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ObjectiveProblem gambling is associated with various negative health behaviors, such as physical inactivity. However, physical activity may also be used as a coping mechanism to manage stress and anxiety. This study aimed to investigate whether personality traits are associated with physical activity levels in individuals attending a rehabilitation center for gambling disorder (GD).MethodsAn observational study was conducted in 71 patients belonging to a Gamblers’ Recovery Association. All of them completed a socio-demographic questionnaire, the Exploratory Personality Questionnaire-III (CEPER-III) and the International Physical Activity Questionnaire (IPAQ). Comparisons with general population and association between personality traits and physical activity were analyzed.ResultsThe study sample predominantly consisted of male participants (91.5%), with the majority having an educational attainment of compulsory schooling or less (70.4%). Additionally, a substantial proportion of participants exhibited school-related problems (43.7%) and had a history of mental health issues (33.8%). Compared to the general population, individuals in the CEPER-III cohort demonstrated significantly lower scores in the following personality traits: paranoid (p

Introduction Poststroke hyperglycaemia is an independent risk factor for poorer outcomes in patients treated with mechanical thrombectomy (MT) and is associated with a lower probability of functional recovery and higher mortality at 3 months. This study aims to evaluate the association between glucose levels during cerebral reperfusion with MT and functional recovery at 3 months, measured by subcutaneous continuous glucose monitoring (CGM) devices.Methods This prospective observational study aims to recruit 100 patients with ischaemic stroke and large anterior circulation vessel occlusion, in whom MT is indicated. CGM will be performed using a Freestyle Libre ProIQ device (FSL-CGM, Abbott Diabetes Care, Alameda, California, USA), which will be implanted on admission to the emergency department, to monitor glucose levels before, during and after reperfusion. The study’s primary endpoint will be the functional status at 3 months, as measured by the dichotomised modified Rankin Scale (0–2 indicating good recovery and 3–6 indicating dependency or death). We will analyse expression profiles of microRNA (miRNA) at the time of reperfusion and 24 hours later, as potential biomarkers of ischaemic-reperfusion injury. The most promising miRNAs include miR-100, miR-29b, miR-339, miR-15a and miR-424. All patients will undergo treatment according to current international recommendations and local protocols for the treatment of stroke, including intravenous thrombolysis if indicated.Ethics and dissemination This study (protocol V.1.1, dated 29 October 2021, code 6017) has been approved by the Clinical Research Ethics Committee of La Paz University Hospital (Madrid, Spain) and has been registered in ClinicalTrials.gov (NCT 05871502). Study results will be disseminated through peer-reviewed publications in Open Access format and at conference presentations.Trial registration number NCT05871502.

We present the largest exome sequencing study of autism spectrum disorder (ASD) to date (n = 35,584 total samples, 11,986 with ASD). Using an enhanced analytical framework to integrate de novo and case-control rare variation, we identify 102 risk genes at a false discovery rate of 0.1 or less. Of these genes, 49 show higher frequencies of disruptive de novo variants in individuals ascertained to have severe neurodevelopmental delay, whereas 53 show higher frequencies in individuals ascertained to have ASD; comparing ASD cases with mutations in these groups reveals phenotypic differences. Expressed early in brain development, most risk genes have roles in regulation of gene expression or neuronal communication (i.e., mutations effect neurodevelopmental and neurophysiological changes), and 13 fall within loci recurrently hit by copy number variants. In cells from the human cortex, expression of risk genes is enriched in excitatory and inhibitory neuronal lineages, consistent with multiple paths to an excitatory-inhibitory imbalance underlying ASD.

