BACKGROUND:Autochthonous strongyloidiasis in Spain has traditionally been considered a recognized but underdiagnosed condition, primarily affecting individuals in agricultural environments along the Mediterranean coast. We describe the first series of autochthonous strongyloidiasis cases diagnosed in Asturias, a region in northern Spain with no previously documented endemic transmission. METHODS:This is a retrospective review of all diagnosed cases of autochthonous strongyloidiasis at the Central University Hospital of Asturias, from 2016 to 2024. Inclusion required no travel history to endemic areas. Clinical records were reviewed for demographic data, symptoms, risk factors, laboratory findings, and treatment outcomes. Diagnosis was based on stool microscopy, S. stercoralis IgG serology, and polymerase chain reaction. RESULTS:We identified 33 patients (54.5 % female, mean age 52 ± 20 years). The primary risk factor was residence in a rural area (63.6 %), frequently associated with gardening that was the most common risk factor (57.5 %). Symptoms were reported in 78.7 % of cases, most commonly abdominal pain (46 %) and pruritus (38.4 %). Eosinophilia was present in 33.3 % of cases. Diagnosis relied primarily on serology (71.4 %) and PCR (56.2 %). Stool microscopy detected larvae in only two patients (6 %). Three patients (9.3 %) developed severe forms, including one fatal case. CONCLUSIONS:This study provides strong evidence of ongoing autochthonous transmission of Strongyloides stercoralis in northern Spain, affecting a younger and more gender-balanced population than previously described. Recreational rather than occupational exposure was the predominant risk factor. Routine screening should be considered in autochthonous individuals with eosinophilia or prior to immunosuppressive therapy to prevent severe outcomes.

OBJECTIVES:The objective of this study was to assess the accuracy of a novel algorithm-designed in accordance with guidelines from the American College of Obstetricians and Gynecologists and the American Society for Microbiology-for detecting group B Streptococcus (GBS) colonization in pregnant women. Additionally, the study aimed to determine the potential impact of this algorithm on early-onset neonatal group B streptococcal disease (GBS-EOD) cases. METHODS:From March 2021 to March 2024, 5034 vaginal-rectal samples were collected from pregnant women at 35 weeks to 37 weeks gestation using ESwab™ medium. Samples were cultured in Todd Hewitt broth, subcultured on Granada medium, and tested with the DiaSorin Simplexa™ GBS Direct Assay (positive if Cycle threshold ≤ 35). Antimicrobial susceptibility testing was conducted on GBS isolates from penicillin-allergic women. GBS-positive women received intrapartum antibiotic prophylaxis. The study also reviewed cases of GBS-EOD during the same period. RESULTS:In total, 938 (18.6%) pregnant women were colonized with GBS. Among these, 625 samples (66.6%) were culture-positive, whereas 313 (33.4%) were culture-negative, but broth-enriched nucleic acid amplification test (NAAT)-positive. No samples were broth-enriched NAAT-negative and culturepositive. The broth-enriched NAAT demonstrated a sensitivity of 100 (95% CI: 99-100) and a specificity of 93 (95% CI: 92-94), along with a positive predictive value of 67 (95% CI: 67-70) and a negative predictive value of 100 (95% CI: 100-100). There was substantial agreement between methods (Cohen's kappa = 0.76 [95% CI: 0.74-0.79]). All 45 GBS isolates from penicillin-allergic women were susceptible to penicillin, ampicillin, and vancomycin, whereas 44.4% (20/45) were resistant to erythromycin, and 40% (18/45) were resistant to clindamycin. No cases of GBS-EOD were detected among the 5563 live newborns during the study period (95% CI: 0-0.054%). DISCUSSION:The novel algorithm was rapid, sensitive, and specific, effectively identifying candidates for intrapartum antibiotic prophylaxis, potentially reducing newborn infection and lowering GBS-EOD incidence and neonatal mortality rates. Integrating broth-enriched NAATs to verify negative culture samples could enhance detection and prevention efforts.

