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Universal autism screening is recommended by the American Academy of Pediatrics at 18 and 24 months. However, many children are not identified until after the age of 4 years, and some not until adulthood, either due to mild or no indication of symptoms early in development, or to co-occurring conditions which may overshadow autism symptoms. This indicates a need for universal autism screening measures for school-age children. This project adapts the widely used toddler autism screening tool, the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F), for use in school-age children, called M-CHAT-School (M-CHAT-S). The study follows the Patient-Reported Outcomes Measurement Information System guidelines for measure development to create parent- and teacher-report versions of the M-CHAT-S for 4- to 8-year-old children. Through expert consensus feedback via a Delphi pool and cognitive interviewing with stakeholders (i.e. parents and teachers), we developed two versions of the M-CHAT-S to be used for verbal and minimally verbal children. The M-CHAT-S poses several advantages to existing measures, including brevity, items updated based on current knowledge and conventions, and narrow age range to assure items are developmentally appropriate. Future steps include validation of the M-CHAT-S to determine its utility as an autism screener for young school-age children.

Clinicians form initial impressions about a childs diagnosis based on behavioral features, but research has not yet identified specific behaviors to guide initial diagnostic impressions. Participants were toddlers (N = 55, mean age 22.9 months) from a multi-site early detection study, referred for concern for ASD due to screening or parent/provider concern. Within 5 min of meeting a child, clinicians noted ASD or non-ASD impression, confidence in impression, and behaviors that informed their impression. These clinicians also determined final diagnoses for each child. When a childs final diagnosis was ASD (n = 35), senior clinicians formed an initial impression of ASD in 22 cases (63%) but missed 13 cases (37%). When final diagnosis was non-ASD (n = 20), senior clinicians made an initial impression of non-ASD in all cases (100%). Results were similar among junior clinicians. Senior and junior clinicians used the same behaviors to form accurate impressions of ASD and non-ASD: social reciprocity, nonverbal communication, and eye contact. Senior clinicians additionally used focus of attention when forming accurate impressions of ASD and non-ASD; junior clinicians used this behavior only when forming accurate non-ASD impressions. Clinicians initial impressions of ASD are very likely to be consistent with final diagnoses, but initial impressions of non-ASD need follow-up. Toddlers who show all four atypical behaviors (social reciprocity, nonverbal communication, eye contact, and focus of attention) might receive expedited ASD diagnoses. However, presence of apparently typical behaviors should not rule out ASD; for some children a longer evaluation is necessary to allow for more opportunities to observe subtle social behavior.

Octavio Luque-Reca,1 Carlos Marchena-Giráldez,2 Myriam Carbonell-Colomer,2 Christa Bewernick,3 Elena Bernabéu-Brotóns2 1Department of Psychology, Universidad Rey Juan Carlos, Madrid, Spain; 2Faculty of Education and Psychology, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain; 3Master’s School of Psycho-Oncology and Palliative Care, Universidad Complutense de Madrid, Madrid, SpainCorrespondence: Elena Bernabéu-Brotóns, Facultad de Educación y Psicología, Universidad Francisco de Vitoria, Ctra. Pozuelo-Majadahonda, km 1.8, 28223, Pozuelo de Alarcón, Madrid, Spain, Email e.bernabeu.prof@ufv.esPurpose: Addressing the complex pattern of digital behaviors and interactions among youth, this research introduces a novel comprehensive scale, the Problematic Smartphone and Social Network Use Scale (PSSNUS), meticulously developed and validated across five studies.Methods: Using a mixed-methods approach across five stages, including focus groups (Study 1; n = 31), cognitive interviews (Study 2; n = 16), exploratory factor analysis (Study 3; n = 316), and expert panel (Study 4; n = 4), this procedure reduced 58 initial items to an 18-item scale. Subsequently, a confirmatory factor analysis and further analyses (Study 5; n = 355) examined the factorial structure’s replicability, reliability, and validity of the scale.Results: The PSSNUS manifested as a reliable (ω ranging 0.70– 0.89) instrument, comprising a structure with five key factors (x2 = 173.994, df = 125, p = 0.002, CFI = 0.994, CFI = 0.993, SRMR = 0.039, and RMSEA = 0.027) that capture both individual and social aspects of this construct: Psychological dependence (PD), Online interaction preference (OIP), Digital recognition desire (DRD), Social networks control seeking (SNCS), and Productivity loss (PL). Minor gender differences in both the DRD factor and in the overall score were found, with females scoring higher. The PSSNUS showed convergent and divergent validity through significant but modest correlations with daily smartphone usage hours, procrastination, emotional intelligence and mental health symptomatology (anxiety, depression and stress). This measure further exhibited incremental validity, controlling for other possible predictors, regarding anxiety, depression, and stress (6.5, 11.5 and 7.5% of additional variance explained), highlighting the DRD dimension’s unique predictive power.Conclusion: Emerging as a solid instrument, the PSSNUS broadens the concept of problematic smartphone use among young Spaniards to include social functioning aspects, serving as an interesting tool for those aiming to explore further the adverse influence of digital media on youth.Keywords: psychometric properties, assessment tool, mobile usage patterns, social media, multidimensional scale, mixed methods

