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Background: The field of education is witnessing an increasing recognition of the pivotal roles played by arts teachers in fostering creativity and shaping students' learning experiences. Within this context, understanding the predictive factors influencing arts teachers' professional development is crucial for educational enhancement. Objective: This study aims to explore the predictive relationships between arts teachers' professional quality, creative style orientation, and their subsequent professional development. By delving into these aspects, the research seeks to provide valuable insights into the dynamics influencing the growth and progression of arts educators. Method: A comprehensive research methodology involving surveys and assessments was employed to gather data from a diverse sample of arts teachers. Measures of professional quality and creative style orientation were utilized, and their correlation with subsequent professional development outcomes was analyzed. Results: The findings reveal significant correlations between arts teachers' professional quality, creative style orientation, and the trajectory of their professional development. A nuanced understanding of how these factors interplay contributes to a more holistic view of the dynamics shaping the career advancement of arts educators. Conclusion: In conclusion, this study underscores the importance of arts teachers' professional quality and creative style orientation as predictive indicators of their professional development. The insights derived from this research can inform targeted interventions and support systems aimed at enhancing the overall effectiveness and job satisfaction of arts educators.

Suicide, as the ultimate expression of suicidal ideation, has accompanied human beings throughout history within specific social and cultural contexts. However, in recent decades the increase in suicides, especially in developed countries after the Second Demographic Transition and the rise of postmaterialist values, has been increasing in the youth population. This study is created from a quantitative perspective and aims to determine the predictors of suicidal ideation in university students in Spain. The fieldwork was carried out in a large sample of Spanish universities over several weeks in 2022, with the participation of hundreds of university students (n = 1472). The predictors of suicidal ideation were gender, types of social relationships, history of bullying, health status, taking antidepressant medication, increased anxiety after COVID-19, economic difficulties in continuing studies, and perspective on their future. The results highlight the need for the greater involvement of universities by establishing programs for preventing, detecting, and treating suicidal ideation, always in coordination with health systems to prevent further suicides in their university community., Depto. de Trabajo Social y Servicios Sociales, Fac. de Trabajo Social, TRUE, pub

Se ha descrito una nueva afección con efectos a largo plazo, el COVID persistente, que incluye una amplia variedad de problemas crónicos de salud con una duración indeterminada. Sin embargo, aún falta evidencia científica de su influencia sobre la población general y sanitaria. Además, en términos de funcionalidad, el COVID persistente está teniendo un impacto importante en la capacidad de las personas para la realización de sus actividades diarias y mantener un estilo de vida activo, experimentando limitaciones físicas que están repercutiendo sobre su calidad de vida. Esta investigación busca identificar las características sociodemográficas, clínicas, epidemiológicas, el estado funcional y la calidad de vida de la población contagiada por COVID19 y la población con COVID persistente. Para ello se ha contado con un total de 2.349 participantes de toda España. Como resultado de los análisis se ha encontrado que la hospitalización, el ingreso en UCI y los antecedentes de neumonía son factores predictores positivos de algunos síntomas de COVID persistente. Además ha demostrado un peor estado funcional, menor nivel de actividad física, mayor severidad de fatiga y peor calidad de vida en pacientes con COVID persistente. Esta tesis proporciona información útil acerca de las características sociodemográficas, clínicas, epidemiológicas, del estado funcional, nivel de actividad física, fatiga y calidad de vida de pacientes con COVID-19 y COVID persistente tanto en población general como en el personal sanitario de AP., Four scientific articles make up the present doctoral thesis, titled “Sociodemographic, clinical, epidemiological, functional, and quality of life characteristics of patients with COVID-19 and persistent COVID", which follows the modality of compilation of publications. Derived from the acute illness caused by COVID-19, a new condition with long-term effects, known as persistent COVID, has been described. This condition includes a wide variety of chronic health problems of indeterminate duration that affect all bodily organs and systems. However, although new data on clinical and epidemiological characteristics have been incorporated, the majority of these have been on hospitalized cohorts, so there is still a lack of scientific evidence addressing how these may influence the onset of different symptoms in the general population. It should be added that healthcare professionals have been one of the groups most affected by this health condition, and it is necessary to further analyze their clinical and epidemiological profile in-depth. Additionally, in terms of functionality, persistent COVID is having a significant impact on people's ability to carry out their daily activities and maintain an active lifestyle, experiencing physical limitations that are affecting their quality of life. With the aim of identifying the sociodemographic, clinical, epidemiological characteristics, functional status, and quality of life of the population infected with COVID-19 and the population with persistent COVID, two cross-sectional studies were carried out. One focused on the analysis of the clinical and epidemiological profile of the general population and primary care health personnel, as well as the factors that predict persistent COVID. The other study examined the functional status, level of physical activity, fatigue, and quality of life in patients with COVID-19 compared to those with persistent COVID.

Background:An interatrial communication is present in most neonates. The majority are considered the "normal" patency of the oval foramen, while a minority are abnormal atrial septal defects. Differentiation between the two with transthoracic echocardiography may be challenging, and no generally accepted method of classification is presently available. We aimed to develop and determine the reliability of a new classification of interatrial communications in newborns. Methods and Results:An algorithm was developed based on echocardiographic criteria from 495 newborns (median age 11[8;13] days, 51.5% females). The algorithm defines three main categories: patency of the oval foramen, atrial septal defect, and no interatrial communication as well as several subtypes. We found an interatrial communication in 414 (83.6%) newborns. Of these, 386 (93.2%) were categorised as patency of the oval foramen and 28 (6.8%) as atrial septal defects.Echocardiograms from another 50 newborns (median age 11[8;13] days, 36.0% female), reviewed by eight experts in paediatric echocardiography, were used to assess the inter- and intraobserver variation of classification of interatrial communications into patency of the oval foramen and atrial septal defect, with and without the use of the algorithm. Review with the algorithm gave a substantial interobserver agreement (kappa = 0.66), and an almost perfect intraobserver agreement (kappa = 0.82). Without the use of the algorithm, the interobserver agreement between experienced paediatric cardiologists was low (kappa = 0.20). Conclusion:A new algorithm for echocardiographic classification of interatrial communications in newborns produced almost perfect intraobserver and substantial interobserver agreement. The algorithm may prove useful in both research and clinical practice.

Background: Dupilumab is a monoclonal antibody against the IL-4/IL-13 receptor-subunit approved for the treatment of moderate-severe atopic dermatitis (AD). Some attempts to increase dose interval have been described in both trial and real-world settings. Objective: This study aimed to identify predictive clinical and demographic factors affecting patient selection for dose spacing or treatment withdrawal due to satisfactory response. Materials and methods: This retrospective study included adult patients with moderate-to-severe AD treated with dupilumab for at least 16 weeks. Descriptive statistics were performed to analyze demographic and clinical variables. Logistic regression models were used to identify predictor variables. Results: A total of 818 adult patients with moderate-to-severe AD was included in the study and 12% (97/818) of them performed dose spacing to 3–4 weeks or treatment withdrawal (8%, 67/818). The presence of non-cutaneous atopic manifestations (OR = 1.59, 95%CI = 1.06–2.38, p = 0.024), prurigo nodularis phenotype (OR = 4.5, 95%CI = 1.87–10.9, p = 0.001) and the age at treatment initiation (OR = 1.82, 95%CI = 1.12–2.94, p = 0.015) were confirmed as the strongest predictors of dose spacing or treatment withdrawal while maintaining dupilumab effectiveness. Conclusion: Our findings contribute to define the patient profile that could maintain the therapeutic response after dose spacing or treatment withdrawal.

Background: Patients (pts) affected with locally advanced rectal cancer (LARC) may respond differently to neoadjuvant chemoradiotherapy (nCRT). The identification of reliable biomarkers able to predict oncological outcomes could help in the development of risk-adapted treatment strategies. It has been suggested that inflammation parameters may have a role in predicting tumor response to nCRT and survival outcomes and in rectal cancer, but no definitive conclusion can be drawn at present. The aim of the current study is to evaluate the role of baseline inflammatory markers as prognostic and predictive factors in a large multicentric Italian cohort of LARC pts. Methods: Patients diagnosed with LARC from January 2002 to December 2019 in 9 Italian centers were retrospectively collected. Patients underwent long-course RT with chemotherapy based on fluoropyrimidine ± oxaliplatin followed by surgery. Inflammatory markers were retrieved based on a pre-treatment blood sample including HEI (hemo-eosinophils inflammation index), SII (systemic index of inflammation), NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) and MLR (monocyte-to-lymphocyte ratio). Outcomes of interest were pathological complete response (pCR), disease-free survival (DFS), and overall survival (OS). Results: 808 pts were analyzed. pCR rate was 22 %, 5yOS and 5yDFS were 84.0% and 63.1% respectively. Multivariate analysis identified that a NLR cut-off value >1.2 and SII cut-off value >500 could predict pCR (p = 0.05 and 0.009 respectively). In addition to age, extramesorectal nodes and RT dose, MLR >0.18 (p = 0.03) and HEI = 3 (p = 0.05) were independent prognostic factors for DFS. Finally, age, RT dose, MLR with a cut-off >0.35 (p = 0.028) and HEI = 3 (p = 0.045) were independent predictors of OS. Conclusions: Higher values of baseline composite inflammatory markers can serve a

