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The present study aimed to determine the emotional characteristics of the Trait-Meta-Mood-Scale (TMMS-24) in music-oriented secondary school students in Italy. A 24-item self-assessment protocol was applied to measure the level of perceived emotional intelligence according to 3 dimensions: attention, clarity and repair. This tool represents one of the most widely used self-assessment measures of perceived emotional intelligence. The objective of the study was to conduct construct validation to examine reliability of the Italian version of the TMMS-24 in order to identify its feasibility for the assessment of emotional intelligence. Exploratory and confirmatory factorial analyses were conducted on a sample of music-oriented secondary school students in Italy (n=402). Exploratory factor analysis outcomes revealed that the three dimensions of the original scale (attention, clarity and emotional repair) are supported in the examined context, showing adequate internal consistency and describing 52.6% of overall variance. Outcomes were confirmed via confirmatory analysis, obtaining good fit indices (CFI=0.986; TLI=0.985; RMSEA=0.038). The TMMS-24 scale is a valid and reliable instrument for measuring the emotional intelligence of secondary school students in Italy.

Erectile dysfunction (ED) poses a significant challenge in clinical practice, necessitating accurate diagnostic strategies to distinguish between organic and psychogenic causes. Current guidelines advocate a comprehensive approach involving medical history, physical examination and blood tests, with second-level analyses like the intracavernous injection of vasoactive drugs (ICI test) and penile duplex ultrasound (PDU) reserved for specific cases. A survey involving 24 urologists experienced in ED was conducted to assess their opinions on the appropriateness of the ICI test and PDU in six clinical scenarios. Results were analyzed using pie charts, revealing varied preferences among experts. The responses indicated diverse viewpoints, with preferences for the ICI test or PDU depending on the patient’s age, comorbidities, response to phosphodiesterase type 5 inhibitors (PDE5i) and concomitant Peyronie’s disease. In some cases, a significant proportion of experts opted for neither test. The study highlights the lack of consensus among experts regarding the routine use of PDU in ED management. Despite its diagnostic capabilities, the clinical utility of PDU remains unclear, and its role may be more justified in certain populations with anatomical abnormalities or specific conditions. The need for rigorous research to determine the impact of PDU on ED management decision-making is emphasized.

This study aims to validate the Spanish version of the Measure of Happiness (MH), a questionnaire that identifies the specific areas of an individual’s life that are related to experienced happiness. The sample consisted of 458 Spanish native speakers (65.7% women, 34.3% men; mean age = 24.14, SD = 8.45) and was divided into two groups: Sample 1 (N = 226) underwent Exploratory Factor Analysis (EFA), and Sample 2 (N = 232) underwent Confirmatory Factor Analysis (CFA). The convergent and discriminant validity of the Spanish version of the MH and its subscales was assessed by calculating Pearson correlations between the MH factors and the Subjective Happiness Scale, the State–Trait Anxiety Inventory, the Beck Depression Inventory, and the WHOQOL-BREF. The EFA and CFA confirmed the original five-factor structure of the MH questionnaire. The only difference in the Spanish version of the MH is that Item 4, which was originally assigned to Factor 2 “Financial Status”, was reallocated to Factor 1 “Psychophysical Status”. The reliability of the Spanish version of the MH questionnaire was also confirmed, and the factors correlated in the expected direction with the constructs of quality of life, happiness, anxiety, and depression. The MH questionnaire demonstrated excellent psychometric properties among Spanish respondents.

