The emotion of gratitude as a mediator between subjective happiness, positive and negative affect and satisfaction with life in Spanish adults / La emoción de gratitud como mediadora entre la felicidad subjetiva, el afecto positivo y negativo y la satisfacción con la vida en adultos españoles

El presente estudio investigó si la satisfacción con la vida se predice a partir de la felicidad subjetiva, afectos positivos y negativos, alteración psicológica y emociones de gratitud y si la emoción de gratitud está mediando la relación con la felicidad subjetiva, los afectos y la satisfacción con la vida. Se hicieron correlación de Pearson, pruebas de regresión lineal múltiple y modelos de mediación en una muestra de 1537 adultos españoles, 73.6% mujeres y 26.4% hombres, edad 18-88 años (M = 42.56 años; DT = 16.29). Se halló que las emociones de gratitud median la relación entre felicidad subjetiva y satisfacción con la vida y entre los afectos positivos y la satisfacción con la vida. Los afectos positivos son los que más se relacionan con la satisfacción con la vida, seguidos por la felicidad subjetiva y las emociones de gratitud. Los hombres están más satisfechos con la vida cuando sienten menos afecto negativo. Además, las emociones de gratitud median la relación entre felicidad subjetiva y satisfacción con la vida y entre los afectos positivos y la satisfacción con la vida. La diferencia principal radica en que las emociones de gratitud son más fuertes en las mujeres que en los hombres.(AU)

This study aims to examine the predictability of satisfaction with life on the basis of subjective happiness, positive and negative affect, psy-chological disturbance and emotion of gratitude. It also seeks to assess whether the emotion of gratitude is a mediating variable withsubjective happiness, affect, and satisfaction with life. Statistical analyses of Pearson'scorrelation, multiple linear regression tests, and mediation models were conducted on asample of 1537 Spanish adults, 73.6% were females, 26.4% males, age between 18-88 yearsold (M = 42.56; SD = 16.29). The emo-tions of gratitude were found to mediate therelationship between subjec-tive happiness and satisfaction with life and between positiveaffect and satisfaction with life. Of the variables studied, positive affect is the most related tosatisfaction with life, followed by subjective happiness and emo-tions of gratitude. Maleparticipants are more satisfied with life when they feel the less negative affect. Regardingmediation models, emotions of grat-itude mediate the relationship between subjectivehappiness and satisfac-tion with life and between positive affect and satisfaction with life. Themaindifferenceis thatemotions of gratitudearestronger infemalesthan in males.(AU)

Teleworking in times of a pandemic: An applied study of industrial companies.

The purpose of this study is to determine the effect of teleworking on self-reported job satisfaction and workers' productivity in the context of the COVID-19 pandemic. A survey was administered to 331 teleworkers belonging to industrial companies, whose data were analyzed with a PLS-SEM structural equation model. The results indicate that communication with coworkers, time spent teleworking, and workplace suitability positively affect self-reported productivity, while trust on the part of supervisors and workplace suitability positively affect job satisfaction. On the other hand, work-family conflict negatively affects job satisfaction and self-reported productivity, whereas communication with coworkers, support from supervisor and time spent teleworking have no significant effect on job satisfaction. This study provides relevant information for industrial organizations to improve the job-satisfaction and productivity in large scaled teleworking contexts, as should have been implemented during the mandatory preventive isolation due to the health crisis related to the transmission of SARs-CoV-2.

Carotid Plaque Burden by 3-Dimensional Vascular Ultrasound as a Risk Marker for Patients with Metabolic Syndrome.

Our aim was to analyse the associations between carotid plaque burden (CPB), cardiovascular risk factors (CVRF), and surrogate markers of CV risk in subjects with metabolic syndrome (MetS). We consecutively included 75 asymptomatic outpatients with MetS components, <60 years old and non-smokers. We determined the presence of CVRF, left ventricular hypertrophy (LVH), carotid intima-media thickness (cIMT), albumin-creatinine ratio (ACR), coronary artery calcium score (CACS) and CPB by 3-dimensional vascular ultrasound (3DVUS) for comparison. A total of 50 (67%) subjects had MetS defined by harmonized criteria. A CPB >0 mm3 and a CACS >0 AU were the risk biomarkers most frequently observed (72% and 77%, respectively), followed by LVH (40%). CPB and CACS revealed association with cardiovascular risk (r = 0.308; p = 0.032 and r = 0.601 p < 0.01, respectively), and CPB also showed association with the burden of CVRF (r = 0.349; p = 0.014). CPB by 3DVUS was a prevalent CV risk marker, directly associated with CVRF and cardiovascular risk in MetS subjects.

