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Introduction: This study examines the distribution of events and event records (EVRs) in elite judo competitions, encompassing both male and female categories. Sample: By analyzing data from the 2018, 2019, and 2021 World Championships, the study incorporates 6487 events (EVs) and 2340 contests classified by their last event (cEV). Results: The predominant occurrence of EV2 and EV3 in male (23.2% and 36.6%) and female (26.8% and 31.7%) contests suggests consistent patterns. Statistical analyses reveal non-uniform distributions of events within temporal units (TUs). Small associations were found between EVRs and TUs for EV1, EV2 and EV3 (Cramer’s V = 0.103 to 0.171; p

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by an isolated decrease in platelet count and an increased risk of bleeding. The pathogenesis is complex, affecting multiple components of the immune system and causing both peripheral destruction of platelets and inadequate production in the bone marrow. In this article, we review the treatment of ITP from a historical perspective, discussing first line and second line treatments, and management of refractory disease.

Caminar es una tarea extraordinariamente compleja que requiere la intervención de todo el sistema nervioso, viéndose afectada por diversas patologías neurológicas. Los exoesqueletos de rehabilitación de la marcha actuales, aunque potencialmente evidencian una mejora tras la rehabilitación, aún no han mostrado su superioridad terapéutica respecto a la terapia convencional de manera concluyente. Además, los dispositivos robóticos y exoesqueletos de rehabilitación de la marcha actuales no permiten entrenar específicamente la transferencia de peso o requieren de un buen estado funcional para ser utilizados. En este artículo se presenta el modelo conceptual de un sistema robótico ambulatorio acoplado al exoesqueleto Exo-H3 para la rehabilitación de la marcha implementando estrategias de aprendizaje por refuerzo. Se espera que este sistema favorezca la plasticidad neuronal al aportar mayor libertad al usuario para explorar nuevos patrones de movimiento y aumentar su control motor voluntario y su participación activa, mientras el exoesqueleto se adapta y garantiza su equilibrio y estabilidad. Los pasos futuros contemplan el diseño y la fabricación de cada uno de los subsistemas robóticos, validando su funcionamiento individual y en conjunto, con la participación de sujetos sanos y patológicos.

Immune thrombocytopenia (ITP) is an autoimmune disease characterized by an isolated decrease in the platelet count and an increased risk of bleeding. The pathogenesis is complex, affecting multiple components of the immune system and causing both peripheral destruction of platelets and impaired central megakaryopoiesis and platelet production in the bone marrow. Here, we intend to contextualize the current knowledge on the pathophysiology, terminology, epidemiology, clinical manifestations, diagnosis, and prognosis of ITP from a historical perspective and the first references to the never-stopping garnering of knowledge about this entity. We highlight the necessity to better understand ITP in order to be able to provide ITP patients with personalized treatment options, improving disease prognosis and reducing the incidence or frequency of refractoriness.

Esta investigação testa o efeito do enriquecimento trabalho-a-família e família-ao- trabalho na satisfação profissional e no compromisso afetivo. Analisa igualmente o efeito da satisfação profissional no compromisso afetivo, e os efeitos da satisfação profissional e do compromisso afetivo na intenção de abandono. A investigação baseia-se numa amostra multissetorial de trabalhadores espanhóis. Os resultados confirmaram todas as relações do modelo, exceto o efeito do enriquecimento trabalho-a-família na satisfação profissional e no compromisso afetivo. Também não confirmaram a relação entre satisfação e intenção de abandono. Da mesma forma, derivam-se implicações gerenciais destinadas a coibir a intenção de abandono por meio de políticas family-friendly que promovam o compromisso afetivo e a satisfação profissional por meio do enriquecimento trabalho-família.

The main aim of this study was to ascertain whether the victory and defeat in the different types of the judo contest, in the elite male and female divisions, are associated to the occurrence of the penalties and scores of the first three events (changes in the scoreboard -either penalty or score-) of them. 2340 contests of the 2018, 2019 and 2021 World Judo Championships were analysed. The Pearson’s chi-squared test expressed that [1] shido-1 in the first event (EV1) of the contests that end before the regular time (BRT) and of those without considering when they end (OC) is associated to defeat for both sexes and, that [2] wazari-1 in the EV1 of the BRT and in the EV2 and EV3 of the BRT, of the contests with the duration extended beyond the regular time (EXT) and of OC is associated to victory for both sexes except in the EV2 of the EXT (only for male athletes in this case). Thus, it is suggested that the victory and defeat in the different types of the judo elite contests are associated with the occurrence of the penalties and scores of the first three events of them.

