Public University of Navarre

Carbon dots (CDs) are fluorescent carbon‐based nanomaterials with remarkable properties, making them more attractive than traditional fluorophores. Consequently, researchers focused on their development and application in fields such as sensing and bioimaging. One potential advantage of employing CDs is using organic waste as carbon precursors in their synthesis, providing a pathway for waste upcycling for a circular economy. However, waste‐based CDs often have low fluorescence quantum yields (QYFL), limiting their practical applications. So, there is a need for a well‐defined strategy to consistently produce waste‐based CDs with appreciable QYFL, irrespective of the starting waste material. Herein, we developed a fabrication strategy based on the hydrothermal treatment of waste materials, using citric acid as a co‐carbon precursor and ethylenediamine as N‐dopant. This strategy was tested with various materials, including corn stover, spent coffee grounds, cork powder, and sawdust. The results showed consistently appreciable QYFL, reaching up to ~40 %. A Life Cycle Assessment (LCA) study demonstrated that producing these waste‐based CDs has lower environmental impacts compared to CDs made solely from commercial reagents. Thus, we have established a framework for the environmentally friendly production of CDs by upcycling different waste materials without significant sacrifices in performance (QYFL).

Research involving secondary school EFL learners has demonstrated that greater intensity of exposure, via CLIL lessons, yields notable benefits. However, studies in primary school are scarce and less optimistic. Furthermore, little is known about the effects of different degrees of CLIL intensity and of learners' exposure to Extramural English (EE) through formal or informal out‐of‐school activities. To address these gaps, this study examines the impact of CLIL and EE on the proficiency of 180 primary school learners of English (aged 10–11 years) divided into a high‐CLIL ( N = 78), a low‐CLIL ( N = 56), and a non‐CLIL ( N = 46) group. Results showed some advantages among high‐CLIL learners, including higher scores and less intragroup variability, while no significant differences were observed between low‐CLIL and non‐CLIL learners. EE activities were common, with several weak but positive correlations found between EE and proficiency, particularly involving watching TV and reading, and mainly affecting non‐CLIL learners.

Introduction Increasing knowledge of obstetric danger signs (ODS) and encouraging birth preparedness and complication readiness (BPCR) practices are strategies to increase skilled maternal health service utilization in low-income countries. One of the methods to increase mothers’ knowledge about ODS and promote BPCR practice is through health education intervention (HEI). However, the effect of context-specific community-based health education led by women’s groups on these outcomes has yet to be comprehensively studied, and the existing evidence is inconclusive. Thus, we aimed to evaluate the effect of a context-specific community-based HEI led by women’s groups on mothers’ knowledge regarding ODS and BPCR practices in southern Ethiopia. Methods An open-label, two-arm parallel group cluster-randomized controlled trial was conducted from January to August 2023 on pregnant women from 24 clusters (kebeles) (12 interventions and 12 controls) in the northern zone of the Sidama region. The Open Data Kit smartphone application was utilized to collect data. The intention-to-treat analysis was used to compare outcomes between groups. We fitted multilevel mixed-effects modified Poisson regression with robust standard error to account for between and within cluster effects. Results One thousand and seventy pregnant women (540 in the intervention and 530 in the control clusters) responded to this study, making the overall response rate 95.02%. Excessive vaginal bleeding (94.3% in the interventional group vs. 88.7% in the control group) was the commonest ODS mentioned during childbirth. Overall, 68.7% of women in the intervention group and 36.2% of mothers in the control group had good knowledge of ODS (P-value < 0.001). Saving money and materials (97.1% in the interventional group vs. 92.7% in the control group) was the most frequently practiced BPCR plan. Overall, 64.3% of women in the intervention group and 38.9% of mothers in the control group practiced BPCR (P-value < 0.001). HEI significantly increased overall knowledge of ODS (adjusted risk ratio [ARR]: 1.71; 99% CI: 1.14–2.57) and improved overall BPCR practice (ARR: 1.55; 99% CI: 1.02–2.39). Conclusions A community-based HEI led by women’s groups improved mothers’ knowledge regarding ODS and BPCR practices in a rural setting in southern Ethiopia. Interventions designed to increase women’s knowledge of ODS and improve BPCR practice must implement context-specific, community-based HEI that aligns with World Health Organization recommendations. Trial registration NCT05865873.