Este artículo tiene como objetivo realizar una revisión bibliográfica del impacto de los costos estratégicos en la sostenibilidad empresarial de las PYMEs. Se basó en una búsqueda exhaustiva en bases de datos de Web of Science (WoS), Scopus y SciELO (Colombia, Chile, Perú, Cuba y Argentina). Se hizo énfasis en la revisión de artículos publicados en inglés, español y portugués entre los años 2010-2022, obteniendo un total de 17 artículos. Los hallazgos más relevantes fueron: se destaca que la sostenibilidad empresarial es una meta a la que muy pocas pymes tienen acceso, debido a la falta de recursos monetarios, una gran competencia y la escasez de financiamiento. Se concluye que los costos estratégicos tienen un impacto significativo en la sostenibilidad empresarial de las pymes. Este impacto toma como base las innovaciones tecnológicas, capacitaciones, incentivos monetarios gubernamentales, adaptabilidad en el mercado y los cambios de enfoque en los planes de gestión.

Abstract Osseous industry has been observed at an increasing number of Neanderthal sites. Bone fragments were used for practical purposes, and a range of bone shaping techniques were employed. The variability of bone tools observed in different assemblages reflects considerable functional diversity. However, no bone spear points have been reported from these contexts. A comprehensive analysis of a bone spear point from the Middle Palaeolithic site of Abric Romaní (Barcelona, Spain) is presented. Through an interdisciplinary, multi-technique, and multi-scale approach combining technology, taphonomy, and functional analysis, compelling evidence for manufacture, use, and hafting was uncovered. The specimen exhibits clear signs of intentional knapping. The presence of microscopic linear impact marks, an impact fracture at the tip and potential internal stress fractures indicate its use as a spear. Furthermore, the observed wear pattern and a morphological adjustment of the trabecular tissue support the hafting hypothesis. Abric Romaní contributes to our understanding of Neanderthal hunting behaviour and the significance of composite bone tools in their technological repertoire 50,000 years ago. This discovery highlights the flexibility and adaptability of Neanderthal technology, providing evidence of bone technology that is sometimes obscured in the archaeological record and offering valuable insights into their hunting strategies during the Middle Palaeolithic.

Current physical literacy recommendations include a focus on enhancing teachers' knowledge and understanding of the concept. This paper explores whether physical education (PE) practitioners in a country where physical literacy is not foregrounded in educational practice are naturally aligning their approach towards the creation of learning experiences that would nurture physical literacy. Ten in-service Spanish PE teachers delivering Educación Secundaria Obligatoria and Bachillerato education programmes to students aged 13 to 18 years (seven male, three female; mean age: 45 years; mean teaching experience: 17.4 years), unfamiliar with the concept of physical literacy, participated in semi-structured interviews exploring their experiences of delivering PE. Thematic analysis revealed teaching craft, curriculum implementation, differentiation strategies, assessment behaviours, utility of feedback, psychomotor development, and sensitivity to affective domains of learning as overarching themes. Findings provide insight into the practices and behaviours of PE teachers who self-identified as being unfamiliar with the concept of physical literacy. Results suggest that learners are well served through the provision of high-quality PE that ubiquitously satisfies the requirements of developing physically literate individuals, implying how teaching is conducted in relation to developing physical literacy is as important, perhaps more so, than what is understood of the concept.

