Search

La incorporación de actividades de trabajo en equipo en los programas de formación universitaria es esencial, ya que es una de las habilidades más valoradas para los profesionales en el campo de la ingeniería. La selección de los grupos de trabajo por parte del profesor es una estrategia que puede conducir a un mejor desempeño en las tareas colaborativas. Este estudio presenta los resultados de una investigación sobre los criterios conscientes para la selección de grupos de trabajo basados en los roles de los estudiantes. La investigación tuvo como objetivo analizar las dinámicas de trabajo en equipo entre estudiantes de diversas disciplinas dentro de los cursos de ingeniería. Se examinaron las opiniones de más de 600 estudiantes matriculados en 10 programas de grado y posgrado. Los resultados indican que los estudiantes de cursos avanzados se sienten más cómodos asumiendo el papel de líder, mientras que los estudiantes de primer año no tienen un perfil claramente definido. La evaluación de los estudiantes con esta metodología también muestra ciertas variaciones dependiendo del año y el tipo de actividad. En general, en los grupos con mejor rendimiento, la mayoría de los miembros reciben evaluaciones similares de sus compañeros. Abstract The incorporation of teamwork activities in university training programs is essential, as it is one of the most valued skills for professionals in the field of engineering. The selection of working groups by the teacher is a strategy that can lead to better performance in collaborative tasks. This study presents the results of research on the conscious selection criteria for group work based on students’ roles. The research aimed to analyze teamwork dynamics among students from various disciplines within engineering courses. The opinions of over 600 students enrolled in 10 undergraduate and postgraduate programs were examined. The results indicate that students in advanced courses feel more comfortable taking on the role of leader, while first-year students do not have a well-defined profile. The evaluation of students using this methodology also shows certain variations depending on the year and type of activity. Overall, in the highest-performing groups, most members receive similar evaluations from their peers.

Machine Learning (ML) has extended its use in several domains to support complex analyses of data. The medical field, in which significant quantities of data are continuously generated, is one of the domains that can benefit from the application of ML pipelines to solve specific problems such as diagnosis, classification, disease detection, segmentation, assessment of organ functions, etc. However, while health professionals are experts in their domain, they can lack programming and theoretical skills regarding ML applications. Therefore, it is necessary to train health professionals in using these paradigms to get the most out of the application of ML algorithms to their data. In this work, we present a platform to assist non-expert users in defining ML pipelines in the health domain. The system’s design focuses on providing an educational experience to understand how ML algorithms work and how to interpret their outcomes and on fostering a flexible architecture to allow the evolution of the available components, algorithms, and heuristics.

Background and objective: Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters. Materials and methods: Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods. Results: The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = 0.003), blood flow (P = 0.024), and interdialytic gain of patients (P = 0.008). Conclusions: Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results. Resumen: Antecedentes y objetivo: La activación del paciente es un concepto que se refiere a la voluntad de gestionar su salud y atención médica. Para evaluarla, se ha desarrollado y validado una medida de activación del paciente (PAM). Diversos estudios informan baja activación en pacientes con enfermedades crónicas. No obstante, la información sobre activación de pacientes en tratamiento con hemodiálisis es escasa. El objetivo del presente estudio es describir el nivel de activación de pacientes en tratamiento crónico de una unidad de HD y su relación con los parámetros de control de la enfermedad. Materiales y métodos: Estudio observacional transversal en pacientes con enfermedad renal crónica avanzada en tratamiento crónico con HD. Se incluyeron 96 pacientes. La activación se midió con el cuestionario PAM-13. Se estudió su relación con variables descriptivas (edad, sexo, comorbilidad, estudios, hábitat) y variables de control de la enfermedad (acceso vascular, flujo sangre, potasemia, fosfatemia, ganancia interdialítica). Para ello se emplearon como métodos estadísticos la prueba de correlación de Spearman, modelo de regresión lineal múltiple y modelo logístico. Resultados: La puntuación media (SD) de PAM-13 fue 63.19 (15.21). La activación se asociaba significativamente con el acceso vascular (P = 0.003), flujo de sangre (P = 0.024), y ganancia interdialítica de los pacientes (P = 0.008). Conclusiones: La activación de pacientes en tratamiento crónico con hemodiálisis es baja. Una mayor activación se relaciona con disponer de fístula arteriovenosa, con mayor flujo sanguíneo y con menor ganancia interdialítica. Son necesarios futuros estudios que confirmen y apliquen nuestros resultados.

Resumen: Antecedentes y objetivo: La activación del paciente es un concepto que se refiere a la voluntad de gestionar su salud y atención médica. Para evaluarla, se ha desarrollado y validado una medida de activación del paciente (PAM). Diversos estudios informan baja activación en pacientes con enfermedades crónicas. No obstante, la información sobre activación de pacientes en tratamiento con hemodiálisis es escasa. El objetivo del presente estudio es describir el nivel de activación de pacientes en tratamiento crónico de una unidad de hemodiálisis (HD) y su relación con los parámetros de control de la enfermedad. Materiales y métodos: Estudio observacional transversal en pacientes con enfermedad renal crónica avanzada en tratamiento crónico con HD. Se incluyeron 96 pacientes. La activación se midió con el cuestionario PAM-13. Se estudió su relación con variables descriptivas (edad, sexo, comorbilidad, estudios, hábitat) y variables de control de la enfermedad (acceso vascular, flujo sangre, potasemia, fosfatemia, ganancia interdialítica). Para ello se emplearon como métodos estadísticos la prueba de correlación de Spearman, modelo de retrogresión lineal múltiple y modelo logístico. Resultados: La puntuación media (desviación estándar [SD]) de PAM-13 fue de 63,19 (15,21). La activación se asociaba significativamente con el acceso vascular (p = 0,003), flujo de sangre (p = 0,024), y ganancia interdialítica de los pacientes (p = 0,008). Conclusiones: La activación de pacientes en tratamiento crónico con hemodiálisis es baja. Una mayor activación se relaciona con disponer de fístula arteriovenosa, con mayor flujo sanguíneo y con menor ganancia interdialítica. Son necesarios futuros estudios que confirmen y apliquen nuestros resultados. Abstract: Background and objective: Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters. Materials and methods: Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods. Results: The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = .003), blood flow (P = .024), and interdialytic gain of patients (P = .008). Conclusions: Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results.

This special issue features four invited papers from the 2023 edition of the MSc. and PhD. thesis contests, organized by CLEI, the Latin American Center for Computing Studies. CLEI's mission includes promoting the scientific growth of all computing fields across Latin America. To recognize these advancements and foster the region's graduate programs, CLEI has been hosting the Latin American Master Thesis Contest (CLTM) annually since 1993 and the Doctoral Thesis Contest (CLTD) since 2016. Both contests are held in conjunction with the Latin American Computing Conference (CLEI conference). The 2023 conference took place in La Paz, Bolivia, and received numerous high-quality submissions for both the MSc. and PhD. contests. Post-conference, the authors of the best works were invited to submit original, unpublished papers to the CLEIej journal. These submissions went through another evaluation round, adhering to the journal's standard review process.

