality at 1 year was 59.2%, and mortality at 5 years was 66.4%. In the Glasgow Outcome Scale, a normal or disabled self-sufficient situation was recorded in 21.5% of patients at 6 months, in 25.5% of patients after 1 year, and in 22.1% of patients after 5 years of follow-up (4.5% missing). The Barthel Index score of survivors improved over time: 50 (25-80) points at 6 months, 70 (35-95) points at 1 year, and 90 (40-100) points at 5 years (p < 0.001). Quality of life evaluated with the EQ-5D-5L at 1 year and 5 years indicated that greater than 50% of patients had no problems or slight problems in all items (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). In the MIMIC-III study (N = 1354), hospital mortality was 31.83% and was 40.5% at 90 days and 56.2% after 5 years. CONCLUSIONS: In patients admitted to the intensive care unit with a diagnosis of nontraumatic intracerebral hemorrhage, hospital mortality up to 90 days after admission is very high. Between 90 days and 5 years after admission, mortality is not high. A large percentage of survivors presented a significant deficit in quality of life and functional status, although with progressive improvement over time. Five years after the hemorrhagic stroke, a survival of 30% was observed, with a good functional status seen in 20% of patients who had been admitted to the hospital.

Load-velocity Relationship of the Bench Press Exercise is not Affected by Breast Cancer Surgery and Adjuvant Therapy.

We examined the effect of breast cancer surgery and adjuvant therapy on the relationship between bar velocity and relative intensity (load-velocity [L-V] relationship) of the bench press (BP) exercise. Twenty-two breast cancer survivors (age: 48.0±8.2 yr., relative strength: 0.40±0.08) completed a loading test up to the one-repetition maximum (1RM) in the BP using a lightweight carbon bar. General and individual relationships between relative intensity (%1RM) and mean propulsive velocity (MPV) were studied. Furthermore, the mean test velocity (MPVTest) and velocity attained to the 1RM (MPV1RM) were analyzed. These procedures and analyses were also conducted in 22 healthy women (age: 47.8±7.1 yr., relative strength: 0.41±0.09) to examine the differences in velocity parameters derived from these L-V relationships. Polynomial regressions showed very close relationships (R2≥0.965) and reduced estimation errors (≤4.9% 1RM) for both groups. Between-group differences in MPV attained to each %1RM were small (≤0.01 m·s-1) and not significant (p≥0.685). Similarly, the MPVTest (0.59±0.06 m·s-1) and MPV1RM (0.17±0.03 m·s-1) were identical for breast cancer survivors and healthy women. These results suggest that practitioners could use the same velocity parameters derived from the BP L-V relationship to prescribe this exercise in middle-aged women, regardless of whether they have suffered from breast cancer.

Using Resistance-Band Tests to Evaluate Trunk Muscle Strength in Chronic Low Back Pain: A Test-Retest Reliability Study.

Exercise is a front-line intervention to increase functional capacity and reduce pain and disability in people with low strength levels or disorders. However, there is a lack of validated field-based tests to check the initial status and, more importantly, to control the process and make tailored adjustments in load, intensity, and recovery. We aimed to determine the test-retest reliability of a submaximal, resistance-band test to evaluate the strength of the trunk stability muscles using a portable force sensor in middle-aged adults (48 ± 13 years) with medically diagnosed chronic low back pain and healthy peers (n = 35). Participants completed two submaximal progressive tests of two resistance-band exercises (unilateral row and Pallof press), consisting of 5 s maintained contraction, progressively increasing the load. The test stopped when deviation from the initial position by compensation movements occurred. Trunk muscle strength (CORE muscles) was monitored in real time using a portable force sensor (strain gauge). Results revealed that both tests were highly reliable (intra-class correlation [ICC] > 0.901) and presented low errors and coefficients of variation (CV) in both groups. In particular, people with low back pain had errors of 14-19 N (CV = 9-12%) in the unilateral row test and 13-19 N (CV = 8-12%) in the Pallof press. No discomfort or pain was reported during or after the tests. These two easy-to-use and technology-based tests result in a reliable and objective screening tool to evaluate the strength and trunk stability in middle-aged adults with chronic low back pain, considering an error of measurement < 20 N. This contribution may have an impact on improving the individualization and control of rehabilitation or physical training in people with lumbar injuries or disorders.