Aim: Stereotactic ablative radiotherapy (SABR) showed increasing survival in oligometastatic patients. Few studies actually depicted oligometastatic disease (OMD) evolution and which patient will remain disease-free and which will rapidly develop a polymetastatic disease (PMD) after SABR. Therefore, apart from the number of active metastases, there are no clues on which proven factor should be considered for prescribing local treatment in OMD. The study aims to identify predictive factors of polymetastatic evolution in lung oligometastatic colorectal cancer patients. Methods: This international Ethical Committee approved trial (Prot. Negrar 2019-ZT) involved 23 Centers and 450 lung oligometastatic patients. Primary end-point was time to the polymetastatic conversion (tPMC). Additionally, oligometastases number and cumulative gross tumor volume (cumGTV) were used as combined predictive factors of tPMC. Oligometastases number was stratified as 1, 2-3, and 4-5; cumGTV was dichotomized to the value of 10 cc. Results: The median tPMC in the overall population was 26 months. Population was classified in the following tPMC risk classes: low-risk (1-3 oligometastases and cumGTV ≤ 10 cc) with median tPMC of 35.1 months; intermediate-risk (1-3 oligometastases and cumGTV > 10 cc), with median tPMC of 13.9 months, and high-risk (4-5 oligometastases, any cumGTV) with median tPMC of 9.4 months (p = 0.000). Conclusion: The present study identified predictive factors of polymetastatic evolution after SABR in lung oligometastatic colorectal cancer. The results demonstrated that the sole metastases number is not sufficient to define the OMD since patients defined oligometastatic from a numerical point of view might rapidly progress to PMD when the cumulative tumor volume is high. A tailored approach in SABR prescription should be pursued considering the expected disease evolution after SABR, with the aim to avoid unn

Background Exercise in the management of persistent whiplash often doesn't specifically address dizziness. This study aimed to determine cervical musculoskeletal and sensorimotor measures, quality of life and psychological factors associated with the presence of dizziness in individuals with persistent whiplash 12 months post exercise intervention commencement. Methods A retrospective cross sectional review of questionnaires on dizziness, physical and psychological disability, quality of life and physical measures prospectively collected from 172 individuals during a randomised controlled trial. Associations between dizziness at 12 months post intervention and possible predictors was analysed with simple and multiple logistic regression models. Results Sixty-three % reported dizziness with a mean University of California Los Angeles dizziness score of 9 (SD 5) and dizziness intensity during activity of 26 mm (SD 24). They had poorer performance on sharpened Rhomberg, Neck muscle endurance (NME), and range of motion, elevated scores on pain, Neck disability index (NDI) and psychological and quality of life measures compared to those without dizziness. Less improvement in NDI and NME flexion from baseline to 12 months post exercise commencement, along with some baseline covariates were related to persistent dizziness and explained 50% of the variance. Conclusion Dizziness following exercise at 12 months post follow-up was associated with lack of improvement in NDI and NME flexion suggesting a cervicogenic role. Alternatively, the presence of dizziness may inhibit exercise response. Additional causes or contributing factors of dizziness should be investigated in those with persistent whiplash to improve quality of life.

Background Exercise in the management of persistent whiplash often doesn't specifically address dizziness. This study aimed to determine cervical musculoskeletal and sensorimotor measures, quality of life and psychological factors associated with the presence of dizziness in individuals with persistent whiplash 12 months post exercise intervention commencement. Methods A retrospective cross sectional review of questionnaires on dizziness, physical and psychological disability, quality of life and physical measures prospectively collected from 172 individuals during a randomised controlled trial. Associations between dizziness at 12 months post intervention and possible predictors was analysed with simple and multiple logistic regression models. Results Sixty-three % reported dizziness with a mean University of California Los Angeles dizziness score of 9 (SD 5) and dizziness intensity during activity of 26 mm (SD 24). They had poorer performance on sharpened Rhomberg, Neck muscle endurance (NME), and range of motion, elevated scores on pain, Neck disability index (NDI) and psychological and quality of life measures compared to those without dizziness. Less improvement in NDI and NME flexion from baseline to 12 months post exercise commencement, along with some baseline covariates were related to persistent dizziness and explained 50% of the variance. Conclusion Dizziness following exercise at 12 months post follow-up was associated with lack of improvement in NDI and NME flexion suggesting a cervicogenic role. Alternatively, the presence of dizziness may inhibit exercise response. Additional causes or contributing factors of dizziness should be investigated in those with persistent whiplash to improve quality of life.

Background Exercise in the management of persistent whiplash often doesn't specifically address dizziness. This study aimed to determine cervical musculoskeletal and sensorimotor measures, quality of life and psychological factors associated with the presence of dizziness in individuals with persistent whiplash 12 months post exercise intervention commencement. Methods A retrospective cross sectional review of questionnaires on dizziness, physical and psychological disability, quality of life and physical measures prospectively collected from 172 individuals during a randomised controlled trial. Associations between dizziness at 12 months post intervention and possible predictors was analysed with simple and multiple logistic regression models. Results Sixty-three % reported dizziness with a mean University of California Los Angeles dizziness score of 9 (SD 5) and dizziness intensity during activity of 26 mm (SD 24). They had poorer performance on sharpened Rhomberg, Neck muscle endurance (NME), and range of motion, elevated scores on pain, Neck disability index (NDI) and psychological and quality of life measures compared to those without dizziness. Less improvement in NDI and NME flexion from baseline to 12 months post exercise commencement, along with some baseline covariates were related to persistent dizziness and explained 50% of the variance. Conclusion Dizziness following exercise at 12 months post follow-up was associated with lack of improvement in NDI and NME flexion suggesting a cervicogenic role. Alternatively, the presence of dizziness may inhibit exercise response. Additional causes or contributing factors of dizziness should be investigated in those with persistent whiplash to improve quality of life.

Background: Elevated levels of depressive symptoms among medical students have been the subject of international and national research before, yet associated risk factors and protective factors are to be determined. This study aims to show the burdens of depression at different stages of academic medical education with a special emphasis on correlated risk factors and protective factors. Methods: A total number of n=1103 medical students of a middle-sized German university were sampled and surveyed regarding depressive symptoms and correlating factors. The assessment of potential depressive symptoms was based on the BDI-II. Correlating factors were surveyed through a self-designed questionnaire consisting of possible cofactors for depressive symptoms based on established scientific literature. Results: Survey response rate was 90.2% (1103/1223). The prevalence of depressive symptoms was 11% for mild, 5.6% for moderate and 2.4% for severe symptoms. The sample's most prevalent risk factors were feeling unable to confide one's own worries to someone else (88%); and experiencing a lack of time for partner, friends and family (77%) or hobbies (76%). Significant predictors for depressive symptoms were neuroticism above all, insufficient emotional support, eating irregular meals, use of medication or drugs to calm down, and mental overload. Factors associated with less depressive symptoms could be identified as: spending time with partner, friends, family, hobbies and exercise; and confiding worries to classmates. Conclusions: Every fifth medical student surveyed reported at least mild depressive symptoms. The majority of the surveyed medical students felt unable to confide their worries to someone else and lamented not having enough time for social interaction with peers, family and hobbies. Certain personality traits - such as neuroticism - and insufficient emotional support showed to play important roles in making medical students more prone to developing depressive sym, Hintergrund: Erhöhte depressive Symptome bei Medizinstudierenden waren bereits weitgehender Gegenstand internationaler und nationaler Forschung, jedoch sind assoziierte Risikofaktoren und Schutzfaktoren bis dato ungenügend ermittelt worden. Ziel dieser Studie ist es, die Belastungen durch depressive Symptome in verschiedenen Stadien der akademischen medizinischen Ausbildung mit besonderem Schwerpunkt auf korrelierte Risikofaktoren und Schutzfaktoren aufzuzeigen.Methoden: Insgesamt wurden n=1103 Medizinstudierende einer mittelgroßen deutschen Universität in die Stichprobe aufgenommen und zu depressiven Symptomen und korrelierenden Faktoren befragt. Die Beurteilung möglicher depressiver Symptome erfolgte nach dem BDI-II. Korrelierende Faktoren wurden durch einen selbst entworfenen Fragebogen erhoben, welcher auf der Grundlage etablierter wissenschaftlicher Literatur mögliche Kofaktoren für depressive Symptome enthielt.Ergebnisse: Die Rücklaufquote der Umfrage betrug 90,2% (1103/1223). Die Prävalenz depressiver Symptome betrug 11% für leichte, 5,6% für mittelschwere und 2,4% für schwere Symptome. Die häufigsten Risikofaktoren der Stichprobe waren der Umstand, die eigenen Sorgen niemand anderem anvertrauen zu können (88%); und Mangel an Zeit für Partner, Freunde und Familie (77%) oder Hobbies (76%). Signifikante Prädiktoren für depressive Symptome waren vor allem Neurotizismus, als unzureichend erlebte emotionale Unterstützung, die Einnahme unregelmäßige Mahlzeiten, Einnahme von Medikamenten oder Drogen zur Selbstberuhigung und subjektives Überforderungserleben. Faktoren, die mit weniger depressiven Symptomen verbunden waren, konnten identifiziert werden als: Zeit mit (Ehe-)Partner, Freunden, Familie, Hobbys und Sport verbringen; und Kommilitonen eigene Sorgen anvertrauen.Schlussfolgerungen: Jeder fünfte befragte Medizinstudierende berichtete von mindestens leichten depressiven Symptomen. Die Mehrheit der befragten Medizinstudierenden fühlte sich nicht in der Lage, ihre

Pathological complete response (pCR) after neoadjuvant chemotherapy in patients with early breast cancer is correlated with better survival. Meanwhile, an expanding arsenal of post-neoadjuvant treatment strategies have proven beneficial in the absence of pCR, leading to an increased use of neoadjuvant systemic therapy in patients with early breast cancer and the search for predictive biomarkers of response. The better prediction of response to neoadjuvant chemotherapy could enable the escalation or de-escalation of neoadjuvant treatment strategies, with the ultimate goal of improving the clinical management of early breast cancer. Clinico-pathological prognostic factors are currently used to estimate the potential benefit of neoadjuvant systemic treatment but are not accurate enough to allow for personalized response prediction. Other factors have recently been proposed but are not yet implementable in daily clinical practice or remain of limited utility due to the intertumoral heterogeneity of breast cancer. In this review, we describe the current knowledge about predictive factors for response to neoadjuvant chemotherapy in breast cancer patients and highlight the future perspectives that could lead to the better prediction of response, focusing on the current biomarkers used for clinical decision making and the different gene signatures that have recently been proposed for patient stratification and the prediction of response to therapies. We also discuss the intratumoral phenotypic heterogeneity in breast cancers as well as the emerging techniques and relevant pre-clinical models that could integrate this biological factor currently limiting the reliable prediction of response to neoadjuvant systemic therapy.