Abstract Background Patients with Rheumatoid Arthritis (RA) have a higher prevalence of comorbidities compared to the general population. However, the implications of multimorbidity on therapeutic response and treatment retention remain unexplored. Objectives: (a) To evaluate the impact of multimorbidity on the effectiveness of the first targeted synthetic or biologic disease-modifying antirheumatic drug (ts/bDMARD), in patients with RA after 2-year follow-up; (b) to investigate the influence of multimorbidity on treatment retention rate. Methods Patients with RA from the BIOBADASER registry exposed to a first ts/bDMARDs were included. Patients were categorized based on multimorbidity status at baseline, defined as a Charlson Comorbidity index (CCI) score ≥ 3. A linear regression model, adjusted for sex and age, was employed to compare the absolute DAS28 score over time after ts/bDMARD initiation between the two groups. The Log-Rank test and Kaplan-Meier curve were used to compare the retention rates of the first ts/bDMARD between the groups. Results A total of 1128 patients initiating ts/bDMARD were included, with 107 (9.3%) exhibiting multimorbidity. The linear regression model showed significantly higher DAS28 (beta coefficient 0.33, 95%CI:0.07–0.58) over a two-year period in patients with multimorbidity, even after adjusting for age and sex. Finally, no differences in the ts/bDMARD retention rate were found between groups (median 6.94–6.96 years in CCI

BackgroundThe early identification of patients’ profiles most likely to respond to and maintain long-term therapy with a biological drug can have clinical and cost-effectiveness implications.ObjectivesTo evaluate the utility of an innovative approach for early identification of patient profiles associated with long-term persistence of golimumab, a tumour necrosis factor inhibitor, in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (SpA) under real-world conditions.DesignRetrospective non-interventional database analysis.MethodsKaplan-Meier curves of golimumab retention over 8 years from the BIOBADASER registry, overall and by indication, were analysed using a novel approach (a two-phase decay model) to identify the point at which the golimumab retention curve shifted from rapid (indicating high golimumab discontinuation rate) to slow decay (low discontinuation rate). Factors associated with golimumab retention at these time points were identified using Cox regression, and retention rates for different patient profiles were calculated.Results885 patients were included. The golimumab retention curve shifted from rapid to slow decay at month 10 for the overall population (retention rate: 73.4%), at month 24 for RA patients (retention: 45.0%), and at month 8 for SpA, including axial SpA and PsA (81.6%). Factors associated with golimumab discontinuation at these early points were, overall, similar to those previously identified at year 8 (RA diagnosis, golimumab as second- or third-line of biological therapy, disease activity over the median and treatment with corticosteroids at golimumab initiation, advanced age [in RA], and female gender [in SpA]).ConclusionWith this novel approach, the factors associated with long-term retention were identified in the initial period of rapid discontinuation of golimumab.

The United States and China are locked in a strategic rivalry covering numerous fields, like trade and finance. The most important one, however, is technology. Given how rapidly this rivalry is growing, we can speak of two ever more clearly defined, albeit still interrelated, ecosystems in the areas of semiconductors and artificial intelligence (AI). In turn, global production chains are being reshaped partly on economic grounds, but, without question, for geopolitical reasons too. These changes will not only impact trade flows throughout the world, but also foreign direct investment (FDI), gradually splitting production into two major blocs, based on differing technologies and standards. Where does the European Union (EU) stand in in all this?

This study screened for Fabry disease (FD) in patients in hemodialysis (HD) in the region of Madrid (CAM) with a cross-sectional design to evaluate HD-prevalent patients, followed by a three-year period prospective design to analyze HD-incident patients. Inclusion criteria: patients older than 18 years on HD in the CAM, excluding patients diagnosed with any other hereditary disease with renal involvement different from FD, that sign the Informed Consent (IC). Exclusion criteria: underaged patients or not agreeing or not being capable of signing the IC. Results: 3470 patients were included, 63% males and with an average age of 67.9 ± 9.7 years. 2357 were HD-prevalent patients and 1113 HD-incident patients. For HD-prevalent patients, average time in HD was 45.2 months (SD 51.3), in HD-incident patients proteinuria was present in 28.4%. There were no statistical differences in plasmatic alpha-galactosidase A (α-GAL-A) activity or Lyso-GL-3 values when comparing HD-prevalent and HD-incident populations and neither between males and females. A genetic study was performed in 87 patients (2.5% of patients): 60 male patients with decreased enzymatic activity and 27 female patients either with a decreased GLA activity, increased Lyso-Gl3 levels or both. The genetic variants identified were: p.Asp313Tyr (4 patients), p.Arg220Gln (3 patients) and M290I (1 patient). None of the identified variants is pathogenic. Conclusions: 76% of HD Centers of the CAM participated in the study. This is the first publication to describe the prevalence of FD in the HD-population of a region of Spain as well as its average α-GAL-A-activity and plasmatic Lyso-Gl3 levels. It is also the first study that combines a cross-sectional design with a prospective follow-up design. This study has not identified any FD patient. Resumen: El objetivo del estudio ha sido realizar un mapa descriptivo de la enfermedad de Fabry (EF) en la Comunidad de Madrid, así como realizar un despistaje de la EF a todo paciente incidente durante un período de 3 años. Criterios de inclusión: Pacientes mayores de 18 años, excluyendo aquellos diagnosticados de cualquier otra enfermedad hereditaria con afectación renal diferente de la EF, que firmaran el consentimiento informado. Criterios de exclusión: pacientes menores de edad, no estar de acuerdo o no ser capaces de firmar el consentimiento informado. Resultados: Se incluyeron 3.470 pacientes (63% hombres), con una edad media de 67,9 ± 9,7 años, de los cuales 2.357 eran pacientes prevalentes y 1.113 incidentes. En el caso de los pacientes prevalentes, el tiempo medio en hemodiálisis (HD) fue de 45,2 (DE 51,3) meses. En pacientes incidentes, la proteinuria estuvo presente en el 28,4%. No hubo diferencias estadísticamente significativas en la actividad plasmática de alfa-galactosidasa A o valores de Lyso-Gl3 al comparar las poblaciones de incidentes y de prevalentes, y tampoco entre hombres y mujeres. Se realizó estudio genético en 87 pacientes (2,5% de los pacientes): 60 varones con disminución de la actividad enzimática y 27 mujeres con una disminución de la actividad enzimática, aumento de los niveles de Lyso-Gl3 o ambos. Las variantes genéticas identificadas fueron: p.Asp313Tyr (4 pacientes), p.Arg220Gln (3 pacientes) y M290I (un paciente). Ninguna de las variantes identificadas fue patógena. Conclusiones: El 76% de los centros de HD de la Comunidad de Madrid participaron en el estudio. Este es el primer estudio epidemiológico prospectivo de EF en la población de HD de una región de España. También es la primera vez que se describen niveles de alfa-galactosidasa A y Lyso-Gl3 en HD, sin embargo, en este estudio no se han identificado pacientes con EF.