Dysexecutive syndrome has been consistently reported in children and adolescents with autism spectrum disorders (ASD). Particularly, impairments have been documented in working memory, inhibition, and mental flexibility. However, the relationship between executive impairments and intellectual functioning is far from clear in this population. This study aimed to investigate how executive functions (EF) are associated with intelligence in ASD. Children and adolescents with ASD (N = 69) were compared to typically developing (TD) individuals (N = 68), matched in chronological age and sex. The Wechsler Intelligence Scales were used to assess participants' intelligence quotient (estimated IQ). EF -- working memory, shifting, and inhibition -- were assessed using the Digit Span, Wisconsin Card Sorting Test and Stroop Test, respectively. TD individuals outperformed ASD in all cognitive assessment measures. Correlation analysis showed that while for the ASD group intelligence was associated with shifting abilities, in the TD group the association was observed for working memory measures. Linear regression analysis supported that the association between intelligence and EF domains differed between groups, particularly regarding shifting abilities (interaction term significant), whereas working memory showed a similar trend in both groups (difference in effect size is non-significant). Results suggest that specific executive function domains are associated with ASD intellectual functioning and differ from TD individuals, which may be related to adaptive behavior outcomes.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder with increasing prevalence, and a male-to-female ratio of 4:1. Research has been suggesting that discrepancy in prevalence may be due to the fact that females camouflage their symptoms. In this study, we aimed to systematically review evidence on the camouflage effect in females with ASD. Following the PRISMA guidelines, we reviewed empirical research published from January 2009 to September 2019 on PubMed, Web of Science, PsychInfo and Scopus databases. Thirteen empirical articles were included in this review. Overall, evidence supports that camouflaging seems to be an adaptive mechanism for females with ASD, despite the negative implications of these behaviours in their daily life.

This article seeks to illustrate the importance of teaching the history of ancient Greece in the Primary Education Degree in Spain. The objective is to observe, from the analysis of a case study carried out at the University of Seville, how students pursuing the Degree in Primary Education acquire knowledge and how they then transfer and adapt this knowledge to a classroom of primary school students. This study highlights several methodologies and facts. It focuses on the necessity that future teachers know the history of ancient Greece in order to understand the legacy of this civilisation in today's world. In addition, it demonstrates the positive impact of integrating methodologies and techniques, such as Cooperative Learning (CL), Project Based Learning (PBL) and Gamification, both on a teacher's own learning and in their future role. This article is part of the activities of the Innovations and Didactic Group Gender and History Cliogen (GINDO-UB/187).

Reseña del libro Nuevos espacios, nuevos formatos, nuevas dramaturgias en el teatro hispánico actual (Madrid, Dykinson, 2022), de Belén Tortosa Pujante y Guadalupe Soria (eds.). La presente reseña analiza la compilación realizada por Belén Tortosa y Guadalupe Soria en su libro Nuevos espacios, nuevos formatos, nuevas dramaturgias en el teatro hispánico actual (2022), surgido a partir del congreso internacional del PERFORMA (2019), así como en el marco de los dos últimos proyectos de investigación del grupo santiagués: “PERFORMA. El teatro fuera del teatro: performatividades contemporáneas en la era digital” y “PERFORMA2. Metamorfosis del espectador en el teatro español actual”. De esta forma, se presenta un conjunto de doce capítulos de autoría diversa en los que se aborda desde diferentes perspectivas el teatro posdramático hispánico, así como las performances o instalaciones de más relevancia en el contexto actual.

Objective: Problem gambling is associated with various negative health behaviors, such as physical inactivity. However, physical activity may also be used as a coping mechanism to manage stress and anxiety. This study aimed to investigate whether personality traits are associated with physical activity levels in individuals attending a rehabilitation center for gambling disorder (GD). Methods: An observational study was conducted in 71 patients belonging to a Gamblers' Recovery Association. All of them completed a socio-demographic questionnaire, the Exploratory Personality Questionnaire-III (CEPER-III) and the International Physical Activity Questionnaire (IPAQ). Comparisons with general population and association between personality traits and physical activity were analyzed. Results: The study sample predominantly consisted of male participants (91.5%), with the majority having an educational attainment of compulsory schooling or less (70.4%). Additionally, a substantial proportion of participants exhibited school-related problems (43.7%) and had a history of mental health issues (33.8%). Compared to the general population, individuals in the CEPER-III cohort demonstrated significantly lower scores in the following personality traits: paranoid (p < 0.05), histrionic (p < 0.001), narcissistic (p < 0.001), passive-aggressive (p < 0.05), and sadistic (p < 0.01). Multivariate logistic regression analysis indicated that the antisocial, borderline, obsessive-compulsive, and self-destructive personality traits were significantly associated (p < 0.05) with the level of physical activity. Conclusion: This study found a link between personality traits and physical activity levels in patients with GD. Gamblers with higher scores on obsessive-compulsive and self-destructive personality traits were more likely to fall into the moderate-high physical activity group. In contrast, those with higher scores on antisocial and borderline personality traits were more likely to be classified in the low physical activity group. [ABSTRACT FROM AUTHOR]

