Reliability, Knowledge Translation, and Implementability of the Spanish Version of the Hammersmith Infant Neurological Examination.

Purpose. This study aimed to: (a) translate and cross-culturally adapt the Hammersmith Infant Neurological Examination (HINE) into Spanish; (b) evaluate its intra- and inter-examiner reliability; (c) support a knowledge translation and tool implementation program in early intervention; and (d) evaluate its reliability and implementation for professionals one year after receiving training. Materials and methods. The translation followed the World Health Organization's recommendations. Reliability was assessed in 25 infants aged between 3 and 15 months with identifiable risks of cerebral palsy (CP). The implementation was also evaluated by analyzing the reliability of professionals without previous experience of the tool by using a pre-survey and a follow-up survey one year after training. The survey covered aspects related to the use of early detection tools of CP and the use of HINE, including attitudes, opinions, and perceptions. Results. An excellent intra- and inter-examiner agreement was obtained for the total score of the HINE intra-class correlation coefficient (ICC = 0.98 in both indices). One year after training, the professionals also showed excellent reliability values (ICC = 0.99), as well as an increase in sensitization and skills in evidence-based practices for the early detection of "high risk" of CP. Conclusions. The Spanish version of HINE is a reliable measure for the neurological evaluation of "high risk" of CP and can be administered after standardized training and without costs to acquire the evaluation. This allows its accessible and widespread implementation in the clinical context.

Aging: working memory capacity and spatial strategies in a virtual orientation task.

Brain networks involved in working and spatial memory are closely intertwined, outlining a potential relation between these processes, which are also affected in non-pathological aging. Working memory is a pre-requisite for other complex cognitive processes. The main aim of this study is to explore how working memory capacity (WMC) can influence the asymmetrical decline in spatial orientation strategies in an older segment of population compared to young participants. Forty-eight older adults and twelve young students took part in the study. Working memory and spatial memory were assessed using the Change Localization Task and The Boxes Room Task, respectively. In The Boxes Room Task, two different configurations assessed the use of egocentric and allocentric reference frames. Results showed that older adults with better WMC outperformed those with lower WMC in several tasks. Independently of WMC capacity, older participants performed better in the allocentric condition of The Boxes Room. In addition, young participants outscored low WMC older participants, but did not differ from high WMC older adults. Overly, these findings support the important relationship between working memory capacity and spatial orientations abilities. Thus, basic cognitive mechanisms engaged in information processing could inform about other brain processes more complex in nature, like spatial orientation skills.

Digital Health and Community Health Worker Support for Diabetes Management: a Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a digital health intervention plus community health worker (CHW) support on self-monitoring of blood glucose and glycosylated hemoglobin (HbA1c) among adult Medicaid beneficiaries with diabetes. DESIGN: Randomized controlled trial. SETTING: Urban outpatient clinic. PARTICIPANTS: Adult Medicaid beneficiaries living with diabetes and treated with insulin and who had a HbA1c ≥ 9%. INTERVENTION: Participants were randomly assigned to one of three arms. Participants in the usual-care arm received a wireless glucometer if needed. Those in the digital arm received a lottery incentive for daily glucose monitoring. Those in the hybrid arm received the lottery plus support from a CHW if they had low adherence or high blood glucose levels. MAIN MEASURES: The primary outcome was the difference in adherence to daily glucose self-monitoring at 3 months between the hybrid and usual-care arms. The secondary outcome was difference in HbA1c from baseline at 6 months. KEY RESULTS: A total of 150 participants were enrolled in the study. A total of 102 participants (68%) completed the study. At 3 months, glucose self-monitoring rates in the hybrid versus usual-care arms were 0.72 vs 0.65, p = 0.23. At 6 months, change in HbA1c in the hybrid versus usual-care arms was - 0.74% vs - 0.49%, p = 0.69. CONCLUSION: There were no statistically significant differences between the hybrid and usual care in glucose self-monitoring adherence or improvements in HbA1C. TRIAL REGISTRATION: This trial is registered with clinicaltrials.gov identifier: NCT03939793.

Design of a randomized controlled trial of digital health and community health worker support for diabetes management among low-income patients.

