Search Results (74)

The effects of long-term adjustments in body weight on the lipid balance in patients with severe obesity are not well understood. This study aimed to evaluate a non-invasive lipidomic approach to identifying biomarkers that could help predict which patients may require additional therapies before and after weight loss. Using mass spectrometry, 275 lipid species were analysed in non-obese controls, patients with severe obesity, and patients one year after bariatric surgery. The results showed that severe obesity disrupts lipid pathways, contributing to lipotoxicity, inflammation, mitochondrial stress, and abnormal lipid metabolism. Although weight loss improved these disturbances, surgery did not fully normalise the lipid profiles of all patients. Outcomes varied depending on their baseline liver health and genetic differences. Persistent alterations in cholesterol handling, membrane composition, and mitochondrial function were observed in partial responders. Elevated levels of sterol lipids, glycerophospholipids, and sphingolipids emerged as markers of complete metabolic recovery, identifying candidates for targeted post-surgical interventions. These findings support the use of lipidomics to personalise obesity treatment and follow-up. Full article

Background and Objectives: Osteoarthritis (OA) of the knee and hip is a major cause of pain and functional impairment. This study evaluated the effects of non-immersive virtual reality (NIVR) combined with conventional physical therapy (CPT) on pain intensity, mechanical hyperalgesia, and perceived recovery in older adults with OA. Materials and Methods: Sixty older adults with mild-to-moderate knee or hip OA were randomly assigned to a NIVR group (NIVR-G; n = 30) or a CPT group (CPT-G; n = 30). Both groups completed 30 sessions over 10 weeks (3 sessions/week). The NIVR-G performed 20 minutes of exergames integrated into CPT. Pain intensity was assessed using the Visual Analog Scale (VAS), and mechanical hyperalgesia was evaluated through pressure pain thresholds (PPTs). Secondary outcomes included the Global Rating of Change (GRoC) and the minimal clinically important difference (MCID) for the VAS. This study is a secondary analysis of a randomized controlled trial registered at ClinicalTrials.gov (ID: NCT05839262). Results: The NIVR-G demonstrated significant reductions in pain intensity after 30 sessions (p < 0.05, d = 1.50), with greater improvements compared to the CPT-G (p < 0.05, d = 1.17). The MCID for the VAS was established at 9.2 mm, with a higher proportion of responders in the NIVR-G (p < 0.05). The NIVR-G also reported superior recovery perception on the GRoC scale (p < 0.05). No significant changes in PPTs were observed in either group. However, the improvements in the NIVR-G diminished four weeks post-intervention. Conclusions: NIVR exergames combined with CPT significantly reduced pain intensity, improved perceived recovery, and resulted in a higher proportion of responders compared to CPT alone. These findings support the use of NIVR as an effective adjunct to CPT in older adults with OA; however, further research is needed to optimize its long-term benefits. Full article

Background/Objectives: SARS-CoV-2 infection increases thrombotic events in hospitalized patients, especially those of greater severity. It has been associated with the cytokine storm and worsening renal and liver function, increased inflammatory markers, and altered coagulation markers. This study analyzes differences in inflammatory, hepatic, renal, and coagulation markers between hospitalized patients with and without COVID-19 who experienced thromboembolic events during the last three years of the pandemic. Methods: This single-center, retrospective observational study, with an inferential component and biomarker analysis, included 663 patients (600 without COVID-19, 63 with COVID-19) admitted between December 2022 and January 2023. Results: Patients with COVID-19 exhibited significantly higher mean glomerular filtration rate (GFR) (100.5 mL/min/1.73 m²; p < 0.01) and alanine aminotransferase (ALT) levels (33.0 IU/L; p < 0.01) compared to those without COVID-19. Ferritin levels were also significantly elevated in COVID-19 patients (441.1; p < 0.01), particularly those with severe disease. Conversely, troponin I was significantly higher in patients without COVID-19 (22.6 × 10⁴ pg/mL; p < 0.001). Among COVID-19 patients, D-dimer levels were significantly higher in those not requiring intensive care unit (ICU) admission (9.0 × 10³ ng/mL; p = 0.023). Multivariate analysis revealed a significant association between COVID-19 and sex. Conclusions: Overall, renal function did not differ significantly between COVID-19 and non-COVID-19 patients. However, renal function was better in patients admitted to the ICU, regardless of COVID-19 status. Troponin I levels were elevated in non-COVID-19 patients, while ferritin and ALT levels were higher in COVID-19 patients. D-dimer levels showed no significant difference between the two groups. Full article

