Implicació de la via de senyalització de la proteïna SFRP5 en la malaltia del fetge gras no alcohòlic i en la comunicació teixit adipós-fetge

La proteïna 5 secretada relacionada amb l’encrespat (SFRP5) és un antagonista de la via de senyalització no canònica de WNT, amb un potencial paper protector i antiinflamatori en front a desequilibris metabòlics com la resistència a la insulina. Per aquestes raons, podria ser que la proteïna SFRP5 tingui un paper rellevant en la patogènia de la malaltia del fetge gras no alcohòlic (MFGNA). En aquest sentit, l’objectiu principal d’aquesta tesi doctoral, és investigar el rol específic de la proteïna SFRP5 i la via no canònica de WNT en la MFGNA, concretament en mostres de sèrum, fetge i teixit adipós de dones amb obesitat mòrbida (OM) y diferents graus de MFGNA. Les troballes més rellevants van ser que els nivells circulants de SFRP5 augmentaven després de la restricció calòrica en OM independentment de si presentaven o no MFGNA. A més, també es va veure que la expressió de SFRP5 hepàtica augmenta en els primers estadis de la MFGNA, probablement duent a terme un paper protector amb la intenció de frenar l’efecte danyí de la via no canònica de WNT; però, en una etapa avançada de la MFGNA, l’acció de la SFRP5 sembla estar desregulada, induint-se en conseqüència WNT5A i JNK, el que afavoreix la progressió de la malaltia. Pel que fa al teixit adipós, l'expressió de SFRP5 sembla estar induïda per l'obesitat i per la progressió de la MFGNA, amb un possible paper protector contra el desequilibri metabòlic; mentre que WNT al teixit adipós s’associa a una major acumulació de greix al fetgeLa proteína 5 secretada relacionada con el encrespado (SFRP5) es un antagonista de la vía de señalización no canónica de WNT, con un potencial papel protector y antiinflamatorio frente a desequilibrios metabólicos como la resistencia a la insulina. Por estas razones, podría ser que la proteína SFRP5 tenga un papel relevante en la patogenia de la enfermedad del hígado graso no alcohólico (EHGNA). En este sentido, el objetivo principal de esta tesis doctoral, es investigar el rol específico de la proteína SFRP5 y la vía no canónica de WNT en la MFGNA, concretamente en muestras de suero, hígado y tejido adiposo de mujeres con obesidad mórbida (OM) y diferentes grados de EHGNA. Los hallazgos más relevantes fueron que los niveles circulantes de SFRP5 aumentaban después de la restricción calórica en OM independientemente de si presentaban o no EHGNA. Además, también se vio que la expresión de SFRP5 hepática aumenta en los primeros estadios de la enfermedad, probablemente desempeñando un papel protector con la intención de frenar el efecto dañino de la vía no canónica de WNT; pero, en una etapa avanzada de la EHGNA, la acción de la SFRP5 parece estar desregulada, induciéndose consecuentemente WNT5A y JNK, lo que favorece la progresión de la enfermedad. Por lo que respecta al tejido adiposo, la expresión de SFRP5 parece estar inducida por la obesidad y por la progresión de la EHGNA, con un posible papel protector contra el desequilibrio metabólico; mientras que WNT en el tejido adiposo se asocia a una mayor acumulación de grasa en el hígadoSpaepcerel tcelda vferi zeznle lda- rpealatotegde npiaro dteei nla 5 M (SFFGRNPA5, )a ius naqnu aen ftuatguoronsis et sotfu tdhieo sn soonn-c naencoensicaarilo Ws NpaTr as igenscallainrge cpeart hewstaoys, hwailtlha zag os. potential protective and anti-inflammatory role against metabolic imbalances such as insulin resistance. For these reasons, it could be that SFRP5 protein has a relevant role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). In this sense, the main objective of this PhD thesis is to investigate the specific role of SFRP5 protein and the non-canonical WNT pathway in NAFLD, specifically in serum, liver and adipose tissue samples from morbidly obese (MO) women with different degrees of NAFLD. The most relevant findings were that circulating levels of SFRP5 increased after caloric restriction in MO regardless of whether they presented NAFLD. Moreover, it was also seen that hepatic SFRP5 expression increases in the early stages of the disease, probably playing a protective role with the intention of ameliorate the damaging effect of the non-canonical WNT pathway; but, at an advanced stage of NAFLD, SFRP5 action seems to be disrupted, consequently inducing WNT5A and JNK action, which triggers disease progression. Regarding adipose tissue, SFRP5 expression seems to be induced by obesity and NAFLD development, with a possible protective role against metabolic imbalance, whereas WNT in adipose tissue is associated with increased fat accumulation in the live

