Hints for Metal-Preference Protein Sequence Determinants: Different Metal Binding Features of the Five Tetrahymena thermophila Metallothioneins

The metal binding preference of metallothioneins (MTs) groups them in two extreme subsets, the Zn/Cd- and the Cu-thioneins. Ciliates harbor the largest MT gene/protein family reported so far, in-cluding 5 paralogs that exhibit relatively low sequence similarity, excepting MTT2 and MTT4. In Tet-rahymena thermophila, three MTs (MTT1, MTT3 and MTT5) were considered Cd-thioneins and two (MTT2 and MTT4) Cu-thioneins, according to gene expression inducibility and phylogenetic analysis. In this study, the metal-binding abilities of the five MTT proteins were characterized, to obtain information about the folding and stability of their cognate- and non-cognate metal complexes, and to characterize the T. thermophila MT system at protein level. Hence, the five MTTs were recombinantly synthesized as Zn2+-, Cd2+- or Cu+-complexes, which were analyzed by electrospray mass spectrometry (ESI-MS), circular dichroism (CD), and UV-vis spectrophotometry. Among the Cd-thioneins, MTT1 and MTT5 were optimal for Cd2+ coordination, yielding unique Cd17- and Cd8- complexes, respectively. When binding Zn2+, they rendered a mixture of Zn-species. Only MTT5 was capable to coordinate Cu+, although yielding heteronuclear Zn-, Cu-species or highly unstable Cu-homometallic species. MTT3 exhibited poor binding abilities both for Cd2+ and for Cu+, and although not optimally, it yielded the best result when coordinating Zn2+. The two Cu-thioneins, MTT2 and MTT4 isoforms formed homometallic Cu-complexes (major Cu20-MTT) upon synthesis in Cu-supplemented hosts. Contrarily, they were unable to fold into stable Cd-complexes, while Zn-MTT species were only recovered for MTT4 (major Zn10-MTT4). Thus, the metal binding preferences of the five T. thermophila MTs correlate well with their previous classification as Cd- and Cu-thioneins, and globally, they can be classified from Zn/Cd- to Cu-thioneins according to the gradation: MTT1>MTT5>MTT3>MTT4>MTT2. The main mechanisms underlying the evolution and specialization of the MTT metal binding preferences may have been in-ternal tandem duplications, presence of doublet and triplet Cys patterns in Zn/Cd-thioneins, and op-timization of site specific amino acid determinants (Lys for Zn/Cd- and Asn for Cu-coordination)

Influence of Gender, Age and Field of Study on Hand Hygiene in Young Adults: A Cross-Sectional Study in the COVID-19 Pandemic Context

The effectiveness of hand hygiene (HH) on reducing the transmission of contagious diseases is widely known, although its use has been commonly associated with the area of healthcare. During the COVID-19 pandemic, HH was one of the main measures established to contain the transmission of this virus. The identification of the main barriers and facilitators of HH in young adults (aged 18–29 years old) will contribute to the better planning of HH training and its posterior success. A total of 716 young adults participated in the study by completing the ad hoc online questionnaire (#YesWeHand), which analyzed, among other aspects, the age range, gender and field of study that they belonged to. From the total participants, 81.3% indicated knowing how to perform HH correctly, while 49.4% affirmed having received training. The main reason for performing HH was concern for their own safety and that of others (75.8%), while forgetfulness (36.5%) was the main reason for not performing HH. In the group of young adults, being female, aged between 22 and 25 years old, and having studied in the area of Health Sciences, had a positive influence on correct HH. It is deemed necessary to maintain HH beyond the primary education stages, and to adapt it to different fields of education, ages, and genders, in order to maximize its success. Given the overrepresentation of participants from the healthcare field, it would be desirable to conduct more studies to ensure a better representation of the different educational levels and fields of study of the participants, in order to identify, in a more reliable way, the variables that influence HH

