The Flourishing Scale: Psychometric Properties in Breast Cancer Patients.

BACKGROUND/OBJECTIVE: Promoting well-being is a key goal of cancer care, and it needs to be assessed using appropriate instruments. Flourishing is considered part of psychological well-being and it is commonly assessed with the Flourishing Scale (FS). To our knowledge, no studies have analyzed the psychometric properties of the FS in breast cancer patients. Our aim here was to provide validity evidence for use of the FS in this context. METHOD: Participants were 217 Spanish women with breast cancer who completed the FS and other scales assessing positive psychology constructs (life satisfaction, positive affect, resilience, self-esteem, optimism) and indicators of psychological maladjustment (negative affect, depression, anxiety, and stress). The internal structure of the FS was analyzed using confirmatory factor analysis (CFA). We calculated the average variance extracted (AVE) to evaluate convergent validity, and both McDonald's omega and Cronbach's alpha coefficients to estimate reliability. Item analysis was performed by computing corrected item-total correlations. Validity evidence based on relationships with other variables was obtained through Pearson correlation analysis, controlling for age and cancer stage. RESULTS: The CFA supported a single-factor structure, with adequate goodness-of-fit indices (CFI = 0.997, NNFI = 0.996, RMSEA = 0.069, and SRMR = 0.047) and standardized factor loadings ranging from 0.70 to 0.87. The value of the AVE was 0.63, and the reliability coefficient obtained with both procedures was 0.91. Corrected item-total correlations ranged from .62 to .78. Correlation analysis showed direct and strong associations between the FS score and scores on positive psychology constructs (range from 0.43 to 0.74), the strongest correlations being with positive affect and life satisfaction. The FS score was inversely correlated with scores on depression, anxiety, stress, negative affect, and pessimism (range from -0.14 to -0.52), the strongest association being with stress. DISCUSSION: The FS is a useful tool for exploring well-being in the breast cancer context, providing useful information for psychological assessment.

Cooling rate modifies the location of aquaporin 3 in spermatozoa of sheep and goat.

The freeze-thawing process induces osmotic changes that may affect the membrane domain location of aquaporins' (AQP) in spermatozoa. Recent studies suggest that changes in AQP3 localization allows better sperm osmo-adaptation, improving the cryoresistance. Ultra-rapid freezing is an alternative cryopreservation technique that requires less equipment than conventional freezing, and it is faster, simpler and can be used in the field. This study aimed to determine the influence of freezing-thawing rates (slow (control) vs. ultra-rapid) on AQP3 expression and location in the spermatozoa from small ruminants (sheep and goats) and its relationship with sperm cryo-damage. Spermatozoa were collected from 10 Merino rams and 10 Murciano-Granadina bucks. The presence and distribution of AQP3 were assessed by Western blotting and immunocytochemistry (ICC), employing a commercial rabbit polyclonal antibody. Sperm motility was CASA system-analyzed, and membrane and acrosome integrity assessed by fluorescence (PI/PNA-FITC). Western blotting did not detect a significant effect of freezing-thawing rate on the amount of AQP3 while ICC found freezing-thawing rate affecting AQP3 location (P < 0.05). In both species, the percentages of spermatozoa showing AQP3 in the post-acrosome region, mid-piece, and principal piece of the tail were greater in samples cryopreserved by slow freezing-thawing (control) than ultra-rapid freezing-thawing rates (P < 0.05). Spermatozoa cryopreserved using ultra-rapid freezing-thawing showed decrease motility, plasma membrane, and acrosome integrity (P < 0.05), which might be related, at least in part, to a lower expression of AQP3. In conclusion, the cooling rate modifies the location of AQP3 in spermatozoa of sheep and goat, which might be associated with sperm cryosurvival.