Characterization of Phosphate Coatings: Influence of the Acid Pickling Conditions.

This research emphasizes the importance of the acid cleaning prior to the phosphate development on high-strength steel rods. It compares the phosphate properties achieved after different acid-pickling conditions. The most common inorganic acids were considered in this study. Additionally, taking into account the environmental and safety concerns of these acids, the assessment of a less harmful organic acid is presented. This study revealed significant differences in the coating morphology and chemical composition whereas no great changes were found in terms of the coating weight or porosity. Thus, hydrochloric and sulfuric acid promote the growth of a Fe-enriched phosphate layer with a less conductive character that is not developed after the pickling with phosphoric acid. The phosphate developed after the citric acid pickling is comparable to that developed after the inorganic acids although with a porosity slightly higher. The temperature of the citric acid bath is an important parameter that affects to the phosphate appearance, composition, and porosity.

Sex-bias in the diagnosis of malnutrition in the elderly: a pilot study.

This research aimed to show that using different cutoff points for women and men in nutritional assessment through the Mini Nutritional Assessment (MNA) and different anthropometric variables, improves the diagnostic accuracy of malnutrition among people over 65 years. A cross-sectional study was carried out in a sample of 240 patients of 65 to 104 years in Córdoba (Spain) between 2013 and 2015. Excluded were those with disabling diseases that prevented informed consent. We assessed Nutritional status using the MNA and the Chang Method (Gold Standard). Global cut points per sex were determined for each independent variable using Receiver Operating Characteristic curves, choosing the best of each according to the highest Youden´s index (J). None of the variables studied showed high precision in the diagnosis of malnutrition in the elderly. Different cutoff points were found for all variables by sex, as well as variations in their validity indexes. The number of lymphocytes was more accurate in women (J = 0.58), being the muscular circumference of the arm the best in men (J = 0.8). Regarding MNA, the Long Form version showed higher sensitivity (S) in women (S = 76%) and short versions in men (S = 71% and 59%) at different cutoff points. The introduction of the sex variable seems determinant to achieve a more accurate diagnostic of malnutrition, avoiding biases derivate from a global study without considering its effect in the development of diseases.

Development of predictive models for nutritional assessment in the elderly.

OBJECTIVE: To propose malnutrition screening methods for the elderly population using predictive multivariate models. Due to the greater risk of nutrition deficiencies in ageing populations, nutritional assessment of the elderly is necessary in primary health care. DESIGN: This was a cross-sectional study. Multivariate models were obtained by means of discriminant analysis and binary logistic regression. The diagnostic accuracy of each multivariate model was determined and compared with the Chang method based on receiver operating characteristic curves. The optimal cut-point, sensitivity, specificity and Youden index were estimated for each of the models. SETTING: The province of Cordoba, Spain. PARTICIPANTS: Two hundred fifty-five patients over the age of 65 years from three health centres and three nursing homes. RESULTS: Fourteen models for predicting risk of malnutrition were obtained, six by discriminant multivariate analysis and eight by binary logistic regression. Sensitivity ranged from 55·6 to 93·1 % and specificity from 64·9 to 94 %. The maximum and minimum Youden indexes were 0·77 and 0·49, respectively. We finally selected a model which does not require a blood test. CONCLUSIONS: The proposed models simplify nutritional assessment in the elderly and, except for number 2 of those calculated by binary logistic regression, have better diagnostic accuracy than the Spanish version of the Mini Nutritional Assessment screening tool. The selected model, whose validation is necessary for the future with other different samples, provides good diagnostic accuracy, and it can be performed by non-medical personnel, making it an accessible, easy and rapid tool in daily clinical practice.

LC-HRMS based on mixed-mode chromatography for the separation of teicoplanin and the unravelment of its composition.

