Universidad Pública de Navarra

Most of the evidence on physical activity for maintaining a healthy weight in adolescents is based solely on aerobic physical activity alone, with little attention given to the muscle strength component. This study aimed to investigate the associations between aerobic activities and muscle‐strengthening activities (MSA) and overweight/obesity among a representative sample of adolescents. Data from the United States‐based Youth Risk Behavior Surveillance System for the 2011–2019 cycle were used in this cross‐sectional study. Adolescents self‐reported their adherence to aerobic and MSA guidelines, as well as their height and weight. Overweight and obesity were defined using the age‐ and sex‐specific criteria of the Centers for Disease Control and Prevention, with a body mass index (BMI) ≥85th and ≥95th percentiles, respectively. We examined the associations between adherence to physical activity guidelines (reference: not meeting either of the physical activity guidelines) and overweight/obesity or obesity using binary logistic regressions. These analyses were adjusted for race/ethnicity, sex, age, screen time, sleep duration, tobacco, alcohol, fruit, vegetables, and soda consumption. A total of 42 829 adolescents (48.98% girls) were included in the study. Of these, 22.23% met both guidelines for physical activity, 30.47% had overweight/obesity, and 14.51% had obesity. Compared with meeting neither guideline, meeting both aerobic and MSA guidelines was associated with lower odds of having overweight/obesity (odds ratio [OR] = 0.64, 95% confidence interval [CI], 0.60 to 0.68) and obesity (OR = 0.52, 95% CI 0.48 to 0.56). These results were consistent across years of assessment, sex, and race/ethnicity. In conclusion, our results highlight the importance of MSA, which is often overlooked in physical activity recommendations in many studies, in combating childhood obesity in the United States.

Objectives Current evidence on the clinical effectiveness about the different types of exercises in the subacromial impingement syndrome (SIS) remains controversial. This study aims to compare the short-term (at 5 weeks) effects of a specific exercise programme with a general exercise programme on shoulder function in adults with SIS. Methods In total, 52 adults with SIS were randomly allocated to 5 weeks to perform specific exercises (experimental group, n=26) or general exercises (control group, n=26). The primary outcome was change in shoulder function, it was assessed using the Shoulder Pain and Disability Index (SPADI) from baseline to 5 weeks. Secondary end points included changes in upper limb function (Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire), pain intensity (Visual Analog Scale (VAS)) and kinesiophobia (Tampa Scale of Kinesiophobia (TSK)). Results All participants completed the trial. The between-group differences at 5 weeks were: SPADI, 13.5 points (95% CI: 4.3 to 15.6; ƞ ² =0.22; p=0.001); DASH, 10.1 points (95% CI: 5.6 to 15.2; ƞ ² =0.27; p<0.001); VAS at rest, 0.2 cm (95% CI: 0.1 to 0.3; ƞ ² =0.07; p=0.553); VAS on movement, 1.7 cm (95% CI: 0.9 to 2.2; ƞ ² =0.24; p<0.001); and TSK, 16.3 points (95% CI: 13.2 to 15.3; ƞ ² =0.33; p<0.001). All differences favoured the experimental group and effect sizes were medium to large for most outcomes. Mediation analyses showed that the effect of the specific exercises on shoulder function was mediated by kinesiophobia (β=2.800; 95% CI: 1.063 to 4.907) and pain on movement (β= −0.690; 95% CI: −1.176 to −0.271). Conclusion In adults with SIS, specific exercises may have a larger effect than general exercises. However, most differences did not reach the minimum threshold to be considered clinically important and the evidence to support exercise as standard treatment warrant further study. Trial registration number Brazilian Registry of Clinical Trials UTN number U111-1245-7878. Registered on 17 January 2020 ( https://ensaiosclinicos.gov.br/rg/RBR-4d5zcg ).