Background/Objectives: Osteoarthritis (OA) is a leading cause of mobility impairment in older adults, yet few studies have explored exergames (EXGs) as a complementary therapy for knee and/or hip OA (KOA/HOA). This study evaluated the effects of integrating EXGs into conventional therapy (CT) on functional mobility. Methods: Sixty participants were randomized into an EXG/CT group or a CT-only group. The interventions lasted 10 weeks (3 sessions/week), and the EXGs were selected from the interactive game Ring Fit Adventure (Nintendo Switch^®, Kyoto, Japan). Results: Functional mobility (Timed Up and Go test) significantly improved in the EXG/CT group but not in the CT group. Additionally, lower-limb strength and aerobic endurance increased in the EXG/CT group. No adverse events were reported, and the adherence was high. Conclusions: These findings support EXG-based interventions as a viable complement to CT. Future studies should design OA-specific EXGs and include patient subgroups to expand the impact of interventions using virtual systems. Full article

Wastewater surveillance has become a valuable tool to monitor the emergence of SARS-CoV-2 variants of concern (VOCs) at the community level. In this study, we aimed to evaluate the presence of Alpha (B.1.1.7), Beta (B.1.351), Delta (B.1617.2), and Omicron (B.1.1.529) VOCs in samples from the inlet of a wastewater treatment plant (WWTP) as well as from two different sewer interceptors (SI-1 and SI-2) from the urban sewage system in Santiago de Compostela (Galicia, NW of Spain) throughout 2021 and January 2022. For this purpose, detection and quantification of the four VOCs was performed using four duplex SARS-CoV-2 allelic discrimination RT-qPCR assays, targeting the S-gene. An N1 RT-qPCR gene assay was used as a reference for the presence of SARS-CoV-2 RNA in wastewater samples. All VOCs were detected in wastewater samples. Alpha, Beta, Delta, and Omicron VOCs were detected in 45.7%, 7.5%, 66.7%, and 72.7% of all samples, respectively. Alpha VOC was dominant during the first part of the study, whereas Delta and Omicron detection peaks were observed in May–June and December 2021, respectively. Some differences were observed among the results obtained for the two city sectors studied, which could be explained by the differences in the characteristics of the population between them. Wastewater-based epidemiology allowed us to track the early circulation and emergence of SARS-CoV-2 variants at a local level, and our results are temporally concordant with clinical data and epidemiological findings reported by the health authorities. Full article

The peak velocity of an athlete’s throws is a determining factor for sports performance. The aim of this study was to analyze the effects of a post-activation performance enhancement (PAPE) protocol with functional electro-mechanical dynamometry (FEMD) on throwing velocity. Thirteen international-level female handball players voluntarily participated in the study. The PAPE protocol considered four sets of eight repetitions controlled by FEMD (four at 30% of 1RM followed by another four at 60% of 1RM). After each series, the athletes’ throwing velocity was measured. Significant differences (p < 0.01) were found in the effect size (ES), which measures the strength of the statistical relationship between two variables by group with the repeated measures ANOVA statistic with an effect size ω² = 0.028. The effect size analysis identified measurements that are considered null for the baseline—PAPE 1 comparison and small baseline—PAPE 2, baseline—PAPE 3, and baseline—PAPE 4. When resistance is controlled during the run as with an FEMD device, only two sets of eight repetitions (four repetitions at 30% and four repetitions at 60% of 1RM) are required for the improvement of throwing speed in elite handball players. Full article

