Eficacia de la monitorización continua de glucosa en adolescentes de 10 a 14 años en la isla de La Palma.

La diabetes tipo 1 es una de las enfermedades crónicas más prevalentes en edades pediátricas, siendo Canarias la Comunidad Autónoma con mayor incidencia en todo el territorio nacional. En el año 2018 se introduce en las islas la Monitorización Continua de Glucosa, como alternativa en el control de la diabetes mellitus de tipo 1. El objetivo de este proyecto es determinar la eficacia de la Monitorización Continua de Glucosa en pacientes con Diabetes Mellitus tipo 1 en la isla de La Palma. Las variables a estudio serán: la calidad de vida, el nivel de satisfacción con el tratamiento, el control glucémico, así como los niveles de hemoglobina glicosilada y el registro de hipoglucemias graves y, se tendrá en cuenta el factor estético. Se realizará un estudio observacional, analítico, longitudinal y prospectivo de tipo antes y después. Como instrumento de medida se repartirán cuestionarios a los usuarios que participen, para ello deberán cumplir los criterios de inclusión descritos en el proyecto. El reparto y la recogida de datos será responsabilidad de la enfermera de la consulta de educación diabetológica.Type 1 diabetes is one of the most prevalent chronic diseases in pediatric ages, being the Canary Islands the Autonomous Community with the highest incidence in the whole national territory. In 2018, Continuous Glucose Monitoring is introduced in the islands, as an alternative in the control of type 1 diabetes mellitus. The objective of this project is to determine the efficacy of Continuous Glucose Monitoring in patients with type 1 Diabetes Mellitus on the island of La Palma. The variables to be studied will be: quality of life, level of satisfaction with the treatment, glycemic control, as well as glycosylated hemoglobin levels and the record of severe hypoglycemia, and the aesthetic factor will be taken into account. An observational, analytical, longitudinal and prospective before and after study will be carried out. As a measuring instrument, five questionnaires will be distributed to participating users, who will have to meet the inclusion criteria described in the project. The distribution and data collection will be the responsibility of the nurse in the diabetes education office

Dislalia: Intervenir "Más allá de la R"

La dislalia funcional es uno de los trastornos o alteraciones del habla más comunes entre la población infantil. Esto la convierte en uno de los temas habituales de trabajo para el ámbito de la logopedia (González Flores, 2016). Aún así, no recibe la importancia que merece dado el gran volumen de casos existentes, los cuales se han visto incrementados tras el periodo de pandemia por el coronavirus. A día de hoy, encontramos menores de un amplio rango de edad que presentan este trastorno y su autoestima se ve mermada por ello. En algunos casos, este trastorno acaba desembocando en frustración y enlentecimiento de los avances en terapia. Este trabajo tiene como objetivo proponer una alternativa de tratamiento, donde tutorizar al niño en la reeducación del habla al mismo tiempo que se promueve un entrenamiento, más allá de la terapia directa o bajo el control de logopeda. A su vez, se indican estrategias de manejo para la frustración.Functional dyslalia is one of the most common speech disorders among children. This makes it one of the usual topics of work for the field of speech therapy (González Flores, 2016). Even so, it does not receive the importance it deserves given the large volume of existing cases, which have increased after the period of the coronavirus pandemic. Today we find children of a wide age range who present this disorder and their self-esteem is diminished as a result. In some cases, this disorder ends up leading to frustration and slowing down progress in therapy. This paper aims to propose a treatment alternative, in which the child is tutored in speech re-education while speech training is promoted, beyond direct therapy or under the control of a speech therapist. At the same time, frustration management strategies are indicated

Evaluación de la atención en deportistas de artes marciales : expertos vs. novatos

