Parental Stress in Families with Children with Early Intervention Needs linked to Socio-Environmental Vulnerability / Estrés Parental en Familias con Niños/as de Necesidades de Atención Temprana ligadas a Vulnerabilidad Socioambiental

Background and objective: Environmental risk factors are associated with a lower capacity to cope with parenting, generating greater stress in the education of children. When faced with social risk factors, mothers of children with special educational needs tend to be more vulnerable to stress. The main aim of this study was to analyse variables associated to the stress perceived by parents of children with early care needs (socio-environmental vulnerability and child’s diagnosis). Method. Four hundred and six parents (233 mothers and 173 fathers) of 239 children with early care (EC) and education needs collaborated in this research. Results. Situations of environmental vulnerability caused high levels of stress in the parents. The experience of stressful events during pregnancy conditioned the later maternal anxiety. A significant positive linear correlation was found between the results achieved in the Overprotective educational style and parental stress. Conclusions. Most interventions in Early Childhood Care and Development Centres focus on the needs of children, leaving parents out of the clinical intervention. This approach should be shifting towards a family-centred model, which will work more effectively and improve the quality of life of the family.(AU)

Antecedentes y objetivos: Factores de riesgo ambiental son asociados a una menor capacidad para afrontar la crianza, generando en la educación de los hijos/as un mayor estrés. Sumidos en factores de riesgo social, las madres de niños/as con necesidades educativas especiales tienden a mostrarse más vulnerables ante el estrés. El objetivo principal de este estudio fue analizar las variables asociadas al estrés percibido por los progenitores de niños/as con necesidades de atención temprana (vulnerabilidad socio-ambiental y diagnóstico del niño). Método. Cuatrocientos seis progenitores (233 madres y 173 padres) de 239 de niños/as con necesidades de Atención Temprana (AT) colaboraron en esta investigación. Resultados. Situaciones de vulnerabilidad ambiental provocaron en las progenitoras elevados niveles de estrés. La vivencia de acontecimientos estresantes durante el embarazo, condicionó la ansiedad materna posterior. Se halló una correlación lineal positiva significativa entre los resultados alcanzados en el estilo educativo Sobreprotector y el Estrés parental. Conclusiones. La mayoría de las intervenciones en los Centros de Atención Temprana y Desarrollo Infantil se centran en las necesidades de los niños, dejando a los padres fuera de la intervención clínica. Este enfoque debería cambiar hacia un modelo centrado en la familia, que funcionará más eficazmente y mejorará la calidad de vida de la familia.(AU)

The initial age-associated decline in early T-cell progenitors reflects fewer pre-thymic progenitors and altered signals in the bone marrow and thymus microenvironments.

Age-related thymus involution results in decreased T-cell production, contributing to increased susceptibility to pathogens and reduced vaccine responsiveness. Elucidating mechanisms underlying thymus involution will inform strategies to restore thymopoiesis with age. The thymus is colonized by circulating bone marrow (BM)-derived thymus seeding progenitors (TSPs) that differentiate into early T-cell progenitors (ETPs). We find that ETP cellularity declines as early as 3 months (3MO) of age in mice. This initial ETP reduction could reflect changes in thymic stromal niches and/or pre-thymic progenitors. Using a multicongenic progenitor transfer approach, we demonstrate that the number of functional TSP/ETP niches does not diminish with age. Instead, the number of pre-thymic lymphoid progenitors in the BM and blood is substantially reduced by 3MO, although their intrinsic ability to seed and differentiate in the thymus is maintained. Additionally, Notch signaling in BM lymphoid progenitors and in ETPs diminishes by 3MO, suggesting reduced niche quality in the BM and thymus contribute to the early decline in ETPs. Together, these findings indicate that diminished BM lymphopoiesis and thymic stromal support contribute to an initial reduction in ETPs in young adulthood, setting the stage for progressive age-associated thymus involution.

Dimeric p53 Mutant Elicits Unique Tumor-Suppressive Activities through an Altered Metabolic Program.