Cystic fibrosis (CF) is a genetic disease that causes dehydration of the surface of the airways, increasing lung infections, most frequently caused by Pseudomonas aeruginosa. Exosomes are nanovesicles released by cells that play an essential role in intercellular communication, although their role during bacterial infections is not well understood. In this article, we analyze the alterations in exosomes produced by healthy bronchial epithelial and cystic fibrosis cell lines caused by the interaction with P. aeruginosa. The proteomic study detected alterations in 30% of the species analyzed. In healthy cells, they mainly involve proteins related to the extracellular matrix, cytoskeleton, and various catabolic enzymes. In CF, proteins related to the cytoskeleton and matrix, in addition to the proteasome. These differences could be related to the inflammatory response. A study of miRNAs detected alterations in 18% of the species analyzed. The prediction of their potential biological targets identified 7149 genes, regulated by up to 7 different miRNAs. The identification of their functions showed that they preferentially affected molecules involved in binding and catalytic activities, although with differences between cell types. In conclusion, this study shows differences in exosomes between CF and healthy cells that could be involved in the response to infection.

Suicide is a major public health problem, especially among individuals over 50 years old. Despite the suitability of this life stage for prevention, research on the efficacy of psychological interventions is scarce and methodologically limited, affecting their clinical utility and efficacy. Brief, flexible interventions that can be applied both in-person and remotely are needed. This study aims to evaluate the efficacy of a brief problem-solving-based suicide prevention program applied through various modalities to individuals over 50 years old. A randomized controlled trial will be conducted. A sample of 212 adults aged 50 or older with suicidal ideation will be randomly assigned to a problem-solving-based psychological intervention administered face-to-face (PSPI-P; n = 53), by telephone multiconference (PSPI-M; n = 53), via a smartphone app (PSPI-A; n = 53), or to a usual care control group (UCCG; n = 53). The intervention will be delivered in 7 sessions or modules of 90 min each. Blind trained evaluators will conduct assessments at pre-intervention, post-intervention, and follow-ups at 3, 6, and 12 months. The primary outcome will be suicidal ideation evaluated using the Suicidal Ideation Scale (SSI) and the Columbia Suicide Severity Rating Scale (C-SSRS). Secondary outcomes will include hopelessness, anxiety and depression symptoms, reasons for living, impulsivity, problem-solving skills, social support, anger syndrome, gratitude, personality, dropouts, treatment adherence, and satisfaction with the intervention. This study will provide evidence of the efficacy of a brief problem-solving-based intervention for suicide prevention in individuals over 50 years old, administered face-to-face, by telephone multiconference, and via a smartphone app. If results are favorable, it will indicate that an effective, accessible, clinically and socially useful suicide prevention intervention has been developed for affected individuals, families, and communities. ClinicalTrials.gov NCT06338904. Registered April 1, 2024.

Background/objective: Despite the potential impact of a physical disability on health-related quality of life (HRQoL), few methodologically rigorous investigations on the topic have been conducted. The objective of this study was to determine the potential impact of HRQoL and associated factors in people with physical disabilities. Methods: The participants were 479 people with physical disabilities (56.8% women, mean age = 52.3 years). HRQoL domains (i.e., physical health, psychological health, social relationships and environment) were assessed using the World Health Organization Quality of Life Brief Version (WHOQOL-BREF); as well as the sociodemographic, disability, and clinical variables. Results: The predictors for the various domains were as follows: physical domain: ethnicity, employment status, medication use, depression, reward, extraversion, and psychoticism; psychological domain: employment status, anxiety, depression, and purpose; social relations domain: employment status, depression, reward, neuroticism, social support, empowerment, optimism and self-esteem; and environment domain: monthly economic income, depression, reward, neuroticism, extraversion, rational problem-solving skills, social support, and empowerment. Conclusions: These findings highlight the need to develop evidence-based programs to promote HRQoL in this population that address the specific predictors within each domain, reduce symptomatology predictive of worse HRQoL; and increase psychological and social resources to better support HRQoL.

