Synthetic Corpus Generation for Deep Learning-Based Translation of Spanish Sign Language.

Sign language serves as the primary mode of communication for the deaf community. With technological advancements, it is crucial to develop systems capable of enhancing communication between deaf and hearing individuals. This paper reviews recent state-of-the-art methods in sign language recognition, translation, and production. Additionally, we introduce a rule-based system, called ruLSE, for generating synthetic datasets in Spanish Sign Language. To check the usefulness of these datasets, we conduct experiments with two state-of-the-art models based on Transformers, MarianMT and Transformer-STMC. In general, we observe that the former achieves better results (+3.7 points in the BLEU-4 metric) although the latter is up to four times faster. Furthermore, the use of pre-trained word embeddings in Spanish enhances results. The rule-based system demonstrates superior performance and efficiency compared to Transformer models in Sign Language Production tasks. Lastly, we contribute to the state of the art by releasing the generated synthetic dataset in Spanish named synLSE.

Prophylactic EUS-guided gallbladder drainage prevents acute cholecystitis in patients with malignant biliary obstruction and cystic duct orifice involvement: a randomized trial (with video).

BACKGROUND AND AIMS: Patients with distal malignant biliary obstruction (MBO) and cystic duct orifice tumoral involvement have an increased risk for the development of acute cholecystitis after self-expandable metallic stent (SEMS) placement. We aimed to determine whether primary EUS-guided gallbladder drainage prevents acute cholecystitis in these patients. METHODS: This was a single-center, randomized control trial in patients with distal MBO enrolled from July 2018 to July 2020. Patients were randomized into 2 groups: an interventional group treated with conventional ERCP biliary drainage with SEMS placement and subsequent primary EUS-guided gallbladder drainage (EUS-GBD) and a control group treated with conventional biliary drainage alone. The primary outcome of the study was the occurrence of post-treatment acute cholecystitis, assessed for ≤12 months or until death. The secondary outcomes were hospitalization length and median survival time. RESULTS: Forty-four patients were included in the study: 22 in each group. Five patients in the control group (22.7%) and none in the intervention group experienced acute cholecystitis. The median hospitalization time was significantly lower in the interventional group than in the control group (2 days vs 1 day, P = .017). There was no difference in the observed median survival rates in the primary EUS-GBD group (2.9 months) and the control group (2.8 months) (P = .580). CONCLUSION: In this single-center study of patients with unresectable MBO and occlusion of the cystic duct orifice, prophylactic EUS-GBD demonstrated a reduced incidence of acute cholecystitis.

Exocrine Pancreatic Insufficiency is Undiagnosed in Some Patients with Diarrhea-Predominant Irritable Bowel Syndrome Using the Rome IV Criteria.

BACKGROUND AND AIMS: Irritable bowel syndrome (IBS) is one of the most frequent disorders in clinical practice, with a mean 7.6-10.8% worldwide prevalence. A study showed that 6.1% of patients with diarrhea-predominant IBS (IBS-D) had severe exocrine pancreatic insufficiency (EPI). We aimed to identify the prevalence of EPI based on fecal elastase stool testing (Fel-1) in IBS-D and the clinical characteristics that may predict the diagnosis of EPI. METHODS: Patients aged > 18 years presenting to tertiary hospital outpatient clinics with IBS-D completed validated questionnaires and gave a stool sample where Fel-1 concentration was measured. Patients with Fel-1 < 100 µg/g represented EPI and > 100 to < 200 µg/g underwent testing for pancreatic pathology with laboratory and endoscopic ultrasound (EUS) evaluation. RESULTS: One hundred forty patients (mean age 60 years, females 75.7%) were studied. EPI was found in 5% (95% CI 2.2-10.4), and pancreatic steatosis was the main EUS finding (71%). Dyspepsia was an independent factor associated with EPI (OR 34.7; 95% CI 4.95-366.37, p = 0.0007). After pancreatic enzyme replacement therapy (PERT), patients showed a significant improvement in the Bristol stool scale (p < 0.0001), bowel movements per day (p < 0.005), distension score (0.0009), pain score (0.0277) and IBS severity (0.0034). CONCLUSION: EPI is present in 5% of patients who fulfill Rome IV criteria for D-IBS, and dyspepsia was an independent symptom strongly associated with EPI. Pancreatic steatosis was the main endoscopic ultrasound finding. After PERT therapy, patients had significantly improved stool frequency, stool consistency, abdominal pain, distension and IBS severity score.