Cancer-related alterations of the p53 tetramerization domain (TD) abrogate wild-type (WT) p53 function. They result in a protein that preferentially forms monomers or dimers, which are also normal p53 states under basal cellular conditions. However, their physiologic relevance is not well understood. We have established in vivo models for monomeric and dimeric p53, which model Li-Fraumeni syndrome patients with germline p53 TD alterations. p53 monomers are inactive forms of the protein. Unexpectedly, p53 dimers conferred some tumor suppression that is not mediated by canonical WT p53 activities. p53 dimers upregulate the PPAR pathway. These activities are associated with lower prevalence of thymic lymphomas and increased CD8+ T-cell differentiation. Lymphomas derived from dimeric p53 mice show cooperating alterations in the PPAR pathway, further implicating a role for these activities in tumor suppression. Our data reveal novel functions for p53 dimers and support the exploration of PPAR agonists as therapies. SIGNIFICANCE: New mouse models with TP53R342P (monomer) or TP53A347D (dimer) mutations mimic Li-Fraumeni syndrome. Although p53 monomers lack function, p53 dimers conferred noncanonical tumor-suppressive activities. We describe novel activities for p53 dimers facilitated by PPARs and propose these are "basal" p53 activities. See related commentary by Stieg et al., p. 1046. See related article by Choe et al., p. 1250. This article is highlighted in the In This Issue feature, p. 1027.

Cribado de cáncer de pulmón: Supervivencia en un amplio programa de detección precoz en España (I-ELCAP) / Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP)

Introducción y objetivo: El cáncer de pulmón (CP) se diagnostica habitualmente en estadios avanzados con una supervivencia media a cinco años del 12%. Ensayos como el National Lung Screening Trial (NLST) y el NEderlands Leuvens longkanker Screenings ONderzoek (NELSON) demuestran una reducción de la mortalidad que justifican la implantación del cribado en población de riesgo. Nuestro objetivo es presentar los resultados de supervivencia del programa de cribado de CP más amplio de España con tomografía computarizada de baja dosis (TCBD). Métodos: Se analizaron los datos del programa Internacional de Detección Precoz de CP (IELCAP) en Valencia, España. Este programa reclutó fumadores o exfumadores con una edad entre 40- 80 años. Se comparan los resultados con otros programas de similar tamaño. Resultados: Un total de 8.278 participantes fueron reclutados con al menos dos rondas de seguimiento, hasta noviembre de 2020 (62,8% varones), realizando una media de seis rondas de cribado por individuo. Diagnosticamos 239 tumores en 12 años de seguimiento. El adenocarcinoma fue el tumor más frecuente con un 61,3% en estadio I. Las tasas de prevalencia e incidencia fueron de 1,5% y 1,4%, respectivamente, con una tasa de detección anual de 0,17. Las tasas de supervivencia cáncer específica a cinco años fueron del 90 y del 80,1% a 10 años. La adherencia fue de 96,84%. Conclusión: La experiencia del programa más amplio de España demuestra que la supervivencia se mejora cuando se realiza en equipos multidisciplinares con experiencia en CP y es similar a programas similares. (AU)

Introduction: Lung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT). Methods: Clinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs. Results: A total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%. Conclusion: Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs. (AU)

[Translated article] Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP) / Cribado de cáncer de pulmón: supervivencia en un amplio programa de detección precoz en España (I-ELCAP)

Introduction: Lung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT). Methods: Clinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs. Results: A total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%. Conclusion: Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs. (AU)

Introducción y objetivo: El cáncer de pulmón (CP) se diagnostica habitualmente en estadios avanzados con una supervivencia media a cinco años del 12%. Ensayos como el National Lung Screening Trial (NLST) y el NEderlands Leuvens longkanker Screenings ONderzoek (NELSON) demuestran una reducción de la mortalidad que justifican la implantación del cribado en población de riesgo. Nuestro objetivo es presentar los resultados de supervivencia del programa de cribado de CP más amplio de España con tomografía computarizada de baja dosis (TCBD). Métodos: Se analizaron los datos del programa Internacional de Detección Precoz de CP (IELCAP) en Valencia, España. Este programa reclutó fumadores o exfumadores con una edad entre 40- 80 años. Se comparan los resultados con otros programas de similar tamaño. Resultados: Un total de 8.278 participantes fueron reclutados con al menos dos rondas de seguimiento, hasta noviembre de 2020 (62,8% varones), realizando una media de seis rondas de cribado por individuo. Diagnosticamos 239 tumores en 12 años de seguimiento. El adenocarcinoma fue el tumor más frecuente con un 61,3% en estadio I. Las tasas de prevalencia e incidencia fueron de 1,5% y 1,4%, respectivamente, con una tasa de detección anual de 0,17. Las tasas de supervivencia cáncer específica a cinco años fueron del 90 y del 80,1% a 10 años. La adherencia fue de 96,84%. Conclusión: La experiencia del programa más amplio de España demuestra que la supervivencia se mejora cuando se realiza en equipos multidisciplinares con experiencia en CP y es similar a programas similares. (AU)

Lung Cancer Screening: Survival in an Extensive Early Detection Program in Spain (I-ELCAP). / Cribado de cáncer de pulmón: Supervivencia en un amplio programa de detección precoz en España (I-ELCAP).

