Evolution of Vitamin D Status and Vitamin D Receptor Gene Expression Among Professional Handball Athletes During a Competitive Period. Relationship with Body Composition, Calcium, Magnesium and Phosphorous

Introduction: A generalized risk of vitamin D deficiency exists worldwide affecting also professional and elite athletes. This study assesses the evolution of vitamin D status and vitamin D receptor (VDR) gene expression and their relationship with body composition, calcium (Ca), magnesium (Mg) and phosphorous (P) among professional handball athletes during a competitive period. Methods: A total of 26 male subjects were recruited: 13 professional handball athletes and 13 non-athlete controls. An observational follow-up study was conducted in 2 time points over a 16-week period. Nutritional intake, body composition, and routinary biochemical parameters were measured via 24-hours recall, bioimpedance and enzyme immunoassay, respectively. Ca and Mg were measured by flame atomic absorption spectrophotometry and P was determined with the colorimetric method of Fiske-Subbarow. 25-hydroxyvitamin-D (25(OH)D) levels and its forms (i.e., 25(OH)D3 and 25(OH)D2) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), whereas VDR gene expression was measured by quantitative real time-polymerase chain reaction (qRT-PCR). Results: A total of 54% of the athletes showed deficient vitamin D status. Moreover, a prevalence of insufficient vitamin D status in handball players affected 46% at baseline, reaching 61% after 16 weeks. Vitamin D showed no evolution during the competitive period and no differences between groups were observed (all p ≥ 0.05). Handball players increased the VDR expression, enhanced body composition, Ca and Mg levels at 16-weeks follow-up (all p < 0.05). VDR gene expression was positively related with body mass and body mass index at follow-up in athletes (all p ≤ 0.038; r ≥ 0.579) and with Ca at baseline in controls (p = 0.026; r = 0.648). Finally, 25(OH)D2 form was directly associated with P in athletes at 16 weeks of study (p = 0.034; r = 0.588). Conclusion: Players of indoor team sports such as handball would be a population at risk of vitamin D deficiency. The 16-weeks competition improved VDR gene expression, body composition, Ca and Mg levels. The associations observed between VDR gene expression and the variables of the study evidenced the importance of this receptor as a marker involved in health status in handball athletes despite vitamin D − although in a deficient status −, Ca, Mg and P showed no remarkable changes during the competition period.Spanish Ministry of Education (grant number AP2009-3701)FIS Project PI10/1993 from the Carlos III Health Institute (Spain)FPU fellowship from the Spanish Ministry of Education and Professional Formation with grant reference FPU18/03655 and FPU18/03702Funding for open access charge: Universidad de Granada/CBU

Association between Body Fatness and Vitamin D3 Status in a Postmenopausal Population

We especially thank all the postmenopausal women who participated in our study and Bienza translators who provided English editing.Vitamin D is a micronutrient that plays a key role in phosphocalcic metabolism. The postmenopausal population presents a risk of deficiency in this vitamin due to hormonal alterations which, in the case of obesity, would be exacerbated. The objective was to assess the status of vitamin D in a postmenopausal population and determine the relationship of 25-hydroxivitamin D [25(OH)D] and its metabolites with anthropometric parameters. The study included 78 healthy postmenopausal women aged from 44 to 76. The nutrient intake assessment was carried out using the 24 h reminder (R24h). 25(OH)D was analyzed using ultra-high-performance liquid chromatography (UHPLC). A total of 80% and 68% of the women studied did not reach sufficient values of 25(OH)D and 25-hydroxivitamin D3 [25(OH)D3], respectively, which was inversely correlated with Body Mass Index (BMI) (r = −0.25, p = 0.04), hip perimeter (r = −0.26 and r = −0.24, all p < 0.05), arm circumference (r = −0.29, p = 0.01) and fat mass (r = −0.28 and r = −0.26, all p < 0.05). 25(OH)D3 is the metabolite that contributed most to this association. In conclusion, 25(OH)D3 levels are related to anthropometric parameters in the postmenopausal women in this study, confirming insufficient status in the majority of the population. Approach strategies are necessary to correct and avoid this risk in order to ensure future quality of life.This research was funded by FIS Carlos III (REF. PI10/1993)

Biomarkers in ocular chronic graft versus host disease: tear cytokine- and chemokine-based predictive model.