Complete pathological response (pCR) is achieved in 10–20% of rectal cancers when treated with short-course radiotherapy (scRT) or long-course chemoradiotherapy (CRT) and in 28% with total neoadjuvant therapy (scRT/CRT + CTX). pCR is associated with better outcomes and a “watch-and-wait” strategy (W&W). The aim of this study was to identify baseline clinical or imaging factors predicting pCR. All patients with preoperative treatment and delays to surgery in Uppsala-Dalarna (n = 359) and Stockholm (n = 635) were included. Comparison of pCR versus non-pCR was performed with binary logistic regression models. Receiver operating characteristics (ROC) models for predicting pCR were built using factors with p < 0.10 in multivariate analyses. A pCR was achieved in 12% of the 994 patients (scRT 8% [33/435], CRT 13% [48/358], scRT/CRT + CTX 21% [43/201]). In univariate and multivariate analyses, choice of CRT (OR 2.62; 95%CI 1.34–5.14, scRT reference) or scRT/CRT + CTX (4.70; 2.23–9.93), cT1–2 (3.37; 1.30–8.78; cT4 reference), tumour length ≤ 3.5 cm (2.27; 1.24–4.18), and CEA ≤ 5 µg/L (1.73; 1.04–2.90) demonstrated significant associations with achievement of pCR. Age < 70 years, time from radiotherapy to surgery > 11 weeks, leucocytes ≤ 109/L, and thrombocytes ≤ 4009/L were significant only in univariate analyses. The associations were not fundamentally different between treatments. A model including T-stage, tumour length, CEA, and leucocytes (with scores of 0, 0.5, or 1 for each factor, maximum 4 points) showed an area under the curve (AUC) of 0.66 (95%CI 0.60–0.71) for all patients, and 0.65–0.73 for the three treatments separately. The choice of neoadjuvant treatment in combination with low CEA, short tumour length, low cT-stage, and normal leucocytes provide support in predicting pCR and, thus, could offer guidance for selecting patients for organ preservation. Simple Summary We studied real-world patients with locally advanced rectal ca

Background Exercise in the management of persistent whiplash often doesn't specifically address dizziness. This study aimed to determine cervical musculoskeletal and sensorimotor measures, quality of life and psychological factors associated with the presence of dizziness in individuals with persistent whiplash 12 months post exercise intervention commencement. Methods A retrospective cross sectional review of questionnaires on dizziness, physical and psychological disability, quality of life and physical measures prospectively collected from 172 individuals during a randomised controlled trial. Associations between dizziness at 12 months post intervention and possible predictors was analysed with simple and multiple logistic regression models. Results Sixty-three % reported dizziness with a mean University of California Los Angeles dizziness score of 9 (SD 5) and dizziness intensity during activity of 26 mm (SD 24). They had poorer performance on sharpened Rhomberg, Neck muscle endurance (NME), and range of motion, elevated scores on pain, Neck disability index (NDI) and psychological and quality of life measures compared to those without dizziness. Less improvement in NDI and NME flexion from baseline to 12 months post exercise commencement, along with some baseline covariates were related to persistent dizziness and explained 50% of the variance. Conclusion Dizziness following exercise at 12 months post follow-up was associated with lack of improvement in NDI and NME flexion suggesting a cervicogenic role. Alternatively, the presence of dizziness may inhibit exercise response. Additional causes or contributing factors of dizziness should be investigated in those with persistent whiplash to improve quality of life.

Complete pathological response (pCR) is achieved in 10–20% of rectal cancers when treated with short-course radiotherapy (scRT) or long-course chemoradiotherapy (CRT) and in 28% with total neoadjuvant therapy (scRT/CRT + CTX). pCR is associated with better outcomes and a “watch-and-wait” strategy (W&W). The aim of this study was to identify baseline clinical or imaging factors predicting pCR. All patients with preoperative treatment and delays to surgery in Uppsala-Dalarna (n = 359) and Stockholm (n = 635) were included. Comparison of pCR versus non-pCR was performed with binary logistic regression models. Receiver operating characteristics (ROC) models for predicting pCR were built using factors with p < 0.10 in multivariate analyses. A pCR was achieved in 12% of the 994 patients (scRT 8% [33/435], CRT 13% [48/358], scRT/CRT + CTX 21% [43/201]). In univariate and multivariate analyses, choice of CRT (OR 2.62; 95%CI 1.34–5.14, scRT reference) or scRT/CRT + CTX (4.70; 2.23–9.93), cT1–2 (3.37; 1.30–8.78; cT4 reference), tumour length ≤ 3.5 cm (2.27; 1.24–4.18), and CEA ≤ 5 µg/L (1.73; 1.04–2.90) demonstrated significant associations with achievement of pCR. Age < 70 years, time from radiotherapy to surgery > 11 weeks, leucocytes ≤ 109/L, and thrombocytes ≤ 4009/L were significant only in univariate analyses. The associations were not fundamentally different between treatments. A model including T-stage, tumour length, CEA, and leucocytes (with scores of 0, 0.5, or 1 for each factor, maximum 4 points) showed an area under the curve (AUC) of 0.66 (95%CI 0.60–0.71) for all patients, and 0.65–0.73 for the three treatments separately. The choice of neoadjuvant treatment in combination with low CEA, short tumour length, low cT-stage, and normal leucocytes provide support in predicting pCR and, thus, could offer guidance for selecting patients for organ preservation. Simple Summary We studied real-world patients with locally advanced rectal ca

Complete pathological response (pCR) is achieved in 10–20% of rectal cancers when treated with short-course radiotherapy (scRT) or long-course chemoradiotherapy (CRT) and in 28% with total neoadjuvant therapy (scRT/CRT + CTX). pCR is associated with better outcomes and a “watch-and-wait” strategy (W&W). The aim of this study was to identify baseline clinical or imaging factors predicting pCR. All patients with preoperative treatment and delays to surgery in Uppsala-Dalarna (n = 359) and Stockholm (n = 635) were included. Comparison of pCR versus non-pCR was performed with binary logistic regression models. Receiver operating characteristics (ROC) models for predicting pCR were built using factors with p < 0.10 in multivariate analyses. A pCR was achieved in 12% of the 994 patients (scRT 8% [33/435], CRT 13% [48/358], scRT/CRT + CTX 21% [43/201]). In univariate and multivariate analyses, choice of CRT (OR 2.62; 95%CI 1.34–5.14, scRT reference) or scRT/CRT + CTX (4.70; 2.23–9.93), cT1–2 (3.37; 1.30–8.78; cT4 reference), tumour length ≤ 3.5 cm (2.27; 1.24–4.18), and CEA ≤ 5 µg/L (1.73; 1.04–2.90) demonstrated significant associations with achievement of pCR. Age < 70 years, time from radiotherapy to surgery > 11 weeks, leucocytes ≤ 109/L, and thrombocytes ≤ 4009/L were significant only in univariate analyses. The associations were not fundamentally different between treatments. A model including T-stage, tumour length, CEA, and leucocytes (with scores of 0, 0.5, or 1 for each factor, maximum 4 points) showed an area under the curve (AUC) of 0.66 (95%CI 0.60–0.71) for all patients, and 0.65–0.73 for the three treatments separately. The choice of neoadjuvant treatment in combination with low CEA, short tumour length, low cT-stage, and normal leucocytes provide support in predicting pCR and, thus, could offer guidance for selecting patients for organ preservation. Simple Summary We studied real-world patients with locally advanced rectal ca

Complete pathological response (pCR) is achieved in 10–20% of rectal cancers when treated with short-course radiotherapy (scRT) or long-course chemoradiotherapy (CRT) and in 28% with total neoadjuvant therapy (scRT/CRT + CTX). pCR is associated with better outcomes and a “watch-and-wait” strategy (W&W). The aim of this study was to identify baseline clinical or imaging factors predicting pCR. All patients with preoperative treatment and delays to surgery in Uppsala-Dalarna (n = 359) and Stockholm (n = 635) were included. Comparison of pCR versus non-pCR was performed with binary logistic regression models. Receiver operating characteristics (ROC) models for predicting pCR were built using factors with p < 0.10 in multivariate analyses. A pCR was achieved in 12% of the 994 patients (scRT 8% [33/435], CRT 13% [48/358], scRT/CRT + CTX 21% [43/201]). In univariate and multivariate analyses, choice of CRT (OR 2.62; 95%CI 1.34–5.14, scRT reference) or scRT/CRT + CTX (4.70; 2.23–9.93), cT1–2 (3.37; 1.30–8.78; cT4 reference), tumour length ≤ 3.5 cm (2.27; 1.24–4.18), and CEA ≤ 5 µg/L (1.73; 1.04–2.90) demonstrated significant associations with achievement of pCR. Age < 70 years, time from radiotherapy to surgery > 11 weeks, leucocytes ≤ 109/L, and thrombocytes ≤ 4009/L were significant only in univariate analyses. The associations were not fundamentally different between treatments. A model including T-stage, tumour length, CEA, and leucocytes (with scores of 0, 0.5, or 1 for each factor, maximum 4 points) showed an area under the curve (AUC) of 0.66 (95%CI 0.60–0.71) for all patients, and 0.65–0.73 for the three treatments separately. The choice of neoadjuvant treatment in combination with low CEA, short tumour length, low cT-stage, and normal leucocytes provide support in predicting pCR and, thus, could offer guidance for selecting patients for organ preservation. Simple Summary We studied real-world patients with locally advanced rectal ca

Ustekinumab has shown efficacy in Crohn’s Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients’ data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index ≤ 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission..

