Validity and reliability of AMPET Greek versión: a first examination of learning motivation in Greek PE settings

Validity and reliability of AMPET Greek versión: a first examination of learning motivation in Greek PE setting

Modelos interculturales: cuestiones conceptuales para el desarrollo de estrategias de intervención

La educación intercultural ha alcanzado en el ámbito de la educación carta de identidad. La problemática de la educación intercultural se ha modificado en nuestros días, no sólo porque los movimientos de población son cada vez más numerosos, plurales y frecuentes, sino también porque las circunstancias del mundo, actualmente, están penetradas por la mundialización de los fenómenos, la responsabilidad de la sociedad civil, el respeto a la diversidad y la consolidación de los derechos de primera, segunda y tercera generación, de una manera tal que nos obliga a replantear el concepto de interculturalidad desde nuevas perspectivas transnacionales y glocales que tienen alcance semántico. Para nosotros, hablar de interculturalidad implica hablar de comunicación intercultural, y ésta se compone de procesos de interacción, tanto verbales, como no verbales, que existen entre los miembros que pertenecen a grupos culturales diferentes en situaciones de diversidad. Atendiendo a estos planteamientos, en este trabajo defendemos que en el desarrollo de estrategias de intervención se tiene que reforzar la comunicación intercultural en un triple sentido: La comunicación intercultural como propuesta, la comunicación intercultural como promotora de innovación, la comunicación intercultural como fortalecimiento personal y de grupoThe intercultural education has reached in educational field specific identity. The conceptual context of the intercultural education has been modified in our days, not only because the migratory movements are more and more numerous, plural and frequent, but also because the circumstances of the world, at the moment, are engaged by the mundialización of the phenomena, the responsibility of the civil society, the respect to the diversity and the consolidation of the human rights (whether first, second or third generation ones), in a such way so that it forces to us to reframe the interculturality concept from new transnational and glocal perspectives that have semantic meaning. For us, to speak of interculturality concept implies to speak of intercultural communication and this one is made up of processes of interaction, as much verbal, as nonverbal, that exist between the members who belong to different cultural groups and are in status of diversity. Taking care of these expositions, in this work we clear that in the development of intercultural strategies in educational intervention, it must reinforce the intercultural communication in a triple sense: The intercultural communication like a ethical chance, the intercultural communication like innovation promoter, the intercultural communication like personal and groupal encouragementS

Validation of a Spanish version of the Leicester Cough Questionnaire in cystic fibrosis

Bronchiectasis; Quality of life; Respiratory diseaseBronquiectasia; Calidad de vida; Enfermedad respiratoriaBronquiectàsia; Qualitat de vida; Malaltia respiratòriaCough is a main symptom in cystic fibrosis (CF). We aim to validate a Spanish version of the Leicester Cough Questionnaire (LCQ-Sp) to measure the impact of cough in CF bronchiectasis. A prospective longitudinal multicentre study was performed. Internal consistency and score changes over a 15-day period in stable state were assessed to analyse reliability. Concurrent validity was analysed by correlation with Saint George’s Respiratory Questionnaire (SGRQ) and convergent validity by assessing the association with clinical variables. Changes in scores between stable state and the first exacerbation were assessed to analyse responsiveness. 132 patients (29.73 ± 10.52 years) were enrolled in four hospitals. Internal consistency was high for the total score and good for the three domains (Cronbach’s α 0.81–0.93). The test–retest reliability showed an intraclass correlation coefficient of 0.86 for the total score. The correlation between LCQ-Sp and SGRQ scores was −0.74. The LCQ-Sp score negatively correlated with sputum volume, and the mean score decreased at the beginning of exacerbations (16.04±3.81 vs 13.91±4.29) with a large effect size. The LCQ-Sp is a reliable, repeatable and responsive instrument to assess the impact of cough in CF bronchiectasis and is responsive to change in the event of exacerbations.The author(s) received no financial support for the research, authorship, and/or publication of this article

The Essential Role of IL-17 as the Pathogenetic Link between Psoriasis and Metabolic-Associated Fatty Liver Disease