Summary: Background: Surgical care holds significant importance in healthcare, especially in low and middle-income countries, as at least 50% of the 4.2 million deaths within the initial 30 days following surgery take place in these countries. The Lancet Commission on Global Surgery proposed six indicators to enhance surgical care. In Colombia, studies have been made using secondary data. However, strategies to reduce perioperative mortality have not been implemented. This study aims to describe the fourth indicator, perioperative mortality rate (POMR), with primary data in Colombia. Methods: A multicentre prospective cohort study was conducted across 54 centres (hospitals) in Colombia. Each centre selected a 7-day recruitment period between 05/2022 and 01/2023. Inclusion criteria involved patients over 18 years of age undergoing surgical procedures in operating rooms. Data quality was ensured through a verification guideline and statistical analysis using mixed-effects multilevel modelling with a case mix analysis of mortality by procedure-related, patient-related, and hospital-related conditions. Findings: 3807 patients were included with a median age of 48 (IQR 32–64), 80.3% were classified as ASA I or II, and 27% of the procedures had a low-surgical complexity. Leading procedures were Orthopedics (19.2%) and Gynaecology/Obstetrics (17.7%). According to the Clavien–Dindo scale, postoperative complications were distributed in major complications (11.7%, 10.68–12.76) and any complication (31.6%, 30.09–33.07). POMR stood at 1.9% (1.48–2.37), with elective and emergency surgery mortalities at 0.7% (0.40–1.23) and 3% (2.3–3.89) respectively. Interpretation: The POMR was higher than the ratio reported in previous national studies, even when patients had a low–risk profile and low-complexity procedures. The present research represents significant public health progress with valuable insights for national decision-makers to improve the quality of surgical care. Funding: This work was supported by Universidad del Rosario and Fundación Cardioinfantil-Instituto de Cardiología grant number CTO-057-2021, project-ID IV-FGV017.

Background Collateral status (CS) plays a crucial role in infarct growth rate, risk of postthrombectomy hemorrhage, and overall clinical outcomes in patients with acute ischemic stroke (AIS) secondary to anterior circulation large‐vessel occlusions (LVOs). Hypoperfusion intensity ratio has been previously validated as an indirect noninvasive pretreatment imaging biomarker of CS. In addition to imaging, derangements in admission laboratory findings can also influence outcomes in patients with AIS‐LVO. Therefore, our study aims to assess the relationship between admission laboratory findings, baseline characteristics, and CS, as assessed by hypoperfusion intensity ratio in patients with AIS‐LVO. Methods and Results In this retrospective study, consecutive patients presenting with AIS secondary to anterior circulation LVO who underwent pretreatment computed tomography perfusion were included. The computed tomography perfusion data processed by RAPID (Ischema View, Menlo Park, CA) generated the hypoperfusion intensity ratio. Binary logistic regression models were used to assess the relationship between patients' baseline characteristics, admission laboratory findings, and poor CS. A total of 221 consecutive patients with AIS‐LVO between January 2017 and September 2022 were included in our study (mean±SD age, 67.0±15.8 years; 119 men [53.8%]). Multivariable logistic regression showed that patients with AIS caused by cardioembolic and cryptogenic causes (adjusted odds ratio [OR], 2.67; 95% CI, 1.20–5.97; P=0.016), those who presented with admission National Institutes of Health Stroke Scale score ≥12 (adjusted OR, 3.12; 95% CI, 1.61–6.04; P=0.001), and male patients (adjusted OR, 2.06; 95% CI, 1.13–3.77; P=0.018) were associated with poor CS. Conclusions Stroke caused by cardioembolic or cryptogenic causes, admission National Institutes of Health Stroke Scale score of ≥12, and male sex were associated with poor CS, as defined by hypoperfusion intensity ratio in the patients with AIS‐LVO.