Introduction: Stress factors influence surgical procedures. This study aims to assess the impact of stress factors on surgical performance in ophthalmology simulation. Specifically, the study aims to identify which exercises are most affected by stress and to examine the relationship between stress levels, surgical complexity, and technical skills. Material and methods: A prospective study of a cohort of 13 ophthalmology residents, at Vall Hebron University Hospital. All study participants received basic training before the study to become familiar with the simulator and surgical maneuvers. Once completed, the participants were invited to perform 3 defined exercises (E1, E2, and E3, increasing difficulty level from 1 to 3) in relaxed conditions. Afterwards, the same exercises were performed again under a stressful environment. The stress was created introducing physical, auditory, and interruptions factors. The results in technical skills were evaluated through the relaxation and stress scores, as well as the time required to complete the exercises under relaxation and stress conditions. A detailed metric was used to assess the variables in relation to stress situations, including physical stress, haste, the presence of background music, and scheduled interruptions.The results are expressed by median and interquartile range. To compare them, Wilcoxon test for paired samples and the Whitney U Test were performed. The results were stratified by year of residence (1–2 years vs 3–4 years). Results: The stress score was significantly lower in the 3 exercises compared to the relax score (75 vs 86, 52 vs 90, 55 vs 61, respectively, p>.05). Time to perform the exercises was less predictable and was even lower in stressful situations with no statistical differences. Under stress, both younger and older residents scored worse on the more complex exercises. Conclusion: Stress affects surgery with simulators. The most difficult exercises are the most likely to be affected by stress. These results suggest that through ophthalmic simulators ophthalmologists have the opportunity to train surgical stress and therefore improving patient safety. Resumen: Introducción: Los factores de estrés influyen en los procedimientos quirúrgicos. Este estudio tiene como objetivo evaluar el impacto de los factores de estrés en el desempeño quirúrgico en simulaciones oftalmológicas. Específicamente, el estudio busca identificar qué ejercicios se ven más afectados por el estrés y examinar la relación entre los niveles de estrés, la complejidad quirúrgica y las habilidades técnicas Materiales y métodos: Estudio prospectivo de una cohorte de 13 residentes de oftalmología en el Hospital Universitario Vall Hebron. Todos los participantes del estudio recibieron entrenamiento básico antes del estudio para familiarizarse con el simulador y las maniobras quirúrgicas. Una vez completado, se invitó a los participantes a realizar tres ejercicios definidos (E1, E2, E3, aumentando el nivel de dificultad de 1 a 3) en condiciones relajadas. Posteriormente, los mismos ejercicios se realizaron nuevamente bajo un entorno estresante. El estrés se creó introduciendo factores físicos, auditivos e interrupciones.Los resultados en habilidades técnicas fueron evaluados mediante la puntuación de relajación y estrés, así como el tiempo requerido para completar los ejercicios bajo condiciones de relajación y estrés. Se utilizó una métrica detallada para evaluar las variables en relación con las situaciones de estrés, incluyendo el estrés físico, la prisa, la presencia de música ambiental e interrupciones programadas.Los resultados se expresan mediante la mediana y el rango intercuartílico. Para compararlos, se realizaron la prueba de Wilcoxon para muestras pareadas y la prueba U de Whitney. Los resultados se estratificaron por año de residencia (1-2 años vs. 3-4 años). Resultados: La puntuación de estrés fue significativamente menor en los tres ejercicios en comparación con la puntuación de relajación (75 vs. 86, 52 vs. 90, 55 vs. 61 respectivamente, p>0.05). El tiempo para realizar los ejercicios fue menos predecible y fue aún menor en situaciones estresantes sin diferencias estadísticas. Bajo estrés, tanto los residentes más jóvenes como los más avanzados obtuvieron peores puntuaciones en los ejercicios más complejos. Conclusión: El estrés afecta a la cirugía con simuladores. Los ejercicios más difíciles son los más propensos a ser afectados por el estrés. Estos resultados sugieren que a través de simuladores oftálmicos, los oftalmólogos tienen la oportunidad de entrenar el estrés quirúrgico y por lo tanto mejorar la seguridad del paciente.

