Repositório Institucional da Universidade Estadual da Paraíba
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Age effects on long-term neuropsychological outcome in paediatric traumatic brain injury
No full textIn order to investigate the relationship between age at injury and long-term neuropsychological impairment, 29 children and adolescents who sustained traumatic brain injury (TBI) were studied at least 6 years post-trauma. Tests of intellectual, memory, visuospatial and frontal lobe functions were administered to patients and 29 normal matched control subjects. Correlations between performance on neuropsychological tests and age showed the following direction: the younger the child when TBI was sustained, the worse the cognitive outcome. After controlling for injury severity, visuospatial functions remained related to age. Patients' performance differed significantly from that of controls in half of the neuropsychological variables analysed. To further investigate the effects of age at injury, the sample was divided in two groups (TBI before and after age of 8) and then compared with their respective controls. Patients damaged earlier presented impaired intellectual and visuospatial functions. The results suggest that neuropsychological sequelae remain after at least 6 years of evolution, and that there is an age at injury effect
Unveiling Drug-Induced Autoimmune-Like Hepatitis in Autoimmune Hepatitis Patients: A Multicenter Retrospective Study
No full textBackground and Aims Acute or chronic exposure to drugs or herbal and dietary supplements (HDS) can cause drug-induced autoimmune-like hepatitis (DI-ALH), a self-limiting condition resembling autoimmune hepatitis (AIH). We investigated the prevalence of drug exposure among AIH patients at diagnosis to recognise cases of DI-ALH and discern features predicting AIH development.Methods We retrospectively included 705 patients diagnosed with AIH. DI-ALH was defined using published criteria. The clinical, biochemical, serological, and histological data of DI-ALH and AIH were analysed to identify predictors of the evolution of each phenotype.Results Most patients were female (n = 496, 70%), with a median age of 57 years and a median follow-up of 55 months. A 59% (n = 417) reported exposure to drugs or HDS, and 8% (n = 58) fulfilled the criteria for DI-ALH. Statins and HDS were the most common culprits. Patients with DI-ALH more frequently had acute severe or fulminant hepatitis (22% vs. 12%, p = 0.013) and higher transaminase levels (ALT: 966 vs. 591, p = 0.001) at diagnosis. In total, 97% of the patients received immunosuppression. DI-ALH patients had a faster biochemical response than i-AIH patients (4 vs. 5, p = 0.031), while treatment withdrawal was attempted in only 29% (n = 17). Approximately 30% (n = 17) of DI-ALH cases presented a flare during follow-up. Neither clinical, histological, nor serological findings nor RUCAM and RECAM could predict a DI-ALH flare.Conclusions DI-ALH is often under-recognised in clinical practice, leading to unnecessary long-term immunosuppression. A causal relationship between drugs and AIH, along with an attempt to withdraw treatment and long-term follow-up, is essential to prevent overtreatment-associated risks
Epidemiological evolution and healthcare services utilization in elderly dementia patients of Catalonia
No full textBackground Assessing the dynamics and burden of dementia is necessary to improve healthcare plans. This study aimed to describe the epidemiology and characteristics of dementia diagnoses in Catalonia (North-East of Spain) and evaluate healthcare services utilization and associated expenditures in people with dementia compared with people without.
Methods Retrospective study including all the dementia population (2013–2020) using data from an administrative database, the Catalan Health Surveillance System, covering a 7.5–7.7-million population. Data included demographic, clinical, healthcare services utilization, and morbidity-associated risk variables, and was analyzed according to dementia type, including Alzheimer’s disease (AD), vascular dementia (VD), frontotemporal dementia (FTD), dementia with Lewy bodies (LBD), and unspecified dementia (UD). We compared comorbidities and morbidity-associated risk, healthcare services utilization and associated expenditures, and mortality rates between people with dementia and the population without dementia adjusted for age, sex, and income level.
Results During the study period, dementia prevalence remained stable, and incidence modestly decreased. AD and VD incidence rates decreased, whereas UD modestly increased, being the highest in 2019. Patients with dementia had a higher prevalence of comorbidities, morbidity-associated risk, healthcare services utilization, specially admissions in nursing homes and intermediate care, healthcare-associated expenditures, and mortality than people without dementia adjusted by age, sex, and income level in 2019. An expenditure €1311.7 per person per year was attributable to dementia, representing an increase of 44.1% of total healthcare costs. Compared to other dementia types, AD and VD had increased admissions, and VD had the highest expenditures. The use of antidepressants and benzodiazepines progressively decreased.