Aim/Purpose: This paper aims to address the gap in comprehensive, real-world applications of Generative Artificial Intelligence (GenAI) in education, particularly in higher education settings. Despite the evident potential of GenAI in transforming educational practices, there is a lack of consolidated knowledge about its practical effectiveness and real-world impact. Background: This study addresses this gap by conducting a systematic literature review to collate and analyze real-life instances of GenAI applications in higher education, thus providing a nuanced understanding of its practical implementations and measurable outcomes. Methodology: The paper utilizes a systematic literature review methodology, adopting the PRISMA approach complemented by a thematic analysis procedure to ensure a comprehensive and in-depth evaluation of the literature. It synthesizes information from relevant articles from 2022 to 2024, focusing on the applications of GenAI in higher education. This analysis covers various aspects, including research settings, analysis scales, data types, collection tools, and analytical methods. Contribution: The paper contributes to the academic community by offering a comprehensive review of GenAI applications in education, highlighting the current precision level of these tools, and providing strategic recommendations for their effective use in academia. Furthermore, the research defines seven specific cases where Gen AI can be utilized as a reference for educational institutions in their adoption strategies. Findings: Key findings include the versatility of GenAI in generating teaching materials, enhancing skill development, supporting student tasks, academic performance evaluation, feedback delivery, and its role as a virtual assistant and in research support. Recommendations for Practitioners: Practitioners are advised to explore the integration of GenAI for diverse educational purposes, from content creation to student assessment, while being cognizant of its limitations and ethical considerations. Recommendation for Researchers: Future research should focus on addressing the gaps identified, such as the implications of GenAI in research roles, its application in various disciplines, and the exploration of newly developed AI tools tailored to specific educational needs. Impact on Society: The findings of this paper highlight the potential of GenAI in revolutionizing the educational sector, offering personalized learning experiences, and significantly influencing teaching methodologies and student engagement, but it also reveals significant deficiencies of Generative AI, known as hallucinations, which can impact the expected results. Future Research: Subsequent research should explore the evolving capabilities of GenAI models, their impact on various academic disciplines, and the development of pedagogical strategies to optimize their use in education.

Reducing the age of first autism diagnosis facilitates access to critical early intervention services. A current "waitlist crisis" for autism diagnostic evaluation thus demands that we consider novel use of available clinical resources. Previous work has found that expert autism clinicians can identify autism in young children with high specificity after only a brief observation; rapid identification by non-experts remains untested. In the current study, 252 children ages 12-53 months presented for a comprehensive autism diagnostic evaluation. We found that junior clinicians in training to become autism specialists (n = 29) accurately determined whether or not a young child would be diagnosed with autism in the first five minutes of the clinic visit in 75% of cases. Specificity of brief observations was high (0.92), suggesting that brief observations may be an effective tool for triaging young children toward autism-specific interventions. In contrast, the lower negative predictive value (0.71) of brief observations, suggest that they should not be used to rule out autism. When trainees expressed more confidence in their initial impression, their impression was more likely to match the final diagnosis. These findings add to a body of literature showing that clinical observations of suspected autism should be taken seriously, but lack of clinician concern should not be used to rule out autism or overrule other indicators of likely autism, such as parent concern or a positive screening result.

Reseña del libro: Barrientos Márquez, María del Mar y Lozano Salado, Lola (eds.). Revolución y Diplomacia: el Trienio Liberal y América. Santiago de Chile, Ariadna, 2023, 166 pp. ISBN: 978-95-66095-92-7.