BACKGROUND: Insulin-dependent diabetes is a challenging disease to manage and involves complex behaviors, such as self-monitoring of blood glucose. This can be especially challenging in the face of socioeconomic barriers and in the wake of the COVID-19 pandemic. Digital health self-monitoring interventions and community health worker support are promising and complementary best practices for improving diabetes-related health behaviors and outcomes. Yet, these strategies have not been tested in combination. This protocol paper describes the rationale and design of a trial that measures the combined effect of digital health and community health worker support on glucose self-monitoring and glycosylated hemoglobin. METHODS: The study population was uninsured or publicly insured; lived in high-poverty, urban neighborhoods; and had poorly controlled diabetes mellitus with insulin dependence. The study consisted of three arms: usual diabetes care; digital health self-monitoring; or combined digital health and community health worker support. The primary outcome was adherence to blood glucose self-monitoring. The exploratory outcome was change in glycosylated hemoglobin. CONCLUSION: The design of this trial was grounded in social justice and community engagement. The study protocols were designed in collaboration with frontline community health workers, the study aim was explicit about furthering knowledge useful for advancing health equity, and the population was focused on low-income people. This trial will advance knowledge of whether combining digital health and community health worker interventions can improve glucose self-monitoring and diabetes-related outcomes in a high-risk population.

Influencia del docente de Educación Física sobre la confianza, diversión, la motivación y la intención de ser físicamente activo en la adolescencia / Influence of Physical Education teacher on confidence, fun, motivation and intention to be physically active in adolescence / Influência do professor de Educação Física na confiança, diversão, motivação e intenção de ser fisicamente ativo na adolescencia

Según el informe de la OMS del 2018, más del 80% de los adolescentes no practican suficiente actividad física. Las clases de Educación Física deberían de ayudar a solventar este problema. Para ello, en este estudio, se pretende analizar la influencia del docente sobre la confianza, diversión, la motivación y la intención de ser físicamente activo en la adolescencia. En el presente estudio participaron 604 estudiantes entre los 13 y 19 años. Se realizaron análisis estadísticos descriptivos, un análisis de fiabilidad y un modelo de ecuaciones estructurales que explica las relaciones causales entre las variables. Los resultados muestran como el apoyo autonomía predice positivamente la confianza (ß = .56, p<.001), la diversión (ß = .29, p<.001) y la motivación (ß = .10, p<.05); mientras que el control psicológico predice negativamente la confianza (ß = -.17, p<.01), la diversión (ß = -.12, p<.001) y la motivación (ß = -.24, p<.001). La confianza predice positivamente la motivación (ß = .37, p<.01), de la misma manera, la diversión predice la motivación (ß = .74, p<.001), por último, la motivación predice de forma positiva la intención de ser físicamente activo (ß = .62, p<.001). En definitiva, el estudio muestra la influencia y la importancia del profesor de EF y de los procesos motivacionales y emocionales presentes en los adolescentes durante las clases de EF sobre la adopción de unos hábitos de vida activos

According to the WHO report of 2018, more than 80% of adolescents do not practice enough physical activity. Physical education classes should help solve this problem. For this, in this study, we intend to analyze the influence of the teacher on confidence, enjoyment, motivation and the intention of being physically active in adolescence. In the present study, 604 students between the ages of 13 and 19 participated. Descriptive statistical analyzes, a reliability analysis and a structural equation model that explains the causal relationships between the variables were performed. The results show how autonomy support positively predicts confidence (ß = .56, p <.001), enjoyment (ß = .29, p <.001) and motivation (ß = .10, p <.05) ; whereas psychological control predicts negatively confidence (ß = -.17, p <.01), enjoyment (ß = -.12, p <.001) and motivation (ß = -.24, p <.001 ). Confidence positively predicts motivation (ß = .37, p <.01), in the same way, enjoyment predicts motivation (ß = .74, p <.001), finally the motivation positively predicts the intention to be physically active (ß = .62, p <.001). In short, the study shows the influence and importance of the PE teacher and the motivational and emotional processes present in adolescents during PE classes on the adoption of active life habits