Introduction: Scientifc literature regarding the characterization of lymphocyte subpopulations of the cecal appendix is sparse, with few precedents limited to immunohistochemical techniques. Methods: We conducted a prospective pilot study to characterize lymphocyte subpopulations of the cecal appendix in children. Participants were divided into three groups: (1) patients without histological acute appendiceal inflammation, (2) patients with histological uncomplicated acute appendicitis, and (3) patients with histological complicated acute appendicitis (gangrenous, perforated). A fresh sample of the base of the appendix was taken from all patients and a fow cytometric study was performed. Quantitative variables were compared using Kruskal–Wallis test and Mann–Whitney U test. Results: This study included 57 patients divided into Group 1 (n=5), Group 2 (n=37), and Group 3 (n=15). Median values (IQR) of the percentage of B-lymphocytes were 67.8 [66.8–68.1] in group 1, 61.15 [53.74–66.4] in group 2, and 52.1 [33–62.02] in group 3 (p=0.02). Median values (IQR) of the percentage of NK-lymphocytes were 0.26 [0.2–0.3] in group 1, 0.55 [0.37–0.66] in group 2, and 0.84 [0.35–1.45] in group 3 (p=0.008). Median values (IQR) of the percentage of T-lymphocytes were 31.9 [31.7–33.1] in group 1, 37.68 [32.15–45.69] in group 2, and 46.9 [37.03–67] in group 3 (p=0.02). Pair comparisons of groups 2 and 3 also showed signifcant diferences in the percentage of B lymphocytes (p=0.03) and T-lymphocytes (p=0.02). Conclusions: Signifcant diferences in lymphocyte subpopulations were identifed according to the histologic grade of the cecal appendix. More specifcally, a lower percentage of B-lymphocytes and a higher percentage of T- and NK-lymphocytes were observed in cases of acute appendicitis. These fndings must be confrmed and their etiopathogenic, diagnostic, and prognostic implications elucidated in future studies with larger sample sizes.

Aim: To explore the differential characteristics in sociodemographic variables, severity of consumption, psychopathological symptomatology, life maladjustment, trauma characteristics, and post-traumatic stress symptomatology between women and men who seek treatment for substance use disorder (SUD) and have experienced lifetime physical and/or sexual abuse. Method: The sample consisted of 26 women and 31 men who had experienced physical/sexual abuse and sought treatment for SUD. Results: Women had been victims of sexual abuse in a significantly higher percentage than men. Women presented a significantly higher frequency of revictimization to another traumatic event and a significantly higher presence of avoidance symptoms than men. Conclusions: This study supports the existence of a more severe profile in women than in men with SUD who have experienced lifetime physical and/or sexual abuse. Consequently, gender-related trauma-informed practice in SUD treatment programmes should be promoted. More research in this field is needed, as this is a preliminary study.

We estimated influenza vaccine effectiveness (IVE) in preventing outpatient and hospitalized cases in the 2022–2023 season. A test-negative design included a representative sample of outpatients and all hospitalized patients with influenza-like illness (ILI) from October 2022 to May 2023 in Navarre, Spain. ILI patients were tested by PCR for influenza virus. Influenza vaccination status was compared between confirmed influenza cases and test-negative controls. Among 3321 ILI patients tested, IVE to prevent influenza cases was 34% (95% confidence interval (CI): 16 to 48) overall, 85% (95%CI: 63 to 94) against influenza B, and 28% (95%CI: 3 to 46) against A(H3N2). Among 558 outpatients, 222 (40%) were confirmed for influenza: 55% A(H3N2), 11% A(H1N1), and 31% B. Overall, IVE to prevent outpatient cases was 48% (95%CI: 8 to 70), 88% (95%CI: 3 to 98) against influenza B, and 50% (95%CI: −4 to 76) against A(H3N2). Of 2763 hospitalized patients, 349 (13%) were positive for influenza: 64% A(H3N2), 17% A(H1N1), and 8% B. IVE to prevent hospitalization was 24% (95%CI: −1 to 42) overall, 82% (95%CI: 49 to 93) against influenza B, and 16% (95%CI: −17 to 40) against A(H3N2). No IVE was observed in preventing influenza A(H1N1). IVE was high to prevent influenza B, moderate against A(H3N2) and null against A(H1N1). A lower proportion of influenza B cases may explain the smaller IVE in hospitalized patients than in outpatients. The null IVE against A(H1N1) was consistent with the observed antigenic drift and supports the new composition of the 2023–2024 influenza vaccine.

