How do sources of teachers’ stress affect the development of burnout? An analysis among Physical Education teachers.

Aunque algunos estudios sugieren que el profesorado de Educación Física experimenta más burnout que los docentes de otras especialidades, el análisis de los principales estresores en este colectivo ha sido escaso hasta la fecha. Objetivos: En primer lugar, el presente estudio pretende identificar los principales estresores percibidos por el profesorado de Educación física. De forma subsecuente, se pretende analizar la relación entre las fuentes de estrés percibidas por el profesorado con el síndrome de burnout en su trabajo. Métodos: Setenta-y-un docentes de Educación Secundaria de Educación Física (M = 43.44; ± 9.68), con una experiencia media de 16.67 años (± 10.44), completaron la Multilevel Teachers Stressor Scale y el Burnout Clinival Subtype Questionnaire. Resultados y discusión: La ambigüedad de la administración, el mal comportamiento de los estudiantes y la carga trabajo fueron los estresores más percibidos por el profesorado de Educación Física. Además, junto a la ambigüedad de la administración y la carga de trabajo, percibir un insuficiente compromiso de los padres y una falta de toma de decisiones se relacionó positivamente con el burnout. Conclusiones: La administración educativa debería diseñar y aplicar estrategias para reducir los principales estresores del profesorado de Educación Física, especialmente aquellos desencadenantes del burnout, con el objetivo de mejorar el funcionamiento psicológico de los docentes, prevenir problemas de salud, y asegurar una buena calidad de la enseñanza. Introduction: Although some studies suggest that Physical Education teachers experience more burnout than teachers of other subjects, the analysis of the main stressors with the Physical Education teachers has been scarce so far. Aim: Firstly, the present study aims to identify the main stressors perceived by the Physical Education teachers so far. Subsequently, this study intends to examine the relationship between the sources of stress perceived by teachers with the burnout syndrome in their work. Methods: Seventy-one secondary school Physical Education teachers (M = 43.44; ± 9.68) with an average of teaching experience of 16.67 years (± 10.44), they completed the Multilevel Teachers Stressor Scale and the Burnout Clinical Subtype Questionnaire. Results & discussion: The ambiguity of the administration, students misbehavior, and workload were the most perceived stressors by the Physical Education teachers. In addition, together with the ambiguity of the administration and workload, perceiving the parents' insufficient involvement and lack of decision-making was positively related to burnout. Conclusions: The educational administration should design and apply strategies to reduce the main stressors of the Physical Education teachers, in particular those that may trigger burnout, with the aim of improving the teachers' psychological functioning, preventing health problems, as well as guarantee a good teaching quality

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

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

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Co-limitation towards lower latitudes shapes global forest diversity gradients

The latitudinal diversity gradient (LDG) is one of the most recognized global patterns of species richness exhibited across a wide range of taxa. Numerous hypotheses have been proposed in the past two centuries to explain LDG, but rigorous tests of the drivers of LDGs have been limited by a lack of high-quality global species richness data. Here we produce a high-resolution (0.025° × 0.025°) map of local tree species richness using a global forest inventory database with individual tree information and local biophysical characteristics from ~1.3 million sample plots. We then quantify drivers of local tree species richness patterns across latitudes. Generally, annual mean temperature was a dominant predictor of tree species richness, which is most consistent with the metabolic theory of biodiversity (MTB). However, MTB underestimated LDG in the tropics, where high species richness was also moderated by topographic, soil and anthropogenic factors operating at local scales. Given that local landscape variables operate synergistically with bioclimatic factors in shaping the global LDG pattern, we suggest that MTB be extended to account for co-limitation by subordinate drivers

Desarrollo de un sistema de edición genómica CRISPR-Cas de aplicación generalizada en bacterias Gram-negativas

Resumen del trabajo presentado en la XIII Reunión del grupo especializado en Microbiología Molecular de la SEM, celebrada en Granada (España) del 07 al 09 de septiembre de 2022.La rápida emergencia de las herramientas de edición genética basados en los sistemas de inmunidad adquirida CRISPR-Cas presentes en un buen número de bacterias y arqueas ha representado la mayor revolución de la última década en lo que respecta a la manipulación genética dirigida de una gran variedad de organismos. A pesar de que entre las bacterias Gram-negativas se encuentra una inmensa variedad de organismos de gran interés biológico, clínico, ambiental y biotecnológico, los métodos avanzados de edición genómica solo se han aplicado en un número limitado de especies. Con objeto de facilitar la implantación de esta metodología en un número amplio de bacterias Gram-negativas con mínimos requerimientos, hemos desarrollado una plataforma, denominada DEMOCRISPR, compuesta de una colección de vectores plasmídicos de amplio espectro para la producción de (i) las proteínas Cas de distintos sistemas CRISPR-Cas, (ii) gRNAs específicos compatibles con dichos sistemas, (iii) sistemas de reparación mediante empalme no homólogo de extremos (NHEJ), y (iv) sistemas de reparación dirigida por recombinación (HDR) de diversos orígenes. En paralelo, hemos construido una serie de vectores plasmídicos con reporters fluorescentes para cuantificar la eficiencia de los procesos de corte de doble cadena y reparación mutagénica. El uso de plásmidos de amplio espectro de hospedador compatibles entre sí para la producción de los complejos endonucleasa CRISPR y los sistemas de reparación, acompañados de espaciadores y secuencias diana estandarizados en reporters fluorescentes facilita la exportación de la plataforma a diversas bacterias Gram-negativas sin necesidad de diseñar gRNAs específicos para dianas presentes en cada organismo. Como prueba de principio, en este trabajo presentamos resultados que muestran la implementación de la plataforma DEMOCRISPR en distintas bacterias Gram-negativas.Este trabajo está financiado por el Programa Operativo FEDER Andalucía, convocatoria 2018 (proyecto UPO-1264127; IP: Fernando Govantes