AbstractObjective To explore the association between anxiety and frailty in community-dwelling postmenopausal women.Methods This was a cross-sectional study in which 390 postmenopausal women (aged 60–83 years) who were attending a comprehensive care program were surveyed between January 2018 and February 2020. Each participant was administered a validated Spanish version of the Hospital Anxiety and Depression Scale (HADS) to assess their anxiety status. Those scoring 8 or higher on the anxiety subscale of the HADS were indicative of anxiety. The assessment of frailty utilized the Fried’s phenotype, with a diagnosis of frailty established if the participant met at least three out of the five criteria. Factors associated with frailty were analyzed using multivariate logistic regression.Results The mean age of participants was 70.08 years, with an average of 12.58 ± 3.19 years since menopause. Frailty was diagnosed in 43.85% of the total series, while anxiety was present in 41.08%, rising to 69.59% in participants with frailty. Neither body mass index, years since menopause, educational level, economic status, nor smoking habit demonstrated significant associations with frailty. Upon multivariate analysis, anxiety (OR 8.56), multimorbidity (OR 2.18), and age (OR 2.73) emerged as independently associated with frailty (p

Objective This study aimed to estimate the incidence of giant cell arteritis (GCA) in Spain and to analyse its clinical manifestations, and distribution by age group, sex, geographical area and season.Methods We included all patients diagnosed with GCA between 1 June 2013 and 29 March 2019 at 26 hospitals of the National Health System. They had to be aged ≥50 years and have at least one positive results in an objective diagnostic test (biopsy or imaging techniques), meet 3/5 of the 1990 American College of Rheumatology classification criteria or have a clinical diagnosis based on the expert opinion of the physician in charge. We calculated incidence rate using Poisson regression and assessed the influence of age, sex, geographical area and season.Results We identified 1675 cases of GCA with a mean age at diagnosis of 76.9±8.3 years. The annual incidence was estimated at 7.42 (95% CI 6.57 to 8.27) cases of GCA per 100 000 people ≥50 years with a peak for patients aged 80–84 years (23.06 (95% CI 20.89 to 25.4)). The incidence was greater in women (10.06 (95% CI 8.7 to 11.5)) than in men (4.83 (95% CI 3.8 to 5.9)). No significant differences were found between geographical distribution and incidence throughout the year (p=0.125). The phenotypes at diagnosis were cranial in 1091 patients, extracranial in 337 patients and mixed in 170 patients.Conclusions This is the first study to estimate the incidence of GCA in Spain at a national level. We found a predominance among women and during the ninth decade of life with no clear variability according to geographical area or seasons of the year.

Summary: Despite the symmetrical structure of nucleosomes, in vitro studies have shown that transcription proceeds with different efficiency depending on the orientation of the DNA sequence around them. However, it is unclear whether this functional asymmetry is present in vivo and whether it could regulate transcriptional directionality. Here, we report that the proximal and distal halves of nucleosomal DNA contribute differentially to nucleosome stability in the genome. In +1 nucleosomes, this asymmetry facilitates or hinders transcription depending on the orientation of its underlying DNA, and this difference is associated with an asymmetrical interaction between DNA and histones. These properties are encoded in the DNA signature of +1 nucleosomes, since its incorporation in the two orientations into downstream nucleosomes renders them asymmetrically accessible to MNase and inverts the balance between sense and antisense transcription. Altogether, our results show that nucleosomal DNA endows nucleosomes with asymmetrical properties that modulate the directionality of transcription.

The present paper argues that the standardised treatment of disaster research and practice perpetuates the production of systematic epistemic injustices against victims of disasters. On the one hand, disaster victims are often prevented from contributing with their opinions and knowledge to the processes of disaster mitigation and disaster conceptualisation. On the other hand, disaster victims tend to lack the hermeneutical resources to make sense of their experiences intelligibly, due to the existence of significant hermeneutical gaps in the hegemonic terminology on the matter. I argue that both forms of epistemic injustice, the testimonial and the hermeneutical, are sustained by an epistemic privilege between the Global North and the Global South in matters of disasters. The second group comprises what I categorise generally as ‘disaster victims’. I identify two forms of structural prejudice that operate against disaster victims: one is the ‘non-expert’ prejudice, and the other is the colonial prejudice. Finally, because of the intercultural nature of disaster environments, I discuss the field of ‘multicultural competencies’ as a useful form of unveiling and counteracting the epistemic injustices contained in both disaster theory and practice.

Temporal and geographical changes in the infections of intestinal helminths of striped dolphins, Stenella coeruleoalba were investigated in waters off the Spanish Mediterranean coast based on a sample of 233 dolphins stranded during 1982-2016. The influence of host-related factors (length and sex) and seasonality was also examined. Four helminth species had a prevalence > 5%, including adults of three cestodes, i.e, Trigonocotyle globicephalae (prevalence: 5.2%), Tetrabothrius forsteri (94.4%) and Strobilocephalus triangularis (18%); and juveniles of an acanthocephalan of the genus Bolbosoma (15.9%), identified as B. capitatum using molecular techniques. One immature specimen of Diphyllobothrium sp. (Cestoda) was also found in a single dolphin, and two juveniles of Bolbosoma balaenae in two dolphins. Trigonocotyle globicephalae seems to have low specificity for striped dolphins and was only found sporadically. Tetrabothrius forsteri and S. triangularis experienced a slight vs. a strong decrease, followed by a recovery, in infection levels throughout the study period, which are compatible with a reduction in the striped dolphin population caused by the Dolphin Morbillivirus outbreak in 1990. Infections of B. capitatum, a parasite typical from pilot whales, suddenly increased in 1990, then vanished. This rapid increase and following decrease are puzzling and can hardly be explained by a single factor. Infections of any helminth species were apparently uncorrelated to geographic origin, dolphin sex or season, but parasite load decreased with dolphin length in the case of T. forsteri and S. triangularis. To our knowledge, this study represents the first investigation of multi-decadal changes in cetacean parasites.

Aim of the study: To demonstrate if a population of Pyrenean chamois Rupicapra p. pyrenaica can live at low altitudes all year long. This could enlarge dramatically its potential habitat. Area of study: A hunting ground in Sobrarbe County, Pyrenees, Spain, in 2022. Material and methods. We interviewed local hunters to find out when the presence of the subspecies in the area dates back. We performed block counts from April to December in the target area for calculating the size of the population. Main results: There was a presence of at least 15 years of the subspecies living at 600 m asl. The population was at least 18 animals, reproduces, and shows a normal demographic structure of kids, yearlings, adult females, and adult males. Research highlights: Low-altitude chamois populations living in forests could be a result of important ecological changes in high mountain pastures producing migrations to newly suitable areas as low-altitude forests. The potential habitat of the subspecies should be broadened.

Chronic cerebral hypoperfusion due to carotid artery stenosis is a major cause of vascular cognitive impairment and dementia (VCID). Bilateral carotid artery stenosis (BCAS) in rodents is a well-established model of VCID where most studies have focused on white matter pathology and subsequent cognitive deficit. Therefore, our aim was to study the implication of adult hippocampal neurogenesis in hypoperfusion-induced VCID in mice, and its relationship with cognitive hippocampal deficits. Mice were subjected to BCAS; 1 and 3 months later, hippocampal memory and neurogenesis/cell death were assessed, respectively, by the novel object location (NOL) and spontaneous alternation performance (SAP) tests and by immunohistology. Hypoperfusion was assessed by arterial spin labeling-magnetic resonance imaging (ASL-MRI). Hypoperfused mice displayed spatial memory deficits with decreased NOL recognition index. Along with the cognitive deficit, a reduced number of newborn neurons and their aberrant morphology indicated a remarkable impairment of the hippocampal neurogenesis. Both increased cell death in the subgranular zone (SGZ) and reduced neuroblast proliferation rate may account for newborn neurons number reduction. Our data demonstrate quantitative and qualitative impairment of adult hippocampal neurogenesis disturbances associated with cerebral hypoperfusion-cognitive deficits in mice. These findings pave the way for novel diagnostic and therapeutic targets for VCID.

