http://hdl.handle.net/10366/3983 2026-07-18T03:16:04Z http://hdl.handle.net/10366/172194 Guía informativa dirigida a cuidadores de personas con daño cerebral adquirido (DCA). Se explica de forma sencilla qué es el DCA, sus causas más frecuentes y las principales áreas afectadas. Incluye recomendaciones para el cuidado físico y emocional de la persona con DCA; así como, pautas para el autocuidado del cuidador y el acceso a recursos especializados. Su diseño visual facilita la comprensión y la difusión de información básica sobre el cuidado integral de las personas con DCA. Se ha desarrollado dentro del proyecto NeuroMotion-USAL. 2025-01-01T00:00:00Z http://hdl.handle.net/10366/172128 [ENG]Background: Cancer cachexia and sarcopenia are highly prevalent complications affecting up to 50% of patients with cancer and are associated with increased treatment toxicity, poorer functional outcomes, and reduced survival. Early identification of muscle deterioration during hospitalization remains challenging. Objective: To evaluate the change in dominant-hand handgrip strength between hospital admission and discharge in hospitalized oncology patients. Methods: This prospective longitudinal study will evaluate hospitalized adults with confirmed malignancy and an expected hospital stay of ≥5 days. Daily handgrip strength and sEMG assessments will be performed as exploratory secondary measures to characterize temporal patterns of muscle function during hospitalization. Baseline and discharge evaluations will additionally include bioelectrical impedance analysis, validated patient-reported outcome measures (SARC-F, EORTC QLQ-C30, PSQI), and serum biomarkers related to inflammatory and nutritional status. Linear mixed models will be used to evaluate longitudinal changes and associations between functional, electrophysiological, and biochemical parameters. Expected results: The study aims to characterize trajectories of muscle function decline during hospitalization, identify candidate biomarker signatures for cachexia detection, and evaluate neuromuscular fatigue patterns using sEMG. Conclusions: This protocol proposes a feasible multimodal framework for monitoring skeletal muscle deterioration during acute oncology hospitalization and may inform future interventional strategies targeting cancer-related cachexia and sarcopenia. 2026-01-01T00:00:00Z http://hdl.handle.net/10366/172127 [ENG]Background: Central nervous system development is a rapid and highly plastic process during the first years of life. Tactile stimuli have been shown to induce cortical changes, but potential sex-related differences remain unexplored. This study aimed to investigate sex-specific differences in cortical activity and cerebral oxygenation in response to tactile stimulation via body massage. Methods: Four healthy full-term infants (two females and two males), all aged 11 weeks, were included in this prospective exploratory study. Each infant received a standardized 5 min massage protocol. Cortical activity and cerebral oxygenation were assessed using an 8-channel electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) before, during, and after the intervention, with a 5 min pre-intervention resting period used as the baseline. Results: EEG analysis focused on a single spectral band (4 Hz–30 Hz). This range was selected to capture the main cortical oscillations in infants, including theta, alpha, and beta activity, while delta activity below 4 Hz was partially excluded to reduce movement and physiological artifacts. Standard infant EEG bands were considered when defining this range. Data shows for the female subject an average PSD of −6.726 (± −4.075), and for the male subject, −12.594 (± −10.741). Although babies are of the same gestational age, they exhibited distinct basal cortical activity, which prevented comparisons from being made. Nevertheless, massage induced similar activity patterns in all subjects with increased cortical electrical activity in the left parietal region relative to baseline. fNIRS data showed that comparable HbO concentration patterns between participants were observed only during the second minute of recording. Relative to baseline, pre-intervention HbO responses displayed an opposite distribution, and the effects of the intervention differed by sex. The female participant exhibited a slight reduction in activation in the right hemisphere accompanied by a modest increase in the most ventral region of the left hemisphere. Conversely, the male participant showed an inverse response pattern, characterized by a marked increase in right hemispheric activation and a