Background We aimed to estimate XBB.1.5 vaccine effectiveness (VE) against COVID-19-related hospitalizations and deaths during BA.2.86/JN.1 predominance, among EU/EEA individuals with ≥65-years. Research design and methods We linked electronic health records to create historical cohorts in Belgium, Denmark, Italy, Navarre (Spain), Norway, Portugal and Sweden. We included individuals aged ≥65-years eligible for the autumnal 2023 COVID-19 vaccine. Follow-up started when ≥80% of country-specific sequenced viruses were BA.2.86/JN.1 (4/dec/23 to 08/jan/24) and ended 25 February 2024. At study site level, we estimated the vaccine confounder-adjusted hazard ratio (aHR) of COVID-19 hospitalizations and deaths between individuals with ≥14 days after vaccination versus unvaccinated in autumn 2023, overall, by time since vaccination and age groups. VE was estimated as (1-pooled aHR)x100 with a random-effects model. Results XBB.1.5 VE against COVID-19 hospitalizations was 50% (95%CI: 45 to 55) and 41% (95%CI: 35 to 46) in 65–79-year-olds and in ≥80-year-olds, respectively. VE against COVID19-related-death was 58% (95%CI: 42 to 69) and 48% (95%CI: 38 to 57), respectively, in both age groups. VE estimates against each outcome declined in all age groups over time. Conclusion Monovalent XBB.1.5 vaccine had a moderate protective effect against severe and fatal COVID-19 likely caused by BA.2.86/JN.1 during the 2023/2024 winter, among persons aged ≥65.

Objective To identify variables related to perceived stress and resilience of international migrants. Method Multicenter, observational, cross-sectional study carried out with 403 migrants residing in Brazil, Spain, or Portugal. The following instruments were used to collect data: Perceived Stress Scale and Resilience Scale. Student's t-test and analysis of variance were applied in the analysis. Results Perceived stress was related to: living in Brazil or Portugal; shorter stay in the host country; being black or brown; and having no religion. Greater resilience was related to: not being divorced; having less education and lower family income; being from developing countries; living in Spain; and having a religion. Conclusion Aspects such as host and origin country, skin color, income, marital status, education, length of stay in the host country, and religion are related to the level of stress and/or resilience of migrants. Knowing this profile is useful for developing public integration policies and interventions that seek to reduce stress and improve resilience. DESCRIPTORS Resilience, Psychological; Stress, Psychological; Transients and Migrants; Emigration and Immigration; Migrant-Receiving Society; Multicenter Study

Objective To identify variables related to perceived stress and resilience of international migrants. Method Multicenter, observational, cross-sectional study carried out with 403 migrants residing in Brazil, Spain, or Portugal. The following instruments were used to collect data: Perceived Stress Scale and Resilience Scale. Student's t-test and analysis of variance were applied in the analysis. Results Perceived stress was related to: living in Brazil or Portugal; shorter stay in the host country; being black or brown; and having no religion. Greater resilience was related to: not being divorced; having less education and lower family income; being from developing countries; living in Spain; and having a religion. Conclusion Aspects such as host and origin country, skin color, income, marital status, education, length of stay in the host country, and religion are related to the level of stress and/or resilience of migrants. Knowing this profile is useful for developing public integration policies and interventions that seek to reduce stress and improve resilience. DESCRIPTORS Resilience, Psychological; Stress, Psychological; Transients and Migrants; Emigration and Immigration; Migrant-Receiving Society; Multicenter Study

We hypothesized that non-hospitalized patients with long COVID would benefit from structured exercise. In a randomized cross-over trial, we assessed the effects of a 6-week personalized PRT intervention, with a 5-day washout period between arms on cardiopulmonary fitness, muscular strength, long COVID symptoms, QoL, and emotional distress.

