Management of Hypnotics in Patients with Insomnia and Heart Failure during Hospitalization: A Systematic Review

Background: Heart failure is a chronic, progressive syndrome of signs and symptoms, which has been associated to a range of comorbidities including insomnia. Acute decompensation of heart failure frequently leads to hospital admission. During hospital admission, long-term pharmacological treatments such as hypnotics can be modified or stopped. Aim: To synthesize the scientific evidence available about the effect of withdrawing hypnotic drugs during hospital admission in patients with decompensated heart failure and insomnia. Method: A systematic review of the literature following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines was carried out in the following scientific databases: PubMed, Scopus, Dialnet and Cochrane. Inclusion criteria: studies including a population of adults with heart failure and sleep disorders in treatment with hypnotics and admitted to hospital, studies written in English or Spanish and published until June 2020. Exclusion criteria: studies involving children, patients admitted to intensive care and patients diagnosed with sleep apnea. Results: We identified a total of 265 documents; only nine papers met the selection criteria. The most frequently used drugs for the treatment of insomnia in patients with heart failure were benzodiazepines and benzodiazepine agonists; their secondary effects can alter perceived quality of life and increase the risk of adverse effects. Withdrawal of these drugs during hospital admission could increase the risk of delirium. Future research in this area should evaluate the management of hypnotics during hospital admission in patients with decompensated heart failure. In addition, safe and efficient non-pharmacological alternatives for the treatment of insomnia in this population should be tested and implemented

Early epigenetic reprogramming in fertilized, cloned, and parthenogenetic embryos

Despite ongoing research in a number of species, the efficiency of embryo production by nuclear transfer remains low. Incomplete epigenetic reprogramming of the nucleus introduced in the recipient oocyte is one factor proposed to limit the success of this technique. Nonetheless, knowledge of reprogramming factors has increased—thanks to comparative studies on reprogramming of the paternal genome brought by sperm on fertilization—and will be reviewed here. Another valuable model of reprogramming is the one obtained in the absence of sperm fertilization through artificial activation—the parthenote—and will also be introduced. Altogether the objective of this review is to have a better understanding on the mechanisms responsible for the resistance to reprogramming, not only because it could improve embryonic development but also as it could benefit therapeutic reprogramming research

Sleep quality in patients with heart failure in the spanish population: A cross-sectional study

Background: Heart failure is a major problem in western societies. Sleep Disorders maintain a bidirectional relationship with heart failure, as shown by studies conducted in other countries. This study aims to describe the quality of sleep in Spanish patients with heart failure. Materials and methods: We carried out a cross-sectional study to analyze the quality of sleep in a sample of 203 patients with a diagnosis of heart failure admitted to an Internal Medicine Service. The Pittsburg Sleep Quality Index (PSQI) was used to evaluate sleep quality in our sample over a one-month period. Results: 75% of the sample presented sleep disorders. The most common problems included the interruption of sleep (73.5% nocturia and 30% breathing difficulties); 35% had poor sleep efficiency; 33% showed a decrease in daytime performance; 84% had used hypnotics at some point to induce sleep and 35% used them regularly. Conclusions: This is the first study to report on the perceived sleep quality of patients with heart failure in Spain. Self-perception of sleep quality differed from that estimated by the PSQI. The prevalence of the use of sleep-inducing medication was very high. The diurnal dysfunction generated by sleep disorders in a heart failure environment can contribute to the development of self-care and cognitive deterioration problems

Sleep quality in patients with heart failure in the spanish population: A cross-sectional study

Background: Heart failure is a major problem in western societies. Sleep Disorders maintain a bidirectional relationship with heart failure, as shown by studies conducted in other countries. This study aims to describe the quality of sleep in Spanish patients with heart failure. Materials and methods: We carried out a cross-sectional study to analyze the quality of sleep in a sample of 203 patients with a diagnosis of heart failure admitted to an Internal Medicine Service. The Pittsburg Sleep Quality Index (PSQI) was used to evaluate sleep quality in our sample over a one-month period. Results: 75% of the sample presented sleep disorders. The most common problems included the interruption of sleep (73.5% nocturia and 30% breathing difficulties); 35% had poor sleep efficiency; 33% showed a decrease in daytime performance; 84% had used hypnotics at some point to induce sleep and 35% used them regularly. Conclusions: This is the first study to report on the perceived sleep quality of patients with heart failure in Spain. Self-perception of sleep quality differed from that estimated by the PSQI. The prevalence of the use of sleep-inducing medication was very high. The diurnal dysfunction generated by sleep disorders in a heart failure environment can contribute to the development of self-care and cognitive deterioration problems