Future Anxiety in Young Spanish Adults: Psychometric Properties of the Dark Future Scale / Ansiedad Futura en Adultos Jóvenes Españoles: Propiedades Psicométricas de la Dark Future Scale

Background/Objective: The Dark Future Scale (DFS) is a self-report instrument which assesses the tendency to think about the future with anxiety, fear, and uncertainty. Although it has been applied in different populations, instrumental studies are scarce, and there is no validated Spanish version. The aim was therefore to develop a Spanish version of the scale (DFS-S) and to analyze its psychometric properties in a sample of young adults. Method: Participants were 1,019 individuals aged from 18 to 24 years. They completed the DFS-S and the IPIP-BFM-20. Validity evidence based on the internal structure, including measurement invariance across gender, as well as on relationships with personality traits was obtained. Reliability and gender differences in DFS-S scores were also examined. Results: Results supported a single-factor structure, χ2(5) = 10.79, CFI = .999, RMSEA = .034, SRMR = .016, that was invariant across gender. Reliability of test scores was satisfactory (ω = .92). In the correlation analysis, future anxiety showed a strong positive correlation with neuroticism (.42) and a moderate negative correlation with extraversion (-.25). Females scored higher than males on future anxiety. Conclusions: The DFS-S has satisfactory psychometric properties and it is an adequate tool for measuring future anxiety among young adults.(AU)

Antecedentes/Objetivo: La Dark Future Scale (DFS) evalúa la ten-dencia a pensar en el futuro con ansiedad, miedo e incertidumbre. Aunque ha sido usadaen diferentes poblaciones, los estudios instrumentales son es-casos y no hay una versión adaptada al español. El objetivo del estudio fue adaptarla al español (DFS-S) y analizar sus propiedades psicométricas en una muestra de adultos jóvenes. Método:Participaron 1.019 jóvenes entre 18 y 24 años. Completaron la DFS-S y el IPIP-BFM-20. Se analizan evidencias de validez basadas en la estructura interna, incluyendo la invarianza de me-dida según el género, y basadas en las relaciones con rasgos de personali-dad, así como análisis de la fiabilidad y de las diferencias de género. Resulta-dos:Los resultados apoyaron una estructura de un solo factor, χ2(5) = 10.79, CFI = .999, RMSEA = .034, SRMR = .016, con invarianza respecto al gé-nero, y con coeficiente de fiabilidad satisfactorio (ω= .92). Se encontró co-rrelación positiva fuerte entre ansiedad futura y neuroticismo (.42) y una correlación negativa moderada con extraversión (-.25). Las puntuaciones en ansiedad futura fueron mayores en las mujeres. Conclusiones:Los resultados muestran propiedades psicométricas satisfactorias delaDFS-S, siendo un instrumento adecuado para medir la ansiedad futura en adultos jóvenes.(AU)

Valorisation of Sub-Products from Pyrolysis of Carbon Fibre-Reinforced Plastic Waste: Catalytic Recovery of Chemicals from Liquid and Gas Phases.

Waste carbon fibre-reinforced plastics were recycled by pyrolysis followed by a thermo-catalytic treatment in order to achieve both fibre and resin recovery. The conventional pyrolysis of this waste produced unusable gas and hazardous liquid streams, which made necessary the treatment of the pyrolysis vapours. In this work, the vapours generated from pyrolysis were valorised thermochemically. The thermal treatment of the pyrolysis vapours was performed at 700 °C, 800 °C and 900 °C, and the catalytic treatment was tested at 700 °C and 800 °C with two Ni-based catalysts, one commercial and one homemade over a non-conventional olivine support. The catalysts were deeply characterised, and both had low surface area (99 m2/g and 4 m2/g, respectively) with low metal dispersion. The thermal treatment of the pyrolysis vapours at 900 °C produced high gas quantity (6.8 wt%) and quality (95.5 vol% syngas) along with lower liquid quantity (13.3 wt%) and low hazardous liquid (92.1 area% water). The Ni-olivine catalyst at the lowest temperature, 700 °C, allowed us to obtain good gas results (100% syngas), but the liquid was not as good (only 58.4 area% was water). On the other hand, the Ni commercial catalyst at 800 °C improved both the gas and liquid phases, producing 6.4 wt% of gas with 93 vol% of syngas and 13.6 wt% of liquid phase with a 97.5 area% of water. The main reaction mechanisms observed in the treatment of pyrolysis vapours were cracking, dry and wet reforming and the Boudouard reaction.

