Cavity-enhanced energy transport in molecular systems.

Molecules are the building blocks of all of nature's functional components, serving as the machinery that captures, stores and releases energy or converts it into useful work. However, molecules interact with each other over extremely short distances, which hinders the spread of energy across molecular systems. Conversely, photons are inert, but they are fast and can traverse large distances very efficiently. Using optical resonators, these distinct entities can be mixed with each other, opening a path to new architectures that benefit from both the active nature of molecules and the long-range transport obtained by the coupling with light. In this Review, we present the physics underlying the enhancement of energy transfer and energy transport in molecular systems, and highlight the experimental and theoretical advances in this field over the past decade. Finally, we identify several key questions and theoretical challenges that remain to be resolved via future research.

Electroluminescence as a Probe of Strong Exciton-Plasmon Coupling in Few-Layer WSe2.

The manipulation of coupled quantum excitations is of fundamental importance in realizing novel photonic and optoelectronic devices. We use electroluminescence to probe plasmon-exciton coupling in hybrid structures consisting of a nanoscale plasmonic tunnel junction and few-layer two-dimensional transition-metal dichalcogenide transferred onto the junction. The resulting hybrid states act as a novel dielectric environment that affects the radiative recombination of hot carriers in the plasmonic nanostructure. We determine the plexcitonic spectrum from the electroluminescence and find Rabi splittings exceeding 50 meV in the strong coupling regime. Our experimental findings are supported by electromagnetic simulations that enable us to explore systematically and in detail the emergence of plexciton polaritons as well as the polarization characteristics of their far-field emission. Electroluminescence modulated by plexciton coupling provides potential applications for engineering compact photonic devices with tunable optical and electrical properties.

Lindblad Master Equation Capable of Describing Hybrid Quantum Systems in the Ultrastrong Coupling Regime.

Despite significant theoretical efforts devoted to studying the interaction between quantized light modes and matter, the so-called ultrastrong coupling regime still presents significant challenges for theoretical treatments and prevents the use of many common approximations. Here we demonstrate an approach that can describe the dynamics of hybrid quantum systems in any regime of interaction for an arbitrary electromagnetic (EM) environment. We extend a previous method developed for few-mode quantization of arbitrary systems to the case of ultrastrong light-matter coupling, and show that even such systems can be treated using a Lindblad master equation where decay operators act only on the photonic modes by ensuring that the effective spectral density of the EM environment is sufficiently suppressed at negative frequencies. We demonstrate the validity of our framework and show that it outperforms current state-of-the-art master equations for a simple model system, and then study a realistic nanoplasmonic setup where existing approaches cannot be applied.

Gaining Insights into Inherited Bleeding Disorders of Complex Etiology in Pediatric Patients: Whole-Exome Sequencing as First-Line Investigation Tool.

INTRODUCTION: Investigation of the molecular basis of inherited bleeding disorders (IBD) is mostly performed with gene panel sequencing. However, the continuous discovery of new related genes underlies the limitation of this approach. This study aimed to identify genetic variants responsible for IBD in pediatric patients using whole-exome sequencing (WES), and to provide a detailed description and reclassification of candidate variants. MATERIAL AND METHODS: WES was performed for 18 pediatric patients, and variants were filtered using a first-line list of 290 genes. Variant prioritization was discussed in a multidisciplinary team based on genotype-phenotype correlation, and segregation studies were performed with available family members. RESULTS: The study identified 22 candidate variants in 17 out of 18 patients (94%). Eleven patients had complete genotype-phenotype correlation, resulting in a diagnostic yield of 61%, 5 (28%) were classified as partially solved, and 2 (11%) remained unsolved. Variants were identified in platelet (ACTN1, ANKRD26, CYCS, GATA1, GFI1B, ITGA2, NBEAL2, RUNX1, SRC, TUBB1), bleeding (APOLD1), and coagulation (F7, F8, F11, VWF) genes. Notably, 9 out of 22 (41%) variants were previously unreported. Variant pathogenicity was assessed according to the American College of Medical Genetics and Genomics guidelines and reclassification of three variants based on family segregation evidence, resulting in the identification of 10 pathogenic or likely pathogenic variants, 6 variants of uncertain significance, and 6 benign or likely benign variants. CONCLUSION: This study demonstrated the high potential of WES in identifying rare molecular defects causing IBD in pediatric patients, improving their management, prognosis, and treatment, particularly for patients at risk of malignancy and/or bleeding due to invasive procedures.