Liquid chromatography - high resolution mass spectrometry (LC-HRMS) based on mixed-mode chromatography has proven to be a useful tool in pharmaceutical analysis for the characterization of very polar antibiotics such as teicoplanin. This compound is a semisynthetic glycopeptide antibiotic thought to be a mixture of five major compounds (named A2-1 through A2-5) and four minor ones (RS-1 to RS-4), all sharing the same glycopeptide core structure (dubbed A3-1) and differing only on the length of a hydrocarbon side chain. These nine compounds have been fully characterized in the past thirty years by means of HPLC coupled to UV and MS detectors. However, HPLC separations were all based on octadecylsilica columns (C18), which nowadays may not be the best choice for the chromatographic separation of such polar and charged compounds. In this work, several different chromatographic alternatives are tested for the separation of teicoplanin, including mixed-mode chemistries. It has been demonstrated that a C18-PFP mixed-mode column provides the best chromatographic resolution, furthermore, confirming the existence of several minor compounds in the composition of teicoplanin. Up to fourteen minor components were characterized by means of High-resolution MS/MS and confirmed by the analysis of a commercial teicoplanin product (Targocid®).

Estado nutricional y factores asociados en pacientes ancianos ambulatorios / Nutritional status and associated factors in ambulatory elderly patients

OBJETIVO: Analizar el estado nutricional (EN) de pacientes mayores de 65 años y establecer su relación con variables sociodemográficas y de salud. DISEÑO: Estudio observacional transversal en pacientes mayores de 65 años. Emplazamiento: Tres centros de salud. PARTICIPANTES: Doscientos cincuenta y cinco pacientes: ambulatorios (PI), en atención domiciliaria (PD) o institucionalizados (PR). Completaron el estudio 243 (tasa respuesta 95,3%). Mediciones principales: Se aplicó el método Chang para determinar el EN. Se recogieron variables sociodemográficas, antropométricas, dependencia, estado anímico, cognitivo y parámetros analíticos. Se analizaron asociaciones aplicando Chi cuadrado y análisis de varianza. Se calculó la razón de prevalencia (RP) para desnutrición. Se aplicó un modelo multivariante (regresión logística binaria). Se consideró significación para p < 0,05. RESULTADOS: La edad media fue 81,3 años (DT = 7,4), y el 72,0% fueron mujeres. El 48,9% eran PI, el 26,8% PD y el 24,2% PR. El 29,6% (IC 95%: 23,9-35,8) presentaba malnutrición. Se estableció mayor desnutrición en relación con vivir en una residencia o precisar ayuda domiciliaria (RP = 5,3), edad mayor de 85 años (RP = 4,9), presentar una dependencia moderada o superior para las actividades de la vida diaria básicas (RP = 3,9) e instrumentales (RP = 3,3), precisar ayuda para la movilidad (RP = 2,9) y presentar deterioro cognitivo moderado/severo (RP = 2,1). Los factores determinantes de desnutrición en el modelo multivariante fueron tener más de 85 años y ser PR o PD. CONCLUSIONES: Se debería hacer hincapié en evaluar el EN en pacientes mayores de 85 años y que viven en una residencia o precisan atención domiciliaria, al ser los grupos de mayor riesgo de desnutrición

OBJECTIVE: To analyze the nutritional status (NS) of patients older than 65 years and establish their relationship with sociodemographic and health variables. DESIGN: Cross-sectional observational study in patients older than 65 years. LOCATION: 3 health centers. PARTICIPANTS: 255 patients: ambulatory (AP), in domiciliary care (DP) or institutionalized (IP). They completed the study 243 (response rate 95.3%). MAIN MEASUREMENTS: The Chang method was applied to determine the NS. Sociodemographic, anthropometric variables, dependence, mood, cognitive and analytical parameters were collected. Associations were analyzed applying chi-square and analysis of variance. The prevalence ratio (PR) for malnutrition was calculated. A multivariate model was applied (binary logistic regression). Significance was considered for p < 0.05. RESULTS: The average age was 81.3 years (SD = 7.4) and 72.0% were women. 48.9% were AP, 26.8% DP and 24.2% IP. 29.6% (95% CI: 23.9-35.8) presented malnutrition. Greater malnutrition was established in relation to living in a residence or requiring home help (PR = 5.3), age over 85 (PR = 4.9), presenting a moderate or higher dependency for basic activities of daily living (PR = 3.9) and instrumental (PR = 3.3), need help for mobility (PR = 2.9) and present moderate/severe cognitive impairment (PR = 2.1). The determinants of malnutrition in the multivariate model were older than 85 years old and being IP or DP. CONCLUSIONS: Emphasis should be placed on evaluating NS in patients older than 85 years of age who live in a residence or require home care, since they are the groups at greatest risk of malnutrition

The role of services content for manufacturing competitiveness: A network analysis.