Cyclosporine A in hospitalized COVID-19 pneumonia patients to prevent the development of interstitial lung disease: a pilot randomized clinical trial.

Post-COVID-19 interstitial lung disease (ILD) is a new entity that frequently causes pulmonary fibrosis and can become chronic. We performed a single-center parallel-group open-label pilot randomized clinical trial to investigate the efficacy and safety of cyclosporine A (CsA) in the development of ILD in the medium term among patients hospitalized with COVID-19 pneumonia. Patients were randomized 1:1 to receive CsA plus standard of care or standard of care alone. The primary composite outcome was the percentage of patients without ILD 3 months after diagnosis of pneumonia and not requiring invasive mechanical ventilation (IMV) (response without requiring IMV). The key secondary composite outcomes were the percentage of patients who achieve a response requiring IMV or irrespective of the need for IMV, and adverse events. A total of 33 patients received at least one dose of CsA plus standard of care (n = 17) or standard of care alone (n = 16). No differences were found between the groups in the percentage of patients who achieved a response without requiring IMV or a response requiring IMV. A higher percentage of patients achieved a response irrespective of the need for IMV in the CsA plus standard of care group although the RR was almost significant 2.833 (95% CI, 0.908-8.840; p = 0.057). No differences were found between the groups for adverse events. In hospitalized patients with COVID-19 pneumonia, we were unable to demonstrate that CsA achieved a significant effect in preventing the development of ILD. (EU Clinical Trials Register; EudraCT Number: 2020-002123-11; registration date: 08/05/2020).

Modulation of miR-29a and miR-29b Expression and Their Target Genes Related to Inflammation and Renal Fibrosis by an Oral Nutritional Supplement with Probiotics in Malnourished Hemodialysis Patients.

Malnutrition is prevalent in patients with chronic kidney disease (CKD), especially those on hemodialysis. Recently, our group described that a new oral nutritional supplement (ONS), specifically designed for malnourished (or at risk) hemodialysis patients with a "similar to the Mediterranean diet" pattern, improved caloric-protein intake, nutritional status and biomarkers of inflammation and oxidation. Our aim in this study was to evaluate whether the new ONS, associated with probiotics or not, may produce changes in miRNA's expression and its target genes in malnourished hemodialysis patients, compared to individualized diet recommendations. We performed a randomized, multicenter, parallel-group trial in malnourished hemodialysis patients with three groups (1: control (C) individualized diet (n = 11); 2: oral nutritional supplement (ONS) + placebo (ONS-PL) (n = 10); and 3: ONS + probiotics (ONS-PR) (n = 10)); the trial was open regarding the intake of ONS or individualized diet recommendations but double-blinded for the intake of probiotics. MiRNAs and gene expression levels were analyzed by RT-qPCR at baseline and after 3 and 6 months. We observed that the expression of miR-29a and miR-29b increased significantly in patients with ONS-PR at 3 months in comparison with baseline, stabilizing at the sixth month. Moreover, we observed differences between studied groups, where miR-29b expression levels were elevated in patients receiving ONS-PR compared to the control group in the third month. Regarding the gene expression levels, we observed a decrease in the ONS-PR group compared to the control group in the third month for RUNX2 and TNFα. TGFB1 expression was decreased in the ONS-PR group compared to baseline in the third month. PTEN gene expression was significantly elevated in the ONS-PR group at 3 months in comparison with baseline. LEPTIN expression was significantly increased in the ONS-PL group at the 3-month intervention compared to baseline. The new oral nutritional supplement associated with probiotics increases the expression levels of miR-29a and miR-29b after 3 months of intervention, modifying the expression of target genes with anti-inflammatory and anti-fibrotic actions. This study highlights the potential benefit of this oral nutritional supplement, especially associated with probiotics, in malnourished patients with chronic renal disease on hemodialysis.

Validity Evidence for the Brief Self-Control Scale in the Spanish Adult Population: A Systematic Study.