Unconventional magnetism mediated by spin-phonon-photon coupling.

Magnetic order typically emerges due to the short-range exchange interaction between the constituent electronic spins. Recent discoveries have found a crucial role for spin-phonon coupling in various phenomena from optical ultrafast magnetization switching to dynamical control of the magnetic state. Here, we demonstrate theoretically the emergence of a biquadratic long-range interaction between spins mediated by their coupling to phonons hybridized with vacuum photons into polaritons. The resulting ordered state enabled by the exchange of virtual polaritons between spins is reminiscent of superconductivity mediated by the exchange of virtual phonons. The biquadratic nature of the spin-spin interaction promotes ordering without favoring ferro- or antiferromagnetism. It further makes the phase transition to magnetic order a first-order transition, unlike in conventional magnets. Consequently, a large magnetization develops abruptly on lowering the temperature which could enable magnetic memories admitting ultralow-power thermally-assisted writing while maintaining a high data stability. The role of photons in the phenomenon further enables an in-situ static control over the magnetism. These unique features make our predicted spin-spin interaction and magnetism highly unconventional paving the way for novel scientific and technological opportunities.

Effects of a mobile application on breastfeeding maintenance in the first 6 months after birth: Randomised controlled trial (COMLACT study).

PROBLEM: It is necessary to continue promoting breastfeeding rates. BACKGROUND: Information and communication technologies have significantly impacted healthcare services and are transforming the sector. There is little evidence of the usefulness of mobile applications to support breastfeeding and increase its duration. AIM: To assess whether mobile application-LactApp® (Barcelona, Spain)-usage compared with standard care increases the 6-month postpartum breastfeeding rate. METHODS: A multicentre, randomised, controlled clinical trial of parallel groups was conducted. The study was conducted in four public hospitals in Spain from January 2022 to January 2023. 270 Women were randomly assigned to each parallel group. The women in the intervention group received free access to the mobile application LactApp®, which provides personalised and convenient support to women about BF. Women in the control group received standard care, which included individual counselling about the benefits of maintaining BF for the first 6 months of the baby's life. FINDINGS: The rate of breastfeeding abandonment at 15 days was 6.4 % in the control group vs 0.0 % in the intervention group (p = 0.105). LactApp® usage did not increase the 6-month postpartum breastfeeding rate compared with standard care (CG = 41.6% vs. IG = 43.6 %; p = 0.826). DISCUSSION: Further studies must explore how technologies can help improve long-term breastfeeding maintenance. The mobile app seems to reduce early weaning in the first 15 days slightly. CONCLUSION: Mobile application usage did not increase the breastfeeding rate compared with standard practice but may reduce breastfeeding abandonment in the first 2 weeks postpartum.

Factors Influencing Duration of Breastfeeding: Insights from a Prospective Study of Maternal Health Literacy and Obstetric Practices.

Numerous factors concerning early breastfeeding abandonment have been described, including health literacy (HL). This study's objective was to analyze factors related to early breastfeeding abandonment (<6 months). This prospective multicentric study examined the duration of breastfeeding at 6 months postpartum and was conducted in four different regions of Spain from January 2021 to January 2023. A total of 275 women participated in this study, which focused on maternal HL and obstetric practices. A decrease in the breastfeeding rate was observed from hospital discharge (n = 224, 81.5%) to the sixth month postpartum (n = 117, 42.5%). A Cox regression analysis revealed that inadequate HL levels, lack of mobilization during labour, and induced labour were significantly associated with early breastfeeding cessation (p = 0.022, p = 0.019, and p = 0.010, respectively). The results highlight that women with adequate HL had a 32% lower risk of early breastfeeding abandonment. In comparison, mobilization during labour and induction of labour were linked to a 32.4% reduction and a 53.8% increase in this risk, respectively. These findings emphasize the importance of considering obstetric and HL factors when addressing the breastfeeding duration, indicating opportunities for educational and perinatal care interventions.

Strong Light-Matter Coupling in Lead Halide Perovskite Quantum Dot Solids.

