Influence of health literacy on acceptance of influenza and pertussis vaccinations: a cross-sectional study among Spanish pregnant women.

OBJECTIVES: Immunisations against influenza and Bordetella pertussis infection are recommended to pregnant women in Valencia (Spain), yet vaccination rates remain low. Health literacy (HL) appears as a crucial factor in vaccination decision-making. We explored the relation between HL of pregnant women and decisions to receive influenza and pertussis immunisations. SETTING: University hospital in Valencia (Spain). PARTICIPANTS: 119 women who gave birth at a hospital in Valencia (Spain) between November 2015 and May 2016. Women in the immediate postpartum period (more than 27 weeks of gestation), between November 2015 and May 2016 were included in the study. Women with impairments, language barriers or illiteracy which prevented completion of the questionnaires, or those who were under 18 years were excluded from enrolment. PRIMARY AND SECONDARY OUTCOME MEASURES: HL level; influenza and pertussis immunisation rate; reasons for rejection of vaccination. RESULTS: 119 participants were included (mean age 32.3±5.5 years, 52% primiparous, 95% full-term deliveries). A higher education level was associated with Short Assessment of Health Literacy for Spanish Adults _50 (adjusted R2=0.22, p=0.014) and Newest Vital Sign (adjusted R2=0.258, p=0.001) scores. Depending on the scale, 56%-85% of participants had adequate HL. 52% (62/119) and 94% (112/119) of women received influenza and pertussis immunisation, respectively. Women rejecting influenza vaccine had a higher HL level (measured by SALHSA_50 tool) than those accepting it (Kruskal-Wallis test p=0.022). 24% of women who declined influenza vaccination felt the vaccine was unnecessary, and 23% claimed to have insufficient information. CONCLUSIONS: Influenza vaccination rate was suboptimal in our study. Women with high HL were more likely to decline immunisation. Information from professionals needs to match patients' HL levels to reduce negative perceptions of vaccination

Tracing the retina to analyze the integrity and phagocytic capacity of the retinal pigment epithelium

We have developed a new technique to study the integrity, morphology and functionality of the retinal neurons and the retinal pigment epithelium (RPE). Young and old control albino (Sprague-Dawley) and pigmented (Piebald Virol Glaxo) rats, and dystrophic albino (P23H-1) and pigmented (Royal College of Surgeons) rats received a single intravitreal injection of 3% Fluorogold (FG) and their retinas were analyzed from 5 minutes to 30 days later. Retinas were imaged in vivo with SD-OCT and ex vivo in flat-mounts and in cross-sections. Fifteen minutes and 24 hours after intravitreal administration of FG retinal neurons and the RPE, but no glial cells, were labeled with FG-filled vesicles. The tracer reached the RPE 15 minutes after FG administration, and this labeling remained up to 30 days. Tracing for 15 minutes or 24 hours did not cause oxidative stress. Intraretinal tracing delineated the pathological retinal remodelling occurring in the dystrophic strains. The RPE of the P23H-1 strain was highly altered in aged animals, while the RPE of the RCS strain, which is unable to phagocytose, did not accumulate the tracer even at young ages when the retinal neural circuit is still preserved. In both dystrophic strains, the RPE cells were pleomorphic and polymegathic

Calibration and performance tests of detectors for laser-accelerated protons

We present the calibration and performance tests carried out with two detectors for intense proton pulses accelerated by lasers. Most of the procedures were realized with proton beams of 0.46-5.60 MeV from a tandem accelerator. One approach made use of radiochromic films, for which we calibrated the relation between optical density and energy deposition over more than three orders of magnitude. The validity of these results and of our analysis algorithms has been confirmed by controlled irradiation of film stacks and reconstruction of the total beam charge for strongly non-uniform beam profiles. For the spectral analysis of protons from repeated laser shots, we have designed an online monitor based on a plastic scintillator. The resulting signal from a photomultiplier directly measured on a fast oscilloscope is especially useful for time-of-flight applications. Variable optical filters allow for suppression of saturation and an extension of the dynamic range. With pulsed proton beams we have tested the detector response to a wide range of beam intensities from single particles to 3 ×105 protons per 100 ns time interval.Project funded by the Spanish Ministry of Economy and Competitiveness and co-funded with FEDER's funds within the INNPACTO 2011 program under Grant No. IPT-2011-0862-900000. This work was supported by the Spanish Plan Nacional de Investigacion Cientifica, Desarrollo e Innovacion Tecnologica (I+D+i) under Grant No. TEC 2013-48036-C3-1-R and the Valencian Local Government under Grants PROMETEOII/2013/010 and ISIC 2011/013. The work of A. J. Gonzalez is financed by CSIC with a JAE-Doc contract under Junta de Ampliacion de Estudios program, cofinanced by the European Social Fund.Peer Reviewe