BACKGROUND To address water scarcity and promote sustainable resource management, more efficient and cost‐effective water treatment solutions are necessary. Particularly, pathogens in drinking water are a topic of growing concern. One promising technology is the use of photocatalytic nanoparticles activated by visible light as antibacterial agents. This study focuses on the characterization and antibacterial properties of Co–Zn ferrite nanocatalysts, tested against Escherichia coli. RESULTS The CoxZn1−xFe2O4 (x = 0, 0.1, 0.4 and 0.6) ferrites were synthesized by the co‐precipitation method. Structural, morphological and optical analyses confirmed that these nanoparticles have a cubic spinel structure, with sizes of around 10 nm, and band gap energies suitable for visible light activation (1.4–1.7 eV). The antibacterial efficacy of the nanoparticles against E. coli was tested and compared with their photocatalytic performance employing phenol as organic pollutant model (highest phenol degradation for x = 0.6). Specifically, the antibacterial capacity of these nanoparticles was evaluated by comparing the ability of bacteria to grow after being incubated with the nanoparticles under visible light and in the dark. It was found that nanoparticles with lower cobalt content (x = 0 and 0.1) significantly reduced bacterial culturability under visible light. Transmission Electron Microscopy analysis revealed that nanoparticles with cobalt content caused bacteria to secrete biofilm, potentially offering some protection against the nanoparticles. CONCLUSION ZnFe2O4 nanoparticles show the highest antibacterial effect amongst those tested. This is attributed to the combined action of Zn²⁺ ion release and the photocatalytic effect under visible light. Furthermore, Zn might inhibit protective biofilm secretion, leading to higher antibacterial effects. © 2024 The Author(s). Journal of Chemical Technology and Biotechnology published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry (SCI).

The triglyceride-glucose (TyG) index has been proposed as an independent predictor of coronary artery disease (CAD). In this retrospective study we further examine this association and its utility as a predictor for major adverse cardiovascular events (MACE). A total of 870 patients who underwent coronary angiography between May 2008 and June 2009 were included in this retrospective study. The TyG index was calculated using the formula Ln (fasting TG [mg/dL] × FBG [mg/dL]/2). The association of TyG index with the presence and severity of CAD, cardiovascular risk factors, and inflammatory markers was evaluated at baseline. In the longitudinal study, the multivariate adjusted Cox hazard model was used to investigate the associations of the TyG index with the occurrence of MACE during a 5-year follow-up, which was defined as endpoint. The TyG index was significantly associated with the presence and severity of CAD. Multiple linear regression analysis showed that a high TyG index, together with inflammatory markers and dyslipidemia, were independently associated with greater stenotic occlusion of coronary arteries (adjusted R ² = 0.031, p<0.001). Kaplan-Meier survival curve (free of MACE) by tertiles of the TyG index showed a higher incidence of MACE in the upper tertile (log-rank test, p = 0.02). Multivariate Cox analysis demonstrated that the risk of incident MACE during the follow-up was associated with higher levels of TyG index, even after adjusting for inflammatory parameters and cardiovascular risk factors: hazard ratio (HR), 1.54 (95% confidence interval 1.18-2.13; p<0.01). We conclude that elevated TyG index is independently associated with a higher risk of CAD and a poor prognosis for MACE.

This work explores the intricate dynamics of water management, energy generation, and irrigation in Spain by examining the evolving regulatory framework governing water resource allocation. It introduces a novel approach to quantify water usage and unpacks the ‘mixed uses’ category for the first time, focusing on entities holding water allocation concessions rather than mere dam ownership. Our f indings reveal the profound influence of private electricity companies on water resource management, despite the significant portion of state-owned dams. The results point to hydroelectric dominance in water allocation and underscore the complex interaction between public ownership and private management of electric companies. This research emphasises the need for nuanced policy considerations in the broader context of energy and agriculture while contributing to a richer understanding of Spain’s unique water governance landscape.

Background This study had two main objectives: firstly, to assess the suitability of the Spanish translation of the Young Person’s Clinical Outcome in Routine Evaluation (YP-CORE) for use in Latin America, and secondly, to investigate its psychometric properties specifically with Ecuadorian adolescents. Methods The research consisted of two phases. In Phase 1, insights were gathered from 19 adolescents and 12 experts regarding their comprehension of the YP-CORE. Based on the feedback received during this phase, a revised version of the YP-CORE was developed. In Phase 2, a psychometric assessment of this modified version was conducted with 298 adolescents in Ecuador, aged 11 to 17 years. Results The psychometric analysis revealed that this adapted version of the YP-CORE demonstrated satisfactory levels of acceptability, internal consistency, and test-retest reliability. The factor analysis favored a two-factor model over a single factor, yet the minimal substantive distinctions between these two factors do not justify the use of subscale scoring. Furthermore, the scores indicated age-related differences, with older adolescents (aged 14 to 17 years) obtaining higher scores, and gender-related variations, with females scoring higher. Conclusions This study addresses the need for, and provides, a Spanish-adapted YP-CORE tailored for use in Latin America. This freely available version has the potential to offer valuable insights into interventions for adolescents in the region and to enhance our understanding of their psychological distress.