Strong coupling between lead halide perovskite materials and optical resonators enables both polaritonic control of the photophysical properties of these emerging semiconductors and the observation of fundamental physical phenomena. However, the difficulty in achieving optical-quality perovskite quantum dot (PQD) films showing well-defined excitonic transitions has prevented the study of strong light-matter coupling in these materials, central to the field of optoelectronics. Herein we demonstrate the formation at room temperature of multiple cavity exciton-polaritons in metallic resonators embedding highly transparent Cesium Lead Bromide quantum dot (CsPbBr3-QD) solids, revealed by a significant reconfiguration of the absorption and emission properties of the system. Our results indicate that the effects of biexciton interaction or large polaron formation, frequently invoked to explain the properties of PQDs, are seemingly absent or compensated by other more conspicuous effects in the CsPbBr3-QD optical cavity. We observe that strong coupling enables a significant reduction of the photoemission line width, as well as the ultrafast modulation of the optical absorption, controllable by means of the excitation fluence. We find that the interplay of the polariton states with the large dark state reservoir plays a decisive role in determining the dynamics of the emission and transient absorption properties of the hybridized light-quantum dot solid system. Our results should serve as the basis for future investigations of PQD solids as polaritonic materials.

Active control of polariton-enabled long-range energy transfer.

Optical control is achieved on the excited state energy transfer between spatially separated donor and acceptor molecules, both coupled to the same optical mode of a cavity. The energy transfer occurs through the formed hybrid polaritons and can be switched on and off by means of ultraviolet and visible light. The control mechanism relies on a photochromic component used as donor, whose absorption and emission properties can be varied reversibly through light irradiation, whereas in-cavity hybridization with acceptors through polariton states enables a 6-fold enhancement of acceptor/donor contribution to the emission intensity with respect to a reference multilayer. These results pave the way for synthesizing effective gating systems for the transport of energy by light, relevant for light-harvesting and light-emitting devices, and for photovoltaic cells.

Ultrastrong exciton-plasmon couplings in WS2 multilayers synthesized with a random multi-singular metasurface at room temperature.

Van der Waals semiconductors exemplified by two-dimensional transition-metal dichalcogenides have promised next-generation atomically thin optoelectronics. Boosting their interaction with light is vital for practical applications, especially in the quantum regime where ultrastrong coupling is highly demanded but not yet realized. Here we report ultrastrong exciton-plasmon coupling at room temperature in tungsten disulfide (WS2) layers loaded with a random multi-singular plasmonic metasurface deposited on a flexible polymer substrate. Different from seeking perfect metals or high-quality resonators, we create a unique type of metasurface with a dense array of singularities that can support nanometre-sized plasmonic hotspots to which several WS2 excitons coherently interact. The associated normalized coupling strength is 0.12 for monolayer WS2 and can be up to 0.164 for quadrilayers, showcasing the ultrastrong exciton-plasmon coupling that is important for practical optoelectronic devices based on low-dimensional semiconductors.

Association between endothelial biomarkers and lipid and glycemic levels: a cross-sectional study with diabetic patients.

Background: Biomarkers can help understand the impact of achieving therapeutic goals in developing vascular diseases in diabetics. Aim: To assess the association between lipid and glycemic profiles and endothelial biomarkers in diabetics. Methods: Cross-sectional study that evaluated lipid and glycemic levels and biomarkers (VCAM-1, Sdc-1, FGF-23 and KIM-1 in diabetics. Results: Higher VCAM-1 levels were associated with higher low-density lipoprotein cholesterol and non-high-density lipoprotein (HDL) cholesterol levels (in the group with inadequate glycohemoglobin A1c [HbA1c] levels), with higher glycemic levels (in the group with inadequate HDL cholesterol levels) and with lower HDL cholesterol levels (both groups). VCAM-1 was independently associated with not achieving adequate HbA1c levels. Conclusion: In uncontrolled diabetics, VCAM-1 was independently associated with having inadequate HbA1c levels, suggesting they may already have endothelial damage.

Ecografía del tercer trimestre combinada con un método clínico para mejorar la predicción del peso del recién nacido a término: un estudio de cohortes en España / Third trimester ultrasound scan combined with a clinical method for accurate birthweight prediction at term: a cohort study in spain