INTRODUCTION: Lung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT). METHODS: Clinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs. RESULTS: A total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%. CONCLUSION: Largest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs.

Linguistic Competence in Early Childhood Education as a Predictor of Verbal Naming Speed.

BACKGROUND: This study determined the predictive value of linguistic competence in children in Early Childhood Education for verbal naming speed. METHOD: The participants were 86 pupils in the second Early Childhood Education cycle. They were evaluated with WPPSI-IV Wechsler Preschool & Primary Scale of Intelligence (Verbal Comprehension, VC) and Vocabulary Acquisition, VA; Childish Vocabulary Test (Vavel) and the Rapid and Automatic Naming Test. RESULTS: Children who had high scores in the Verbal Comprehension Index and Vocabulary Acquisition spent less time doing the verbal naming task. Linguistic competence predicted verbal naming speed, with Vavel having the strongest correlation. CONCLUSIONS: Linguistic competence of children in Early Childhood Education allows us to predict their aptitude for verbal naming. Lexical-semantic knowledge was linguistic competence dimension with the highest predictive value for the Verbal Naming Task. Automatic Naming and Verbal Comprehension depend on the same cerebral area, Wernicke's area.

Linguistic Competence in Early Childhood Education as a Predictor of Verbal Naming Speed / La Competencia Lingüística en Educación Infantil Como Predictor de la Velocidad de Denominación Verbal

Background: This study determined the predictive value of linguistic competence in children in Early Childhood Education for verbal naming speed. Method: The participants were 86 pupils in the second Early Childhood Education cycle. They were evaluated with WPPSI-IV Wechsler Preschool & Primary Scale of Intelligence (Verbal Comprehension, VC) and Vocabulary Acquisition, VA; Childish Vocabulary Test (Vavel) and the Rapid and Automatic Naming Test. Results: Children who had high scores in the Verbal Comprehension Index and Vocabulary Acquisition spent less time doing the verbal naming task. Linguistic competence predicted verbal naming speed, with Vavel having the strongest correlation. Conclusions: Linguistic competence of children in Early Childhood Education allows us to predict their aptitude for verbal naming. Lexical-semantic knowledge was linguistic competence dimension with the highest predictive value for the Verbal Naming Task. Automatic Naming and Verbal Comprehension depend on the same cerebral area, Wernicke’s area. (AU)

Antecedentes: el presente estudio determinó el valor predictivo de la competencia lingüística de niños/as de Educación Infantil en la velocidad de denominación verbal. Método: participaron 86 alumnos de segundo ciclo de Educación Infantil, quienes fueron evaluados con los Índices de Comprensión Verbal (ICV) y Adquisición de Vocabulario (AV) de WPPSI-IV; Vavel Infantil y el Test de Denominación Verbal (TDV). Resultados: alumnos/as que obtuvieron una puntuación elevada en el ICV y en AV precisaron de menos tiempo en el TDV. La competencia lingüística predijo la velocidad de denominación, siendo Vavel Infantil la tarea que obtuvo una mayor correlación. Conclusiones: la competencia lingüística de niños/as de Educación Infantil permite predecir su aptitud para denominación verbal. El conocimiento léxico-semántico fue la dimensión de competencia lingüística con mayor valor predictivo para el TDV. Las tareas propuestas dependen de la misma base anatómica. Las tareas de denominación y comprensión léxica están ligadas al lóbulo temporal y, más concretamente, al área de Wernicke. (AU)

Diagnóstico precoz del cáncer de pulmón: utilidad de la tomografía computarizada de baja dosis de radiación / Lung Cancer Screening: Use of Low-Dose Computed Tomography

Introducción: El pronóstico del cáncer de pulmón (CP) está relacionado directamente con el estadio de la enfermedad al diagnóstico. Material y métodos: Realizamos TC de baja dosis (TCBD) a personas asintomáticas ≥ 50 años, fumadores o exfumadores de ≥ 10 paquetes-año, sin antecedentes oncológicos. Seguimos un algoritmo de evaluación según el tamaño y la morfología de los nódulos. En los CP diagnosticados se estableció el tratamiento adecuado y el seguimiento fue de 5 años. Resultados: Estudiamos 4.951 personas (65,4% varones) con una media de edad de 56,89 ± 5,26 años; 550 presentaron nódulos. De 3.891 nódulos detectados, 692 (19,57%) fueron considerados positivos, hallando 38 tumores (36 CP). En el estudio anual, 224 sujetos mostraban algún nódulo, siendo 288 (7,91%) positivos (13 CP). En el 80% el control se realizó con TCBD y se indicó biopsia en el 5,8% (basal) y 7,6% (anual) de los nódulos positivos. La prevalencia fue del 0,89 y la incidencia del 0,1%. La sensibilidad, la especificidad, el VPP y el VPN en el estudio basal fueron del 92,31, del 89,54, del 6,55 y del 99,93%, respectivamente, y en el anual, del 76,92, del 95,7, del 4,52 y del 99,94%, respectivamente. Se detectaron 52 tumores (49 CP), 25 (52,08%) en estadio I. La supervivencia global de los CP fue del 58,5% a los 5 años, y la supervivencia cáncer específica, del 67,1% (75,8% en los pacientes quirúrgicos). Conclusiones: La TCBD integrada en un programa elaborado de detección y evaluación de nódulos es una herramienta útil para diagnosticar CP en estadio precoz

