Cantharidin: A Multiporpuse Beetlejuice.

Cantharidin is produced by beetles of two families, Meloidae (true blister beetles) and Oedemeridae (false blister beetles). Nevertheless, it is mainly members of the meloid family that have been widely studied in the traditional medicines and pharmacology of different cultures and countries. The meloids cantharidin's role is going to be reviewed in this paper, including the cantharidin discovery, its adaptative function, and worldwide uses. Finally, we recovered information on the implementation of this compound in South American civilizations in different therapeutic treatments as well as sexual stimulants and aphrodisiacs.

Sentinel lymph node biopsy versus observation in high-risk cutaneous squamous cell carcinoma in immunosuppressed and immunocompetent patients: An inverse probability of treatment weighting study.

BACKGROUND: The survival benefit of sentinel lymph node biopsy (SLNB) in immunocompetent and immunosuppressed patients with high-risk cutaneous squamous cell carcinoma (cSCC) has not been established. OBJECTIVE: To determine whether SLNB improves disease-specific survival (DSS) in high-risk cSCC. Secondary objectives were to analyse disease-free survival, nodal recurrence-free survival and overall survival (OS). METHODS: Multicentre, retrospective, observational cohort study comparing survival outcomes in immunosuppressed and immunocompetent patients treated with SLNB or watchful waiting. Inverse probability of treatment weighting was used to adjust for possible confounding effects. RESULTS: We studied 638 tumours in immunocompetent patients (SLNB n = 42, observation n = 596) and 173 tumours in immunosuppressed patients (SLNB n = 28, observation n = 145). Overall, SLNB was positive in 15.7% of tumours. SLNB was associated with a reduced risk of nodal recurrence (NR) (hazard ratio [HR], 0.05 [95% CI, 0.01-0.43]; p = 0.006), disease specific mortality (HR, 0.17 [95% CI, 0.04-0.72]; p = 0.016) and all-cause mortality (HR, 0.33 [95% CI, 0.15-0.71]; p = 0.004) only in immunocompetent patients. CONCLUSIONS: SLNB was associated with improvements in NR, DSS and OS in immunocompetent but not in immunosuppressed patients with high-risk cSCC.

Assesment of Hypoderma infestation in a wild population of Cervus elaphus from mountains Atlantic ecosystems in southwestern Europe (Spain).

Hypodermosis in Cervus elaphus was studied in the Riaño Regional Hunting Reserve, Province of León, north-western Spain. One hundred and ten red deer were examined for the presence of warble fly larvae. They were analyzed by PCR analysis of the COI region of mt-DNA and identified as Hypoderma actaeon. The prevalence of larvae was 42.7% with a mean intensity of 12.5 ± 18 (range 1-80) warbles/deer infested. The distribution of larvae in the infested animals showed an aggregated/overdispersed pattern (aggregation index = 25.84), where the larvae are not randomly or uniformly distributed, but strongly aggregated among their hosts. Larvae were found in all three states. First and second-instars were observed mainly in the autumn until the end of winter (November-March) and third-instars in late winter until mid-spring (March-May). The adult animals and the males had a higher prevalence than the young and the females, finding statistically significant differences only according to the sex of the animals. Seasonal variations were observed in the prevalence with the highest number of infested animals in winter and autumn, but not in terms of the mean intensity of parasites. Additionally, we assessed the presence of anti-Hypoderma antibodies in serum by means of indirect ELISA tests, using a crude larval extract (CLE) and a purified fraction the hypodermin C (HyC) obtained from first instars of Spanish isolates of Hypoderma lineatum (cattle). These findings confirm that H. actaeon is widely distributed in northern Spain, and provide new information about its chronobiology in mountainous Atlantic ecosystems from southwestern Europe.

Contribution to the Knowledge of Gastrointestinal Nematodes in Roe Deer (Capreolus capreolus) from the Province of León, Spain: An Epidemiological and Molecular Study.