Impact of nursing interventions on the prevention of ocular surface disorders in critical care patients: A systematic review.

BACKGROUND: Intensive care unit (ICU) patients are at an increased risk of ocular surface injuries because of various factors such as reduced tear production and impaired protective mechanisms. Despite the significance of ocular care in ICU settings, there is a lack of consensus on effective interventions, leading to inadequate prevention of ocular surface disease (OSD). AIM: This systematic review aimed to assess the effectiveness of nursing eye care in preventing OSD in ICU patients. Secondary objectives included identifying primary risk factors for ocular injuries and examining the most effective preventive methods. STUDY DESIGN: A systematic review following PRISMA guidelines was conducted, encompassing a literature search, article selection, quality assessment and data synthesis. Studies meeting inclusion criteria were observational studies and clinical trials, focusing on adults admitted to ICUs under sedation and receiving mechanical ventilation. RESULTS: Of 3545 initially identified articles, 12 studies met inclusion criteria. These studies involved a total of 1853 participants. Various interventions were assessed, including saline rinsing, lubricating drops, gel lubricants, occlusion with polyethylene dressing, passive blinking and eyelid closure with tape. Moist chamber occlusion every 6 h combined with gel lubrication emerged as the most effective method in preventing OSD. CONCLUSIONS: Gel lubrication along with moist chamber occlusion proved to be the most effective strategy in preventing ocular injuries in ICU patients. Conversely, the routine use of physiological saline was associated with increased severity of corneal lesions. Properly defined protocols and well-trained nursing teams are crucial for reducing ocular injuries in ICU settings. RELEVANCE TO CLINICAL PRACTICE: The findings underscore the importance of implementing evidence-based eye care protocols in ICUs, emphasizing the use of gel lubrication and ocular surface protection to mitigate the risk of OSD. This highlights the need for comprehensive training programmes for ICU nursing staff to ensure optimal ocular care delivery.

Multiple pre- and postzygotic components of reproductive isolation between two co-occurring Lysimachia species.

Genetic divergence between species depends on reproductive isolation (RI) due to traits that reduce interspecific mating (prezygotic isolation) or are due to reduced hybrid fitness (postzygotic isolation). Previous research found that prezygotic barriers tend to be stronger than postzygotic barriers, but most studies are based on the evaluation of F1 hybrid fitness in early life cycle stages. We combined field and experimental data to determine the strength of 17 prezygotic and postzygotic reproductive barriers between two Lysimachia species that often co-occur and share pollinators. We assessed postzygotic barriers up to F2 hybrids and backcrosses. The two species showed near complete RI due to the cumulative effect of multiple barriers, with an uneven and asymmetric contribution to isolation. In allopatry, prezygotic barriers contributed more to reduce gene flow than postzygotic barriers, but their contributions were more similar in sympatry. The strength of postzygotic RI was up to three times lower for F1 progeny than for F2 or backcrossed progenies, and RI was only complete when late F1 stages and either F2 or backcrosses were accounted for. Our results thus suggest that the relative strength of postzygotic RI may be underestimated when its effects on late stages of the life cycle are disregarded.

Perampanel for the treatment of people with idiopathic generalized epilepsy in clinical practice.