Segundo o relatório da OMS de 2018, mais de 80% dos adolescentes não praticam atividade física suficiente. Aulas de educação física devem ajudar a resolver este problema. Para isso, neste estudo, pretendemos analisar a influência do professor sobre a confiança, a diversão, a motivação e a intenção de ser fisicamente ativo na adolescência. No presente estudo, participaram 602 estudantes com idades entre 13 e 19 anos. Análises estatísticas descritivas, uma análise de confiabilidade e um modelo de equações estruturais que explica as relações causais entre as variáveis foram realizadas. Os resultados mostram como o apoio à autonomia prediz positivamente confiança (ß = .56, p <.001), diversão (ß = .29, p <.001) e motivação (ß = .10, p <.05) ; enquanto o controle psicológico prediz confiança negativa (ß = -.17, p <.01), diversão (ß = -.12, p <.001) e motivação (ß = -.24, p <.001 ). A confiança prediz positivamente a motivação (ß = 0,37, p <0,01), da mesma forma, a diversão prediz a motivação (ß = 0,74, p <0,001), enfim, a motivação prediz positivamente a intenção de ser fisicamente ativo (ß = 0,62, p <0,001). Em suma, o estudo mostra a influência e importância do professor de EF e dos processos motivacionais e emocionais presentes nos adolescentes durante as aulas de EF sobre a adoção de hábitos de vida ativos

Escala de reserva cognitiva: ajuste del modelo teórico y baremación / Cognitive Reserve Scale: testing the theoretical model and norms

Introducción. La teoría de la reserva cognitiva contribuiría a explicar las diferencias en el rendimiento intelectual en sujetos con deterioro cognitivo similar y en sujetos sanos. Sin embargo, son necesarios más datos psicométricos que garanticen el uso de los instrumentos de medición de reserva cognitiva. Objetivo. Aportar evidencias de validez respecto a la estructura interna de la escala de reserva cognitiva (ERC) y establecer un baremo de referencia para la interpretación de sus puntuaciones. Sujetos y métodos. Un total de 172 sujetos completaron la ERC y fueron distribuidos en dos grupos en función de la edad: 36-64 años (n = 110) y 65-88 años (n = 62). Resultados. El análisis factorial mediante modelos de ecuaciones estructurales exploratorios indicó un moderado ajuste de los datos al modelo propuesto. En general, los índices de discriminación fueron correctos (entre 0,21 y 0,50), y se registró congruencia entre los ítems a lo largo de los períodos de juventud, adultez y madurez para ambos grupos de edad. Se observaron valores adecuados del índice de fiabilidad (alfa de Cronbach: 0,80) y de los errores típicos de medida (media: 51,40 ± 11,11). Conclusiones. La ERC se enmarcaría dentro del modelo teórico hipotetizado y las puntuaciones podrían interpretarse mediante el baremo ofrecido, lo que avalaría su empleo en la investigación en este campo (AU)

Introduction. The cognitive reserve theory may contribute to explain cognitive performance differences among individuals with similar cognitive decline and among healthy ones. However, more psychometric analysis are needed to guarantee the usage of tests for assessing cognitive reserve. Aims. To study validity evidences in relation to the structure of the Cognitive Reserve Scale (CRS) and to create reference norms to interpret the scores. Subjects and methods. A total of 172 participants completed the scale and they were classified into two age groups: aged 36-64 years (n = 110) and 65-88 years (n = 62). Results. The exploratory factor analysis using ESEM revealed that the data fitted the proposed model. Overall, the discriminative indices were acceptable (between 0.21 and 0.50) and congruence was observed in the periods of young adulthood, adulthood and late adulthood, in both age group. Besides, the index of reliability (Cronbach’s alpha: 0.80) and the typical mean error test (mean: 51.40 ± 11.11) showed adequate values for this type of instrument. Conclusion. The CRS seemed to be set under the hypothetical theoretical model, and the scores might be interpreted by the norms showed. This study provided guarantees for the usage of the CRS in research (AU)

Functional mitral regurgitation after a first non-ST segment elevation acute coronary syndrome: very-long-term follow-up, prognosis and contribution to left ventricular enlargement and atrial fibrillation development.