Introduction: The prognosis of lung cancer (LC) correlates directly with the stage of the disease at the time of diagnosis. Material and methods: We performed low-dose CT (LDCT) in asymptomatic individuals ≥ 50 years old, smokers or former smokers of ≥ 10 pack-years, with no history of cancer. We followed an evaluation algorithm, according to the size and morphology of the nodules. The appropriate treatment for the LC diagnosis was given and patients were followed up for 5 years. Results: We studied 4,951 individuals (65.4% males) with an average age of 56.89 ± 5.26 years; 550 presented nodules. Of the 3,891 nodules detected, 692 (19.57%) were considered positive, and 38 tumors (36 LC) were identified. In the annual follow-up, nodules were found in 224 subjects, 288 (7.91%) of which were positive (13 LC). In 80%, the study was performed with LDCT, and biopsy was indicated in 5.8% (baseline) and in 7.6% (annual) of the positive nodules. Prevalence was 0.89 and incidence was 0.1%. The sensitivity, specificity, PPV and NPV in the baseline study were 92.31, 89.54, 6.55 and 99.93%, respectively, and in the annual study, they were 76.92, 95.7, 4.52 and 99.94%, respectively. A total of 52 tumors were detected (49 LC), 25 (52.08%) in stage I. The 5-year overall survival rate for LC was 58.5% and cancer-specific survival was 67.1% (75.8% in surgical patients). Conclusion: LDCT integrated into an elaborate nodule detection and evaluation program is a useful tool for diagnosing early-stage LC

Lung Cancer Screening: Use of Low-Dose Computed Tomography. / Diagnóstico precoz del cáncer de pulmón: utilidad de la tomografía computarizada de baja dosis de radiación.

INTRODUCTION: The prognosis of lung cancer (LC) correlates directly with the stage of the disease at the time of diagnosis. MATERIAL AND METHODS: We performed low-dose CT (LDCT) in asymptomatic individuals ≥50years old, smokers or former smokers of ≥10 pack-years, with no history of cancer. We followed an evaluation algorithm, according to the size and morphology of the nodules. The appropriate treatment for the LC diagnosis was given and patients were followed up for 5years. RESULTS: We studied 4,951 individuals (65.4% males) with an average age of 56.89±5.26years; 550 presented nodules. Of the 3,891 nodules detected, 692 (19.57%) were considered positive, and 38 tumors (36LC) were identified. In the annual follow-up, nodules were found in 224 subjects, 288 (7.91%) of which were positive (13LC). In 80%, the study was performed with LDCT, and biopsy was indicated in 5.8% (baseline) and in 7.6% (annual) of the positive nodules. Prevalence was 0.89 and incidence was 0.1%. The sensitivity, specificity, PPV and NPV in the baseline study were 92.31, 89.54, 6.55 and 99.93%, respectively, and in the annual study, they were 76.92, 95.7, 4.52 and 99.94%, respectively. A total of 52 tumors were detected (49LC), 25 (52.08%) in stageI. The 5-year overall survival rate for LC was 58.5% and cancer-specific survival was 67.1% (75.8% in surgical patients). CONCLUSION: LDCT integrated into an elaborate nodule detection and evaluation program is a useful tool for diagnosing early-stage LC.