El objetivo del estudio fue determinar las diferencias en el desempeño de una tarea de atención en relación con la pericia en artes marciales. Participaron 12 deportistas de artes marciales expertos y 13 novatos. Se les aplicó el Test of Variables of Attention (Greenberg, 1996) y se analizaron los datos de la prueba para cada variable, condición y segmentos en los que se divide, con un método estadístico no-paramétrico de permutaciones. Las comparaciones intergrupos indicaron una tendencia a que el puntaje global de Trastorno por Déficit de Atención e Hiperactividad (TDAH) de la prueba fuera mejor en los expertos que en los novatos. Se hizo un análisis intragrupo para conocer el comportamiento de cada grupo a lo largo de la prueba; los resultados indicaron que los deportistas expertos muestran mayor consistencia en el número de aciertos y tiempos de reacción a lo largo de la prueba, lo que se traduce como un mejor desempeño cuando se compara con la forma en que los deportistas novatos responden a la tarea. Los resultados sugieren que el entrenamiento físico y mental de las disciplinas de artes marciales podría producir una mejora en las capacidades de atención de los deportistas.The aim of this study is to determine differences in the performance of an attention-related task involving martial arts skills. 12 expert martial arts athletes and 13 novices took part, performing the Test of Variables of Attention (Leark, Greenberg, Kindschi, Dupuy and Hughes, 2007). Using a non-parametric statistical permutation method, the test data for each variable, condition and segment of the test was analysed. Comparisons of the groups showed a trend toward a higher global Attention Deficit Hyperactivity Disorder (ADHD) score by the expert athletes as compared with the novices. In order to find out each group's performance during the test, a statistical intra-group analysis was performed. Generally, the results revealed more consistent accuracy and response times by the experts than by the novice athletes. The results suggest that physical and mental training in the martial arts may increase the attention skills of sportsmen and women.O objectivo do estudo foi determinar as diferenças no desempenho de uma tarefa atencional tendo em conta a perícia em artes marciais.Participaram no estudo 12 desportistas especialistas em artes marciais e 13 iniciantes. Foi aplicado aos participantes o Test of Variables of Attention (Greenberg, 1996) e analisaram-se os dados do teste para cada variável, condição e segmentos em que se dividem, através de um método estatístico nãoparamétrico de permutações. As comparações intergrupos indicaram uma tendência para que a pontuação global de Transtorno do Défice de Atenção e Hiperactividade (TDAH) fosse maior nos especialistas do que nos iniciantes. Foi realizada uma análise intragrupo para conhecer o comportamento de cada grupo ao longo da prova; os resultados indicaram que os desportistas especialistas revelaram maior consistência no número de acertos e tempos de reacção ao longo da prova, o que se traduz num melhor desempenho quando comparados com a forma como os desportistas iniciantes respondem à tarefa. Os resultados sugerem que o treino físico e mental das disciplinas de artes marciais poderia produzir uma melhoria nas capacidades atencionais dos desportistas

Programa de educación sexual para prevenir la violencia de género en los niños del 6to grado de primaria de la Institución Educativa N° 88004 Manuel González Prada - Chimbote – 2017

El informe de tesis lleva por título “PROGRAMA DE EDUCACIÓN SEXUAL PARA PREVENIR LA VIOLENCIA DE GÉNERO EN LOS NIÑOS DEL 6to GRADO DE PRIMARIA DE LA INSTITUCIÓN EDUCATIVA N° 88004 MANUEL GONZÁLEZ PRADA - CHIMBOTE – 2017” tuvo como objetivo general demostrar que el programa de educación sexual previene la violencia de género en los niños de 6to grado de educación primaria – Chimbote, 2017, y asimismo, como objetivos específicos debe medir el nivel de violencia de género de los estudiantes de 6to grado, identificar el nivel de violencia de género en su dimensión (Violencia Psicológica, Violencia Sexual y Violencia Física) y por ultimo demostrar que el programa de Educación Sexual ayuda a prevenir la violencia de género en los niños de 6to grado de educación primaria – Chimbote, 2017Tesi

Iron therapy substantially restores qEEG maturational lag among iron-deficient anemic infants

