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In recent decades, there has been a growing interest in modeling spatial–temporal data, which can be found in many fields including geoscience, meteorology and ecology, among many others. The spatial–temporal dependence structure modeling, using a random field approach, is an indispensable tool to estimate the parameters that define this structure. However, this estimation may be greatly affected by the presence of atypical observations in the sampled data. Our proposal is to extend the results of Uribe-Opazo et al. (J Appl Stat 39:615–630, 2012) and De Bastiani et al. (Test 24:322–340, 2015) in the studies of diagnostic techniques to assess the sensitivity of the maximum likelihood estimators to small perturbations in the response variable for the spatial–temporal linear models with separable covariance. The method’s viability is illustrated in a simulation study, and in an application to eggs anchovy (Engraulis ringens) abundance data in ichthyoplankton surveys from the northern zone of Chile. The results show that the proposed methodology allows to detect influential observations in a spatial-temporal data set when their covariances are separable.

Cadmium (Cd)-induced oxidative stress and antioxidant defense mechanisms were analyzed in roots and leaves of Vigna mungo L. Seeds were germinated in perlite-vermiculite and irrigated with Hoagland nutrient solution. At day 6, seedlings were exposed to 40 μM Cd under semi-hydroponic conditions for a period of 12 days. Growth anomalies and abnormal chromatin condensation were observed in Cd-treated plants, in comparison with control ones. Cd accumulation was observed in roots of treated plants. The analyses of antioxidative defense and oxidative parameters in roots, stems and leaves showed different tissue-specific responses. Superoxide dismutase (SOD) and guaiacol peroxidase (GPx) activities and the level of lipid peroxidation (MDA content) decreased in roots. However, they increased in leaves. Catalase activity and chlorophyll content, on the other hand, decreased over exposure to Cd stress. Total glutathione, non-protein thiols, reduced glutathione (GSH) and phytochelatins increased significantly, while oxidized glutathione (GSSG) decreased, as compared with control plants. The present data suggest that the presence of Cd in soil and water can cause oxidative damage that may be detrimental for optimum production of nutritional mung.

Background: The main objective of this research was to analyze whether there were changes in the use of antidepressants, anxiolytics, and hypnotic-sedative drugs, in the context of primary health care, during the COVID-19 pandemic compared to the pre-pandemic period. We further sought to study consumption in vulnerable population groups. Methods: A cross-sectional observational study was performed in a primary health district of Spain. The data were obtained from the Andalusian Public Health System database, for the pre-COVID-19 period, from March 2019 to February 2020, and for the COVID-19 period, from March 2020 to February 2021. Univariant and bivariant analyses were performed. The effect size was measured using the Rosenthal test. Results: While the total number of medical prescriptions decreased by 2.5% in the COVID-19 period, the prescriptions of psychiatric drugs increased by 6.1%. The increase in the dose consumption per 1000 inhabitants (DHD) was highest for anxiolytics (7.2%), followed by hypnotic-sedatives (5.6%) and antidepressants (3.7%). The consumption of antidepressants, anxiolytics, and sedative-hypnotic drugs was higher in women, older people, and rural areas and lower in areas with social transformation needs, with these differences being statistically significant. Conclusions: The consumption of psychiatric drugs has increased over the COVID-19 pandemic, especially in women, older people, and rural areas. Thus, we should reflect on the adequate use of these drugs.

We analyzed plasma melatonin levels in different groups of preterm newborns without hypoxia and their relationship with several perinatal variables like gestational age or neonatal pain. Prospective cohort study of preterm newborns (PTNB) without perinatal hypoxia, Apgar > 6 at 5 min, and oxygen needs on the third day of life. We compared melatonin levels at day 3 of life in different groups of non-hypoxic preterm infants (Student’s t -tests, Mann-Whitney U , and chi 2 ) and analyzed the relationship of melatonin with GA, birth weight, neonatal pain (Premature Infant Pain Profile (PIPP) scale), caffeine treatment, parenteral nutrition, or the development of free radical diseases (correlation study, linear regression) and factors associated with moderate/intense pain and free radical diseases (logistic regression analysis). Sixty-one preterm infants with gestational age (GA) of 30.7 ± 2.0 weeks with no oxygen requirements at day 3 of life were studied with plasma melatonin levels of 33.8 ± 12.01 pg/ml. Preterm infants weighing < 1250 g at birth had lower plasma melatonin levels ( p  = 0.05). Preterm infants with moderate or severe pain (PPIPP > 5) have lower melatonin levels ( p  = 0.01), and being preterm with PIPP > 5 is associated with lower plasma melatonin levels ( p  = 0.03). Being very preterm (GA < 32 GS), having low weight for gestational age (LWGA), receiving caffeine treatment, or requiring parenteral nutrition did not modify melatonin levels in non-hypoxic preterm infants ( p  = NS). Melatonin on day 3 of life in non-hypoxic preterm infants is not associated with later development of free radical diseases (BPD, sepsis, ROP, HIV, NEC). Conclusion : We observed that preterm infants with moderate to severe pain have lower melatonin levels. These findings are relevant because they reinforce the findings of other authors that melatonin supplementation decreases pain and oxidative stress in painful procedures in premature infants. Further studies are needed to evaluate whether melatonin could be used as an analgesic in painful procedures in preterm infants. Trial registration : Trial registration was not required since this was an observational study. What Is Known: • Melatonin is a potent antioxidant and free radical scavenger in newborns under stress conditions: hypoxia, acidosis, hypotension, painful procedures, or parenteral nutrition. • Pain stimulates the production of melatonin. • Various studies conclude that melatonin administration decreases pain during the neonatal period. What Is New: • Non-hypoxic preterm infants with moderate to severe pain (PIPP>5) have lower levels of melatonin. • Administration of caffeine and treatment with parenteral nutrition do not modify melatonin levels in non-hypoxic preterm infants.