IL-17; Enfermedad del hígado graso asociada al metabolismo; PsoriasisIL-17; Metabolic-associated fatty liver disease; PsoriasisIL-17; Malaltia del fetge gras associada al metabolisme; PsoriasiInterleukin 17 (IL-17) is an effector cytokine that plays a key role in the pathogenesis of both psoriasis and metabolic-associated fatty liver disease (MAFLD), a condition that is more prevalent and severe in patients with psoriasis. In liver inflammation, IL-17 is mainly produced by CD4+ T (TH17) and CD8+ T cells (Tc17), although numerous other cells (macrophages, natural killer cells, neutrophils and Tγδ cells) also contribute to the production of IL-17. In hepatocytes, IL-17 mediates systemic inflammation and the recruitment of inflammatory cells to the liver, and it is also implicated in the development of fibrosis and insulin resistance. IL-17 levels have been correlated with progression from MAFLD to steatohepatitis, cirrhosis, and even hepatocellular carcinoma. Clinical trials have shown that inhibiting IL-17A in patients with psoriasis could potentially contribute to the improvement of metabolic and liver parameters. A better understanding of the key factors involved in the pathogenesis of these chronic inflammatory processes could potentially lead to more efficient treatment for both psoriasis and MAFLD, and help to develop holistic strategies to improve the management of these patients.Financial support for the expert meetings and manuscript preparation were provided by Novartis Farmacéutica S.A

According to Hepatitis C Virus (HCV) Infection Stage, Interleukin-7 Plus 4-1BB Triggering Alone or Combined with PD-1 Blockade Increases TRAF1lowHCV-Specific CD8+Cell Reactivity.

Hepatitis C virus (HCV)-specific CD8+T cells suffer a progressive exhaustion during persistent infection (PI) with HCV. This process could involve the positive immune checkpoint 4-1BB/4-1BBL through the loss of its signal transducer, TRAF1. To address this issue, peripheral HCV-specific CD8+T cells (pentamer-positive [pentamer+]/CD8+T cells) from patients with PI and resolved infection (RI) after treatment were studied. The duration of HCV infection and the liver fibrosis progression rate inversely correlated with the likelihood of detection of peripheral pentamer+/CD8+cells. In PI, pentamer+/CD8+cells had impaired antigen-specific reactivity that worsened when these cells were not detectableex vivoShort/midduration PI was characterized by detectable peripheral PD-1+CD127lowTRAF1lowcells. After triggering of T cell receptors (TCR), the TRAF1 level positively correlated with the levels of CD127, Mcl-1, and CD107a expression and proliferation intensity but negatively with PD-1 expression, linking TRAF1lowto exhaustion.In vitrotreatment with interleukin-7 (IL-7) upregulated TRAF1 expression, while treatment with transforming growth factor-β1 (TGF-β1) did the opposite, suggesting that the IL-7/TGF-β1 balance, besides TCR stimulation, could be involved in TRAF1 regulation. In fact, the serum TGF-β1 concentration was higher in patients with PI than in patients with RI, and it negatively correlated with TRAF1 expression. In line with IL-7 increasing the level of TRAF1 expression, IL-7 plus 4-1BBL treatmentin vitroenhanced T cell reactivity in patients with short/midduration infection. However, in patients with long-lasting PI, anti-PD-L1, in addition to the combination of IL-7 and 4-1BBL, was necessary to reestablish T cell proliferation in individuals with slowly progressing liver fibrosis (slow fibrosers) but had no effect in rapid fibrosers. In conclusion, a peripheral hyporeactive TRAF1lowHCV-specific CD8+T cell response, restorable by IL-7 plus 4-1BBL treatment, characterizes short/midduration PI. In long-lasting disease, HCV-specific CD8+T cells are rarely detectableex vivo, but treatment with IL-7, 4-1BBL, and anti-PD-L1 recovers their reactivityin vitroin slow fibrosers.IMPORTANCEHepatitis C virus (HCV) infects 71 million people worldwide. Two-thirds develop a chronic disease that can lead to cirrhosis and hepatocellular carcinoma. Direct-acting antivirals clear the infection, but there are still patients who relapse. In these cases, additional immunotherapy could play a vital role. A successful anti-HCV immune response depends on virus-specific CD8+T cells. During chronic infection, these cells are functionally impaired, which could be due to the failure of costimulation. This study describes exhausted specific T cells, characterized by low levels of expression of the signal transducer TRAF1 of the positive costimulatory pathway 4-1BB/4-1BBL. IL-7 upregulated TRAF1 expression and improved T cell reactivity in patients with short/midduration disease, while in patients with long-lasting infection, it was also necessary to block the negative PD-1/PD-L1 checkpoint. When the results are taken together, this work supports novel ways of restoring the specific CD8+T cell response, shedding light on the importance of TRAF1 signaling. This could be a promising target for future immunotherapy