A study of gastrointestinal nematodes in roe deer was carried out in the regional hunting reserves of Riaño and Mampodre, Province of León, Spain, to provide information on their prevalence and intensity of infection in relation to the sampling areas, age of the animals, and body weight. Through a regulated necropsy of the animals, all of them harbored gastrointestinal nematodes in their digestive tract, with a mean intensity of parasitism of 638 ± 646.1 nematodes/infected animal. Eleven genera were found and 18 species of gastrointestinal nematodes were identified, three of them polymorphic: Trichostrongylus axei, Trichostrongylus vitrinus, Trichostrongylus capricola, Trichostrongylus colubriformis, Haemonchus contortus, Spiculopteragia spiculoptera/Spiculopteragia mathevossiani, Ostertagia leptospicularis/Ostertagia kolchida, Ostertagia (Grosspiculopteragia) occidentalis, Teladorsagia circumcincta/Teladorsagia trifurcate, Marshallagia marshalli, Nematodirus europaeus, Cooperia oncophora, Capillaria bovis, Oesophagostomum venulosum, and Trichuris ovis. All of them have already been cited in roe deer in Europe, but Marshallagia marshalli, Capillaria bovis, and Ostertagia (Grosspiculopteragia) occidentalis are reported for the first time in Spain in this host. The abomasum was the intestinal section, where the prevalence (98.9%) and mean intensity (x¯ = 370.7 ± 374.4 worms/roe deer; range 3-1762) were significantly higher, but no statistically significant differences were found when comparing the sampling areas and age of animals. The animals with lower body weight had a higher parasite load than those in better physical condition, finding, in this case, statistically significant differences (p = 0.0020). Seven genera and 14 species were identified. In the small intestine, 88% of the animals examined presented gastrointestinal nematodes, with an average intensity of x¯ = 131.7 ± 225.6 parasites/infected animal, ranging between 4-1254 worms. No statistically significant differences were found when the three parameters studied were compared. Four genera and seven species were identified. In the large intestine/cecum, 78.3% of the examined roe deer presented adult worms, with an average intensity of 6.3 ± 5.5 worms/infected animal; range 1-26 worms. Only statistically significant differences were observed when considering the mean intensity of parasitism and the sampling area (p = 0.0093). Two genera and two species were identified. Several of the species found in the study were studied molecularly, and with the sequences obtained compared with those deposited in GenBank, phylogenetic trees were prepared to determine their taxonomic status. Using coprological techniques, the existing correlation in the shedding of gastrointestinal nematode eggs in roe deer was investigated with that of semi-extensive sheep farms in the same study area to verify the existence of cross-transmission of these parasites between wild and domestic animals. The high values found in the studied parameters show that northern Spain is an area of high-intensity infection for roe deer.

Genetic deletion of HVEM in a leukemia B cell line promotes a preferential increase of PD-1- stem cell-like T cells over PD-1+ T cells curbing tumor progression.

Introduction: A high frequency of mutations affecting the gene encoding Herpes Virus Entry Mediator (HVEM, TNFRSF14) is a common clinical finding in a wide variety of human tumors, including those of hematological origin. Methods: We have addressed how HVEM expression on A20 leukemia cells influences tumor survival and its involvement in the modulation of the anti-tumor immune responses in a parental into F1 mouse tumor model of hybrid resistance by knocking-out HVEM expression. HVEM WT or HVEM KO leukemia cells were then injected intravenously into semiallogeneic F1 recipients and the extent of tumor dissemination was evaluated. Results: The loss of HVEM expression on A20 leukemia cells led to a significant increase of lymphoid and myeloid tumor cell infiltration curbing tumor progression. NK cells and to a lesser extent NKT cells and monocytes were the predominant innate populations contributing to the global increase of immune infiltrates in HVEM KO tumors compared to that present in HVEM KO tumors. In the overall increase of the adaptive T cell immune infiltrates, the stem cell-like PD-1- T cells progenitors and the effector T cell populations derived from them were more prominently present than terminally differentiated PD-1+ T cells. Conclusions: These results suggest that the PD-1- T cell subpopulation is likely to be a more relevant contributor to tumor rejection than the PD-1+ T cell subpopulation. These findings highlight the role of co-inhibitory signals delivered by HVEM upon engagement of BTLA on T cells and NK cells, placing HVEM/BTLA interaction in the spotlight as a novel immune checkpoint for the reinforcement of the anti-tumor responses in malignancies of hematopoietic origin.

Identification of Hypoderma actaeon (Diptera: Oestridae) in red deer (Cervus elaphus) from northern Spain: Microscopy study and molecular analysis.