Evolution of Scientific Production on Health Literacy and Health Education—A Bibliometric Analysis

In the last few years, there has been an emphasis on the importance of health literacy (HL) and health education (HE) as basic tools to empower individuals and the community. The increasing interest in HL and HE has been observed through the evolution of publications and the nature of the main trends in the last few years. Knowing how HL and HE have evolved in scientific publications can help us to identify trends and set work priorities in this scope. Based on this, a bibliometric analysis (from 2000 to 2021) was conducted in two phases: first, an analysis was performed on the publications included in the Web of Science (WOS); second, a more specific analysis was conducted on the Core Collection from WOS. The data were analyzed with two software programs, the and Bibliometrix package for RStudio, and VOSviewer to analyze number of publications, citations, authors, collaborations, keywords trends, keywords evolutions and clusters of related terms. A total of 1799 articles were found in the first phase, and 727 in the second. The results from both analyses showed that the publications increased unequally until 2020, and considerably decreased in 2021; however, in spite of this, the number of citations remained constant. Likewise, five word clusters related with HL and HE were identified. D. Nutbeam stood out as the most prolific author on the subject, the USA as the country with the most publications, and the International Journal of Environmental Research and Public Health as having the most articles on the subject. This analysis may be a useful and helpful tool for future studies on the subject.This study has been co-financed under the RETSASO EFA 341/19 Project with FEDER funds. In addition, it has been subsidized by the DOTS University Chair (Chair for the Development of Healthy and Sustainable Organizations and Territoires), approved by agreement No. 193/2017 of the Governing Council of the University of Lleida on 19 July 2017

Both Amyloid-β Peptide and Tau Protein Are Affected by an Anti-Amyloid-β Antibody Fragment in Elderly 3xTg-AD Mice

Altres ajuts: ARR received an FPU fellowship and GSM a PIF-UAB fellowshipAlzheimer's disease (AD) is the most common dementia worldwide. According to the amyloid hypothesis,the early accumulation of the Aβ-peptide triggers tau phosphorylation,synaptic dysfunction, and eventually neuronal death leading to cognitive impairment, as well as behavioral and psychological symptoms of dementia. ScFv-h3D6 is a single-chain variable fragment that has already shown its ability to diminish the amyloid burden in 5-month-old 3xTg-AD mice. However, tau pathology is not evident at this early stage of the disease in this mouse model. In this study, the effects of scFv-h3D6 on Aβ and tau pathologies have been assessed in 22-month-old 3xTg-AD mice. Briefly, 3xTg-AD female mice were treated for 2 weeks with scFv-h3D6 and compared with 3xTg-AD and non-transgenic (NTg) mice treated with PBS. The treatment with scFv-h3D6 was unequivocally effective in reducing the area of Aβ staining. Furthermore, a tendency for a reduction in tau levels was also observed after treatment that points to the interplay between Aβ and tau pathologies. The pro-inflammatory state observed in the 3xTg-AD mice did not progress after scFv-h3D6 treatment. In addition, the treatment did not alter the levels of apolipoprotein E or apolipoprotein J. Thus, a 2-week treatment with scFv-h3D6 was able to reduce AD-like pathology in elderly 3xTg-AD female mice

Informe de resposta ràpida sobre l’ús de l’espirometria telemàtica autoadministrada en el seguiment de pacients amb fibrosi quística

Espirometria; Fibrosi quística; TelemedicinaEspirometría; Fibrosis quística; TelemedicinaSpirometry; Cystic fibrosis; TelemedicineL'objectiu d'aquest informe és analitzar les recomanacions sobre l’ús de l’espirometria telemàtica autoadministrada en el seguiment de pacients amb FQ d’acord amb les guies de pràctica clínica, documents de consens publicats i posicionaments de les societats científiques, posant èmfasi en aquelles que facin referència al context de la pandèmia per COVID-1