Objective: To use quantitative electroencephalography (qEEG) to assess the impact of iron-deficiency anemia on central nervous system maturation in the first year of life. Method: Twenty-five infants (3–12 months old) presenting ferropenic anemia (IDA) and 25 healthy controls (CTL1), matched by age/gender with the former, were studied in two stages. Electroencephalogram during spontaneous sleep was recorded from all participants; the fast Fourier transform was calculated to obtain absolute power (AP) and relative power (RP) qEEG measures. In the first stage, a qEEG comparison between CTL1 and IDA was performed. Second stage consisted in comparing qEEG of the IDA infants before and after supplementation with iron (IDA-IS group), and comparing qEEG of the IDA-IS group with another control age-matched group (CTL2). Non-parametric multivariate permutation tests (NPT) were applied to assess differences between CTL1 and IDA groups, as well as IDA vs. IDA-IS, and IDA-IS vs. CTL2. Results: More power in slow frequency bands and less power in fast frequency bands in 64% of IDA babies were observed. NPT evinced higher alpha AP and RP (P < 0.001), less theta AP, and less delta and theta RP in CTL1 than in IDA. After iron-restoration therapy, alpha AP and RP increased while theta AP and theta and delta RP decreased, reaching almost normal values. Discussion: This work reveals CNS developmental delay through the study of qEEG (less rapid and more slow frequencies) which recovered significantly with iron supplementation. It is concluded that IDA constitutes a high risk factor for a lag of CNS maturation.CONACYT-Project No. CO1/40257-A1

Abnormal EEG signal energy in the elderly: a wavelet analysis of event-related potentials during a stroop task

Background: Previous work showed that elderly with excess in theta activity in their resting state electroencephalogram (EEG) are at higher risk of cognitive decline than those with a normal EEG. By using event-related potentials (ERP) during a counting Stroop task, our prior work showed that elderly with theta excess have a large P300 component compared with normal EEG group. This increased activity could be related to a higher EEG signal energy used during this task. New method: By wavelet analysis applied to ERP obtained during a counting Stroop task we quantified the energy in the different frequency bands of a group of elderly with altered EEG. Results: In theta and alpha bands, the total energy was higher in elderly subjects with theta excess, specifically in the stimulus categorization window (258–516 ms). Both groups solved the task with similar efficiency. Comparison with existing methods: The traditional ERP analysis in elderly compares voltage among conditions and groups for a given time window, while the frequency composition is not usually examined. We complemented our previous ERP analysis using a wavelet methodology. Furthermore, we showed the advantages of wavelet analysis over Short Time Fourier Transform when exploring EEG signal during this task. Conclusions: The higher EEG signal energy in ERP might reflect undergoing neurobiological mechanisms that allow the elderly with theta excess to cope with the cognitive task with similar behavioral results as the normal EEG group. This increased energy could promote a metabolic and cellular dysregulation causing a greater decline in cognitive function.Instituto de Física La Plat

Identification of circulating microRNA profiles associated with pulmonary function and radiologic features in survivors of SARS-CoV-2-induced ARDS