Hypoderma spp. larvae were observed subcutaneously in the dorsal and lumbar regions of red deer (Cervus elaphus) hunted in the province of León (northwestern Spain) causing a myiasis. They were removed and initially classified by their size, shape, color, and location under the skin into the three larval stages that parasitize these animals. The morphological characteristics of the first and second-instar are described and from the features of the third-instar the species was identified as Hypoderma actaeon. To accurately identify this species, five isolates of genomic DNA from the third-instar, two from the second-instar and two from first-instar of H. actaeon were analyzed by PCR analysis of the COI region of mt-DNA. The results confirmed that the examined samples exactly matched with H. actaeon. This study has shown the morphological identification of the three larval stages of H. actaeon and, for the first time, the first and second-instar larvae have been molecularly characterized. Finally, identification of only H. actaeon suggests that this species is the only affecting red deer in the Iberian Peninsula.

Del Chamanismo al Galenismo: un acercamiento a la curaduría de la nueva sala permanente del museo de la Academia Nacional de Medicina / From Shamanism to Galenism: an approach to the curatorship of the new permanent room of the museum of the National Academy of Medicine

La nueva sala 'Del Chamanismo Al Galenismo' del Museo Ricardo Rueda González inaugurada en noviembre del año 2022, da inicio al museo con el fin de narrar una historia de la medicina desde el contexto local. Aquí se evidencia la experiencia humana compartida del sufrimiento y la esperanza entendidas como enfermedad y tratamiento que fue representada en el mundo prehispánico, durante la colonia y el en siglo XIX.

The new room 'From Shamanism to Galenism' of the Ricardo Rueda González Museum, inaugurated in November 2022, opens the museum with the aim of narrating a history of medicine from the local context. Here the shared human experience of suffering and hope understood as illness and treatment that was represented in the pre-Hispanic world, during the colony and in the 19th century is evidenced.

Glycolysis, monocarboxylate transport, and purinergic signaling are key events in Eimeria bovis-induced NETosis.

The protozoan parasite Eimeria bovis is the causative agent of bovine coccidiosis, an enteric disease of global importance that significantly affects cattle productivity. Previous studies showed that bovine NETosis-an important early host innate effector mechanism of polymorphonuclear neutrophil (PMN)-is elicited by E. bovis stages. So far, the metabolic requirements of E. bovis-triggered NET formation are unknown. We here studied early glycolytic and mitochondrial responses of PMN as well as the role of pH, distinct metabolic pathways, P2 receptor-mediated purinergic signaling, and monocarboxylate transporters 1 and 2 (MCT1, MCT2) in E. bovis sporozoite-induced NET formation. Seahorse-based experiments revealed a rapid induction of both neutrophil oxygen consumption rate (OCR) and early glycolytic responses, thereby reflecting immediate PMN activation and metabolic changes upon confrontation with sporozoites. The impact of these metabolic changes on NET formation was studied via chemical inhibition experiments targeting glycolysis and energy generation by the use of 2-fluor-2-deoxy-D-glucose (FDG), 6-diazo-5-oxo-L-norleucin (DON), sodium dichloroacetate (DCA), oxythiamine (OT), sodium oxamate (OXA), and oligomycin A (OmA) to block glycolysis, glutaminolysis, pyruvate dehydrogenase kinase, pyruvate dehydrogenase, lactate dehydrogenase, and mitochondrial ATP-synthase, respectively. Overall, sporozoite-induced NET formation was significantly diminished via PMN pretreatments with OmA and OXA, thereby indicating a key role of ATP- and lactate-mediated metabolic pathways. Consequently, we additionally studied the effects of extracellular pH, MCT1, MCT2, and purinergic receptor inhibitors (AR-C141900, AR-C155858, theobromine, and NF449, respectively). Pretreatment with the latter inhibitors led to blockage of sporozoite-triggered DNA release from exposed bovine PMN. This report provides first evidence on the pivotal role of carbohydrate-related metabolic pathways and purinergic receptors being involved in E. bovis sporozoite-induced NETosis.

Differential Engraftment of Parental A20 PD-L1 WT and PD-L1 KO Leukemia Cells in Semiallogeneic Recipients in the Context of PD-L1/PD-1 Interaction and NK Cell-Mediated Hybrid Resistance.