Background Police forces are abundant circulating and might arrive before the emergency services to Out-of-Hospital-Cardiac-Arrest victims. If properly trained, they can provide basic life support and early defibrillation within minutes, probably increasing the survival of the victims. We evaluated the impact of local police as first responders on the survival rates of out-of-hospital cardiac arrest victims in Navarra, Spain, over 7 years. Methods A retrospective analysis of an ongoing Out-of-Hospital Cardiac registry to compare the characteristics and survival of Out-of-Hospital-Cardiac-Arrest victims attended to in first place by local police, other first responders, and emergency ambulance services between 2014 and 2020. Results Of 628 cases, 73.7% were men (aged 68.9 ± 15.8), and 26.3% were women (aged 65,0 ± 14,7 years, p < 0.01). Overall survival of patients attended to by police in the first place was 17.8%, other first responders 17.4% and emergency services 13.5% with no significant differences (p > 0.1). Time to initiating cardiopulmonary resuscitation is significant for survival. When police arrived first and started CPR before the emergency services, they arrived at a mean of 5.4 ± 3 min earlier (SD = 3.10). This early police intervention showed an increase in the probability of survival by 10.1%. Conclusions The privileged location and the sole amount of personnel of local police forces trained in life support and their fast delivery of defibrillators as first responders can improve the survival of out-of-hospital cardiac arrest victims.

Context: Despite the large number of studies published to date, the effect of lifestyle-based interventions on improving adherence to the Mediterranean diet (MedDiet) in young people has not been meta-analyzed. Objective: The aim of the present systematic review and meta-analysis was two-fold: (1) to determine the pooled intervention effects of lifestyle-based interventions on improving adherence to the MedDiet in a young population aged 3 years-18 years and (2) to examine the potential factors related to those intervention effects. Data sources: A systematic search of the MEDLINE (via PubMed), Scopus, Cochrane Library, and Web of Science databases was performed from their inception until June 15, 2023. Data extraction: Different meta-analyses were independently performed to observe the effect of lifestyle-based interventions on adherence to the MedDiet (according to the Mediterranean Diet Quality Index in children and adolescents [KIDMED]). Data analysis: Compared with the control group, the intervention group showed a small increase in KIDMED score (d = .27; 95% confidence interval [CI], .11 to .43; P < .001; I2 = 89.7%). Similarly, participants in the lifestyle-based intervention groups had a 14% higher probability of achieving optimal adherence to the MedDiet (risk difference = .14; 95% CI, .02 to .26; P = .023; I2 = 96.8%). Greater improvements in achieving optimal adherence to the MedDiet were found in interventions delivered out of school (risk difference = .24, 95% CI, .04 to .44; I2 = 88.4%), those aimed at parents or at both children and parents (risk difference = .20, 95% CI, .07 to .34; I2 = 98.2%), and those including only participants with overweight/obesity (risk difference = .34, 95% CI, .15 to .52; I2 = .0%). Conclusion: Healthy lifestyle-based interventions seem to be effective in increasing adherence to the MedDiet and in achieving optimal adherence to this dietary pattern among children and adolescents. Systematic review registration: PROSPERO registration no. CRD2022369409.

Profile determination in field hockey is critical to determining athletes' physical strengths and weaknesses, and is key in planning, programming, and monitoring training. This study pursued two primary objectives: (i) to provide descriptive data on sprinting, deceleration, and change of direction (COD) abilities and (ii) to elucidate the mechanical variables that influence sprint and COD performance in elite female field hockey players. Using radar and time-gate technology, we assessed performance and mechanical data from 30 m sprinting, deceleration, and COD tests for 26 elite female hockey players. A machine learning approach identified mechanical variables related to sprint and COD performance. Our findings offer a framework for athlete categorization and the design of performance-enhancing training strategies at the international level. Two pivotal mechanical variables-relative maximum horizontal force (F0) and maximum velocity (Vmax)-predominantly influence the times across all tested distances. However, the force-velocity profile (FVP) and horizontal deceleration do not influence the variance in the COD test outcomes. These insights can guide the design, adjustment, and monitoring of training programs, assisting coaches in decision making to optimize performance and mitigate injury risks for female hockey players.