Background: Acute coronary syndrome (ACS) hospital admissions decreased during the start of the COVID-19 outbreak. Information is limited on how Google searches were related to patients' behaviour during this time. Methods: We examined de-identified data from 2019 through 2020 regarding the following monthly items: (i) admissions for ACS from the Veterans Affairs Healthcare System; (ii) out-of-hospital cardiac arrest (OHCA) from the National Emergency Medical Services Information System (NEMSIS) public dataset; and (iii) Google searches for “chest pain,” “coronavirus,” “chest pressure,” and “hospital safe” from Google Trends. We analyzed the trends for ACS admissions, OHCA, and Google searches. Results: During the early months of the first COVID-19 outbreak, the following occurred: (i) Veterans Affairs data showed a significant reduction in ACS admissions at a national and regional (Florida) level; (ii) the NEMSIS database showed a marked increase in OHCA at a national level; and (iii) Google Trends showed a significant increase in the before-mentioned Google searches at a national and regional level. Conclusions: ACS hospital admissions decreased during the beginning of the pandemic, likely owing to delayed healthcare utilization secondary to patients fear of acquiring a COVID-19 infection. Concordantly, the volume of Google searches for hospital safety and ACS symptoms increased, along with OHCA events, during the same time. Our results suggest that Google Trends may be a useful tool to predict patients’ behaviour and increase preparedness for future events, but statistical strategies to establish association are needed. Résumé: Contexte: Les admissions à l’hôpital pour un syndrome coronarien aigu (SCA) ont diminué au début de la pandémie de COVID-19. Or, il existe peu de données sur les recherches effectuées par les patients dans Google pendant cette période. Méthodologie: Nous avons examiné des données mensuelles dépersonnalisées de 2019 à 2020 sur les éléments suivants : i) admissions pour un SCA dans le système de santé de Veterans Affairs aux États-Unis; ii) arrêts cardiaques extrahospitaliers (ACEH) de l’ensemble de données publiques du National Emergency Medical Services Information System (NEMSIS); et iii) les recherches dans Google selon Google Trends pour « chest pain » (douleur thoracique), « coronavirus », « chest pressure » (oppression thoracique) et « hospital safe » (sécurité dans les hôpitaux). Nous avons également analysé les tendances relatives aux admissions pour un SCA, aux ACEH et aux recherches dans Google. Résultats: Pour les premiers mois de la première vague de COVID-19, les observations sont les suivantes : i) les données de Veterans Affairs ont montré une réduction significative des admissions pour un SCA à l’échelle nationale et régionale (Floride); ii) la base de données du NEMSIS a montré une augmentation marquée des ACEH à l’échelle nationale; et iii) les tendances observées au moyen de Google Trends indiquent une augmentation significative à l’échelle nationale et régionale des recherches dans Google à l’aide des termes mentionnés précédemment. Conclusions: Les admissions à l’hôpital pour un SCA ont diminué au début de la pandémie, probablement en raison de la crainte des patients de contracter la COVID-19, qui les a amenés à repousser le recours à des soins de santé. Pendant la même période, le volume des recherches dans Google à propos de la sécurité dans les hôpitaux et les symptômes de SCA a augmenté, tout comme le nombre d’ACEH. Nos résultats semblent indiquer que Google Trends pourrait être un outil pratique pour prédire les comportements des patients et mieux se préparer aux événements futurs, mais il convient d’élaborer des stratégies statistiques permettant de mieux caractériser ces liens.

El dominio del idioma inglés es un requisito indispensable para la persona profesional del siglo XXI. Por ende, las universidades estatales costarricenses y, en particular, la Universidad Nacional (UNA) deben velar por un ejercicio adecuado y eficiente de la mediación pedagógica del profesorado de inglés como lengua extranjera, esto en cuanto a) a las competencias académicas, b) a las competencias en el idioma, c) a la competencias para la atención a la diversidad e inclusión, d) a las competencias pedagógicas, e) a las competencias en evaluación y f) a las competencias tecnológicas. El presente manuscrito problematiza los principios mencionados previamente en el ámbito de la docencia universitaria desde una perspectiva personal; por lo tanto, se argumentan las líneas por seguir identificadas para enfrentar los desafíos de la era contemporánea.

Objective To evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).Design Observational cohort analysis based on a multicentre international registry.Setting Data were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.Participants A total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.Methods Multivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.Results From October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).Conclusions In patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.

The key system to know the neutron and gamma fields during the commissioning at IFMIF-DONES facility will be the STart-Up Monitoring Module (STUMM), which will include tens of very sophisticated and miniaturised detectors providing crucial information about the radiation fields. In particular, there will be MFCs (micro-fission chambers), ICs (Ionisation Chambers), SPNDs (Self-Powered Neutron Devices) and GTs (Gamma Thermometers).The current state-of-the-art does not provide answers about the performance of the detectors in the very specific working conditions inside the IFMIF-DONES Test Cell, as a very high spatial density of detectors inside the STUMM vessel, an extremely harsh environment with neutron flux up to 5·1014n/cm2/s and the need of long mineral cables (>30 m) to drive the very weak current signals from the irradiation area to the closest electronics cubicles available in the facility.Except for the extremely high neutron flux provided by IFMIF-DONES, all the other very critical conditions can be replicated by means of a 1:1 scaled prototype of the STUMM (STUMM-PROTO), which will be subjected to comprehensive testing and irradiation campaigns in order to increase the knowledge about the performance of the detectors above mentioned.The present work shows the wide range of capabilities offered by STUMM-PROTO as well as the current status of its construction and some first notions about the experimental campaigns to be implemented.