The Brief Self-Control Scale (BSCS) has been widely studied across languages and populations. However, research examining the Spanish version is scant and limited to the adolescent population. Our aim here was to provide validity evidence for use of the BSCS with Spanish adults by analyzing and comparing the psychometric properties of different versions of the scale (13-item, 10-item, 9-item, 8-item, and 7-item). Confirmatory factor analysis was used to test the internal structure based on one-factor and two-factor models. Results obtained in a sample of 676 Spanish adults showed adequate fit indices for the two-factor structure of the 9-item, 8-item, and 7-item versions of the BSCS, although only the 9-item and 8-item BSCS were found to be invariant across gender. Item homogeneity and reliability of factor scores for these two versions (9-item and 8-item) were satisfactory. We also provide novel validity evidence based on relationships with indicators of psychological adjustment and wellbeing. Scores on the 9-item and 8-item BSCS correlated with life satisfaction, flourishing, self-esteem, distress, depression, and loneliness, and hence both may be suitable for use in mental health assessment contexts.

Life Satisfaction and Character Strengths in Women With Breast Cancer: Zest and Hope as Predictors.

BACKGROUND: Empirical evidence shows that life satisfaction is positively related to character strengths, and although this association has been observed in different populations, it is scarce in breast cancer patients. This study analyzes the relationship between character strengths and life satisfaction in Spanish women diagnosed with breast cancer. METHODS: A sample of 117 women completed the Satisfaction with Life Scale (SWLS) and the Spanish version of the VIA Inventory of Strengths (VIA-IS). Correlation analysis and regression modeling were performed to determine which strengths predict life satisfaction. RESULTS: The results of the correlation analysis showed that 15 strengths were positively and significantly associated with life satisfaction, with the highest correlations corresponding to zest, hope, curiosity, social intelligence, love, gratitude, and judgment. Regression modeling indicated that of these, zest and hope were key strengths for predicting life satisfaction. CONCLUSIONS: These findings suggest that intervention programs based on the development of zest and hope could help to improve life satisfaction and, therefore, the psychological well-being of women with breast cancer.

Repeated measures ANOVA and adjusted F-tests when sphericity is violated: which procedure is best?

Introduction: One-way repeated measures ANOVA requires sphericity. Research indicates that violation of this assumption has an important impact on Type I error. Although more advanced alternative procedures exist, most classical texts recommend the use of adjusted F-tests, which are frequently employed because they are intuitive, easy to apply, and available in most statistical software. Adjusted F-tests differ in the procedure used to estimate the corrective factor ε, the most common being the Greenhouse-Geisser (F-GG) and Huynh-Feldt (F-HF) adjustments. Although numerous studies have analyzed the robustness of these procedures, the results are inconsistent, thus highlighting the need for further research. Methods: The aim of this simulation study was to analyze the performance of the F-statistic, F-GG, and F-HF in terms of Type I error and power in one-way designs with normal data under a variety of conditions that may be encountered in real research practice. Values of ε were fixed according to the Greenhouse-Geisser procedure (ε^). We manipulated the number of repeated measures (3, 4, and 6) and sample size (from 10 to 300), with ε^ values ranging from the lower to its upper limit. Results: Overall, the results showed that the F-statistic becomes more liberal as sphericity violation increases, whereas both F-HF and F-GG control Type I error; of the two, F-GG is more conservative, especially with large values of ε^ and small samples. Discussion: If different statistical conclusions follow from application of the two tests, we recommend using F-GG for ε^ values below 0.60, and F-HF for ε^ values equal to or above 0.60.

How can we improve our use of allergen immunotherapy as a treatment option for asthma and severe asthma?

