Relación de la vitamina B12 y deterioro cognitivo en personas mayores

Los déficits nutricionales son muy frecuentes en personas mayores, al igual que hay una prevalencia en este grupo de población de un deterioro en la función cognitiva. Determinar la existencia de relación entre el deterioro cognitivo y el estatus de vitamina B12 en el organismo adquiere gran importancia a la hora de comprobar si es posible reducir la prevalencia de este déficit cognitivo mediante la suplementación con esta vitamina en personas de edad avanzada. Por tanto, se ha hecho una revisión sistemática con el fin de determinar la relación existente entre la función cognitiva de las personas mayores y el estatus de vitamina B12, así como evaluar el efecto de la suplementación con la vitamina B12 en estos pacientes como tratamiento para el retraso del deterioro cognitivo. Por otro lado, también se establece como objetivo evaluar la relación entre estos suplementos de vitamina B12 con los niveles séricos de homocisteína. Tras la realización de la revisión, se concluye que los resultados tras la suplementación con vitamina B12 son diferentes en función de si el paciente tiene un estado cognitivo normal o si posee algún tipo de deterioro cognitivo, así como también se han visto diferencias en los resultados tras la suplementación entre los pacientes con niveles adecuados de vitamina B12 y homocisteína en comparación con aquellos con deficiencias en la vitamina B12 y las altas concentraciones de homocisteína

The dynamic assembly of distinct RNA polymerase I complexes modulates rDNA transcription

Cell growth requires synthesis of ribosomal RNA by RNA polymerase I (Pol I). Binding of initiation factor Rrn3 activates Pol I, fostering recruitment to ribosomal DNA promoters. This fundamental process must be precisely regulated to satisfy cell needs at any time. We present in vivo evidence that, when growth is arrested by nutrient deprivation, cells induce rapid clearance of Pol I-Rrn3 complexes, followed by the assembly of inactive Pol I homodimers. This dual repressive mechanism reverts upon nutrient addition, thus restoring cell growth. Moreover, Pol I dimers also form after inhibition of either ribosome biogenesis or protein synthesis. Our mutational analysis, based on the electron cryomicroscopy structures of monomeric Pol I alone and in complex with Rrn3, underscores the central role of subunits A43 and A14 in the regulation of differential Pol I complexes assembly and subsequent promoter association.The project was supported by grant BFU2013-48374-P of the Spanish MINECO and by the Ramón Areces Foundation. O.G. held a research contract under the Ramón y Cajal program of the Spanish MINECO (RYC-2011-07967). IRB Barcelona is the recipient of a Severo Ochoa Award of Excellence from the Spanish MINECO.Peer reviewe

UGR Empática: programa de intervención para el desarrollo de la empatía en el alumnado de Ciencias de la Salud y Ciencias de la Educación