The contribution of natural killer (NK) cells to tumor rejection in the context of programmed death-ligand 1/programmed death 1 (PD-L1/PD-1) blockade is a matter of intense debate. To elucidate the role of PD-L1 expression on tumor cells and the functional consequences of engaging PD-1 receptor on cytotoxic cells, PD-L1 expression was genetically inactivated and WT or PD-L1-deficient parental tumor cells were adoptively transferred intravenously into F1 recipients. The engraftment of PD-L1-deficient A20 tumor cells in the spleen and liver of F1 recipients was impaired compared with A20 PD-L1 WT tumor counterparts. To elucidate the mechanism responsible for this differential tumor engraftment and determine the relevance of the role of the PD-L1/PD-1 pathway in the interplay of tumor cells/NK cells, a short-term competitive tumor implantation assay in the peritoneal cavity of semiallogeneic F1 recipients was designed. The results presented herein showed that NK cells killed target tumor cells with similar efficiency regardless of PD-L1 expression, whereas PD-L1 expression on A20 tumor cells conferred significant tumor protection against rejection by CD8 T cells confirming the role of the co-inhibitory receptor PD-1 in the modulation of their cytotoxic activity. In summary, PD-L1 expression on A20 leukemia tumor cells modulates CD8 T-cell-mediated responses to tumor-specific antigens but does not contribute to inhibit NK cell-mediated hybrid resistance, which correlates with the inability to detect PD-1 expression on NK cells neither under steady-state conditions nor under inflammatory conditions.

Three Intervention Programs in Secondary Education on Attitudes Toward Persons With a Disability.

Persons with a disability make up a social group which is in an especially vulnerable situation. They have to face obstacles and difficulties in their participation as part of the community with equal opportunities, in which attitude of others is a determining factor. This study makes a comparative analysis of three intervention programs (1 "Simulation and Modeling," 2 "Information and Awareness Raising," and 3 "Adapted Sport") on attitudes toward persons with a disability of adolescents in secondary schools. Each program is based on a concrete technique, but they all have the common thread of the direct, structured contact technique with persons with a disability. The effectiveness of the three programs in changing attitudes is analyzed, and their impact on the different factors of the attitude construct (1 "acceptance/rejection," 2 "competence/limitation," and 3 "equality of opportunities") is also studied. The results show the effectiveness of the three programs. The students show more positive attitudes toward persons with a disability in all the groups, especially program 1. Analyzing the general influence of the three programs on the factors of the attitude construct, it can be seen that in factors 2 and 3, the attitudes have significantly improved in all three programs. Finally, the results show that each program has been more effective on a concrete attitude factor.

Molecular and Pathogenic Characterization of Cylindrocarpon-like Anamorphs Causing Root and Basal Rot of Almonds.

Three almond nurseries were prospected in the South of Spain (Sevilla) to evaluate the sanitary status of the nursery plant material. Samples consisted of main roots, secondary roots and six-month-old basal stems 'GxN-15', 'Nemaguard', 'Cadaman', 'Rootpac-40' and 'Rootpac-20' rootstocks planted in the soil, and twigs of mother plants from 'Lauranne', 'Guara', 'Marcona', 'Marta' and 'Ferragnes' almond cultivars. Endophytic and potential pathogenic fungi were identified in mother plants and 70 Cylindrocarpon-like anamorph isolates were detected in the root system and basal stems of analyzed rootstocks. Based on partial sequencing of the his3 gene and multilocus phylogenetic analysis of the concatenated ITS, tub2, his3 and tef1-α partial sequences, seven Cylindrocarpon-like anamorph species were identified as Dactylonectria torresensis, D. novozelandica, D. macrodidyma, Ilyonectria liriodendri, Neonectria sp. 1, N. quercicola and Cylindrocladiella variabilis. Pathogenicity was assessed on young healthy detached twigs of 'Guara' almond cultivar and one-year-old 'Lauranne' potted almonds grafted onto 'GxN-15' rootstocks. Among the seven Cylindrocarpon-like anamorph species, I. liriodendri, Neonectria sp. 1 and N. quercicola were the most aggressive. Inoculated detached shoots developed necrotic lesions 15 days after inoculation. Inoculated trees showed sectorized necrosis in the main and secondary roots and the basal stem of the rootstock 5 months after inoculation. The most aggressive species were able to cause necrosis also in the grafted cultivar, and I. liriodendri, and N. quercicola also reduced the root biomass. This is the first report of Cylindrocarpon-like anamorph species causing root and basal rot of almonds.