IntroductionAlthough previous research has demonstrated that resilience can be protective against various mental health conditions such as depression, existing studies examining the relationship between resilience and depression have limitations. To our knowledge, the moderators of the relationship have not been examined. The aim of this study was to determine whether resilience acts as a protective factor against depression in informal caregivers and to examine potential moderators of the relationship between these variables.MethodsIn this cross-sectional study, 554 randomly selected informal caregivers participated (86.8% women, average age = 55.3 years). Major depressive episode, depressive symptomatology, resilience, positive environmental reward, negative automatic thoughts, self-efficacy, and personality were assessed.ResultsA total of 16.1% of informal caregivers met criteria for a depressive episode and 57.4% were at risk of developing depression. The average resilience score was 26.3 (SD = 7.6); 62.6% of participants were in the lower quartile of the resilience scale. The gender of the informal caregiver and self-efficacy acted as moderating variables in the relationship between resilience and depression. The impact of resilience on depressive symptoms was more pronounced in female informal caregivers, and increased as self-efficacy increased.DiscussionBased on these findings, programs aimed at preventing depression in informal caregivers should focus on promoting resilience, especially in women, and introduce strategies to enhance self-efficacy to increase their impact.

Background Due to the accessibility barriers of in-person programs for active aging, the development of programs that use innovative technologies is needed. Video games can be an engaging tool for disseminating active aging interventions. Objective The objective of this pilot study was to analyze the feasibility of a cognitive–behavioral intervention to promote active aging administered through a video game. Methods Fifty-five participants (63.6% women, mean age = 53.0 years) were randomly assigned to a cognitive–behavioral intervention to promote active aging administered through an interactive multimedia online video game with a complementary app (CBI-V; n = 29) or to a control group that received nonspecific online information (CG; n = 26). Results Only 3.6% of the participants dropped out of the study (6.9% in CBI-V and 0.0% in CG; without significant differences between groups). The mean number of modules completed was 7.6 (SD = 0.9) out of 8 in the CBI-V and 7.9 (SD = 0.5) in the control group (CG), without significant between-group differences. In the CBI-V, the mean total time dedicated to the game was 516.8 min (SD = 94.3), including 143.2 min (SD = 31.6) of cognitive training tasks, and the mean of completed tasks was 206.2 (SD = 33.7) out of 259. Participants were highly engaged (M = 39.9, SD = 8.6) and satisfied (M = 25.8, SD = 4.5) with the intervention. After the intervention, the CBI-V group significantly improved on SF-36 dimensions of General Health (p = .0386), Vitality (p = .0283), Social Functioning (p = .0130), and Physical Summary Index (p = .0370) compared to the CG, with medium effect sizes (d = 0.56–0.75). Conclusions The results demonstrate the feasibility of the video game intervention to promote active aging and encourage conducting a large-scale randomized controlled trial.

Cumulative evidence suggests that zebrafish is a useful model in psychiatric research. Weighted Gene Co-expression Network Analysis (WGCNA) enables the reduction of genome-wide expression data to modules of highly co-expressed genes, which are hypothesized to interact within molecular networks. In this study, we first applied WGCNA to zebrafish brain expression data across different experimental conditions. Then, we characterized the different co-expression modules by gene-set enrichment analysis and hub gene-phenotype association. Finally, we analyzed association of polygenic risk scores (PRSs) based on genes of some interesting co-expression modules with alcohol dependence in 524 patients and 729 controls from Galicia, using competitive tests. Our approach revealed 34 co-expression modules in the zebrafish brain, with some showing enrichment in human synaptic genes, brain tissues, or brain developmental stages. Moreover, certain co-expression modules were enriched in psychiatry-related GWAS and comprised hub genes associated with psychiatry-related traits in both human GWAS and zebrafish models. Expression patterns of some co-expression modules were associated with the tested experimental conditions, mainly with substance withdrawal and cold stress. Notably, a PRS based on genes from co-expression modules exclusively associated with substance withdrawal in zebrafish showed a stronger association with human alcohol dependence than PRSs based on randomly selected brain-expressed genes. In conclusion, our analysis led to the identification of co-expressed gene modules that may model human brain gene networks involved in psychiatry-related traits. Specifically, we detected a cluster of co-expressed genes whose expression was exclusively associated with substance withdrawal in zebrafish, which significantly contributed to alcohol dependence susceptibility in humans.

