Two decades of assistive technologies to empower people with disability: a systematic mapping study.

PURPOSE: Information and Communication Technologies have transformed our lives in different social areas, facilitating interpersonal relationships thanks to technological tools. In the specific case of people with disabilities, Assistive Technologies (ATs) break down barriers and increase opportunities to become active members of society with equal opportunities. MATERIALS AND METHODS: This paper presents a systematic mapping study that analyzes the current state-of-the-art of ATs proposed in the literature to support the empowering of people with disability. Specifically, this paper focuses on (1) describing a global vision of the scientific literature published in the last 20 years about ATs in the computer science field and (2) identifying research needs, gaps, and trends. RESULTS: For this purpose, an in-depth analysis of 389 primary studies is presented. The information obtained from the mapping process is also constrained. Concretely, 35 ATs versus 22 disabilities are compared, obtaining striking peaks for some disabilities described in the discussion. CONCLUSIONS: Finally, the findings show that several areas have been covered only lightly, revealing interesting future directions and challenges for junior researchers.

• ATs have the potential to break down barriers for people with disabilities, enabling them to participate more fully in society. This implies a need for rehabilitation programs to incorporate ATs into their strategies to enhance social inclusion.• Given the transformative role of ICT, rehabilitation programs should focus on helping people with disabilities develop the necessary technological skills to utilize ATs effectively.• This work highlights the diversity of ATs and disabilities, suggesting a need for personalized rehabilitation plans that match specific ATs to individual disabilities.• Rehabilitation professionals should be trained to assess and recommend appropriate ATs for each case. Rehabilitation programs should consider incorporating cutting-edge ATs and staying involved in research to contribute to future developments to cover gaps and challenges identified.

From bench to bedside: Biosensing strategies to evaluate endocrine disrupting compounds based on epigenetic events and their potential use in medicine.

The relationship between endocrine system disorders and health risks due to chemical environmental compounds has become a growing concern in recent years. Involuntary exposure to endocrine disruptors (EDCs) is associated with the worldwide increase of diseases such as cancer, obesity, diabetes, and neurocortical disorders. EDCs are compounds that target the nuclear hormonereceptors (NHR) leading to epigenetic changes. Consequently, the use of biosensing strategies based on epigenetic events have a great potential to provide outstanding information about the exposition of EDCs and their evaluation in human health. This review addresses the novel trends in biosensing EDCs evaluation based on DNA methylation assays associated with different human diseases.

Clinical and therapeutic potential of protein kinase PKR in cancer and metabolism.

The protein kinase R (PKR, also called EIF2AK2) is an interferon-inducible double-stranded RNA protein kinase with multiple effects on cells that plays an active part in the cellular response to numerous types of stress. PKR has been extensively studied and documented for its relevance as an antiviral agent and a cell growth regulator. Recently, the role of PKR related to metabolism, inflammatory processes, cancer and neurodegenerative diseases has gained interest. In this review, we summarise and discuss the involvement of PKR in several cancer signalling pathways and the dual role that this kinase plays in cancer disease. We emphasise the importance of PKR as a molecular target for both conventional chemotherapeutics and emerging treatments based on novel drugs, and its potential as a biomarker and therapeutic target for several pathologies. Finally, we discuss the impact that the recent knowledge regarding PKR involvement in metabolism has in our understanding of the complex processes of cancer and metabolism pathologies, highlighting the translational research establishing the clinical and therapeutic potential of this pleiotropic kinase.

Working with the HL7 metamodel in a Model Driven Engineering context.

HL7 (Health Level 7) International is an organization that defines health information standards. Most HL7 domain information models have been designed according to a proprietary graphic language whose domain models are based on the HL7 metamodel. Many researchers have considered using HL7 in the MDE (Model-Driven Engineering) context. A limitation has been identified: all MDE tools support UML (Unified Modeling Language), which is a standard model language, but most do not support the HL7 proprietary model language. We want to support software engineers without HL7 experience, thus real-world problems would be modeled by them by defining system requirements in UML that are compliant with HL7 domain models transparently. The objective of the present research is to connect HL7 with software analysis using a generic model-based approach. This paper introduces a first approach to an HL7 MDE solution that considers the MIF (Model Interchange Format) metamodel proposed by HL7 by making use of a plug-in developed in the EA (Enterprise Architect) tool.