Vascularity can distinguish neoplastic from non-neoplastic bile duct lesions during digital single-operator cholangioscopy.

BACKGROUND AND AIMS: Various macroscopic features are proposed for the diagnosis of biliary lesions during digital single-operator cholangioscopy (DSOC); however, neovasculature may be one of the most reliable features of neoplasia. We aimed to evaluate the detection of neovasculature during DSOC to distinguish neoplastic from non-neoplastic bile duct lesions. METHODS: A retrospective, single-center, cohort study was used. Neovasculature was defined as the presence of irregular or "spider" vascularity on bile duct lesions. The accuracy of detection of neovasculature for the identification of neoplastic lesions was estimated using the histologic results, surgical specimens, and/or 6-month follow-up as the criterion standard. Interobserver agreement analysis (kappa value) was performed between 2 expert endoscopists and 3 nonexpert physicians. RESULTS: Ninety-five patients were included; the median age was 65.6 years (range, 20-93 years), and 51 (53.7%) patients were female. Signs of neovasculature were observed in 65 of 95 (68.4%) patients. Histology confirmed neoplasia in 48 of 95 (50.5%) patients, and 6-month follow-up survival confirmed neoplasia in 52 of 95 (54.7%) patients. The use of vascularity for identifying neoplastic lesions achieved an accuracy of 80%, sensitivity of 94%, specificity of 63%, positive predictive value of 75%, negative predictive value of 90%, positive likelihood ratio of 2.53 (95% confidence interval, 1.71-3.76), and negative likelihood ratio of 0.09 (95% confidence interval, 0.03-0.28). The interobserver and intraobserver agreement were excellent (κ > 80%; P < .001) between expert endoscopists and nonexpert physicians. CONCLUSION: Detection of irregular or spider vascularity on bile duct lesions during DSOC evaluations accurately identifies biliary neoplastic lesions. Prospective multicenter trials are required to evaluate neovasculature as a single factor for predicting neoplasia.

Adverse childhood experiences. Knowledge and use by pediatrics residents.

INTRODUCTION: Adverse childhood experiences (ACEs) have been associated with the acquisition of risk behaviors and development of chronic and mental diseases since adolescence and in adult life. OBJECTIVE: To identify the knowledge and the frequency pediatrics residents ask about ACEs with. METHODS: Through an online survey sent to all resident physicians of the 2017-2018 academic year of a tertiary care children's hospital, demographic variables, knowledge, use, training and barriers to interrogate and search for ACEs were collected. RESULTS: 21% of residents answered the survey; the majority were women (70 %), less than 5 % of participants were familiar with ACEs, 31 % enquired about them in parents and their children, and 71 % considered having some barrier to interrogate about them. CONCLUSIONS: Participants in this study showed limited knowledge about ACEs, which had an impact on the frequency they enquired about them with in their patients and their parents; at least half had the perception that it is beyond the reach of the pediatrician to identify them.

INTRODUCCIÓN: Las experiencias adversas en la infancia (EAI) se han relacionado con la adquisición de conductas de riesgo y el desarrollo de enfermedades crónicas y mentales, desde la adolescencia y en la vida adulta. OBJETIVO: Identificar el conocimiento y la frecuencia con la que médicos residentes de pediatría interrogan sobre las EAI. MÉTODOS: Mediante una encuesta en línea enviada a todos los médicos residentes del año académico 2017-2018 de un hospital pediátrico de tercer nivel, se recabaron variables demográficas, del conocimiento, uso, entrenamiento y barreras para interrogar sobre EAI. RESULTADOS: 21 % de los residentes respondió la encuesta, la mayoría fue del sexo femenino (70 %), menos de 5 % de los participantes estaba familiarizado con las EAI, 31 % interrogaba sobre ellas a los padres e hijos y 71 % consideró que tiene alguna barrera para interrogarlas. CONCLUSIONES: Los participantes de este estudio mostraron un conocimiento limitado sobre las EAI, lo que repercutió en la frecuencia con la que preguntaban al respecto a sus pacientes y padres; al menos la mitad tuvo la percepción que identificarlas está fuera del alcance del pediatra.