BackgroundBreast cancer shows significant clinical, morphologic, and molecular variation. Telomeres are nucleoprotein complexes composed of hexanucleotide repeat DNA sequence, TTAGGG, and numerous telomere-associated proteins. The maintenance of telomere length is carried out by a ribonucleoprotein called telomerase, which consists of two main components: a catalytic subunit called hTERT (human telomerase reverse transcriptase) and an RNA template called hTR (human telomerase RNA). The importance of evaluating hTERT expression lies in its potential therapeutic application, being an attractive target due to its almost non-existent expression in normal somatic cells. It is also expected that the anti-neoplastic effect would appear earlier in neoplastic cells with shorter telomeres. Additionally, a significant relationship has been observed between Her2-Neu overexpression and Her2-Neu positivity, which could suggest new combined therapies.The aim of this study was to detect the expression of hTERT, estrogen receptor (ER), progesterone receptor (PR), and HER2-Neu in neoplastic breast tissue embedded in paraffin before treatment and to investigate the relationship between them and with baseline and post-treatment telomere length, as well as with various clinicopathological parameters.Materials and methodsA cross-sectional-correlational, 21 women diagnosed with breast cancer at the Oncology Service of the High Specialty Medical Unit No. 1 of Bajio of the Mexican Institute of Social Security. The study complies with the Helsinki Declaration and was approved by the Institutional Ethical Committee of the Mexican Institute of Social Security (R-2019-1001-127). A peripheral blood sample was obtained before oncological treatment and at the end of oncological treatment for the measurement of telomere length by extracting DNA from leukocytes, was performed by the quantitative polymerase chain reaction (PCR) method described by Cawthon. Tumor samples were collected from each patient at the oncology department for immunohistochemical determination of biomarker expression (ER, PR, Her2/neu) and hTERT.ResultsOf the 21 cases included in the study, the median age was 57.57 years. Eighteen cases were classified as invasive ductal carcinoma NOS (85.71%), 10 were histologic grade 2 (47.61%), 16 cases were hormone receptor positive (76.19%), 7 were Her2Neu positive (33.33%), and only 2 cases were triple negative (9.52%). Positive hTERT expression was detected in 11 cases (52.38%) and was negative in the remaining cases. A significant association was identified between hTERT-positive cases and Her2-Neu positive cases (p = 0.04). Baseline and post-treatment telomere lengths showed a significant difference using the non-parametric Wilcoxon t-test (p = 0.002). In hTERT-positive cases, there was significant telomere shortening at the end of oncological treatment (6.14 ± 1.54 vs. 4.75 ± 1.96 Kb, p = 0.007).ConclusionPositive hTERT immunostaining cases were associated with poor prognostic factors, such as Her2-Neu overexpression and post-treatment telomere shortening. In the future, hTERT immunostaining could be used to select patients for therapies with antagonistic effects on hTERT, as well as in the selection of more appropriate chemotherapy regimens for patients who express it.

Our research used a SVAR to analyze the underlying copper price shocks, that is, a commodity shock for the Junín department in Peru. The results of a short- and long-run SVAR were based on traditional matrix constraints that capture the fact that domestic shocks do not affect international prices. The main conclusion is that before the pandemic a shock in the international price of copper decreases economic growth and inflation in the department of Junín in Peru, after the pandemic the opposite happens. As a result of the model, the short and long-run effects of the international copper price on the main macroeconomic variables of Junín in Peru are statistically significant. Before the pandemic, the dynamics of the international copper price reflected the existence of the curse of mining resources in copper institutions. Before the pandemic, a percentage increase in the international price of copper decreased economic growth, reflecting the existence of the mining resource curse in copper institutions. After the pandemic, a percentage increase in the price of copper increases economic growth by up to 0.0488%, then decreases over time, noting the transitory effect of economic recovery and poor management of mineral resources.

The present study aimed to determine the emotional characteristics of the Trait-Meta-Mood-Scale (TMMS-24) in music-oriented secondary school students in Italy. A 24-item self-assessment protocol was applied to measure the level of perceived emotional intelligence according to 3 dimensions: attention, clarity and repair. This tool represents one of the most widely used self-assessment measures of perceived emotional intelligence. The objective of the study was to conduct construct validation to examine reliability of the Italian version of the TMMS-24 in order to identify its feasibility for the assessment of emotional intelligence. Exploratory and confirmatory factorial analyses were conducted on a sample of music-oriented secondary school students in Italy (n=402). Exploratory factor analysis outcomes revealed that the three dimensions of the original scale (attention, clarity and emotional repair) are supported in the examined context, showing adequate internal consistency and describing 52.6% of overall variance. Outcomes were confirmed via confirmatory analysis, obtaining good fit indices (CFI=0.986; TLI=0.985; RMSEA=0.038). The TMMS-24 scale is a valid and reliable instrument for measuring the emotional intelligence of secondary school students in Italy.