La capacidad empática es fundamental para garantizar el éxito profesional en las carreras de Ciencias de la Educación y Ciencias de la Salud. En tanto que se trata de una capacidad que puede entrenarse, este proyecto pretende desarrollar la empatía en el estudiantado de estas ramas del conocimiento. Para ello se diseñó una acción de innovación docente consistente en una serie de materiales didácticos en formato multimedia en los que se abordan diferentes aspectos de la empatía y que han sido empleados por los docentes de diferentes materias durante sus clases. Los materiales se han agrupado en 8 sesiones, cada una de ellas conteniendo dos actividades breves. Las actividades han sido presentaciones en videos en torno a 5 minutos y casos prácticos de elaboración propia de los componentes del equipo del PID. En cada sesión se ha incluido un ejercicio de aprendizaje por autoevaluación. La duración ha sido de 8 semanas, a razón de una sesión compuesta por las 2 actividades cada semana. Para determinar la eficacia de la acción innovadora se ha evaluado la capacidad de empatía en el estudiantado antes de iniciar el proyecto y tras la finalización del mismo, a través del Índice de Reactividad Interpersonal (IRI), una escala que mide la empatía de forma multidimensional. El IRI ofrece una medida compuesta de la empatía, incluyendo su dimensión cognitiva y afectiva. La empatía cognitiva se mide mediante el grado en el que la persona comprende el punto de vista de otra persona. El IRI tiene 2 escalas para medir empatía cognitiva: a) la Escala de Toma de Perspectiva, que evalúa cómo la persona intenta adoptar las perspectivas de otras personas y ver las cosas desde su punto de vista; y b) la Escala de fantasía, que mide la tendencia a identificarse con los personajes de las películas, novelas, obras teatrales y otras situaciones ficticias. La de mayor interés para este proyecto es la primera. En cuanto a la empatía afectiva o emocional, el IRI intenta captar la respuesta emocional de la persona cuando observa el estado afectivo de otras personas, y lo hace con otras 2 escalas: c) Escala de Preocupación Empática consta de ítems sobre los sentimientos de simpatía, compasión y preocupación por los demás; y d) la Escala de Angustia Personal, que valora si la persona experimenta ansiedad y malestar cuando observa que otros están atravesando por experiencias negativas. En nuestro estudio, el interés estaba en que aumentase la puntuación en la escala de preocupación empática, pero no en la de angustia personal. Los objetivos específicos fueron la mejora en las dimensiones de la capacidad empática más relevantes, considerando que la toma de perspectiva y la preocupación empática son las más relacionadas con el desempeño profesional del estudiantado al que iba dirigido el proyecto. En general, los resultados indican que el conjunto del alumnado que ha participado en el PID ha mejorado su capacidad empática. Por tanto, podemos considerar que los materiales creados son válidos para tal fin y pueden ser de aplicación práctica a la docencia.Empathic skills are fundamental to ensure professional success in the fields of Education and Health Sciences. As it is an ability that can be trained, this project aims to develop empathy in students of these branches of knowledge. To this end, a teaching innovation action was designed consisting of a series of teaching materials in multimedia format in which different aspects of empathy are addressed and which have been used by teachers of different subjects during their classes. The materials have been grouped into 8 sessions, each containing two short activities. The activities consisted of 5-minute video presentations and case studies developed by the IDP team. Each session included a self-assessment learning exercise. The duration was 8 weeks, with one session consisting of the 2 activities each week. To determine the effectiveness of the innovative action, the students' capacity for empathy was assessed before the start of the project and after its completion, using the Interpersonal Reactivity Index (IRI), a scale that measures empathy in a multidimensional way. The IRI provides a composite measure of empathy, including both cognitive and affective dimensions. Cognitive empathy is measured by the degree to which a person understands another person's point of view. The IRI has 2 scales to measure cognitive empathy: a) the Perspective Taking Scale, which assesses how the person tries to adopt other people's perspectives and see things from their point of view; and b) the Fantasy Scale, which measures the tendency to identify with characters in films, novels, plays and other fictional situations. Of most interest for this project is the first one. As for affective or emotional empathy, the IRI attempts to capture the person's emotional response when observing the affective state of other people, and does so with 2 other scales: c) the Empathic Concern Scale consists of items on feelings of sympathy, compassion and concern for others; and d) the Personal Distress Scale, which assesses whether the person experiences anxiety and discomfort when observing that others are going through negative experiences. In our study, the focus was on increasing scores on the empathic concern scale, but not on the personal distress scale. The specific objectives were to improve the most relevant dimensions of empathic ability, considering that perspective-taking and empathic concern are the most related to the professional performance of the target students. In general, the results indicate that the students who participated in the IDP as a whole have improved their empathic ability. Therefore, we can consider that the materials created are valid for this purpose and can be of practical application in teaching

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Sub1 contacts the RNA polymerase II stalk to modulate mRNA synthesis