This paper explores the phenomenon of international servicification of manufacturing from the period 1995 to 2011. By applying empirical techniques of Social Network Analysis and graph theory, we find that the network of flows of intermediate services embodied in manufacturing exports is still slightly dense and would not correspond to a traditional centre-periphery structure. The mapping shows a numerous, highly cohesive group of countries, with China, the USA and Germany as central economies and an increasing leading role of Asian economies, which would indicate their commitment to upgrading within global value chains. We go a step further by empirically analysing the impact of the countries' centrality in the global network of intermediate services on manufacturing competitiveness. Our findings reveal that, together with the level of embodiment of intermediate services into manufacturing exports, who the providers of those services inputs are is a key determining factor for manufacturing competitiveness.

[Nutritional status and associated factors in ambulatory elderly patients]. / Estado nutricional y factores asociados en pacientes ancianos ambulatorios.

OBJECTIVE: To analyze the nutritional status (NS) of patients older than 65 years and establish their relationship with sociodemographic and health variables. DESIGN: Cross-sectional observational study in patients older than 65 years. LOCATION: 3 health centers. PARTICIPANTS: 255 patients: ambulatory (AP), in domiciliary care (DP) or institutionalized (IP). They completed the study 243 (response rate 95.3%). MAIN MEASUREMENTS: The Chang method was applied to determine the NS. Sociodemographic, anthropometric variables, dependence, mood, cognitive and analytical parameters were collected. Associations were analyzed applying chi-square and analysis of variance. The prevalence ratio (PR) for malnutrition was calculated. A multivariate model was applied (binary logistic regression). Significance was considered for p<0.05. RESULTS: The average age was 81.3 years (SD=7.4) and 72.0% were women. 48.9% were AP, 26.8% DP and 24.2% IP. 29.6% (95% CI: 23.9-35.8) presented malnutrition. Greater malnutrition was established in relation to living in a residence or requiring home help (PR=5.3), age over 85 (PR=4.9), presenting a moderate or higher dependency for basic activities of daily living (PR=3.9) and instrumental (PR=3.3), need help for mobility (PR=2.9) and present moderate/severe cognitive impairment (PR=2.1). The determinants of malnutrition in the multivariate model were older than 85 years old and being IP or DP. CONCLUSIONS: Emphasis should be placed on evaluating NS in patients older than 85 years of age who live in a residence or require home care, since they are the groups at greatest risk of malnutrition.

The Effect of Loading on the Diffusivity of Chlorides in Mortar.

This study focuses on the effect generated by a compressive load, in the range 15%-60% of the ultimate load (Fu), in the chloride penetration rate of cement-based materials. The modifications produced in the microstructure influence the transport properties, and, thus, the validation of several interesting parameters, such as, the load value and the loading time, including both static and dynamic loading modes, was evaluated. This analysis was performed by impedance spectroscopy (IS), a non-destructive technique that allowed, after the appropriate modeling analysis, the assessment of the resistivity of the sample, a parameter that has been correlated to the diffusion coefficient in a previous investigation. The experimental arrangement was designed to allow the recording of the impedance spectra under the effect of a compressive load and, thus, the real-time monitoring of the chloride diffusivity was provided. An increase in the diffusion coefficient was verified for a load at 60%Fu whereas no variations were obtained for the load fixed at 30%. A relevant difference could be checked if the values were measured once the load was removed, showing the importance of the precise loading stage for the chloride diffusion study.

¿Es válido el cribado nutricional de los ancianos a través del Mini Nutritional Assesment (MNA-SF) en su versión corta adaptada al castellano? / Is the Spanish short version of Mini Nutritional Assessment (MNA-SF) valid for nutritional screening of the elderly?

