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Background: We aimed to study anxiety, depression and quality of life in smokers after stroke by sex. Methods: A longitudinal prospective study with a 24-month follow-up of acute stroke patients who were previously active smokers. Anxiety and depression were evaluated with the Hospital Anxiety and Depression scale, and quality of life was evaluated with the EQ-5D questionnaire. Results: One hundred and eighty patients participated (79.4% men); their mean age was 57.6 years. Anxiety was most prevalent at 3 months (18.9% in men and 40.5% in women) and depression at 12 months (17.9% in men and 27% in women). The worst perceived health occurred at 24 months (EQ-VAS 67.5 in men and 65.1 in women), which was associated with depression (p < 0.001) and Rankin Scale was worse in men (p < 0.001) and depression in women (p < 0.001). Continued tobacco use was associated with worse perceived health at 3 months in men (p = 0.034) and at 12 months in both sexes. Predictor variables of worse perceived health at 24 months remaining at 3 and 12 months were tobacco use in men and neurological damage in women. Conclusion: Differences by sex are observed in the prevalence of anxiety and depression and associated factors and in the predictive factors of perceived health.

Background: School nurses play a crucial role in promoting student health, addressing issues such as substance use, mental health, physical health, violence, and sexual health. However, their job satisfaction has been understudied, particularly in relation to the challenges they face. Objective: This study evaluates the job satisfaction and professional quality of life among school nurses and nurses working in educational settings in Spain. Methods: A descriptive cross-sectional study was conducted (November 2023–February 2024) with 553 nurses from various regions of Spain, using the Font-Roja job satisfaction and CPV-35 professional quality of life questionnaires. Results: Our results showed significant differences in job satisfaction between nurses in healthcare and educational settings, influenced by factors such as workload and institutional support. Most participants (97.5% women, median age ~40 years) had less than 5 years of experience. The lack of a dedicated nurse in half of the schools highlights disparities in service provision. Discussion: This study emphasizes the need for supportive policies and work environments to improve the well-being and job satisfaction of nurses in school settings.

This study sought to evaluate the impact of virtual reality (VR) tools in procedural planning of transcatheter aortic valve replacement. A prospective study involving 11 patients referred for transcatheter aortic valve replacement was conducted. A multidetector computed tomography was used to acquire and segment the anatomy of the access route and landing zone. From the information obtained with the multidetector computed tomography in DICOM format, we built a virtual platform (VisuaMed, Techer Team, Valencia, Spain) that contains all the clinical information of the patients and a virtualized model of their anatomy. Wearing VR devices, the professional was able to ‘walk inside’ the anatomy in an interactive and immersive way. Decisions after the evaluation of routine clinical images were compared with those after experience with VR models and intraprocedural findings.

Thyroid dysfunction is a common health disorder. However, data on its incidence remain scarce and geographically limited. This study aimed to assess the incidence of thyroid dysfunction in the Spanish adult population and factors associated with its onset. A nationwide observational population‑based cohort study was conducted, including 1,629 euthyroid individuals (not receiving levothyroxine/thionamides, and TSH levels of 0.2-5.0mIU/mL) at baseline (2008–2010), who were re-evaluated in 2016–2017. Multivariable logistic regression analysis assessed the association between incident thyroid dysfunction and potential exposure factors. ROC analysis identified optimal TPOAb and TSH cut-offs for predicting incident hypothyroidism. The age- and sex-adjusted incidence of hypothyroidism was 13.38cases/1,000persons-year (CI95% 10.52–16.25) for TSH ≥ 5mIU/mL, and 6.78cases/1,000persons-year (CI95% 4.73–8.83) for TSH ≥ 10mIU/mL. The incidence of hyperthyroidism was 2.65cases/1,000persons-year (CI95% 1.46–3.83). Female sex, age between 30 and 40 and > 60 years, TPOAb > 20mIU/L and TSH > 2.8mIU/mL were independently associated with new cases of hypothyroidism. The presence of obesity, diabetes or urinary iodine levels were not associated with the incidence of thyroid disease. Baseline TPOAb and TSH cut-offs best predicting hypothyroidism were 9.1mIU/L (AUC 0.654; CI95% 0.583–0.725; p  < 0.001), and 2.03mIU/mL (AUC 0.702; CI95% 0.639–0.766; p  < 0.001) respectively. This study provides data on incidence rates and risk factors of thyroid dysfunction in the adult Spanish population.