El propósito de esta investigación fue establecer la relación entre el estrés laboral y la resiliencia durante el período de la pandemia de COVID-19 en enfermeras peruanas, utilizando un diseño correlacional. La muestra consistió en 112 enfermeras cuyas edades oscilaban entre los 22 y los 60 años, seleccionadas mediante un muestreo no probabilístico. Los hallazgos revelaron una correlación significativa e inversa entre el estrés laboral y la resiliencia, lo que indica que, a menor nivel de estrés laboral, mayor es la resiliencia manifestada por la persona (r = -0.31; p < 0.05). Después de analizar los resultados, se observó que el nivel de estrés predominaba en un 33%, mientras que el nivel de resiliencia baja prevalecía en un 37.5%. En conclusión, se infirió que los individuos que abordan su vida de manera asertiva y perseverante es probable que experimenten menos estrés y sean capaces de enfrentar los desafíos y obstáculos de manera positiva a lo largo de su trayectoria.

The rapid advancement of artificial intelligence (AI), coupled with the global rollout of 4G and 5G networks, has fundamentally transformed the Big Data landscape, redefining data management and analysis methodologies. The ability to manage and analyze such vast and varied datasets has exceeded the capacity of any individual or organization. This study introduces an enhanced framework that expands upon the traditional four Vs of Big Data—volume, velocity, volatility, and veracity—by incorporating six additional dimensions: value, validity, visualization, variability, volatility, and vulnerability. This comprehensive framework offers a novel and straightforward approach to understanding and addressing the complexities of Big Data in the AI era. This article further explores the use of ‘Big D’, an AI-driven, RAG-based Big Data analytical bot powered by the ChatGPT-4o model (ChatGPT version 4.0). This article’s innovation represents a significant advance in the field, accelerating and deepening the extraction and analysis of insights from large-scale datasets. This will enable us to develop a more nuanced and comprehensive understanding of intricate data landscapes. In addition, we proposed a framework and analytical tools that contribute to the evolution of Big Data analytics, particularly in the context of AI-driven processes.

Abstract Indigenous People and Local Communities (IPLC) can play an important role in reforestation for climate change mitigation while providing environmental and livelihood benefits. However, there is a lack of direct comparison between different reforestation design's carbon uptake potential and their relevance to community reforestation. We evaluate the carbon capture and survival of the four most common reforestation designs in a 14‐year‐long project in an Emberá community in eastern Panama. We look at native timber mixtures and monocultures, agroforestry, and natural regrowth with enrichment planting. To explain the differences between plots, we compare design, management and environmental characteristics using redundancy analyses (RDA). We then contextualize our results with the project leader's perspectives of success using interviews and workshops. In the first decade, mixtures and monocultures of timber stored on average roughly 3× more carbon than agroforestry and enrichment planting (140 tCO2/ha compared to 40 tCO2/ha and 53 tCO2/ha). The project design had the largest influence on carbon storage and survival with an explanatory power of 31% followed by management and environmental characteristics (14% and 2% respectively). The largest threat to the survival and growth was the risk of fire which caused mortality in more than 2/3 of the plots. Some damage was offset by natural regrowth which accounted for 34% of the total carbon, but the participants generally perceived natural regrowth as being “dirty.” They had a strong preference for agroforestry, particularly coffee (Coffea spp.), a crop with negligible carbon value, but high economic value. ‘Practical implication’: The findings underscore the need to balance carbon sequestration with local economic preferences, integrate community input, mitigate environmental risks and adopt long‐term, holistic approaches for effective reforestation projects.