Producción CientíficaPurpose: To develop a tear molecule level-based predictive model based on a panel of tear cytokines and their correlation with clinical features in ocular chronic graft versus host disease (cGVHD). Methods: Twenty-two ocular cGVHD patients and 21 healthy subjects were evaluated in a controlled environmental research laboratory (CERLab). Clinical parameters were recorded, and tears were collected. Levels of 15 molecules (epidermal growth factor [EGF], IL receptor antagonist [IL-1Ra], IL-1β, IL-2, IL-6, IL-8/CXCL8, IL-10, IL-12p70, IL-17A, interferon inducible protein [IP]-10/CXCL10, IFN-γ, VEGF, TNF-α, eotaxin 1, and regulated on activation normal T cell expressed and secreted [RANTES]) were measured by multiplex-bead assay and correlated with clinical parameters. Logistic regression was used to develop a predictive model. Leave-one-out cross-validation was applied. Classification capacity was evaluated in a cohort of individuals with dry eye (DE) of other etiologies different from GVHD. Results: Epidermal growth factor and IP-10/CXCL10 levels were significantly decreased in ocular cGVHD, positively correlating with tear production and stability and negatively correlating with symptoms, hyperemia, and vital staining. Interleukin-1Ra, IL-8/CXCL8, and IL-10 were significantly increased in ocular cGVHD, and the first two correlated positively with symptoms, hyperemia, and ocular surface integrity while negatively correlating with tear production and stability. Predictive models were generated, and the best panel was based on IL-8/CXCL8 and IP-10/CXCL10 tear levels along with age and sex, with an area under the receiving operating curve of 0.9004, sensitivity of 86.36%, and specificity of 95.24%. Conclusions: A predictive model based on tear levels of IL-8/CXCL8 and IP-10/CXCL10 resulted in optimal sensitivity and specificity. These results add further knowledge to the search for potential biomarkers in this devastating ocular inflammatory disease.Ministry of Economy and Competitiveness, Madrid, Spain, SAF-2010 15631 (AES)

El ácido fólico y la vitamina B12 como biomarcadores de morbilidad y mortalidad en pacientes con shock séptico

