Hábitos y conocimientos sobre fotoprotección y factores de riesgo para quemadura solar en corredores de maratones de montaña

Background and objectives: The incidence of skin cancer in our society is growing at an alarming rate due to overexposure to solar UV radiation in recreational and occupational settings. The aim of this study was to evaluate sun exposure and protection attitudes, behaviors, and knowledge among mountain ultramarathon runners and to assess risk factors for sunburn in this population. Material and methods: Cross-sectional survey of runners who participated in the «Gran Trail Aneto-Posets» race in Aragon, Spain. Using a validated questionnaire, we collected data on sociodemographic characteristics, running experience, sunburn in the previous summer, and sun exposure and protection behaviors. We calculated descriptive statistics and performed bivariate and multivariate analyses of associations using history of sunburn as the primary outcome. Statistical significance was set at a p level of less than 0.05. Results: We surveyed 657 runners (72.1% men) with a mean age of 39.71 years; 45.1% reported sunburn in the past year. The most common protective measures used were sunglasses (74.7%), sunscreen (sun protection factor = 15) (61.9%), a hat (52.2%), and other protective clothing (7.4%). Risk factors for sunburn were younger age, low Fitzpatrick skin type (I and II), running for three or more hours a day, and staying in the shade as a protective measure. By contrast, protective factors were use of sunscreen and seeking shade rather than sun at midday (p < 0.001). Conclusions: Sunburn is common among long-distance mountain runners, despite what appears to be adequate sun protection knowledge and behaviors. Targeted strategies are needed to improve sun protection behaviors among mountain runners

Hábitos, actitudes y conocimientos sobre la exposición solar de corredores de fondo en la Costa del Sol

A nivel dermatológico, la elevada exposición solar a radiación ultravioleta asociada a la práctica de actividades deportivas al aire libre, máxime en actividades recreativas de larga duración como son los corredores de fondo, aumenta el fotoenvejecimiento de la piel y la incidencia de cáncer de piel. El propósito del estudio fue evaluar los hábitos, actitudes y conocimientos sobre la exposición solar de corredores de fondo de nuestra comunidad. Se realizó un estudio transversal descriptivo mediante encuesta con un muestreo de conveniencia entre aquellos participantes de las medias maratones populares de Fuengirola y Marbella celebradas en el mes de septiembre del año 2016. En la muestra evaluada se ha hallado una intensa exposición solar realizando actividades al aire libre, asociado ello a una prevalencia de quemaduras solares elevada (uno de cada 2 corredores). Exposure to UV radiation during the practice of sports in the open air is especially high in sustained recreational activities such as long-distance running. UV exposure increases skin photoaging and the incidence of skin cancer. This study aimed to describe habits and attitudes related to sun exposure among long-distance runners in our area of southern Spain as well as to evaluate the runners’ knowledge of exposure. A cross-sectional descriptive study was designed to survey a convenience sample of participants in half marathons in Fuengirola and Marbella in September 2016. We found a high level of sun exposure among participants in this outdoor activity. The prevalence of sunburn was also high, experienced by half of the runners surveyed

Sun exposure and protection habits in transplant athletes: an international survey

Background: Transplant recipients are particularly prone to the development of skin cancer, and overexposure to UV radiation during outdoor activities increases the risk of carcinogenesis. Objective: The aim of this study was to analyze sun-related behaviors and knowledge in transplant athletes, examine the equency of sunburns, and explore associations with a history of skin cancer. Materials and methods: Cross-sectional descriptive study. Participants (n = 170) in the XXI World Transplant Games from >50 countries completed a questionnaire on sun protection habits and knowledge, type of transplant, immunosuppressive therapy, and personal history of skin cancer. Results: The most common transplanted organs were the kidney (n = 79), the liver (n = 33), and the heart (n = 31). Overall, 61.3% of athletes had been doing sport for >15 years and 79.5% spent >1–2 h a day outdoors. Fifteen % of athletes had a history of skin cancer. The prevalence of sunburn in the previous year was 28.9%, higher in athletes aged <50 years (37.2%); without a primary school education (58.3%), not taking cyclosporin (32.6%), and athletes who played basketball (75%). The main sun protection measures used were sunscreen (68.9%) and sunglasses (67.3%). Use of a hat or cap was the only measure significantly associated with a reduced prevalence of sunburn. Conclusions: Despite high awareness that sun exposure increases the risk of skin cancer, sunburn was common in transplant athletes. Efforts should be made to strengthen multidisciplinary sun protection education strategies and ensure periodic dermatologic follow-up to prevent sun-induced skin cancer in this population.This work has been supported by the project no. PID2020-117224RB-100 of State Programs of Generation of Knowledge and Scientific and Technological Strengthening of the System from the Spanish Ministry of Science and Innovation. This is part of the research of the Institute of Biomedicine of Málaga (IBIMA) and the Junta de Andalucía working group CTS-162. Funding for open access charge: Universidad de Málaga/CBUA