Health literacy in childhood and adolescence. A bibliometric analysis of scientific publications and professionals’ involvement

Background: Health Literacy (HL) is a powerful tool to empower children and adolescents in their own health. School nurses are the professionals who, with their expertise in health promotion and education, can facilitate this literacy throughout the educational process. Purpose: To analyze the scientific production in HL in childhood and adolescence in the last two decades, and to determine the involvement of professionals in this field, with emphasis on nursing professionals. Methods: A bibliometric analysis of the scientific literature (from 2000 to 2021) of articles retrieved from the Web of Science database was carried out. Original articles in all languages were considered as inclusion criteria. Bibliometrix 3.1.4 package from RStudio and VOSviewer were used to analyze publications and explain main results about citations, authors, countries, keywords trends, evolution, clusters of related terms, and professionals’ involvement. Results: A total of 2032 articles were included in the analysis. The results of the analysis showed that both publications and citations increased substantially since 2014. The most prolific authors in this field are not the most cited so far. The countries that published the most during the period evaluated were the United States, Australia and Canada. The keyword clusters identified in this scientometric study made it possible to determine hotspots in the study of HL in childhood and adolescence, with “mental health” being one of the main terms identified. There are different health-related professionals who are publishing in this field; in spite of this, nurses are not visible as authors in the publications. Conclusion: The scientific literature on HL in childhood and adolescence is a growing field in which different professionals are involved. Despite the increase in the number of publications, and despite the role that nurses play in schools regarding HL, their presence in scientific production is practically nonexistent.This work was supported by DOTSS University Chair [193/2017]

L'explotació de recursos forestals en el nord i en el sud des del punt de vista de la sostenibilitat

El present projecte té com a objectiu l'estudi de la sostenibilitat de l'explotació forestal que es realitza en l'hemisferi nord i en el sud. Per això, s'han escollit quatre països que disposen, dins de les seves fronteres, de grans extensions boscoses, cada un d'ells amb un tipus de bosc diferent: Brasil (Selva Amazònica), República Democràtica del Congo (Selva Equatorial), Canadà (Bosc Boreal) i Espanya (Bosc Mediterrani). Amb aquests països s'ha realitzat una comparativa tant de forma qualitativa com quantitativa. Pel que fa a l'anàlisi qualitatiu, s'han recollit dades del PIB per càpita dels diferents països de l'any 2010 i les principals metodologies d'explotació forestal que aquests realitzen. Així, els països amb més PIB per càpita eren també els països que utilitzaven mètodes d'explotació menys agressius i es consideren, per tant, els països amb una extracció dels seus recursos més sostenible. En quant a l'anàlisi quantitatiu, s'han utilitzat les dades de PIB per càpita, taxa de desforestació (ha/any) i taxa de creixement del bosc (ha/any) de cada tipus de bosc. Amb aquestes dades s'ha construït un índex, l'índex de sostenibilitat d'extracció, que pretén ser una eina d'estandardització per a la comparativa entre països i/o boscos diferents. El resultat ha estat el mateix en les dues anàlisis.El presente proyecto tiene como objetivo el estudio de la sostenibilidad de la explotación forestal que se realiza en el hemisferio norte y el sur. Para hacerlo, se han elegido cuatro países que disponen, dentro de sus fronteras, de grandes extensiones boscosas, cada uno de ellos con una tipología de bosque distinta: Brasil (Selva Amazónica), República Democrática del Congo (Selva Ecuatorial), Canadá (Bosque Boreal) y España (Bosque Mediterráneo). Con estos países ha realizado una comparativa tanto cualitativa como cuantitativa. Con respecto al análisis cualitativo, se han recogido dato del PIB por cápita de los distintos países del año 2010 y las principales metodologías de explotación forestal que éstos realizan. Así, los países con más PIB por cápita eran también los países que utilizaban los métodos de extracción menos agresivos y se consideran, por lo tanto, los países con una extracción de sus recursos más sostenible. En cuanto al análisis cuantitativo, se han utilizado datos de PIB por cápita, tasa de deforestación (ha/año) y tasa de crecimiento del bosque (ha/año) para cada tipo de bosque. Con estos datos se ha construido un índice, el índice de sostenibilidad de extracción, que pretende ser una herramienta de estandarización para la comparativa entre países y/o bosques distintos. El resultado ha sido el mismo en los dos análisis.This project aims to study the sustainability of logging that takes place in the northern hemisphere and in the south. To do it, focuses on four countries that have, within their boarders, large extensions of forests, each one with different typologies of forest: Brazil (Amazon jungle), Democratic Republic of Congo (equatorial forest), Canada (boreal forest) and Spain (Mediterranean forest). In these countries there has been a qualitative and quantitative comparison. Regarding the qualitative analysis, data were collected are GDP per capita and major logging methodologies they perform. Thus, countries with GDP per capita were also the countries using the extraction methods are considerer less aggressive and, therefore, countries with more sustainability resources extraction. As for the quantitative analysis, we used GDP per capita data, rate of deforestation (ha/year) and forest growth rate (ha/year) for each forest type. With these data, we designed and index, the sustainability index extraction, intended as a tool comparative standardization between countries and/or different forests. The result was the same in both analyses