Introducción: para el cribado nutricional del anciano, existe una versión corta del Mini Nutritional Assessment Large Form (MNA-LF) denominada Mini Nutritional Assessment Short Form (MNA-SF). Esta permite el uso de la circunferencia de la pantorrilla (CP) o del índice de masa corporal (IMC) y guarda buena correlación con la versión larga. Son escasos los trabajos que han analizado la validez del MNA-SF. Objetivo: establecer la validez de las dos variantes del MNA-SF en su versión al castellano, basado en el IMC (MNA-SF [IMC]) o en la circunferencia de pantorrilla (MNA-SF [CP]) para conocer su fiabilidad. Diseño: estudio de pruebas de diagnósticos con 255 sujetos mayores de 65 años. El método Chang se utilizó como gold standard. Se calcularon el índice Kappa de Cohen, la sensibilidad y la especificidad, los valores predictivos positivos y negativos, el índice de Youden y el índice de validez. Resultados: los índices Kappa del método Chang fueron muy bajos al cotejar los resultados con los de las versiones del MNA-SF (IMC y CP) (0,335 y 0,286, respectivamente). Se obtuvieron los siguientes resultados de validez para MNA-SF (IMC) y MNA-SF (CP): sensibilidad 70% y 67%, especificidad 68% y 66% e índice de Youden 0,38 y 0,33, respectivamente, clasificando correctamente al 68,5% y al 66,5% de los ancianos. Conclusiones: el MNA-SF es una herramienta útil (fácil, no invasiva y rápida de cumplimentar) pero limitada para el cribado nutricional, lo que evidencia la necesidad de mejorar su capacidad discriminatoria

Introduction: a short version of the Mini Nutritional Assessment Large Form (MNA-LF) called Mini Nutritional Assessment Short Form (MNA-SF) is available for nutritional screening of the elderly. This MNA-SF allows the use of the circumference of the calf (CC) or body mass index (BMI) and shows a good correlation with the MNA-LF. However, only a few researches that have analyzed the validity of the MNA-SF can be found. Objective: to analyze the validity of the MNA-SF (including two different methods, based on the BMI (MNA-SF [BMI]) or using the calf circumference (MNA-SF [CC]). Design: study of diagnostic tests with 255 subjects over 65 years of age. The Chang method was used as gold standard. Cohen's Kappa index, sensitivity and specificity, positive and negative predictive values, the Youden index and the validity index were calculated. Results: the Kappa indexes for the Chang method were very low when comparing the results with those of the MNA-SF versions (IMC and CP) (0.335 and 0.286, respectively). The following validity results were obtained for MNA-SF (IMC) and MNA-SF (CP): sensitivity 70% and 67%, specificity 68% and 66% and Youden index 0.38 and 0.33, respectively, correctly classifying to 68.5% and 66.5% of the elderly. Conclusions: MNA SF is a useful tool (easy, non-invasive and quick to complete) but very limited for nutritional screening

[Is the Spanish short version of Mini Nutritional Assessment (MNA-SF) valid for nutritional screening of the elderly?] / ¿Es válido el cribado nutricional de los ancianos a través del Mini Nutritional Assesment (MNA-SF) en su versión corta adaptada al castellano?

INTRODUCTION: Introduction: a short version of the Mini Nutritional Assessment Large Form (MNA-LF) called Mini Nutritional Assessment Short Form (MNA-SF) is available for nutritional screening of the elderly. This MNA-SF allows the use of the circumference of the calf (CC) or body mass index (BMI) and shows a good correlation with the MNA-LF. However, only a few researches that have analyzed the validity of the MNA-SF can be found. Objective: to analyze the validity of the MNA-SF (including two different methods, based on the BMI (MNA-SF [BMI]) or using the calf circumference (MNA-SF [CC]). Design: study of diagnostic tests with 255 subjects over 65 years of age. The Chang method was used as gold standard. Cohen's Kappa index, sensitivity and specificity, positive and negative predictive values, the Youden index and the validity index were calculated. Results: the Kappa indexes for the Chang method were very low when comparing the results with those of the MNA-SF versions (IMC and CP) (0.335 and 0.286, respectively). The following validity results were obtained for MNA-SF (IMC) and MNA-SF (CP): sensitivity 70% and 67%, specificity 68% and 66% and Youden index 0.38 and 0.33, respectively, correctly classifying to 68.5% and 66.5% of the elderly. Conclusions: MNA SF is a useful tool (easy, non-invasive and quick to complete) but very limited for nutritional screening.