Impact of a Virtual Endoscopy Training Curriculum in Novice Endoscopists: First Experience in Argentina.

BACKGROUND: Virtual reality simulation in gastrointestinal endoscopy is an educational tool that allows repetitive instruction in a non-patient care environment. AIM: To determine the impact of a virtual endoscopy training curriculum applying an objective pre- and post-training analysis on trainee endoscopists. METHODS: A before-after training study was carried out. Subjects were first year fellows of gastroenterology, who completed a questionnaire and then performed two pre-training simulated cases. The virtual endoscopy training curriculum consisted of an 8-h workday utilizing two GI MENTOR™ in a specialized clinical simulation center. After the training, all subjects completed the same two cases they did in the pre-training. Pre- and post-training results' comparisons were made by paired t test. RESULTS: Totally, 126 subjects were included (mean age 30 years, 61% female). A significant improvement from pre- to post-training was observed in psychomotor skills (total time, percentage, and number of balloons exploded) and endoscopic skills (cecal intubation time, percentage of examined mucosa, and efficacy of screening). There was also an improvement in the quality of the endoscopic study; percentage of examined mucosa over 85% showed a significant improvement post-training with an adjusted OR of 2.72 (95% CI 1.51-4.89, p = 0.001). CONCLUSIONS: Virtual endoscopy training curriculum produces a significant improvement in the trainee endoscopists performance and their psychomotor skills and introduces the concept of a quality endoscopic study in a non-patient, risk-free environment.

A rare cause of extrahepatic biliary tract stricture: a neuroendocrine carcinoma.

The case was an 82-year-old Hispanic female who complained of painless jaundice and weight loss. Endoscopic retrograde cholangiopancreatography (ERCP) showed a distal common bile duct (CBD) stricture with dilatation of the intra and extra-hepatic bile ducts.

Evaluation of four techniques for injection of the proximal interphalangeal joint in horses.

OBJECTIVE: To describe a dorsoproximal midline (DPM) standing technique for proximal interphalangeal joint (PIPJ) injection and to compare it to established dorsolateral flexed (DLF), palmaroproximal (PP), and dorsolateral standing (DLS) techniques. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Sixty cadaver equine thoracic limbs. METHODS: Limbs were divided into four groups (n = 15 each group), DLF, DPM, PP, and DLS. For each technique, three operators injected radiopaque contrast and methylene blue into the PIPJ in five limbs. The number of attempts required was recorded. Successful injection was confirmed by radiographic presence of contrast media within the PIPJ. Iatrogenic cartilage damage was assessed by gross examination. Statistical analysis was performed by Wilcoxon signed-rank test (P < .05). RESULTS: The overall success rates were 86.6% to 93.3%. Although there was no difference in success rate, the frequency of needle repositioning was influenced by injection technique (P = .009). Dorsolateral standing had the highest mean ± SD value of attempts required to insert the needle in the joint space (2.62 ± 1.94). Injection technique influenced cartilage damage (P = .025), with the highest frequency recorded for DLS. CONCLUSION: All four techniques for injecting the PIPJ were highly successful; DLS was associated with the highest number of needle repositionings and the highest incidence of iatrogenic injury to cartilage. CLINICAL SIGNIFICANCE: Dorsolateral flexed should be considered as an alternative to the DLS technique to reduce iatrogenic cartilage injury when injecting the PIPJ. Dorsoproximal midline and DLF techniques have success rates comparable to traditional techniques, with lower incidence of iatrogenic cartilage damage in cadaver limbs.

Few-mode fiber, splice and SDM component characterization by spatially-diverse optical vector network analysis.

This paper discusses spatially diverse optical vector network analysis for space division multiplexing (SDM) component and system characterization, which is becoming essential as SDM is widely considered to increase the capacity of optical communication systems. Characterization of a 108-channel photonic lantern spatial multiplexer, coupled to a 36-core 3-mode fiber, is experimentally demonstrated, extracting the full impulse response and complex transfer function matrices as well as insertion loss (IL) and mode-dependent loss (MDL) data. Moreover, the mode-mixing behavior of fiber splices in the few-mode multi-core fiber and their impact on system IL and MDL are analyzed, finding splices to cause significant mode-mixing and to be non-negligible in system capacity analysis.