A Strategic Study about Quality Characteristics in e-Health Systems Based on a Systematic Literature Review.

e-Health Systems quality management is an expensive and hard process that entails performing several tasks such as analysis, evaluation, and quality control. Furthermore, the development of an e-Health System involves great responsibility since people's health and quality of life depend on the system and services offered. The focus of the following study is to identify the gap in Quality Characteristics for e-Health Systems, by detecting not only which are the most studied, but also which are the most used Quality Characteristics these Systems include. A strategic study is driven in this paper by a Systematic Literature Review so as to identify Quality Characteristics in e-Health. Such study makes information and communication technology organizations reflect and act strategically to manage quality in e-Health Systems efficiently and effectively. As a result, this paper proposes the bases of a Quality Model and focuses on a set of Quality Characteristics to enable e-Health Systems quality management. Thus, we can conclude that this paper contributes to implementing knowledge with regard to the mission and view of e-Health (Systems) quality management and helps understand how current researches evaluate quality in e-Health Systems.

Comparison of the prevalence and distribution of human papillomavirus infection and cervical lesions between urban and native habitants of an Amazonian region of Peru.

We made a study of the prevalence of human papillomavirus (HPV) and cervix lesions in an Amazonian Bora native population (Bn) and compared it with the prevalence in an urban population in Iquitos (Iq). We also examined the distribution of HPV types among abnormal cervical smears in the Iq population. Swabs and cytologies were collected from 472 females. DNA consensus PCR, followed by direct sequencing, were used to determinate the HPV types in the swabs. Cytologies were classified based on the lesion grade. HPV prevalence was 43.9% in Iq and 35.4% in Bn. Cervix lesion prevalence was 20.0% in Iq and 0.3% in Bn. The frequency of high-risk HPV types among HPV+ females was 71.9% in Iq and 56.3% in Bn. The frequencies of low-risk and undetermined risk HPV types were 19.3/6.3% (Iq/ Bn) and 12.3/37.5% (Iq/Bn), respectively. In lesIq (women seeking cytological services with a previous cervix lesion diagnosis) the prevalence of HPV, was 72.9%. The incidence of carcinoma and high-grade squamous intraepithelial cervix lesions in lesIq were 31.2 and 18.8%, respectively. The Bn population had a lower incidence of high-risk HPV and cervix lesions. The high-risk strain HPV16 was significantly more frequent in Iq compared with Bn. lesIq high-risk HPVs were more frequent in high-grade squamous intraepithelial lesions and carcinoma. High-risk HPV16 prevalence was significantly higher than the prevalence of the other high-risk HPVs, especially in the high-grade squamous intraepithelial lesions and carcinoma.

¿Qué debemos conocer de los inhibidores de bomba protones, para su uso en las unidades de dolor? / What need to know the Proton Pump Inhibitors to use in the chronic pain clinic?

Los inhibidores de la bomba de protones (IBP) son fármacos útiles para el control de la patología asociada con la acidez gástrica, patología con una alta prevalencia dentro de la población general. En las Unidades de dolor tratamos pacientes con pluripatología y polimedicados, entre ellas patologías asociadas con la acidez gástrica. Así como también utilizamos fármacos como AINES, glucocorticoides, bifosfonatos... que pueden reactivar, empeorar la patología ligada a la acidez. El conocimiento de los aspectos farmacológicos de los IBP, tanto farmacocinéticos como farmacodinámicos, es necesario y preciso para poder elegir el más adecuado para nuestros pacientes con pluripatologia y polimedicados evitando las posibles interacciones farmacológicas que podrían afectar al estado de salud de nuestros pacientes (AU)

Protón Pump Inhibitors (PPIs) have shown their usefulness in the treatment of acid-related disorders, highly prevalent in normal population. Pain units are used to treating patients with a wide range of diseases, including acid related-disorders, who are also being prescribed many different drugs, like NSAIDs, corticosteroids or biphosponates, which may reactívate or even worsen acid-related disorders. Knowledge of the pharmacological aspects of PPIs, both their pharmacokinetics and pharmacodynamics, is needed to properly choose the one which fits most to our multi-pathologic, multi-treated patients, in order to avoid possible pharmacological interactions than could endanger their health condition (AU)

Pioderma gangrenoso como síndrome paraneoplásico de un adenocarcinoma de recto / Gangrenous pyoderma as paraneoplastic syndrome of an adenocarnocima of the rectum