pronounced decrease in the left hemisphere during the intervention period. Conclusions: These preliminary observations suggest the presence of early variations in cortical processing that warrant further investigation in larger samples, although they cannot be considered conclusive. While baseline response patterns differed between participants, both showed increased left parietal activity during tactile stimulation. The inversion of HbO responses between the pre-intervention and intervention phases points to potential sex-related differences in hemodynamic trajectories. Nevertheless, these results remain preliminary, and larger, well-powered studies are required to determine whether these patterns reflect stable, sex-dependent developmental changes. 2026-01-01T00:00:00Z http://hdl.handle.net/10366/172126 [ENG]Background – Kinesiophobia (excessive fear of movement due to belief of injury) is highly prevalent in rheumatologic diseases, yet its prevalence and associations in psoriatic arthritis (PsA) remain unexplored. Objective – To determine the prevalence of kinesiophobia in PsA and examine its associations with central sensitization (CS), demographic characteristics, disease activity, physical function, and patient-reported outcomes. Methods – Cross-sectional study of 246 consecutive PsA patients. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia-11. CS was measured by Central Sensitization Inventory (CSI). Disease activity, functional status, physical activity, sleep quality, anxiety, depression, and fatigue were systematically evaluated. Univariate and multivariable analyses (logistic and linear regression) were performed. Results – Kinesiophobia was present in 45.5% (112/246) of patients. Patients with kinesiophobia demonstrated significantly higher CSI scores (41.5 vs. 29; p < 0.001), reduced physical activity (1619.5 vs. 2, 970 MET-minutes/week; p = 0.01), greater disease activity (cDAPSA: 13 vs. 11; p = 0.001), functional impairment (HAQ-DI; p = 0.001), and increased comorbid anxiety and depression (p = 0.001). A significant correlation existed between kinesiophobia and CSI (r = 0.39; p < 0.001). In multivariable logistic regression, central sensitization (OR: 1.03; 95% CI: 1.00–1.05; p = 0.02) and sleep quality (PSQI; OR: 1.09; 95% CI: 1.00–1.1; p = 0.03) emerged as independent predictors, explaining 20% of kinesiophobia variance. In linear regression, these variables accounted for 12% of variance (R2 = 0.12). Conclusion – Kinesiophobia functions as an amplifier of pain perception and functional disability, particularly in patients with symptom-inflammation discordance. A bidirectional pathophysiologic relationship between kinesiophobia and CS likely perpetuates chronic pain and disability. Multidimensional interventions may enhance clinical outcomes in kinesiophobic PsA patients, especially those with high perceived impact despite adequate inflammatory control. 2026-01-01T00:00:00Z http://hdl.handle.net/10366/172122 [ENG]Background: Obstructive sleep apnea (OSA) is increasingly recognized in chronic inflammatory diseases, yet its prevalence and clinical correlates in psoriatic arthritis (PsA) remain poorly characterized. Objective: The objective of this study was to evaluate OSA prevalence and its relationship with disease activity, functional impairment, and comorbidities in PsA patients. Methods: A cross-sectional analysis of 247 consecutive PsA patients was conducted. OSA diagnosis was determined through medical record review. Disease activity was assessed using cDAPSA and ASDAS-CRP. Functional disability was measured using HAQ-DI and BASFI. Sleep quality (PSQI) and psychological symptoms (HADS) were evaluated. Inflammatory markers included CRP, IL-6, and TNF-α. Multivariable logistic regression identified independent predictors of OSA. Results: OSA prevalence was found to be 8.9% (22/247). OSA+ patients had significantly higher median age (58.0 vs. 54.0 years, p = 0.02), tender joint count (2.0 vs. 1.0, p = 0.002), functional disability (1.1 vs. 0.3, p = 0.001), fatigue (30.5 vs. 38.0, p = 0.04), anxiety (7.5 vs. 5.0, p = 0.03), depression (7.0 vs. 3.0, p = 0.004), and worse sleep quality (11.5 vs. 7.0, p = 0.001). Notably, no significant differences in inflammatory markers (CRP, swollen joints) were found between groups despite substantially higher pain burden in OSA+ patients. Female sex and greater tender joint count emerged as independent predictors of OSA. Conclusions: OSA occurs in ~9% of unselected PsA patients and is independently associated with functional disability, psychological distress, and elevated tender joint counts despite comparable inflammatory markers. This dissociation suggests that OSA drives pain amplification through non-inflammatory mechanisms. These findings support the use of systematic OSA screening in PsA patients with pain or disability disproportionate to inflammatory burden, particularly in those with psychological comorbidities. 