Prácticas de Atención Temprana en el sureste de España: perspectiva de profesionales y familias / Early Childhood Intervention practices in the southeast of Spain: professionals and families perspective

Actualmente en España estamos viviendo un proceso de transformación en Atención Temprana hacia un modelo centrado en la familia. Ésta empieza a cobrar un especial protagonismo como eje fundamental de la intervención, participando activamente en el proceso educativo y rehabilitador del niño. La evidencia científica señala que la adecuada interacción del profesional con la familia, a través de la implementación de prácticas relacionales y participativas, es fundamental para el éxito de la intervención. Por ello, resulta interesante conocer cómo se realizan esas interacciones y cómo son percibidas por los dos agentes. Se aplicó el cuestionario de Estilos de Interacción entre Padres y Profesionales en Atención Temprana (EIPPAT) (Escorcia, García-Sánchez, Sánchez-López & Hernández-Pérez, 2016) para analizar las estrategias y estilos de interacción de los profesionales con las familias. El cuestionario fue cumplimentado por 504 familias y 187 profesionales. Los resultados demuestran que los profesionales españoles desarrollan más prácticas relacionales y menos prácticas participativas con las familias. Sin embargo, creen que hacen más prácticas participativas de las que las familias realmente reciben, según la percepción de estas familias. Se concluye sobre la necesidad de mejorar la formación del profesional en las implicaciones de las prácticas centradas en la familia en Atención Temprana

Currently in Spain we are living a process of transformation in Early childhood intervention towards a model centred on the family. This model begins to take on a special role as the fundamental axis of the intervention, participating actively in the educational and rehabilitation process of the child. Scientific evidence shows that suitable interaction of professionals with the family, through the implementation of relational and participatory practices, is fundamental for the success of the intervention. Therefore, it is crucial to know how these interactions are carried out and how they are perceived by them. The Styles Questionnaire of Interaction between Parents and Professionals in Early Intervention (SIPPEI) (Escorcia-Mora, García-Sánchez, Sánchez-López & Hernández-Pérez, 2016) was applied in order to analyze the strategies and styles of interaction of professionals with families. The questionnaire was completed by 504 families and 187 professionals. The results obtained show that Spanish professionals develop more relational practices and less participatory practices with families. However, professionals believe that they do more participatory practices than families actually receive, from the perception of these families. This leads us to conclude, about the need to improve professional training about the implications of family-centred practices in Early Intervention

Murine cytomegalovirus M72 promotes acute virus replication in vivo and is a substrate of the TRiC/CCT complex.

Betaherpesvirus dUTPase homologs are core herpesvirus proteins, but little is known about their role during infection. Human cytomegalovirus (HCMV) UL72 and murine cytomegalovirus (MCMV) M72 have been designated dUTPase homologs, and previous studies indicate UL72 is dispensable for replication and enzymatically inactive. Here, we report the initial characterization of MCMV M72. M72 does not possess dUTPase activity, and is expressed as a leaky-late gene product with multiple protein isoforms. Importantly, M72 augments MCMV replication in vitro and during the early stage of acute infection in vivo. We identify and confirm interaction of M72 with the eukaryotic chaperonin tailless complex protein -1 (TCP-1) ring complex (TRiC) or chaperonin containing tailless complex polypeptide 1 (CCT). Accumulating biochemical evidence indicates M72 forms homo-oligomers and is a substrate of TRiC/CCT. Taken together, we provide the first evidence of M72's contribution to viral pathogenesis, and identify a novel interaction with the TRiC/CCT complex.

Ortogeriatría: primer registro multicéntrico autonómico de fracturas de cadera en Castilla y León (España) / Orthogeriatrics: The First multicentre regional register of hip fractures in Castilla y León (Spain)

Objetivo: El objetivo de este trabajo es describir las características de los pacientes con fractura de cadera en los hospitales públicos de Castilla y León recogidos durante un periodo de tiempo de 3 meses (noviembre del 2014 y octubre y noviembre del 2015). Material y método: El grupo de trabajo de Ortogeriatría de Castilla y León elabora un registro común para recoger datos de las fracturas de cadera. Se incluyen mayores de 74 años ingresados por fractura de cadera, en 13 hospitales públicos de la comunidad, los meses de noviembre del 2014 y octubre-noviembre del 2015. Es un estudio multicéntrico, prospectivo y observacional en el que se recogieron variables clínicas, funcionales, sociales y mortalidad intrahospitalaria. Resultados: Se analizaron 776 pacientes, con una edad media de 86,6±6 años. La demora quirúrgica fue de 4±2,8 días y la estancia media hospitalaria de 10±4,7 días. El riesgo anestésico fue ASA 3±0,6. El 66,5% de los pacientes tuvieron complicaciones médicas intrahospitalarias y precisaron transfusión el 55,5%. Fallecieron durante la hospitalización un 4,6%. La estancia media prequirúrgica se relacionó con la estancia global, con p<0,001. Conclusiones: Los registros de fractura de cadera son una herramienta esencial para evaluar el proceso y mejorar la calidad asistencial de estos pacientes. Este es el primer registro multicéntrico de fracturas de cadera en ancianos realizado en una región de España y puede ser un buen precedente de referencia ante el futuro registro nacional (AU)