Even though the implementation of Content and Language Integrated Learning (CLIL) and its results have been researched extensively, fewer works have focused on the effect of contextual factors (CF) on teachers’ beliefs and on which ones are perceived as constraints. Furthermore, no research has explored how training might change those beliefs and help to adjust or modify some of the negative effects that CF exert on teaching practices. This qualitative study explores six in-service CLIL secondary teachers’ beliefs about CF and the effect a training course had on them. Results confirmed CF are perceived as constraints to the successful implementation of CLIL, and training appears to have a positive effect in shaping negative teachers’ beliefs and attitudes into more favourable ones. This, in turn, may help teachers to cope with the unfavourable teaching situations that CF may provoke on a daily basis. Since CF still seem to hinder CLIL success, considering teachers’ beliefs about them in CLIL teacher training programmes may contribute largely to teachers’ effectiveness.

CYTOP fiber, used mainly in strain detection and refractive index characterization of liquids, can be polished for the detection of UV light radiation. The study investigates the transmission spectra of CYTOP fiber exposed to different intensities of UV light, demonstrating a linear relationship. A simplified system using a single wavelength, 395 nm, shows real-time performance of the sensor in a range from 1 to 15 mW. The results reveal the potential of CYTOP fiber as a UV sensor with a sensitivity of 0.65%/mW and a limit of detection of 0.3 mW, offering implications for monitoring UV radiation exposure and related health risks. In addition, the effect of the UV light was also observed at longer wavelengths with a lower intensity variation, which suggests CYTOP fiber could be used for transmitting the UV radiation detection in telecommunications bands.

Background: Obesity is prevalent and increasing but understudied across Pacific Islanders. Tuvalu is a South Pacific country with a high obesity rate and faces multiple threats of food insecurity. Home garden serves as a sustainable food source and can be a possible intervention for the obesity pandemic in Tuvalu. This study investigated Tuvaluans' home garden use and obesity, and explored factors associated with increased use of home gardens. Methods: We conducted a nationwide, cross-sectional study in Tuvalu during 2022. Structured questionnaires were administered during the in-person interviews, and trained interviewers measured the height and weight of each participant. The association between home garden use, obesity and severe obesity were tested with univariate and multivariable logistic regression. We also applied overlapping weights to balance the distribution of baseline demographic factors. Results: The average body mass index was 34.87 kilogrammes (kg) / square metre (m2) among the study population of 1024 adults (630 from Funafuti and 394 from other islands in Tuvalu). Overall, people having home gardens was associated lower odds for severe obesity compared to those without a home garden in overlap weighting models (odds ratio (OR) = 0.946, 95% CI = 0.897-0.997, P = 0.039) and the association was stronger in Funafuti (OR = 0.927, 95% CI = 0.866-0.991, P = 0.027) than in the outlying islands (OR = 0.967, 95% CI = 0.889-1.052, P = 0.435). Furthermore, increased age was positively associated with having a home garden in Funafuti, and smoking showed an inverse association. Conclusions: Having a home garden is associated with lower odds of severe obesity in Tuvalu, and the association is stronger in Funafuti. Smokers are less likely to have home gardens, and increased age is positively associated with having home gardens. These findings promote more home garden utilisation and provide evidence for targeted interventions in Tuvalu.