This article introduces a new integrated development environment called CREATOR (didaCtic and geneRic assEmbly progrAmming simulaTOR) that provides an interactive platform for educational assembly programming. CREATOR is specially designed for the academic environment, so it is very intuitive to users who are encountering assembly for the first time. It makes the traditional theory classes interactive, engaging students’ participation. Moreover, it is a multiplatform simulator that can be used with a web browser without requiring a server or additional installations, and it can be used on different types of devices. CREATOR allows all the necessary steps to be performed on the same tool, from the implementation of the assembly program to its execution on real hardware. For this purpose, it allows editing, compiling, simulating, debugging, and loading the program on the hardware device without auxiliary software. In addition, it is also capable of detecting compilation errors, execution errors, and violations of the parameter passing convention, helping users understand the reason for a given error so that they can resolve it. CREATOR offers the RISC-V and MIPS32 architectures by default. However, it is possible to modify these architectures or add new architectures in the tool as needed by any user. This feature allows teachers to prepare practical labs adapted to the teaching objectives, and it can also be used for research, e.g., for the study of different instruction sets.

Introduction The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Group therapy has been included in several programs for chemsex users. Objectives To describe and to compare the different group therapy treatments for problematic chemsex users in NGOs community treatment settings in Spain. Methods We conducted several interviews with key informants from 5 NGO in Spain. A qualitative analysis of the different group therapy treatments for problematic chemsex was performed. Results Different models of groups were described including: psychoeducational, support, interpersonal process, harm reduction and mindfulness-based cognitive groups. Most of the group interventions developed were support and psychoeducational based. There were fewer interpersonal group and relapse prevention group therapy. The different models of group intervention were considered useful and necessary for deliver information in a culturally sensitive context and for reducing drug use, social isolation and loneliness. Conclusions Chemsex is a phenomenon that needs a multidisciplinary approach, including individual and group therapy. Group therapy for problematic chemsex has several advantages over individual model treatments, including the reduction of sense of isolation, loneliness, information and feedback from peers. More research is needed to analyze the implementation and efficacy of group therapy for chemsex users in different contexts. Disclosure of Interest None Declared

Relearning to walk requires progressive training in real scenarios—overground—along with assistance in basic tasks, such as balancing. In addition, user ability must be maximized through compliant robotic assistance as needed. Despite decades of research, gait rehabilitation robotic devices yield controversial results. This article presents the conceptual design of a novel walking assistance and rehabilitation robot, the NIMBLE robot, aimed at providing ambulatory, bodyweight-supported gait training, assisting the user’s center of mass trajectory to aid weight transfer and dynamic balance during walking. NIMBLE consists of a robotic mobile frame, a partial bodyweight support (PBWS) system, an ambulatory lower-limb exoskeleton (Exo-H3) and a cable-driven pelvis-assisting robot. Designed as a modular structure, it differentiates hierarchical communication levels through a Robot Operating System (ROS) 2 network. We present the mechatronic design and experimental results assessing the impact of the mechatronic coupling between the robotic modules on the walking kinematics and the frame movement control performance. The robotic frame hardly affects the walking kinematics up to 2 degrees in both the sagittal and frontal planes, making it feasible for lateral balance and weight translation training. Moreover, it successfully tracks and follows user trajectories. The NIMBLE robotic frame assessment shows promising results for ambulatory gait rehabilitation.

IntroductionThis study aimed to determine the body accelerations (BA) profile of the judo contest of the male and female weight divisions and to ascertain the involvement of the vertical, mediolateral and anteroposterior axes in it.MethodsForty-eight male and forty-eight female national and international level athletes (some of them medalists in World, European and national championships) participated in a 5-min simulated contest (official fight time plus breaks) against an opponent of the same sex and weight division, wearing an accelerometer. Heart rate, blood lactate and ratings of perceived exertion were recorded to certify that the athletes performed the fullest.ResultsThe t2way test expressed differences in the athletes' BA (p = 0.001) and three profiles were identified: the light/middle weight male divisions, the light/middle weight female divisions and the heavy male and female ones. Athletes of all weight divisions performed their BA during the contest in all three directions (the one-sample Person's chi-square did not detect any significantly predominant one: p = 0.400, p = 0.631, p = 0.844, p = 0.749, p = 0.644 and p = 0.895, for male light, moderate and heavy, female light, moderate and heavyweight athletes, respectively). Monte Carlo method simulations suggested as the most likely scenarios those with BA involving all axes, with a slight preference of the anteroposterior and mediolateral ones.DiscussionThese results suggest that the demands on judo athletes in a contest differ between weight classes and sexes.