The main objective of this study was to analyze the degree of knowledge and compliance of Spanish pediatricians with the “do not do” recommendations of the Spanish Association of Pediatrics. A nationwide cross-sectional, descriptive study was carried out using a 25-item questionnaire among Spanish pediatricians. Univariate, bivariate, and multivariate analyses were performed. A total of 1137 pediatricians participated in the study. Most of them were women (75.1%), older than 55 (28.3%), worked in specialized care (56.9%), with public financing (91.2%), and had been working for more than 20 years (44.9%). The median of inappropriate answers per question was 9.1%. The bivariate and multivariate analyses showed that the factors that influenced higher adequacy to the “do not do” recommendations were younger than 45 years, working in specialized care, and working in the public health system. Conclusion :This research is the first nationwide study in Spain to analyze the adequacy of “do not do” pediatric clinical recommendations. The study showed a high level of compliance by Spanish pediatricians with these recommendations. However, there is a lack of knowledge in less frequent infectious pathologies such as HIV or fungal infections, in not prolonging antibiotic treatment unnecessarily and directing it appropriately according to the antibiogram results. These aspects may be improved by designing measures to enhance pediatricians’ knowledge in these specific aspects. Some demographical factors are related to higher adequacy. Performing this research in other countries may allow assessing the current clinical practice of pediatricians. What is Known: • Low-value care is defined as care that delivers little or no benefit, may cause patients harm, or outcomes marginal benefits at a disproportionately increased cost. • Few nationwide studies have assessed adherence to \"do not do\" guidelines, especially in pediatric settings. What is New: • Albeit there is a high level of compliance by Spanish pediatricians with the «do not do» recommendations, there is a lack of knowledge in different aspects that may be improved. • Some demographical factors are related to higher adequacy. Performing this research in other countries may allow assessing the current clinical practice of pediatricians.

Background: Medication conciliation allows finding discrepancies and medication errors in healthcare transitions, but there are few studies performed after hospital discharge, in the context of primary health care. Therefore, the main aim of this research was to evaluate the process of medication conciliation in primary health care, after hospital discharge. We further sought to analyze some demographic aspects of the patients that could be associated with potential discrepancies. Methods: A cross-sectional study was performed using the database which contained the records generated by the medication reconciliations performed by the physicians of the Andalusian Public Health Service, in Spain. Results: A total of 6115 medication conciliations were analyzed, and discrepancies were found in 73.7% of them. A total of 50.6% were medication errors, the most frequent being medication omission. Medication errors were more prevalent in women of 65 years and older. Conclusions: After hospital discharge, most patients show medication discrepancies in their records, particularly older women. To prevent this, primary health care plays an essential role in the conciliation process, therefore more research is needed in this context.

Objective: Since obesity has been associated with a higher inflammatory burden and worse response to therapy in patients with chronic inflammatory rheumatic diseases (CIRD), we aimed to confirm the potential association between body mass index (BMI) and disease activity in a large series of patients with CIRDs included in the Spanish CARdiovascular in rheuMAtology (CARMA) registry. Methods: Baseline data analysis of patients included from the CARMA project, a 10-year prospective study of patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) attending outpatient rheumatology clinics from 67 Spanish hospitals. Obesity was defined when BMI (kg/m2) was >30 according to the WHO criteria. Scores used to evaluate disease activity were Disease Activity Score of 28 joints (DAS28) in RA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in AS, and modified DAS for PsA. Results: Data from 2234 patients (775 RA, 738 AS, and 721 PsA) were assessed. The mean ± SD BMI at the baseline visit were: 26.9 ± 4.8 in RA, 27.4 ± 4.4 in AS, and 28.2 ± 4.7 in PsA. A positive association between BMI and disease activity in patients with RA (β = 0.029; 95%CI (0.01–0.05); p = 0.007) and PsA (β = 0.036; 95%CI (0.015–0.058); p = 0.001) but not in those with AS (β = 0.001; 95%CI (−0.03–0.03); p = 0.926) was found. Disease activity was associated with female sex and rheumatoid factor in RA and with Psoriasis Area Severity Index and enthesitis in PsA. Conclusions: BMI is associated with disease activity in RA and PsA, but not in AS. Given that obesity is a potentially modifiable factor, adequate control of body weight can improve the outcome of patients with CIRD and, therefore, weight control should be included in the management strategy of these patients.