Introduction: The time trends of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy previously described in the ISAAC (International Study of Asthma and Allergies in Childhood) in 2002 are unknown; or if the geographical or age differences in Spain persist. Objective: To describe the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy in different Spanish geographical areas and compare them with those of the ISAAC. Methods: Cross-sectional study of the prevalence of rhinitis, rhinoconjunctivitis and nasal allergy, carried out in 2016-2019 on 19943 adolescents aged 13-14 years and 17215 schoolchildren aged 6-7 years from six Spanish areas (Cartagena, Bilbao, Cantabria, La Coruña, Pamplona, and Salamanca), through a questionnaire based on the Global Asthma Network (GAN) protocol. Results: The prevalences of recent rhinitis and rhinoconjunctivitis (last 12 months), and nasal allergy/hay fever were 35.1%, 17.6%, and 14.6% in the adolescents and 20%, 8.5%, and 8.9% in the schoolchildren, respectively, with rhinoconjunctivitis in adolescents varying from 20.9% in Bilbao to 13.4% in Cartagena; and in schoolchildren, from 9.8% in La Coruña to 6.4% in Pamplona. These prevalences of rhinoconjunctivitis and nasal allergy in adolescents were higher than those described in the ISAAC (16.3% and 13%) and similar in schoolchildren to the ISAAC (9% and 9.4%). Conclusions: There has been a stabilisation of rhinitis, rhinoconjunctivitis and nasal allergy in schoolchildren that slows the previous upward trend of ISAAC; and a slight non-significant increase in rhinoconjunctivitis and nasal allergy in adolescents. The variability found in adolescents would require local research to be better understood.

Background: Pediatric acute appendicitis (PAA) involves a substantial consumption of health and economic resources. The identification of serum biomarkers that may help predict the post-surgical evolution of these patients is a field of great interest. Patients and Methods: This was a prospective, observational substudy within the Biomarkers for the Diagnosis of Appendicitis in Pediatrics (BIDIAP) cohort aimed at evaluating the association between post-surgical increase in serum IL-6 and different outcomes related to the clinical evolution of children operated on for PAA. Sixty-nine children with a confirmed diagnosis of acute appendicitis and both pre-operative and post-operative serum IL-6 were included in the study. Three multivariable-adjusted linear regression models were fitted to analyze the association between an increase of >10% in post-operative serum IL-6 level with the length of stay, the number of post-operative emetic episodes, and the onset of oral feeding. Two multivariable-adjusted logistic regression models were fitted to assess the association of the same exposure with the indication of antibiotherapy at discharge and with positivity in peritoneal fluid culture. Results: Thirteen children showed an increase of >10% in the post-operative serum IL-6 value (group 1) whereas 56 showed only a minor increase, or no change (group 2). After accounting for potential confounders, children in group 1 had a mean of three-day longer hospital stay (difference, 3.33; 95% confidence interval [CI], 0.57-6.09) and higher odds of a positive result in peritoneal fluid culture (odds ratio [OR], 37.43; 95% CI, 1.02-1361.28) than children in group 2. Conclusions: An increase of >10% in post-operative serum IL-6 value could predict longer hospital stay and higher odds of positive peritoneal fluid culture. Future prospective studies are needed to replicate these findings and to broaden the range of biomarkers that could predict the post-operative evolution of children operated on for PAA.

The herbicides glyphosate and pyrithiobac inhibit the enzyme 5‐enolpyruvylshikimate‐3‐phosphate synthase (EPSPS) in the aromatic amino acid biosynthetic pathway and acetolactate synthase (ALS) in the branched‐chain amino acid biosynthetic pathway, respectively. Here we characterise the protease activity profiles of a sensitive (S), a glyphosate‐resistant (GR) and a multiple‐resistant (MR) population of Amaranthus palmeri in response to glyphosate and pyrithiobac. Amino acid accumulation and cysteine protease activities were induced with both herbicides in the S population and with pyrithiobac in the GR population, suggesting that the increase in cysteine proteases is responsible for the increased degradation of the available proteins and the observed increase in free amino acids. Herbicides did not induce any changes in the proteolytic activities in the populations with target‐site resistance, indicating that this effect was only induced in sensitive plants.