2026-01-01T00:00:00Z http://hdl.handle.net/10366/172121 Background: Displaced individuals endure challenges, including conflict, forced migration, family separation, human rights violations, limited access to essential services, and increased exposure to violence and abuse. These hardships significantly impact their mental health, often leading to heightened trauma-related symptoms. Methods: We used a cross-sectional correlational design in refugee camps, homes, and centers across Jordan and Spain. 200 refugees with confirmed status in the past ten years were recruited. Demographic data were collected via a demographic form, the PTSD-8 Inventory assessed traumatic symptoms, and data analysis included descriptive statistics, independent t-tests, one-way ANOVA, and Chi-square tests. Results: Most participants had a secondary education, were unemployed, and had low incomes. PTSD symptoms were prevalent, with rates of recurrent thoughts (63.5%), re-experiencing events (57.5%), nightmares (50.5%), sudden reactions (56.5%), activity avoidance (53.5%), avoidance of specific thoughts or feelings (56.5%), jumpiness (53.5%), hypervigilance (53.5%), feeling on guard (41.5%), and general avoidance (43.5%) rated from rarely to most of the time. All symptoms were significantly more frequent among refugees in Jordan than in Spain. Conclusions and Recommendations: Intrusive thoughts were more frequent among females, urban residents, and unemployed individuals. Avoidance behaviors were higher in married and unemployed individuals. Hypervigilance was more prevalent among females, married individuals, and those with lower incomes. Regionally, females and married individuals in Jordan exhibited more intrusive thoughts and avoidance. In Spain, intrusive thoughts and hypervigilance were more common among females and the unemployed. The findings highlight the urgent need for targeted mental health interventions, particularly in refugee camps like those in Jordan, where PTSD symptom rates were significantly higher. Programs should prioritize trauma-focused therapies, such as Cognitive Behavioral Therapy, while adopting gender-sensitive approaches to address the heightened vulnerability of women and unemployed individuals. Given the strong link between unemployment and symptom severity, livelihood support and vocational training should be integrated into psychosocial care. Policymakers in host countries like Jordan could benefit from adopting integration strategies similar to Spain’s, which may contribute to lower PTSD prevalence. Additionally, community-based awareness initiatives could improve early symptom recognition and access to care. Future research should explore longitudinal outcomes to assess the long-term impact of displacement and resettlement conditions on mental health. 2025-01-01T00:00:00Z http://hdl.handle.net/10366/171901 [EN] Background: Loneliness has emerged as a psychosocial issue in oncology, with implications for emotional well- being, social and daily functioning, and adaptation to illness. However, its relationship with perceived social support and functional independence in patients with cancer remains insufficiently characterized. Objective: To analyze loneliness in patients with cancer and its association with sociodemographic, psychosocial, and functional variables. Methods: We conducted a cross-sectional study in 153 adults with cancer recruited from the onco-haematology day hospital at the Complejo Asistencial Universitario de Salamanca, Spain. Global loneliness was assessed with the UCLA Loneliness Scale, and emotional and social loneliness with the De Jong Gierveld Loneliness Scale. Perceived social support was evaluated with the Duke-UNC Functional Social Support Questionnaire, quality of life with the EORTC QLQ-C30, functional independence with the Barthel Index, and anxiety and depressive symptoms with the Hospital Anxiety and Depression Scale (HADS). Correlation analyses and multivariable linear and logistic regression models were performed. Results: The median UCLA loneliness score was 36 (range 20–79), indicating variability in perceived loneliness. Higher loneliness was associated with lower perceived social support, greater depressive and anxiety symptoms, and lower functional independence. In multivariable