Hybrid optical CDMA-FSO communications network under spatially correlated gamma-gamma scintillation.

In this paper, we propose a new hybrid network solution based on asynchronous optical code-division multiple-access (OCDMA) and free-space optical (FSO) technologies for last-mile access networks, where fiber deployment is impractical. The architecture of the proposed hybrid OCDMA-FSO network is thoroughly described. The users access the network in a fully asynchronous manner by means of assigned fast frequency hopping (FFH)-based codes. In the FSO receiver, an equal gain-combining technique is employed along with intensity modulation and direct detection. New analytical formalisms for evaluating the average bit error rate (ABER) performance are also proposed. These formalisms, based on the spatially correlated gamma-gamma statistical model, are derived considering three distinct scenarios, namely, uncorrelated, totally correlated, and partially correlated channels. Numerical results show that users can successfully achieve error-free ABER levels for the three scenarios considered as long as forward error correction (FEC) algorithms are employed. Therefore, OCDMA-FSO networks can be a prospective alternative to deliver high-speed communication services to access networks with deficient fiber infrastructure.

850-nm hybrid fiber/free-space optical communications using orbital angular momentum modes.

Light beams can carry orbital angular momentum (OAM) associated to the helicity of their phasefronts. These OAM modes can be employed to encode information onto a laser beam for transmitting not only in a fiber link but also in a free-space optical (FSO) one. Regarding this latter scenario, FSO communications are considered as an alternative and promising mean complementing the traditional optical communications in many applications where the use of fiber cable is not justified. This next generation FSO communication systems have attracted much interest recently, and the inclusion of beams carrying OAM modes can be seen as an efficient solution to increase the capacity and the security in the link. In this paper, we discuss an experimental demonstration of a proposal for next generation FSO communication system where a light beam carrying different OAM modes and affected by ℳ turbulence is coupled to the multimode fiber link. In addition, we report a better and more robust behavior of higher order OAM modes when the intermodal dispersion is dominant in the fiber after exceeding its maximum range of operation.

Healthy Eating in the Spanish University Community: A Case Study.

The Mediterranean Diet (MedD), which UNESCO recognizes as an Intangible Cultural Heritage, constitutes a healthy eating pattern that helps prevent illness. The aim of this work is to know how well the university community of Almeria (Spain) adheres to MedD as a healthy lifestyle standard. For this purpose, the authors administered a survey to students, teachers, and administrative and service personnel at the University of Almeria. The sample for the survey comprised 610 people. Of whom, 64.7% were women; 23% were Teaching, and Research Staff (PDI); 17.3% were Administration and Services Staff (PAS); and 59.7% were students. The average age was 32 years. Results show an average level of MedD adherence overall in the university community, although 40.9% have a low adherence level. The most representative MedD adherent can be profiled as a young Spanish female, who values sustainability, reads the labels of the products she consumes, exercises regularly, cooks healthy food, and recycles waste. We suggest [to the University authorities] to advertise the benefits of the Mediterranean Diet among the university community and offer menus based on the MedD in the university canteen.

Adolescent Behaviours and Their Relationship to the Risk of Developing Eating Disorders.

Eating disorders (ED) in adolescents represent a significant problem in today's society, with multiple factors influencing them, such as predisposing factors, precipitating factors and perpetuating factors. OBJECTIVE: This paper aimed to determine the relationships between some of the factors considered to be predisposing and precipitating in terms of the development of ED in adolescents and to relate them to the SCOFF index. PARTICIPANTS: The sample was made up of 264 subjects aged between 15 and 19 (48.8% females and 51.1% males). METHODS: This study was conducted in two phases. In the first study phase, a descriptive analysis of the sample was performed, encompassing the frequencies of the independent variables and dependent variable (ED). In the second phase of study, we created several linear regression models. RESULTS: A total of 11.7% of adolescents are at high risk for ED, and the variables that predict the variability of manifesting the danger of ED are the following: physical self-conception and family relationships. CONCLUSIONS: This work shows the need to approach eating disorders in a multidisciplinary way (biological and social), since this will enable the disease to be better conceptualized and prevention guidelines to be more effective.