Conclusions Using a population dataset, this study showed that dementia is associated with a high burden and healthcare needs, providing useful information to design improved healthcare plans
Structure and mechanistic basis of NrdR, a bacterial master regulator of ribonucleotide reduction
No full textRibonucleotide reductases (RNRs) are the essential enzymes responsible for synthesizing dNTPs, the building blocks of DNA. In bacteria, the entire RNR network is controlled by the master regulator NrdR. As a regulator of
an essential pathway with no eukaryotic equivalent, NrdR is a promising antimicrobial target. Recent structural studies have outlined a mechanism of action for NrdR, in which ATP and dATP induce changes in the protein
quaternary structure, regulating RNR repression. However, due to a lack of functional studies linking the known structures to their biological roles, the activation mechanism of NrdR is not yet fully understood.
Here, we conducted a comprehensive study of NrdR in Escherichia coli and Pseudomonas aeruginosa. We delimited the NrdR regulon, combining transcriptomics and motif-based sequence analysis. We crystallized E. coli
NrdR and identified the protein-protein interfaces involved in its oligomerization, including strong interactions between NrdR dimers to form tetramers, and less stable interfaces connecting such tetramers. We examined the variability of the quaternary structures of NrdR depending on the bound nucleotides by SEC-MALS and atomic force microscopy, and correlated structure to function using point mutations, EMSAs, and in vitro transcription
assays. Overall, our results demonstrate the mechanism used by NrdR to modulate its quaternary structure and activity, deciphering essential interactions between subunits, and paving the way for targeted antimicrobial
therapies
De la ironía al sarcasmo: una aproximación al dircurso parlamentario español
No full textEn este trabajo se va a estudiar la ironía recogida en los discursos parlamentarios en lengua española. A partir de este objeto de investigación, y siguiendo la Teoría de la Argumentación, se parte de la hipótesis de que la ironía en su valoración negativa se convierte en sarcasmo (que se llegará a entender aquí como la variante de la ironía). Entenderemos, además, que la ironía, como arma dialéctica, es el escudo que permite al político consolidar su rol de adversario gracias a la dependencia máxima del contexto sociocultural. Para todo ello, se presentarán muestras discursivas, por un lado, para defender que este recurso pragmático es un mecanismo de cohesión en el proceso discursivo de la argumentación ideológica del político; y, por otro lado, para intentar categorizar los mecanismos lingüísticos para su expresión
Diversidad entre estudiantes universitarios y diferencias en la intensidad de dedicación a los estudios
No full textEl Comunicado de Roma de finales de 2020 es muy explícito en la importancia de garantizar la equidad de oportunidades en el sistema universitario, tanto a nivel de acceso, progreso académico como de inserción laboral. Esto requiere conocer, no sólo las condiciones de vida de los estudiantes a nivel económico y social, sino identificar los cambios que se producen a nivel de los procesos de aprendizaje.En este sentido, son varias las investigaciones recientes que apuntan a que una de las tendencias actuales entre la población estudiantil universitaria es el incremento de su diversidad. Y, dentro de esta diversidad, se han detectado también diferencias crecientes en la intensidad de dedicación a los estudios.Es cierto que las normativas académicas de las universidades han evolucionado hacía mayores dosis de flexibilidad. Por ejemplo, a través de las opciones de matrícula a tiempo completo y tiempo parcial. Pero, más allá de estas opciones, hay indicios de que la diversidad es creciente.El objetivo de este trabajo es aportar evidencia empírica sobre estas diferencias, aprovechando la información que aporta la encuesta Vía Universitaria. Esta encuesta, que respondieron más de 40 000 estudiantes universitarios en los primeros meses del año 2021, permite identificar tipologías de estudiantes en relación con su compromiso y dedicación a la universidad, más allá de la tradicional distinción según modalidad de matrícula.Como conclusión del análisis, se pueden identificar las características (demográficas, familiares, económicas, sociales, laborales y de estudio), que más inciden en que un estudiante pertenezca a una u otra de estas tipologías. Esto tiene importancia práctica considerable, por ejemplo, a la hora de diseñar itinerarios curriculares o políticas universitarias
Assessment of an Iterative Framework for Brain PET Simulation in Epilepsy
No full textTreballs Finals de Grau de Física, Facultat de Física, Universitat de Barcelona, Curs: 2026, Tutors: Aida Niñerola Baizán, Arnau Farré MeleroMonte Carlo–based PET simulation frameworks are widely used in methodological research, and their underlying modeling and optimization strategies must be validated to ensure clinical relevance. This work evaluates an iterative PET simulation framework for brain imaging in epilepsy using patient-specific simulations derived from clinical PET and MRI data of 13 subjects.