BackgroundResistance training is hardly recommended for postmenopausal women to counteract negative effects of hormonal changes. However, some concern exists about the marked hemodynamic responses caused by high-load resistance exercises. In this regard, studies on young, healthy, physically active individuals suggest that set configuration can modulate acute cardiovascular, metabolic, and cardiac autonomic responses caused by resistance training sessions, but this has not yet been explored in postmenopausal women.MethodsA sample of 60 physically active postmenopausal women (30 normotensive, 30 hypertensive) will participate in this crossover study. After a medical exam, ergometry, familiarization session, and two testing sessions, participants will complete three experimental sessions and one control session in a randomized order. Each experimental session includes 36 repetitions of four exercises (horizontal leg press, bench press, prone leg curl, and lat pull-down) differing in set configuration: 9 sets of 4 repetitions (i.e., 33% intensity of effort) with 45 s of inter-set recovery, 6 sets of 6 repetitions (50% intensity of effort) with 72 s, and 4 sets of 9 repetitions (75% intensity of effort) with 120 s; with 4 min rest between exercises. Before and immediately after each session, arterial stiffness, hemodynamic variables, cardiac autonomic modulation, baroreflex sensitivity, sympathetic vasomotor tone, and resting oxygen uptake will be evaluated. Furthermore, perceived effort, mechanical performance (e.g., power, velocity), heart rate, and lactatemia will be collected throughout sessions. The impact of set configuration on these variables will be analyzed, along with comparisons between normotensive and hypertensive women.DiscussionCardiovascular responses to resistance exercise have been scarcely studied in females, particularly postmenopausal women. The results of this study will provide information about the modulating role of set structure on metabolic and cardiovascular responses of normotensive and hypertensive postmenopausal women to resistance training.Clinical trial registrationNCT05544357 on 7 December 2022.

Social media users can actively choose how they portray themselves and review the information they share to form and manage positive impressions on their audience. A high Body Mass Index (BMI) can lead to a bias of attention towards self-reported unattractive personal body areas. This dysfunctional body-related attention can lead to increased body dissatisfaction. Concerning social networks, people who usually post more photos on Instagram more frequently show higher body satisfaction. The main objective of this work was to analyze the relationship between BMI in young people, their own exposition on Instagram, positive body image and certain psychological variables: self-esteem, coping and well-being. The population-based sample consisted of 687 young Instagram users aged between 18 to 35 years old. The results found in this work revealed that BMI had a significant influence on the body exposure on Instagram in both genders, as well as in body image and certain psychological variables, such as coping and well-being. Moreover, we found that there is not a direct relation between BMI and the exposure of the entire body on Instagram. This relationship exists through positive body image, appearance care and management appearance behaviors. These results imply that positive body image affects body’s exposure, so people with obesity or overweight tend to upload less photos with half or full body visible than people with normal weight or underweight. This is not because of their weight, but their valuation and appreciation of their bodies.

En los estudios superiores está plenamente integrado el desarrollo y evaluación de competencias transversales. En esta ponencia se muestra la experiencia en el Departamento de Ingeniería Mecánica y de Materiales (DIMM) de la Universitat Politècnica de València (UPV) del uso de la Simulación Dinámica de Sistemas Multicuerpo (SDSM) como entorno en el que poner en práctica y aumentar el dominio de competencias transversales en últimos cursos y Trabajos Fin de Grado, utilizando la SDSM tanto de manera aislada como combinada con otras materias propias de la ingeniería mecánica o de otras ingenierías.

Despite the fact that the first red tide reported on the coasts of the Iberian Peninsula was due to Lingulodinium polyedra, knowledge about their frequency and, particularly, about the environmental conditions contributing to bloom initiation is still scarce. For this reason, L. polyedra bloom episodes were observed and studied in three Galician rias during the summer season based on the 1993–2008 record database period; additionally, samples were collected in summer 2008. Proliferations of L. polyedra occurred in the rias of Ares and Barqueiro in June and August, respectively, while in the Ria of Coruña, they persisted from the end of June to early September. Red tides developed when the surface temperature reached 17 °C, with “seasonal thermal window” conditions, and when salinities were ≥30, i.e., an “optimal salinity window”; when these parameters were lower than these thresholds, cyst germination decreased. A cyst transport mechanism from sediments to the surface must also exist; this mechanism was found to be natural (tidal currents) in the ria of Barqueiro or anthropogenic (dredging) in the rias of Ares and Coruña. Surface temperatures during summer were usually favorable for cyst germination (85 to 100%) during the 1993–2008 period; however, water temperatures below 10 m depth only rarely reached the 17 °C threshold (2 to 18%). During this 16-year period, dredging activities could explain 71% (Coruña) and 44% (Ares) of the recorded bloom events. When a bloom episode developed in early summer, favorable conditions did not lead to a new red tide, probably due to the lag period required by cysts for germination. Moreover, blooms did not develop when high densities of diatoms (>1,000,000 cells·L−1) remained in the water column as a result of summer upwelling pulses occurring in specific years. The temperature–sediment disturbance pattern found in this study provides a useful tool for the prevention of eventual risks resulting from red tides of this dinoflagellate.