Funding: financial support for the study was provided by Project FIS PI10/1993 from the Spanish Carlos III Health Institute and by the European Regional Development Fund. Lourdes Herrera-Quintana and Héctor Vázquez-Lorente are under a FPU fellowship from the Spanish Ministry of Education.Introduction and objective: a study was made of the folic acid (Fol) and vitamin B12 (B12) serum concentrations in critical patients with septic shock upon admission and after three days of stay in the Intensive Care Unit (ICU), with an analysis of their association to inflammatory parameters and patient morbidity-mortality. Methods: a prospective analytical study was made of 30 critically ill patients with septic shock. Demographic data, comorbidities, clinical information and severity scores were recorded. Data collected included serum Fol and B12 levels using the DxI® Autoanalyzer (Beckman Coulter) based on a competitive electrochemoluminescence immunoassay. Results: mean serum Fol was within the reference range stipulated by the laboratory on the first day. Nevertheless, a total of 21.4 % of the patients had high Fol levels, with 14.2 % being Fol deficient. An association was observed between Fol (p < 0.012) status and 28-day mortality, and the number of days of mechanical ventilation, fraction of inspired oxygen (FiO2 ) and fibrinogen increased in patients with higher Fol levels (p < 0.05). In addition, 85.7 % of cases had B12 levels above the reference values, with a correlation being observed between B12 and Fol. Conclusions: this study proposes Fol as a novel morbidity-mortality biomarker in critical septic patients, and reinforces the usefulness of B12 as a morbidity biomarker. It is thus suggested that the measurement of Fol upon admission and over the first 72 hours of hospital stay could provide prognostic information about the clinical course and outcome of septic shock patients.Introducción y objetivo: se realizó un estudio de las concentraciones séricas de ácido fólico (Fol) y vitamina B12 (B12) en pacientes críticos con shock séptico al ingreso y después de tres días de estancia en la Unidad de Cuidados Intensivos (UCI), con un análisis de su asociación con los parámetros inflamatorios y la morbimortalidad de los pacientes. Método: se realizó un estudio analítico prospectivo de 30 pacientes críticos con shock séptico. Se registraron datos demográficos, comorbilidades, información clínica y puntuaciones de gravedad. Los datos recopilados incluyeron los niveles séricos de Fol y B12 utilizando el autoanalizador DxI® (Beckman Coulter) basado en un inmunoensayo de electroquimioluminiscencia competitivo. Resultados: la media de Fol sérico estuvo dentro del rango de referencia estipulado por el laboratorio el primer día. Sin embargo, el 21,4 % de los pacientes presentaban niveles altos de Fol y el 14,2 % presentaban deficiencia de Fol. Se observó una asociación entre el estado de Fol (p < 0,012) con la mortalidad a los 28 días, con el número de días de ventilación mecánica, con la fracción de oxígeno inspirado (FiO2 ) y con el fibrinógeno, que aumentaron en los pacientes con niveles de Fol más altos (p < 0,05). Además, el 85,7 % de los casos tenían niveles de B12 por encima de los valores de referencia, observándose una correlación entre B12 y Fol. Conclusiones: este estudio propone al Fol como nuevo biomarcador de morbimortalidad en los pacientes críticos con sepsis y refuerza la utilidad de la B12 como biomarcador de morbilidad. Por tanto, se sugiere que la medición de Fol al ingreso y durante las primeras 72 horas de estancia hospitalaria podría proporcionar información pronóstica sobre el curso clínico y el resultado de los pacientes con shock séptico.Spanish Carlos III Health InstituteMinisterio de Educación, Cultura y DeporteEuropean Regional Development Fun

Risk factors for thrombotic microangiopathy in allogeneic hematopoietic stem cell recipients receiving GVHD prophylaxis with tacrolimus plus MTX or sirolimus

Post-transplant complications.-- et al.Transplantation-associated thrombotic microangiopathy (TA-TMA) is a feared complication of allogeneic hematopoietic SCT (HSCT) owing to its high mortality rate. The use of calcineurin inhibitors or sirolimus (SIR) for GVHD prophylaxis has been suggested as a potential risk factor. However, the impact of tacrolimus (TAC) and SIR combinations on the increased risk of TA-TMA is currently not well defined. We retrospectively analyzed the incidence of TA-TMA in 102 allogeneic HSCT recipients who consecutively received TAC plus SIR (TAC/SIR) (n=68) or plus MTX (TAC/MTX)±ATG (n=34) for GVHD prophylaxis. No significant differences were observed in the incidence of TA-TMA between patients receiving TAC/SIR vs TAC/MTX±ATG (7.4% vs 8.8%, P=0.8). Only grade III-IV acute GVHD, previous HSCT and serum levels of TAC >25 ng/mL were associated with a greater risk of TA-TMA. Patients developing TA-TMA have significantly poorer survival (P<0.001); however, TA-TMA ceased to be an independent prognostic factor when it was included in a multivariate model. In conclusion, the combination of TAC/SIR does not appear to pose a higher risk of TA-TMA. By contrast, we identified three different risk groups for developing TA-TMA.Peer Reviewe

La inseguridad como detonante de acción colectiva de los estudiantes en Puebla.