Spider silk gut: Development and characterization of a novel strong spider silk fiber

Spider silk fibers were produced through an alternative processing route that differs widely from natural spinning. The process follows a procedure traditionally used to obtain fibers directly from the glands of silkworms and requires exposure to an acid environment and subsequent stretching. The microstructure and mechanical behavior of the so-called spider silk gut fibers can be tailored to concur with those observed in naturally spun spider silk, except for effects related with the much larger cross-sectional area of the former. In particular spider silk gut has a proper ground state to which the material can revert independently from its previous loading history by supercontraction. A larger cross-sectional area implies that spider silk gut outperforms the natural material in terms of the loads that the fiber can sustain. This property suggests that it could substitute conventional spider silk fibers in some intended uses, such as sutures and scaffolds in tissue engineering.Ministerio de Economía y Competitividad (España) MAT2012-38412-C02-01Fondo Nacional de Ciencias Naturales de China 31160420, 31060282, 30760041Programa de Formación de Jóvenes Científicos (JingGang Star) 20133BCB2302

Patient profile and management of delirium in older adults hospitalized due to COVID-19

SARS-CoV-2 can cause neurologic symptoms, as well as respiratory ones. Older adults are at risk of developing acute delirium in older persons (ADOP). The combination of experiencing respiratory isolation due to COVID-19, as well as other associated risk factors for older adults, may have had an impact on ADOP and ADOP management in the acute hospital setting. This study aimed to analyze the characteristics of ADOP in patients admitted to a COVID-19 unit. An observational prospective study on a sample of 108 patients was carried out between November 2020 and May 2021. The following data were collected: sociodemographic characteristics, risk factors for ADOP, management of ADOP, and impact on ADOP on both functional and cognitive deteriora-tion. A 29.6% proportion of older adults admitted to an acute COVID-19 unit presented hyperactive ADOP, mainly during the night. Management of ADOP in our sample involved mainly pharmaco-logical treatment and had a serious impact on hospital stay and both functional and cognitive dete-rioration. Preventive strategies and being accompanied by a relative or a carer may be useful to manage ADOP during hospital admission due to COVID-19

Association between life skills and academic performance in adolescents in the autonomous community of aragon (Spain)

Background: Learning and socio-emotional development is promoted through the creation and nurturing of an optimal school climate. This study aims to analyze the relationship between life skills and academic performance in a large sample of adolescents from the autonomous community of Aragón (Spain). Methods: A cross-sectional study was conducted on the life skills and academic performance of a sample of 7th and 8th grade middle school students during the academic year 2018–2019. A sample of 43 middle schools were randomly selected; the final sample comprised 1745 students. The following data were collected through an anonymized, previously validated questionnaire: sociodemographic variables, social skills, self-efficacy, affective balance, and academic performance. Results: We found a statistically significant association between life skills and academic performance (p < 0.001) in our sample. We also observed significant gender differences in life skills, with boys obtaining higher scores in cognitive skills and affective balance, and with girls achieving higher scores in social skills. Conclusion: We argue that life skills should be integrated into educational policies in order to improve the academic performance and health outcomes of students. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Durability and wear resistance of laser-textured hardened stainless steel surfaces with hydrophobic properties

Hydrophobic surfaces are of high interest to industry. While surface functionalization has attracted significant interest, from both industry and research, the durability of engineered surfaces remains a challenge, as wear and scratches deteriorate their functional response. In this work, a cost-effective combination of surface engineering processes on stainless steel was investigated. Low-temperature plasma surface alloying was applied to increase surface hardness from 172 to 305 HV. Then, near-infrared nanosecond laser patterning was deployed to fabricate channel-like patterns that enabled superhydrophobicity. Abrasion tests were carried out to examine the durability of such engineered surfaces during daily use. In particular, the evolution of surface topographies, chemical composition, and water contact angle with increasing abrasion cycles were studied. Hydrophobicity deteriorated progressively on both hardened and raw stainless steel samples, suggesting that the major contributing factor to hydrophobicity was the surface chemical composition. At the same time, samples with increased surface hardness exhibited a slower deterioration of their topographies when compared with nontreated surfaces. A conclusion is made about the durability of laser-textured hardened stainless steel surfaces produced by applying the proposed combined surface engineering approach