Changes in health sciences students' perception of obstetric violence after an educational intervention

Background Obstetric violence is a type of gender-based violence that is presented structurally. This type of violence has physical and psychological consequences for both the women who experience it and health professionals. The World Health Organization adds that health professionals need training to ensure that pregnant women are treated with compassion and dignity. Objectives The objective of the study was to evaluate health sciences students' perception of obstetric violence and to identify possible changes after an educational intervention. Design A pre-post quasi-experimental study was carried out between January and June 2019. Settings and participants Students of medicine and nursing from Jaume I University (Universitat Jaume I) (Spain). Methods An ad hoc scale comprising 33 items was designed to measure the students' perceptions. In addition, sociodemographic and control variables were collected. Descriptive analyses of the sample and the scale were carried out, and a bivariate analysis was performed. Results Of the students surveyed, 89.7% were women, and the majority was nursing students. Of the 33 items, 28 (84.84%) showed statistically significant changes in the pre-post-intervention measurement. Twenty-five of the 33 items (75.75%) showed a relationship with the sociodemographic variables of gender, field, course and ever having been pregnant. Conclusion This study shows the change in health sciences students' perceptions of obstetric violence after an educational intervention. In addition, the normalization of this type of violence was observed with the progression of training and with personal obstetric experience.Background Obstetric violence is a type of gender-based violence that is presented structurally. This type of violence has physical and psychological consequences for both the women who experience it and health professionals. The World Health Organization adds that health professionals need training to ensure that pregnant women are treated with compassion and dignity

Factors associated with the development of septic shock in patients with candidemia: A post hoc analysis from two prospective cohorts

Background: Almost one third of the patients with candidemia develop septic shock. The understanding why some patients do and others do not develop septic shock is very limited. The objective of this study was to identify variables associated with septic shock development in a large population of patients with candidemia. Methods: A post hoc analysis was performed on two prospective, multicenter cohort of patients with candidemia from 12 hospitals in Spain and Italy. All episodes occurring from September 2016 to February 2018 were analyzed to assess variables associated with septic shock development defined according to The Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3). Results: Of 317 candidemic patients, 99 (31.2%) presented septic shock attributable to candidemia. Multivariate logistic regression analysis identifies the following factors associated with septic shock development: age > 50 years (OR 2.57, 95% CI 1.03-6.41, p = 0.04), abdominal source of the infection (OR 2.18, 95% CI 1.04-4.55, p = 0.04), and admission to a general ward at the time of candidemia onset (OR 0.21, 95% CI, 0.12-0.44, p = 0.001). Septic shock development was independently associated with a greater risk of 30-day mortality (OR 2.14, 95% CI 1.08-4.24, p = 0.02). Conclusions: Age and abdominal source of the infection are the most important factors significantly associated with the development of septic shock in patients with candidemia. Our findings suggest that host factors and source of the infection may be more important for development of septic shock than intrinsic virulence factors of organisms

ALBIRA: A small animal PET/SPECT/CT imaging system

Purpose: The authors have developed a trimodal PET/SPECT/CT scanner for small animal imaging. The gamma ray subsystems are based on monolithic crystals coupled to multianode photomultiplier tubes (MA-PMTs), while computed tomography (CT) comprises a commercially available microfocus x-ray tube and a CsI scintillator 2D pixelated flat panel x-ray detector. In this study the authors will report on the design and performance evaluation of the multimodal system. Methods: X-ray transmission measurements are performed based on cone-beam geometry. Individual projections were acquired by rotating the x-ray tube and the 2D flat panel detector, thus making possible a transaxial field of view (FOV) of roughly 80 mm in diameter and an axial FOV of 65 mm for the CT system. The single photon emission computed tomography (SPECT) component has a dual head detector geometry mounted on a rotating gantry. The distance between the SPECT module detectors can be varied in order to optimize specific user requirements, including variable FOV. The positron emission tomography (PET) system is made up of eight compact modules forming an octagon with an axial FOV of 40 mm and a transaxial FOV of 80 mm in diameter. The main CT image quality parameters (spatial resolution and uniformity) have been determined. In the case of the SPECT, the tomographic spatial resolution and system sensitivity have been evaluated with a99mTc solution using single-pinhole and multi-pinhole collimators. PET and SPECT images were reconstructed using three-dimensional (3D) maximum likelihood and ordered subset expectation maximization (MLEM and OSEM) algorithms developed by the authors, whereas the CT images were obtained using a 3D based FBP algorithm. Results: CT spatial resolution was 85μm while a uniformity of 2.7% was obtained for a water filled phantom at 45 kV. The SPECT spatial resolution was better than 0.8 mm measured with a Derenzo-like phantom for a FOV of 20 mm using a 1-mm pinhole aperture collimator. The full width at half-maximum PET radial spatial resolution at the center of the field of view was 1.55 mm. The SPECT system sensitivity for a FOV of 20 mm and 15% energy window was 700 cps/MBq (7.8 × 10−2%) using a multi-pinhole equipped with five apertures 1 mm in diameter, whereas the PET absolute sensitivity was 2% for a 350–650 keV energy window and a 5 ns timing window. Several animal images are also presented. Conclusions: The new small animal PET/SPECT/CT proposed here exhibits high performance, producing high-quality images suitable for studies with small animals. Monolithic design for PET and SPECT scintillator crystals reduces cost and complexity without significant performance degradation.This study was supported by the Spanish Plan Nacional de Investigacion Cientifica, Desarrollo e Innovacion Tecnologica (I+D+I) under Grant No. FIS2010-21216-CO2-01 and Valencian Local Government under Grant PROMETEO 2008/114. The authors also thank Brennan Holt for checking and correcting the text.Sánchez Martínez, F.; Orero Palomares, A.; Soriano Asensi, A.; Correcher Salvador, C.; Conde Castellanos, PE.; González Martínez, AJ.; Hernández Hernández, L.... (2013). ALBIRA: A small animal PET/SPECT/CT imaging system. Medical Physics. 40(5):5190601-5190611. https://doi.org/10.1118/1.4800798S5190601519061140