analyses, perceived social support and functional independence remained independently associated with lower loneliness, while depressive symptoms were associated with higher loneliness only in the linear model. Conclusions: Loneliness was more closely associated with psychosocial and functional than sociodemographic variables. These findings support loneliness assessment in comprehensive cancer care and suggest that social support and functional status may be key loneliness correlates. [ES] Antecedentes: La soledad ha emergido como un problema psicosocial en oncología, con implicaciones en el bienestar emocional, el funcionamiento social y diario, y la adaptación a la enfermedad. Sin embargo, su relación con el apoyo social percibido y la independencia funcional en pacientes con cáncer sigue sin estar suficientemente caracterizada. Objetivo: Analizar la soledad en pacientes con cáncer y su asociación con variables sociodemográficas, psicosociales y funcionales. Métodos: Se realizó un estudio transversal en 153 adultos con cáncer reclutados en el hospital de día de oncohematología del Complejo Asistencial Universitario de Salamanca, España. La soledad global se evaluó con la Escala de Soledad de la UCLA, y la soledad emocional y social con la Escala de Soledad de De Jong Gierveld. El apoyo social percibido se evaluó con el Cuestionario de Apoyo Social Funcional Duke-UNC, la calidad de vida con el EORTC QLQ-C30, la independencia funcional con el Índice de Barthel, y los síntomas de ansiedad y depresión con la Escala de Ansiedad y Depresión Hospitalaria (HADS). Se realizaron análisis de correlación y modelos de regresión lineal y logística multivariante. Resultados: La mediana de la puntuación de soledad de la UCLA fue de 36 (rango 20–79), lo que indica variabilidad en la soledad percibida. Una mayor soledad se asoció con un menor apoyo social percibido, mayores síntomas de depresión y ansiedad, y una menor independencia funcional. En los análisis multivariantes, el apoyo social percibido y la independencia funcional se mantuvieron asociados de forma independiente con una menor soledad, mientras que los síntomas depresivos se asociaron con una mayor soledad solo en el modelo lineal. Conclusiones: La soledad se asoció más estrechamente con las variables psicosociales y funcionales que con las sociodemográficas. Estos hallazgos respaldan la evaluación de la soledad en la atención integral del cáncer y sugieren que el apoyo social y el estado funcional pueden ser correlatos clave de la soledad. 2026-06-13T00:00:00Z http://hdl.handle.net/10366/171630 The prevalence of cognitive disorders such as Alzheimer's disease (AD) is increasing due to the global rise in longevity. The accumulation of amyloid β (Aβ) deposits and hyperphosphorylated Tau protein (p-Tau) are considered the main hallmarks of AD. A growing body of evidence suggests that the regular intake of flavonoid-rich foods could reduce the risk of developing AD or mitigate its progression. This study explores the potential of quercetin (Q) and epicatechin (EC) as effective molecules against AD-like pathology, using the Caenorhabditis elegans BR5270 strain, which expresses the pro-aggregant F3DK280 fragment of the human Tau protein. The results showed that after exposure to 150 µM of EC or Q, worms exhibited increased lifespan, improved chemotaxis, and delayed age-related decline in locomotion. To explore the molecular mechanisms involved, the expression of genes associated with the inhibition of p-Tau proteotoxicity were measured by RT-qPCR. It was found that Q and EC significantly increased the expression levels of autophagy-related genes and of a key gene for de novo synthesis of α- tubulin. EC and Q delay neurodegeneration in the C. elegans tauopathy model, suggesting their potential to reduce the risk of AD progression. 2025-01-01T00:00:00Z http://hdl.handle.net/10366/171629 Phenolic acids are one of the major classes of phenolic compounds occurring as secondary metabolites in plants; among them, hydroxybenzoic and hydroxycinnamic acids are outstanding. These compounds are widespread in the human diet through plant-based foods, where they contribute to sensory and functional properties. Their consumption has also been associated with positive effects in human health, owing to their recognized biological activities (e.g., antioxidant, anti inflammatory, antimicrobial, antidiabetic, or anticarcinogenic). Technological and functional properties of phenolic acids have made them interesting compounds for food, pharmaceutical, and cosmetic companies, so that suitable preparation processes are required to meet