Molecular Evolution of Unicellular Eukaryote Metallothioneins: Tandem Repetition of Coordinating Domains

[eng] Metallothioneins (MTs) are a superfamily of ubiquitous and small cysteine rich metalloproteins present in all eukaryotes and some prokaryotes organisms, that exhibit preferences to coordinate divalent or monovalent heavy metal ions such as Zn(II), Cd(II) or Cu(I). This ability is used by MTs to participate in toxic metal detoxification, metal ion homeostasis and protection against oxidative stress. Features of MT sequences, as well as their structural arrangements, are crucial to determine their metal-abilities and the related functions. In this PhD thesis, we aimed at expanding the knowledge of some peculiar MTs, which are characterized by their unusual long sequence, their Cys-distribution and their modular folding. Thus, initially, the five Tetrahymena thermophila MTs (MTT1 to MTT5), which represent one of the longest MTs reported so far, were characterized to decipher their divalent or monovalent metal preferences. The modular structure of MTT1, MTT3 and MTT5 isoforms, which contain high occurrence of doublets and triplets confer a clear Zn-character to these MTs. Contrarily, MTT2 and MTT4 in which no modular structures, nor Cys doublets and triplets, are present, exhibit a specific Cu-thionein character. The gradation of metal-binding preferences from Zn-thionein to Cu-thionein shown by each MT, as well as the sequence features, constitute an important information source for MT evolutionary studies. Later, two other MTs from the human pathogenic opportunistic fungus Cryptococcus neoformans (CnMT1 and CnMT2) were characterized. Their unusual long sequence, not known in fungal MTs so far, together with their high Cys content, explained their extraordinary Cu detoxification capacity. The modular structure of CnMT1 and CnMT2, with three and five 7-Cys containing regions, respectively, separated by cysteine-free spacers, leads to their folding into Cu5 clusters upon Cu coordination, which enhances their detoxification capacity. This extraordinary ability becomes decisive for C. neoformans virulence in order to avoid the copper toxicity induced by macrophages during mammalian host infection. The sequence analysis of these Cys-rich regions in CnMTs revealed their homology to other well characterized fungal MT models, as Neurospora crassa and Agaricus bisporus MTs, whose Cys pattern almost exactly coincides with that found in CnMTs, this supporting the emergence of the long C. neoformans MTs by ancient tandem repetitions of a primeval fungal MT unit. Finally, in this work other hypothetical fungal MTs were identified in silico, among which those of other human opportunistic pathogenic fungi such as Histoplasma capsulatum, Paracoccidioides brasiliensis, Coccidioides immitis or Fusarium genus fungi. The strategy used in our group to characterize MTs, allowed us to identify a new fungal MT from F. verticillioides which presents the same Cu-thionein features (Cu5 clusters) than each Cys-building blocks from C. neoformans MTs. Evenly, the characteristics presented in F. verticillioides MT is extensible to F. graminearum and F. oxysporum MTs, given that the MT sequences are identical. Overall, this PhD thesis work contributes to enlarge the current limited knowledge about molecular evolution of unicellular eukaryote MTs and at the same time, it opens the door to characterize new pathogenic fungal MTs, whose results may provide interesting conclusions to decipher the role of MTs as virulent determinants and its function as Cu detoxifying.[eng] Les Metal•lotioneïnes (MTs) són una superfamília de metal•loproteïnes petites, ubiqües i riques en cisteïna, presents en tot els eucariotes i alguns organismes procariotes, que coordinen metalls pesants divalents o monovalents com el Zn(II), el Cd(II) o el Cu(I). Aquesta habilitat és utilitzada per les MTs per participar en la detoxificació de metalls, en l'homeostasi d'ions metàl•lics i la protecció contra l'estrès oxidatiu. Les característiques de les seqüències de MT, així com la disposició estructural, són crucials per determinar les seves habilitat metàl•liques i les funcions que se'n deriven. Aquesta tesi pretén ampliar el coneixement d'algunes MTs peculiars, que es caracteritzen per la seva llarga seqüència inusual, la seva distribució de cisteïnes i el seu plegament modular. S'han caracteritzar les cinc MTs de Tetrahymena thermophila (MTT1 a MTT5), sent de les més llargues identificades fins ara. L'estructura modular de MTT1, MTT3 i MTT5, contenen un elevat nombre de doblets i triplets de cisteïna, conferint-los un caràcter de Zn-tioneïna. Contràriament, MTT2 i MTT4, les quals no contenen estructures modulars, ni doblets ni triplets, exhibeixen un caràcter específic de Cu-tioneïna. Els resultats obtinguts en les anàlisis constitueixen una font important d'informació per a l'estudi d'evolució de les MTs. Seguidament, es van caracteritzar dos MTs del fong oportunista patogen d'humans Cryptococcus neoformans (CnMT1 i CnMT2). La seva llarga seqüència, no descrita en MTs de fongs fins el moment, juntament amb l'elevat contingut en cisteïnes, expliquen la seva extraordinària capacitat de detoxificació del Cu. L'estructura modular amb tres (en CnMT1) i cinc (en CnMT2) blocs de 7-cisteïnes cadascun, separats per espaiadors lliures de cisteïnes, permeten el seu plegament en clústers Cus, millorant les seves capacitats detoxificants. Aquesta habilitat resulta decisiva per la virulència de C. neoformans, evitant la toxicitat per coure, induïda pels macròfags durant la infecció de l'hoste, en mamífers. Cadascun d'aquests blocs presenta homologia amb altres MTs de fongs models, com són la MT de Neurospora crassa o la d'Agaricus bisporus, fet que suggereix que les CnMT1 i CnMT2 van evolucionar a partir de repeticions en tàndem d'una mateixa MT primitiva. Finalment, es presenta també la identificació in silico d'MTs hipotètiques d'altres fongs patògens, entre les quals es troben les MTs del gènere Fusarium, i d'entre les que s'ha caracteritzat una nova MT