Exposure to air particulate matter has been linked with hypertension and blood pressure levels. The metabolic risks of air pollution could vary according to the specific characteristics of each area, and has not been sufficiently evaluated in Spain. We analyzed 1103 individuals, participants in a Spanish nationwide population based cohort study (di@bet.es), who were free of hypertension at baseline (2008–2010) and completed a follow-up exam of the cohort (2016–2017). Cohort participants were assigned air pollution concentrations for particulate matter < 10 μm (PM 10 ) and < 2.5 μm (PM 2.5 ) during follow-up (2008–2016) obtained through modeling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). Mean and SD concentrations of PM 10 and PM 2.5 were 20.17 ± 3.91 μg/m 3 and 10.83 ± 2.08 μg/m 3 respectively. During follow-up 282 cases of incident hypertension were recorded. In the fully adjusted model, compared with the lowest quartile of PM 10, the multivariate weighted ORs (95% CIs) for developing hypertension with increasing PM 10 exposures were 0.82 (0.59–1.14), 1.28 (0.93–1.78) and 1.45 (1.05–2.01) in quartile 2, 3 and 4 respectively ( p for a trend of 0.003). The corresponding weighted ORs according to PM 2.5 exposures were 0.80 (0.57–1.13), 1.11 (0.80–1.53) and 1.48 (1.09–2.00) ( p for trend 0.004). For each 5-μg/m 3 increment in PM 10 and PM 2.5 concentrations, the odds for incident hypertension increased 1.22 (1.06–1.41) p  = 0.007 and 1.39 (1.07–1.81) p  = 0.02 respectively. In conclusion, our study contributes to assessing the impact of particulate pollution on the incidence of hypertension in Spain, reinforcing the need for improving air quality as much as possible in order to decrease the risk of cardiometabolic disease in the population.

Most of the indicators for STEM programs in higher education such as the number of programs and students enrolled depend on what is considered as a STEM program. Currently, each country develops its own STEM indicators, without establishing comparable criteria across countries for the selection of the programs considered STEM, which make it difficult for a correct comparison between countries. Despite this, the OECD publishes comparative reports on the state of STEM higher education among its member countries. The OECD develops these reports with data provided by each country; that is, each country decides the mechanisms to produce the data. This paper proposes a selection criterion of STEM programs to generate internationally comparable data. This work obtains the selection criterion through a conceptual and contextual socio-historical review of the STEM movement. This work conducts an exploratory case study in Mexico from 2011 to 2017 to show the discrepancy in STEM higher education indicators when using different selection criteria. The results show that 60% of the programs classified as STEM, do not meet the classification criteria established. Also, that 60 % of misclassified programs have a higher curricular content of administrative or social subjects, but in their name includes words that refer to STEM fields. The authors call these programs as Management-STEM (MSTEM).

ObjectivesThe objective of COAST-Y was to evaluate the effect of continuing versus withdrawing ixekizumab (IXE) in patients with axial spondyloarthritis (axSpA) who had achieved remission.MethodsCOAST-Y is an ongoing, phase III, long-term extension study that included a double-blind, placebo (PBO)-controlled, randomised withdrawal-retreatment period (RWRP). Patients who completed the originating 52-week COAST-V, COAST-W or COAST-X studies entered a 24-week lead-in period and continued either 80 mg IXE every 2 (Q2W) or 4 weeks (Q4W). Patients who achieved remission (an Ankylosing Spondylitis Disease Activity Score (ASDAS)<1.3 at least once at week 16 or week 20, and <2.1 at both visits) were randomly assigned equally at week 24 to continue IXE Q4W, IXE Q2W or withdraw to PBO in a blinded fashion. The primary endpoint was the proportion of flare-free patients (flare: ASDAS≥2.1 at two consecutive visits or ASDAS>3.5 at any visit) after the 40-week RWRP, with time-to-flare as a major secondary endpoint.ResultsOf 773 enrolled patients, 741 completed the 24-week lead-in period and 155 entered the RWRP. Forty weeks after randomised withdrawal, 83.3% of patients in the combined IXE (85/102, p<0.001), IXE Q4W (40/48, p=0.003) and IXE Q2W (45/54, p=0.001) groups remained flare-free versus 54.7% in the PBO group (29/53). Continuing IXE significantly delayed time-to-flare versus PBO, with most patients remaining flare-free for up to 20 weeks after IXE withdrawal.ConclusionsPatients with axSpA who continued treatment with IXE were significantly less likely to flare and had significantly delayed time-to-flare compared with patients who withdrew to PBO.