Abstract Objective: To develop and assess an equation based on maternal clinical parameters and third trimester ultrasound biometry (combined method), and compare it with ultrasound estimated foetal weight (EFW) calculated using the Hadlock 2 formula. Material and methods: Cohort study. A total of 1,224 women with singleton pregnancies who had undergone foetal ultrasound scanning (USS) at 34 weeks were recruited. The study was conducted at a reference center in Valencia (Spain) between January and December 2016. A gestation-adjusted projection (GAP) method was applied to estimated foetal-weight-for-gestational-age by foetal gender at delivery (EFWa). A multivariate regression was created to estimate foetal weight at term (EFWmr) using anthropometric, demographic, ultrasonographic and obstetric-neonatal variables. EFWa and EFWmr were calculated and compared with actual birthweight. Results: The proportion for EFWmr within <10% of actual birthweight was greater than EFWa (82% vs. 65%, p<0.001). The mean relative error in foetal-weight predictions by using EFWmr was reduced from 6.7% to 0.9% (difference 5.7% 95% CI: 5.4 to 6.0) paired t-test p<0.001, significantly improving the accuracy attainable with USS. The EFWmr outperformed the GAP method in predicting birthweight, within 1% relative error. For new- borns <2,500 g, the proportion of estimates within <10% of the actual birthweight for the EFWmr was greater than that of the EFWa (20.4 vs. 16.3%, p=0.005). For babies with normal birthweight (2,500-3,999 g), EFWmr was a better predictor of birthweight than EFWa (84.5 vs. 65.7%, p<0.001). Conclusions: Mathematical modelling to predict birthweight improves third trimester routine ultrasound measurement to estimate neonatal weight at term.

RESUMEN Objetivos: desarrollar y evaluar un modelo predictivo de acuerdo con los parámetros clínicos maternos y la biometría de la ecografía del tercer trimestre, que pueda mejorar el poder de predicción del peso al nacer en el recién nacido a término, en comparación con la estimación calculada por ecografía del peso fetal (PFE) usando la fórmula de Hadlock II. Materiales y métodos: revisión de 1224 mujeres con embarazos únicos que se habían sometido a una ecografía fetal a las 34 semanas (EF). El estudio se realizó en un centro de referencia en Valencia (España) entre enero y diciembre de 2016. Se aplicó un método de proyección ajustada de gestación (PAG) para estimar el peso al nacer para la edad gestacional y sexo fetal en el parto (PFEa). Se creó una regresión multivariante para estimar el peso fetal al nacer (PFErm) mediante variables antropométricas, demográficas, ecográficas y obstétrico-neonatales. Los modelos PFErm y PFEa fueron calculados para comparar sus diferencias respecto al peso real al nacer. Resultados: la proporción de PFErm dentro de < 10 % del peso real al nacer fue mayor que la de PFEa (82 % vs. 65 %, p< 0,001). El error relativo medio en las predicciones de peso fetal mediante el uso PFErm pasó de 6, a 0,9 % (Diferencia de proporciones: 5,7 %; IC 95 %: 5,4-6,0); medias pareadas: p < 0,001, siendo significativamente mejor que la precisión que puede ser obtenida con el método ecográfico. El PFErm superó al método PAG y predice el peso al nacer con un error relativo del 1 %. Para recién nacidos con < 2500 g la proporción de estimaciones del peso real < 10 % del PFErm fue mayor que la del PFEa (20,4 % vs. 16,3 %; p = 0,005). En los recién nacidos con peso normal al nacer (2500-3999 g), la capacidad predictiva para estimar el peso al nacer realizada mediante PFErm fue mejor que la realizada mediante PFEa (84,5 % vs. 65,7%; p < 0,001). Conclusiones: el modelo matemático creado para predecir el peso al nacer mejora la medición rutinaria de la ecografía en el tercer trimestre del embarazo para estimar el peso del recién nacido a término.

Mantenimiento de la lactancia materna exclusiva a los 3 meses posparto: experiencia en un departamento de salud de la Comunidad Valenciana / Maintenance of exclusive breastfeeding after three months postpartum: An experience in a health department of a Valencian Community