Ustekinumab has shown efficacy in Crohn’s Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients’ data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index ≤ 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission..

Complete pathological response (pCR) is achieved in 10–20% of rectal cancers when treated with short-course radiotherapy (scRT) or long-course chemoradiotherapy (CRT) and in 28% with total neoadjuvant therapy (scRT/CRT + CTX). pCR is associated with better outcomes and a “watch-and-wait” strategy (W&W). The aim of this study was to identify baseline clinical or imaging factors predicting pCR. All patients with preoperative treatment and delays to surgery in Uppsala-Dalarna (n = 359) and Stockholm (n = 635) were included. Comparison of pCR versus non-pCR was performed with binary logistic regression models. Receiver operating characteristics (ROC) models for predicting pCR were built using factors with p < 0.10 in multivariate analyses. A pCR was achieved in 12% of the 994 patients (scRT 8% [33/435], CRT 13% [48/358], scRT/CRT + CTX 21% [43/201]). In univariate and multivariate analyses, choice of CRT (OR 2.62; 95%CI 1.34–5.14, scRT reference) or scRT/CRT + CTX (4.70; 2.23–9.93), cT1–2 (3.37; 1.30–8.78; cT4 reference), tumour length ≤ 3.5 cm (2.27; 1.24–4.18), and CEA ≤ 5 µg/L (1.73; 1.04–2.90) demonstrated significant associations with achievement of pCR. Age < 70 years, time from radiotherapy to surgery > 11 weeks, leucocytes ≤ 109/L, and thrombocytes ≤ 4009/L were significant only in univariate analyses. The associations were not fundamentally different between treatments. A model including T-stage, tumour length, CEA, and leucocytes (with scores of 0, 0.5, or 1 for each factor, maximum 4 points) showed an area under the curve (AUC) of 0.66 (95%CI 0.60–0.71) for all patients, and 0.65–0.73 for the three treatments separately. The choice of neoadjuvant treatment in combination with low CEA, short tumour length, low cT-stage, and normal leucocytes provide support in predicting pCR and, thus, could offer guidance for selecting patients for organ preservation. Simple Summary We studied real-world patients with locally advanced rectal ca

This file contains the genealogy of French Canadian individuals married in Quebec between the beginning of European settlement in the early 17th century and 1960 was compiled in the BALSAC database. (N = 4,364,381 individuals, as of March 2015, http://balsac.uqac.ca) - ‘individual’: recoded individual number ; - ‘father’: recoded father's number; - ‘mother’: recoded mother's number; - ‘sex’: individual sexe; - ‘immigrant’: logical value (true ou false) specifying if the individual is an immigrant (the first of his uniparental lineage to have married in Quebec); - ‘founder’: a logical value (true or false) specifying if the individual is a founder (the first of his uniparental lineage); - ‘married’: a logical value (true or false) specifying whether the individual is married; - ‘maternal_lineage’: the maternal lineage number of the individual if it is a woman; - 'paternal_lineage’: the paternal lineage number of the individual if it is a man; - ‘wedding_year’: the year of the individual's first marriage (deduced from a data frame containing all marriages, sorted by couple); - ‘wedding_parish’: URB of the individual's first marriage (deduced from a data frame that contained all marriages, sorted by couple); - ‘estimated_wedding_year’: year of marriage estimated for individuals who do not have one (20 years minus the year of marriage of the couple's first child); - ‘number_married_children’: number of the individual's children who have married; - ‘number_married_children_Quebec’: number of the individual's children who were married in Quebec; - ‘number_married_sons’ : number of sons of the individual who got married; - ’number_married_daughters’: number of daughters of the individual who got married; - ‘number_married_sons_Quebec’: number of the individual's sons who married in Quebec; - ‘number_married_daughters_Quebec’: number of the individual's daughters who married in Quebec; - ‘maternal_lineage_in

Background Exercise in the management of persistent whiplash often doesn't specifically address dizziness. This study aimed to determine cervical musculoskeletal and sensorimotor measures, quality of life and psychological factors associated with the presence of dizziness in individuals with persistent whiplash 12 months post exercise intervention commencement. Methods A retrospective cross sectional review of questionnaires on dizziness, physical and psychological disability, quality of life and physical measures prospectively collected from 172 individuals during a randomised controlled trial. Associations between dizziness at 12 months post intervention and possible predictors was analysed with simple and multiple logistic regression models. Results Sixty-three % reported dizziness with a mean University of California Los Angeles dizziness score of 9 (SD 5) and dizziness intensity during activity of 26 mm (SD 24). They had poorer performance on sharpened Rhomberg, Neck muscle endurance (NME), and range of motion, elevated scores on pain, Neck disability index (NDI) and psychological and quality of life measures compared to those without dizziness. Less improvement in NDI and NME flexion from baseline to 12 months post exercise commencement, along with some baseline covariates were related to persistent dizziness and explained 50% of the variance. Conclusion Dizziness following exercise at 12 months post follow-up was associated with lack of improvement in NDI and NME flexion suggesting a cervicogenic role. Alternatively, the presence of dizziness may inhibit exercise response. Additional causes or contributing factors of dizziness should be investigated in those with persistent whiplash to improve quality of life.

Introducció: Els carcinomes escamosos de cap i coll (CECC) són tumors que es diagnostiquen freqüentment en una fase localment avançada, fet que condiciona un modest pronòstic. Tot i el maneig multidisciplinari, presenten una supervivència global (SG) menor a 40% als 5 anys, deguda a 50-60% de recurrències locals i 20-30% de metàstasi a distància als 2 anys. Per tot això, hi ha una necessitat de detectar biomarcadors que ens ajudin a seleccionar la millor modalitat terapèutica per a cada pacient i a desenvolupar noves estratègies que reverteixin les resistències als tractaments convencionals. Objectius: Amb la hipòtesi que els nivells d'expressió de gens implicats en les vies de reparació de l'ADN i l'activació de la via de l'transductor de senyal i activador de la transcripció 3 (STAT3) poden jugar un paper pronòstic i predictiu de resposta a diferents tractaments de CECC, avaluem la correlació dels primers amb l'eficàcia a l'quimioradioteràpia (QRT) amb platí i de la segona amb la de la combinació de paclitaxel i cetuximab. Material i mètodes: Per avaluar el primer objectiu, vam determinar els nivells d'expressió d'ARNm dels gens BRCA1, RAP80, proteïna 1 de unió a p53 (53BP1), mediador del punt de control de el dany de l'ADN 1 (MDC1) i RNF8, tots ells relacionats amb la reparació de l'ADN, i els correlacionem amb la resposta i la SG en 72 pacients amb CECC localment avançat (CECC-LA) tractats amb carboplatí setmanal AUC 2 i radioteràpia (RT). Per avaluar el segon objectiu, analitzem retrospectivament les mostres tumorals disponibles de 52 pacients d'una sèrie amb CECC recurrent / metastàsic (CECC R / M) tractats amb paclitaxel i cetuximab entre 2008 i 2017, i vam determinar els nivells transcripcionals de STAT3, l'expressió de STAT3 fosforilat (pSTAT3) i la hipermetilació de promotor del gen de la fosfatasa T de proteïna tirosina de tipus receptor (PTPRT). Resultats: A la primera sèrie, la resposta completa (RC) a la QRT va ser significativament superior en els pac, Introducción: Los carcinomas escamosos de cabeza y cuello (CECC) son tumores que se diagnostican frecuentemente en una fase localmente avanzada, hecho que condiciona un modesto pronóstico. A pesar del manejo multidisciplinar, presentan una supervivencia global (SG) menor al 40% a los 5 años, debida a un 50-60 % de recurrencias locales y un 20-30% de metástasis a distancia a los 2 años. Por todo esto, existe una necesidad de detectar biomarcadores que nos ayuden a seleccionar la mejor modalidad terapéutica para cada paciente y a desarrollar nuevas estrategias que reviertan las resistencias a los tratamientos convencionales. Objetivos: Con la hipótesis de que los niveles de expresión de genes implicados en las vías de reparación del ADN y la activación de la vía del transductor de señal y activador de la transcripción 3 (STAT3) pueden jugar un papel pronóstico y predictivo de respuesta a diferentes tratamientos del CECC, evaluamos la correlación de los primeros con la eficacia a la quimiorradioterapia (QRT) con platino y de la segunda con la de la combinación de paclitaxel y cetuximab. Material y métodos: Para evaluar el primer objetivo, determinamos los niveles de expresión de ARNm de los genes BRCA1, RAP80, proteína 1 de unión a p53 (53BP1), mediador del punto de control del daño del ADN 1 (MDC1) y RNF8, todos ellos relacionados con la reparación del ADN, y los correlacionamos con la respuesta y la SG en 72 pacientes con CECC localmente avanzado (CECC-LA) tratados con carboplatino semanal AUC 2 y radioterapia (RT). Para evaluar el segundo objetivo, analizamos retrospectivamente las muestras tumorales disponibles de 52 pacientes de una serie con CECC recurrente/metastásico (CECC R/M) tratados con paclitaxel y cetuximab entre 2008 y 2017, y determinamos los niveles transcripcionales de STAT3, la expresión de STAT3 fosforilado (pSTAT3) y la hipermetilación del promotor del gen de la fosfatasa T de proteína tirosina de tipo receptor (PTPRT). Resultados: En la primera se, Background: Head and neck squamous cell carcinomas (HNSCC) are tumors that are frequently diagnosed in a locally advanced phase, a fact that determines a bad prognosis. Despite multidisciplinary management, they have a 5-year overall survival (OS) of less than 40%, due to 50-60% local recurrences and 20-30% 2-year distant metastases. For this reason, there is a need to detect biomarkers that help us to select the best therapeutic modality for each patient and develop new strategies to reverse resistance to conventional treatments. Objectives: With the hypothesis that the expression levels of genes involved in DNA repair pathways and the activation of the signal transducer and activator of transcription 3 (STAT3) pathway may play a prognostic and predictive role in response to different HNSCC treatments, we evaluated the correlation of the first ones with the efficacy of chemoradiotherapy (CRT) with platinum and of the second ones with that of the combination of paclitaxel and cetuximab. Material and methods: To evaluate the first endpoint, we determined the mRNA expression levels of the genes BRCA1, RAP80, p53-binding protein 1 (53BP1), mediator of DNA damage checkpoint 1 (MDC1) and RNF8, all of them related to DNA repair and correlated them with response and OS in 72 patients with locally advanced HNSCC (LA-HNSCC) treated with weekly AUC 2 carboplatin and radiotherapy (RT). To evaluate the second endpoint, we retrospectively analyzed the available tumor samples from 52 patients from a series with recurrent / metastatic HNSCC (R / M HNSCC) treated with paclitaxel and cetuximab between 2008 and 2017, and we determined the transcriptional levels of STAT3, the expression of phosphorylated STAT3 (pSTAT3), and the hypermethylation of the receptor-type tyrosine-protein phosphatase T (PTPRT) promoter. Results: In the first series, the complete response (CR) to CRT was significantly higher in patients who had tumors with low levels of 53BP1 compared to those with tumors wit, Universitat Autònoma de Barcelona. Programa de Doctorat en Medicina