Summary: Cell-surface signaling (CSS) is a signal transfer system of Gram-negative bacteria that produces the activation of an extracytoplasmic function σ factor (σECF) in the cytosol in response to an extracellular signal. Activation requires the regulated and sequential proteolysis of the σECF-associated anti-σ factor, and the function of the Prc and RseP proteases. In this work, we have identified another protease that modulates CSS activity, namely the periplasmic carboxyl-terminal processing protease CtpA. CtpA functions upstream of Prc in the proteolytic cascade and seems to prevent the Prc-mediated proteolysis of the CSS anti-σ factor. Importantly, using zebrafish embryos and the A549 lung epithelial cell line as hosts, we show that mutants in the rseP and ctpA proteases of the human pathogen Pseudomonas aeruginosa are considerably attenuated in virulence while the prc mutation increases virulence likely by enhancing the production of membrane vesicles.

Test-driven development (TDD) is an agile practice of writing test code before production code, following three stages: red, green, and refactor. In the red stage, the test code is written; in the green stage, the minimum code necessary to make the test pass is implemented, and in the refactor stage, improvements are made to the code. This practice is widespread across the industry, and various studies have been conducted to understand its benefits and impacts on the software development process. Despite its popularity, TDD studies often focus on the technical aspects of the practice, such as the external/internal quality of the code, productivity, test smells, and code comprehension, rather than the context in which it is practiced. In this paper, we present a systematic literature review using Scopus, Web of Science, and Google Scholar that focuses on the TDD practice and the influences that lead to the introduction of test smells/anti-patterns in the test code. The findings suggest that organizational structure influences the testing strategy. Additionally, there is a tendency to use test smells and TDD anti-patterns interchangeably, and test smells negatively impact code comprehension. Furthermore, TDD styles and the relationship between TDD practice and the generation of test smells are frequently overlooked in the literature.

Introduction and objective: Music has been closely linked to medicine since ancient times, and has brought numerous benefits to the health of patients. Patients with chronic kidney disease (CKD) undergoing hemodialysis (HD) generally have a health-related quality of life (HRQL) lower than the reference values ​​of the general population. The objective of the present study is to verify if the intervention of classical music live and “in situ” during the treatment of HD has effects on the HRQoL of the patients. Materials and methods: A prospective, group-randomized intervention study of 4 weeks’ duration was carried out in patients with chronic kidney disease undergoing hemodialysis. Descriptive variables are included for data analysis: age, sex, months in treatment, Kt/V, hemoglobinand albumin. Result variable: HRQL, measured with the Kidney Diseasse health questionnaire Quality of life (KDQOL-SF) before and after the musical intervention. Results: Patients participated in 2 groups, the intervention group and the control group. The analysis of the results shows that the intervention group improved their quality of life compared to the initial measurement. The difference between the pre and post time of the intervention group with respect to the control group increased the mean score (pm) in all the scales significantly, except in the Work situation, Sexual function and Social support scales. The most important results were given on the Symptoms/problems scale with an increase of 15.78 (p

CDK4/6 inhibitor resistance is common in breast cancer. Here, the authors show that p16 overexpression may be linked to reduced efficacy of CDK4/6 inhibition, and show that the combination with PI3K inhibitors may increase anti-tumour effects.

Resumen: Introducción y objetivo: La música ha estado estrechamente unida a la medicina desde la antigüedad, y ha aportado numerosos beneficios a la salud de los pacientes. El paciente con enfermedad renal crónica en tratamiento de hemodiálisis (HD), generalmente, presenta una calidad de vida relacionada con la salud (CVRS) inferior a los valores de referencia de la población general. El objetivo del presente estudio es verificar si la intervención de música clásica en directo e in situ’ durante el tratamiento de HD tiene efectos sobre la CVRS de los pacientes. Materiales y métodos: Se realizó un estudio de intervención, prospectivo y aleatorizado por grupos, en pacientes con enfermedad renal crónica en tratamiento con HD. Durante 4 semanas un grupo de pacientes recibía la intervención con música clásica en directo 30 o 40 min durante las sesiones de HD, mientras el grupo control realizaba el tratamiento habitual. Variables descriptivas: edad, sexo, meses en tratamiento, Kt/V, hemoglobina y albúmina. Variable resultado: CVRS, se midió con el cuestionario de salud Kidney Diseasse Quality of life (KDQOL-SF) antes y después de la intervención musical. Resultados: Participaron 90 pacientes distribuidos en 2 grupos, el grupo intervención y el grupo control. El análisis de los resultados muestra que el grupo con intervención mejoró su calidad de vida respecto a la medición inicial. La diferencia entre el momento pre- y post- del grupo intervención respecto al grupo control aumentó la puntuación media (pm) en todas las escalas de forma significativa, excepto en las escalas Situación laboral, Función sexual y Apoyo social. Los resultados más importantes se dieron en escala Síntomas/problemas con un aumento de 15,78 (p

Machine Learning allows facing complex tasks related to data analysis with big datasets. This Artificial Intelligence branch allows not technical contexts to get benefits related to data processing and analysis. In particular, in medicine, medical professionals are increasingly interested in Machine Learning to identify patterns in clinical cases and make predictions regarding health issues. However, many do not have the necessary programming or technological skills to perform these tasks. Many different tools focus on developing Machine Learning pipelines, from libraries for developers and data scientists to visual tools for experts or platforms to learn. However, we have identified some requirements in the medical context that raise the need to create a customized platform adapted to end-user found in this context. This work describes the design process and the first version of KoopaML, an ML platform to bridge the data science gaps of physicians while automatizing Machine Learning pipelines. The platform is focused on enhanced interactivity to improve the engagement of physicians while still providing all the benefits derived from the introduction of Machine Learning pipelines in medical departments, as well as integrated ongoing training during the use of the tool’s features.

Science, Technology, Engineering, and Mathematics (STEM) degrees represent a future employment scenario with low unemployment rates due to the high demand for qualified personnel. However, the STEM sector also represents an educational field marked by horizontal segregation and the gender gap. Different factors play a role in deciding which higher education studies to pursue. From a theoretical and empirical approach, this study aims to identify which factors are associated with the gender gap in the STEM higher education sector. Furthermore, as a research question, it is proposed: are the factors identified at a theoretical and empirical level associated with the gender gap in the STEM higher education sector the same? The empirically validated questionnaire “Questionnaire with university students on STEM studies in Higher Education” (QSTEMHE) was applied to the student community of public and private universities in Spain in 2021, using simple random probability sampling to answer the research question and objective. A final sample of 2101 participants of different genders belonging to different branches of knowledge was obtained. The data analysis was carried out using qualitative methodology and the phenomenological method, following different stages. Firstly, a theoretical conceptual map of the main factors identified in the literature and their authors was composed. Secondly, an empirical conceptual map has been designed with the factors identified in the narratives of the study participants. Finally, these maps were complemented with a SWOT analysis based on the participants' discourses. As a result, it has been observed that there are extrinsic and intrinsic factors and that social constructs and gender stereotypes strongly influence the perception of men, women, and professions and the masculinisation and feminisation of these. Outreach interventions should be proposed from the institutional educational spheres to alleviate existing biases about studies and professions.