Effect of noise in CT image reconstruction using QR- Decomposition algorithm

[EN] The QR-Decomposition algorithm for CT 3D image reconstruction uses a linear system of equations to model the CT system response. Linear systems have a condition number that can be used to estimate the image noise. In this work the number of projections and the number of pixels in the detector have been studied to characterize the CT and the linear system of equations. The condition number of the system is estimated for the previous parameters used to generate the CT model with the aim of characterizing how these parameters affect the condition number and therefore bound the image noise level. It is shown that the condition number mainly depends on the size of pixels of the detector rather than the number of projections and this algorithm can be applied to low dose CT 3D image reconstruction without compromising image qualityThis work was supported by the Spanish Plan Nacional de Investigacion Científica, Desarrollo e Innovación Tecnológica (I+D+I) under Grant No. FIS2010-21216-CO2-01 and Valencian Local Government under Grants PROMETEOII/2013/010 and ISIC 2011/013Iborra, A.; Rodríguez-Álvarez, MJ.; Soriano, A.; Sánchez, F.; Bellido, P.; Conde, P.; Crespo, E.... (2013). Effect of noise in CT image reconstruction using QR- Decomposition algorithm. IEEE. 5-9. http://hdl.handle.net/10251/167122S5

Effect of TNF-α genetic variants and CCR5Δ32 on the vulnerability to HIV-1 infection and disease progression in Caucasian Spaniards

<p>Abstract</p> <p>Background</p> <p>Tumor necrosis factor alpha (TNF-α) is thought to be involved in the various immunogenetic events that influence HIV-1 infection.</p> <p>Methods</p> <p>We aimed to determine whether carriage of the <it>TNF-α-238G>A, -308G>A </it>and <it>-863 C>A </it>gene promoter single nucleotide polymorphisms (SNP) and the <it>CCR5Δ32 </it>variant allele influence the risk of HIV-1 infection and disease progression in Caucasian Spaniards. The study group consisted of 423 individuals. Of these, 239 were uninfected (36 heavily exposed but uninfected [EU] and 203 healthy controls [HC]) and 184 were HIV-1-infected (109 typical progressors [TP] and 75 long-term nonprogressors [LTNP] of over 16 years' duration). <it>TNF-α </it>SNP and the <it>CCR5Δ32 </it>allele were assessed using PCR-RFLP and automatic sequencing analysis methods on white blood cell DNA. Genotype and allele frequencies were compared using the χ 2 test and the Fisher exact test. Haplotypes were compared by logistic regression analysis.</p> <p>Results</p> <p>The distribution of <it>TNF-α-238G>A, -308G>A </it>and <it>-863 C>A </it>genetic variants was non-significantly different in HIV-1-infected patients compared with uninfected individuals: <it>-238G>A</it>, p = 0.7 and p = 0.3; <it>-308G>A</it>, p = 0.05 and p = 0.07; <it>-863 C>A</it>, p = 0.7 and p = 0.4, for genotype and allele comparisons, respectively. Haplotype analyses, however, indicated that carriers of the haplotype H3 were significantly more common among uninfected subjects (p = 0.04). Among the infected patients, the distribution of the three <it>TNF-α </it>genetic variants assessed was non-significantly different between TP and LTNP: <it>-238G>A</it>, p = 0.35 and p = 0.7; <it>-308G>A</it>, p = 0.7 and p = 0.6: <it>-863 C>A</it>, p = 0.2 and p = 0.2, for genotype and allele comparisons, respectively. Haplotype analyses also indicated non-significant associations. Subanalyses in the LTNP subset indicated that the <it>TNF-α-238A </it>variant allele was significantly overrepresented in patients who spontaneously controlled plasma viremia compared with those who had a detectable plasma viral load (genotype comparisons, p = 0.02; allele comparisons, p = 0.03). The <it>CCR5Δ32 </it>distribution was non-significantly different in HIV-1-infected patients with respect to the uninfected population (p = 0.15 and p = 0.2 for genotype and allele comparisons, respectively) and in LTNP vs TP (p = 0.4 and p = 0.5 for genotype and allele comparisons, respectively).</p> <p>Conclusions</p> <p>In our cohort of Caucasian Spaniards, <it>TNF-α </it>genetic variants could be involved in the vulnerability to HIV-1 infection. <it>TNF-α </it>genetic variants were unrelated to disease progression in infected subjects. The <it>-238G>A </it>SNP may modulate the control of viremia in LTNP. Carriage of the <it>CCR5Δ32 </it>variant allele had no effect on the risk of infection and disease progression.</p