OBJECTIVE: To assess the relationship between functional mitral regurgitation (MR) after a non-ST segment elevation acute coronary syndrome (NSTSEACS) and long-term prognosis, ventricular remodelling and further development of atrial fibrillation (AF), since functional MR is common after myocardial infarction. DESIGN AND SETTING: Prospective cohort study conducted in a tertiary referral centre. PATIENTS: We prospectively studied 237 patients consecutively discharged in New York Heart Association class I-II (74% men; mean age 66.1 years) after a first NSTSEACS. All underwent an ECG the first week after admission and were echocardiographically and clinically followed-up (median 6.95 years). RESULTS: MR was detected in 95 cases (40.1%) and became an independent risk factor for the development of heart failure (HF) and major adverse cardiovascular events (MACE) (per MR degree, HRHF 1.71, 95% CI 1.138 to 2.588, p=0.01; HRMACE 1.49, 95% CI 1.158 to 1.921, p=0.002). Left ventricular diastolic (grade I 12.7±40.7; grade II 26.8±12.4; grade III 46.3±50.9 mL, p=0.01) and systolic (grade I 10.4±37.3; grade II 10.12±12.7; grade III 36.8±46.0 mL, p=0.02) mean volumes were higher after follow-up in patients with MR, in proportion to the initial degree of MR. In the rhythm analysis (126 patients; previously excluding those with any history of AF) during follow-up, 11.4% of patients with degree I MR, 14.3% with degree II MR and 75% with degree III MR developed AF, while only 5.1% of those with degree 0 developed AF, p<0.001. CONCLUSIONS: MR is common after an NSTSEACS. The presence and greater degree of MR confers a worse long-term prognosis after a first NSTSEACS. This can in part be explained by increased negative ventricular remodelling and increased occurrence of AF.

STIM1 restores coronary endothelial function in type 1 diabetic mice.

RATIONALE: The endoplasmic reticulum (ER) is a major intracellular Ca(2+) store in endothelial cells (ECs). The Ca(2+) concentration in the ER greatly contributes to the generation of Ca(2+) signals that regulate endothelial functions. Many proteins, including stromal interaction molecule 1/2 (STIM1/2), Orai1/2/3, and sarcoplasmic/endoplasmic reticulum Ca(2+)-ATPase 3 (SERCA3), are involved in the ER Ca(2+) refilling after store depletion in ECs. OBJECTIVE: This study is designed to examine the role of Ca(2+) in the ER in coronary endothelial dysfunction in diabetes. METHODS AND RESULTS: Mouse coronary ECs (MCECs) isolated from diabetic mice exhibited (1) a significant decrease in the Ca(2+) mobilization from the ER when the cells were treated by SERCA inhibitor, and (2) significant downregulation of STIM1 and SERCA3 protein expression in comparison to the controls. Overexpression of STIM1 restored (1) the increase in cytosolic Ca(2+) concentration due to Ca(2+) leak from the ER in diabetic MCECs, (2) the Ca(2+) concentration in the ER, and (3) endothelium-dependent relaxation that was attenuated in diabetic coronary arteries. CONCLUSIONS: Impaired ER Ca(2+) refilling in diabetic MCECs, due to the decrease in STIM1 protein expression, attenuates endothelium-dependent relaxation in diabetic coronary arteries, while STIM1 overexpression has a beneficial and therapeutic effect on coronary endothelial dysfunction in diabetes.

A web server for automatic analysis and extraction of relevant biological knowledge.

MOTIVATION: This application aims at assisting researchers with the extraction of significant medical and biological knowledge from data sets with complex relationships among their variables. RESULTS: Non-hypothesis-driven approaches like Principal Curves of Oriented Points (PCOP) are a very suitable method for this objective. PCOP allows for obtaining of a representative pattern from a huge quantity of data of independent variables in a very flexible and direct way. A web server has been designed to automatically realize 'non-linear pattern' analysis, 'hidden-variable-dependent' clustering, and new samples 'local-dispersion-dependent' classification from the data involving new statistical techniques using the PCOP calculus. The tools facilitate the managing, comparison and visualization of results in a user-friendly graphical interface. AVAILABILITY: http://ibb.uab.es/revresearch.