Objetivos: Determinar la prevalencia de la lactancia materna exclusiva (LME) a los 3 meses posparto, y conocer las causas que contribuyen al abandono precoz. Diseño: Estudio observacional y restrospectivo. Emplazamiento: Departamento de Salud de la Ribera, Valencia, España. Participantes: Niños nacidos entre diciembre de 2012 y enero de 2017. Mediciones principales: prevalencia de lactancia materna al alta y de LME a los 3 meses. Motivos de abandono de LME. Determinación de Chi-cuadrado entre variables categóricas. Metodología: Las mujeres fueron entrevistadas en el posparto y a los 3 meses posparto, teniendo en cuenta las variables asociadas al inicio de la lactancia y su continuación. También se recogió información sobre las características socio-demográficas y obstétrico-neonatales. Resultados: Un total de 1.338 mujeres fueron seleccionadas. La prevalencia de lactancia materna al alta se situó en el 68,2% (913) y a los 3 meses descendió al 46,7% (625). La duración de la LME fue de 68,7±32,7 días (IC 95%: 66,9-71,2). Encontramos diferencias estadísticamente significativas entre el tipo de lactancia al alta y las variables, año del estudio, país de origen y paridad (p < 0,001; p = 0,005 y p = 0,05, respectivamente). La hipogalactia (21,8%) y el aumento de peso del recién nacido inferior al recomendado (14,9%) fueron los factores más frecuentes que motivaron el abandono precoz. Conclusiones: La prevalencia de la LME a los 3 meses es baja comparada con otros estudios similares, aunque observamos una tendencia al alza. La creencia en la hipogalactia influyó en el mantenimiento de la LME

Aims: To investigate the prevalence of EBF at 3-months postpartum, and the early factors for discontinuation. Design: Observational, retrospective study. Location: Health department of La Ribera, Valencia, Spain. Participants: Newborns between December 2012 to January 2017. Methods: Pregnant women were interviewed at postpartum and at 3 months regarding variables associated with breastfeeding initiation and continuation, matched with socio-demographic and obstetric-neonatal information. Main measurements: Prevalence of breastfeeding at discharge and exclusive breastfeeding at 3 months. Reasons for interrupt exclusive breastfeeding. Chi-square determination between qualitative variables. Findings: One thousand three hundred and thirty-eighth women were recruited. EBF at discharge was 68.2% (913) and at 3 months 46.7% (625). EBF duration was 68.7±32.7 days (95% CI: 66.9-71.2). We found statistically significant differences between the type of breastfeeding and the variables, year of study, country of origin and parity (P<0.001, P=0.005 and P=0.05 respectively). Hypogalactia (21.8%) and lower than recommended increase in newborn weight gain (14.9%) were most frequent factors for discontinuation. Conclusion: The prevalence of EBF at 3 months is low compared to other similar studies, although we see an upward trend. Belief in hypogalactia influenced the maintenance of exclusive breastfeeding

Sexualidade nas pessoas com traumatismo vertebro-medular: Intervenções do enfermeiro especialista em enfermagem de reabilitação / Sexuality in people with spinal cord injury: Interventions by rehabilitation nurses

Enquadramento teórico: A lesão vertebro medular causa um grande impacto na vida das pessoas. A sexualidade é uma parte integrante da vida do ser humano. Quando acometido por uma lesão medular, a pessoa sofre sequelas sensório motoras que condicionam a vivência da atividade sexual. Considerando que, após uma lesão vertebro medular, o ser humano não passa a ser assexuado, é necessário estabelecer um plano de intervenção de Enfermagem de Reabilitação para facilitar a adaptação e conduzir à nova realidade. Objetivos: identificar as dificuldades a nível da sexualidade dos indivíduos que sofrem uma Lesão Vertebro Medular (LVM); identificar as intervenções do Enfermeiro Especialista em Enfermagem de Reabilitação (EEER) para potencializar a funcionalidade, relativamente à sexualidade, das pessoas com LVM. Metodologia: estudo de natureza exploratória, descritiva com abordagem qualitativa do tipo fenomenológico. Nele participaram nove pessoas, duas do sexo feminino e sete do sexo masculino, com idades entre os 20 e os 50 anos. Foi solicitado o preenchimento de um questionário, via email, para os participantes que reuniam os critérios de inclusão. Dos inquiridos que aceitaram fazer parte da amostra, foi realizada a análise das suas respostas, que permitiu entender a vivência da sexualidade no regresso a casa e a intervenção do Enfermeiro Especialista em Enfermagem de Reabilitação (EEER). Resultados: do estudo emergiram quatro áreas principais: a adaptação e as novas aprendizagens; a autoestima; a resposta física; e o papel dos EEER. Conclusões: Os/as participantes expõem que a LVM é um acontecimento devastador e que trouxe grandes alterações/dificuldades relativamente à sua sexualidade. Reconhecendo as limitações inerentes à LVM e analisando as dificuldades e sugestões obtidas, é premente mudar paradigmas da Enfermagem de Reabilitação em relação ao papel do EEER no campo da sexualidade. Deste estudo, fica patente a necessidade de implementar medidas baseadas numa abordagem sem tabus em relação ao sexo, com informações precisas, claras e baseadas na evidência científica que permitam à pessoa e à família uma transição eficaz.