There is a limited understanding of the pathophysiology of postacute pulmonary sequelae in severe COVID-19. The aim of current study was to define the circulating microRNA (miRNA) profiles associated with pulmonary function and radiologic features in survivors of SARS-CoV-2-induced ARDS. The study included patients who developed ARDS secondary to SARS-CoV-2 infection (n = 167) and a group of infected patients who did not develop ARDS (n = 33). Patients were evaluated 3 months after hospital discharge. The follow-up included a complete pulmonary evaluation and chest computed tomography. Plasma miRNA profiling was performed using RT-qPCR. Random forest was used to construct miRNA signatures associated with lung diffusing capacity for carbon monoxide (DLCO) and total severity score (TSS). Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were conducted. DLCO < 80% predicted was observed in 81.8% of the patients. TSS showed a median [P25;P75] of 5 [2;8]. The miRNA model associated with DLCO comprised miR-17-5p, miR-27a-3p, miR-126-3p, miR-146a-5p and miR-495-3p. Concerning radiologic features, a miRNA signature composed by miR-9-5p, miR-21-5p, miR-24-3p and miR-221-3p correlated with TSS values. These associations were not observed in the non-ARDS group. KEGG pathway and GO enrichment analyses provided evidence of molecular mechanisms related not only to profibrotic or anti-inflammatory states but also to cell death, immune response, hypoxia, vascularization, coagulation and viral infection. In conclusion, diffusing capacity and radiological features in survivors from SARS-CoV-2-induced ARDS are associated with specific miRNA profiles. These findings provide novel insights into the possible molecular pathways underlying the pathogenesis of pulmonary sequelae.This work is supported by Instituto de Salud Carlos III (COV20/00110), co-funded by European Regional Development Fund (ERDF)/“A way to make Europe”. CIBERES is an initiative of the Instituto de Salud Carlos III. Suported by: Programa de donaciones “estar preparados” UNESPA (Madrid, Spain) and Fundación Francisco Soria Melguizo (Madrid, Spain). Supported by La Fundació La Marató de TV3, projecte amb codi 202108-30/-31. COVIDPONENT is funded by Institut Català de la Salut and Gestió de Serveis Sanitaris. MM is the recipient of a predoctoral fellowship (PFIS: FI21/00187) from Instituto de Salud Carlos III. MCGH is the recipient of a predoctoral fellowship from “University of Lleida”. DdGC has received financial support from Instituto de Salud Carlos III (Miguel Servet 2020: CP20/00041), co-funded by the European Social Fund (ESF)/“Investing in your future”. AC acknowledges receiving financial support from Instituto de Salud Carlos III (ISCIII; Sara Borrell 2021: CD21/00087). ENL and GL were funded by COVID1005 and ACT210085 from National Agency of Investigation & Development & Development (ANID), Chil

Genome-wide transcriptional profiling of pulmonary functional sequelae in ARDS- secondary to SARS-CoV-2 infection

Background: Up to 80% of patients surviving acute respiratory distress syndrome (ARDS) secondary to SARS-CoV- 2 infection present persistent anomalies in pulmonary function after hospital discharge. There is a limited un-derstanding of the mechanistic pathways linked to post-acute pulmonary sequelae. Aim: To identify the molecular underpinnings associated with severe lung diffusion involvement in survivors of SARS-CoV-2-induced ARDS. Methods: Survivors attended to a complete pulmonary evaluation 3 months after hospital discharge. RNA sequencing (RNA-seq) was performed using Illumina technology in whole-blood samples from 50 patients with moderate to severe diffusion impairment (DLCO<60%) and age- and sex-matched individuals with mild-normal lung function (DLCO≥60%). A transcriptomic signature for optimal classification was constructed using random forest. Transcriptomic data were analyzed for biological pathway enrichment, cellular deconvolution, cell/tissue-specific gene expression and candidate drugs. Results: RNA-seq identified 1357 differentially expressed transcripts. A model composed of 14 mRNAs allowed the optimal discrimination of survivors with severe diffusion impairment (AUC=0.979). Hallmarks of lung sequelae involved cell death signaling, cytoskeleton reorganization, cell growth and differentiation and the immune response. Resting natural killer (NK) cells were the most important immune cell subtype for the pre-diction of severe diffusion impairment. Components of the signature correlated with neutrophil, lymphocyte and monocyte counts. A variable expression profile of the transcripts was observed in lung cell subtypes and bodily tissues. One upregulated gene, TUBB4A, constitutes a target for FDA-approved drugs. Conclusions: This work defines the transcriptional programme associated with post-acute pulmonary sequelae and provides novel insights for targeted interventions and biomarker development.MCGH is the recipient of a predoctoral fellowship from the University of Lleida. MM is the recipient of a predoctoral fellowship (PFIS: FI21/00187) from Instituto de Salud Carlos III. AC is supported by Instituto de Salud Carlos III (Sara Borrell 2021: CD21/00087). DdGC has received financial support from Instituto de Salud Carlos III (Miguel Servet 2020: CP20/00041), co-funded by the European Social Fund (ESF) “Investing in your future”. IML is supported by a Miguel Servet contract (CPII20/00029) from the Instituto de Salud Carlos III, co-funded by the European Social Fund (ESF) “Investing in your future”. CIBERES is an initiative of the Instituto de Salud Carlos III. This work is supported by the Instituto de Salud Carlos III (COV20/00110), co-funded by the European Regional Development Fund (ERDF) “A way to make Europe”. Supported by: Programa de donaciones "estar preparados"; UNESPA (Madrid, Spain) and Fundación Francisco Soria Melguizo (Madrid, Spain). Funded by: La Fundació La Marató de TV3, project with code 202108–30/ 31. COVIDPONENT is funded by the Institut Català de la Salut and Gestió de Serveis Sanitaris. This research was funded in part by a grant (PI19/01805) from the Instituto de Salud Carlos III, co-funded by the European Regional Development Fund (ERDF) “A way to build Europe” and by the Fundación Rioja Salu