Abstract Background Engagement in exercise by haemodialysis (HD) patients has been shown to generate benefits both in terms of improved functional capacity and in the health-related quality of life. The use of non-immersive virtual reality (VR) games represents a new format for the implementation of intradialysis exercise. Some studies have shown that engaging in exercise for 6 months reduces the consumption of antihypertensive drugs and decreases the time spent admitted to hospital among individuals receiving HD treatments. The objective of this study was to evaluate changes in the consumption of healthcare resources and micro-costing for patients on HD who completed a VR exercise program. Materials and methods Design: This study is a secondary analysis of a clinical trial. The participants performed an intradialysis exercise program with non-immersive virtual reality for 3 months. The variables were recorded in two periods: 12 months before and 12 months after the start of the exercise program. Results The micro-costing analysis showed a significant decrease in the mean cost, in euros, for the consumption of laboratory tests − 330 (95% CI:[− 533, − 126];p = 0.003), outpatient visits − 351 ([− 566, − 135];p = 0.003), and radiology tests − 111 ([− 209, − 10];p = 0.03) in the 12 months after the implementation of the exercise program relative to the 12 months prior to its start. Conclusion The implementation of intradialysis exercise programs decreased the expenditure of some healthcare resources. Future studies could help clarify if longer interventions would have a stronger impact on these cost reductions.

Abstract Background The increasing prevalence of male infertility and the declining trend in sperm quality has been associated to compounds known as “endocrine-disruptors”. The proven endocrine-disrupting effects of atrazine and propazine herbicides led us to conduct long-term research based on highly accurate specific analytical methods with a view to confirming the suspected association. Among the proposed developments was a sensitive analytical method for the simultaneous determination of three metabolites of atrazine and propazine. Results In this work, the method was for first time used for the chromatographic separation and determination of deethyl- and deisopropyl-atrazine (DEA and DIA, respectively) and propazine-2-hydroxy (PP-2OH) in human seminal plasma by LC–ESI-MS/MS using deuterated atrazine (d5-AT) as internal standard (IS). Chromatographic and mass spectrometric conditions such as the mobile phase composition and flow-rate, injected volume, dry gas source temperature and flow-rate, nebulizer pressure and capillary voltage were all carefully optimized. Analytes were identified and quantified by using the multiple reaction monitoring (MRM) mode as applied to positive ions ([M + H]+). Transitions at three different m/z values for each analyte were selected from precursor ions, and the 212.1 → [128]+, 188.1 → [146]+ and 174.1 → [68.1]+ transitions for PP-2OH, DEA and DIA, respectively, were found to be quantitative. The proposed method was validated in terms of precision (repeatability and reproducibility), linear range (10–240 ng mL–1), limit of detection (150–210 pg mL–1), and quantification (500–700 pg mL–1), recovery, accuracy and matrix effects on extracts from variably treated seminal plasma samples. The overall analytical method was successfully applied to human seminal plasma samples from volunteers. PP-2OH was found at concentrations from 1.10 to 11.3 ng mL–1 in four of the six samples, and so was DIA at 9.60 ng mL–1 in one. Conclusions These results are suggestive of bioaccumulation of the target analytes in humans. Untargeted analytes including suspected parent molecules (atrazine and propazine) and other ions [viz., deethyldeisopropyl-atrazine (DD) and diamino-s-chlorotriazine (DACT)] were also detected under the working conditions used. These results may open up new prospects for as yet very incipient research into the bioaccumulation of endocrine disruptors in seminal plasma. Graphical Abstract

Genetic overlap involving rare disrupting mutations may contribute to high comorbidity rates between autism spectrum disorders and epilepsy. Despite their polygenic nature, genome-wide association studies have not reported a significant contribution of common genetic variation to comorbidity between both conditions. Analysis of common genetic variation affecting specific shared pathways such as miRNA dysregulation could help to elucidate the polygenic mechanisms underlying comorbidity between autism spectrum disorders and epilepsy. We evaluated here the role of common predisposing variation to autism spectrum disorders and epilepsy across target genes of 14 miRNAs selected through bibliographic research as being dysregulated in both disorders. We considered 4,581 target genes from various in silico sources. We described negative genetic correlation between autism spectrum disorders and epilepsy across variants located within target genes of the 14 miRNAs selected (p = 0.0228). Moreover, polygenic transmission disequilibrium test on an independent cohort of autism spectrum disorders trios (N = 233) revealed an under-transmission of autism spectrum disorders predisposing alleles within miRNAs’ target genes across autism spectrum disorders trios without comorbid epilepsy, thus reinforcing the negative relationship at the common genetic variation between both traits. Our study provides evidence of a negative relationship between autism spectrum disorders and epilepsy at the common genetic variation level that becomes more evident when focusing on the miRNA regulatory networks, which contrasts with observed clinical comorbidity and results from rare variation studies. Our findings may help to conceptualize the genetic heterogeneity and the comorbidity with epilepsy in autism spectrum disorders.

The genus Natronomonas is classified on the family Haloarculaceae, within the class Halobacteria and currently includes six species isolated from salterns, saline or soda lakes, and salt mines. All are extremely halophilic (optimal growth at 20–25% [w/v] NaCl) and neutrophilic, except Natronomonas pharaonis, the type species of the genus, that is haloalkaliphilic (showing optimal growth at pH 9.0) and possesses distinct phenotypic features, such as a different polar lipid profile than the rest of species of the genus. We have carried out a genome-based study in order to determine the phylogenetic structure of the genus Natronomonas and elucidate its current taxonomic status. Overall genomic relatedness indexes, i.e., OrthoANI (Average Nucleotide Identity), dDDH (digital DNA–DNA hybridization), and AAI (Average Amino acid Identity), were determined with respect to the species of Natronomonas and other representative taxa of the class Halobacteria. Our data show that the six species of Natronomonas constitute a coherent cluster at the genus level. Besides, we have characterized a new haloarchaeon, strain F2-12T, isolated from the brine of a pond of a saltern in Isla Cristina, Huelva, Spain, and we determined that it constitutes a new species of Natronomonas, for which we propose the name Natronomonas aquatica sp. nov. Besides, the metabolic analysis revealed a heterotrophic lifestyle and a versatile nitrogen metabolism for members of this genus. Finally, metagenomic fragment recruitments from a subset of hypersaline habitats, indicated that the species of Natronomonas are widely distributed in saline lakes and salterns as well as on saline soils. Species of this haloarchaeal genus can be considered as ubiquitous in intermediate to high salinity habitats.

Stress urinary incontinence (SUI) is a condition that causes the involuntary loss of urine when making small efforts, which seriously affects daily life of people who suffer from it. Women are more affected by this form of incontinence than men, since parity is the main risk factor. Weakening of the pelvic floor tissues is the cause of SUI, although a complete understanding of the cellular and molecular mechanisms of the pathology is still lacking. Reconstructive surgery to strengthen tissue in SUI patients is often associated with complications and/or is ineffective. Mesenchymal stromal cells from the maternal side of the placenta, i.e. the decidua, are proposed here as a therapeutic alternative based on the regenerative potential of mesenchymal cells. The animal model of SUI due to vaginal distention simulating labor has been used, and decidual mesenchymal stromal cell (DMSC) transplantation was effective in preventing a drop in pressure at the leak point in treated animals. Histological analysis of the urethras from DMSC-treated animals after VD showed recovery of the muscle fiber integrity, low or no extracellular matrix (ECM) infiltration and larger elastic fibers near the external urethral sphincter, compared to control animals. Cells isolated from the suburethral connective tissue of SUI patients were characterized as myofibroblasts, based on the expression of several specific genes and proteins, and were shown to achieve premature replicative senescence. Co-culture of SUI myofibroblasts with DMSC via transwell revealed a paracrine interaction between the cells through signals that mediated DMSC migration, SUI myofibroblast proliferation, and modulation of the proinflammatory and ECM-degrading milieu that is characteristic of senescence. In conclusion, DMSC could be an alternative therapeutic option for SUI by counteracting the effects of senescence in damaged pelvic tissue.