their increasing research and industrial demand. To fulfill these needs, an efficient production of pure compounds is required that cannot be fully satisfied by their isolation from natural sources or chemical synthesis, which suffer limitations such as low yield, time-consuming, or non-environmentally friendly processes. Biotechnological approaches including the construction of heterologous plant or microbial systems can be an alternative for enhancing phenolic acid production or addressing pathways toward the biosynthesis of particular target compounds. This chapter offers an overview on phenolic acids occurrence in food and natural sources, biosynthesis and advances in their biotechnological production 2023-01-01T00:00:00Z http://hdl.handle.net/10366/171628 [ENG]Introduction: Increasing evidence supports the role of gut microbiota in many aspects of human health, including immune, metabolic and neurobehavioral traits. Several studies have focused on how different components of the diet, such as polyphenols, can modulate the composition and function of the gut microbiota leading to health benefits. Methods: The effects on the resistance against thermally induced oxidative stress of C. elegans grown in the presence of flavonoids (quercetin or epicatechin) and fed different probiotic strains, namely Lactobacillus plantarum CLC17, Bifidobacterium longum NCIMB 8809 and Enterococcus faecium CECT 410, were explored. Results: Feeding C. elegans with the assayed bacteria in the absence of flavonoids did not significantly affect body size and fertility of the worms neither improve their resistance against oxidative stress compared to E. coli controls. However, increased resistance to stress was found when C. elegans was cultivated in the presence of both L. plantarum and flavonoids, but not with B. longum or E. faecium. An exploratory study revealed the presence of glycosylated and sulfated metabolites together with the aglycone in worms treated with quercetin and fed any of the different assayed LAB strains. However, in the assays with epicatechin a differential metabolite, tentatively identified as 5-(4′-hydroxyphenyl)-γ-valerolactone 3′-O-glucoside, was detected in the worms fed L. plantarum but not with the other bacteria. Conclusion: The obtained results indicated that the interactions bacteria/polyphenol play a key role in the effects produced in C. elegans regarding resistance against oxidative stress, although those effects cannot be only explained by the ability of bacteria to metabolize polyphenols, but other mechanisms should also be involved. 2022-01-01T00:00:00Z http://hdl.handle.net/10366/171600 Abstract Background Alzheimer’s disease (AD) is the most prevalent form of dementia worldwide, representing a growing public health concern as populations age. While biological mechanisms have been extensively studied, less is known about how sociodemographic determinants - such as residence, education, and socioeconomic context - affect the onset and distribution of AD in Spain. This study explores the association between sociodemographic factors and AD diagnosis among patients in primary health care centers in the province of Salamanca. Methods A cross-sectional, observational, and retrospective study was conducted using data from the Medora 4 electronic health records system of the Castilla y León Regional Health Service (SACYL). A total of 760 patients with a confirmed diagnosis of AD between 2009 and 2019 were randomly selected from an initial cohort of 1,623 individuals (95% confidence level, 2.59% margin of error). Variables analyzed included age, sex, place of residence (urban/rural), educational level, occupation, depressive symptoms, and family history of dementia. Data were analyzed with descriptive and inferential statistics using chi-square and Kruskal–Wallis tests (p < 0.05). Results Conclusion Among the 760 participants, 70% were women (n = 535) and 30% men (n = 225), with a mean age above 65 years. AD prevalence was significantly higher among urban residents (50.8%) than rural residents (49.2%) (p = 0.016). Women were disproportionately affected in both environments, especially in rural areas (74.1% vs. 66.1% in urban areas). Depression was recorded in 40.3% of patients, more frequently among women, though no significant association was observed with AD onset. Advanced age and female sex were confirmed as predominant risk factors. This study reveals a significant urban – rural disparity in AD prevalence in Salamanca, Spain, and confirms the higher vulnerability of older women. The findings underscore the need for targeted prevention and early detection strategies within primary care, particularly in urban settings where prevalence is higher. Understanding these sociodemographic determinants is crucial for designing equitable, community-based dementia care policies. 