This research investigates the challenges and opportunities rural elementary teachers perceive in using AI as a pedagogical tool to support student learning in rural schools. Using a convergent parallel mixed methods approach, we analyzed the responses from 45 rural teachers who participated in professional development on AI integration in rural education. Through both closed-ended and open-ended survey responses, we employed an adaptation of the TPACK framework (I-TPACK) and the AI literacy framework proposed by UNESCO to identify the primary challenges and opportunities in utilizing AI for pedagogical purposes in rural education. The results highlight resource accessibility and teacher professional development as critical challenges and opportunities to reduce the digital divide in rural communities. Teachers see the inclusion of AI as an opportunity to personalize learning, reduce workload, and facilitate teaching in multigrade classrooms without perceiving it as a job threat. At the same time, they emphasize the need for technological and didactic resources aligned with the specific characteristics of their contexts, such as offline resources and adaptable AI curricula to address the prevalent issue of limited or absent internet connectivity in many rural schools. Full article

River morphology is highly dynamic, requiring accurate datasets and models for effective management, especially in flood-prone regions. Climate change and urbanisation have intensified flooding events, increasing risks to populations and infrastructure. Woody debris, a natural element of river ecosystems, poses a dual challenge: while it provides critical habitats, it can obstruct water flow, exacerbate flooding, and threaten infrastructure. Traditional debris detection methods are time-intensive, hazardous, and limited in scope. This study introduces a novel tool integrating artificial intelligence (AI) and computer vision (CV) to detect woody debris in rivers using aerial drone imagery that is fully integrated into a geospatial Web platform (WebGIS). The tool identifies and segments debris, assigning risk levels based on obstruction severity. When using orthoimages as input data, the tool provides georeferenced locations and detailed reports to support flood mitigation and river management. The methodology encompasses drone data acquisition, photogrammetric processing, debris detection, and risk assessment, and it is validated using real-world data. The results show the tool’s capacity to detect large woody debris in a fully automatic manner. This approach automates woody debris detection and risk analysis, making it easier to manage rivers and providing valuable data for assessing flood risk. Full article

Background: The few epidemiologic studies of infection exposure in early life and acute leukemia (AL) risk in Latino children have yielded inconsistent results, suggesting a possible effect of ethnicity. Here, we examined the correlation between infection exposure and acute leukemia risk in children from Mexico City—One of the biggest Latino cities worldwide. Methods: This study included 1455 Mexican children diagnosed with de novo AL (2002–2016), and 1455 control individuals frequency-matched by age and health institution. The AL population included acute lymphoblastic leukemia (ALL), Pre-B ALL, and acute myeloblastic leukemia (AML). Logistic regression analyses were performed to investigate direct and indirect proxies of infection in children or their mothers. Results: Upper respiratory tract infections during the child’s first year of life were a risk factor for AL (OR, 2.76; 95% CI, 1.48–5.15), including ALL (OR, 3.14; 95% CI, 1.67–5.89) and Pre-B (OR, 3.11; 95% CI, 1.63–5.96). Mother’s infections before and during pregnancy were protective factors against AL (OR, 0.55; 95% CI, 0.47–0.64; and OR, 0.61; 95% CI, 0.52–0.72, respectively). These associations included ALL and Pre-B. In contrast, only mothers’ infections before pregnancy and respiratory tract infections were protective factors against AML (OR, 0.45; 95% CI, 0.33–0.62; and OR, 0.50; 95% CI, 0.37–0.68, respectively). Conclusions: Infections during the first year of life were associated with AL development in children of Mexico City. Additionally, mothers’ exposure to respiratory tract infections before and during pregnancy reduced the AL risk in this Latino population. Full article