A Protective Factor for Emotional and Behavioral Problems in Children: The Parental Humor.

In order to prevent the development of emotional and behavioral problems, risk and protective factors must be identified. This study aims to establish a link between perceived parental humor and children mental health. The sample comprises 762 pupils aged 10 to 15 (M = 12.23; SD = 1.12), who completed self-reports evaluating perceived parental humor (EEE-H) and their own emotional and behavioral strengths and difficulties (SDQ). The results indicate that parental humor is negatively associated with internalizing problems in children; no association with externalizing problems is observed. According to the study, girls who perceive low parental humor are the most likely to display internalizing problems, while girls perceiving high parental humor are the least likely to do so. Parental humor, characterized by calmness, cheerfulness, and optimism, is a protective factor against internalizing problems in children, especially girls. We recommend training for parents and training and intervention programs for families to encourage activities that boost parental humor.

On the Andean genus Leschenius (Coleoptera: Curculionidae: Entiminae): Updated phylogeny, with a new species from Ecuador, discovery of males, and larval description of the potato weevil Leschenius vulcanorum.

The weevil genus Leschenius del Río (Curculionidae: Entiminae: Naupactini) is distributed in the northern Andes, in Colombia and Ecuador. Among its species, L. vulcanorum stands out as an important pest of potatoes in its parthenogenetic form, which is known as "tiroteador de la papa". In this study, the adult male and the larval stage (first and mature larvae) of L. vulcanorun are described and illustrated for the first time. A description of the male of Leschenius bifurcatus is also provided. A new bisexual species was discovered, Leschenius ventrilingulatus sp. nov., and is described from Ecuador. An updated phylogenetic analysis was performed, including the new species, with results indicating a sister group relationship between L. ventrilingulatus and L. vulcanorum. They can be distinguished because the former is usually of smaller size and is covered by denser and thicker setae, has shorter antennae, a subcylindrical shape of the pronotum, shorter elytra (about 1.5×longer than wide at base), the female has ventrite 4 with a posterior rounded projection, and posterior margin of ventrite 5 subacute, not excavated. This paper also includes lectotype designations, a revised key to all known species of Leschenius, habitus photos of males and females, illustrations of genitalia, and a distribution map.

Water Flux Prediction in Direct Contact Membrane Distillation Subject to Inorganic Fouling.

Freshwater is a limited resource, which has driven the development of new purification and water-reuse technologies. One promising technology for water treatment is membrane distillation (MD). One of the main problems of MD, and of many desalination technologies, is membrane fouling, which reduces the performance of the membrane. This work presents a mathematical model that aims to predict distillate fluxes in direct-contact MD when fouling occurs as salts are deposited onto the membrane surface, forming an inorganic fouling layer. The mathematical model uses a heat- and mass-transfer formulation for prediction of the distillate flux under steady state conditions, and it is combined with the cake-filtration theory to represent the distillate fluxes after the onset of membrane fouling. Model results agree well with experimental observation of distillate fluxes, both before (~12-14 kg m-2 h-1) and after the onset of membrane fouling, with root-mean-square errors smaller than 1.4 kg m-2 h-1 in all the experiments. These results suggest that the cake-filtration theory can be used to represent water flux decline in MD membranes prone to inorganic fouling. From our experiments and from the modelling exercise, we found that the onset of membrane failure was relatively constant; the precipitation reaction constant is conditioned by the physicochemical interaction between the feed solution and the membrane; and the rate of flux decline after membrane fouling depends on flow conditions as well as on the precipitation compound. However, the proposed model has limitations that must be addressed in future investigations to validate it under a wider range of operating conditions, for membranes composed by other materials and with different feed solutions to address organic, biological, and/or colloidal fouling, which typically occur under real conditions.

The impact of CD160 deficiency on alloreactive CD8 T cell responses and allograft rejection.