Propósito: Los síndromes paraneoplásicos sonentidades sintomáticas provocadas por el cáncer endiversos lugares del organismo. Su incidencia estáinfraestimada y no siempre son bien conocidos. Pretendemospresentar un ejemplo de los hechos quedebe cumplir una entidad nosológica para ser consideradacomo síndrome paraneoplásico: relacióntemporal y curso evolutivo paralelo.Material y métodos: Mujer de 72 años quedebuta con una lesión cutánea finalmente diagnosticadacomo pioderma gangrenoso precediendo a unaneoplasia digestiva.Conclusiones: El tumor digestivo más frecuentementeasociado al pioderma gangrenoso es elcolorectal. Se puede afirmar que está bien establecidala existencia de esta enfermedad cutánea comosíndrome paraneoplásico

Purpose: Paraneoplastic syndromes are clinicalsyndromes caused by tumors occurring in placesdistant from the tumor itself. Its incidence isunderestimated. We present a case of paraneoplasticsyndrome as an example, indicating thecharacteristics these syndromes must follow to beconsidered as suchMaterial and methods: A 72 year oldwoman with a skin disorder diagnosed as pyodermagangraenosum before the diagnosis of a colo-rectalcancer were made.Conclusion: Colo-rectal tumors are thedigestive neoplasms more frequently associated topyoderma. The relation between pyoderma as aparaneoplastic syndrome of colo-rectal cancer iswell established

HER-2-neu: ¿posible diana del carcinoma vesical? / HER-2-neu: a possible target of bladder carcinoma?

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Insulin resistance is not associated with liver fibrosis progression in HIV/hepatitis C virus-coinfected patients.

Insulin resistance (IR) is a common condition in chronic hepatitis C. Recent studies have reported that IR is associated with liver fibrosis progression in these patients. However, there is no information available on this issue in human immunodeficiency virus (HIV)/hepatitis C virus (HCV)-coinfected patients. For these reasons, we investigate the relationship between IR and liver fibrosis in patients with HIV and HCV infections. This was a cross-sectional study where patients from an Infectious Diseases Unit with HIV/HCV coinfection who underwent a liver biopsy, with available frozen sera samples at the time of biopsy and a known or estimated date of infection were included. IR was determined by the homeostasis model assessment (HOMA-IR) method. The relationship between histological findings and several variables, including HOMA-IR values, was examined. Seventy-nine patients fulfilled the inclusion criteria. Age at HCV infection >21 years was the only variable independently associated with advanced liver fibrosis (stages F3 and F4) [adjusted odds ratio (AOR) 4.15; 95% confidence interval (CI) 1.5-11.3]. The variables associated with a fibrosis progression rate above the median were age at HCV infection >21 years (AOR 6.41; 95% CI 2.16-27.96) and previous exposure to nevirapine (AOR 8.9; 95% CI 2.01-39.36). There was no association between HOMA-IR values and the presence of advanced fibrosis or a faster fibrosis progression. Thus IR is not associated with liver damage or fibrosis progression in HIV/HCV-coinfected individuals.

La forma de captar participantes influye en su grado de colaboración / The way participants are recruited affects their degree of collaboration

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Prediction of liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfected patients by simple non-invasive indexes.

BACKGROUND: Liver biopsy is an invasive technique with associated major complications. There is no information on the validity of five non-invasive indexes based on routinely available parameters, estimated and validated in hepatitis C virus (HCV) monoinfected patients, in human immunodeficiency virus (HIV)/HCV coinfected patients. AIM: To validate these predictive models of liver fibrosis in HIV/HCV coinfected patients. PATIENTS: A total of 357 (90%) of 398 patients from five hospitals were investigated, who underwent liver biopsy and who had complete data to validate all of the models considered. METHODS: The predictive accuracy of the indexes was tested by measuring areas under the receiver operating characteristic curves. Diagnostic accuracy was calculated by estimating sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values. RESULTS: The models performed better when liver biopsies>or=15 mm were used as reference. In this setting, the Forns and Wai indexes, models aimed at discriminating significant fibrosis, showed PPV of 94% and 87%, respectively. Using these models, 27-34% of patients could benefit from exclusion of liver biopsy. If both models were applied sequentially, 41% of liver biopsies could be spared. The indexes aimed at predicting cirrhosis achieved NPV of up to 100%. However, they showed very low PPV. CONCLUSIONS: The diagnostic accuracy of these models was lower in HIV/HCV coinfected patients than in the validation studies performed in HCV monoinfected patients. However, simple fibrosis tests may render liver biopsy unnecessary in deciding anti-HCV treatment in over one third of patients with HIV infection and chronic hepatitis C.