OBJECTIVE: This study was undertaken to evaluate perampanel (PER) when used under real-world conditions to treat people with idiopathic generalized epilepsy (IGE) included in the PERaMpanel pooled analysIs of effecTiveness and tolerability (PERMIT) study. METHODS: The multinational, retrospective, pooled analysis PERMIT explored the use of PER in people with focal and generalized epilepsy treated in clinical practice across 17 countries. This subgroup analysis included PERMIT participants with IGE. Time points for retention and effectiveness measurements were 3, 6, and 12 months (last observation carried forward, defined as "last visit," was also applied to effectiveness). Effectiveness was evaluated by seizure type (total seizures, generalized tonic-clonic seizures [GTCS], myoclonic seizures, absence seizures) and included ≥50% responder rate and seizure freedom rate (defined as no seizures since at least the previous visit). Safety/tolerability was monitored throughout PER treatment and evaluated by documenting the incidence of adverse events (AEs), including psychiatric AEs and those leading to treatment discontinuation. RESULTS: The Full Analysis Set included 544 people with IGE (51.9% women, mean age = 33.3 years, mean epilepsy duration = 18.1 years). At 3, 6, and 12 months, 92.4%, 85.5%, and 77.3% of participants were retained on PER treatment, respectively (Retention Population, n = 497). At the last visit, responder and seizure freedom rates were, respectively, 74.2% and 54.6% (total seizures), 81.2% and 61.5% (GTCS), 85.7% and 66.0% (myoclonic seizures), and 90.5% and 81.0% (absence seizures) (Effectiveness Population, n = 467). AEs occurred in 42.9% of patients and included irritability (9.6%), dizziness/vertigo (9.2%), and somnolence (6.3%) (Tolerability Population, n = 520). Treatment discontinuation due to AEs was 12.4% over 12 months. SIGNIFICANCE: This subgroup analysis of the PERMIT study demonstrated the effectiveness and good tolerability of PER in people with IGE when administered under everyday clinical practice conditions. These findings are in line with clinical trial evidence, supporting PER's use as broad-spectrum antiseizure medication for the treatment of IGE.

A non-invasive, concealed electrocardiogram and bioimpedance measurement system for captive primates.

Captive housed non-human primates, specifically great apes such as chimpanzees (Pan troglodytes) are frequently reported to have died from or are diagnosed with potentially fatal heart conditions that require the monitoring of physiological signals such as electrocardiogram (ECG) or respiratory rate. ECG screening must be conducted after applying full anaesthesia, causing potential physical and emotional stress as well as risk for the animal. Here, we present an electronic system that simultaneously measures the ECG and the electrical bioimpedance for the early detection of abnormal cardiovascular activity. Modified gloves whose fingers are equipped with electrodes enable the caregiver to obtain three cardiovascular signals (ECG, pulse rate and respiratory rate) by placing the fingertips on specific parts of the non-human primate without needing any prior physical preparations. Validation (ECG and bioimpedance) was performed both on humans and on captive housed chimpanzees, where all the signals of interest were correctly acquired.

Assessment of the unified model of performance: accuracy of group-average and individualised alertness predictions.

To be effective as a key component of fatigue-management systems, biomathematical models that predict alertness impairment as a function of time of day, sleep history, and caffeine consumption must demonstrate the ability to make accurate predictions across a range of sleep-loss and caffeine schedules. Here, we assessed the ability of the previously reported unified model of performance (UMP) to predict alertness impairment at the group-average and individualised levels in a comprehensive set of 12 studies, including 22 sleep and caffeine conditions, for a total of 301 unique subjects. Given sleep and caffeine schedules, the UMP predicted alertness impairment based on the psychomotor vigilance test (PVT) for the duration of the schedule. To quantify prediction performance, we computed the root mean square error (RMSE) between model predictions and PVT data, and the fraction of measured PVTs that fell within the models' prediction intervals (PIs). For the group-average model predictions, the overall RMSE was 43 ms (range 15-74 ms) and the fraction of PVTs within the PIs was 80% (range 41%-100%). At the individualised level, the UMP could predict alertness for 81% of the subjects, with an overall average RMSE of 64 ms (range 32-147 ms) and fraction of PVTs within the PIs conservatively estimated as 71% (range 41%-100%). Altogether, these results suggest that, for the group-average model and 81% of the individualised models, in three out of four PVT measurements we cannot distinguish between study data and model predictions.

Electroencephalographic markers from routine sleep discriminate individuals who are vulnerable or resilient to sleep loss.