Multiplex protein profiling of bronchial aspirates reveals disease-, mortality- and respiratory sequelae-associated signatures in critically ill patients with ARDS secondary to SARS-CoV-2 infection

Introduction: Bronchial aspirates (BAS) obtained during invasive mechanical ventilation (IMV) constitutes a useful tool for molecular phenotyping and decision making. Aim: To identify the proteomic determinants associated with disease pathogenesis, all-cause mortality and respiratory sequelae in BAS samples from critically ill patients with SARS-CoV-2-induced ARDS. Methods: Multicenter study including 74 critically ill patients with COVID-19 and non-COVID-19 ARDS. BAS were obtained by bronchoaspiration after IMV initiation. Three hundred sixty-four proteins were quantified using proximity extension assay (PEA) technology. Random forest models were used to assess predictor importance. Results: After adjusting for confounding factors, CST5, NADK, SRPK2 and TGFa were differentially detected in COVID-19 and non-COVID-19 patients. In random forest models for COVID-19, CST5, DPP7, NADK, KYAT1 and TYMP showed the highest variable importance. In COVID-19 patients, reduced levels of ENTPD2 and PTN were observed in nonsurvivors of ICU stay, even after adjustment. AGR2, NQO2, IL-1a, OSM and TRAIL showed the strongest associations with in-ICU mortality and were used to construct a proteinbased prediction model. Kaplan-Meier curves revealed a clear separation in mortality risk between subgroups of PTN, ENTPD2 and the prediction model. Cox regression models supported these findings. In survivors, the levels of FCRL1, NTF4 and THOP1 in BAS samples obtained during the ICU stay correlated with lung function (i.e., DLCO levels) 3 months after hospital discharge. Similarly, Flt3L and THOP1 levels were correlated with radiological features (i.e., TSS). These proteins are expressed in immune and nonimmune lung cells. Poor host response to viral infectivity and an inappropriate reparative mechanism seem to be linked with the pathogenesis of the disease and fatal outcomes, respectively. Conclusion: BAS proteomics identified novel factors associated with the pathology of SARS-CoV-2-induced ARDS and its adverse outcomes. BASbased protein testing emerges as a novel tool for risk assessment in the ICU

A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study

Background: The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU. Methods: This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group. Results: Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR < 0.05). Cox regression analysis revealed that low expression levels of eight miRNAs were associated with a higher risk of death (HR from 1.56 to 2.61). LASSO regression for variable selection was used to construct a miRNA classifier. A 4-blood miRNA signature composed of miR-16-5p, miR-192-5p, miR-323a-3p and miR-451a predicts the risk of all-cause in-ICU mortality (HR 2.5). Kaplan‒Meier analysis confirmed these findings. The miRNA signature provides a significant increase in the prognostic capacity of conventional scores, APACHE-II (C-index 0.71, DeLong test p-value 0.055) and SOFA (C-index 0.67, DeLong test p-value 0.001), and a risk model based on clinical predictors (C-index 0.74, DeLong test-p-value 0.035). For 28-day and 90-day mortality, the classifier also improved the prognostic value of APACHE-II, SOFA and the clinical model. The association between the classifier and mortality persisted even after multivariable adjustment. The functional analysis reported biological pathways involved in SARS-CoV infection and inflammatory, fibrotic and transcriptional pathways. Conclusions: A blood miRNA classifier improves the early prediction of fatal outcomes in critically ill COVID-19 patients.11 página