Introducción: Diversos estudios han reportado un déficit de autocuidado por parte de estudiantes de enfermería con un predominio de inadecuados hábitos alimentarios, tabaquismo, sedentarismo, elevado consumo de alcohol y mal manejo del estrés. Objetivo: Caracterizar el estilo de vida de los estudiantes de la carrera de Licenciatura en Enfermería de ocho instituciones de educación superior de la República Argentina. Material y métodos: Estudio multicéntrico, descriptivo y cuantitativo. Se implementó el instrumento Health Promoting Lifestile Profile – II de Nola Pender compuesto por 52 reactivos y agrupado en seis dimensiones. Resultados: Participaron 1718 estudiantes de la carrera de Licenciatura en Enfermería de ocho instituciones de nivel superior de Argentina. Los encuestados tenían una edad media de 29,48 años (DE=9,66), de instituciones carácter público (67,00%) y del segundo año del plan de estudios (32,54%). Las dimensiones mejor y peor valoradas fueron Autorrealización y Manejo del estrés con un 61,93% y 19,38% de la muestra con valoración saludable, respectivamente. El Estilo de vida en general fue caracterizado como regular en el 68,92% de los estudiantes y fue saludable solo en el 4,77%. Conclusión: El estilo de vida de los estudiantes fue mayormente regular y se identificaron relaciones con las variables sociodemográficas y educativas. Palabras clave: Estilos de vida saludable; Estudiantes; Enfermería; Autocuidado; Promoción de la Salud.   Abstract. Introduction: Several studies have reported a deficit of self-care in nursing students with a predominance of inadequate eating habits, smoking, a sedentary lifestyle, high alcohol consumption, and poor stress management. Objective: the purpose of this research was to characterize the lifestyle of students of the Bachelor's Degree in Nursing at eight institutions of higher education in Argentina. Material and methods: Multicenter, descriptive, and quantitative study. The Nola Pender's Health Promoting Lifestyle Profile - II tool which consist of 52 items that are categorized into six dimensions. Results: A total of 1,718 undergraduate nursing students from eight institutions of higher education in Argentina participated in the study. Respondents had a mean age of 29.48 years (SD: 9.66), were from public institutions (67.00%) and were in the second year of the study plan (32.54%). The best and worst rated dimensions were Self-realization and Stress management with 61.93% and 19.38% of the sample having a healthy rating, respectively. Lifestyle in general was characterized as regular in 68.92% of the students and was healthy in only 4.77%. Conclusion: It can be concluded that the lifestyle of the students was mostly regular, and relationships were identified between the sociodemographic and educational variables. Keywords: Healthy lifestyles; Students; Nursing; Self-care; Health Promotion.

Introduction: Several studies have reported a deficit of self-care in nursing students with a predominance of inadequate eating habits, smoking, a sedentary lifestyle, high alcohol consumption, and poor stress management. Objective: the purpose of this research was to characterize the lifestyle of students of the Bachelor's Degree in Nursing at eight institutions of higher education in Argentina. Material and methods: Multicenter, descriptive, and quantitative study. The Nola Pender's Health Promoting Lifestyle Profile - II tool which consist of 52 items that are categorized into six dimensions. Results: A total of 1,718 undergraduate nursing students from eight institutions of higher education in Argentina participated in the study. Respondents had a mean age of 29.48 years (SD: 9.66), were from public institutions (67.00%) and were in the second year of the study plan (32.54%). The best and worst rated dimensions were Self-realization and Stress management with 61.93% and 19.38% of the sample having a healthy rating, respectively. Lifestyle in general was characterized as regular in 68.92% of the students and was healthy in only 4.77%. Conclusion: It can be concluded that the lifestyle of the students was mostly regular, and relationships were identified between the sociodemographic and educational variables. Introducción: Diversos estudios han reportado un déficit de autocuidado por parte de estudiantes de enfermería con un predominio de inadecuados hábitos alimentarios, tabaquismo, sedentarismo, elevado consumo de alcohol y mal manejo del estrés. Objetivo: Caracterizar el estilo de vida de los estudiantes de la carrera de Licenciatura en Enfermería de ocho instituciones de educación superior de la República Argentina. Material y métodos: Estudio multicéntrico, descriptivo y cuantitativo. Se implementó el instrumento Health Promoting Lifestile Profile – II de Nola Pender compuesto por 52 reactivos y agrupado en seis dimensiones. Resultados: Participaron 1718 estudiantes de la carrera de Licenciatura en Enfermería de ocho instituciones de nivel superior de Argentina. Los encuestados tenían una edad media de 29,48 años (DE=9,66), de instituciones carácter público (67,00%) y del segundo año del plan de estudios (32,54%). Las dimensiones mejor y peor valoradas fueron Autorrealización y Manejo del estrés con un 61,93% y 19,38% de la muestra con valoración saludable, respectivamente. El Estilo de vida en general fue caracterizado como regular en el 68,92% de los estudiantes y fue saludable solo en el 4,77%. Conclusión: El estilo de vida de los estudiantes fue mayormente regular y se identificaron relaciones con las variables sociodemográficas y educativas.