Sleep loss impairs cognition; however, individuals differ in their response to sleep loss. Current methods to identify an individual's vulnerability to sleep loss involve time-consuming sleep-loss challenges and neurobehavioural tests. Here, we sought to identify electroencephalographic markers of sleep-loss vulnerability obtained from routine night sleep. We retrospectively analysed four studies in which 50 healthy young adults (21 women) completed a laboratory baseline-sleep phase followed by a sleep-loss challenge. After classifying subjects as resilient or vulnerable to sleep loss, we extracted three electroencephalographic features from four channels during the baseline nights, evaluated the discriminatory power of these features using the first two studies (discovery), and assessed reproducibility of the results using the remaining two studies (reproducibility). In the discovery analysis, we found that, compared to resilient subjects, vulnerable subjects exhibited: (1) higher slow-wave activity power in channel O1 (p < 0.0042, corrected for multiple comparisons) and in channels O2 and C3 (p < 0.05, uncorrected); (2) higher slow-wave activity rise rate in channels O1 and O2 (p < 0.05, uncorrected); and (3) lower sleep spindle frequency in channels C3 and C4 (p < 0.05, uncorrected). Our reproducibility analysis confirmed the discovery results on slow-wave activity power and slow-wave activity rise rate, and for these two electroencephalographic features we observed consistent group-difference trends across all four channels in both analyses. The higher slow-wave activity power and slow-wave activity rise rate in vulnerable individuals suggest that they have a persistently higher sleep pressure under normal rested conditions.

Adaptations in athletic performance and muscle architecture are not meaningfully conditioned by training free-weight versus machine-based exercises: Challenging a traditional assumption using the velocity-based method.

BACKGROUND: Although the superior effectiveness of free-weight over machine-based training has been a traditionally widespread assumption, longitudinal studies comparing these training modalities were scarce and heterogeneous. OBJECTIVE: This research used the velocity-based method to compare the effects of free-weight and machine-based resistance training on athletic performance and muscle architecture. METHODS: Thirty-four resistance-trained men participated in an 8-week resistance training program allocated into free-weight (n = 17) or machine-based (n = 17) groups. Training variables (intensity, intraset fatigue, and recovery) were identical for both groups, so they only differed in the use of a barbell or specific machines to execute the full squat, bench press, prone bench pull, and shoulder press exercises. The velocity-based method was implemented to accurately adjust the planned intensity. Analysis of covariance and effect size (ES) statistics were used to compare both training modalities on a comprehensive set of athletic and muscle architecture parameters. RESULTS: No between-group differences were found for any athletic (p ≥ 0.146) and muscle architecture (p ≥ 0.184) variable. Both training modalities significantly and similarly improved vertical jump (Free-weight: ES ≥ 0.45, p ≤ 0.001; Machine-based: ES ≥ 0.41, p ≤ 0.001) and lower limb anaerobic capacity (Free-weight: ES ≥ 0.39, p ≤ 0.007; Machine-based: ES ≥ 0.31, p ≤ 0.003). Additionally, the machine-based group meaningfully enhanced upper limb anaerobic power (ES = 0.41, p = 0.021), whereas the free-weight group significantly improved the change of direction (ES = -0.54, p = 0.003) and 2/6 balance conditions analyzed (p ≤ 0.012). Changes in sprint capacity (ES ≥ -0.13, p ≥ 0.274), fascicle length, and pennation angle (ES ≤ 0.19, p ≥ 0.129) were not significant for either training modality. CONCLUSION: Adaptations in athletic performance and muscle architecture would not be meaningfully influenced by the resistance modality trained.

Delving into the study of lactic acid bacteria and yeasts distribution in table olive biofilms using a non-destructive procedure.

To turn table olives into appropriate carriers of beneficial bacteria and yeasts to consumers, it is essential to have reliable methods for analysing microorganisms in biofilms. This work validates the application of a non-destructive procedure to study the lactic acid bacteria and yeasts distribution in fruits during Spanish-style green table olive fermentations. Laboratory-scale fermentations were inoculated simultaneously with three Lactiplantibacillus pentosus strains (LPG1, 119, and 13B4) and two yeasts (Wickerhamomyces anomalus Y12 and Saccharomyces cerevisiae Y30), all of them natives of table olive fermentations. Data showed that L. pentosus LPG1 and yeasts W. anomalus Y12 were quite prone to colonise olive biofilms, but only the Lactiplantibacillus strain also can penetrate the epidermis of the fruit and colonise the flesh. Applying a non-destructive treatment consisting in shelling the fruits with glass beads led to obtaining similar lactic acid bacteria and yeast recovery than the classical stomacher destructive method. However, the glass bead procedure improved the quality of the metagenomics analysis (especially when using 16 S rRNA gene-based sequencing). Results show the great utility of procedures that do not destroy the fruit for studying fermented vegetable biofilms.

