Feasibility of the 30 s Sit-to-Stand Test in the Telehealth Setting and Its Relationship to Persistent Symptoms in Non-Hospitalized Patients with Long COVID

Fatigue, dyspnea and pain are the main limitations of patients with long COVID. The aim of this study was to determine the feasibility of the 30 s sit-to-stand (30s-STS) test in the telehealth setting and its relationship to persistent symptoms in a sample of non-hospitalized patients with long COVID. A cross-sectional study was conducted in community patients with long COVID. Data collection and assessments were performed by videoconference and consisted of the fatigue assessment scale (FAS), London activity of daily living scale (LCADL), post-COVID-19 functional status (PCFS) and European quality of life questionnaire (EQ-5D-5L), including the pain/discomfort dimension. The 30s-STS test was performed using a standardized protocol adapted for remote use, and the modified Borg scale (0-10) was used to assess dyspnea and lower limb fatigue immediately after the test. The feasibility of the 30s-STS test was assessed by the proportion of eligible participants who were able to complete the test. Safety was assessed by the number of adverse events that occurred during the test. Seventy-nine participants were included (median age: 44 years, 86.1% women). Performance in the 30s-STS test was 11.5 ± 3.2 repetitions with 60.8% of the sample below reference values. All eligible participants were able to complete the test. No adverse events were reported during the evaluation. Participants with lower 30s-STS performance had more fatigue and dyspnea, worse quality of life, more severe pain/discomfort, and worse functional status (p < 0.05). A significant correlation was obtained between LCADL and dyspnea, reported on the Borg scale (0-10) post 30s-STS (r = 0.71; p < 0.001). In conclusion, the 30s-STS test proved to be a feasible test to implement in the telehealth setting and is related to fatigue, dyspnea, quality of life and pain in non-hospitalized patients with long COVID. Clinicians may use this test when assessment of the physical sequelae of COVID-19 in the face-to-face setting is not possible

Nuevos registros de arañas (Arachnida: Araneae) para el estado de Jalisco, México/ New records of spiders (Arachnida: Araneae) for the state of Jalisco, Mexico

New records of Hibana futilis (Banks, 1898) (adult female), Marpissa pikei (Peckham &amp; Peckham, 1888) (adult male), Metacyrba punctata (Peckham &amp; Peckham, 1894) (juveniles) and Paraphidippus fartilis (Peckham &amp; Peckham, 1888) (adult female) from Jalisco state are provided. Marpissa pikei is a new record from MexicoNew records of Hibana futilis (Banks, 1898) (adult female), Marpissa pikei (Peckham &amp; Peckham, 1888) (adult male), Metacyrba punctata (Peckham &amp; Peckham, 1894) (juveniles) and Paraphidippus fartilis (Peckham &amp; Peckham, 1888) (adult female) from Jalisco state are provided. Marpissa pikei is a new record from Mexic

Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across ten countries: Global validation of the PTG-PTD theoretical model

info:eu-repo/semantics/publishedVersio

Plasma extracellular vesicles reveal early molecular differences in amyloid positive patients with early-onset mild cognitive impairment

In the clinical course of Alzheimer's disease (AD) development, the dementia phase is commonly preceded by a prodromal AD phase, which is mainly characterized by reaching the highest levels of Aβ and p-tau-mediated neuronal injury and a mild cognitive impairment (MCI) clinical status. Because of that, most AD cases are diagnosed when neuronal damage is already established and irreversible. Therefore, a differential diagnosis of MCI causes in these prodromal stages is one of the greatest challenges for clinicians. Blood biomarkers are emerging as desirable tools for pre-screening purposes, but the current results are still being analyzed and much more data is needed to be implemented in clinical practice. Because of that, plasma extracellular vesicles (pEVs) are gaining popularity as a new source of biomarkers for the early stages of AD development. To identify an exosome proteomics signature linked to prodromal AD, we performed a cross-sectional study in a cohort of early-onset MCI (EOMCI) patients in which 184 biomarkers were measured in pEVs, cerebrospinal fluid (CSF), and plasma samples using multiplex PEA technology of Olink© proteomics. The obtained results showed that proteins measured in pEVs from EOMCI patients with established amyloidosis correlated with CSF p-tau181 levels, brain ventricle volume changes, brain hyperintensities, and MMSE scores. In addition, the correlations of pEVs proteins with different parameters distinguished between EOMCI Aβ( +) and Aβ(-) patients, whereas the CSF or plasma proteome did not. In conclusion, our findings suggest that pEVs may be able to provide information regarding the initial amyloidotic changes of AD. Circulating exosomes may acquire a pathological protein signature of AD before raw plasma, becoming potential biomarkers for identifying subjects at the earliest stages of AD development

Transdisciplinary studies in socio-ecosystems: Theoretical considerations and its application in Latin American contexts