Evolution of Scientific Production on Health Literacy and Health Education—A Bibliometric Analysis

In the last few years, there has been an emphasis on the importance of health literacy (HL) and health education (HE) as basic tools to empower individuals and the community. The increasing interest in HL and HE has been observed through the evolution of publications and the nature of the main trends in the last few years. Knowing how HL and HE have evolved in scientific publications can help us to identify trends and set work priorities in this scope. Based on this, a bibliometric analysis (from 2000 to 2021) was conducted in two phases: first, an analysis was performed on the publications included in the Web of Science (WOS); second, a more specific analysis was conducted on the Core Collection from WOS. The data were analyzed with two software programs, the and Bibliometrix package for RStudio, and VOSviewer to analyze number of publications, citations, authors, collaborations, keywords trends, keywords evolutions and clusters of related terms. A total of 1799 articles were found in the first phase, and 727 in the second. The results from both analyses showed that the publications increased unequally until 2020, and considerably decreased in 2021; however, in spite of this, the number of citations remained constant. Likewise, five word clusters related with HL and HE were identified. D. Nutbeam stood out as the most prolific author on the subject, the USA as the country with the most publications, and the International Journal of Environmental Research and Public Health as having the most articles on the subject. This analysis may be a useful and helpful tool for future studies on the subject.This study has been co-financed under the RETSASO EFA 341/19 Project with FEDER funds. In addition, it has been subsidized by the DOTS University Chair (Chair for the Development of Healthy and Sustainable Organizations and Territoires), approved by agreement No. 193/2017 of the Governing Council of the University of Lleida on 19 July 2017

Health literacy in childhood and adolescence. A bibliometric analysis of scientific publications and professionals’ involvement