Anatomically derived attenuation maps and an iterative activity map optimization strategy anchored to real PET images were employed. Clinical fidelity was evaluated using uptake ratios relevant to epilepsy assesment, together with other similarity and image quality metrics. Simulated PET images reproduced clinically relevant uptake ratios with a global mean relative error of approximately 4% and showed stable convergence. Noise and contrast characteristics were preserved, supporting the
proposed framework as a reliable methodology for quantitative epilepsy PET studie
Brief Report: Emphysema as a Prognostic Factor in Patients With Advanced NSCLC With COPD Receiving Immune Checkpoint Inhibitors
No full textIntroduction: Chronic obstructive pulmonary disease (COPD) and emphysema are independent risk factors for lung cancer development and have been independently associated with longer overall survival (OS) in patients with NSCLC treated with immune checkpoint inhibitors (ICIs). However, their combined impact on prognosis remains unclear. This study evaluates emphysema as a prognostic factor in patients with COPD with advanced NSCLC (aNSCLC) undergoing immunotherapy. Methods: This study included patients with aNSCLC with COPD (defined by spirometry) treated with single-agent ICI as first-or second-line treatment, from 2013 to 2024. Patients were classified based on visually detected emphysema on chest computed tomography. Results: The study included 111 patients with COPD, of whom 77 had coexisting emphysema. Patients with COPD and emphysema had significantly longer OS compared with those without emphysema (17.3 versus 8.5 mo, p = 0.008), with a nonsignificant trend toward improved progression-free survival (3.3 versus 2.4 mo, p = 0.641). Emphysema remained an independent factor of better OS in multivariate analysis (hazard ratio: 0.49; 95% confidence interval: 0.30-0.81). Adverse event rates were similar regardless of emphysema status (p = 0.455). Conclusions: This study suggests that visually detected emphysema on chest computed tomography could be a potential prognostic marker in patients with aNSCLC with COPD receiving ICIs. Further studies are guaranteed to confirm these findings
Democratic mathematical practices: Analysis of a school experience
No full textEn este artículo proponemos caracterizar las prácticas matemáticas democráticas promovidas en una clase de matemáticas con estudiantes de 12 y 13 años centrada en la enseñanza y el aprendizaje de la medida de longitud. Se muestra que la promoción de estas prácticas posibilita negociar exitosamente significados matemáticos. Se realiza un análisis donde junto con la identificación de prácticas matemáticas democráticas se observan normas, para describir e interpretar los procesos interactivos que dan forma a la participación de profesor y estudiantes en las sesiones de clase. Los resultados indican el dominio de prácticas relacionadas con la articulación y resolución de conflictos. También se constata un determinado tipo de normas en relación con cada tipo de práctica matemática democrática
Suicidal ideation with and without intention to act: A transdiagnostic network analysis on the interplay between psychopathology, impulsivity, and childhood maltreatment.
No full textBackground: Suicide represents a significant public health concern. Suicide prevention strategies are shifting toward transdiagnostic perspectives examining interrelated risk factors, but their interrelationships remain unclear. This study investigated relationships between psychopathological dimensions, impulsivity, and childhood maltreatment in individuals with suicidal ideation (SI), comparing those with versus without intention to act using network analysis.
Methods: Data were obtained from the Suicide Prevention and Intervention Study project. Participants were categorized into two groups based on their intention to act according to the Columbia Suicide Severity Rating Scale. Psychological symptoms, impulsivity traits, and childhood maltreatment were assessed. Network analysis was performed, and centrality measures were computed.
Results: A total of 1,265 individuals were categorized into the SI without intention to act (n = 345) and SI with intention to act (n = 920) groups. The former showed lower depression and hostility scores, and lower prevalence of major depressive and anxiety disorders. Network analyses revealed that in the SI without intention to act group, obsessive-compulsive symptoms were central, connecting to depression and anxiety, while negatively correlating with non-planning impulsivity. In contrast, the SI with intention to act group showed a more densely interconnected network where emotional abuse served as a bridge between childhood maltreatment and other psychopathological dimensions.
Conclusions: This study identifies symptom interaction patterns between individuals with SI without and with intention to act. Understanding these relationships may improve suicide risk assessment and inform personalized interventions, potentially reducing the transition from ideation to action. Trauma-focused approaches addressing emotional abuse may be especially relevant for individuals at high risk