An extensional strain sensing mechanosome drives adhesion-independent platelet activation at supraphysiological hemodynamic gradients.

BACKGROUND: Supraphysiological hemodynamics are a recognized driver of platelet activation and thrombosis at high-grade stenosis and in blood contacting circulatory support devices. However, whether platelets mechano-sense hemodynamic parameters directly in free flow (in the absence of adhesion receptor engagement), the specific hemodynamic parameters at play, the precise timing of activation, and the signaling mechanism(s) involved remain poorly elucidated. RESULTS: Using a generalized Newtonian computational model in combination with microfluidic models of flow acceleration and quasi-homogenous extensional strain, we demonstrate that platelets directly mechano-sense acute changes in free-flow extensional strain independent of shear strain, platelet amplification loops, von Willebrand factor, and canonical adhesion receptor engagement. We define an extensional strain sensing "mechanosome" in platelets involving cooperative Ca2+ signaling driven by the mechanosensitive channel Piezo1 (as the primary strain sensor) and the fast ATP gated channel P2X1 (as the secondary signal amplifier). We demonstrate that type II PI3 kinase C2α activity (acting as a "clutch") couples extensional strain to the mechanosome. CONCLUSIONS: Our findings suggest that platelets are adapted to rapidly respond to supraphysiological extensional strain dynamics, rather than the peak magnitude of imposed wall shear stress. In the context of overall platelet activation and thrombosis, we posit that "extensional strain sensing" acts as a priming mechanism in response to threshold levels of extensional strain allowing platelets to form downstream adhesive interactions more rapidly under the limiting effects of supraphysiological hemodynamics.

Recent Progress in Micro- and Nanotechnology-Enabled Sensors for Biomedical and Environmental Challenges.

Micro- and nanotechnology-enabled sensors have made remarkable advancements in the fields of biomedicine and the environment, enabling the sensitive and selective detection and quantification of diverse analytes. In biomedicine, these sensors have facilitated disease diagnosis, drug discovery, and point-of-care devices. In environmental monitoring, they have played a crucial role in assessing air, water, and soil quality, as well as ensured food safety. Despite notable progress, numerous challenges persist. This review article addresses recent developments in micro- and nanotechnology-enabled sensors for biomedical and environmental challenges, focusing on enhancing basic sensing techniques through micro/nanotechnology. Additionally, it explores the applications of these sensors in addressing current challenges in both biomedical and environmental domains. The article concludes by emphasizing the need for further research to expand the detection capabilities of sensors/devices, enhance sensitivity and selectivity, integrate wireless communication and energy-harvesting technologies, and optimize sample preparation, material selection, and automated components for sensor design, fabrication, and characterization.

A Fault-Detection System Approach for the Optimization of Warship Equipment Replacement Parts Based on Operation Parameters.

Systems engineering plays a key role in the naval sector, focusing on how to design, integrate, and manage complex systems throughout their life cycle; it is therefore difficult to conceive functional warships without it. To this end, specialized information systems for logistical support and the sustainability of material solutions are essential to ensure proper provisioning and to know the operational status of the frigate. However, based on an architecture composed of a set of logistics applications, this information system may require highly qualified operators with a deep knowledge of the behavior of onboard systems to manage it properly. In this regard, failure detection systems have been postulated as one of the main cutting-edge methods to address the challenge, employing intelligent techniques for observing anomalies in the normal behavior of systems without the need for expert knowledge. In this paper, the study is concerned to the scope of the Spanish navy, where a complex information system structure is responsible for ensuring the correct maintenance and provisioning of the vessels. In such context, we hereby suggest a comparison between different one-class techniques, such as statistical models, geometric boundaries, or dimensional reduction to face anomaly detection in specific subsystems of a warship, with the prospect of applying it to the whole ship.

Prevalence, attitude, knowledge, and risk perception towards COVID-19 in COPD patients associated to biomass exposure.