Objective: This systematic review and meta-analysis aimed to (I) evaluate the evidence on the effects of high-intensity interval training (HIIT) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive patients; (II) determine whether HIIT impacts SBP and DBP differently; and (III) assess the clinical relevance of these effects. Methods: A comprehensive search was conducted across multiple electronic databases, resulting in the inclusion of seven randomized clinical trials in the meta-analysis. The outcomes were analyzed using random-effects models to compute mean differences (MD) and standardized mean differences (SMD) for SBP and DBP. Results: A small reduction in SBP was observed with HIIT interventions (MD −3.00; 95% CI −4.61 to −1.39; p < 0.0001; SMD −0.28; 95% CI −0.42 to −0.13; p = 0.0003). However, no statistically significant reductions were detected for DBP (MD −0.70; 95% CI −1.80 to 0.39; p = 0.21; SMD −0.07; 95% CI −0.22 to 0.08; p = 0.35). Despite demonstrating statistical significance for SBP, the effects did not reach clinical relevance. Conclusions: HIIT interventions yield small reductions in SBP, with minimal impact on DBP. These findings suggest limited clinical relevance in the management of hypertension. Further randomized controlled trials are necessary to standardize HIIT protocols, with specific emphasis on intensity control and manipulation, to better understand their potential role in hypertensive populations. Full article

Background and Objective: Nutrimetabolomics may reveal novel insights into early metabolic alterations and the role of dietary exposures on prostate cancer (PCa) risk. We aimed to prospectively investigate the associations between plasma metabolite concentrations and PCa risk, including clinically relevant tumor subtypes. Methods: We used a targeted and large-scale metabolomics approach to analyze plasma samples of 851 matched PCa case–control pairs from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Associations between metabolite concentrations and PCa risk were estimated by multivariate conditional logistic regression analysis. False discovery rate (FDR) was used to control for multiple testing correction. Results: Thirty-one metabolites (predominately derivatives of food intake and microbial metabolism) were associated with overall PCa risk and its clinical subtypes (p < 0.05), but none of the associations exceeded the FDR threshold. The strongest positive and negative associations were for dimethylglycine (OR = 2.13; 95% CI 1.16–3.91) with advanced PCa risk (n = 157) and indole-3-lactic acid (OR = 0.28; 95% CI 0.09–0.87) with fatal PCa risk (n = 57), respectively; however, these associations did not survive correction for multiple testing. Conclusions: The results from the current nutrimetabolomics study suggest that apart from early metabolic deregulations, some biomarkers of food intake might be related to PCa risk, especially advanced and fatal PCa. Further independent and larger studies are needed to validate our results. Full article

Background: We evaluated the prevalence and characteristics of persistent signs and/or symptoms in children and young people (CYP) one year after hospitalization for acute COVID-19 compared with a control group of CYP hospitalized for other conditions. Methods: We conducted an observational study in three hospitals in Madrid, which included a group of children aged between 1 month and 18 years who were hospitalized due to acute COVID-19 from March 2020 to December 2021. We also selected a comparison group of patients hospitalized for other, unrelated conditions within the same month. Eligible participants had no history of COVID-19 at recruitment or during follow-up. Data were collected from clinical records and a standardized questionnaire completed by the patients’ families. The primary outcome was the presence of persistent symptoms one year after hospitalization. Results: A total of 96 patients were enrolled and analyzed (50 acute COVID-19 patients and 46 non-COVID-19 participants). Of these, 34/96 (35%) met the criteria for persistent symptoms (CYP: 17/50 (34%) COVID-19 participants and 17/46 (37%) non-COVID-19 participants (p = 0.767)). Symptoms persisted ≥12 months in 14/50 (28%) COVID-19 participants and in 7/46 (15%) non-COVID-19 participants (p = 0.140). Both before and after admission, all of the participants provided similar ratings for all of the specific items related to emotional welfare, social relationships, and current activities. Readmissions occurred in 11/50 (22%) COVID-19 participants and in 6/46 (13%) non-COVID-19 participants (p = 0.267). Conclusions: We identified a non-significant difference in the prevalence of persistent symptoms 1 year after hospitalization between children and young people (CYP) with acute COVID-19 and those hospitalized for non-COVID-19-related conditions. Full article