The World Health Organization has emphasized the importance of consuming small fruits for the prevention of chronic health problems, including diabetes, cardiovascular diseases, cancer, and obesity, which are named chronic non-communicable diseases (NCDs). Azara serrata Ruiz & Pav., commonly called “aroma de Castilla”, is a shrub endemic to Chile from the Salicaceae family that produces an underutilized blue-grey berry that grows wild in southern Chile. The species is widely used as a medicinal plant by the Andean communities of southern Chile. In this work, a high-resolution mass spectrometric analysis of the methanolic extract revealed several phenolic compounds for the first time in the edible berry of this endemic species. Furthermore, several glycosylated anthocyanins were detected and quantified using UHPLC coupled with UV/Vis detection and trapped ion mobility mass spectrometry (UHPLC-DAD-TIMS-TOF) for the anthocyanin-rich extract, which was prepared using an optimized anthocyanin extraction protocol. The extract proved to be active in the inhibition of several enzymes linked to NCDs, such as acetylcholinesterase, tyrosinase, amylase, lipase, and glucosidase (IC50 = 3.92 ± 0.23, 12.24 ± 0.03, 11.12 ± 0.10, 32.43 ± 0.0, and 371.6 ± 0.0 μg/mL, respectively). Furthermore, the extract concentrated in anthocyanins showed good antioxidant activity evidenced by the bleaching of the radicals DPPH and ABTS, ferric-reducing antioxidant power (FRAP), and oxygen radical absorbance capacity (ORAC). The results show that these neglected endemic small berries can be a source of healthy phytochemicals. These Chilean berries can be used as functional food and their extracts are candidates for use as functional ingredients in naturally healthy products.

Premature ejaculation (PE) is a common male sexual dysfunction that can cause significant distress in the patient and partner. This study aimed to compare the current international guidelines on PE to highlight their similarities and differences. We examined the latest guidelines from the European Association of Urology (EAU), American Urological Association/Sexual Medicine Society of North America (AUA/SMSNA), and International Society of Sexual Medicine (ISSM) by comparing definitions, classifications, epidemiology, pathophysiology, and recommendations on diagnosis and therapy. The quality of guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) Global Rating Scale (GRS). We found significant variations in the definitions of PE and recommendations on management of patients. The EAU guidelines were the most recent, the AUA/SMSNA guidelines lacked detail in some areas, and the ISSM guidelines were the most complete but also the least updated. The search for a unified definition and the development of standardized diagnostic and therapeutic pathways remain concrete issues to improve the management of patients with PE worldwide.

ObjectivesPostoperative haematuria is a feared complication following prostate enucleation, and it may occur even weeks after discharge. We evaluated the risk of bleeding after discharge and its predictive factors in patients who underwent Thulium laser enucleation of the prostate (ThuLEP). MethodsBetween January 2015 and December 2018, patients with surgical indication for benign prostatic hyperplasia underwent ThuLEP in 4 urology departments. All procedures were performed by experienced urologists. Postoperative haematuria was defined as macroscopic haematuria occurring 7 days after discharge. Readmission rate due to macroscopic haematuria was assessed. Logistic regression models tested for predictors of postoperative bleeding requiring readmission. ResultsOverall, 748 patients were included, and 52 (6.9%) of them were readmitted after discharge because of macroscopic haematuria. No cases of deep venous thrombosis or pulmonary embolism were diagnosed. Mean length of stay for surgical treatment was 2.1 days, and mean hospitalization for readmission was 5.6 days. None of the readmitted patients required reintervention, while 46.1% of them required blood transfusions. Diabetes mellitus (P < 0.05), a long bridge of oral anticoagulant drugs with low molecular weight heparin (LMWH) (P < 0.05) and history of constipation (P < 0.05) were significant predictors of readmission after discharge due to macroscopic haematuria. ConclusionsPatients with a clinical history of diabetes mellitus or constipation and patients who undergo a long bridge of oral anticoagulant therapy with LMWH are at higher risk of bleeding requiring readmission after ThuLEP.