Current Addiction in Youth : Online Sports Betting

Background: Gambling landscape has changed in recent years with the emergence of online gambling (OG). Greater accessibility and availability of this betting modality can increase the risk of developing a gambling disorder (GD). Online sports betting (OSB) is currently the most common type of OG, but little is known about the clinical characteristics of OSB compared to slot-machine (SM) gamblers, the most common offline gambling disorder. Methods: This was a prospective study conducted between October 2005 and September 2019, and included outpatients diagnosed with GD seen in a Pathological Gambling and Behavioral Addictions referral unit. Only patients with OSB and SM disorders were included. The main objective was to assess the clinical profile of OSB compared to SM gamblers, and to define clinical predictors for developing OSB gambling disorder. Logistic regression was performed to determine the effects of variables on the likelihood of this disorder. Results: Among 1,186 patients attended in our Unit during the study period, 873 patients were included; 32 (3.7%) were OSB gamblers and 841 (96.3%) were SM gamblers. Overall, mean age was 45 ± 13 years and 94.3% were men. Compared to SM patients, OSB patients were younger (34.9 ± 9.5 vs. 45.3 ±13), more frequently single (43.8 vs. 20.6%) and had a university education level (43.8 vs. 4.5%); they were also more frequently non-smokers (18.7 vs. 66.7%) and had fewer psychiatric comorbidities (12.5 vs. 29.4%) than SM gamblers. GD duration before treatment initiation was shorter in OSB patients than in SM gamblers, most of them (81.3 vs. 42.4%) with ≤ 5 years of GD duration. OSB gamblers showed significant differences in weekly gambling expenditure, spending higher amounts than SM patients. Younger age (OR: 0.919; 95% CI: 0.874-0.966), university education level (OR: 10.658; 95% CI: 3.330-34.119), weekly expenditure >100€ (OR: 5.811; 95% CI:1.544-21.869), and being a non-smoker (OR:13.248; 95% CI:4.332-40.517) were associated with an increased likelihood of OSB gambling behavior. Conclusions: We identified different profiles for OSB and SM gamblers. Younger age, university education level, higher weekly expenditure, and non-smoking habit were associated with OSB compared to SM disorders. Prevention strategies should help young people become aware of the severe risks of OSB

Políticas de gobierno electrónico en brasil: contexto, gestión de TIC y resultados