Water scarcity and droughts are major challenges for cattle production in Iran due to the resulting feed shortages. Cactus plants were studied for 3 years (2017–2019) for their agronomic and water productivity. The study used a four-replication randomized block design. Normal, moderate drought stress and severe drought stress irrigation were applied in 2017. The irrigation depths applied to the cactus plants were established by referencing cumulative pan evaporation values, with 100, 140 and 180 mm in 2017; 140, 190 and 240 mm in 2018; and 160, 210 and 260 mm in 2019, representing the total depth of water added during each irrigation event. In 2018 and 2019, the normal and severe drought stress treatments produced the most and least number of cladodes per plant, respectively. As dry stress increased, the cladode length, breadth and diameter decreased. Severe drought stress had the greatest potassium content and the lowest neutral detergent fibre (NDF) and acid detergent fibre (ADF) concentrations. Normal irrigation had the greatest effect on water productivity in 2018 and 2019. The usual treatment produced the greatest fresh and dry yields in 2018 (57.3 and 4.51 t ha−1) and 2019 (112 and 8.97 t ha−1). Under mild drought stress, the crude protein content was 8%, and under severe drought stress, it was 7%. The results suggest that Kerman, Iran, can grow cactus with less water. La pénurie d'eau et les sécheresses sont des défis majeurs en face de la production de bétail en Iran en raison des pénuries alimentaires qui en résultent. Les plantes cactus ont été étudiées pendant trois ans (2017–2019) pour leur productivité agronomique et hydrique. L'étude a utilisé un plan en blocs aléatoire à quatre répétitions. Des systèmes d'irrigation normaux, modérés et sévères en ce qui concerne la sécheresse ont été appliqués en 2017. Les profondeurs d'irrigation appliquées aux plantes de cactus ont été établies en référençant les valeurs cumulatives d'évaporation pan, avec 100, 140 et 180 mm en 2017; 140, 190 et 240 mm en 2018; et 160, 210 et 260 mm en 2019, représentant la profondeur totale d'eau ajoutée lors de chaque événement d'irrigation. En 2018 et 2019, les traitements de stress de sécheresse normale et sévère ont produit le plus grand et le moins grand nombre de cladodes par plante, respectivement. À mesure que la contrainte sèche augmentait, la longueur, la largeur et le diamètre des cladodes diminuaient. Le stress de sécheresse sévère a eu la plus grande teneur en potassium et les plus faibles concentrations de la fibre de détergent neutre (NDF) et de la fibre de détergent acide (ADF). L'irrigation normale a exercé le plus grand impact sur la productivité de l'eau en 2018 et 2019. Le traitement habituel a produit les meilleurs rendements frais et secs en 2018 (57,3 et 4,51 t ha-1) et 2019 (112 et 8,97 t ha-1). En cas de sécheresse légère, la teneur en protéines brutes était de 8%, et en cas de sécheresse sévère, elle était de 7%. Les résultats suggèrent que Kerman, en Iran, peut cultiver des cactus avec moins d'eau. Data available in article supplementary material.

Introduction: Addressing suicide requires an understanding of regional patterns of epidemiology, with health variables being central. However, the clinical profile of people who commit suicide has received little attention. The objectives of this study were to analyze the sociodemographic, clinical, and forensic characteristics of persons who committed suicide in Galicia between 2013 and 2016, analyze suicide mortality rates, and identify trajectories of hospitalizations and associated variables. Material and methods: A population study was carried out on the 1354 people who died by suicide in Galicia. Results: The most common profile was a retired man, 57.9 years old (SD= 18.5), from an urban and inner area. 43.6% had been previously hospitalized, 41.6% had been diagnosed with physical disorders, and 26.8% with mental disorders. 48.2% had been prescribed psychiatric medications and 29.6% had received outpatient psychiatric care. The highest prevalence of death by suicide (27.5%) was in 2014, with the predominant method being hanging (59.1%). The average raw rate was 12.3/100,000. Three trajectories of hospitalizations emerged: 94.83% had experienced few hospitalizations; 2.95% an increasing pattern; and 2.22% a decreasing pattern. These trajectories were associated with number of psychiatric appointments, prescription of psychiatric medications, and diagnoses of physical and mental disorders. Conclusions: These findings are crucial for detection and prevention. (c) 2021 Sociedad Espanola de Psiquiatria y Salud Mental (SEPSM). Published by Elsevier Espana, S.L.U. All rights reserved.