Las matronas y la alfabetización en salud relacionada con la vacunación, ¿un aspecto infrautilizado? / Midwives, vaccines and health literacy: an underexplored relationship?

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¿Podemos mejorar la predicción del peso al nacer? Modelo multivariante en mujeres en normopeso / Can we improve prediction of birth weight? A multivariate model in women with normal body mass index

Objetivo. Construir un modelo predictivo que mejore la estimación del peso del recién nacido. Material y métodos. Estudio observacional y descriptivo sobre 140 gestantes seleccionadas con muestreo bietápico en el Departamento de Salud de La Ribera (Valencia). Se clasificaron en 4 grupos dependiendo del índice de masa corporal (IMC) pregestacional. El peso fetal fue estimado por ecografía en la semana 35 a 40 de gestación por un ginecólogo. Resultados. Las variables que se relacionaron estadísticamente con el peso al nacer para la categoría de IMC pregestacional de normopeso fueron: altura uterina medida entre la semana 35-40 de gestación, peso proyectado a la semana 40 por la ecografía del tercer trimestre (PP40s), edad gestacional, ferritina sérica del tercer trimestre y cigarrillos consumidos en el tercer trimestre (p < 0,001; p < 0,001; p < 0,001; p = 0,007; p = 0,006, respectivamente). Se construyó un modelo multivariante para la categoría de normopeso para estimar el peso al nacer (PErm) obteniendo una R2 = 0,72 (F = 47,32; p < 0,001). Las diferencias de las medias obtenidas entre PP40s y PErm, con el peso del recién nacido, fueron significativas (p < 0,001). El modelo multivariante infravalora el peso al nacer en 0,07 g (error medio 0,54%) y la PP40s lo sobrestima en 300,89 g (error medio 10,75%). Conclusiones. El modelo multivariante construido, para la categoría de normopeso, mejora la precisión de la ecografía (AU)

Objectives. To construct a predictive model that improves birthweight estimation. Material and methods. A comparative, descriptive study was carried out in 140 pregnant women selected through two-stage sampling in the health department of La Ribera (Spain). The women were classified in 4 groups depending on their pre-gestational body mass index (BMI). Fetal weight was estimated by ultrasound at 35-40 weeks by a gynecologist. Results. The variables significantly related to birth weight in women with a normal pregestational BMI were, symphysis fundal height between 35-40 weeks, projected birth weight estimated at 40 weeks by ultrasound, gestational age, ferritin level in the third trimester, and the number of cigarettes smoked in the third trimester (P<.001, P<.001, P<.001, P<.007, P<.006, respectively). A multivariate model was created for the normal weight group to estimate birth weight, resulting in R2=.72 (F=47.32, P<.001). The differences in the means for fetal weight at week 40 and projected birth weight estimated by ultrasound at 35-40 weeks with birth weight were significant (P<.001). Birth weight was underestimated by 0.07 g in the multivariate model (mean error 0.54%) and overestimated by 300.89 g by projected birth weight estimated at 35-40 weeks (mean error 10.75%). Conclusions. The multivariate model created for the normal weight group improves the accuracy of ultrasound (AU)

Estrutura fatorial do WISC-III em crianças com dificuldades de aprendizagem / WISC-III factor structure for children with learning disabilities / Estructura factorial del WISC-III en niños con problemas de aprendizaje

O presente trabalho busca verificar qual o modelo fatorial mais adequado para o WISC-III no grupo clínico das crianças com dificuldades de aprendizagem. Foram analisados 263 protocolos de testes aplicados em alunos de escolas públicas, encaminhados por seus professores para avaliação psicológica. Foram utilizadas as técnicas estatísticas da análise fatorial exploratória e confirmatória. O presente estudo, além de corroborar a estrutura fatorial definida na padronização brasileira, vai ao encontro dos resultados da pesquisa internacional quanto à definição do modelo de quatro fatores como o de melhor ajuste para esse grupo clínico. Apesar de também ter identificado dois modelos trifatoriais como vantajosos quanto ao ajuste, parcimônia e interpretabilidade teórica, a estrutura quadrifatorial é a mais indicada para interpretar clinicamente as pontuações que expressam as habilidades cognitivas do grupo estudado, uma vez que permite aproveitar as normas existentes do WISC-III para a população geral.