INTRODUCTION: In patients suffering from allergic asthma, especially in the pediatric age-group, allergen immunotherapy (AIT) could be of benefit and has the potential of long-term disease modification. AREAS COVERED: We reviewed the evidence for a beneficial effect of AIT in allergic asthma. A correct selection of the possible candidates for AIT is crucial. We define the comprehensive allergic asthma diagnosis: confirming asthma, confirming allergic sensitization and having symptoms on exposure to the relevant allergens.We analyze why the first trials on AIT for asthma were contradictory; we consider the results of systematic reviews and discuss the high degree of heterogeneity often found in meta-analysis. We assess recent, double-blind, placebo-controlled trials in sublingual AIT that provide robust evidence for a reduction in acute asthma exacerbations and a decrease in the use of inhaled corticosteroids. Further, we demonstrate how real-world trials and large pharmacy data-based analyses confirm these findings for SLIT and SCIT. Finally, we explore the option of AIT in severe asthma patients, once well-controlled on biologic therapy. EXPERT OPINION: Clear indications for AIT in asthma guidelines would benefit allergic asthmatics. AIT is a therapeutic option in appropriately selected asthmatics. Three years treatment has the potential for long-term tolerance, with persisting benefits years after discontinuation.

Immunomodulatory Effects in Healthy Individuals Following a 4-Week Taoist Qigong Intervention: A Comparative Study.

BACKGROUND Qigong, an ancient health preservation technique forming part of Traditional Chinese Medicine, combines slow body movements, breathing, and meditation. While this meditative movement system has been reported to offer various physical and psychological benefits, studies on the Taoist school of qigong are sparse. This study, therefore, aimed to investigate the effects of Taoist qigong on white blood cells and other immune parameters in healthy individuals. MATERIAL AND METHODS Thirty-eight participants were recruited for the study, with 21 assigned to the experimental group and 17 to the control group. Participants in the experimental group engaged in a four-week Taoist qigong program. Blood samples for immune parameter quantification, including leukocyte count, neutrophil, eosinophil, basophil, lymphocyte, and large unstained cell (LUC) counts, as well as concentrations of IgG, IgA, IgM, C3, and C4, were collected one day before the experiment started and one day after it ended. RESULTS Post-program, the experimental group exhibited significantly lower total leukocyte counts, and reduced numbers of lymphocytes and LUCs. Additionally, a higher percentage of monocytes was noted in this group. CONCLUSIONS Taoist qigong practice induced a distinct immunomodulatory profile, characterized by decreased counts of several white blood cell parameters and increased percentages of certain agranulocytes. This outcome presents intriguing implications from a psychobiological perspective and highlights the need for further research into the immune effects of Taoist mind-body practice.

Aeroallergen immunotherapy associated with reduced risk of severe COVID-19 in 1095 allergic patients.

Introduction: Allergen immunotherapy (AIT) brings along changes in the immune system, restoring dendritic cell function, reducing T2 inflammation and augmenting the regulatory cell activation. Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, interferes with the immune system causing immune suppression during the first phase and over-activation in more advanced disease. We decided to explore the interaction of both in a real-world observational trial. Methods: We registered COVID-19 outcomes in patients with allergic disorders in Latin America, treated with and without AIT. The registry was conducted during the first 1.3 years of the pandemic, with most of the data collected before COVID-19 vaccination was concluded in most countries. Data collection was anonymous via a web-based instrument. Ten countries participated. Results: 630/1095 (57.6%) of the included patients received AIT. Compared to patients without AIT, those treated with AIT had a reduced risk ratio (RR) for COVID-19 lower respiratory symptoms (RR 0.78, 95% CI: 0.6703-0.9024; p = 0.001662) and need for oxygen therapy (RR 0.65, 95% CI: 0.4217-0.9992; p = 0.048). In adherent patients on maintenance sublingual immunotherapy/subcutaneous immunotherapy (SLIT/SCIT) the RR reduction was larger [RR = 0.6136 (95% CI 0.4623-0.8143; p < 0.001) and RR: 0.3495 (95% CI 0.1822-0.6701; p < 0.005), respectively]. SLIT was slightly more effective (NS). We excluded age, comorbidities, level of health care attendance, and type of allergic disorder as confounders, although asthma was related to a higher frequency of severe disease. When analyzing patients with allergic asthma (n = 503) the RR reduction favoring AIT was more pronounced with 30% for lower respiratory symptoms or worse (RR 0.6914, 95% CI 0.5264 to 0.9081, p = 0.0087) and 51% for need of oxygen therapy or worse (RR 0.4868, 95% CI 0.2829-0.8376, p = 0.0082). Among severe allergic patients treated with biologics (n = 24) only 2/24 needed oxygen therapy. There were no critical cases among them. Conclusion: In our registry AIT was associated with reduced COVID-19 severity.