INTRODUCCIÓN: Introducción: para el cribado nutricional del anciano, existe una versión corta del Mini Nutritional Assessment Large Form (MNA-LF) denominada Mini Nutritional Assessment Short Form (MNA-SF). Esta permite el uso de la circunferencia de la pantorrilla (CP) o del índice de masa corporal (IMC) y guarda buena correlación con la versión larga. Son escasos los trabajos que han analizado la validez del MNA-SF. Objetivo: establecer la validez de las dos variantes del MNA-SF en su versión al castellano, basado en el IMC (MNA-SF [IMC]) o en la circunferencia de pantorrilla (MNA-SF [CP]) para conocer su fiabilidad. Diseño: estudio de pruebas de diagnósticos con 255 sujetos mayores de 65 años. El método Chang se utilizó como gold standard. Se calcularon el índice Kappa de Cohen, la sensibilidad y la especificidad, los valores predictivos positivos y negativos, el índice de Youden y el índice de validez. Resultados: los índices Kappa del método Chang fueron muy bajos al cotejar los resultados con los de las versiones del MNA-SF (IMC y CP) (0,335 y 0,286, respectivamente). Se obtuvieron los siguientes resultados de validez para MNA-SF (IMC) y MNA-SF (CP): sensibilidad 70% y 67%, especificidad 68% y 66% e índice de Youden 0,38 y 0,33, respectivamente, clasificando correctamente al 68,5% y al 66,5% de los ancianos. Conclusiones: el MNA-SF es una herramienta útil (fácil, no invasiva y rápida de cumplimentar) pero limitada para el cribado nutricional, lo que evidencia la necesidad de mejorar su capacidad discriminatoria.

Superiority of wall motion score index over left ventricle ejection fraction in predicting cardiovascular events after an acute myocardial infarction.

BACKGROUND:: There are few data on the prognostic significance of the wall motion score index compared with left ventricle ejection fraction after an acute myocardial infarction. Our objective was to compare them after the hyperacute phase. METHODS:: Transthoracic echocardiograms were performed in 352 consecutive patients with myocardial infarction, after the first 48 hours of admission and before hospital discharge (median 56.3 hours (48.2-83.1)). We evaluated the ability of the wall motion score index and left ventricular ejection fraction to predict the combined endpoint (mortality and rehospitalization for heart failure) as a primary objective and the independent events of the combined endpoint as a secondary objective. RESULTS:: In 80.7% of patients, the wall motion score index was high despite having an ejection fraction >40%. No patient had an ejection fraction <55% with a normal index. After a follow-up of 30.5 months (24.2-49.5), both variables were predictors of the composite endpoint and all-cause mortality ( p<0.0001), although only the wall motion score index was a predictor of readmission for heart failure ( p=0.007). By multivariate analysis, a wall motion score index >1.8 proved to be the most powerful predictor of the composite endpoint (hazard ratio: 8.5; 95% confidence interval 3.7-18.8; p<0.0001). The superiority of the wall motion score index over ejection fraction was especially significant in patients with less myocardial damage (non-ST elevation myocardial infarction, or left ventricle ejection fraction >40%). CONCLUSIONS:: Both variables provide important prognostic information after a myocardial infarction. Beyond the hyperacute phase, wall motion score index is a more powerful prognostic predictor, especially in subgroups with less myocardial damage.

Validation (in Spanish) of the Mini Nutritional Assessment survey to assess the nutritional status of patients over 65 years of age.