Biogenesis ofmessenger RNA is critically influenced by the phosphorylation state of the carboxy-terminal domain (CTD) in the largest RNA polymerase II(RNAPII) subunit. Several kinases and phosphatases are required to maintain proper CTD phosphorylation levels and, additionally, several other proteins modulate them, including Rpb4/7 and Sub1. The Rpb4/7 heterodimer, constituting the RNAPII stalk, promote phosphatase functions and Sub1 globally influences CTD phosphorylation, though its mechanism remains mostly unknown. Here, we show that Sub1 physically interacts with the RNAPII stalk domain,Rpb4/7, likely through its C-terminal region,and associates with Fcp1. While Rpb4 is not required for Sub1 interaction with RNAPII complex, a fully functional heterodimer is required for Sub1 association to promoters. We also demonstrate that a complete CTD is necessary for proper association of Sub1 to chromatin and to the RNAPII. Finally, genetic data show a functional relationship between Sub1 and the RNAPII clamp domain. Altogether, our results indicate that Sub1, Rpb4/7 and Fcp1 interaction modulates CTD phosphorylation. In addition, Sub1 interaction with Rpb4/7 can also modulate transcription start site selection and transcription elongation rate likely by influencing the clamp function.Spanish Ministry of Economy and Competitiveness (MINECO) [BFU2013-48374-P]; Predoctoral fellowships from MINECO (to J.A.L.); Technician Formation Program from the Spanish National Research Council (CSIC) (to N.G.-P.). Funding for open access charge: MINECO [BFU2013-48374-P].Peer reviewe

Regulation of RNAPII phosphorylation

Trabajo presentado a la I Reunión Red de Excelencia Temática: "RNA Life", celebrada en Valencia del 24 al 25 de febrero de 2016.BFU2015-71978-REDT.Peer Reviewe

Sub1/PC4, more than a RNAPII transcription factor

Trabajo presentado en la II Reunión de la Red de Excelencia Temática: RNA Life, celebrada en Madrid (España), los días 19 y 20 de julio de 2017Biogenesis of mRNA is critically influenced by the phosphorylation state of the carboxy-terminal domain (CTD) in the largest RNA polymerase II (RNAPII) subunit. Several kinases and phosphatases are required to maintain proper CTD phosphorylation levels and, additionally, several other proteins modulate them, including Rpb4/7 and Sub1. The Rpb4/7 heterodimer, constituting the RNAPII stalk, promote phosphatase functions, and Sub1 globally influences CTD phosphorylation, though its mechanism remained mostly unknown until recently. Sub1 was initially identified as a coactivator factor, with a role during transcription initiation, due to conserved functional and structural features with human PC4. However, over the last years many evidences showed that it influences processes downstream during mRNA biogenesis, such as elongation, termination and RNAPII phosphorylation. The recent discover that Sub1 directly interacts with the RNAPII stalk adds new insights into how it achieves all these tasks. Moreover, we showed that this interaction likely occurs via the carboxi-terminal region of Sub1 (Sub1-CT), of unknown function so far. We also demonstrated that a complete RNAPII-CTD is necessary for proper association of Sub1 to chromatin and to the RNAPII. Altogether, our results indicate that Sub1 in association with Rpb4/7 and the CTD phosphatase Fcp1, modulates CTD phosphorylation, which crucially regulates the biogenesis of mRNAs. We also provide evidence indicating that Sub1 contributes to RNAPII clamp function elucidating Sub1 role during the transition from the open to the closed complex formation, thus facilitating transcription elongation. On the other hand, genome wide studies showed that Sub1 also binds to all RNAP III-transcribed genes and the rDNA gene transcribed by RNAPI, though, in this latter case, Sub1 binding is controversial. In agreement, genome wide experiments performed by us show that tRNAs transcription is decreased when lacking SUB1. As in the case of RNAPII, Sub1 works in different steps of RNAPIII transcription cycle. It stimulates both transcription initiation and reinitiation in vitro. Additionally, Sub1 and PC4, as ssDNA binding proteins, have been involved in the maintenance of genome stability. Therefore, it is clear that the role of Sub1 in transcription regulation in particular, and in gene expression in general, is more complicated and important than anticipated. Although many progresses have been done regarding Sub1 role in transcription, several important questions remains unanswered: What is the role of Sub1-CT? Is Sub1 a gene looping factor? Is Sub1 shared by all the three RNAPs?Peer reviewe