Variation of existence and location of aquaporin 3 in relation to cryoresistance of ram spermatozoa.

Introduction and objective: Osmotic changes during the process of freeze-thawing involve changes in the location of aquaporins (AQPs) in membrane domains of spermatozoa. Some AQPs, like aquaporin 3 (AQP3), are linked to sperm cryotolerance in the porcine species. Conspicuous individual variability exists between rams and their ejaculates, which may be classified as displaying good freezability (GFE) or poor freezability (PFE), depending on several endogenous and environmental factors. The present work aimed to examine whether differences in freezability could even involve changes in location and expression of AQP3 in ram spermatozoa. Methods: Thirty ejaculates from 10 rams (three of each) were evaluated and subsequently classified as GFE (n = 13) or PFE (n = 17) through a principal component analysis (PCA) and k-means cluster analysis. Spermatozoa were examined for the presence, abundance and distribution of AQP3 by western blot and immunocytochemistry, employing a commercial rabbit polyclonal antibody (AQP3 - ab125219). Results and discussion: Although AQP3 was found in the sperm acrosome, midpiece, principal and end piece of the tail in both fresh and after frozen-thawed samples, its highest immunolabeling was found in the mid- and principal piece. In the GFE group, the expression of AQP3 in the mid- and principal piece was greater (P < 0.05) in frozen-thawed samples than in fresh specimens while such differences were not detected in the PFE group. Sperm cryotolerance relates to changes in AQP3 expression and thus AQP3 could be used as a biomarker for cryotolerance. Conclusion: A greater capacity of AQP3 localization in mid- and principal piece of the spermatozoa could be linked to an increase the osmo-adaptative capacity of ejaculates with better capacity to withstand freeze-thawing processes.

Development and psychometric properties of the Stressors in Breast Cancer Scale.

Background: A diagnosis of breast cancer generates psychological stress, due not only to treatment and its side effects but also to the impact on different areas of the patient's daily life. Although there are instruments for measuring psychological stress in the cancer context, there is currently no tool for assessing stressors specific to breast cancer. Aims: The aim of this study was to develop the Stressors in Breast Cancer Scale (SBCS). Method: A panel of experts evaluated the clarity and relevance of scale items, providing validity evidence based on test content. Psychometric properties of the scale were then analyzed. Results: Validity evidence based on the internal structure of the SBCS was obtained through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), following a cross-validation strategy. The CFA supported a second-order factor model with five dimensions: physical appearance and sex strains, health and daily difficulties, interpersonal relationship strains, healthcare strains, and worries and concerns about the future. This structure was invariant across two groups distinguished by time from cancer diagnosis (less than 3 and 3 years or more from diagnosis). Reliability, based on McDonald's omega and Cronbach's alpha coefficients, ranged from 0.83 to 0.89 for factor scores, and reached 0.95 for total scores. Validity evidence was also provided by correlations with depression, anxiety, perceived stress, and perceived health and quality of life. Discussion: The results support the use of the SBCS for measuring stress as a stimulus in the breast cancer context. Implications for clinical practice and research are discussed.

Effect on nutritional status and biomarkers of inflammation and oxidation of an oral nutritional supplement (with or without probiotics) in malnourished hemodialysis patients. A multicenter randomized clinical trial "Renacare Trial".