This work contributes to the investigation of a factorial model that is more appropriate for Brazilian children with learning disabilities (LD). 263 WISC-III test protocols of public school students with academic difficulties referred by their teachers for psychological evaluation were analyzed. Statistical techniques of exploratory factor analysis and confirmatory factor analysis were performed. This study, besides corroborating the factor structure defined in the Brazilian standardization, meets the results of the international research for the definition of four-factor model as the best adjusting for the LD population. Although we have also identified two three-factor models as advantageous as to the fit, parsimony and theoretical interpretability, the four-factor structure is the most suitable for clinical interpretation of the scores that express the LD group cognitive abilities, since it allows us to leverage existing standards of WISC-III for the general population.

El presente trabajo busca verificar cual el modelo factorial más adecuado para el WISC-III en el grupo clínico de niños con dificultades de aprendizaje. Se analizaron 263 testes aplicados en alumnos de escuelas públicas, encaminados por sus maestros para evaluación psicológica. Se utilizaron las técnicas estadísticas del análisis factorial exploratorio y confirmatorio. Este estudio, además de corroborar la estructura factorial definida en la estandarización brasileña, coincide con los resultados de la investigación internacional en cuanto a la definición del modelo de cuatro factores como de mejor ajuste para ese grupo clínico. Además de haber también identificado dos modelos trifactoriales como ventajosos en cuanto al ajuste, a la economía factorial y a la interpretabilidad teórica, la estructura de cuatro factores es la más indicada para interpretar clinicamente los puntajes que expresan las habilidades cognitivas del grupo estudiado, pues permite aprovechar las normas ya existentes del WISC-III para la población general.

Estrutura fatorial do WISC-III em crianças com dificuldades de aprendizagem / WISC-III factor structure for children with learning disabilities / Estructura factorial del WISC-III en niños con problemas de aprendizaje

O presente trabalho busca verificar qual o modelo fatorial mais adequado para o WISC-III no grupo clínico das crianças com dificuldades de aprendizagem. Foram analisados 263 protocolos de testes aplicados em alunos de escolas públicas, encaminhados por seus professores para avaliação psicológica. Foram utilizadas as técnicas estatísticas da análise fatorial exploratória e confirmatória. O presente estudo, além de corroborar a estrutura fatorial definida na padronização brasileira, vai ao encontro dos resultados da pesquisa internacional quanto à definição do modelo de quatro fatores como o de melhor ajuste para esse grupo clínico. Apesar de também ter identificado dois modelos trifatoriais como vantajosos quanto ao ajuste, parcimônia e interpretabilidade teórica, a estrutura quadrifatorial é a mais indicada para interpretar clinicamente as pontuações que expressam as habilidades cognitivas do grupo estudado, uma vez que permite aproveitar as normas existentes do WISC-III para a população geral.(AU)

This work contributes to the investigation of a factorial model that is more appropriate for Brazilian children with learning disabilities (LD). 263 WISC-III test protocols of public school students with academic difficulties referred by their teachers for psychological evaluation were analyzed. Statistical techniques of exploratory factor analysis and confirmatory factor analysis were performed. This study, besides corroborating the factor structure defined in the Brazilian standardization, meets the results of the international research for the definition of four-factor model as the best adjusting for the LD population. Although we have also identified two three-factor models as advantageous as to the fit, parsimony and theoretical interpretability, the four-factor structure is the most suitable for clinical interpretation of the scores that express the LD group cognitive abilities, since it allows us to leverage existing standards of WISC-III for the general population.(AU)

El presente trabajo busca verificar cual el modelo factorial más adecuado para el WISC-III en el grupo clínico de niños con dificultades de aprendizaje. Se analizaron 263 testes aplicados en alumnos de escuelas públicas, encaminados por sus maestros para evaluación psicológica. Se utilizaron las técnicas estadísticas del análisis factorial exploratorio y confirmatorio. Este estudio, además de corroborar la estructura factorial definida en la estandarización brasileña, coincide con los resultados de la investigación internacional en cuanto a la definición del modelo de cuatro factores como de mejor ajuste para ese grupo clínico. Además de haber también identificado dos modelos trifactoriales como ventajosos en cuanto al ajuste, a la economía factorial y a la interpretabilidad teórica, la estructura de cuatro factores es la más indicada para interpretar clinicamente los puntajes que expresan las habilidades cognitivas del grupo estudiado, pues permite aprovechar las normas ya existentes del WISC-III para la población general.(AU)