AIM: To validate the Mini Nutritional Assessment (MNA) in a Spanish population over 65 years of age with varying degrees of independence. DESIGN: This cross-sectional validation study used the Chang nutritional assessment method as a reference test. PARTICIPANTS: 248 subjects (72.2% female), with a mean age of 81.3, completed the study. They were classified into three groups: (i) autonomous patients who were able to take part in activities outside their home; (ii) patients who require help with daily self-care; (iii) patients living in a residential health care facility. SETTING: Three health centres and three residential care homes situated in Cordoba (Spain). RESULTS: The kappa values for intra-observer and inter-observer agreement were 0.870 and 0.784, respectively. The intra-class correlation coefficient intra-observer was 0.874 and the inter-observer was 0.789. The sensitivity and specificity readings for the diagnostic accuracy of MNA were 63.2% and 72.9% in the total sample, respectively. The area under the curve was 0.726. For patients in the Group A, B and C, the sensitivity was 89.3%, 60.7% and 18.8%, and the specificity was 23.3%, 56.8% and 94.1%, respectively. CONCLUSION: The results for the reliability of the survey were excellent, and its internal consistency was acceptable. The diagnostic accuracy, as measured by the sensitivity and specificity readings, was lower than that obtained with the original survey. It can therefore be considered more suitable for a population with limited autonomy, and less appropriate for independent patients. The results may not be relevant to patients outside of the Cordova region in Spain.

Comparison of spatial normalization strategies of diffusion MRI data for studying motor outcome in subacute-chronic and acute stroke.

A common means of studying motor recovery in stroke patients is to extract Diffusion Tensor Imaging (DTI) parameters from the corticospinal tract (CST) and correlate them with clinical outcome scores. To that purpose, conducting group-level analyses through spatial normalization has become a popular approach. However, the reliability of such analyses depends on the accuracy of the particular registration strategy employed. To date, most studies have employed scalar-based registration using either high-resolution T1 images or Fractional Anisotropy (FA) maps to warp diffusion data to a common space. However, more powerful registration algorithms exist for aligning major white matter structures, such as Fiber Orientation Distribution (FOD)-based registration. Regardless of the strategy chosen, automatic normalization algorithms are prone to distortions caused by stroke lesions. While lesion masking is a common means to lessen such distortions, the extent of its effect on tract-related DTI parameters and their correlation with motor outcome has yet to be determined. Here, we aimed to address these concerns by first investigating the effect of common T1 and FA-based registration as well as novel FOD-based registration algorithms with and without lesion masking on lesion load and DTI parameter extraction of the CST in datasets typically acquired for subacute-chronic and acute stroke patients. Second, we studied how differences in these procedures influenced correlation strength between CST damage (through DTI parameters) and motor outcome. Our results showed that, for high-quality subacute-chronic stroke data, FOD-based registration captured significantly higher lesion loads and significantly larger FA asymmetries in the CST. This was also associated with significantly stronger correlations in motor outcome with respect to T1 or FA-based registration methods. For acute data acquired in a clinical setting, there were few observed differences, suggesting that commonly employed FA-based registration is appropriate for group-level analyses.

A Plasmodium berghei sporozoite-based vaccination platform against human malaria.

There is a pressing need for safe and highly effective Plasmodium falciparum (Pf) malaria vaccines. The circumsporozoite protein (CS), expressed on sporozoites and during early hepatic stages, is a leading target vaccine candidate, but clinical efficacy has been modest so far. Conversely, whole-sporozoite (WSp) vaccines have consistently shown high levels of sterilizing immunity and constitute a promising approach to effective immunization against malaria. Here, we describe a novel WSp malaria vaccine that employs transgenic sporozoites of rodent P. berghei (Pb) parasites as cross-species immunizing agents and as platforms for expression and delivery of PfCS (PbVac). We show that both wild-type Pb and PbVac sporozoites unabatedly infect and develop in human hepatocytes while unable to establish an infection in human red blood cells. In a rabbit model, similarly susceptible to Pb hepatic but not blood infection, we show that PbVac elicits cross-species cellular immune responses, as well as PfCS-specific antibodies that efficiently inhibit Pf sporozoite liver invasion in human hepatocytes and in mice with humanized livers. Thus, PbVac is safe and induces functional immune responses in preclinical studies, warranting clinical testing and development.

The silver effect of admission glucose level on excellent outcome in thrombolysed stroke patients.