CD160 is a member of the immunoglobulin superfamily with a pattern of expression mainly restricted to cytotoxic cells. To assess the functional relevance of the HVEM/CD160 signaling pathway in allogeneic cytotoxic responses, exon 2 of the CD160 gene was targeted by CRISPR/Cas9 to generate CD160 deficient mice. Next, we evaluated the impact of CD160 deficiency in the course of an alloreactive response. To that aim, parental donor WT (wild-type) or CD160 KO (knock-out) T cells were adoptively transferred into non-irradiated semiallogeneic F1 recipients, in which donor alloreactive CD160 KO CD4 T cells and CD8 T cells clonally expanded less vigorously than in WT T cell counterparts. This differential proliferative response rate at the early phase of T cell expansion influenced the course of CD8 T cell differentiation and the composition of the effector T cell pool that led to a significant decreased of the memory precursor effector cells (MPECs) / short-lived effector cells (SLECs) ratio in CD160 KO CD8 T cells compared to WT CD8 T cells. Despite these differences in T cell proliferation and differentiation, allogeneic MHC class I mismatched (bm1) skin allograft survival in CD160 KO recipients was comparable to that of WT recipients. However, the administration of CTLA-4.Ig showed an enhanced survival trend of bm1 skin allografts in CD160 KO with respect to WT recipients. Finally, CD160 deficient NK cells were as proficient as CD160 WT NK cells in rejecting allogeneic cellular allografts or MHC class I deficient tumor cells. CD160 may represent a CD28 alternative costimulatory molecule for the modulation of allogeneic CD8 T cell responses either in combination with costimulation blockade or by direct targeting of alloreactive CD8 T cells that upregulate CD160 expression in response to alloantigen stimulation.

Capacidad potencial de un centro coordinador de urgencias y emergencias para predecir ingresos hospitalarios y en unidades de cuidados intensivos por COVID-19 / Potential capacity of an emergency dispatch center to predict COVID-19–related hospital and intensive care unit admissions

Objetiv: Analizar la asociación entre la demanda asistencial percibida en el Centro Coordinador de Urgencias y Emergencias (CCUE) de Castilla La Mancha (CLM) y los ingresos hospitalarios y en unidades de cuidados intensivos (UCI) por COVID-19, así como sus características temporales, para valorar la potencial aplicación como herramienta predictiva de ingresos por COVID-19. Método: Estudio observacional retrospectivo de las llamadas diarias realizadas al CCUE de CLM entre el 1 de marzo y el 14 de octubre de 2020. Se analizaron los códigos “diarrea”, “disnea”, “fiebre” y “malestar general” que fueron usados como variables predictoras, y su relación con los ingresos hospitalarios y en UCI. Resultados: A través del 112 se recibieron 831.943 llamadas (máximo el 13 de marzo: 10.582 llamadas). En la línea 900 fueron 208.803 llamadas (máximo el 15 de marzo: 23.744 llamadas). Se encontró una relación estadísticamente significativa entre los códigos de regulación estudiados y el número de llamadas con los ingresos hospitalarios y en UCI, con una capacidad predictora de 2 semanas en relación a los picos de ocupación. Los códigos con mayor relación fueron “malestar general” y “diarrea”. Conclusiones: Se encontró una asociación entre el número de llamadas a un CCUE por disnea, fiebre, malestar general y diarrea y el número de llamadas con los ingresos hospitalarios y en UCI por COVID-19 con una antelación de 2 semanas, principalmente por malestar general y diarrea. El diseño de sistemas expertos predictivos y su automatización mediante inteligencia artificial podría formar parte de los programas de preparación, planificación y anticipación de los sistemas de salud ante futuras pandemias.

Objectives: To analyze the association between the perceived care demand in the emergency call center of Castilla La Mancha (and hospital and ICU admissions for COVID-19, as well as their temporal characteristics, to explore its potential capacity as a predictive tool for COVID hospital admissions. Material and methods: Retrospective observational study on the daily calls made to the emergency call center of Castilla La Mancha, both calls to 112 and those made to COVID line, in the period between March 1 and October 14, 2020. The data were analyzed by codes "diarrhea", "dyspnea", "fever" and "general discomfort" that were used as predictor variables, and their relationship with hospital admissions and ICU admissions. Results: A total of 831,943 calls were received at the CLM emergency call center through 112, with a maximum on March 13, 2020 with 10,582 calls. On COVID line, a total of 208,803 calls were received in that period, with a maximum on March 15 with 23,744. A statistically significant relationship was found between the regulation codes studied (specific symptoms) and the number of calls with hospital admissions and ICU admissions, with a predictive capacity of 2 weeks in relation to occupancy peaks. The codes with the greatest relationship were "general malaise" and "diarrhea". Conclusion: We have found an association between the number of calls to a CCUE due to dyspnea, fever, general discomfort, diarrhea and the number of calls with hospital admissions and ICU for COVID-SARS-2 2 weeks in advance, mainly due to general discomfort and diarrhea. The design of predictive expert systems and their automation using artificial intelligence could be part of the preparation, planning and anticipation programs of health systems in the near future in the event of future pandemics. (AU)

