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Patient-reported outcome measures (PROMs) have gained considerable interest in health care moving beyond traditional outcome measures of morbidity and mortality. In breast cancer surgery, women's' perceptions of appearance, function and quality of life have become increasingly important. The BREAST-Q questionnaire is a validated PROM for use in cosmetic and reconstructive breast surgery in clinical practice. The objective of this study was to validate the Spanish electronic version of the BREAST-Q questionnaire, to verify the measurement equivalence of digital and paper versions and to identify the possible disadvantages and advantages of implementing this new tool. The study population included 113 patients undergoing breast cancer survey at a single hospital in Barcelona (Spain) who were able to complete both the electronic and paper versions of the preoperative module of the BREAST-Q questionnaire. The intraclass correlation coefficient (ICC) in the four domains of the questionnaire between the two versions of the questionnaire was >0.9, with a weighted kappa of >0.74 at item level. The reliability of the internal consistency was also excellent, with Cronbach's alpha coefficient of >0.70 in all domains. Age was a limiting factor for the delivery of the electronic version of BREAST-Q, with 69 years of age as the cut-off point to obtain reliable results. The interchangeability of the electronic and paper versions of the BREAST-Q questionnaire facilitates implementation of this instrument in routine surgical oncological practice. [ABSTRACT FROM AUTHOR]

Background: In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim: To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Design and setting: Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Method: Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization. Results: We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged ≥ 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries). Predictors of ICU admission or death were greater age (OR = 1.05; 95%CI = 1.03 to 1.07), male sex (OR = 2.94; 95%CI = 1.55 to 5.82), autoimmune disease (OR = 2.82; 95%CI = 1.00 to 7.84), bilateral pulmonary infiltrates (OR = 2.86; 95%CI = 1.41 to 6.13), elevated lactate-dehydrogenase (OR = 2.85; 95%CI = 1.28 to 6.90), elevated D-dimer (OR = 2.85; 95%CI = 1.22 to 6.98) and elevated C-reactive protein (OR = 2.38; 95%CI = 1.22 to 4.68). Myalgia or arthralgia (OR = 0.31; 95%CI = 0.12 to 0.70) was protective factor against ICU admission and death. Predictors of hospitalization were chills (OR = 5.66; 95%CI = 1.68 to 23.49), fever (OR = 3.33; 95%CI = 1.89 to 5.96), dyspnoea (OR = 2.92; 95%CI = 1.62 to 5.42), depression (OR = 6.06; 95%CI = 1.54 to 40.42), lymphopenia (OR = 3.48; 95%CI = 1.67 to 7.40) and elevated C-reactive protein (OR = 3.27; 95%CI = 1.59 to 7.18). Anosmia (OR = 0.42; 95%CI = 0.19 to 0.90) was the only significant protective factor for hospitalization after adjusting for age and sex. Conclusion: Determining the clinical, biological and radiological characteristics of patients with suspected COVID-19 infection will be key to early treatment and isolation and the tracing of contacts. [ABSTRACT FROM AUTHOR]

• A research site was built with 16 piezometers placed between 30 and 90 m from the shore. • New monitoring techniques were applied to improve coastal aquifers characterization. • CHERT allows a better definition of seawater intrusion than piezometers data. • The combination of these techniques allows a better spatial and temporal resolution. The characterization of saline water intrusion (SWI) and its hydrodynamics is a key issue to understand submarine groundwater discharge (SGD) and manage groundwater resources in coastal areas. To test and compare different methods of characterization and monitoring, a new experimental site has been constructed in a coastal alluvial aquifer north of Barcelona city (Catalonia, Spain). The site is located between 30 and 90 m from the seashore and comprises 16 shallow piezometers organized in nests of three with depths ranging between 15 and 25 m and 4 solitary piezometers. The objective of this paper is to combine different recently developed monitoring techniques to evaluate temporal variations in the aquifer hydrodynamics of the site at different spatial scales before and after the dry season of 2015. At the site scale, fibre optic distributed temperature sensing (FO-DTS), for the first time applied to study SWI, and cross-hole electrical resistivity tomography (CHERT) has been applied. At the meter/borehole scale, electrical conductivity of the formation has been applied not only in a repeated manner ("time lapse"), but also for the first time at relatively high frequency (1 sample every 10 min). CHERT has provided a better characterization of the seawater intrusion than electrical conductivity data obtained from piezometers. The combination of techniques has allowed improving the understanding of the system by: 1) characterizing the extent and shape of SWI; 2) differentiating two different dynamics in the aquifer; and 3) identifying preferential flow paths over different time and spatial intervals. Future challenges and the application of these techniques in other areas are also discussed. [ABSTRACT FROM AUTHOR]