Objective: The objective of this study is to describe the characteristics of the patients with hip fracture admitted to the Public Hospitals of Castilla y León during three monthly periods (November 2014, and October and November 2015). Material and method: The Castilla y León orthogeriatrics work group created a common register to collect data on hip fractures. The study included patients 75 years-old and over hospitalised with hip fractures in the 13 public hospitals in the community during November 2014, and October and November 2015. A multicentre, prospective, and observational study was conducted, in which clinical, functional, and social variables, as well as in-hospital mortality, were collected. Results: The analysis included data from a total of 776 patients with a mean age of 86 (±6) years. The surgical delay was 4±2.8 days, and the mean hospital stay was 10±4.7 days. The anaesthesia risk was ASA 3±0.6. Around two-thirds (66.5%) of the patients had medical complications while in hospital, and 55.5% required a transfusion. In-hospital mortality was 4.6%. The mean pre-surgical stay was related to the overall stay: P<.001. Conclusions: Hip fracture registers are an essential tool for evaluating the process and for improving the treatment quality of these patients. This is the first multicentre register of hip fracture in the elderly created in a Spanish region, and could be a good precedent reference for a future national register (AU)

The HIDEA School-Based Screening Scale for Teachers to Detect ADHD Markers in Elementary Students / Escala HIDEA de cribado escolar orientada al profesorado para detectar marcadores TDAH en Primaria

Background: Attention-deficit/hyperactivity disorder (ADHD) is associated with academic difficulties both short- and long-term. The aim of the study was to provide a new brief ADHD screening scale that could be easily used by teachers and educational professionals in elementary schools. Method: Participants were teachers of 158 children with a prior diagnosis of ADHD and 169 children without a diagnosis of ADHD. An initial pool of 38 items was generated from ADHD symptoms of both DSM-5 and CIE-10 criteria, as well from Conners 3, EDAH, SDQ and ADHD-RS-IV scales. Results: A 5-item model showed the best fit (c2 = 7.04; d.f. = 5; p = .218; RMSEA = .035; CFI = .999; TLI = .999). The HIDEA total score was highly correlated with both ADHD-IN (r = .93; p<.001) and ADHD-HY (r = .87; p<.001). The ROC curve for the HIDEA total score gave an AUC value of .998 (95%, CI = [.994, 1.000]). HIDEA scale showed a good sensitivity (97%) and very good specificity (3%). Conclusion: The HIDEA scale has shown adequate psychometric properties. It is potentially useful for screening ADHD in elementary grade as part of a preventive strategies in school settings (AU)

Introducción: el trastorno por déficit de atención e hiperactividad (TDAH) está asociado a dificultades académicas tanto a corto como a largo plazo. El objetivo de este estudio fue desarrollar una escala breve de cribado del TDAH de sencillo manejo para profesorado y profesionales de Educación Primaria. Método: los participantes fueron educadores/as de 158 niños/as con un diagnóstico previo de TDAH, y 169 sin diagnóstico TDAH. Se generó un pool inicial de 38 ítems a partir del DSM-5 y CIE-10, así como de las escalas Conners 3, EDAH, SDQ y ADHD-RS-IV. Resultados: el modelo de 5-ítems mostró el mejor ajuste (c2 = 7.04; d.f. = 5; p = .218; RMSEA = .035; CFI = .999; TLI = .999). La puntuación en la escala HIDEA correlacionaba de manera elevada tanto con la «inatención» (r = .93; p<.001) como con la «hiperactividad/impulsividad» (r = .87; p<.001). La curva ROC obtuvo un AUC de .998 (95%, CI = [.994, 1.000]). HIDEA mostró buena sensibilidad (97%) y buena especificidad (3%). Conclusión: la escala HIDEA ha mostrado unas propiedades psicométricas adecuadas, mostrando ser una herramienta de cribado clínico para el TDAH en Primaria, potencialmente útil en estrategias preventivas aplicables en la escuela (AU)

The HIDEA School-Based Screening Scale for Teachers to Detect ADHD Markers in Elementary Students.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is associated with academic difficulties both short- and long-term. The aim of the study was to provide a new brief ADHD screening scale that could be easily used by teachers and educational professionals in elementary schools. METHOD: Participants were teachers of 158 children with a prior diagnosis of ADHD and 169 children without a diagnosis of ADHD. An initial pool of 38 items was generated from ADHD symptoms of both DSM-5 and CIE-10 criteria, as well from Conners 3, EDAH, SDQ and ADHD-RS-IV scales. RESULTS: A 5-item model showed the best fit (c2 = 7.04; d.f. = 5; p = .218; RMSEA = .035; CFI = .999; TLI = .999). The HIDEA total score was highly correlated with both ADHD-IN (r = .93; p<.001) and ADHD-HY (r = .87; p<.001). The ROC curve for the HIDEA total score gave an AUC value of .998 (95%, CI = [.994, 1.000]). HIDEA scale showed a good sensitivity (97%) and very good specificity (3%). CONCLUSION: The HIDEA scale has shown adequate psychometric properties. It is potentially useful for screening ADHD in elementary grade as part of a preventive strategies in school settings.