Fundamento: los materiales docentes para el estudio independiente en la enseñanza de la Farmacología Clínica son recursos que facilitan el aprendizaje a distancia en función de una enseñanza integral durante la pandemia de COVID-19. Objetivo: elaborar materiales docentes para el estudio independiente de los contenidos de la Farmacología Clínica durante la COVID-19. Métodos: se realizó una investigación de desarrollo en el campo de la educación médica, entre abril a junio de 2020 en la Facultad de Medicina de Villa Clara. Se utilizaron métodos teóricos para la fundamentación de la investigación y actualización mediante la revisión bibliográfica. Como método empírico, se utilizó la revisión documental de los documentos necesarios para el producto diseñado. Resultados: se elaboraron tres guías didácticas y tres materiales de apoyo a la docencia que permitieron una mejor apropiación de los contenidos y mejores resultados docentes en los estudiantes. Conclusiones: los materiales docentes para la enseñanza de la Farmacología Clínica en tiempos de pandemia fueron valorados como pertinentes y metodológicamente adecuados por el grupo de especialistas seleccionados.

Abstract Background Phelan-McDermid syndrome (PMS) is a rare genetic disorder compromising the 22q13 terminal region and affecting SHANK3, a gene crucial to the neurobehavioural phenotype and strongly linked to autism (ASD) and intellectual disability (ID). The condition is characterised by global developmental delay, ID, speech impairments, hypotonia and autistic behaviours, although its presentation and symptom severity vary widely. In this study, we provide a thorough description of the behavioural profile in PMS and explore differences related to deletion size and language ability. Methods We used standard clinical assessment instruments to measure altered behaviour, adaptive skills and autistic symptomatology in sixty participants with PMS (30 females, median age 8.5 years, SD=7.1). We recorded background information and other clinical manifestations and explored associations with deletion size. We performed descriptive and inferential analyses for group comparison. Results We found delayed gross and fine motor development, delayed and impaired language (~70% of participants non or minimally verbal), ID of different degrees and adaptive functioning ranging from severe to borderline impairment. Approximately 40% of participants experienced developmental regression, and half of those regained skills. Autistic symptoms were frequent and variable in severity, with a median ADOS-2 CSS score of 6 for every domain. Sensory processing anomalies, hyperactivity, attentional problems and medical comorbidities were commonplace. The degree of language and motor development appeared to be associated with deletion size. Conclusions This study adds to previous research on the clinical descriptions of PMS and supports results suggesting wide variability of symptom severity and its association with deletion size. It makes the case for suitable psychotherapeutic and pharmacological approaches, for longitudinal studies to strengthen our understanding of possible clinical courses and for more precise genomic analysis.

United Nations Sustainable Development Goal 4 (SDG 4) focuses on education and seeks to promote inclusive, equitable, and quality education, providing opportunities for all. In this context, it seeks to promote intersectionality (gender and ethnicity) as a fundamental factor in education, and in science, technology, engineering, and mathematics (STEM) careers in particular. Similarly, it aims to support programs that include the gender gap in their studies to mitigate the lack of Indigenous women and/or students from native peoples in STEM careers. The objective of this work was to carry out a categorization of programs aimed at Indigenous students in their processes of access, retention, and follow-up in STEM careers, with the purpose of making visible the variety of approaches and programs that have been created in different regions of the world. A systematic review was conducted to analyze the programs, and the classical content analysis method of scientific production was employed. The main results of the analysis are classified into three main categories: the characteristics of the studies, the programs, and their results. In relation to the study's contribution, the aim is to generate knowledge and understanding of the programs identified to promote the inclusion of this underrepresented population in STEM education.

The development of science, technology, engineering, and mathematics (STEM) requires more qualified professionals in these fields. However, gender segregation in higher education in this sector is creating a gender gap that means that for some disciplines female representation does not even reach 30% of the total. In order to propose measures to address the phenomenon, it is necessary to understand the possible causes of this issue.A systematic literature review and mapping were carried out for the study, following the PRISMA guidelines and flowchart. The research questions to be answered were (RQ1) What studies exist on the gender gap in relation to the choice of higher education in the STEM field; and (RQ2) How do gender roles and stereotypes influence decision-making related to higher education? The review of peer-reviewed scientific articles, conferences texts, books and book chapters on the European education area was applied. A total of 4571 initial results were obtained and, after the process marked by the PRISMA flowchart, the final results were reduced to 26. The results revealed that gender stereotypes are strong drivers of the gender gap in general, and the Leaky Pipeline and Stereotype Threat in particular. To narrow the gender gap, it is necessary to focus on influences from the family, the educational environment, and the peer group, as well as from the culture itself. Positive self-concept, self-efficacy, self-confidence, and self-perception need to be fostered, so that the individual chooses their studies according to their goals.

Background: The pandemic caused by the spread of COVID19 generated throughout the world great changes in all areas of life. Social distancing was carried out very drastically in some countries, and even in the field of dental care, some countries prohibited the practice of dentistry. Objective: To demonstrate that the dental office is safe regarding the possibility of contagion of Sars-Cov-2 as long as good biosecurity protocols are used. Methods: A structured survey of 19 questions was applied to 103 patients who subsequently attended a periodontics and oral and maxillofacial surgery office in Mexico, to receive care from these specialties between April 2020 and July 2021. The questions posed in this survey were aimed at knowing the opinion of the patients regarding the measures that this establishment has for the prevention of the transmission of COVID19, as well as questions regarding the possible effects of attending this office in contagion of the disease from patients and their families. Results: A total of 18 (17.5%) patients reported having suffered COVID19, and none reported that they fell ill after the consultation. None of the clinic's specialists and assistants have fallen ill with COVID-19 during the pandemic. Conclusions: It is not necessary to suspend or condition dental care during times of pandemics such as what happened with COVID19, as long as strict safety protocols are observed within clinical facilities.

The use of advanced algorithms and models such as Machine Learning, Deep Learning and other related approaches of Artificial Intelligence have grown in their use given their benefits in different contexts. One of these contexts is the medical domain, as these algorithms can support disease detection, image segmentation and other multiple tasks. However, it is necessary to organize and arrange the different data resources involved in these scenarios and tackle the heterogeneity of data sources. This work presents the CARTIER-IA platform: a platform for the management of medical data and imaging. The goal of this project focuses on providing a friendly and usable interface to organize structured data, to visualize and edit medical images, and to apply Artificial Intelligence algorithms on the stored resources. One of the challenges of the platform design is to ease these complex tasks in a way that non-AI-specialized users could benefit from the application of AI algorithms without further training. Two use cases of AI application within the platform are provided, as well as a heuristic evaluation to assess the usability of the first version of CARTIER-IA.