Purpose. To investigate the potential predictive factors of the visual change achieved with accelerated epi-on and epi-off corneal collagen crosslinking (CXL) in keratoconus. Methods. This retrospective comparative study analyzed 67 eyes treated with an accelerated epithelium-on (epi-on group) and epithelium-off (epi-off group) CXL. The clinical outcomes were evaluated and compared during a 1-year follow-up. Likewise, the relationship of the change achieved with both CXL techniques in the corrected distance visual acuity (CDVA) with different preoperative data was investigated. Results. The mean CDVA change at 3 months postoperatively was −0.04 ± 0.19 and −0.07 ± 0.25 in the epi-on and epi-off groups, respectively (p = 0.809). In the epi-on group, this change was significantly correlated with the preoperative apical (r = −0.375, p = 0.045) and central corneal thickness (r = −0.402, p = 0.031). In the epi-off group, the CDVA change was significantly correlated with not only the preoperative apical (r = 0.402, p = 0.028) and central corneal thickness (r = 0.367, p = 0.046) but also with some topometric and aberrometric indices (r ≤ −0.374, p ≤ 0.042). Furthermore, the change in CDVA in the epi-on group could be predicted from age, preoperative refractive astigmatism J45 component, anterior corneal asphericity, and posterior corneal high order aberration root mean square (p = 0.002, R2 = 0.503). In the epi-off group, the CDVA change could be predicted from the preoperative minimum corneal thickness and magnitude of the vertical anterior corneal primary coma component (p = 0.001, R2 = 0.446). Conclusions. Clearly, different predictive factors of the visual change induced with the accelerated epi-on and epi-off CXL techniques are present, suggesting a different mechanism of action for stiffening the cornea and inducing changes in this structure.

The ultimate goal of stereotactic radiotherapy (SRT) of brain metastases (BM) is to avoid or postpone whole brain radiotherapy (WBRT). A nomogram based on multi-institutional data was developed by Gorovets, et al. to estimate the 6 and 12-months WBRT-free survival (WFS). The aim of the current retrospective study was to validate the nomogram in a cohort of postoperative BM patients treated with adjuvant SRT. We reviewed the data of 68 patients treated between 2008-2017 with postoperative SRT for BM. The primary endpoint was the WFS. The receiver operating characteristic curve and area under the curve (AUC) were calculated for both 6- and 12-months time points. After a median follow-up of 64 months, the 1-year cumulative incidence of local and distant brain relapse rates were 15% [95% CI=8-26%] and 34% [95% CI=24-48%], respectively. At recurrence, repeated SRT or salvage WBRT were applied in 33% and 57% cases, respectively. The WFS rates at 6 and 12 months were 88% [95% CI=81-97%] and 67% [95% CI=56-81%], respectively. Using the Gorovets nomogram, the 6 months rates were overestimated while they were accurate at 12 months. AUC values were 0.47 and 0.62 for the 6- and 12-months respectively. Overall, Harrell's concordance index was 0.54. This nomogram-predicted well the 12 months WFS but its discriminative power was quite low. This underlines the limits of this kind of predictive tool and leads us to consider the use of big data analysis in the future.

BACKGROUND: Prior antibiotic therapy (pATB) is known to impair efficacy of single-agent immune checkpoint inhibitors (ICIs), potentially through the induction of gut dysbiosis. Whether ATB also affects outcomes to chemo-immunotherapy combinations is still unknown. PATIENTS AND METHODS: In this international multicentre study, we evaluated the association between pATB, concurrent ATB (cATB) and overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) in patients with non-small-cell lung cancer (NSCLC) treated with first-line chemo-immunotherapy at eight referral institutions. RESULTS: Among 302 patients with stage IV NSCLC, 216 (71.5%) and 61 (20.2%) patients were former and current smokers, respectively. Programmed death-ligand 1 tumour expression in assessable patients (274, 90.7%) was ≥50% in 76 (25.2%), 1%-49% in 84 (27.9%) and <1% in 113 (37.5%). Multivariable analysis showed pATB-exposed patients to have similar OS {hazard ratio (HR) = 1.42 [95% confidence interval (CI): 0.91-2.22]; P = 0.1207} and PFS [HR = 1.12 (95% CI: 0.76-1.63); P = 0.5552], compared to unexposed patients, regardless of performance status. Similarly, no difference with respect to ORR was found across pATB exposure groups (42.6% versus 57.4%, P = 0.1794). No differential effect was found depending on pATB exposure duration (≥7 versus <7 days) and route of administration (intravenous versus oral). Similarly, cATB was not associated with OS [HR = 1.29 (95% CI: 0.91-1.84); P = 0.149] and PFS [HR = 1.20 (95% CI: 0.89-1.63); P = 0.222] when evaluated as time-varying covariate in multivariable analysis. CONCLUSIONS: In contrast to what has been reported in patients receiving single-agent ICIs, pATB does not impair clinical outcomes to first-line chemo-immunotherapy of patients with NSCLC. pATB status should integrate currently available clinico-pathologic factors for guiding first-line treatment decisions, whilst there should be no concern in offering cATB during c

Background : Appendectomy can be challenging and occasionally converted to extensive resection for complicated appendicitis. However, optimal treatment strategies can be developed using preoperative risk assessment. Thus, we aimed to investigate the preoperative predictors of extensive resection in complicated appendicitis patients undergoing surgery. Materials and methods : In total, 173 complicated appendicitis patients undergoing surgery between 2014 and 2019 were classified into the appendectomy (n = 153) or extensive resection (n = 20) groups. Clinicopathological factors and surgical outcomes were compared between groups. Results : Extensive resection was performed in 20 of 173 complicated appendicitis patients (11.5%). The rates of having defects in the wall structure at the appendix root on computed tomography images were significantly higher, and the duration from onset to surgery was significantly longer in the extensive resection group. Significant differences were found in operative duration, blood loss and postoperative hospitalization, but none in the incidence of postoperative complications between groups. Multivariate analyses showed that defects in the wall structure at the appendix root and five days or longer from onset were identified as independent predictors of extensive resection. Conclusions : Defects in the wall structure at the appendix root and five days or longer from onset predict extensive resection performance in complicated appendicitis patients.