Summary: Background: The clinical relevance of recurrent venous thromboembolism (VTE) after discontinuing anticoagulation in patients with COVID-19-associated VTE remains uncertain. We estimated the incidence rates and mortality of VTE recurrences developing after discontinuing anticoagulation in patients with COVID-19-associated VTE. Methods: A prospective, multicenter, non-interventional study was conducted between March 25, 2020, and July 26, 2023, including patients who had discontinued anticoagulation after at least 3 months of therapy. All patients from the registry were analyzed during the study period to verify inclusion criteria. Patients with superficial vein thrombosis, those who did not receive at least 3 months of anticoagulant therapy, and those who were followed for less than 15 days after discontinuing anticoagulation were excluded. Outcomes were: 1) Incidence rates of symptomatic VTE recurrences, and 2) fatal PE. The rate of VTE recurrences was defined as the number of patients with recurrent VTE divided by the patient-years at risk of recurrent VTE during the period when anticoagulation was discontinued. Findings: Among 1106 patients with COVID-19-associated VTE (age 62.3 ± 14.4 years; 62.9% male) followed-up for 12.5 months (p25-75, 6.3–20.1) after discontinuing anticoagulation, there were 38 VTE recurrences (3.5%, 95% confidence interval [CI]: 2.5–4.7%), with a rate of 3.1 per 100 patient-years (95% CI: 2.2–4.2). No patient died of recurrent PE (0%, 95% CI: 0–7.6%). Subgroup analyses showed that patients with diagnosis in 2021–2022 (vs. 2020) (Hazard ratio [HR] 2.86; 95% CI 1.45–5.68) or those with isolated deep vein thrombosis (vs. pulmonary embolism) (HR 2.31; 95% CI 1.19–4.49) had significantly higher rates of VTE recurrences. Interpretation: In patients with COVID-19-associated VTE who discontinued anticoagulation after at least 3 months of treatment, the incidence rate of recurrent VTE and the case-fatality rate was low. Therefore, it conceivable that long-term anticoagulation may not be required for many patients with COVID-19-associated VTE, although further research is needed to confirm these findings. Funding: Sanofi and Rovi, Sanofi Spain.

IntroductionThe term emotional eating (EE) describes the tendency to eat as an automatic response to negative emotions and has been linked to anxiety and depression, common symptoms among the university population. The EE tendencies have also been associated with excessive internet use and an increase in alcohol intake among young university students.MethodsThe aim of this study is to examine the relationship between the tendency towards EE and other health-compromising behaviors, such as excessive internet use or high alcohol intake. Additionally, it aims to investigate the association of these risky behaviors with the participants’ performance level in a virtual reality (VR) task that assesses their executive functioning, and to assess impulsivity and levels of anxiety and depression.ResultsThe results associate EE with excessive internet (r = 0.332; p

Solid tumors generally exhibit chromosome copy number variation, which is typically caused by chromosomal instability (CIN) in mitosis. The resulting aneuploidy can drive evolution and associates with poor prognosis in various cancer types as well as poor response to T-cell checkpoint blockade in melanoma. Macrophages and the SIRPα-CD47 checkpoint are understudied in such contexts. Here, CIN is induced in poorly immunogenic B16F10 mouse melanoma cells using spindle assembly checkpoint MPS1 inhibitors that generate persistent micronuclei and diverse aneuploidy while skewing macrophages toward a tumoricidal ‘M1-like’ phenotype based on markers and short-term anti-tumor studies. Mice bearing CIN-afflicted tumors with wild-type CD47 levels succumb similar to controls, but long-term survival is maximized by SIRPα blockade on adoptively transferred myeloid cells plus anti-tumor monoclonal IgG. Such cells are the initiating effector cells, and survivors make de novo anti-cancer IgG that not only promote phagocytosis of CD47-null cells but also suppress tumor growth. CIN does not affect the IgG response, but pairing CIN with maximal macrophage anti-cancer activity increases durable cures that possess a vaccination-like response against recurrence.