Sensitivity to change of the Beach Questionnaire to behaviour, attitudes and knowledge related to sun exposure: quasi-experimental before-after study

Background: Health questionnaires must present accredited measurement properties such as validity, reliability and sensitivity to change, the latter being essential for interventions to be planned and for evaluating their effectiveness. The aim of this study was to evaluate the sensitivity to change of a Beach Questionnaire.Methods: Quasi-experimental before-after study carried out in 2011, for a study population of adolescents attending schools in the Costa del Sol. First, the questionnaire was administered to the adolescents, after which a multicomponent educational intervention was carried out; finally, three months later, the same questionnaire was re-administered to the same adolescents. Changes were assessed in the categories of each item, using the McNemar test, and the changes in the scores, standardised to a range of 0–100, using the Student t test for paired samples, and including the mean of the differences and the 95% confidence interval. The level of statistical significance was set at p < 0.05.Results: 228 adolescents, aged 14–17 years, and 55.3% were girls. Statistically significant changes were observed in sunburn experiences, exposure to the sun at mid-day and attitudes to sun exposure and suncreams. For the seven items related to knowledge about sun exposure, a higher rate of correct answers was observed. The analysis of changes, within the standardised range, revealed a significant improvement in the scores for sun exposure habits (MD 4.33; CI 95% 2.2-6.5), attitudes to sun exposure (MD 2.22; CI 95% 1.2-3.2) and knowledge (MD 9.10; CI 95% 7.1-11.1), but not in those for sun-protection practices (MD 0.23; CI 95% -1.2-1.7).Conclusions: The Beach Questionnaire on behaviour, attitudes and knowledge related to sun exposure is the first such instrument in Spanish language to provide sufficient sensitivity to change. It constitutes a useful tool for epidemiologic research into photoprotection and for skin cancer prevention programmes.The authors would like to acknowledge support from the Research Department of the Costa del Sol Hospital

Validation of a Questionnaire Designed to Study Knowledge, Attitudes, and HabitsRelated to Sun Exposure Among Young Adults: The CHACES Questionnaire