Recomendaciones del Grupo GARIN para el manejo de pacientes no críticos con diabetes o hiperglucemia de estrés y nutrición artificial

Background & aims: By means of this update, the GARIN working group aims to define its position regarding the treatment of patients with diabetes or stress hyperglycaemia and artificial nutrition. In this area there are many aspects of uncertainty, especially in non-critically ill patients. Methods: Bibliographical review, and specific questions in advance were discussed and answered at a meeting in the form of conclusions. Results: We propose a definition of stress hyperglycaemia. The indications and access routes for artificial nutrition are no different in patients with diabetes/stress hyperglycaemia than in non-diabetics. The objective must be to keep pre-prandial blood glucose levels between 100 and 140 mg/dl and post-prandial levels between 140 and 180 mg/dl. Hyperglycemia can be prevented through systematic monitoring of capillary glycaemias and adequately calculate energy-protein needs. We recommend using enteral formulas designed for patients with diabetes (high monounsaturated fat) to facilitate metabolic control. The best drug treatment for treating hyperglycaemia/diabetes in hospitalised patients is insulin and we make recommendations for adapt the theoretical insulin action to the nutrition infusion regimen. We also addressed recommendations for future investigation. Conclusions: This recommendations about artificial nutrition in patients with diabetes or stress hyperglycaemia can add value to clinical work.Introducción y objetivos: En el tratamiento de los pacientes con diabetes o hiperglucemia de estrés y la nutrición artificial existen muchas áreas de incertidumbre, sobre todo en pacientes no críticos. El grupo de trabajo GARIN tiene como objetivo definir su posición en este campo. Material y métodos: Revisión bibliográfica previa y reunión presencial en la que se discutieron y contestaron preguntas específicas sobre el tema. Resultados: Proponemos una definición de hiperglucemia de estrés. Las indicaciones y las rutas de acceso a la nutrición artificial no difieren en los pacientes con hiperglucemia de estrés o diabetes respecto a los no diabéticos. El objetivo debe ser mantener los niveles de glucemia preprandial entre 100 y 140 mg/dl y postprandial entre 140 y 180 mg/dl. La hiperglucemia puede prevenirse a través de una monitorización sistemática de las glucemias capilares y un cálculo adecuado de las necesidades energético-proteicas. Recomendamos el uso de fórmulas enterales diseñadas para pacientes con diabetes (alto contenido en grasas monoinsaturadas) para facilitar el control metabólico. El mejor tratamiento farmacológico para tratar la hiperglucemia/diabetes en pacientes hospitalizados es la insulina, aconsejando adaptar la acción teórica de la insulina al régimen de infusión de la nutrición. También realizamos recomendaciones para investigaciones futuras. Conclusiones: Estas recomendaciones aportan respuestas concretas sobre cuestiones comunes en la asistencia a pacientes con diabetes o hiperglucemia de estrés y nutrición artificial

Consumption of cows' milk is associated with lower risk of type 2 diabetes mellitus. A cross-sectional study

The aim of this prospective, adult population-based study was to analyse the prevalence of type 2 diabetes mellitus in relation to the intake of cows' milk and the prevalence of anti-beta-lactoglobulin (anti-β-LG) antibodies. Measurements were made of weight, height, levels of anti-islet antibodies, anti-β-LG antibodies and tumour necrosis factor alpha (TNF-α) in all the participants. The likelihood of having positive anti-β-LG antibodies was higher in subjects who consumed milk more frequently. Subjects who consumed milk less than once per day were more likely to have type 2 diabetes than those who consumed milk more than once per day. The levels of TNF-α were significantly higher in individuals with positive anti-β-LG antibodies and in those who consumed milk more often. The prevalence of anti-β-LG antibodies was associated with the intake of milk and with the TNF-α levels, but not with the prevalence of type 2 diabetes. © 2012 Elsevier Ltd.This study was supported by the CIBER in Diabetes and Associated Metabolic Disorders (Instituto de Salud Carlos III); Ministerio de Ciencia e Innovación (JCI-2010-08372) and Consejería Innovación, Ciencia y Empresa (P09-CTS-5125)

Negative impact of HIV infection on broad-spectrum anti-HCV neutralizing antibody titers in HCV-infected patients with advanced HCV-related cirrhosis