Social and Individual Factors Associated with Eating Disorders in Young Athletes: Effects on Concentration and Fatigue.

Eating disorders are a growing societal problem, especially among young people. This study aims to determine the individual and social factors that support and perpetuate the risk of eating disorders (ED) and their possible consequences on an individual's athletic and academic performances. The sample consisted of 395 athletes between 12 and 16 years of age (M = 14.07; SD = 1.35), of whom 142 (35.9%) were female, and 253 (64.1%) were male. A questionnaire was administered to collect information on sociodemographic data, body image, use of social networks, social relationships, sports practice, risk of developing ED, and academic and sports performance. In the resulting analysis, an initial cross-tabulation was carried out to observe the body distortion of the respondents as a function of BMI, followed by a linear regression to analyze the factors influencing the risk of suffering from ED. In addition, correlations were made to determine the relationship between the risk of manifesting ED and academic and sports performance. The main results show that 77.7% of the young athletes present a risk of ED (M = 13.3; DT = 3.33) due to a high body image distortion, which becomes the determining factor. In addition, relationships with family and friends have a significant influence on this. On the other hand, behaviors related with eating disorders affect concentration (r = -0.122; p = 0.01) and fatigue (r = -0.376; p < 0.01). For all these reasons, generating and promoting prevention and early detection guidelines during adolescence is necessary.

Influence of the practice of physical exercise and healthy eating on the Vigour of university lectures.

Introduction: Vigour at work is characterized by high levels of energy and high desire to make an effort at work. This article is the result of a research carried out with university teachers in Spain whose main objective is to show what type and frequency of physical exercise and diet influence Vigour. Methods: The sample consisted of 121 subjects, 62% of whom were women and 37.2% men. A questionnaire was administered to collect information on sociodemographic data, physical exercise habits, eating habits and Vigour at work. Cross-tabulations of the dimensions of Vigour with sex, age and type of contract offered were performed. Spearman correlations and Correspondence Analysis are also carried out to provide information on the intensity and type of relationships between the Vigour dimensions. Finally, the influence of the frequency of physical exercise and diet on Total Vigour is investigated. Results: The results show that the relationships between the dimensions are very strong (sig = 0.001). In addition, the practice of moderate-high intensity physical exercise and maintaining a good adherence to the Mediterranean Diet is related to high levels of Total Vigour (F = 7.955; sig = 0.006). As for the influence of the sociodemographic variables used, significant differences were only observed in the Physical Strength dimension for sex (X2 = 6.173; p = 0.046) and age (X2 = 9.449; p = 0.051) and, with respect to the type of contract, in Emotional Energy (X2 = 19.487; p < 0.001). Discusión and conclusions: The main conclusions of our study show that practicing physical exercise of medium-high intensity four hours or more per week and a high adherence to the MD is more related to high Vigour levels than just eating well or just practicing exercise. And more studies are needed on the influence of sociodemographic variables on Vigour and its different dimensions.

Academic Stress in University Students: The Role of Physical Exercise and Nutrition.

The university experience can cause academic stress that, in turn, can lead to comorbidities. Students increasingly face demands and challenges that require a large amount of physical and psychological resources. These circumstances can make them experience physical and mental fatigue, lower their interest in studying, and even lead them to lose control over their academic performance and health. The objective of this work is to determine the relationship between the practice of physical exercise, eating patterns, and academic stress among university students. A questionnaire was administered to 742 students using non-probabilistic sampling. The mean age was 21.24 (DT = 3.8), and 20.1% were men and 79.4% were women. To identify academic stress, the Stress Manifestation Scale of the Students Stress Inventory (SSI) subscale was used; the Mediterranean Diet Score was applied for eating patterns, and the practice of exercise was measured by weekly hours of exercise. The results show that there is a relationship between academic stress and physical exercise, but not with adherence to the Mediterranean Diet. However, there is a relationship between the consumption of "unhealthy" foods exceeding the recommendations for the Spanish population and academic stress. In short, physical activity and diet are variables that are related to psychological well-being. Therefore, they should constitute the backbone of actions designed by university managers to eliminate or reduce stress suffered by students. Finally, the work demonstrates the need to create new scales that consider not only the foods that help alleviate stress but also their portions.