Debido a limitaciones para abordar la complejidad de la relación sociedad-naturaleza, los esfuerzos para solucionar los problemas ambientales han sido en general infructuosos. Aquí proponemos que el enfoque holístico de “socio-ecosistema” por parte de la academia, podría contribuir a disminuir estas limitaciones desde la adopción de cuatro cambios: i) ontológico, que presenta el concepto de “socio-ecosistemas”; ii) epistemológico, que propone a la transdisciplina como la forma de entenderlos, iii) metodológico, que sugiere intervenir en ellos de forma participativa y adaptativa y, iv) cambios institucionales que facilitarían la adopción de esta propuesta. Este planteamiento se complementa con la descripción de una experiencia transdiciplinaria en la cuenca del río San Juan Zitácuaro, México, en el contexto de un curso internacional de manejo de socio-ecosistemas.Given the difficulties to approach the complex relationship bettween society and nature, efforts to solve environmental problems have generally been unsuccessful. Here we suggest that a hollistic “socio-ecosystem” approach by the sciencies could help diminish these difficulties by embracing four kinds of changes: i) ontological, which introduces the concept of “socio-ecosystem”; ii) epistemological, which proposes transdiscipline as the way to understand them, iii) metholodogical, which suggests that in intervention in them must be participatory and adaptive, iv) institutional changes that would facilitate the adoption of this approach. This is then followed by a description of a transdisciplinary work experience in the Zitácuaro river basin, in Mexico, in the context of an international course on socio-ecosystem management.Fil: Ortega Uribe, Tamara. Universidad de Chile; ChileFil: Mastrangelo, Matias Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Agrarias; ArgentinaFil: Villarroel Torrez, Daniel. Universidad de Buenos Aires. Facultad de Agronomía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Piaz, Agustín Gabriel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de San Martín. Escuela de Humanidades. Centro de Estudios de Historia de la Ciencia y de la Técnica ; ArgentinaFil: Vallejos, María. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura. Universidad de Buenos Aires. Facultad de Agronomía. Instituto de Investigaciones Fisiológicas y Ecológicas Vinculadas a la Agricultura; ArgentinaFil: Saenz Ceja, Jesús Eduardo. Universidad Nacional Autónoma de México. Centro de Investigaciones en Ecosistemas; MéxicoFil: Gallego, Federico. Universidad de la República. Facultad de Ciencias; UruguayFil: Franquesa Soler, Monserrat. Instituto de Ecología; MéxicoFil: Calzada Peña, Leonardo. Universidad Nacional Autónoma de México; MéxicoFil: Espinosa Mellado, Noelia. Universidad de la Armada; MéxicoFil: Fiestas Flores, Jerico. Instituto de Estudios Peruanos; PerúFil: Gill Mairhofer, Luis R.. Ministerio de la Defensa Pública; ParaguayFil: González Espino, Zarahí. Instituto Superior de Tecnologías y Ciencias Aplicadas. Facultad de Medio Ambiente. Departamento de Meteorología; CubaFil: Luna Salguero, Betsabé Montserrat. Sociedad de Historia Natural Niparajá; MéxicoFil: Martinez Peralta, Claudia María. Comisión de Ecología y Desarrollo Sustentable del Estado de Sonora. Dirección General de Conservación; MéxicoFil: Ochoa, Olivia. Universidad Nacional Autónoma de México; MéxicoFil: Pérez Volkow,Lucía. No especifica;Fil: Sala, Juan Emilio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico; ArgentinaFil: Sánchez Rose, Isabelle. Universidad Central de Venezuela; VenezuelaFil: Weeks, Madeline. University of Cambridge; Reino UnidoFil: Ávila García, Daniela. Universidad Nacional Autónoma de México; MéxicoFil: García Reyes, Isabel Bueno. Universidad Nacional Autónoma de México. Centro de Investigaciones en Ecosistemas; MéxicoFil: Carmona, Alejandra. Universidad Austral de Chile. Instituto de Economía Agraria; ChileFil: Castro Videla, Fernando Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza; Argentina. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Mendoza-San Juan; ArgentinaFil: Ferrer Gonzalez, César Sergio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Ciencias Humanas, Sociales y Ambientales; ArgentinaFil: Frank Buss, María Elisa. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de La Pampa. Facultad de Agronomía; ArgentinaFil: López Carapia, Gabriela. Universidad Nacional Autónoma de México; MéxicoFil: Núñez Cruz, Martha. Universidad Nacional Autónoma de México; MéxicoFil: Taboada Hermoza, Rossi. Universidad Nacional Mayor de San Marcos; PerúFil: Benet, Daniel. Alternare A. C.; MéxicoFil: Venegas, Ysmael. Alternare A. C.; MéxicoFil: Balvanera, Patricia. Universidad Nacional Autónoma de México. Centro de Investigaciones en Ecosistemas; MéxicoFil: Mwampamba, Tuyeni H.. Universidad Nacional Autónoma de México. Centro de Investigaciones en Ecosistemas; MéxicoFil: Lazos Chavero, Elena. Universidad Nacional Autónoma de México. Centro de Investigaciones en Ecosistemas; MéxicoFil: Noellemeyer, Elke Johanna. Universidad Nacional de La Pampa. Facultad de Agronomía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Maass, Manuel. Universidad Nacional Autónoma de México. Centro de Investigaciones en Ecosistemas; Méxic

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Capitulo 6. Ciencias Administrativas, Contables, Económicas y de Negocio

La informalidad laboral es uno de los principales problemas que aquejan a la&nbsp;economía&nbsp;colombiana, según el DANE “para el trimestre marzo – mayo de 2019 la proporción de ocupados informales fue del 48, 1%, resultados que arrojó un estudio en 23 ciudades y áreas metropolitanas principales del País” (p4). Ese casi 50% de informalidad, por supuesto que es un problema de gran significancia de afectación para cualquier economía, ya que este es uno de los flagelos que&nbsp;reduce la productividad de un País, por ende, afecta su crecimiento y desarrollo económico.&nbsp; Paul Krugman (2010), Premio Nobel de Economía de 2008, postula que “la capacidad de un país de mejorar su nivel de vida a lo largo del tiempo depende casi que por entero de su capacidad de aumentar su producción por trabajador” (p.23)