Although the Geriatric Depression Scale (GDS) is a well-established instrument for the assessment of depressive symptoms in older adults, this has not been validated specifically for Portuguese cognitively impaired persons. The objective of this study was to analyze the psychometric properties of two Portuguese versions of the GDS (GDS-27 and GDS-15) in a Portuguese mild-to-moderate cognitively impaired sample. Clinicians assessed for major depressive disorder and cognitive functioning in 117 participants with mild to moderate cognitive decline (76.9% female, Mage = 83.66 years). The internal consistency of GDS-27 and GDS-15 were 0.874 and 0.812, respectively. There was a significant correlation between GDS-27 and GDS-15 with Beck Depression Inventory-II GDS-27: rho = 0.738, p < 0.001; GDS-15: rho = 0.760, p < 0.001), suggesting good validity. A cutoff point of 15/16 in GDS-27 and 8/9 in GDS-15 resulted in identification of persons with depression (GDS-27: sensitivity 100%, specificity 63%; GDS-15: sensitivity 90%, specificity 62%). Overall, the GDS-27 and GDS-15 are reliable and valid instruments for the assessment of depression in Portuguese-speaking cognitively impaired persons.

Although the Geriatric Depression Scale (GDS) is a well-established instrument for the assessment of depressive symptoms in older adults, this has not been validated specifically for Portuguese older adults with cognitive impairment. The objective of this study was to analyze the psychometric properties of two Portuguese versions of the GDS (GDS-27 and GDS-15) in a sample of Portuguese older adults with mild-to-moderate cognitive impairment. Clinicians assessed for major depressive disorder and cognitive functioning in 117 participants with mild-to-moderate cognitive decline (76.9% female, Mage = 83.66 years). The internal consistency of GDS-27 and GDS-15 were 0.874 and 0.812, respectively. There was a significant correlation between GDS-27 and GDS-15 with the Beck Depression Inventory-II (GDS-27: rho = 0.738, p < 0.001; GDS-15: rho = 0.760, p < 0.001), suggesting good validity. A cutoff point of 15/16 in GDS-27 and 8/9 in GDS-15 resulted in the identification of persons with depression (GDS-27: sensitivity 100%, specificity 63%; GDS-15: sensitivity 90%, specificity 62%). Overall, the GDS-27 and GDS-15 are reliable and valid instruments for the assessment of depression in Portuguese-speaking older adults with cognitive impairment.

Although sleep issues are among the symptoms commonly experienced by the non-professional caregiver population, and the Pittsburgh Sleep Quality Index (PSQI) is the most widely used instrument for the assessment of sleep quality, this has not been validated specifically for this population. The objective of this study was to analyze the factorial structure and psychometric properties of the Spanish version of the PSQI in a sample of Spanish non-professional caregivers. Trained clinical psychologists assessed sleep quality using the PSQI, as well as caregiver burden and psychological distress in 201 non-professional caregivers (87.1% female, Mage = 56.2 years). The internal consistency of the PSQI was 0.75. The two-factor model (Sleep quality and Disturbances) had an acceptable fit to the data, was found to be superior to the one-factor model, and more parsimonious than the three-factor model. There was a significant correlation between the PSQI and caregiver burden, as well as between the PSQI and psychological distress (p < 0.001 in all cases). A total score ≥ 9 allowed the identification of caregivers with possible anxiety and depression disorders (sensitivity 70.5%, specificity 71.9%). The results show that the PSQI is a reliable and valid instrument for the assessment of sleep quality in caregivers.

Mutational analysis of SARS-CoV-2 can quantify their relative importance over time, enable the dominant mutations to be identified and facilitate near real-time detection, comparison, and tracking of evolving variants. Collected samples in Asturias an autonomous community of Spain with a large aged population, and high levels of migration and tourism was monitored and tracked from its beginning in February 2020 until its decline and stabilization in August 2021, were characterized using whole genomic sequence and single nucleotide polymorphism. Data held in the GISAID database was analyzed to establish patterns in the appearance and persistence of SARS-CoV-2 strains. Only 138 non-synonymous mutations occurring in more than 1% of the population of SARS-CoV-2 were found, identifying 10 major variants worldwide (7 arose before January 2021), 19 regional and 1 local. In Asturias only 17 different variants were found. After vaccination, no further regional majority variants were found. Only half of the defined variants circulated and no new variants were generated, indicating that infection control measures (fast diagnosis, prevention measures and vaccination) were efficient.