Objectives: The current study aimed to assess the impact of HIV on the production of anti-HCV antibodies in HCV-infected individuals with advanced HCV-related cirrhosis before and 36 weeks after the sustained virological response (SVR) induced by direct-acting antivirals (DAAs) therapy. Methods: Prospective study on 62 patients (50 HIV/HCV-coinfected and 12 HCV-monoinfected). Plasma anti-E2 and HCV-nAbs were determined respectively by ELISA and microneutralization assays. Results: At baseline, the HCV-group had higher anti-E2 levels against Gt1a (p = 0.012), Gt1b (p = 0.023), and Gt4a (p = 0.005) than the HIV/HCV-group. After SVR, anti-E2 titers against Gt1a (p < 0.001), Gt1b (p = 0.001), and Gt4a (p = 0.042) were also higher in the HCV-group than HIV/HCV-group. At 36 weeks post-SVR, plasma anti-E2 titers decreased between 1.3 and 1.9-fold in the HIV/HCV-group (p < 0.001) and between 1.5 and 1.8-fold in the HCV-group (p ≤ 0.001). At baseline, the HCV-group had higher titers of HCV-nAbs against Gt1a (p = 0.022), Gt1b (p = 0.002), Gt2a (p < 0.001), and Gt4a (p < 0.001) than the HIV/HCV-group. After SVR, HCV-nAbs titers against Gt1a (p = 0.014), Gt1b (p < 0.001), Gt2a (p = 0.002), and Gt4a (p = 0.004) were also higher in the HCV-group. At 36 weeks post-SVR, HCV-nAbs decreased between 2.6 and 4.1-fold in the HIV/HCV-group (p < 0.001) and between 1.9 and 4.0-fold in the HCV-group (p ≤ 0.001). Conclusions: HIV/HCV-coinfected patients produced lower levels of broad-spectrum anti-HCV antibodies than HCV-monoinfected patients.This study was supported by grants from Instituto de Salud Carlos III (ISCII; grant numbers PI20/00474 and PI17/00657 to JB, PI20/00507 and PI17/00903 to JGG, PI19CIII/00009 to IM, and PI20CIII/00004 and PI17CIII/00003 to SR). The study was also funded by the Spanish AIDS Research Network (RD16/0025/0017, RD16/0025/0018 and RD16CIII/0002/0002) and CIBER -Consorcio Centro de Investigación Biomédica en Red- (CB 2021), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – NextGenerationEU (CB21/13/00044 and CB21/13/00039). DSC is a ‘Sara Borrell’ researcher from ISCIII (grant number CD20CIII/00001).S

Poor Physical Performance Is Associated with Postoperative Complications and Mortality in Preoperative Patients with Colorectal Cancer

Introduction: Poor physical performance has been shown to be a good predictor of complications in some pathologies. The objective of our study was to evaluate, in patients with colorectal neoplasia prior to surgery, physical performance and its relationship with postoperative complications and in-hospital mortality, at 1 month and at 6 months. Methods: We conducted a prospective study on patients with preoperative colorectal neoplasia, between October 2018 and July 2021. Physical performance was evaluated using the Short Physical Performance Battery (SPPB) test and hand grip strength (HGS). For a decrease in physical performance, SPPB < 10 points or HGS below the EWGSOP2 cut-off points was considered. Nutritional status was evaluated using subjective global assessment (SGA). The prevalence of postoperative complications and mortality during admission, at 1 month, and at 6 months was evaluated. Results: A total of 296 patients, mean age 60.4 ± 12.8 years, 59.3% male, were evaluated. The mean BMI was 27.6 ± 5.1 kg/m2. The mean total SPPB score was 10.57 ± 2.07 points. A total of 69 patients presented a low SPPB score (23.3%). Hand grip strength showed a mean value of 33.1 ± 8.5 kg/m2 for men and 20.7 ± 4.3 kg/m2 for women. A total of 58 patients presented low HGS (19.6%). SGA found 40.2% (119) of patients with normal nourishment, 32.4% (96) with moderate malnutrition, and 27.4% (81) with severe malnutrition. Postoperative complications were more frequent in patients with a low SPPB score (60.3%vs38.6%; p=0.002) and low HGS (64.9%vs39.3%, p=0.001). (...)This research was partially funded by the 2019 research grants of SANCYD (Sociedad Andaluza de Nutrición Clínica y Dietética) and by an unrestricted grant from Persan Farma. Partial funding for open access charge: Universidad de Málag