Background Chest CT has been proposed as a screening test to rule out SARS-CoV-2 lung infection in acute stroke. Our objectives are to analyze the predictive value of neck CT angiography (CTA) source images compared with conventional chest CT, the interobserver concordance and the reliability of the diagnosis using a mobile app. Methods A retrospective observational study that included acute stroke patients admitted to a stroke center. Two raters blinded to the clinical data evaluated and classified the pulmonary findings in chest CT and neck CTA source images according to the COVID-19 Reporting and Data System (CO-RADS). CTA findings were evaluated using a conventional workstation and the JOIN mobile app. Scores of 3–5 were grouped as appearing typical or indeterminate for COVID-19 lung involvement and 0–2 as appearing atypical or negative for pneumonia. SARS-CoV-2 infection was confirmed by polymerase chain reaction (PCR). Results A total of 242 patients were included (42 with PCR-confirmed COVID-19). In the cohort of 43 patients with both neck CTA and chest CT, the predictive value for COVID-19 was equivalent (sensitivity, 53.8%; specificity, 92.9%). The interobserver agreement in the classification into CO-RADS 3–5 or 1–2 in CTA was good (K = 0.694; standard error, 0.107). In the cohort of 242 patients with neck CTA, the intraobserver agreement between the workstation and the JOIN app was perfect (K = 1.000; standard error 0.000). Conclusions Neck CTA enables the accurate identification of COVID-19-associated lung abnormalities in acute stroke. CO-RADS evaluations through mobile applications have a predictive value similar to the usual platforms.

Background Timely coordination between stroke team members is of relevance for stroke code management. We explore the feasibility and potential utility of a smartphone application for clinical and neuroimaging data sharing for improving workflow metrics of stroke code pathways, and professionals’ opinions about its use. Methods We performed an observational pilot study including stroke code activations at La Paz University Hospital in Madrid, from June 2019 to March 2020. Patients were classified according to the activation or not of the JOIN app by the attending physician. Clinical data and time-to-procedures were retrieved from the app or from the hospital records and the Madrid regional stroke registry as appropriate and compared between both groups. An anonymous survey collected professionals’ opinions about the app and its use. Results A total of 282 stroke code activations were registered. The JOIN app was activated in 111 (39%) cases. They had a significant reduction in imaging-to-thrombolysis (31 vs 20 min, p = .026) and in door-to-thrombolysis times (51 vs 36 min, p = .004), with more patients achieving a door-to-needle time below 45 min (68.8% vs 37.8%, p = .016). About 50% of the users found the app useful for facilitating the diagnosis and decision-making; interoperability with clinical files was considered an opportunity for improvement. Conclusions This pilot study suggests that JOIN helps improve and document workflow metrics in acute stroke management in a comprehensive stroke centre. These results support testing JOIN in a prospective randomised study to confirm its usefulness and the general applicability of the results.

Abstract Background The diagnosis of coeliac disease (CD) in individuals that have started a gluten-free diet (GFD) without an adequate previous diagnostic work-out is a challenge. Several immunological assays such as IFN-γ ELISPOT have been developed to avoid the need of prolonged gluten challenge to induce the intestinal damage. We aimed to evaluate the diagnostic accuracy of activated gut-homing CD8+ and TCRγδ+ T cells in blood after a 3-day gluten challenge and to compare it with the performance of IFN-γ ELISPOT in a HLA-DQ2.5 subsample. Methods A total of 22 CD patients and 48 non-CD subjects, all of them following a GFD, underwent a 3-day 10-g gluten challenge. The percentage of two T cell subsets (CD8+ CD103+ β7hi CD38+/total CD8+ and TCRγδ+ CD103+ β7hi CD38+/total TCRγδ+) in fresh peripheral blood drawn baseline and 6 days after the challenge was determined by flow cytometry. IFN-γ ELISPOT assays were also performed in HLA-DQ2.5 participants. ROC curve analysis was used to assess the diagnostic performance of the CD8+ T cell response and IFN-γ ELISPOT. Results Significant differences between the percentage of the two studied subsets of CD8+ and TCRγδ+ cells at days 0 and 6 were found only when considering CD patients (p < 10−3 vs. non-CD subjects). Measuring activated CD8+ T cells provided accurate CD diagnosis with 95% specificity and 97% sensitivity, offering similar results than IFN-γ ELISPOT. Conclusions The results provide a highly accurate blood test for CD diagnosis in patients on a GFD of easy implementation in daily clinical practice.