Chronic obstructive pulmonary disease (COPD) patients due to biomass exposure (BE-COPD) could be more affected than COPD due to tobacco smoke (TE-COPD) by the coronavirus disease 2019 (COVID-19) pandemic. The aim of this work was to determine the prevalence of COVID-19 in BE-COPD and TE-COPD and if housing conditions, poor attitude, knowledge, and risk perception towards COVID-19, particularly in BE-COPD women, could represent a risk factor for contagion.An 11% prevalence of COVID-19 was found with no significant difference between COPD groups. The BE-COPD group showed poorer socioeconomic status. No significant differences were found to be associated with SARS-CoV-2 infection regarding housing conditions, poor knowledge, attitude, and risk perception towards COVID-19. Living in urban areas and perceiving risk in COVID-19 were significantly associated with increased adherence to sanitary measures and concern of contagion. Around 40% of all patients showed poor risk perception and adherence to sanitary measures towards COVID-19.

[Validation of the Five Facet Mindfulness Questionnaire scale in medical students and doctors in Chile]. / Validación de la escala Five Facet Mindfulness Questionnaire en estudiantes de medicina y médicos en Chile.

BACKGROUND: The increasing use of Mindfulness-based interventions requires standardized construct-based measurement instruments for clinical and research purposes. The Five Facet Mindfulness Questionnaire scale with five factors was developed in the United States and validated in Spain. There are versions of 39, 24 and 15 items (FFMQ-39, FFMQ-24 and FFMQ-15). OBJECTIVE: To validate the FFMQ-24 and FFMQ-15 scale in Chile. METHODOLOGY: Six experts performed a linguistic adaptation of the Spanish version of the FFMQ-24. The adapted instrument was applied to a sample of 795 physicians. Internal validity was analyzed by calculating Cronbach's alpha (α) and confirmatory factor analysis (CFA). Finally, 15 items were retained, and the 5-factor solution was maintained. The FFMQ-15 scale was applied to a sample of 365 medical students and analyzed by calculating (α) and CFA. The external validity of FFMQ-15 was evaluated with the Mental Health Continiuum-14 (MHC-14) scale. RESULTS: Linguistic changes were made. The CFA of FFMQ-24 obtained a lower-than-expected fit for a 5-factor solution. The (α) value varied between .68 and .86 in all dimensions. The FFMQ-15 had an adequate fit for five factors for physicians (c2 = 216.17, df = 80, p < .01; CFI = .96; TLI = .94; RMSEA = .05 [.04, .06]; SRMR = .04) and students (c2 = 163.61, df = 80, p < .01; CF = .96; TLI = .94; RMSEA = .05 [.04, .07]; SRMR = .05). External validity with MHC-14 was adequate. CONCLUSION: The FFMQ-15 scale has acceptable internal consistency and adequate internal and external validity in Chile.

[Validation of the 12 items self-compassion scale in Chile]. / Validación del instrumento Self-Compassion Scale para valoración de la autocompasión en estudiantes y médicos en Chile.

BACKGROUND: Self-compassion is understood as a mental framework when facing difficulties in life or personal insufficiency. It arises in response to the negative aspects of self-esteem. It is assessed using the 26 item and six factor Self-Compassion Scale (SCS) in the United States and Spain but not in Chile. AIM: To validate the 12-item version (SCS-12) of the self-compassion scale. MATERIAL AND METHODS: A back translation process of the original SCS-12 scale was carried out and then it was reviewed by 6 experts. The scale was applied to a sample of 359 medical students and 795 physicians. For internal validity, confirmatory factor analyses (CFA) were performed for one, two, three, and six factors. For external validity, bivariate correlations were made with variables about mental health, burnout, symptoms of depression and anxiety. Finally, a path analysis was carried out to study the relationship between the six factors and mental health. RESULTS: The CFA for the six-factor model presents the best fit for both groups of respondents (χ2 = 216.17, df = 80, p < .01; comparative fit index (CF)I = .96; Tucker-Lewis index (TL)I = .94; Root Mean Square Error of Approximation (RMSEA) = .05 [.04, .06]; Standarized Root Mean-Square(SRMR) = .04 and χ2 = 85.97, df = 39, p < .01; CFI = .97; TLI = .95; RMSEA = .06 [.04, .07]; SRMR = .04). The external validity was adequate. CONCLUSIONS: The 12-item version of the linguistically adapted Self-Compassion Scale instrument applied to medical students and physicians in Chile, had adequate internal validity and psychometric properties.