The aim of this multicentre project (seven hospitals across the Spanish National Health Service) was to study the phenotypic and genotypic susceptibility of C. trachomatis to the main antimicrobials used (macrolides, doxycycline, and quinolones) in isolates from patients with clinical treatment failure in whom reinfection had been ruled out. During 2018–2019, 73 clinical isolates were selected. Sixty-nine clinical specimens were inoculated onto confluent McCoy cell monolayers for phenotypic susceptibility testing. The minimum inhibitory concentration for azithromycin and doxycycline was defined as the lowest concentration associated with an at least 95% reduction in inclusion-forming units after one passage in the presence of the antibiotic compared to the initial inoculum for each strain (control). Sequencing analysis was performed for the genotypic detection of resistance to macrolides, analysing mutations in the 23S rRNA gene (at positions 2057, 2058, 2059, and 2611), and quinolones, analysing a fragment of the gyrA gene, and searching for the G248T mutation (Ser83->Ile). For tetracyclines, in-house RT-PCR was used to test for the tet(C) gene. The phenotypic susceptibility testing was successful for 10 isolates. All the isolates had minimum inhibitory concentrations for azithromycin ≤ 0.125 mg/L and for doxycycline ≤ 0.064 mg/L and were considered sensitive. Of the 73 strains studied, no mutations were found at positions T2611C or G248T of the gyrA gene. We successfully sequenced 66 isolates. No macrolide resistance-associated mutations were found at positions 2057, 2058, 2059, or T2611C. None of the isolates carried the tet(C) gene. We found no evidence for genomic resistance in this large, clinically relevant dataset.

Due to the limited availability of in-person interventions for caregivers, the development of effective programs that use new technologies to prevent depression is needed. The goal of this research was to assess the efficacy of a cognitive behavioral intervention for the prevention of depression, administered to nonprofessional caregivers through a smartphone application (app). One hundred and seventy-five caregivers were randomly assigned to either an app-based cognitive behavioral intervention (CBIA), the CBIA intervention plus a telephone conference call (CBIA + CC), or an attention control group (ACG). At post-intervention, the incidence of depression was lower in the CBIA and CBIA + CC compared to the ACG (1.7% and 0.0% vs. 7.9%, respectively). The absolute risk, relative risk, and number needed to treat compared to the ACG were 6.2%, 21.6%, and 16 for the CBIA, whilst they were 8%, 0.0%, and 13 for the CBIA + CC. Depressive symptomatology was significantly lower in the CBIA and CBIA + CC compared to the ACG (d = 0.84, Cliff’s δ = 0.49; d = 1.56, Cliff’s δ = 0.72), as well as in the CBIA + CC compared to the CBIA (d = 0.72, Cliff’s δ = 0.44). The prevention of depression was more likely in participants who received the CBIA, and adding the conference call in the CBIA + CC group improved the likelihood of this.

Silver nanoparticles (AgNPs) play an important role in the medical field due to their potent antimicrobial activity. This, together with the constant emergence of resistance to antimicrobial drugs, means AgNPs are often investigated as an alternative to solve this problem. In this article, we analyzed the antifungal and antiamoebic effects of a recently described type of AgNP, silver nanorings (AgNRs), and compared them with other types of AgNPs. Tests of the activity of AgNPs against various fungal and amoebic species were carried out. In all cases, AgNPs showed a high biocidal effect, although with fungi this depended on the species involved. Antifungal activity was detected by the conditioning of culture media or water but this effect was not dependent on the release of Ag ions. On the other hand, the proliferation of Acanthamoeba castellanii trophozoites was reduced by silver nanorings (AgNRs) and silver nanowires (AgNWs), with AgNWs being capable of totally inhibiting the germination of A. castellanii cysts. AgNRs constitute a new type of AgNP with an antifungal and antiacanthamoebic activity. These results open the door to new and effective antimicrobial therapies as an alternative to the use of antifungals or antiamoebic drugs, thus avoiding the constant appearance of resistance and the difficulty of eradicating infections.