El 24 de febrero de 2020 asalta a Puebla la noticia del asesinato de tres estudiantes universitarios, dos colombianos y un mexicano y el chofer del auto de la empresa Uber que los transportaba. La tristeza, la rabia y la impotencia fueron experimentadas por los jóvenes de distintas universidades poblanas, quienes de inmediato se organizaron para realizar un conjunto de acciones colectivas que culminaron con la Mega Marcha estudiantil del 5 de marzo. ¿Qué factores permitieron la unidad de los estudiantes en el proyecto común de la lucha universitaria por la seguridad? Este documento analiza un conjunto de entrevistas, que permiten presentar la experiencia, percepciones, juicios y crítica de 22 líderes estudiantiles. Dos aspectos constituyen la estructura de la investigación: la experiencia generacional compartida de la violencia y la acción colectiva como espacio de encuentro y colaboración para la exigencia de la seguridad.   Abstract On February 24, 2020, the news of the murder of three university students, two of them Colombians, and one Mexican, and the Uber driver that transported them surprised Puebla. Young people from different Puebla universities experienced sadness, anger, and helplessness. They immediately self-organized to carry out collective actions that culminated in the student Mega March on March 5. What factors allowed the unity of the students in the joint project of the university struggle for security? This document analyzes a set of interviews which presenting the experience, perceptions, judgments, and criticism of 22 student leaders. Two aspects constitute the structure of the research: the shared generational experience of violence and collective action as a space for meeting and collaboration for the demand for security. Keywords: collective action, students, insecurity, social movements, Puebla, Mexico

La inseguridad como detonante de acción colectiva de los estudiantes en Puebla.

El 24 de febrero de 2020 asalta a Puebla la noticia del asesinato de tres estudiantes universitarios, dos colombianos y un mexicano y el chofer del auto de la empresa Uber que los transportaba. La tristeza, la rabia y la impotencia fueron experimentadas por los jóvenes de distintas universidades poblanas, quienes de inmediato se organizaron para realizar un conjunto de acciones colectivas que culminaron con la Mega Marcha estudiantil del 5 de marzo. ¿Qué factores permitieron la unidad de los estudiantes en el proyecto común de la lucha universitaria por la seguridad? Este documento analiza un conjunto de entrevistas, que permiten presentar la experiencia, percepciones, juicios y crítica de 22 líderes estudiantiles. Dos aspectos constituyen la estructura de la investigación: la experiencia generacional compartida de la violencia y la acción colectiva como espacio de encuentro y colaboración para la exigencia de la seguridad.   Abstract On February 24, 2020, the news of the murder of three university students, two of them Colombians, and one Mexican, and the Uber driver that transported them surprised Puebla. Young people from different Puebla universities experienced sadness, anger, and helplessness. They immediately self-organized to carry out collective actions that culminated in the student Mega March on March 5. What factors allowed the unity of the students in the joint project of the university struggle for security? This document analyzes a set of interviews which presenting the experience, perceptions, judgments, and criticism of 22 student leaders. Two aspects constitute the structure of the research: the shared generational experience of violence and collective action as a space for meeting and collaboration for the demand for security. Keywords: collective action, students, insecurity, social movements, Puebla, Mexico

The Influence of Perceived Parenting on Substance Initiation Among Mexican Children

Parents shape their children\u27s behaviors and impact their developmental trajectories. Despite this, few studies have examined the potential relationship between child reported parenting factors and lifetime substance use and use intentions. The current study examined the potential impact of parenting factors (i.e., positive parenting, supervision, parental illicit substance use, substance-specific communication) on early substance use and intentions among Latinx children. Data for the present study utilized a representative sample of Mexican children (n = 52,171; 5th and 6th grades) who participated in a national survey on substance use. Children reported their demographics, lifetime substance use/intentions, and perceived parenting characteristic and practices. Child reported parental (i.e., individual or both parents) illicit substance use was associated with the largest increases in risk for reporting lifetime use of all substances examined. Higher levels of positive parenting were consistently associated with reductions in risk for reporting intentions for and use of all substances examined. Parent-child substance specific communication was not significantly related to child reported lifetime use or use intentions, with the exception of a minor decrease in the odds of reporting lifetime inhalant use. Supervision was associated with small to modest increase in risk. Substance use prevention efforts targeting Latinx populations may benefit from promoting positive parenting and direct supervision during childhood. Targeted prevention efforts may be needed for Latinx children exposed to parental illicit substance use, as they may be especially at risk for early substance initiation