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Abstract Background Foot pain has been associated to factors like: fat, body mass index, age increased, female gender and the presence of pathologies. Although evidence is limited. The purpose is to determine the predictive factors for foot pain in the adult population. Methods From January to December 2021, 457 patients were > 18 years, gave signed informed consent to take part to this cross sectional study. All completed demographic data and various questionnaires related to pain: Foot Function Index, EuroQoL-5D and Visual Analogue Scale (foot pain). Anthropometric measurements were obtained using McPoil platform and foot posture was assessed by the Foot Posture Index (FPI). To determine whether a volume change is a predictive factor for foot pain, a parameter was established: the volumetric index for footwear (VIF). Factors linked to the presence of pain, including the considered VIF variables, were analyzed through multivariable logistic regression. Results Among the study population, 40.7% were male and 59.3% female. The mean age of 39.06 years and a body mass index of 25.58 Kg/cm2. The logistic regression model had a classification capability of 72.4%, a sensitivity of 72.3% and a specificity of 73%, in which, the predictors considered were the variables found to have a significant association with FFI-pain > 45 points,, showed that younger women, with a higher BMI, higher values of right FPI (pronation), poorer overall perceived health and with problems in walking were more likely to experience foot pain. Conclusion Predictive factors for foot pain in the adult population include gender, age, Body Mass Index, FPI on the right foot, perceived health and mobility. Clinical implication, the presented measure aids physicians in assessing their patients´ foot pain likelihood.

En el presente artículo se muestra una propuesta para museizar los edificios patrimoniales con carácter histórico y cultural utilizados por la red de Hospederías de Castilla la Mancha a través de un guiaje interpretativo. Con esta iniciativa se pretende ofrecer un valor añadido al servicio turístico del hospedaje, así como poner en valor los edificios históricos en los que dichos alojamientos se asientan. El valor de esta investigación radica en la necesidad de la sociedad en general y el turista en particular que se aloja en alguna de estas hospederías, de conocer el lugar donde pernocta o que visita, mejorando considerablemente su experiencia turística en el destino. Así mismo, se justifica por los grandes beneficios que puede llegar a suponer para el respeto y la protección de nuestro patrimonio, pues se pretende conseguir el compromiso social por parte de estos turistas, de cuidar, preservar y salvaguardar la historia de estos edificios singulares.

The International Fusion Materials Irradiation Facility- DEMO Oriented Neutron Source (IFMIF-DONES) is a scientific infrastructure aimed to provide an intense neutron source for the qualification of materials to be used in future fusion power reactors. Its implementation is critical for the construction of the fusion DEMOnstration Power Plant (DEMO).IFMIF-DONES is a unique facility requiring a broad set of technologies. Although most of the necessary technologies have already been validated, there are still some aspects that introduce risks in the evolution of the project.In order to mitigate these risks, a consortium of companies, with the support of research centres and the funding of the CDTI (Centre for the Development of Industrial Technology and Innovation), has launched the DONES EVO Programme, which comprises six lines of research: • Improvement of signal transmission and integrity (planning and integration risks) • Optimisation of RF conditioning processes (planning and reliability risks) • Development of a reliable beam extraction device (reliability risks) • Development of technologies for the production of medical isotopes (reliability risks) • Improvement of critical parts of the lithium purification system (safety and reliability risks) • Validation of the manufacture of critical components with special materials (reliability risk).DONES EVO will focus on developing the appropriate response to the risks identified in the IFMIF-DONES project through research and prototyping around the associated technologies.This contribution will present a discussion of the risks, the proposed response to them and the evolution of the technologies involved, following selected experiments carried out throughout the project.

Over the last decade, high-end fruits such as berries, have faced the impact of Drosophila suzukii (Matsumura, 1931) (Diptera: Drosophilidae) across Asia, Europe, and the Americas. Yet, none of the countries from Central America has officially reported this pest. We carried out surveys in the blackberry fields of Costa Rica. We placed a proprietary mixture of liquid attractants into red-cup traps with lateral holes, as it has been widely demonstrated as best to capture D. suzukii. Subsequently, we collected both adults and larvae for analysis. The adults were identified using key morphological features of D. suzukii, while the larvae were used for molecular analysis of the samples. The results revealed the first record of establishment of D. suzukii infesting blackberry in Costa Rica, Central America. These discoveries reveal the spread of the pest in Latin America and the importance of intensifying the surveillance process in other countries in this region.