Statistical moments of scintillation light distribution analysis with dSiPMs and monolithic crystals

[Otros] Monolithic scintillation crystals offer the possibility to preserve the scintillation light distribution, specially when black painted. Furthermore, the statistical moments of that distribution can provide accurate information about the three spatial components. Nevertheless, for monolithic crystal the moments estimation has an associated error due to the symmetry truncation of the light distribution towards the crystal borders. For the 2-D impact coordinates determination, this error is called compression as it is accentuated near the edges. The computation of all centered moments is, therefore, affected by this error. Digital SiPMs (dSiPMs) can offer complete information about the light distribution, since all cells are purely digital detectors, so that other ways to obtain ¿-impact coordinates can be performed. In this work, a comparison between the statistical moments analysis and an alternative fitting the light distribution for each event to a theoretical distribution has been made. With the fitted approach, compression is avoided and an approximately constant spatial resolution is obtained for the entire photodetection area. Moreover, DOI information is improved and preserved all over the crystal.This work was supported by the Spanish Plan Nacional de Investigacion Científica, Desarrollo e Innovación Tecnologica (I+D+I) under Grant No. FIS2010-21216-CO2-01 and Valencian Local Government under Grants PROMETEOII/2013/010 and ISIC 2011/013Conde, P.; González Martínez, AJ.; Hernández, L.; Bellido, P.; Crespo, E.; Iborra, A.; Moliner, L.... (2013). Statistical moments of scintillation light distribution analysis with dSiPMs and monolithic crystals. IEEE. 10-13. https://doi.org/10.1109/NSSMIC.2013.6829086S101

Time reconstruction study using tubes of response backprojectors in List Mode algorithms, applied to amonolithic crystals based breast PET

[Otros] The LM-EM algorithm has the advantage to calculate the emission probabilities needed for the reconstruction process on the fly, without the need of a pre-calculated system matrix. The reconstruction time for this algorithm strongly depends on the used backprojector and the available statistics. This algorithm when implemented in systems using monolithic crystals to detect gamma radiation allows one to extensively exploit the virtual pixilation feature, not available for systems based on pixilated crystals. In this work we present a backprojector for LM-EM, the TOR method, which achieves a tradeoff between computational efficiency and image quality. Its temporal subset algorithm optimization (LM-OS) has also been implemented in order to achieve real-time reconstructions. To evaluate the performances of LM-OS algorithm with the TOR method backprojector and only with one iteration on the datasets, studies based on the system spatial resolution, uniformity, and contrast coefficients were carried out and they were compared with those obtained with LM-EM and MLEM algorithms using twelve iteration. Finally, a study on reconstruction time using LM-OS has been performed with breast patients dataProject funded by the Spanish Ministry of Economy and Competitiveness and co-funded with FEDER's funds within the INNPACTO 2011 program. This work was supported by the Spanish Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica (I+D+i) under Grant No. FIS2010-21216-CO2-01 and the Valencian Local Government under Grants PROMETEOII/2013/010 and ISIC 2011/013Moliner, L.; Correcher, C.; González Martínez, AJ.; Conde, P.; Crespo, E.; Hernandez, L.; Rigla, JP.... (2013). Time reconstruction study using tubes of response backprojectors in List Mode algorithms, applied to amonolithic crystals based breast PET. IEEE. 14-18. https://doi.org/10.1109/NSSMIC.2013.6829372S141