The studied farms are small family businesses, and so, in more than half of the cases, their continuity is not guaranteed. Livestock management is typical of a mountain system, in which the animals graze throughout the year in cultivated fields, sown meadows, forests near the farms, and mountain pastures during the three summer months. The herds always have the constant surveillance of a shepherd. Farmers consider the current infrastructure present in mountain grasslands insufficient to facilitate the management and care of their herd. Their activity conflicts with various species of wildlife, such as the wild boar, Sus scrofa, roe deer, Capreolus capreolus, or griffon vulture, Gyps fulvus, and large carnivores such as the brown bear, Ursus arctos, or the grey wolf Canis lupus, despite all of them taking preventive measures to defend their herds from predators. The most widely used prevention measures are the presence of mastiff dogs, Canis lupus familiaris, next to the herds and the use of electric fencing to lock up livestock at night. Farmers reject the presence of bears and wolves in their area, considering it a real threat to the continuity of their economic activity, which presents a high degree of vulnerability.

Objectives: Sex differences in adult cellulitis, a frequent cause of hospitalization, have not been analyzed. These differences were investigated in a large cellulitis series. Methods: This was a prospective observational study of 606 Spanish hospitalized cellulitis patients. Different comorbidities, clinical, diagnostic, and treatment data were compared between the sexes. Multiple logistic regression modeling was performed to determine the variables independently associated with sex. Results: Overall 606 adult cellulitis patients were enrolled; 314 (51.8%) were male and 292 (48.2%) were female. Females were older (mean age 68.8 vs 58.9 years, p < 0.0001), less likely to have prior wounds (p = 0.02), and more likely to have venous insufficiency (p = 0.0002) and edema/lymphedema (p = 0.0003) than males. The location of the infection differed between the sexes (p = 0.02). Males were more likely to have positive pus cultures (p = 0.0008), the causing agent identified (p = 0.04), and higher rates of Staphylococcus aureus infection (p = 0.04) and received longer antibiotic treatment (p = 0.03). Factors independently associated with female sex in the multivariate analysis were older age (p < 0.0001), prior cellulitis (p = 0.01), presence of edema/lymphedema as the predisposing factor (p = 0.004), negative versus positive pus culture (p = 0.0002), and location of cellulitis other than in the lower extremities (p = 0.035). Conclusions: Differences between male and female patients with cellulitis were age, recurrence, presence of edema/lymphedema, positivity of pus culture, and topography of the infection.

Open Education (OE) opens up learning opportunities to, potentially, every person in the world. Additionally, it allows teachers, researchers, and practitioners to find, share, reuse, and improve existing resources under a dependable legal framework. Aiming to spread and foster the introduction of open policies in Higher Education (HE) institutions, the gamified interactive learning experience Catch the Open! was developed. Catch the Open! targets HE educators who wish to learn, or who wish to deepen their existing knowledge, about OE and Open Educational Practices (OEP). Within the gamified learning experience, the user becomes an educator, Alex, the game character, who receives a task from the Rector: to investigate how to best include OE and OEP in teaching and learning practice within the institution. Alex proceeds to explore and gather information in a web-based 2D virtual HE institution where students, colleagues, and guest researchers will help her to develop a comprehensive understanding of OE and the practical application of OEP. The educational content within Catch the Open! is underpinned by an OE competences framework for HE educators, developed in a previous phase of the Erasmus+ OpenGame project. In this paper, the design process to link pedagogical and technological approaches, which results in the Catch the Open! gamified web-based interactive application, is presented as well as the application itself. Moreover, two phases of piloting with 153 HE educators from six different HE institutions are presented. The obtained findings showed that the gamified environment helped in learning about OE. On the other hand, learners also suggested several improvement aspects of the gamified environment, such as the length of finishing a learning mission while playing.

Resumen: Se determinaron las repercusiones biopsicosociales en población española afectada por un proceso de desahucio. Revisión panorámica en PubMed, Scopus, PsycINFO, CINAHL, LILACS, CSIC, MEDES, Scielo, Dialnet, Cuiden Plus y Cochrane hasta septiembre de 2018. La estrategia de búsqueda fue (Eviction OR “Home eviction” OR “Housing eviction” OR “Households at risk of eviction” OR Foreclosure) AND (“Health” OR “Mental Health” OR “Psychosocial impact” OR “Impacts on health” OR “Social impact indicators” OR “Social Determinants of Health” OR “Social Indicators”). Se seleccionaron 11 estudios con año de publicación en 2008 y posteriores, cuantitativos o cualitativos. Se midió la calidad y se organizaron los resultados atendiendo al modelo biopsicosocial. Desde el punto de vista físico, se identificó una deficiente autopercepción de la salud y aumentaron las enfermedades crónicas, el dolor y el consumo de fármacos. Psicológicamente, se detectaron pensamientos negativos, emociones recurrentes y aumento de ansiedad, depresión, trastorno mental y estrés postraumático. Socialmente, se describe una afectación de la familia, la descendencia y la persona avalista, así como del sistema sanitario con más visitas médicas y a urgencias. Se identificaron peores indicadores en las mujeres respecto a dolor de cabeza, tabaquismo, autopercepción del estado de salud general, salud mental y malestar mental (mayor depresión, ansiedad y otros tipos de malestar psicológico), y peor autopercepción de la salud en las hijas frente a los hijos. Es necesario un abordaje desde la salud pública, vigilancia epidemiológica, protocolos de actuación y programas de salud para asesorar, diagnosticar, prevenir, proteger y promover la salud de la población afectada. Abstract: The biopsychosocial consequences in Spanish population affected by an eviction process were described in this paper. A scoping review was conducted, consulting the following databases: PubMed, Scopus, PsycINFO, CINAHL, LILACS, CSIC, MEDES, Scielo, Dialnet, Cuiden Plus and Cochrane. The search strategy was (Eviction OR “Home eviction” OR “Housing eviction” OR “Households at risk of eviction” OR Foreclosure) AND (“Health” OR “Mental Health” OR “Psychosocial impact” OR “Impacts on health” OR “Social impact indicators” OR “Social Determinants of Health” OR “Social Indicators”).Eleven articles published between 2008 and September 2018 were selected. They followed a quantitative or qualitative methodology. The research quality was measured, and the results were organized according to the biopsychosocial model. From the physical perspective, results described a poor self-perception of health, as well as an increase of chronic diseases, pain, drug consumptions. From the psychological perspective, it was found negative thoughts, recurrent emotions and increased anxiety, depression, mental disorder and post-traumatic stress. From the social perspective, it was found that family, the offspring and the guarantor were affected, as well as the health system with greater medical visits and emergencies. This review showed worse health indicators among women, such as a headache, smoking habits, worse self-perception of health and more mental health disorders (depression, anxiety and other types of psychological distress). Daughters revealed worse self-perception of health than sons. It is necessary an approach from public health, epidemiological surveillance, action protocols and health programs, to advise, diagnose, prevent, protect and promote the health of the Spanish population affected.