First systematic meteorological observations of the Americas (Recife, 1640-1642) - wind direction, precipitation, fog, thunder, and lightning

Daily systematic meteorological observations made by George Marcgrave in Recife from 1640 to 1642 have been retrieved. These observations were published in 1658 by Piso in “De Indiae utriusque re naturali et medica”. Specifically, in chapter two “De Aeris temperie atque Anni tempestatibus” of the first book entitled “Tractatus topographicus et meteorologicus Brasiliae, cum observatione eclipsis Solaris”. Marcgrave recorded meteorological observations during six years with sub-daily resolution, nevertheless Piso only published the daily observations relative to the years of 1640, 1641 and 1642. The observations are recorded in three tables, one per year, that show the wind direction and the presence of rainfall. Rainy days are identified with a “p.” (from pluvia), about the meaning of a rainy day for Marcgrave, he writes “In these tables, we have noted with the letter P all the days on which even a very fine and brief rain fell so that no one thinks that during those days it rained continuously”. The wind direction is registered in 24 directions using letters according to the Franco names e.g. N (Nordoni), E (Ostroni), S (Sundroni), W (Vuestroni). This is known thanks to a Marcgrave's annotation “We have annotated the winds with letters: S.O. designates the Euro, N.O. the Boreas or Aquilon”. SO are the initials of Sundostroni and correspond with the SE direction in which the Euro wind blows. NO are the initials of Nordostroni, which corresponds with the NE direction in which the Aquilon or Boreas blow. The chapter shows not tabulated information in text format among tables, this informs about the days with fog, thunders, and lightning. All the meteorological information has been digitized by 'key entry'. These observations are the first systematic meteorological observations from the Americas and from the southern hemisphere. Although the observations retrieved cover only three years, they are very interesting due to the singular climate forcing situation i.e. one solar cycle before (1635-1645) the Maunder minimum (1645-1715) and two eruptions with a clear impact on the climatic system in 1640 (Parker, Philippines and Hokkaido-Komagatake, Japan)

The first systematic meteorological observations in the Americas (Recife, 1640–42)

In 1639, the German naturalist Georg Marcgraf established the first astronomical observatory in the Americas, located in Recife (Brazil). There, he made the first daily systematic meteorological observations of wind direction, precipitation, fog, and thunder and lightning from 1640 to 1642. We outline the circumstances that led to this observatory being established and analyze the observations. The range of values obtained from all the variables recorded by Marcgraf corresponds well with Recife’s current climate. However, wetter-than-normal conditions were recorded during 1640, while anomalous concentrations of foggy days occurred from May to December 1641. We hypothesize that these anomalous record foggy days could be associated with the highly explosive eruptions of the Komagatake and Parker volcanoes, both in 1640

Discovering HIV related information by means of association rules and machine learning

Acquired immunodeficiency syndrome (AIDS) is still one of the main health problems worldwide. It is therefore essential to keep making progress in improving the prognosis and quality of life of affected patients. One way to advance along this pathway is to uncover connections between other disorders associated with HIV/AIDS-so that they can be anticipated and possibly mitigated. We propose to achieve this by using Association Rules (ARs). They allow us to represent the dependencies between a number of diseases and other specific diseases. However, classical techniques systematically generate every AR meeting some minimal conditions on data frequency, hence generating a vast amount of uninteresting ARs, which need to be filtered out. The lack of manually annotated ARs has favored unsupervised filtering, even though they produce limited results. In this paper, we propose a semi-supervised system, able to identify relevant ARs among HIV-related diseases with a minimal amount of annotated training data. Our system has been able to extract a good number of relationships between HIV-related diseases that have been previously detected in the literature but are scattered and are often little known. Furthermore, a number of plausible new relationships have shown up which deserve further investigation by qualified medical experts