Background: Malnutrition in patients undergoing hemodialysis is frequent and associated with a reduction in muscular mass and strength, with an increment in biomarkers of inflammation and oxidation. Materials and methods: Randomized, multicenter, parallel-group trial in malnourished hemodialysis patients with three groups [(1) control (C) individualized diet, (2) oral nutritional supplement-ONS- + placebo-SU- PL-, and (3) ONS + probiotics-SU-PR]; the trial was open regarding the intake of ONS or individualized diet recommendations, but double-blind for the intake of probiotics. We obtained, at baseline and after 3 and 6 months, anthropometric measurements, handgrip strength, bioelectrical impedance analysis (BIA), dietary records, and routine biochemical parameters. Inflammation and oxidation were determined using ELISA techniques (Versamax and ProcartaPlex multiplex Immunoassay). Results were analyzed by intention to treat. Results: A total of 31 patients (11 corresponding to group C, 10 to SU-PL, and 10 to SU-PR) completed the 6-months trial. The two groups that took supplements significantly increased their protein calorie, fat (total and n-3), and fiber intake. Weight and fat-free mass (FFM) also increased significantly in the groups on supplements, both at 3 and 6 months, and dynamometry did so in the SU-PL group. At month 3, prealbumin and vitamin D were significantly increased in the SU-TOT (SU-PL + SU-PR) group. No changes were observed regarding levels of phosphorus and potassium in any of the groups. Urea increased significantly at 6 months in the SU-PL group. There were significant changes in some inflammation biomarkers in the groups on supplements during the intervention (brain-derived neurotrophic factor, bone morphogenetic protein-2, MCP-1, IL-1-beta, IL-10, IL-4, and IL-8). The total antioxidant capacity (TAC) increased significantly in the supplemented patients, with no significant changes observed in isoprostanes. Conclusion: The specific ONS improved protein-calorie intake, nutritional status (mainly FFM), and some biomarkers of inflammation/oxidation. The addition of probiotics could have a synergistic effect with ONS in such biomarkers. Clinical trail registration: https://clinicaltrials.gov/ct2/show/, identifier NCT03924089.

Non-normal Data in Repeated Measures ANOVA: Impact on Type I Error and Power.

BACKGROUND: Repeated measures designs are commonly used in health and social sciences research. Although there are other, more advanced, statistical analyses, the F-statistic of repeated measures analysis of variance (RM-ANOVA) remains the most widely used procedure for analyzing differences in means. The impact of the violation of normality has been extensively studied for between-subjects ANOVA, but this is not the case for RM-ANOVA. Therefore, studies that extensively and systematically analyze the robustness of RM-ANOVA under the violation of normality are needed. This paper reports the results of two simulation studies aimed at analyzing the Type I error and power of RM-ANOVA when the normality assumption is violated but sphericity is fulfilled. METHOD: Study 1 considered 20 distributions, both known and unknown, and we manipulated the number of repeated measures (3, 4, 6, and 8) and sample size (from 10 to 300). Study 2 involved unequal distributions in each repeated measure. The distributions analyzed represent slight, moderate, and severe deviation from normality. RESULTS: Overall, the results show that the Type I error and power of the F-statistic are not altered by the violation of normality. CONCLUSIONS: RM-ANOVA is generally robust to non-normality when the sphericity assumption is met.

Psychometric properties of the perceived stress scale (pss-10) with breast cancer patients.

Breast cancer diagnosis is one of the most difficult events that a woman can experience during her life and it usually produces high levels of stress. Global measures of perceived stress are useful for screening and for comparing stress levels between cancer patients and other clinical and nonclinical populations. One such instrument that is widely used is the Perceived Stress Scale (pss-10), but its psychometric properties have scarcely been analysed with breast cancer patients. The aim of this study was to provide validity evidence regarding the use of the 10-item version of the pss-10 as a tool for measuring perceived stress in this context. Participants were 215 Spanish breast cancer patients who completed the PSS-10 and the DASS-21, a measure of affective distress (depression, anxiety, and stress). The internal structure of the PSS-10 was examined through confirmatory factor analysis (CFA), and the reliability of test scores was estimated using McDonald's omega coefficient. Validity evidence based on relationships with other variables was also obtained using correlation analysis. The CFA supported a correlated two-factor structure: perceived helplessness (six negatively worded items) and perceived self-efficacy (four positively worded items). Reliability coefficients for scores on these two factors were 0.87 and 0.73, respectively. Scores on affective distress (DASS-21) were strongly and positively correlated with perceived helplessness and moderately and negatively correlated with perceived self-efficacy. The PSS-10 is an adequate tool for measuring perceived stress in the breast cancer context and it may be useful for identifying women at risk of psychological maladjustment.