Aim: To describe the latest scientific evidence regarding community-based interventions performed on patients in need of palliative care worldwide. Introduction and background: Given the rise of chronic diseases, their complexities and the fragility of patients, we are facing around 56.8 million people in need of palliative care. Community-based healthcare, particularly palliative care, can address social inequalities and improve the biopsychosocial health of disadvantaged populations. Therefore, primary care, as the main health referent in the community, has a central role in the care of these patients. Methods: This is an integrative review from January 2017 to June 2022 that follows the PRISMA statement and has been registered in PROSPERO. PubMed, Cuiden, the Web of Science (WoS), Cochrane and LILACS were the five databases searched. The scientific quality assessment of the articles was carried out following the CASPe methodology. Study selection was carried out by two researchers, A.V.L. and J.M.C.T., using the inclusion and exclusion criteria mentioned below. In cases of doubt or discrepancy, a third author (J.R.S.) was consulted. Results: The interventions mentioned in the 16 articles analysed were classified under the following categories: music therapy, laughter therapy, spiritual and cognitive interventions, aromatherapy, interdisciplinary and community-based teams, advance care planning and community, volunteering, telemedicine and care mapping. Example: Educating people to talk about different ethical issues could improve their quality of life and help develop more compassionate cities. Conclusions: We have identified interventions that are easily accessible (laughter therapy, telemedicine or music therapy), simple enough to be carried out at the community level and do not incur high costs. This is why they are recommended for people with palliative care needs in order to improve their quality of life. Full article

This article proposes a theoretical framework for STEM education. It begins by determining the epistemological (based on the Model of Educational Reconstruction and General Systems Theory) and pedagogical (grounded in Situated Learning Theory and co-teaching) alignments. Once these issues are established, a pedagogical model is proposed to facilitate the implementation of the STEM approach in the classroom. This is the IDEARR model, consisting of six phases (Initial, Deconstruction, Explanation, Application, Review, and Reporting) to address an ill-defined problem. This article concludes with a reflection on the educational implications that arise from adopting this theoretical framework for working on STEM education in classrooms, particularly those related to the organization and operation of educational institutions and the initial and ongoing training of teachers. Full article

Background/Objectives: Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a hereditary small vessel disease leading to significant morbidity and mortality. Despite advances in genetic diagnosis, the underlying pathophysiology remains incompletely understood. Proteomic studies offer insights into disease mechanisms by identifying altered protein expression patterns. Here, we conducted a proteomic analysis to elucidate molecular pathways associated with CADASIL. Methods: We enrolled genetically diagnosed CADASIL patients and healthy, genetically related controls. Plasma samples were subjected to proteomic analysis using the Olink platform, measuring 552 proteins across six panels. The data were analyzed from several approaches by using three different statistical methods: Exploratory Principal Component Analysis (PCA) and Partial Least Squares–Discriminant Analysis (PLS-DA), differential expression with moderated t-test, and gene set enrichment analysis (GSEA). In addition, bioinformatics analysis, including volcano plot, heatmap, and Variable Importance on Projection (VIP) scores from the PLS-DA model were drawn. Results: Significant differences in protein expression were observed between CADASIL patients and controls. RSPO1 and FGF-19 exhibited elevated levels (p < 0.05), while PPY showed downregulation (p < 0.05) in CADASIL patients, suggesting their involvement in disease pathogenesis. Furthermore, MIC-A/B expression varied significantly between patients with mutations in exon 4 versus exon 11 of the NOTCH3 gene (p < 0.05), highlighting potential immunological mechanisms underlying CADASIL. We identified altered pathways using GSEA, applied after ranking the study data. Conclusions: Our study provides novel insights into the proteomic profile of CADASIL, identifying dysregulated proteins associated with vascular pathology, metabolic dysregulation, and immune activation. These findings contribute to a deeper understanding of CADASIL pathophysiology and may inform the development of targeted therapeutic strategies. Further research is warranted to validate these biomarkers and elucidate their functional roles in disease progression. Full article