[Orthogeriatrics: The First multicentre regional register of hip fractures in Castilla y León (Spain)]. / Ortogeriatría: primer registro multicéntrico autonómico de fracturas de cadera en Castilla y León (España).

OBJECTIVE: The objective of this study is to describe the characteristics of the patients with hip fracture admitted to the Public Hospitals of Castilla y León during three monthly periods (November 2014, and October and November 2015). MATERIAL AND METHOD: The Castilla y León orthogeriatrics work group created a common register to collect data on hip fractures. The study included patients 75 years-old and over hospitalised with hip fractures in the 13 public hospitals in the community during November 2014, and October and November 2015. A multicentre, prospective, and observational study was conducted, in which clinical, functional, and social variables, as well as in-hospital mortality, were collected. RESULTS: The analysis included data from a total of 776 patients with a mean age of 86 (±6) years. The surgical delay was 4±2.8 days, and the mean hospital stay was 10±4.7 days. The anaesthesia risk was ASA 3±0.6. Around two-thirds (66.5%) of the patients had medical complications while in hospital, and 55.5% required a transfusion. In-hospital mortality was 4.6%. The mean pre-surgical stay was related to the overall stay: P<.001. CONCLUSIONS: Hip fracture registers are an essential tool for evaluating the process and for improving the treatment quality of these patients. This is the first multicentre register of hip fracture in the elderly created in a Spanish region, and could be a good precedent reference for a future national register.

Viral RNA at Two Stages of Reovirus Infection Is Required for the Induction of Necroptosis.

Necroptosis, a regulated form of necrotic cell death, requires the activation of the RIP3 kinase. Here, we identify that infection of host cells with reovirus can result in necroptosis. We find that necroptosis requires sensing of the genomic RNA within incoming virus particles via cytoplasmic RNA sensors to produce type I interferon (IFN). While these events that occur prior to the de novo synthesis of viral RNA are required for the induction of necroptosis, they are not sufficient. The induction of necroptosis also requires late stages of reovirus infection. Specifically, efficient synthesis of double-stranded RNA (dsRNA) within infected cells is required for necroptosis. These data indicate that viral RNA interfaces with host components at two different stages of infection to induce necroptosis. This work provides new molecular details about events in the viral replication cycle that contribute to the induction of necroptosis following infection with an RNA virus.IMPORTANCE An appreciation of how cell death pathways are regulated following viral infection may reveal strategies to limit tissue destruction and prevent the onset of disease. Cell death following virus infection can occur by apoptosis or a regulated form of necrosis known as necroptosis. Apoptotic cells are typically disposed of without activating the immune system. In contrast, necroptotic cells alert the immune system, resulting in inflammation and tissue damage. While apoptosis following virus infection has been extensively investigated, how necroptosis is unleashed following virus infection is understood for only a small group of viruses. Here, using mammalian reovirus, we highlight the molecular mechanism by which infection with a dsRNA virus results in necroptosis.

Differentiation of benign and malignant lung lesions: Dual-Energy Computed Tomography findings.

PURPOSE: To determine whether parameters generated by Dual-Energy Computed Tomography (DECT) can distinguish malignant from benign lung lesions. METHODS: A prospective review of 125 patients with 126 lung lesions (23 benign and 103 malignant) who underwent lung DECT during arterial phase. All lesions were confirmed by tissue sampling. A radiologist semi-automatically contoured lesions and placed regions of interest (ROIs) in paravertebral muscle (PVM) for normalization. Variables related to absorption in Hounsfield units (HU), effective atomic number (Zeff), iodine concentration (ρI) and spectral CT curves were assessed. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity as predictors of malignancy. Multivariate logistic regression analysis was performed. RESULTS: Reproducibility of measures normalized with PVM was poor. Bivariate analysis showed minimum Zeff and normalized mean Zeff to be statistically significant (p=0.001), with area under the curve (AUC) values: 0.66 (CI 95% 0.54-0.80) and 0.72 (CI 95%, 0.60-0.84), respectively. Logistic regression models showed no differences between raw and normalized measurements. In both models, minimum HU (OR: 0.9) and size (OR: 0.1) were predictive of benign lesions. CONCLUSIONS: A quantitative approach to DECT using raw measurements is simpler than logistic regression models. Normalization to PVM was not clinically reliable due to its poor reproducibility. Further studies are needed to confirm our findings.