A practical intervention was devised in order to promote and to assess Critical Thinking in undergraduate students of Engineering. First, in collaboration with specialists in education, the concept of Critical Thinking, and its skills and dispositions on which to focus on, was determined. Second, a teaching strategy was designed in order to be as effective as possible, considering the limitations of the intervention. This strategy took advantage of the computer lab sessions where discussion and questioning encouraged the development of Critical Thinking. Then, the instruments to assess the acquired skills and attitudes of the students were developed. Finally, a quantitative analysis of the results was conducted in order to evaluate the validity and reliability of the strategy. This paper presents a full description of the intervention carried on for two years. Besides the desired effects on the students’ performance, some conclusions regarding the development of appropriate instruments to deal with a large group of students are drawn. This intervention has proven to be effective in order to help the students to develop their Critical Thinking skills, and it is particularly suitable for large groups.

The influence of multimodal incident sound fields on the acoustic behaviour of large aftertreatment devices incorporating a monolith is modelled and analysed in detail. The analytical mode matching method is applied to the compatibility conditions of the three-dimensional acoustic fields at the device geometric discontinuities, leading to the computation of the complex wave amplitudes in all the subdomains involved and the corresponding device transmission loss. To have a realistic model, three-dimensional propagation must be considered in the inlet/outlet ducts and chambers, while one-dimensional wave propagation has to be assumed along the small capillaries of the aftertreatment device monolith (such catalytic converters and particulate filters); therefore, the monolith can be replaced by a plane wave four-pole transfer matrix from an acoustical point of view. On the other hand, for large aftertreatment device inlet ducts such as those found in heavy-duty and off-road engines, the usual models with plane incident wave excitation are not accurate since the onset of higher order incident modes in the inlet duct is expected for the frequency range of interest. Therefore, a variation of the acoustic attenuation performance is likely to occur depending on these modes, similar to the results previously found in the case of large dissipative silencers. Results are presented for three different multimodal incident sound field hypotheses: equal modal amplitude, equal modal power and equal modal energy density. A relevant influence on the sound attenuation is found for the test problems considered in the current investigation.

IntroductionThe knowledge of the aetiology of Behçet disease (BD), an immune-mediated vasculitis, is limited. HLA-B, mainly HLA-B51, and HLA-A molecules are associated with disease, but the ultimate cause of this association remains obscure. There is evidence that NK cells participate in the etiopathology of BD. NK cells have activator and inhibitor surface receptors, like the KIR and the NKG2 families. Classical HLA-class I molecules (A, B and C) are keys in the activity control of the NK because they are KIR ligands. Most NKG2 receptors bind HLA-E, which presents only nonapeptides derived from the signal peptide of other class-I molecules.ObjectiveThis study investigates the contribution of the pair HLA-E and ligand, nonapeptide derived from the 3-11 sequence of the signal peptides of class I classical molecules, to the susceptibility to BD.MethodsWe analyzed the frequency of the HLA-derivated nonapeptide forms in 466 BD patients and 444 controls and an HLA-E functional dimorphism in a subgroup of patients and controls. Results: In B51 negative patients, the frequency of VMAPRTLLL was lower (70.4% versus 80.0% in controls; P=0.006, Pc=0.04, OR=0.60, 95%CI 0.41-0.86), and the frequency of VMAPRTLVL was higher (81.6% versus 71.4% in controls; P=0.004, Pc=0.03, OR=1.78, 95%CI 1.20-2.63). In homozygosity, VMAPRTLLL is protective, and VMAPRTLVL confers risk. The heterozygous condition is neutral. There were no significant differences in the distribution of the HLA-E dimorphism.DiscussionOur results explain the association of BD with diverse HLA-A molecules, reinforce the hypothesis of the involvement of the NK cells in the disease and do not suggest a significant contribution of the HLA-E polymorphism to disease susceptibility.