The State Reform processes combined with the emergence and use of Information and Communication Technology (ICT) originated electronic government policies and initiatives in Brazil. This paper dwells on Brazilian e-government by investigating the institutional design it assumed in the state's public sphere, and how it contributed to outcomes related to e-gov possibilities. The analyses were carried out under an interpretativist perspective by making use of Institutional Theory. From the analyses of interviews with relevant actors in the public sphere, such as state secretaries and presidents of public ICT companies, conclusions point towards low institutionalization of e-gov policies. The institutional design of Brazilian e-gov limits the use of ICT to provide integrated public services, to amplify participation and transparency, and to improve public policies management.Os processos de reforma do estado combinados com a emergência e uso de tecnologia da informação e comunicação (tic) deram origem, no brasil, a políticas e ações de governo eletrônico. este artigo debruça-se sobre o e-governo brasileiro, investigando o desenho institucional que ele assumiu na esfera estadual do país e como contribui para os resultados associados às possibilidades do e-gov. numa perspectiva interpretativista, utilizou-se a teoria institucional como lente teórica no exame do campo. a partir da análise de entrevistas feitas a atores relevantes na esfera dos estados brasileiros, tais como secretários de estado e presidentes de empresas públicas de informática, as conclusões apontam para a baixa institucionalização das políticas de e-governo. o desenho institucional do governo eletrônico brasileiro limita a utilização das tic na prestação de serviços públicos integrados, na ampliação de participação e transparência, e no aprimoramento de políticas públicas.Los procesos de reforma del estado combinados con la emergencia y uso de tecnologías de la información y comunicación (tic) originaron, en brasil, políticas y acciones de gobierno electrónico. este artículo analiza el e-gobierno brasileño, investigando el modelo institucional que este asumió en la esfera estatal del país y cómo contribuye a los resultados asociados a las posibilidades del e-gob. en una perspectiva interpretativista, utilizó la teoría institucional como lente teórico en el examen de campo. a partir del análisis de entrevistas hechas a actores relevantes en la esfera de los estados brasileños, tales como secretarios de estado y presidentes de empresas públicas de informática, las conclusiones señalan la baja institucionalización de las políticas de e-gobierno. el modelo institucional del gobierno electrónico brasileño limita la utilización de las tic en la prestación de servicios públicos integrados, en la ampliación de la participación y transparencia, y en el mejoramiento de las políticas públicas

ELECTRONIC GOVERNMENT POLICIES IN BRAZIL: CONTEXT, ICT MANAGEMENT AND OUTCOMES

The State Reform processes combined with the emergence and use of Information and Communication Technology (ICT) originated electronic government policies and initiatives in Brazil. This paper dwells on Brazilian e-government by investigating the institutional design it assumed in the state's public sphere, and how it contributed to outcomes related to e-gov possibilities. The analyses were carried out under an interpretativist perspective by making use of Institutional Theory. From the analyses of interviews with relevant actors in the public sphere, such as state secretaries and presidents of public ICT companies, conclusions point towards low institutionalization of e-gov policies. The institutional design of Brazilian e-gov limits the use of ICT to provide integrated public services, to amplify participation and transparency, and to improve public policies management

Podocytopathy in patients with monoclonal gammopathy: three patients and literature review

Focal segmental glomerulosclerosis; Multiple myeloma; PodocytopathyGlomeruloesclerosis segmentaria focal; Mieloma múltiple; PodocitopatíaGlomeruloesclerosi focal segmentària; Mieloma múltiple; PodocitopatiaBackground Renal manifestations of monoclonal gammopathies are of increasing interest among nephrologists. Typical manifestations include light chain cast nephropathy, amyloidosis or renal damage mediated by monoclonal immunoglobulin deposition. Podocytopathies in the setting of an underlying monoclonal gammopathy constitute a rare manifestation of these diseases and, although being described in the literature, remain a challenge since most data derive from case reports. Methods A retrospective review of the clinical data of Hospital del Mar and Hospital Vall d’Hebron was performed to identify patients with minimal change disease (MCD) or focal and segmental glomerulosclerosis (FSGS) in the setting of neoplasms that produce monoclonal (M) protein. Additionally, a literature review on this topic was performed. This study aims to describe the clinical characteristics and outcomes of these patients. Results Three patients were identified to have podocytopathy and monoclonal gammopathy between the years 2013 and 2020. All three were males and >65 years of age. Two patients were diagnosed with MCD and one patient was diagnosed with FSGS. All patients underwent a kidney biopsy and light and electron microscopic studies were performed. The underlying causes of monoclonal gammopathy were multiple myeloma in two cases and Waldeström macroglobulinemia in one case. Two patients developed nephrotic syndrome during the follow-up. All patients were under active hematological treatment. One patient presented a complete remission of proteinuria whereas the other two presented a partial remission. Conclusions Podocytopathies may infrequently be found in patients with monoclonal gammopathies. Patients with overt glomerular proteinuria and hematological disorders with M protein should undergo a kidney biopsy for prompt diagnosis and to specify a prognosis. In addition, further study on this matter must be done to understand the pathophysiology and treat these patients appropriately