This case-control study analyzed the sleep disturbance, psychological distress and perceived burden in female family caregivers of dependent people with dementia (n = 74) compared with female family caregivers of dependent people without dementia (n = 74) and with age-matched non-caregiver control females (n = 74). Participants completed the Pittsburgh Sleep Quality Index (PSQI), the 12-item General Health Questionnaire (GHQ-12), the Caregiver Burden Inventory (CBI) and an ad hoc questionnaire to collect sociodemographic data. There were significant differences between the groups in PSQI total (F = 24.93; p < 0.001), psychological distress (F = 26.71; p < 0.001) and in all sleep domains assessed: subjective sleep quality (F = 16.19; p < 0.001), sleep latency (F = 9.5; p< 0.001), sleep duration (F = 18.57; p < 0.001), habitual sleep efficiency (F = 19.77; p < 0.001), sleep disturbances (F = 9.22; p < 0.001), use of sleep medications (F = 4.24; p< 0.01) and daytime dysfunction (F = 5.57; p < 0.01). In all measures, the female family caregivers of dependent people with dementia showed the significantly higher mean scores. Regarding the two groups of female caregivers, statistically significant differences were found in daily hours of care (t = −2.45; p < 0.05) and perceived burden (t = −3.65; p < 0.001), as well as in the following dimensions of caregiver burden: time-dependence burden (t = −5.09; p < 0.001), developmental burden (t = −2.42; p < 0.05) and physical burden (t = −2.89; p < 0.01). These findings suggest that female family caregivers of dependent patients with dementia should be subject to psychopathological screening and preventive cognitive-behavioral interventions in clinical practice in primary health care.

The most common causal agents of fungal keratitis are yeasts of the Candida genus. Adhesion constitutes the first stage of pathogenesis. Previous studies have shown that glycosaminoglycans from the corneal cell surface play an essential role in bacterial keratitis, although little is known about their role in fungal infections. The objective of this work is to analyze the role that glycosaminoglycans (GAGs) play in the adhesion of fungi of the Candida genus to corneal epithelial cells. The participation of GAGs in the adhesion of fungi was studied through the specific inhibition of the synthesis of these molecules by enzymatic digestion using specific lyases and the silencing of various genes involved in heparan sulfate sulfation. The results seem to indicate that glycosaminoglycans act to some extent as receptors for this fungus, although there are differences between fungal species. Treatment with inhibitors partially reduced the adherence of fungal species. Digestion of cell surface heparan sulfate further reduced the adherence of Candida albicans and Candida glabrata compared to chondroitin sulfate, indicating that the binding is preferentially mediated by heparan sulfate. Degradation of both heparan sulfate and chondroitin sulfate produced similar effects on the adherence of Candida parapsilosis. However, adhesion of C. albicans hyphae is not dependent on GAGs, suggesting the expression of other adhesins and the recognition of other receptors present in corneal cells. Our results open the door to new strategies for stopping the adhesion of pathogenic fungi, and their subsequent invasion of the cornea; thus, reducing the probability of the keratitis development.

BACKGROUND:Cognitive therapy and behavioural activation are both widely applied and effective psychotherapies for depression, but it is unclear which works best for whom. Individual participant data (IPD) meta-analysis allows for examining moderators at the participant level and can provide more precise effect estimates than conventional meta-analysis, which is based on study-level data.AIMS:This article describes the protocol for a systematic review and IPD meta-analysis that aims to compare the efficacy of cognitive therapy and behavioural activation for adults with depression, and to explore moderators of treatment effect. (PROSPERO: CRD42022341602).METHOD:Systematic literature searches will be conducted in PubMed, PsycINFO, EMBASE and the Cochrane Library, to identify randomised clinical trials comparing cognitive therapy and behavioural activation for adult acute-phase depression. Investigators of these trials will be invited to share their participant-level data. One-stage IPD meta-analyses will be conducted with mixed-effects models to assess treatment effects and to examine various available demographic, clinical and psychological participant characteristics as potential moderators. The primary outcome measure will be depressive symptom level at treatment completion. Secondary outcomes will include post-treatment anxiety, interpersonal functioning and quality of life, as well as follow-up outcomes.CONCLUSIONS:To the best of our knowledge, this will be the first IPD meta-analysis concerning cognitive therapy versus behavioural activation for adult depression. This study has the potential to enhance our knowledge of depression treatment by using state-of-the-art statistical techniques to compare the efficacy of two widely used psychotherapies, and by shedding more light on which of these treatments might work best for whom.