The teaching of entrepreneurship is of vital importance for the socio-economic development of nations, especially due to its impact on the students’ entrepreneurial intention. This study analyzes the factors driving the interest in this subject in university students who take entrepreneurship courses. Through a binary logistic regression model applied to 85 students from a Chilean state university, it was revealed that the favorable attitude towards the teaching of entrepreneurship and the student’s self-confidence have a positive and significant impact on their entrepreneurial intention. It was also determined that the chosen career and work experience are relevant predictors. It is concluded that the interest of students to undertake entrepreneurship increases when they perceive that the teaching of this topic is useful for their training as an entrepreneur, and when they have the deep conviction that they are capable of undertaking entrepreneurship. There is also a greater chance that the student will undertake entrepreneurship if they have work experience and are pursuing entrepreneurial studies. The results are expected to contribute to a deeper understanding of the factors that lead university students to undertake entrepreneurship, which evidences the importance of developing plans of studies that enhance student confidence and a favorable attitude towards learning entrepreneurship., O ensino do empreendedorismo é de vital importância para o desenvolvimento socioeconômico das nações, principalmente pelo seu impacto na intenção de empreender dos alunos. A presente pesquisa analisa os impulsionadores da intenção empreendedora em estudantes universitários que fazem cursos de empreendedorismo. Mediante um padrão de regressão logística binária aplicado a 85 alunos de uma universidade pública chilena, foi possível perceber que a atitude favorável ao ensino do empreendedorismo e a autoconfiança do aluno têm um impacto positivo e significativo na intenção de empreender. Também foi determinado que o curso escolhido e a experiência de trabalho são preditores relevantes. Conclui-se que a intenção empreendedora do aluno se acrescenta quando percebe que o ensino do empreendedorismo é útil para a sua formação como empreendedor, bem como quando tem a convicção íntima de que é capaz de empreender. Aliás, existe uma probabilidade maior de o aluno se candidatar caso tenha experiência profissional e esteja se formando em um curso empreendedor. Espera-se que os resultados contribuam para uma compreensão mais aprofundada dos fatores que levam os universitários a empreender, evidenciando a importância do desenvolvimento de programas de estudos que acrescentem a confiança dos alunos e uma atitude favorável ao ensino do empreendedorismo., La enseñanza del emprendimiento es de vital importancia para el desarrollo socioeconómico de las naciones, especialmente por su incidencia en la intención de emprender del alumnado. El presente estudio analiza los factores impulsores de la intención emprendedora en estudiantes universitarios que cursan asignaturas de emprendimiento. A través de un modelo de regresión logística binaria aplicado a 85 estudiantes de una universidad pública de Chile se develó que la actitud favorable hacia la enseñanza del emprendimiento y la autoconfianza del discente inciden de manera positiva y significativa en la intención de emprender. También se determinó que la carrera elegida y la experiencia laboral constituyen predictores relevantes. Se concluye que la intención emprendedora del estudiante aumenta cuando percibe que la enseñanza del emprendimiento es útil para su formación como emprendedor y cuando tiene el convencimiento íntimo de que es capaz de emprender. Por lo demás, existe mayor probabilidad de que el estudiante emprenda si posee experiencia laboral y cursa una carrera de perfil emprendedor. Se espera que los resultados aporten a una comprensión más profunda sobre los factores que llevan a los alumnos universitarios a emprender, evidenciándose así la importancia de desarrollar programas de estudio que potencien la confianza del estudiantado y una actitud favorable hacia la enseñanza del emprendimiento.

The teaching of entrepreneurship is of vital importance for the socio-economic development of nations, especially due to its impact on the students’ entrepreneurial intention. This study analyzes the factors driving the interest in this subject in university students who take entrepreneurship courses. Through a binary logistic regression model applied to 85 students from a Chilean state university, it was revealed that the favorable attitude towards the teaching of entrepreneurship and the student’s self-confidence have a positive and significant impact on their entrepreneurial intention. It was also determined that the chosen career and work experience are relevant predictors. It is concluded that the interest of students to undertake entrepreneurship increases when they perceive that the teaching of this topic is useful for their training as an entrepreneur, and when they have the deep conviction that they are capable of undertaking entrepreneurship. There is also a greater chance that the student will undertake entrepreneurship if they have work experience and are pursuing entrepreneurial studies. The results are expected to contribute to a deeper understanding of the factors that lead university students to undertake entrepreneurship, which evidences the importance of developing plans of studies that enhance student confidence and a favorable attitude towards learning entrepreneurship., O ensino do empreendedorismo é de vital importância para o desenvolvimento socioeconômico das nações, principalmente pelo seu impacto na intenção de empreender dos alunos. A presente pesquisa analisa os impulsionadores da intenção empreendedora em estudantes universitários que fazem cursos de empreendedorismo. Mediante um padrão de regressão logística binária aplicado a 85 alunos de uma universidade pública chilena, foi possível perceber que a atitude favorável ao ensino do empreendedorismo e a autoconfiança do aluno têm um impacto positivo e significativo na intenção de empreender. Também foi determinado que o curso escolhido e a experiência de trabalho são preditores relevantes. Conclui-se que a intenção empreendedora do aluno se acrescenta quando percebe que o ensino do empreendedorismo é útil para a sua formação como empreendedor, bem como quando tem a convicção íntima de que é capaz de empreender. Aliás, existe uma probabilidade maior de o aluno se candidatar caso tenha experiência profissional e esteja se formando em um curso empreendedor. Espera-se que os resultados contribuam para uma compreensão mais aprofundada dos fatores que levam os universitários a empreender, evidenciando a importância do desenvolvimento de programas de estudos que acrescentem a confiança dos alunos e uma atitude favorável ao ensino do empreendedorismo., La enseñanza del emprendimiento es de vital importancia para el desarrollo socioeconómico de las naciones, especialmente por su incidencia en la intención de emprender del alumnado. El presente estudio analiza los factores impulsores de la intención emprendedora en estudiantes universitarios que cursan asignaturas de emprendimiento. A través de un modelo de regresión logística binaria aplicado a 85 estudiantes de una universidad pública de Chile se develó que la actitud favorable hacia la enseñanza del emprendimiento y la autoconfianza del discente inciden de manera positiva y significativa en la intención de emprender. También se determinó que la carrera elegida y la experiencia laboral constituyen predictores relevantes. Se concluye que la intención emprendedora del estudiante aumenta cuando percibe que la enseñanza del emprendimiento es útil para su formación como emprendedor y cuando tiene el convencimiento íntimo de que es capaz de emprender. Por lo demás, existe mayor probabilidad de que el estudiante emprenda si posee experiencia laboral y cursa una carrera de perfil emprendedor. Se espera que los resultados aporten a una comprensión más profunda sobre los factores que llevan a los alumnos universitarios a emprender, evidenciándose así la importancia de desarrollar programas de estudio que potencien la confianza del estudiantado y una actitud favorable hacia la enseñanza del emprendimiento.

Introduction: Pre-eclampsia is a progressive, multisystemic condition characterized by an abnormal vascular response with increased systemic vascular re- sistance, endothelial dysfunction and platelet aggregation. Objective: To assess predictive factors of vascular reactivity in women with hypertensive disorder of pregnancy. Method: An analytical observational study was carried out with 80 pregnant women, selected from a study’s population of 203, with a diagnosis of hypertensive disorder in the 34 th week of pregnancy at the Hospital Universitario Ana Betancourt de Mora from Camagüey province, Cuba, between March 2018 to March 2019. Results: Out of the 80 obstetric patients studied in a one-year period, 27 were hyperreactive (33.7%) and more than half were normoreactive (66.3%). The ROC curve threshold value of 0.503 produced a 29.8% of false positives and an 84.2% of true positives. Conclusions: More than half of the obstetric patients were diagnosed as normoreactive and one third had cardiovascular hyperreactivity. A positive result of the sustained weight test, cardiovascular reactivity index of blood pressure, P wave dispersion and the presence of chronic high blood pressure, pre-eclampsia, overweight and gestational diabetes were predictive factors of this cardiovascular hyperreactivity., Introducción: La preeclampsia es una afección multisistémica progresiva que se caracteriza por una respuesta vascular anormal con aumento de la resistencia vascular sistémica, disfunción endotelial y agregación plaquetaria. Objetivo: Evaluar los factores predictivos de reactividad vascular en mujeres con trastorno hipertensivo del embarazo. Método: Se realizó un estudio observacional analítico con 80 embarazas, seleccionadas de un universo de 203, con diagnóstico de trastorno hipertensivo en la semana 34 de gestación, en el Hospital Universitario Ana Betancourt de Mora de la provincia de Camagüey, Cuba, entre marzo de 2018 y marzo de 2019. Resultados: De las 80 pacientes obstétricas estudiadas en el período de un año, 27 resultaron hiperreactivas (33,7%) y más de la mitad normorreactivas (66,3%). El valor del umbral de la curva ROC de 0,503 produjo un 29,8% de falsos positivos y un 84,2% de verdaderos positivos. Conclusiones: Más de la mitad de las pacientes obstétricas se diagnosticaron como normoreactivas y la tercera parte tuvo hiperreactividad cardiovascular. La prueba de peso sostenido positiva, el índice de reactividad cardiovascular de la presión arterial, la dispersión de la onda P y la presencia de hipertensión arterial crónica, preeclampsia, sobrepeso y diabetes gestacional constituyeron factores predictivos de esta hiperreactividad cardiovascular.