Higher admission glucose levels (AGL) are associated with less favorable outcome in thrombolysis. But, could AGL's impact on outcome vary by onset-to-treatment (OTT) time? Is hyperglycemia associated with a shorter therapeutic time window for excellent outcome for thrombolysed stroke patients? We assessed predictive values of AGL, baseline NIHSS, age, and OTT time quartiles on excellent outcome (3-month modified Rankin score of 0-1) in 773 patients treated by rt-Pa. We added the AGL × OTT time quartile interaction in the model and separately analyzed the predictive values of AGL, age, and NIHSS for each OTT time quartile if the interaction was significant. AGL, baseline NIHSS, age, and OTT time quartiles were significant predictors. When added in the model, the AGL × OTT interaction was significant (OR: 0.96, 95% CI: 0.94-0.99, p: 0.0009). AGL was predictive only during the third OTT time quartile (181-224 min). During this period, the predicted rate of excellent outcome was 16% for AGL = 6.5 mmol/L and 8% for AGL = 8 mmol/L. The rate of excellent outcome was not decreased in hyperglycemic patients for OTT time ≤ 180 min (20 vs. 24.5% p: 0.37), but was decreased for OTT time > 180 min (9.6 vs. 26.7% p: 0.00001). Similar results were found in patients with MCA recanalization, but not in patients without recanalization. The therapeutic time window for excellent outcome is shortened in hyperglycemic patients. This would support the design of "freezing penumbra" randomized trials based on ultra-early AGL control.

Estudio de la situación nutricional de pacientes mayores de 65 años incluidos en el programa de atención domiciliaria de una población urbana / Study of the nutritional status of patients over 65 years included in the home care program in an urban population

Objetivo: Analizar el estado nutricional de pacientes mayores de 65 años incluidos en el programa de atención domiciliaria (PAD). Diseño: Estudio observacional transversal. Emplazamiento: Tres centros de salud. Participantes: Un total de 218 pacientes del PAD. Método: Se aplicó el cuestionario Mini Nutritional Assessment (MNA). Se recogieron 57 variables: sociodemográficas, antropométricas, de dependencia, estados anímico y cognitivo y parámetros analíticos. Se analizaron asociaciones mediante la aplicación de la Chi-cuadrado y análisis de varianza. Se consideró un nivel de significación para p < 0,05. Resultados: La edad media fue de 83,9 años (DT = 7,4); el 34,9% estaban institucionalizados y el 80,7% eran mujeres. El 21,2% de los pacientes presentaban malnutrición y el 40,1%, riesgo de la misma. Se estableció asociación significativa entre peor estado nutricional y mayor edad, menor IMC, mayor dependencia en actividades básicas e instrumentales de la vida diaria y mayor deterioro cognitivo. Las menores cifras medias de hemoglobina, albúmina y hierro también se asociaron a desnutrición y riesgo de la misma. Conclusiones: Más de la mitad de los pacientes del PAD presentan desnutrición o riesgo de la misma, y en una proporción elevada, alteración en parámetros analíticos susceptibles de ser corregidos. La alteración cognitiva y dependencia funcional están relacionadas con la desnutrición, por lo que los pacientes con estas características deberían recibir una mayor atención desde el punto de vista nutricional (AU)

Objective: To analyse the nutritional status of patients older than 65 years included in the home care program (PAD). Design: Croos-sectional study. Emplacement: 3 urban health centers. Participants: 218 patients in the PAD. Method: Mini Nutritional Assessment questionnaire (MNA) was applied. Sociodemographic, anthropometric, dependency, emotional and cognitive status and analytical parameters: 57 variables were collected. Possible associations were analysed by applying the chi square and variance analysis. The level of significance was considered to be P<.05 was considered. Results: The mean age was 83.9 years (SD=7.4); 34.9% were institutionalized and 80.7% were women; 21.2% of patients were malnourished and 40.1% were at risk of it. A significant association was established between poorer nutritional status and older age, lower BMI, greater dependence on basic and instrumental activities of daily living and greater cognitive impairment. The lowest mean hemoglobin, albumin, and iron levels were also associated with malnutrition and risk of malnutrition. Conclusions: More than half of PAD patients are malnourished or at risk for it, and a high proportion of them some laboratory abnormality susceptible to be corrected. Most cognitive impairment and functional dependence are closely related to malnutrition; so patients with these characteristics should receive more attention from the nutritional point of view (AU)