Potential capacity of an emergency dispatch center to predict COVID-19-related hospital and intensive care unit admissions. / Capacidad potencial de un centro coordinador de urgencias y emergencias para predecir ingresos hospitalarios y en unidades de cuidados intensivos por COVID-19.

OBJECTIVES: To analyze the association between the perceived care demand in the emergency call center of Castilla La Mancha (and hospital and ICU admissions for COVID-19, as well as their temporal characteristics, to explore its potential capacity as a predictive tool for COVID hospital admissions. MATERIAL AND METHODS: Retrospective observational study on the daily calls made to the emergency call center of Castilla La Mancha, both calls to 112 and those made to COVID line, in the period between March 1 and October 14, 2020. The data were analyzed by codes "diarrhea", "dyspnea", "fever" and "general discomfort" that were used as predictor variables, and their relationship with hospital admissions and ICU admissions. RESULTS: A total of 831,943 calls were received at the CLM emergency call center through 112, with a maximum on March 13, 2020 with 10,582 calls. On COVID line, a total of 208,803 calls were received in that period, with a maximum on March 15 with 23,744. A statistically significant relationship was found between the regulation codes studied (specific symptoms) and the number of calls with hospital admissions and ICU admissions, with a predictive capacity of 2 weeks in relation to occupancy peaks. The codes with the greatest relationship were "general malaise" and "diarrhea". CONCLUSION: We have found an association between the number of calls to a CCUE due to dyspnea, fever, general discomfort, diarrhea and the number of calls with hospital admissions and ICU for COVID-SARS-2 2 weeks in advance, mainly due to general discomfort and diarrhea. The design of predictive expert systems and their automation using artificial intelligence could be part of the preparation, planning and anticipation programs of health systems in the near future in the event of future pandemics.

OBJETIVO: Analizar la asociación entre la demanda asistencial percibida en el Centro Coordinador de Urgencias y Emergencias (CCUE) de Castilla La Mancha (CLM) y los ingresos hospitalarios y en unidades de cuidados intensivos (UCI) por COVID-19, así como sus características temporales, para valorar la potencial aplicación como herramienta predictiva de ingresos por COVID-19. METODO: Estudio observacional retrospectivo de las llamadas diarias realizadas al CCUE de CLM entre el 1 de marzo y el 14 de octubre de 2020. Se analizaron los códigos "diarrea", "disnea", "fiebre" y "malestar general" que fueron usados como variables predictoras, y su relación con los ingresos hospitalarios y en UCI. RESULTADOS: A través del 112 se recibieron 831.943 llamadas (máximo el 13 de marzo: 10.582 llamadas). En la línea 900 fueron 208.803 llamadas (máximo el 15 de marzo: 23.744 llamadas). Se encontró una relación estadísticamente significativa entre los códigos de regulación estudiados y el número de llamadas con los ingresos hospitalarios y en UCI, con una capacidad predictora de 2 semanas en relación a los picos de ocupación. Los códigos con mayor relación fueron "malestar general" y "diarrea". CONCLUSIONES: Se encontró una asociación entre el número de llamadas a un CCUE por disnea, fiebre, malestar general y diarrea y el número de llamadas con los ingresos hospitalarios y en UCI por COVID-19 con una antelación de 2 semanas, principalmente por malestar general y diarrea. El diseño de sistemas expertos predictivos y su automatización mediante inteligencia artificial podría formar parte de los programas de preparación, planificación y anticipación de los sistemas de salud ante futuras pandemias.

Coping Strategies by University Students in Response to COVID-19: Differences between Community and Clinical Groups.