Background: Health Literacy (HL) is a powerful tool to empower children and adolescents in their own health. School nurses are the professionals who, with their expertise in health promotion and education, can facilitate this literacy throughout the educational process. Purpose: To analyze the scientific production in HL in childhood and adolescence in the last two decades, and to determine the involvement of professionals in this field, with emphasis on nursing professionals. Methods: A bibliometric analysis of the scientific literature (from 2000 to 2021) of articles retrieved from the Web of Science database was carried out. Original articles in all languages were considered as inclusion criteria. Bibliometrix 3.1.4 package from RStudio and VOSviewer were used to analyze publications and explain main results about citations, authors, countries, keywords trends, evolution, clusters of related terms, and professionals’ involvement. Results: A total of 2032 articles were included in the analysis. The results of the analysis showed that both publications and citations increased substantially since 2014. The most prolific authors in this field are not the most cited so far. The countries that published the most during the period evaluated were the United States, Australia and Canada. The keyword clusters identified in this scientometric study made it possible to determine hotspots in the study of HL in childhood and adolescence, with “mental health” being one of the main terms identified. There are different health-related professionals who are publishing in this field; in spite of this, nurses are not visible as authors in the publications. Conclusion: The scientific literature on HL in childhood and adolescence is a growing field in which different professionals are involved. Despite the increase in the number of publications, and despite the role that nurses play in schools regarding HL, their presence in scientific production is practically nonexistent.This work was supported by DOTSS University Chair [193/2017]

Experiences of telenursing in overcoming challenges and applaying strategies by COVID-19 patients in home isolation : qualitative study in primary care

During the first wave of the COVID-19 pandemic, there was a significant increase in the use of telenursing to provide care for patients at home. However, the quality of the patient experience when nurses rely on technology instead of personal contact has not been thoroughly investigated. This study aimed to understand the perspectives of COVID-19 patients in home isolation who received telenursing from primary care nurses during the initial phase of the pandemic. A qualitative study was conducted that employed purposive sampling and involved semi-structured interviews via videoconference with fourteen COVID-19 patients from two primary health centers in Catalonia (Spain). Thematic analysis was used, and the study adhered to the COREQ checklist. The findings revealed three themes related to the challenges faced by COVID-19 patients in home isolation: physical symptoms, emotional and social difficulties, and a lack of information. Three themes emerged regarding the strategies patients employed to overcome thesechallenges and the role of nurses: self-care, emotional support, and personal commitment. The patients reported having achieved strategies to improve their physical, psychological, and situational well-being despite the unprecedented situation. The study highlights that telenursing is a valuable resource for delivering patient-centered care, which could lead to changes in organisational policies and the development of best clinical practices

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Positive Body Image among Adolescents Scale (PBIAS) into Spanish and Catalan

The Positive Body Image among Adolescents Scale (PBIAS) explores the factors that bolster and interfere with developing and maintaining a positive body image during adolescence. The aim of this study was to translate, adapt, and validate the PBIAS into Spanish and Catalan. A cross-sectional study was conducted for the instrument's translation, cross-cultural adaptation, and psychometric validation. A process of translation, back-translation, expert consultation, and piloting was followed. The reliability and statistical validity were evaluated. The Cronbach's alpha was 0.95 in both the Spanish and Catalan versions. Pearson's correlation coefficients were statistically significant (r > 0.087) for all items analyzed. The resulting values of the Spanish and Catalan versions indicate a good level of concordance (p < 0.001) with the original questionnaire, the comparative fit index being 0.914 and 0.913, the Tucker-Lewis index being 0.893 and 0.892, the root mean square error of approximation being 1.31 and 1.28, and the standardized root mean square residual being 0.051 and 0.060, respectively. The instrument presents a good level of internal consistency, a high level of reliability, and statistical validity compared to the original instrument. The PBIAS in Spanish and Catalan can be a useful assessment instrument for educators and health professionals in the context of adolescent mental health literacy. This work contributes to the Sustainable Development Goals (Goal 3) of the United Nations 2030 Agenda