Language delay (LD) and its relationship with later language impairment in preterm children is a topic of major concern. Previous studies comparing LD in preterm (PT) and full-term (FT) children were mainly carried out with samples of extremely preterm and very preterm children (sometimes with additional medical problems). Very few of them were longitudinal studies, which is essential to understand developmental relationships between LD and later language impairment. In this study, we compare the prevalence of LD in low-risk preterm children to that of FT children in a longitudinal design ranging from 10 to 60 months of age. We also analyze which variables are related to a higher risk of LD at 22, 30 and 60 months of age. Different language tests were administered to three groups of preterm children of different gestational ages and to one group of full-term children from the ages of 10 to 60 months. ANOVA comparisons between groups and logistic regression analyses to identify possible predictors of language delay at 22, 30 and 60 months of age were performed. The results found indicate that there were practically no differences between gestational age groups. Healthy PT children, therefore, do not have, in general terms, a higher risk of language delay than FT children. Previous language delay and cognitive delay are the strongest and longest-lasting predictors of later language impairment. Other factors, such as a scarce use of gestures at 10 months or male gender, affect early LD at 22 months of age, although their effect disappears as children grow older. Low maternal education appears to have a late effect. Gestational age does not have any significant effect on the appearance of LD

Purpose. To investigate the potential predictive factors of the visual change achieved with accelerated epi-on and epi-off corneal collagen crosslinking (CXL) in keratoconus. Methods. This retrospective comparative study analyzed 67 eyes treated with an accelerated epithelium-on (epi-on group) and epithelium-off (epi-off group) CXL. The clinical outcomes were evaluated and compared during a 1-year follow-up. Likewise, the relationship of the change achieved with both CXL techniques in the corrected distance visual acuity (CDVA) with different preoperative data was investigated. Results. The mean CDVA change at 3 months postoperatively was −0.04 ± 0.19 and −0.07 ± 0.25 in the epi-on and epi-off groups, respectively (p = 0.809). In the epi-on group, this change was significantly correlated with the preoperative apical (r = −0.375, p = 0.045) and central corneal thickness (r = −0.402, p = 0.031). In the epi-off group, the CDVA change was significantly correlated with not only the preoperative apical (r = 0.402, p = 0.028) and central corneal thickness (r = 0.367, p = 0.046) but also with some topometric and aberrometric indices (r ≤ −0.374, p ≤ 0.042). Furthermore, the change in CDVA in the epi-on group could be predicted from age, preoperative refractive astigmatism J45 component, anterior corneal asphericity, and posterior corneal high order aberration root mean square (p = 0.002, R2 = 0.503). In the epi-off group, the CDVA change could be predicted from the preoperative minimum corneal thickness and magnitude of the vertical anterior corneal primary coma component (p = 0.001, R2 = 0.446). Conclusions. Clearly, different predictive factors of the visual change induced with the accelerated epi-on and epi-off CXL techniques are present, suggesting a different mechanism of action for stiffening the cornea and inducing changes in this structure.

Objectives: To identify predictive factors associated with limb volume reduction using different decongestive lymphatic therapy (DLT) systems in patients with lymphoedema, over a period of up to 28 days. Methods: A multicountry (Canada, France, Germany, the United Kingdom) prospective cohort study using (DLT): skin care, exercise, compression bandaging, and manual lymphatic drainage for up to 4 weeks. Reduction in limb volume comparing DLT with (1) standard multilayer bandaging with inelastic material, and with (2) multilayer bandaging with Coban2, together with the identification of factors associated with limb volume changes. Results: Out of 264 patients with upper or lower limb lymphedema, 133 used Coban2 and 131 used standard care. Following DLT, mean limb volume reduction was 941 mL using Coban2 compared with 814 mL using standard care. A difference of 127 mL was found (95% confidence interval -275 to 529 mL, p = 0.53). Of the 176 patients with leg swelling, 166 (94.3%) had a limb volume measurement after 28 days and were included in the risk factor analysis. Of these, 132 (79.5%) were female, with overall mean age of 60.1 years (standard deviation = 14.7), with secondary lymphedema in 102/163 (62.6%). Duration of lymphedema was >10 years in 75/161 (46.6%) and 99/166 (59.7%) were International Society of Lymphology late-stage II/III, indicating longstanding and/or a high frequency of patients with advanced stages of lymphedema. Ninety-one (54.8%) received Coban2 and 75 (45.2%) had standard care. Multivariable factors for a greater leg volume reduction were large initial leg volume (p < 0.001), DLT treatment duration of 4 weeks compared with 2 weeks (p = 0.01), and peripheral arterial disease (p = 0.015). Conclusion: Limb volume changes were found to be similar between groups. Lack of standardization of DLT makes interpretation of effectiveness problematic. There is an urgent need for randomized-controlled trials. Despite this, severe lymphedema with a

Introduction: Efficacy of anti-TNF-a agents seems inferior to IL-17 and IL-23 inhibitors. Nevertheless, after biosimilars approval, anti TNF-a agents are recommended as first-line for psoriatic patients, for economic reasons. Methods: Predictive factors of response or non-response to adalimumab in bionaive patients who started adalimumab (originator or biosimilar) over 12 years in 9 dermatologic centers in Italy. Effectiveness was assessed with Psoriasis Area and Severity Index (PASI75 and PASI90) at weeks 12, 24 and 48. Multiple logistic regressions were used for variables predicting clinical response; Kaplan–Meier survival curves and Cox regression for drug survival. Results: The drug survival analysis showed reduced hazard ratio of overall discontinuation with male gender and scalp localization. In contrast, baseline PASI and genital psoriasis were significantly associated with increased risk of overall discontinuation. Predictive factors of non-response seemed elevated in patients with baseline PASI, older age groups, previously treated patients with phototherapy, females or patients with palmo-plantar while scalp psoriasis, previous cyclosporine and acitretin appeared as a positive predictive factor. Conclusions: This real-life analysis might be useful for clinicians in case of bio-naive patients with moderate-to-severe psoriasis and various comorbidities.

Objectives: To identify predictive factors associated with limb volume reduction using different decongestive lymphatic therapy (DLT) systems in patients with lymphoedema, over a period of up to 28 days. Methods: A multicountry (Canada, France, Germany, the United Kingdom) prospective cohort study using (DLT): skin care, exercise, compression bandaging, and manual lymphatic drainage for up to 4 weeks. Reduction in limb volume comparing DLT with (1) standard multilayer bandaging with inelastic material, and with (2) multilayer bandaging with Coban2, together with the identification of factors associated with limb volume changes. Results: Out of 264 patients with upper or lower limb lymphedema, 133 used Coban2 and 131 used standard care. Following DLT, mean limb volume reduction was 941 mL using Coban2 compared with 814 mL using standard care. A difference of 127 mL was found (95% confidence interval -275 to 529 mL, p = 0.53). Of the 176 patients with leg swelling, 166 (94.3%) had a limb volume measurement after 28 days and were included in the risk factor analysis. Of these, 132 (79.5%) were female, with overall mean age of 60.1 years (standard deviation = 14.7), with secondary lymphedema in 102/163 (62.6%). Duration of lymphedema was >10 years in 75/161 (46.6%) and 99/166 (59.7%) were International Society of Lymphology late-stage II/III, indicating longstanding and/or a high frequency of patients with advanced stages of lymphedema. Ninety-one (54.8%) received Coban2 and 75 (45.2%) had standard care. Multivariable factors for a greater leg volume reduction were large initial leg volume (p < 0.001), DLT treatment duration of 4 weeks compared with 2 weeks (p = 0.01), and peripheral arterial disease (p = 0.015). Conclusion: Limb volume changes were found to be similar between groups. Lack of standardization of DLT makes interpretation of effectiveness problematic. There is an urgent need for randomized-controlled trials. Despite this, severe lymphedema with a

Professional drivers are considered prone to health risks. For this reason we have conducted a predictive study to analyze variables that may be predictors of stress in driving. Participating in this study were 372 drivers (93.4% men, 6.6% women) recruited through non-probabilistic sampling. The aim of the study is to develop a prediction model for job stress in professional drivers using the following indicators: personality, impulsiveness, hardy personality, job, age, seat comfort, seat suspension, lumbar support and driving hours. We found that the variables with predictive power over driving stress were: commitment over relaxed driving (Delta R-2 = 0.101; beta = 0.135), danger prevention (Delta R-2 = 0.139; beta = 0.342) and fatigue and anxiety (Delta R-2 = 0.063; beta = -0.227); control over alertness and vigilance (Delta R-2 = 0.069; beta = 0.278); agreeableness over sensation-seeking (Delta R-2 = 0.047; beta = -0.268). In conclusion, driver stress can be predicted by certain variables. This study contributes to better understanding of driver stress and promotes safety at the wheel, thus helping to prevent traffic accidents.

Successful school re-entry is important for children following cancer treatment. However, this process is a challenge for teachers. Objectives: To identify (1) the difficulties and needs that teachers have in helping youth cancer survivors be successful in school, (2) the most effective resources that teachers are currently using for helping them, and (3) the ideal contents for a program that could help teachers in this area. Methods: Twenty-eight teachers participated in a Delphi study. Results: A lack of knowledge regarding how to best help and having to deal with the student’s problems were identified as difficulties. Specific training, psychological support, and advice from health professionals were the most commonly reported needs. Maintaining contact with the family and the students and providing personalized attention were viewed as the most useful resources. Finally, knowledge about the disease itself and how to facilitate successful school re-entry were identified as important program components. Conclusion: The findings provide important new information regarding the lack of both resources and support for teachers who seek to help youth cancer survivors. The findings can be used to inform the development of an intervention to help teachers become more successful in facilitating successful school re-entry.