Background. Outstanding exercise performance has been associated with an exacerbated vagal outflow. Nevertheless, during high-altitude hypobaric-hypoxia (HH), there is a baroreflex-dependent parasympathetic withdrawal and exercise performance deterioration. Notably, vagal control is pivotal in exercise performance, and exogenous oxytocin (OXY) administration has been shown to enhance parasympathetic drive; however, no evidence shows their role in exercise performance during HH. Then, this study aimed to examine the effect of prolonged exogenous oxytocin (OXY) administration on exercise performance during hypobaric hypoxia (HH) in rats. Results. A vehicle group (n = 6) and an OXY group (n = 6) performed incremental exercise and baroreflex tests during both normobaric normoxia (NN) and HH (PO2: 100 mmHg, simulated 3,500 m) prior (pre-) and after (post-) 14 days of administration. The results showed that at pre-, there were no significant differences in exercise performance between the two groups, while at post-, the OXY group exhibited similar performance between NN and HH, while the Vehicle group maintained a significant decline in performance at HH compared to NN. At post-, the Vehicle group also demonstrated a reset in the baroreflex and a worse bradycardic response in HH, which was reversed in the OXY group, while the hypoxic ventilatory response was similar in both groups. Conclusion. The findings suggest prolonged OXY administration prevents impaired exercise performance and vagal control during short-term HH.

BACKGROUND: In type 1 diabetes, telomere length (TL) may predict complications and could be influenced by glycaemic control and physical activity, but its relationship with physical fitness in youths remains unexplored. The aim of the study was to assess the association between physical fitness and TL in youth with type 1 diabetes, both at baseline and one year later. METHODS: Eighty-three children and adolescents (aged 6–18 years; 44.6% girls) with type 1 diabetes from the Diactive-1 Cohort Study were involved in this study. Physical fitness was assessed using spirometry on a cycloergometer (i.e., peak oxygen consumption), dynamometry, and maximal isometric strength (one-repetition maximum [1RM]), and muscle power. Leucocyte TL was assessed using multiplex monochrome real-time quantitative polymerase chain reaction. RESULTS: Positive cross-sectional associations were identified between 1RM (unstandardized beta coefficient [B] = 0.042, 95% bias corrected and accelerated [BCa] confidence interval [CI] 0.012–0.069), muscle power (B = 0.056, 95% BCa CI 0.02–0.250), and overall physical fitness (B = 0.043, 95% BCa CI 0.015–0.071) with TL independent of maturation, glycated haemoglobin, and diabetes duration. However, no associations were observed one year later. CONCLUSION: Higher levels of fitness, particularly muscle strength, may play a role in telomere dynamics in youth with type 1 diabetes, suggesting that strength training exercise could be beneficial.

This paper examines the relationship between kin-based institutions and quality of government in the regions of Spain, France, and Italy. The results show that the rate of cousin marriage during the twentieth century is a strong predictor of the modern-day quality of government in the regions of these three countries. Regions characterized by a higher prevalence of cousin marriage tend to have on average worse governance outcomes. This finding holds after accounting for country fixed effects and different variables that may be correlated with both consanguinity and regional quality of government, including an extensive array of geographical, historical, and contemporary factors. The observed association between cousin marriage and quality of government persists when I utilize an instrumental variable approach that exploits regional variation in the degree of historical exposure to the marriage laws of the medieval Catholic Church to address potential endogeneity concerns. Furthermore, the paper also provides evidence consistent with the idea that the effect of cousin marriage on the quality of government operates through its impact on a series of cultural traits such as impersonal trust, fairness, and conformity-obedience.

Introduction Pharmacogenetics (PGx) has the potential to improve patient care, allowing to transform medical interventions by providing personalized therapeutic strategies. Scientific evidence supports the use of PGx in clinical practice and international organizations are developing clinical guidelines to facilitate the utilization of PGx testing. However, clinical implementation of PGx is limited and unequal worldwide. Content This review summarizes regional and national Spanish initiatives to implement PGx in the clinical practice. Summary and Outlook Diverse strategies to implement PGx in healthcare are applied across countries or even in the different regions of a specific country. Such was the case of Spain, a European country with 17 Autonomous Regions and two Autonomous Cities, each one with capacity to manage their own healthcare systems. Nevertheless, during the past years, many initiatives and strategies have been launched in Spain to develop different aspects of PGx. Importantly, the National Healthcare System has approved a PGx testing catalogue. This review highlights the crucial work and efforts of scientific societies (like the Spanish Society of Pharmacogenetics and Pharmacogenomics), of experts in PGx, of healthcare providers and of governmental parties in the implementation of PGx to personalize patient therapy, focused in Spain.