Styles Questionnaire of Interaction between Parents and Practitioners in early intervention: content validityp / Cuestionario de estilos de interacción entre padres y profesionales en atención temprana: validez de contenido

Nowadays, Early Childhood Intervention in Spain is taking interest in a family-centred approach. In this context, we present the Styles Questionnaire of Interaction between Parents and Practitioners in Early Intervention -known as SIPPEI (EIPPAT). This is a tool to identify actions, practices and interaction styles conducted by the practitioner to guide families (participative and relational practices). This paper shows the items set of the aforementioned Questionnaire -versions for practitioners and caregivers. Formerly, we detailed the hard work and effort invested to ensure content validity, as we had two focus group -consisting of 15 professionals and 11 parents) and a systematized expert judgment by 11 professionals and 5 mothers. Subsequently, an implementation of the questionnaire was developed by a group of 41 practitioners in order to assess the importance given to the items. The results show that the procedure followed to create the questionnaire accomplishes the main objectives. Thus, we got a questionnaire highly regarded by professionals in this area

En un momento en el que, la Atención Temprana en España, está empezando a interesarse por el enfoque centrado en la familia, presentamos el Cuestionario de Estilos de Interacción entre Padres y Profesionales en Atención Temprana (EIPPAT). Un instrumento que permite identificar el grado de implementación de diferentes actuaciones, prácticas y estilos de interacción llevadas a cabo por el profesional de Atención Temprana para orientar a las familias (prácticas relacionales y participativas). El trabajo presenta los ítems del EIPPAT, en sus versiones para profesionales y cuidadores principales del niño. Previo a ello, detalla los esfuerzos realizados para asegurar su validez de contenido: dos grupos focales de discusión (conformados por 15 profesionales y 11 padres/madres), que posibilitasen la construcción inicial del instrumento; un juicio de expertos sistematizado (11 profesionales y 5 madres); y una aplicación del EIPPAT, para la valoración de la importancia otorgada a sus ítems, por un grupo de 41 profesionales en ejercicio. Los resultados evidencian que el procedimiento seguido para la elaboración del instrumento cubre sus objetivos, disponiendo de un cuestionario altamente valorado por los profesionales en las dimensiones que evalúa

Actividad ortogeriátrica en los hospitales públicos de Castilla y León: descripción y revisión de la literatura / Orthogeriatric activity in public hospitals of Castilla y León: Description and review of the literature

El beneficio de la colaboración entre traumatología y geriatría en la atención del anciano que ingresa por fractura de cadera está ampliamente demostrado. Para conocer las características de colaboración entre Traumatología y Geriatría en los hospitales públicos de Castilla y León se realizó una encuesta a todos los geriatras de la comunidad, interrogándoles sobre el tipo de colaboración que mantenían con Traumatología para la atención del anciano que ingresa con fractura de cadera y detalles sobre el tratamiento de las complicaciones. Los resultados más relevantes fueron que la mayoría de los hospitales mantienen una colaboración ortogeriátrica con alto grado de implicación por parte de Geriatría y el geriatra atiende las complicaciones médicas de estos pacientes. La estancia media hospitalaria es de 10 d y la estancia prequirúrgica de 3 d. En este artículo se detallan cómo se manejan los problemas clínicos más frecuentes en nuestra comunidad, comparándolo con las recomendaciones actuales de las guías de práctica clínica y de las últimas publicaciones (AU)

The benefits of the collaboration between orthopaedics and geriatrics in the management and care of elderly patients admitted with hip fracture have been widely demonstrated. A questionnaire was sent to all hospital geriatricians of Castilla y León in order to determine the characteristics this collaboration between orthopaedics and geriatrics in the public hospitals of Castilla y León. They were asked about the type of collaboration with orthopaedics in the care of the elderly patient admitted with hip fracture and details of the treatment of the complications. Most of the hospitals maintain a high level of orthogeriatric collaboration with geriatricians, and the geriatrician attends to most of the medical complications of these patients. The average hospital stay is 10 days, with a surgical delay of 3 days. Management of the most frequent clinical problems in hospitals of Castilla y León are detailed in this article, comparing them with the latest articles and current recommendations from clinical practice guides (AU)