El uso masivo de datos geográficos requiere de información cartográfica. Los modelos digitales derivados del procesado de datos LIDAR (Light Detection and Ranging) se plantean como fuentes de información, entre otros campos, en el análisis del paisaje urbano. Así, su aplicación permite la valoración de las líneas de horizonte de un observador situado en un entorno urbano. Esta es una cuestión especialmente relevante en las áreas turísticas de litoral, donde, por ejemplo, las tarifas son distintas entre habitaciones de un hotel con o sin vistas al mar. El objetivo de este trabajo es analizar las debilidades de los métodos de captura automatizada de datos para la valoración de las líneas de horizonte de un observador situado en un entorno turístico urbano, en concreto, el de Puerto de la Cruz (Tenerife, Canarias). El método de análisis es la comparación entre el Modelo Digital de Superficie (MDS) obtenido a partir de archivos .LAZ de 2x2 km de extensión (densidad de 0,5 puntos /m2), procedentes del Instituto Geográfico Nacional (IGN) y el Modelo Digital del Terreno (MDT) en combinación con los volúmenes de la edificación a partir de la información proveniente de la Sede Electrónica del Catastro (SEC). Los resultados obtenidos inicialmente nos demuestran que, a la hora de realizar un análisis de visibilidad preciso, logramos mejores resultados con los archivos LIDAR que con la combinación entre un MDS y la volumetría edificada del Catastro. También se constata la existencia de algunos errores de clasificación de puntos en los archivos LIDAR que obligan a utilizar un método intermedio para mejorar los resultados.

Stroke is one of the most prevalent diseases worldwide caused primarily by a thrombotic vascular occlusion that leads to cell death. To date, t-PA (tissue-type plasminogen activator) is the only thrombolytic therapy approved which targets fibrin as the main component of ischemic stroke thrombi. However, due to its highly restrictive criteria, t-PA is only administrated to less than 10% of all stroke patients. Furthermore, the research in neuroprotective agents has been extensive with no translational results from medical research to clinical practice up to now. Since we first described the key role of NETs (Neutrophil Extracellular Traps) in platelet-rich thrombosis, we asked, first, whether NETs participate in fibrin-rich thrombosis and, second, if NETs modulation could prevent neurological damage after stroke. To this goal, we have used the thromboembolic in situ stroke model which produces fibrin-rich thrombotic occlusion, and the permanent occlusion of the middle cerebral artery by ligature. Our results demonstrate that NETs do not have a predominant role in fibrin-rich thrombosis and, therefore, DNase-I lacks lytic effects on fibrin-rich thrombosis. Importantly, we have also found that NETs exert a deleterious effect in the acute phase of stroke in a platelet-TLR4 dependent manner and, subsequently, that its pharmacological modulation has a neuroprotective effect. Therefore, our data strongly support that the pharmacological modulation of NETs in the acute phase of stroke, could be a promising strategy to repair the brain damage in ischemic disease, independently of the type of thrombosis involved.

The PI3K/AKT pathway, negatively regulated by PTEN, plays a paramount role in glucose metabolism regulation due to its activation by the insulin receptor signaling pathway. We generated a PTEN-KO mouse to evaluate the systemic effect of the overactivation of the PI3K/AKT pathway in insulin signaling and glucose homeostasis. Our results demonstrate that PTEN-KO mice show very low glucose levels in the fasted state, which poorly respond to glucose and pyruvate administration. Insulinemia decreased without alterations in pancreatic islets. Among the possible reasons, we uncover the deregulation of the expression of proximal tubule glucose transporter and consequent glycosuria. Moreover, we evidence an altered activation of hepatic gluconeogenesis-related genes. In addition, the expression of several genes related to β-oxidation showed a delayed or even absent response to fasting, suggesting that the lack of PTEN not only impairs glucose metabolism but also slows down the use of lipids as a metabolic fuel. We conclude that the inducible full PTEN-KO mice could be a good model to study the metabolic interactions between glycidic and lipidic metabolism in hypoinsulinemic hypoglycemia and that PTEN could be an important mediator in the disease and/or a potential drug target.

Background: Secukinumab has been shown effective for psoriatic arthritis (PsA) and axial spondylarthritis (AxSpA) in randomized trials. The aim of this study was to analyze baseline patient and disease characteristics associated with a better retention rate of secukinumab under real-world conditions.Patients and Methods: Real-life, prospective multicenter observational study involving 138 patients, 61 PsA and 77 AxSpA, who were analyzed at baseline, 6, 12 months and subsequently every year after starting secukinumab regardless of the line of treatment. Demographics and disease characteristics, measures of activity, secukinumab use, and adverse events were collected. Drug survival was analyzed using Kaplan-Meier curves and factors associated with discontinuation were evaluated using Cox regression. The machine-learning J48 decision tree classifier was also applied.Results: During the 1st year of treatment, 75% of patients persisted with secukinumab, but accrued 71% (n = 32) in total losses (n = 45). The backward stepwise (Wald) method selected diagnosis, obesity, and gender as relevant variables, the latter when analyzing the interactions. At 1 year of follow-up, the Cox model showed the best retention rate in the groups of AxSpa women (95%, 95% CI 93–97%) and PsA men (89%, 95% CI 84–93%), with the worst retention in PsA women (66%, 95% CI 54–79%). The J48 predicted secukinumab retention with an accuracy of 77.2%. No unexpected safety issues were observed.Conclusions: Secukinumab shows the best retention rate at 1 year of treatment in AxSpA women and in PsA men, independently of factors such as the time of disease evolution, the line of treatment or the initial dose of the drug.

In the global health emergency caused by the COVID-19, clinical trial management has proven to be critical for the pharmaceutical industry, sponsors, and healthcare professionals. Our experience as a sponsor managing interventional oncology clinical studies has provided us with some data and insights. Though limited by sample size, our data emphasize the importance of quickly adopting measures that first prioritize patient safety and data validity, then consider contingency measures such as telemedicine, virtual medical review, and remote monitoring. Successful adaptations of healthcare and patient management in response to COVID-19 have been fundamental to ensuring continuing clinical cancer research.

Background and PurposeThe immune response subsequent to an ischemic stroke is a crucial factor in its physiopathology and outcome. It is known that TLR4 is implicated in brain damage and inflammation after stroke and that TLR4 absence induces neutrophil reprogramming toward a protective phenotype in brain ischemia, but the mechanisms remain unknown. We therefore asked how the lack of TLR4 modifies neutrophil function and their contribution to the inflammatory process.MethodsIn order to assess the role of the neutrophilic TLR4 after stroke, mice that do not express TLR4 in myeloid cells (TLR4loxP/Lyz-cre) and its respective controls (TLR4loxP/loxP) were used. Focal cerebral ischemia was induced by occlusion of the middle cerebral artery and infarct size was measured by MRI. A combination of flow cytometry and confocal microscopy was used to assess different neutrophil characteristics (circadian fluctuation, cell surface markers, cell complexity) and functions (apoptosis, microglia engulfment, phagocytosis, NETosis, oxidative burst) in both genotypes.ResultsAs previously demonstrated, mice with TLR4 lacking-neutrophils had smaller infarct volumes than control mice. Our results show that the absence of TLR4 keeps neutrophils in a steady youth status that is dysregulated, at least in part, after an ischemic insult, preventing neutrophils from their normal circadian fluctuation. TLR4-lacking neutrophils showed a higher phagocytic activity in the basal state, they were preferentially engulfed by the microglia after stroke, and they produced less radical oxygen species (ROS) in the first stage of the inflammatory process.ConclusionsTLR4 is specifically involved in neutrophil dynamics under physiological conditions as well as in stroke-induced tissue damage. This research contributes to the idea that TLR4, especially when targeted in specific cell types, is a potential target for neuroprotective strategies.