Diagnosticians report that autism spectrum disorder (ASD) is immediately apparent in some, but not all, children ultimately diagnosed. Clinicians' initial diagnostic impressions have implications for ASD early detection, yet the literature raises questions about their accuracy. This study explores diagnostic impressions of ASD specialists made within the first 5 minutes of meeting a young child and investigates factors associated with the match between initial impressions and final diagnoses. Participants were children (n = 294, aged 12-53 months) referred for an ASD evaluation as part of multi-site ASD screening studies. After 5 minutes observing each child, clinicians with expertise diagnosing ASD recorded if they thought the child would meet criteria for ASD following a complete evaluation, and recorded their confidence in this impression. Clinicians' initial impressions matched the final diagnosis in 81% of cases. Ninety-two percent of cases initially thought to have ASD met criteria following a full evaluation; however, 24% of cases initially thought not to have ASD also met criteria, suggesting a high miss rate. Clinicians were generally confident in their initial impressions, reporting highest confidence for children initially thought correctly not to have ASD. ASD behavioral presentation, but not demographic characteristics or developmental level, were associated with matching initial impression and final diagnosis, and confidence. Brief observations indicating ASD should trigger referral to intervention services, but are likely to under-detect positive cases and should not be used to rule out ASD, highlighting the need to incorporate information beyond initial clinical impression. LAY SUMMARY: When children come in for an autism evaluation, clinicians often form early impressions-before doing any formal testing-about whether the child has autism. We studied how often these early impressions match the final diagnosis, and found that clinicians could not easily rule out autism (many children who initially appeared not to have autism were ultimately diagnosed), but were generally accurate ruling in autism (when a child appeared to have autism within 5 minutes, they were almost always so diagnosed).

Se evaluaron las propiedades psicométricas de la Escala de Cuidador de Zarit (EZ) aplicada a cuidadores formales e informales de personas con esquizofrenia en el Perú. Se evaluó la validez interna de la escala de Zarit Abreviada (EZA) mediante el coeficiente de Kuder- Richarson 21 y se obtuvo un valor similar a la escala EZ (coeficiente= ,856). La medida de adecuación KMO evidenció elevada correlación entre los ítems (,816) lo mismo que la prueba de esfericidad de Bartlett (p< ,001). Un sólo factor explica el 54,77% de la variabilidad total de los datos. En cuidadores informales la fiabilidad de la EZ obtuvo elevada consistencia interna (Coeficiente alfa de Cronbach= ,908; Coeficiente de Spearman- Brown=,895). La EZ aplicada a cuidadores formales e informales obtuvo adecuada confiabilidad. La EZA con un coeficiente de ,879 sensibilidad de 88,2% y especificidad de 92,3% resultó ser un instrumento recomendable para evaluar la sobrecarga.

Abstract Background Mesenchymal stromal cells (MSCs) have been shown to exert their therapeutic effects through the secretion of broad spectrum of paracrine factors, including extracellular vesicles (EVs). Accordingly, EVs are being pursued as a promising alternative to cell-based therapies. Menstrual blood-derived stromal cells (MenSCs) are a type of MSC that, due to their immunomodulatory and regenerative properties, have emerged as an innovative source. Additionally, new strategies of cell priming may potentially alter the concentration and cargo of released EVs, leading to modification of their biological properties. In this study, we aimed to characterize the EVs released by MenSCs and compare their therapeutic potential under three different preconditioning conditions (proinflammatory stimuli, physioxia, and acute hypoxia). Methods MenSCs were isolated from five healthy women. Following culturing to 80% confluence, MenSCs were exposed to different priming conditions: basal (21% O2), proinflammatory stimuli (IFNγ and TNFα, 21% O2), physioxia (1–2% O2), and acute hypoxia (

Few studies have shown the psychological impact of the COVID-19 pandemic on new mothers’ health, but the long-term consequences of the crisis are yet unknown. This study aimed at evaluating the changes experienced in perinatal mental health 6 months after the start of the COVID-19 pandemic in Spain. Women (n = 176, average age = 33.80) were recruited during the pandemic. Participants completed the Edinburgh Postnatal Depression Scale, the Satisfaction With Life Scale and Positive, and the Negative Affect Schedule. Results showed a decrease in depressive symptoms, t(174) = 2.58, p = .01, d = 0.02, whereas anxiety symptoms remained high, t(174) = 1.31, p = .19. In terms of psychological well-being, the results showed a decrease in life satisfaction, t(175) = 2.58, p = .011, d = 0.16, and negative affect, t(175) = 3.15, p = .002, d = 0.26, and an increase in positive affect, t(175) = -4.45, p < .001, d = 0.35. This study is expected to shed light on the design of future interventions aimed at the prevention of symptoms and to enhance life satisfaction during the perinatal stage.