Objective The mechanical thrombectomy (MT) benefit is related to the degree of reperfusion achieved. First pass effect (FPE) is defined as complete/near revascularisation of the large-vessel occlusion (modified Thrombolysis in Cerebral Infarction (mTICI) 2c-3) after a single device pass. This study assessed the health benefit and economic impact of achieving FPE for acute ischaemic stroke (AIS) patients from the Spanish National Health System (NHS) perspective.Design A lifetime Markov model was used to estimate incremental costs and health outcomes (measured in quality-adjusted life-years (QALYs)) of patients that achieve FPE. A subanalysis of the Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischaemic Stroke (STRATIS) registry was performed to obtain clinical outcomes. The base case included all patients that achieved at least a final mTICI ≥2 b, while the alternative scenario included all patients regardless of their final mTICI (0–3). Treatment costs were updated to reflect current practice based on expert panel consensus, while other acute and long-term costs were obtained from a previous cost-effectiveness analysis of MT performed in Spain. Sensitivity analyses were performed to assess the model’s robustness.Setting Spanish healthcare perspective.Participants AIS patients in Spain.Interventions FPE following MT.Outcome measures The model estimated QALYs, lifetime costs and net monetary benefit for the FPE and non-FPE group, depending on the inclusion of reperfusion groups and formal care costs.Results STRATIS subanalysis estimated significantly better clinical outcomes at 90 days for the FPE group in all scenarios. In the base case, the model estimated lifetime cost saving per patient of €16 583 and an incremental QALY gain of 1.2 years of perfect health for the FPE group. Cost savings and QALY gains were greater in the alternative scenario (-€44 289; 1.75). In all scenarios, cost savings were driven by the long-term cost reduction.Conclusion Achieving FPE after MT can lead to better health outcomes per AIS patient and important cost savings for the Spanish NHS.

Atypical sensory processing described in autism spectrum disorders (ASDs) frequently cascade into behavioral alterations: isolation, aggression, indifference, anxious/depressed states, or attention problems. Predictive machine learning models might refine the statistical explorations of the associations between them by finding out how these dimensions are related. This study investigates whether behavior problems can be predicted using sensory processing abilities. Participants were 72 children and adolescents (21 females) diagnosed with ASD, aged between 6 and 14 years (M = 7.83 years; SD = 2.80 years). Parents of the participants were invited to answer the Sensory Profile 2 (SP2) and the Child Behavior Checklist (CBCL) questionnaires. A collection of 26 supervised machine learning regression models of different families was developed to predict the CBCL outcomes using the SP2 scores. The most reliable predictions were for the following outcomes: total problems (using the items in the SP2 touch scale as inputs), anxiety/depression (using avoiding quadrant), social problems (registration), and externalizing scales, revealing interesting relations between CBCL outcomes and SP2 scales. The prediction reliability on the remaining outcomes was “moderate to good” except somatic complaints and rule-breaking, where it was “bad to moderate.” Linear and ridge regression achieved the best prediction for a single outcome and globally, respectively, and gradient boosting machine achieved the best prediction in three outcomes. Results highlight the utility of several machine learning models in studying the predictive value of sensory processing impairments (with an early onset) on specific behavior alterations, providing evidences of relationship between sensory processing impairments and behavior problems in ASD.

Abstract De novo mutations (DNMs), including germinal and postzygotic mutations (PZMs), are a strong source of causality for Autism Spectrum Disorder (ASD). However, the biological processes involved behind them remain unexplored. Our aim was to detect DNMs (germinal and PZMs) in a Spanish ASD cohort (360 trios) and to explore their role across different biological hierarchies (gene, biological pathway, cell and brain areas) using bioinformatic approaches. For the majority of the analysis, a combined ASD cohort (N = 2171 trios) was created using previously published data by the Autism Sequencing Consortium (ASC). New plausible candidate genes for ASD such as FMR1 and NFIA were found. In addition, genes harboring PZMs were significantly enriched for miR-137 targets in comparison with germinal DNMs that were enriched in GO terms related to synaptic transmission. The expression pattern of genes with PZMs was restricted to early mid-fetal cortex. In contrast, the analysis of genes with germinal DNMs revealed a spatio-temporal window from early to mid-fetal development stages, with expression in the amygdala, cerebellum, cortex and striatum. These results provide evidence of the pathogenic role of PZMs and suggest the existence of distinct mechanisms between PZMs and germinal DNMs that are influencing ASD risk.