Last year, the COVID-19 pandemic had severe consequences on the health and well-being of millions of people. Different studies try to identify the main effects that the crisis and several lockdowns have had on the citizens' mental health. This research analyses the coping strategies generated by students from a community group and a clinical group in response to this crisis, using the Coping Responses Inventory-Adult Form (CRI-A) by Moos with a sample of 1074 students of Universidad de Extremadura. Multivariate analysis and receiver operating characteristic curve analysis have been carried out, revealing, amongst other things, a greater predisposition of the clinical sample towards factors such as seeking guidance and support, cognitive avoidance or emotional discharge. Results show that students with prior mental health problems perform an unhealthy coping response based on avoidance strategies. This group of students suffers a double source of distress and anxiety, one derived from their prior psychopathologic problems and the stress of the lockdown and another one originating from an inefficient coping response, which makes coping strategies raise levels of distress and anxiety.

Placental growth factor testing in the management of late preterm preeclampsia without severe features: a multicenter, randomized, controlled trial.

BACKGROUND: In women with late preterm preeclampsia, the optimal time for delivery remains a controversial topic, because of the fine balance between the maternal benefits from early delivery and the risks for prematurity. It remains challenging to define prognostic markers to identify women at highest risk for complications, in which case a selective, planned delivery may reduce the adverse maternal and perinatal outcomes. OBJECTIVE: This trial aimed to determine whether using an algorithm based on the maternal levels of placental growth factor in women with late preterm preeclampsia to evaluate the best time for delivery reduced the progression to preeclampsia with severe features without increasing the adverse perinatal outcomes. STUDY DESIGN: This parallel-group, open-label, multicenter, randomized controlled trial was conducted at 7 maternity units across Spain. We compared selective planned deliveries based on maternal levels of placental growth factor at admission (revealed group) and expectant management under usual care (concealed group) with individual randomization in singleton pregnancies with late preterm preeclampsia from 34 to 36+6 weeks' gestation. The coprimary maternal outcome was the progression to preeclampsia with severe features. The coprimary neonatal outcome was morbidity at infant hospital discharge with a noninferiority hypothesis (noninferiority margin of 10% difference in incidence). Analyses were conducted according to intention-to-treat. RESULTS: Between January 1, 2016, and December 31, 2019, 178 women were recruited. Of those women, 88 were assigned to the revealed group and 90 were assigned to the concealed group. The data analysis was performed before the completion of the required sample size. The proportion of women with progression to preeclampsia with severe features was significantly lower in the revealed group than in the concealed group (adjusted relative risk, 0.5; 95% confidence interval, 0.33-0.76; P=.001). The proportion of infants with neonatal morbidity was not significantly different between groups (adjusted relative risk, 0.77; 95% confidence interval, 0.39-1.53; P=.45). CONCLUSION: There is evidence to suggest that the use of an algorithm based on placental growth factor levels in women with late preterm preeclampsia leads to a lower rate of progression to preeclampsia with severe features and reduces maternal complications without worsening the neonatal outcomes. This trade-off should be discussed with women with late preterm preeclampsia to allow shared decision making about the timing of delivery.

The Impact of Cooperative Learning on University Students' Academic Goals.

Cooperative learning encourages the development of interpersonal skills and motivates students to participate more actively in the teaching and learning process. This study explores the impact of cooperative learning on the academic goals influencing university students' behavior and leading to the attainment of a series of academic objectives. To this end, a quasi-experimental pretest-posttest control group design was used, with a sample of 509 university students from Preschool, Primary and Social Education undergraduate degree courses. Using the Academic Goals Questionnaire (AGQ), pretest and posttest measures were taken via self-reports to evaluate three types of academic goals: learning goals, social reinforcement goals and achievement goals. The results show that cooperative learning is an effective tool for encouraging university students to develop academic goals that motivate them to fully engage with the tasks they are set in order to acquire knowledge and skills (learning goals). In addition, when students are asked to work as part of a team on an autonomous basis without the structure and supervision necessary to ensure a minimum standard of cooperation, they display a greater tendency toward social reinforcement goals than toward learning and achievement goals. These findings contribute new knowledge to the conceptual framework on cooperative learning. Goals may be considered one of the most important variables influencing students' learning and the use of cooperative learning techniques in university classrooms creates the necessary conditions for encouraging students to develop goals oriented toward learning.