Evidence-based practice (EBP) refers to the integration of scientific evidence into the clinical setting. This study aimed to determine whether Latin American physiotherapists use EBP, analyze the associated factors, barriers, and facilitators, and examine the relationships between these elements in clinical practice. To conduct this cross-sectional study, the web-based questionnaire survey method was chosen. Survey was self-administered questionnaires to assess understanding of various EBP-related terms and determine their knowledge and ability to apply these concepts in clinical practice. The association between attitudes, awareness, and knowledge scores and the demographic data such as age group, years of experience, professional membership registry, and self-reported education was assessed. The questionnaire was distributed to a total of 5000 physical therapists, of which 4099 (82%) responded from seven Latin American countries (Argentina, Bolivia, Chile, Colombia, México, Perú, and Venezuela), between June 1, 2020, and May 31, 2024. Overall, the physical therapists had positive attitudes, beliefs, and interests in EBP. Their educational background, knowledge, and skills related to assessing and interpreting information were associated to the use of EBP. In addition, 53% of respondents indicated that lack of time was the main obstacle to the use of EBP. The top 3 barriers included insufficient time (53%), lack of information resources (20.8%), and lack of research tools (13.6%). Among Latin American physical therapists, individual characteristics workplace, clinical experience, educational background, and demographic characteristics, may behave as facilitators or barriers when performing an EBP. Thus, identifying methods and strategies to support physical therapists in adopting EBP in the Latin American is necessary. The academization of physiotherapy training might change this in the future.

Background Hospital-associated functional decline affects nearly one-third of the hospitalized older adults. The aim of this trial is to investigate the effect of a cognitive stimulation intervention provided via immersive virtual reality (IVR), with or without a multicomponent physical exercise intervention (ME) in hospitalized patients aged 75 or older with severe functional dependency at admission (Barthel Index < 60 points). Methods This clinical randomized controlled trial will be conducted in the Acute Geriatric Unit of a tertiary hospital in Spain. A total of 212 acute patients will be enrolled according to the following criteria: age ≥ 75, Barthel Index < 60, able to collaborate, expected length of stay ≥ 5 days, absence of clinical instability and severe dementia (Global Deterioration Scale 7) or other end-stage disease. Patients will be randomly assigned to a control group (CG) or any of the three intervention groups (IG): IVR, ME, or IVR + ME. The IVR group will watch ad-hoc videos showing Spanish regional landscapes and villages, approximately 4 min per day for three consecutive days. The ME group will undergo aerobic and strength exercise for progressive training of the upper and lower limbs. The IVR + ME group will do both cognitive and physical intervention. The primary outcomes will be cognitive and physical measures at discharge. Mood, quality of life, isometric strength, and acceptance of IVR will be also assessed. Discussion This project has the potential to enhance physical and psychological well-being of patients with severe functional dependency hospitalized for acute conditions, using technology. Virtual reality is expected to be favourably perceived by hospitalized older adults. This intervention represents a novelty in the geriatric patients’ care, comprising IVR and/or ME dispensed within the patient’s room, and including patients who are commonly excluded from research clinical trials. Trial registration This study was approved by the Navarra Clinical Research Ethics Committee on May 17th, 2023 (PI_2023/60). The trial is registered at ClinicalTrials.gov, registration number NCT06340282, 24th May 2024.

This text reviews the transformations of the commons in Spain in the long 19 th century based on the notion of “bundles of rights”. The contention is that the process of change was prompted by the clashes between alternative models, beginning with privatization or preservation and culminating in a complex landscape of property rights. In terms of privatization, several alternatives were advocated and eventually implemented, depending on the social groups that promoted them and their balance of power. In stylized form, two options that while not necessarily incompatible stand in opposition: on the one hand, privatization in the form of large property units with the land concentrated in the hands of an elite of creditors and investors, and on the other, small plots involving broader social participation and greater access. In turn, the preservation of communal lands did not rule out the privatization of their use, in some cases in favor of large industrial companies in the timber, resin, and cork sectors, and on other occasions in the service of social inclusion policies through the distribution of plots for their cultivation by the rural proletariat.