Las campañas escolares de prevención del cáncer cutáneo han demostrado ser eficaces y costo-efectivas. Su éxito depende de un adecuado dise˜no, basado en la encuestación previa de la población diana (alumnos, profesores y padres). Sin embargo, son escasos los cuestionarios validados en castellano que estudien hábitos y conocimientos sobre exposición solar en infancia, y nulos en la población adultojuvenil. Objetivos: Elaborar y validar un cuestionario que explore las conductas relacionadas con la exposición solar en población adultojuvenil. Metodología: Se elaboraron 2 cuestionarios, dirigidos a población adulta (mayor de 18 a˜nos) y juvenil (11-17 a˜nos), incluyendo datos demográficos, color de piel, fototipo, quemaduras solares, prácticas, actitudes y conocimientos relacionados con la exposición solar. Tras el pilotaje y análisis de validez de contenido, se dise˜nó un estudio de validación en 2 fases: I) Análisis de la validez y consistencia interna de los ítems (estudio trasversal sobre 1.482 adolescentes-adultos, con estudio de validez de constructo [mediante análisis factorial exploratorio] y de consistencia interna [alfa de Cronbach]), II) Estudio de la estabilidad (test-retest sobre 39 sujetos). Resultados: El pilotaje demostró la validez de contenido de sendos cuestionarios. El análisis de los componentes principales reveló 2 componentes en cada dimensión estudiada, explicando más del 50% de la varianza. Todos los ítems mostraron buena correlación entre ellos. Se demostró validez en la fase i (coeficiente alfa de Cronbach entre 0,45-0,8, excepto el área de conocimientos [0,335]) y estabilidad en la fase ii (acuerdo absoluto > 60%).Skin cancer prevention campaigns in schools have been shown to be both effectiveand cost-effective. The success of such programs depends on the use of an appropriate designinformed by a prior survey of the target population (pupils, teachers, and parents). There are,however, very few validated Spanish-language questionnaires designed to study the habits andknowledge of this population with respect to sun exposure in childhood and none designed foruse with a young adult population.Objectives: To construct and validate a questionnaire designed to explore sun exposure beha-viors in a young adult population.Methodology: Two questionnaires were developed, one for adults (18+) and the other for youngadults (11-17); both included demographic information, skin color, Fitzpatrick skin type, andhistory of sunburn as well as questions on knowledge, attitudes and practices related to sunexposure. The content was then piloted and its validity analyzed. The subsequent validationstudy was divided into 2 phases as follows: 1) analysis of the validity and internal consistencyof the items in a cross-sectional study of 1,482 adults and adolescents, using exploratory factoranalysis to test construct validity and Cronbach to measure internal consistency; and 2)evaluation of test-retest reliability in 39 individuals.Results: The pilot study demonstrated the content validity of both questionnaires. Principalcomponent analysis revealed that 2 components in each of the dimensions studied accountedfor over 50% of the variance. A good correlation was found between the items studied. Validitywas demonstrated in the first phase of the analysis with a Cronbach of between 0.45 and 0.8for all components except knowledge (0.335). In the second phase, test-retest reliability wasdemonstrated (absolute agreement > 60%).Conclusions: The psychometric properties of the questionnaire make it a valid and reliable toolfor the study of knowledge, attitudes, and habits with respect to sun exposure in the youngadult school population

Role of particle size on the multicycle calcium looping activity of limestone for thermochemical energy storage

The calcium looping process, based on the reversible reaction between CaCO3 and CaO, is recently attracting a great deal of interest as a promising thermochemical energy storage system to be integrated in Concentrated Solar Power plants (CaL-CSP). The main drawbacks of the system are the incomplete conversion of CaO and its sintering-induced deactivation. In this work, the influence of particle size in these deactivation mechanisms has been assessed by performing experimental multicycle tests using standard limestone particles of well-defined and narrow particle size distributions. The results indicate that CaO multicycle conversion benefits from the use of small particles mainly when the calcination is carried out in helium at low temperature. Yet, the enhancement is only significant for particles below 15 μm. On the other hand, the strong sintering induced by calcining in CO2 at high temperatures makes particle size much less relevant for the multicycle performance. Finally, SEM imaging reveals that the mechanism responsible for the loss of activity is mainly pore-plugging when calcination is performed in helium, whereas extensive loss of surface area due to sintering is responsible for the deactivation when calcination is carried out in CO2 at high temperature

HCV eradication with DAAs differently affects HIV males and females: A whole miRNA sequencing characterization

Gender-specific consequences after HCV eradication are unexplored. MicroRNAs (miRNAs) play a crucial role in the immune response against viral infections. However, few have highlighted miRNA role in sex-biased disease or therapy response. We aim to assess gender differences reflected in the miRNA expression of HIV/HCV-coinfected patients who achieve sustained virological response (SVR) with direct acting antivirals (DAAs). We conducted a prospective study of miRNA expression in PBMCs from 28 chronic HIV/HCV-coinfected patients (HIV/HCV) at baseline and after achieving SVR with DAAs. Sixteen HIV-monoinfected patients (HIV) and 36 healthy controls (HC) were used as controls. Identification of significant differentially expressed (SDE) miRNAs was performed with generalized linear model and mixed GLMs. We also explored putative dysregulated biological pathways. At baseline, the HIV/HCV patients showed differences in the miRNA profile concerning the HIV group (165 and 102 SDE miRNAs for males and females, respectively). Gender-stratified analysis of HIV/HCV group at baseline versus at SVR achievement showed higher differences in males (80 SDE miRNAs) than in females (55 SDE miRNAs). After SVR, HIV/HCV group showed similar values to HIV individuals, especially in females (1 SDE miRNA). However, ten miRNAs in males remained dysregulated, which were mainly involved in cancer, fatty acid, and inflammatory pathways. Taken together, our results show gender-biased dysregulation in the miRNA expression profile of PBMCs after HCV eradication with DAAs. These differences were normalized in females, while miRNA profile and their target-related pathways in males lack of normalization, which may be related to a high-risk of developing liver-related complications.This work has been supported by grants from Institute of Health Carlos III, Spain [PI15CIII/00031 and PI18CIII/00020/ to AFR and VB] and the Foundation Universidad Alfonso X el Sabio-Santander, Spain [Grant no. 1.010.932 to AFR]. AFR is supported by the Miguel Servet programme from Fondo de Investigación Sanitaria (ISCIII), Spain [CP14/CIII/00010 and CPII20CIII/0001]. This study has been conducted within the Spanish AIDS Research Network (RIS), The SPANISH AIDS Research Network – funded by the Institute of Health Carlos III (ISCIII) [RD16CIII/0002/0002].S