2026-01-23T00:00:00Z http://hdl.handle.net/10366/171324 Introducción: La negativa a la fístula arteriovenosa es un reto en hemodiálisis. La intervención enfermera es determinante en la toma de decisiones compartidas. Objetivo: Evaluar el impacto de una intervención multidisciplinar estructurada para abordar la negativa de pacientes con enfermedad renal crónica a la creación de una fístula arteriovenosa. Material y Método: Estudio piloto prospectivo y multicéntrico dividido en cuatro grupos según su situación respecto al acceso vascular. La intervención incluyó educación visual, formación del equipo en habilidades comunicativas y ecografía. Se analizaron variables demográficas, clínicas y de intervención. El estudio contó con aprobación ética y consentimiento informado. Análisis mediante pruebas paramétricas (t-Student, ANOVA) y no paramétricas (U de Mann-Whitney, Kruskal-Wallis). Resultados: Se incluyeron 51 pacientes con una edad media de 67,4±13,4 años (68,6% hombres). Tras la intervención, el 68,6% optó por fístula arteriovenosa. Enfermería lideró el 100% de las primeras consultas (media 30±12,7 minutos). La aceptación fue total en el grupo ERCA (100%) y alta en incidentes (78%), frente al 35% en prevalentes con CVC>6 meses (p<0,001). Las consultas sucesivas multidisciplinares aumentaron significativamente la aceptación frente a consultas solo de enfermería (p<0,05). Las principales barreras fueron miedo a la cirugía (54%) y comodidad del catéter (46%). Quienes aceptaron la fístula fueron más jóvenes (p<0,05). Conclusiones: La enfermería lidera positivamente la toma de decisiones mediante un enfoque estructurado y empático. La consulta ERCA es clave para la planificación anticipada, mientras que en portadores de catéter de larga duración se requieren intervenciones más tempranas. 2026-03-30T00:00:00Z http://hdl.handle.net/10366/171122 [ENG]The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD).  METHODS: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45-75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor's office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9-17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211. 2022-11-19T00:00:00Z http://hdl.handle.net/10366/171114 Nomophobia is a specific phobia characterized by the appearance of anxiety, nervousness, discomfort and distress when the mobile phone is not used and is considered an emerging public health problem because of the negative consequences on the physical and mental health of young people and adolescents, especially women. Neurofeedback-Assisted Mindfulness Training Programs may prove beneficials for improving self-control abilities, a key ability in addressing addictive behaviors. The main objective of this study is to evaluate the impact, in a young population aged 18-35 years, of an intervention based on Neurofeedback-Assisted Mindfulness Training Program (NAMTP) on disorders associated with problematic use of mobile phones. The effect of the intervention on the total score in the nomophobia test and habits of internet and social network use, as well as on signs of depression, anxiety and stress will be analyzed. As a secondary objective, the effect of the intervention on signs of insomnia will be analyzed. Randomized, controlled clinical-trial with two-parallel groups. 40 young adults (18-35 years) will be included and randomly assigned to Intervention Group-NAMTP or Control Group (CG). The NAMTP will include a total of 25 sessions (2-3/week) during 3-months. Each session will have a duration of 10/15 min. The instrument to be used for the neurofeedback sessions is MUSE® (InteraXon Inc.). Study variables will be collected at the baseline visit and at the final visit (3-months after randomization). During these visits, questionnaires will be administered to evaluate the main and secondary variables that will include the Smartphone Addiction Scale-Short Version, Nomophobia Questionnaire, Depression, Anxiety and Stress Scale 21-item (DASS-21) and Athens Insomnia Scale. This trial will make an important contribution to the need for evidence of effective education programs and other primary care interventions through new non-invasive interventions in reducing the risk of developing addictions to new technologies and alleviating the symptoms of discomfort associated with this problem. The project was approved by the Clinical Research Ethics Committee of the Salamanca Health Area (CEIm Code: PI 2023 071340). ClinicalTrials.gov, http://www.Clinicaltrials.gov/ct2/show/NCT06188910. 