The overuse of antibiotics in humans and livestock has driven the emergence and spread of antimicrobial resistance and has therefore prompted research on the discovery of novel antibiotics. Complestatin (Cm) and corbomycin (Cb) are glycopeptide antibiotics with an unprecedented mechanism of action that is active even against methicillin-resistant and daptomycin-resistant Staphylococcus aureus . They bind to peptidoglycan and block the activity of peptidoglycan hydrolases required for remodeling the cell wall during growth. Bacterial signaling through two-component transduction systems (TCSs) has been associated with the development of S. aureus antimicrobial resistance. However, the role of TCSs in S. aureus susceptibility to Cm and Cb has not been previously addressed. In this study, we determined that, among all 16 S. aureus TCSs, VraSR is the only one controlling the susceptibility to Cm and Cb. Deletion of vraSR increased bacterial susceptibility to both antibiotics. Epistasis analysis with members of the vraSR regulon revealed that deletion of spdC, which encodes a membrane protein that scaffolds SagB for cleavage of peptidoglycan strands to achieve physiological length, in the vraSR mutant restored Cm and Cb susceptibility to wild-type levels. Moreover, deletion of either spdC or sagB in the wild-type strain increased resistance to both antibiotics. Further analyses revealed a significant rise in the relative amount of peptidoglycan and its total degree of cross-linkage in ΔspdC and ΔsagB mutants compared to the wild-type strain, suggesting that these changes in the cell wall provide resistance to the damaging effect of Cm and Cb. IMPORTANCE Although Staphylococcus aureus is a common colonizer of the skin and digestive tract of humans and many animals, it is also a versatile pathogen responsible for causing a wide variety and number of infections. Treatment of these infections requires the bacteria to be constantly exposed to antibiotic treatment, which facilitates the selection of antibiotic-resistant strains. The development of new antibiotics is, therefore, urgently needed. In this paper, we investigated the role of the sensory system of S. aureus in susceptibility to two new antibiotics: corbomycin and complestatin. The results shed light on the cell-wall synthesis processes that are affected by the presence of the antibiotic and the sensory system responsible for coordinating their activity.

The automation of welding processes requires the use of automated systems and equipment , in many cases industrial robotic systems, to carry out welding processes that previously required human intervention. Automation in the industry offers numerous advantages, such as increased efficiency and productivity, cost reduction, improved product quality, increased flexibility and safety, and greater adaptability of companies to market changes. The field of welding automation is currently undergoing a period of profound change due to a combination of technological, regulatory, and economic factors worldwide. Nowadays, the most relevant aspect of the welding industry is meeting customer requirements by satisfying their needs. To achieve this, the automation of the welding process through sensors and control algorithms ensures the quality of the parts and prevents errors, such as porosity, unfused areas, deformations, and excessive heat. This paper proposes an intelligent and adaptive system based on the measurement of welding joints using laser scanning and the subsequent analysis of the obtained point cloud to adapt welding trajectories. This study focuses on the optimization of T-joints under specific welding conditions and is intended as an initial implementation of the algorithm, thus establishing a basis to be worked on further for a broader welding application.

With the United Nations Sustainable Development Goals (SDG) (2015–2030) focused on the reduction in maternal mortality, monitoring and forecasting maternal mortality rates (MMRs) in regions like Africa is crucial for health strategy planning by policymakers, international organizations, and NGOs. We collected maternal mortality rates per 100,000 births from the World Bank database between 1990 and 2015. Joinpoint regression was applied to assess trends, and the autoregressive integrated moving average (ARIMA) model was used on 1990–2015 data to forecast the MMRs for the next 15 years. We also used the Holt method and the machine-learning Prophet Forecasting Model. The study found a decline in MMRs in Africa with an average annual percentage change (APC) of −2.6% (95% CI −2.7; −2.5). North Africa reported the lowest MMR, while East Africa experienced the sharpest decline. The region-specific ARIMA models predict that the maternal mortality rate (MMR) in 2030 will vary across regions, ranging from 161 deaths per 100,000 births in North Africa to 302 deaths per 100,000 births in Central Africa, averaging 182 per 100,000 births for the continent. Despite the observed decreasing trend in maternal mortality rate (MMR), the MMR in Africa remains relatively high. The results indicate that MMR in Africa will continue to decrease by 2030. However, no region of Africa will likely reach the SDG target.

Humanity’s need for freshwater has more than doubled since the 1960s, in line with population and economic growth [...]