HCV eradication with DAAs differently affects HIV males and females: A whole miRNA sequencing characterization

Gender-specific consequences after HCV eradication are unexplored. MicroRNAs (miRNAs) play a crucial role in the immune response against viral infections. However, few have highlighted miRNA role in sex-biased disease or therapy response. We aim to assess gender differences reflected in the miRNA expression of HIV/HCV-coinfected patients who achieve sustained virological response (SVR) with direct acting antivirals (DAAs). We conducted a prospective study of miRNA expression in PBMCs from 28 chronic HIV/HCV-coinfected patients (HIV/HCV) at baseline and after achieving SVR with DAAs. Sixteen HIV-monoinfected patients (HIV) and 36 healthy controls (HC) were used as controls. Identification of significant differentially expressed (SDE) miRNAs was performed with generalized linear model and mixed GLMs. We also explored putative dysregulated biological pathways. At baseline, the HIV/HCV patients showed differences in the miRNA profile concerning the HIV group (165 and 102 SDE miRNAs for males and females, respectively). Gender-stratified analysis of HIV/HCV group at baseline versus at SVR achievement showed higher differences in males (80 SDE miRNAs) than in females (55 SDE miRNAs). After SVR, HIV/HCV group showed similar values to HIV individuals, especially in females (1 SDE miRNA). However, ten miRNAs in males remained dysregulated, which were mainly involved in cancer, fatty acid, and inflammatory pathways. Taken together, our results show gender-biased dysregulation in the miRNA expression profile of PBMCs after HCV eradication with DAAs. These differences were normalized in females, while miRNA profile and their target-related pathways in males lack of normalization, which may be related to a high-risk of developing liver-related complications

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

A facility and community-based assessment of scabies in rural Malawi.

Background Scabies is a neglected tropical disease of the skin, causing severe itching, stigmatizing skin lesions and systemic complications. Since 2015, the DerMalawi project provide an integrated skin diseases clinics and Tele-dermatology care in Malawi. Clinic based data suggested a progressive increase in scabies cases observed. To better identify and treat individuals with scabies in the region, we shifted from a clinic-based model to a community based outreach programme. Methodology/principal findings From May 2015, DerMalawi project provide integrated skin diseases and Tele-dermatological care in the Nkhotakota and Salima health districts in Malawi. Demographic and clinical data of all patients personally attended are recorded. Due to a progressive increase in the number of cases of scabies the project shifted to a community-based outreach programme. For the community outreach activities, we conducted three visits between 2018 to 2019 and undertook screening in schools and villages of Alinafe Hospital catchment area. Treatment was offered for all the cases and school or household contacts. Scabies increased from 2.9% to 39.2% of all cases seen by the DerMalawi project at clinics between 2015 to 2018. During the community-based activities approximately 50% of the population was assessed in each of three visits. The prevalence of scabies was similar in the first two rounds, 15.4% (2392) at the first visit and 17.2% at the second visit. The prevalence of scabies appeared to be lower (2.4%) at the third visit. The prevalence of impetigo appeared unchanged and was 6.7% at the first visit and 5.2% at the final visit. Conclusions/significance Prevalence of scabies in our setting was very high suggesting that scabies is a major public health problem in parts of Malawi. Further work is required to more accurately assess the burden of disease and develop appropriate public health strategies for its control