In previous studies, our group developed a method based on Confocal Laser Scanning Microscopy and Image Analysis (CLSM-IA) to analyze the diversity and biomass of cyanobacteria in microbial mats. However, this method cannot be applied to heterotrophic microorganisms, as these do not have autofluorescence. In this article, we present a method that combines CLSM-IA and Hoechst 33342 and SYTOX Green fluorochromes (FLU-CLSM-IA) to determine the viability and biomass of Micrococcus luteus DE2008, isolated from a saline microbial mat (Ebro Delta, Tarragona, Spain). The method has been applied to assess the effect of salinity on this microorganism. A reduction in viability and biomass (live cells) was observed as the salt concentration increases. The largest effect was at 100‰ NaCl with a cell death of 27.25% and a decrease in total and individual biomass of 39.75 and 0.009 mgC/cm3, respectively, both with respect to optimal growth (10 ‰ NaCl). On the other hand, another important contribution of this article was that combining the FLU-CLSM-IA results with those achieved by plate counts enabled us to determine, for first time, the viability and the total biomass of the “dormant cells” (66.75% of viability and 40.59 mgC/cm3 of total biomass at 100‰ NaCl). FLU-CLSM-IA is an efficient, fast, and reliable method for making a total count of cells at pixel level, including the dormant cells, to evaluate the viability and the biomass of a hetetrophic microorganism, M. luteus DE2008.

A bacterial strain (DE2008) was isolated from a consortium of microorganisms living in the microbial mats of the Ebro Delta with the ability to grow under conditions of high concentrations of lead and copper. Strain DE2008 has been characterized by microscopic and metabolic techniques and identified by sequencing of PCR-amplified 16S rRNA gene fragments as Micrococcus luteus . The strain is highly resistant to lead and copper. Micrococcus luteus DE2008 grew optimally until levels of 1 mM of Pb(NO 3 ) 2 and CuSO 4 , respectively, and was completely inhibited at 3 mM Pb(NO 3 ) 2 and at 1.5 mM CuSO 4 . Elemental analysis determined by energy-dispersive X-ray spectroscopy (EDX) coupled with scanning electron microscopy and transmission electron microscopy from polluted cultures of DE2008 show that this microorganism can biosorpt Pb and Cu in exopolysaccharide envelopes, without accumulating them inside the cells.

Major depressive disorder (MDD) is a complex psychiatric disorder that affects the lives of hundreds of millions of individuals around the globe. Even today, researchers debate if morphological alterations in the brain are linked to MDD, likely due to the heterogeneity of this disorder. The application of deep learning tools to neuroimaging data, capable of capturing complex non-linear patterns, has the potential to provide diagnostic and predictive biomarkers for MDD. However, previous attempts to demarcate MDD patients and healthy controls (HC) based on segmented cortical features via linear machine learning approaches have reported low accuracies. In this study, we used globally representative data from the ENIGMA-MDD working group containing 7,012 participants from 30 sites (N=2,772 MDD and N=4,240 HC), which allows a comprehensive analysis with generalizable results. Based on the hypothesis that integration of vertex-wise cortical features can improve classification performance, we evaluated the classification of a DenseNet and a Support Vector Machine (SVM), with the expectation that the former would outperform the latter. As we analyzed a multi-site sample, we additionally applied the ComBat harmonization tool to remove potential nuisance effects of site. We found that both classifiers exhibited close to chance performance (balanced accuracy DenseNet: 51%; SVM: 53%), when estimated on unseen sites. Slightly higher classification performance (balanced accuracy DenseNet: 58%; SVM: 55%) was found when the cross-validation folds contained subjects from all sites, indicating site effect. In conclusion, the integration of vertex-wise morphometric features and the use of the non-linear classifier did not lead to the differentiability between MDD and HC. Our results support the notion that MDD classification on this combination of features and classifiers is unfeasible. Future studies are needed to determine whether more sophisticated integration of information from other MRI modalities such as fMRI and DWI will lead to a higher performance in this diagnostic task.