2024-01-01T00:00:00Z http://hdl.handle.net/10366/171113 Atherosclerosis, a leading cause of mortality, necessitates effective management of hypercholesterolemia, specifically elevated low-density lipoprotein cholesterol (LDL-C). The emergence of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) has revolutionised lipid-lowering. PCSK9i demonstrates substantial LDL-C reduction and cardiovascular benefits, particularly in statin-intolerant or nonresponsive individuals. However, the potential pleiotropic effects of PCSK9i, especially on arterial stiffness, remain a subject of investigation. This systematic review and meta-analysis seek to provide a nuanced understanding of the potential pleiotropic effects of PCSK9i, specifically on arterial health. The primary objective was to analyse the influence of PCSK9i on arterial stiffness, extending beyond traditional lipid-lowering metrics and contributing to a more comprehensive approach to cardiovascular risk reduction. A systematic search was conducted across major databases, clinical trial registries and grey literature. Inclusion criteria comprised adults in prospective cohort studies undergoing PCSK9i augmentation in lipid-lowering therapy, with a focus on arterial stiffness measured by pulse wave velocity (PWv). Random-effects meta-analyses, sensitivity analyses and meta-regression models were employed to assess the pooled effect of adding PCSK9i to lipid-lowering interventions on arterial stiffness. Five studies (158 participants) met the inclusion criteria, demonstrating a significant reduction in PWv (mean difference: -2.61 m/s [95% CI: -3.70, -1.52]; ES: -1.62 [95% CI: -2.53, -.71]) upon adding PCSK9i to lipid-lowering interventions. Subgroup analysis and meta-regression models suggested potential sex-based and baseline PWv-dependent variations, emphasising patient-specific characteristics. The meta-analysis provides robust evidence that adding PCSK9i to lipid-lowering interventions significantly improves arterial stiffness, indicating broader vascular benefits beyond LDL-C reduction. 2024-10-01T00:00:00Z http://hdl.handle.net/10366/171112 [ENG]Postpartum is a critical phase for women's health, characterized by physical, psychological, and social changes. Social networks have emerged as a predominant communication channel, offering support and quick access to information about motherhood. However, their use can also negatively influence body image and dietary behavior, especially in a context of pro-slimness beauty standards. Postpartum women are particularly vulnerable to body dissatisfaction, but there are still few studies that specifically analyze the impact of social networks at this stage. This scoping review aims to map and describe the available evidence on how the possible influence of exposure to social media content on body image perception and the adoption of eating and exercise-related habits in women during the postpartum period has been investigated. This scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) guidelines, adapted for exploratory reviews. We searched for studies published in the last 10-years in databases such as PubMed, Scopus, Web of Science, CINAHL, and BVS, using terms related to social networks, body image, diet, exercise, and the postpartum period. Eight studies were included after applying eligibility criteria based on the PIO framework. An assessment of the quality of methodological reporting was performed using best practice guidelines such as SRQR, STROBE, CONSORT, and PRISMA, for descriptive purposes. We analyzed 8 studies suggesting that social networks may negatively influence the body image, eating and exercise habits of postpartum women. The publications represent unrealistic aesthetic standards, associated with body dissatisfaction, restrictive diets, and intensive exercise, with prevalent nutritional misinformation. Although positive messages of body acceptance were identified, they were scarce, suggesting the need for regulation and media education. Social networks could exert a relevant influence on women's body image and self-care habits in the postpartum period, promoting unrealistic aesthetic standards that could have a negative impact on their physical and emotional well-being. It is essential to implement media literacy strategies, promote inclusive content, and regulate misinformation on these platforms to mitigate their adverse effects and promote a healthy and sustainable recovery. 2025-07-12T00:00:00Z