Analysis of incidence, risk factors and clinical outcome of thromboembolic and bleeding events in 431 allogeneic hematopoietic stem cell transplantation recipients

This is an open-access paper.-- et al.Allogeneic hematopoietic stem cell transplantation recipients have an increasing risk of both hemorrhagic and thrombotic complications. However, the competing risks of two of these life-threatening complications in these complex patients have still not been well defined. We retrospectively analyzed data from 431 allogeneic transplantation recipients to identify the incidence, risk factors and mortality due to thrombosis and bleeding. Significant clinical bleeding was more frequent than symptomatic thrombosis. The cumulative incidence of a bleeding episode was 30.2% at 14 years. The cumulative incidence of a venous or arterial thrombosis at 14 years was 11.8% and 4.1%, respectively. The analysis of competing factors for venous thrombosis revealed extensive chronic graft-versus-host disease to be the only independent prognostic risk factor. By contrast, six factors were associated with an increased risk of bleeding; advanced disease, ablative conditioning regimen, umbilical cord blood transplantation, anticoagulation, acute III-IV graft-versus-host disease, and transplant-associated microangiopathy. The development of thrombosis did not significantly affect overall survival (P=0.856). However, significant clinical bleeding was associated with inferior survival (P<0.001). In allogeneic hematopoietic stem cell transplantation, significant clinical bleeding is more common than thrombotic complications and affects survival.Peer Reviewe

Bad Prognosis in Critical Ill Patients with COVID‐19 during Short‐Term ICU Stay Regarding Vitamin D Levels

Background and aims: Vitamin D inadequacy may be involved in the mechanisms of SARS‐CoV‐2 infection and in potential risk factors for disease propagation or control of coronavirus disease 2019 (COVID‐19). This study assessed a short‐term evolution of vitamin D status and its influence upon different clinical parameters in critically ill patients with COVID‐19. Methods: A prospective analytical study in which 37 critically ill volunteers between 41 and 71 years of age with COVID‐19 were evaluated at baseline and three days of intensive care unit (ICU) stay. 25‐OH‐D3 and 25‐OH‐D2 were analyzed by liquid chromatography–tandem mass spectrometry and total 25‐ OH‐D levels were calculated as the sum of both. Results: All patients presented low 25‐OH‐D levels at baseline, decreasing total 25‐OH‐D (p = 0.011) mainly through 25‐OH‐D2 (p = 0.006) levels during ICU stay. 25‐OH‐D2 levels decreased a mean of 41.6% ± 89.6% versus 7.0% ± 23.4% for the 25‐OH‐ D3 form during the ICU stay. Patients who did not need invasive mechanical ventilation presented higher levels of 25‐OH‐D2 at baseline and follow‐up. Lower 25‐OH‐D and 25‐OH‐D3 levels were associated with higher D‐dimer at baseline (p = 0.003; p = 0.001) and at follow up (p = 0.029), higher procalcitonin levels (p = 0.002; p = 0.018) at follow up, and lower percentage lymphocyte counts (p = 0.044; p = 0.040) during ICU stay. Conclusions: Deficient vitamin D status in critical patients was established at the admission and further worsened after three days of stay. Lower vitamin D levels were related to key altered clinical and biochemical parameters on patients with SARS‐CoV‐2 infec‐ tion. Given the different response of the 25‐OH‐D3 and 25‐OH‐D2 forms, it would be useful to mon‐ itor them on the evolution of the critically ill patient.FIS Projects from Carlos III Health Institute [REF. PI10/1993]Spanish Ministry of Educatio