Background: Craniofacial injuries are thought to be commonly associated with traumatic brain injury (TBI), but there is conflicting evidence in the literature. This retrospective cohort study aims to evaluate the incidence of TBI in patients with craniofacial trauma. Methods: The study included 2982 consecutive patients with either solitary or concurrent diagnoses of TBI and facial fractures, seen and evaluated at a single level II trauma center between 1 January 2010 and 31 December 2020. Continuous variables were compared against whether the patient had one or both diagnoses. Results: Of the target population, 55.8% had a solitary diagnosis of TBI; 30.28% had a solitary diagnosis of facial fractures; and 13.92% had concurrent diagnoses of both TBI and facial fractures. Patients with concurrent diagnoses had a significantly longer mean length of stay (LOS) compared to those with solitary diagnoses (9.92 ± 16.33 days vs. 6.21 ± 10.96 days, p < 0.01), but age (p = 0.68) and ICU LOS (p = 0.09) did not differ significantly between the two groups. Conclusions: Trauma to the face should be given special attention due to the increased chance of TBI with craniofacial fractures. Patients with concurrent diagnoses of TBI and facial fractures had worse hospital outcomes than those with solitary diagnoses of either TBI or facial trauma.

Background/purpose: We compare the outcomes of conservative management of adhesive small bowel obstruction (ASBO) before and after the implementation of an enteral hyperosmolar water-soluble contrast protocol. Methods: We performed a retrospective chart review of all patients with ASBO admitted into the Hospital de Niños de la Santísima Trinidad (Córdoba, Argentina) between June 2017 through June 2022. Patients admitted before June 2020 (group 1) received traditional conservative management (no enteral feeding, gastric decompression, and intravenous hydroelectrolytic resuscitation). Surgery was indicated at the discretion of the treating surgeon. Patients admitted after June 2020 (group 2) received water-soluble contrast 12–24 h after admission. Surgery was indicated if contrast agent was not seen in the colon in a radiographic examination 24 h after the administration, or if symptoms persisted despite the presence of contrast in the colon and in case of clinical worsening or protocol discontinuation. Group outcomes were compared. Surgical rate was the main outcome. Results: Fifty-three episodes of ASBO were included. Surgical treatment was indicated in 80 % of group 1 and in 66 % of group 2 (p = 0.28). The sensitivity and specificity of hyperosmolar water-soluble contrast to predict the success of conservative management were 100 % and 60 %, respectively. The complication rate after contrast administration was 66.66 %. Vomiting was the most common complication. Conclusions: Hyperosmolar water-soluble contrast did not significantly decrease the rate of surgical procedures. However, it is a sensitive tool predicting the success of conservative management and is not associated with the occurrence of major complications. Level of evidence: Level III Type of study: Retrospective comparative study.

AbstractThe COVID-19 pandemic has brought about a profound transformation in the educational landscape in recent months. Educators worldwide have been challenged to tackle academic issues they could never have imagined. Among the most stressful situations faced by students and teachers is implementing online assessments. This paper proposes a system that includes exam prototypes for computer architecture modules at the higher education level. This system generates a wide range of questions and variations on the server side, supported by a set of simulators, resulting in many unique examination proposals. This system streamlines the monitoring process for the teacher, as it eliminates the possibility of two students receiving similar exams and reduces student stress by allowing them to practice with a limitless number of exam samples. This paper also highlights several indicators that demonstrate the advantages of this framework.