Purpose: To identify predictive factors for postoperative uncorrected visual acuity (UCVA) following diffractive multifocal intraocular lens implantation. Subject and Method: Forty five eyes of 28 patients who underwent cataract surgery with diffractive multifocal intraocular lens TECNISR ZMB00 (AMO) implantation from January 2015 to March 2018 were included. We formed two groups randomly with 18 eyes of 11 patients defined as the training set for preoperative factors and 27 eyes of 17 patients defined as the validation set for postoperative effects. All eyes had undergone superior corneal incisions of 2.4 mm. The predictive factors included age, mean corneal refractive power, corneal astigmatism, spherical equivalent, coma and spherical aberration of cornea, depth of angle recess, mesopic and photopic pupil diameters, PDist and MDist (distances from the alignment light to the photopic and the mesopic pupil centers, respectively). The good-UCVA group was defined as patients who had logMAR ≦ 0 one month after the surgery. Independent-related factors were identified by stepwise logistic regression analyses. Results: Only PDist was adopted (P = 0.0108) in the training set. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.91. In the validation set, it had a sensitivity of 66%, a specificity of 100% and a cut-off value of 0.23. Conclusions: It is supposed that distances from the alignment light to the PDist influence the postoperative UCVA following multifocal diffractive intraocular lens implantation., identifier:Acta medica Nagasakiensia, 62(3), pp.101-106; 2019

Background: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. Objective: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. Methods: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. Results: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). Conclusions: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

This study aimed to determine predictive factors associated with poor outcomes among older adult inpatients in the convalescent rehabilitation ward. We also examined the validity of factors that were identified as predictive of poor outcomes. Study subjects were 104 older adult inpatients in the convalescent rehabilitation ward, divided into two groups based on outcome at discharge. Group I included the outcomes of death or transfer to an acute care hospital and Group II included all other outcomes. Data were retrospectively collected from older adults’ medical records, including: activities of daily living, swallowing grade, nutritional index, and blood biochemistry data. Logistic regression analysis was used to extract predictive factors associated with poor outcomes. Next, we calculated the Stratum-specific likelihood ratio (SSLR) for each extracted factor. Two items were extracted as predictive factors with AUCs ≥ 0.7 : N-terminal pro-brain natriuretic peptide (NT-proBNP) and days from onset to hospitalization. The SSLRs showed the risk for a poor outcome increased when NT-proBNP was ≥ 2500 pg / ml, and when there were ≥ 35 days from onset to hospitalization. Our findings suggest these predictive factors provide a valid index to predict poor outcomes among older adults from the early stage of admission.

The results of a longitudinal study on the cognitive development of one group of full-term and three groups of low risk preterm children with different gestational ages (GA) are presented. The 181 participants were divided into four GA groups of similar size. The aims were: 1) To check if there are differences in cognitive development (measured through the Batelle scale) among the GA groups. 2) To establish the predictive factors of cognitive development at 22 and 60 months of age, taking into account biomedical, environmental and individual factors. The results of the repeated measures ANOVA performed at 22 and 60 months of age indicated that the cognitive trajectories of the four GA groups were similar. Linear regression analyses showed that the effect of the different predictors changed in relation to the time of measurement of cognitive development. Biological factors and the quality of home environment had a moderate effect on the cognitive development at 22 months of age. Cognitive results obtained at 22 months of age, and, to a lesser extent, working memory had the greatest effect on cognitive development at 60 months. GA does not predict cognitive development. Preterm children do not show cognitive delay if they are healthy

Background Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. Objective Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. Methods Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. Results In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). Conclusions Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

The importance of water is currently associated with the supply of large cities and with health, despite advances in sanitation and drinking water. Hence, it is key to study the ways in which people relate to water and how they represent it, to try to shape or modify behavior in favor of its preservation and more sustainable use, in order to identify advances in analysis of the forms of relationship between Social Representations (SR) and pro-environmental behavior. A literature search was carried out through search engines, Open Access directories, virtual libraries and databases, forming a corpus of 29 articles. In the results, three existing approaches or schools of SR were identified within the framework of the term water, as well as an inventory in which 11 types of SR of water were identified, and another with methodological tools and studies where the presence of predictive factors of pro-environmental behavior., Resumo Atualmente, a importância da água está associada ao suprimento de grandes cidades e à saúde, apesar dos avanços no saneamento e na água potável. Portanto, é fundamental estudar as maneiras pelas quais as pessoas relacionam-se com a água e como elas a representam, tentar moldar ou modificar o comportamento em favor de sua preservação e uso mais sustentável, a fim de identificar avanços em análise das formas de relação entre Representações Sociais (RS) e comportamento pró-ambiental. Uma pesquisa bibliográfica foi realizada por meio de mecanismos de busca, diretórios de acesso aberto, bibliotecas virtuais e bancos de dados, formando um corpus de 29 artigos. Nos resultados, três abordagens existentes ou escolas de RS foram identificadas no âmbito do termo água, bem como um inventário no qual foram identificados 11 tipos de RS de água, e outro com ferramentas metodológicas e estudos onde a presença de fatores preditivos de comportamento pró-ambiental., Resumen La importancia del agua actualmente está asociada al abastecimiento de grandes ciudades y a la salud, a pesar de los avances en materia de saneamiento y agua potable. De allí que sea clave estudiar las formas en que las personas se relacionan con el agua y cómo la representan, para intentar moldear o modificar el comportamiento en pro de su preservación y de un uso más sustentable, con el propósito de identificar los avances en los análisis de las formas de relación entre las Representaciones Sociales (RS) y el comportamiento pro-ambientalista. Se realizó una búsqueda de literatura a través de buscadores, directorios Open Access, bibliotecas virtuales y bases de datos, conformando un corpus de 29 artículos. En los resultados, se identificaron tres enfoques o escuelas existentes de las RS en el marco del término agua, así como un inventario en el que se identificaron 11 tipos de RS del agua y otro con herramientas metodológicas y estudios donde se han confirmado la presencia de factores predictivos del comportamiento pro-ambientalista.

Background: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. Objective: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. Methods: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. Results: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). Conclusions: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

Background: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. Objective: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. Methods: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. Results: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). Conclusions: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

BACKGROUND: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. OBJECTIVE: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. METHODS: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. RESULTS: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). CONCLUSIONS: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

[Abstract] The results of a longitudinal study on the cognitive development of one group of full-term and three groups of low risk preterm children with different gestational ages (GA) are presented. The 181 participants were divided into four GA groups of similar size. The aims were: 1) To check if there are differences in cognitive development (measured through the Batelle scale) among the GA groups. 2) To establish the predictive factors of cognitive development at 22 and 60 months of age, taking into account biomedical, environmental and individual factors. The results of the repeated measures ANOVA performed at 22 and 60 months of age indicated that the cognitive trajectories of the four GA groups were similar. Linear regression analyses showed that the effect of the different predictors changed in relation to the time of measurement of cognitive development. Biological factors and the quality of home environment had a moderate effect on the cognitive development at 22 months of age. Cognitive results obtained at 22 months of age, and, to a lesser extent, working memory had the greatest effect on cognitive development at 60 months. GA does not predict cognitive development. Preterm children do not show cognitive delay if they are healthy.

©Pere Llorens-Vernet, Jordi Miró. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 31.07.2020. BACKGROUND: In recent years, there has been an exponential growth of mobile health (mHealth)-related apps. This has occurred in a somewhat unsupervised manner. Therefore, having a set of criteria that could be used by all stakeholders to guide the development process and the assessment of the quality of the apps is of most importance. OBJECTIVE: The aim of this paper is to study the validity of the Mobile App Development and Assessment Guide (MAG), a guide recently created to help stakeholders develop and assess mobile health apps. METHODS: To conduct a validation process of the MAG, we used the Delphi method to reach a consensus among participating stakeholders. We identified 158 potential participants: 45 patients as potential end users, 41 health care professionals, and 72 developers. We sent participants an online survey and asked them to rate how important they considered each item in the guide to be on a scale from 0 to 10. Two rounds were enough to reach consensus. RESULTS: In the first round, almost one-third (n=42) of those invited participated, and half of those (n=24) also participated in the second round. Most items in the guide were found to be important to a quality mHealth-related app; a total of 48 criteria were established as important. Privacy, security, and usability were the categories that included most of the important criteria. CONCLUSIONS: The data supports the validity of the MAG. In addition, the findings identified the criteria that stakeholders consider to be most important. The MAG will help advance the field by providing developers, health care professionals, and end users with a valid guide so that they can develop and

Background: We analyzed the efficacy and toxicity of cabazitaxel (CBZ) at high and low initial doses in Japanese patients with docetaxel-resistant castration-resistant prostate cancer (CRPC). Methods: We retrospectively evaluated 118 patients who received CBZ for docetaxel-resistant CRPC in 10 university hospitals in Japan between 2014 and 2016. The rate of decrease of prostate-specific antigen (PSA), adverse events, progression-free survival (PFS), and overall survival (OS) were compared between patients receiving initially high (≥22.5 mg/m2, n = 36) and low (≤20 mg/m2, n = 80) CBZ doses. Factors associated with survival and grade 4 neutropenia were evaluated. Results: PSA values decreased by > 50% in 22 patients (19%), with a higher frequency in the high-dose group than in the low-dose group (29 and 14%, P = 0.073). The median PFS time for the all-patient, high- and low-dose groups was 2.8 months (95% confidence interval [CI] 1.9–4.4), 2.1 months (1.2–5.5), and 3.0 months (2.0–4.4), respectively (P = 0.904). The median OS times were 16.3 months (95% CI 9.7–30.9), 30.9 months (11.8–47.4), and 10.2 months (8.6–20), respectively (P = 0.020). In multivariate analyses, PFS was significantly associated with existing bone metastasis at diagnosis (P = 0.005) and OS with PSA > 100 ng/ml (P = 0.007), hemoglobin < 12 g/dl (P = 0.030), and low initial CBZ dose (P = 0.030). Grade 4 neutropenia occurred in 53 patients (45%) and was associated with a low CBZ dose (hazard ratio 0.21, 95% CI 0.08–0.59, P = 0.002). Conclusions: CBZ at a higher initial dose may have similar response rate and response duration, but longer survival duration after treatment with higher toxicity than a lower initial dose for docetaxel-resistant CRPC in Japanese patients.