[Prevalence of serum antibodies against Bartonella ssp. in a health population from the south area of the Seville province]. / Prevalencia de anticuerpos séricos frente a Bartonella spp. en una población sana del área sur de la provincia de Sevilla.

OBJECTIVE: To know the prevalence of serum antibodies against Bartonella spp. in a healthy population from south of Spain. PATIENTS AND METHODS: A clinical-epidemiological survey was conducted among 146 healthy individuals. An indirect immunofluorescence commercial technique was used in a sample of serum from each individual to detect the present of IgG type serum antibodies against Bartonella spp., considering a result equal to or greater than 1:128 as positive. RESULTS: Thirty six (24.7%) of all the subjects studied were asymptomatic carriers of antibodies against Bartonella spp. No crossed reactions against Chlamydia trachomatis, C. pneumoniae or Coxiella burnetti were observed. No significant association was found between the presence of seropositivity for Bartonella spp. and other factors. CONCLUSION: There is an elevated frequency of asymptomatic carriers of antibodies against Bartonella spp. among the healthy population of our area. This suggests that most of the infections by Bartonella are subclinical.

Valoración del dolor de los pacientes ingresados en un Servicio de Oncología / Pain assessment of inpatients at an Oncology Department

El dolor es un síntoma que disminuye en gran medida la calidad de vida de los pacientes oncológicos, por lo que creímos oportuno un estudio en nuestro medio analizando dicho síntoma y el tratamiento que aplicamos para su control. Para lo cual realizamos un estudio transversal con todos los pacientes oncológicos que ingresaron en nuestro servicio a lo largo de un mes, valorando la presencia o no de dolor, así como si lo hubiera, el tipo, etiología e intensidad y el tratamiento que recibían. Encontramos que el dolor es un síntoma frecuente, en la mayoría de los casos se debe al efecto directo del tumor o sus metástasis y suele ser de características somáticas. No siempre se valora de forma adecuada, tanto en tipo como en intensidad, lo que nos puede llevar a la aplicación de un tratamiento poco apropiado o deficiente en algunas ocasiones, así mismo, sería preciso poner una mayor atención en el tratamiento de los efectos secundarios de los analgésicos para conseguir un buen control sintomático (AU)

Pain is a symptom that decreases quality of life in oncologic patients, and we thought it important to study this symptom as well as the treatment applied for its control in our setting. Thus we performed a cross-sectional study in all oncologic inpatients seen in our department over one month, in whom we analyzed the presence or absence of pain, and in the former case we assessed its etiology, type, severity, and treatment. We found that pain is a frequent symptom, most often produced by a direct effect of tumor or metastatic disease, and usually has somatic characteristics. It is not always properly assessed, and this may lead to deficient treatment. In addition, treating analgesic medication side effects is important for a good symptoms control (AU)

[Texas revised inventory of grief: adaptation to Spanish, reliability and validity]. / Inventario Texas Revisado de Duelo (ITRD): adaptación al castellano, fiabilidad y validez.

OBJECTIVES: To adapt into Spanish the Texas Revised Inventory of Grief (TRIG) of Faschinbaguer et al (1977, 1981) and to examine its reliability and validity. DESIGN: Two stages: a) cross-culture adaptation of a questionnaire, and b) cross-sectional study of reliability and validity. SETTING: Primary care teams in Vizcaya, north of Spain. PARTICIPANTS: 118 people who had been widowed between 3 months and 3 years before the study. MAIN MEASUREMENTS AND RESULTS: Cross-culture adaptation: the TRIG was translated from American English, then back-translated and finally compared with the version in American Spanish by Grabowski & Frantz (1993). Reliability: the Cronbach's alpha coefficients (internal consistency) of the 2 TRIG scales were 0.75 and 0.86. Factorial validity: all items except one threw saturation >0.40 on the 2 factors extracted from the varimax rotation. Validity by hypothesis: the TRIG scales showed differences (P<.05) between the grieving in terms of the expected or unexpected character of death, the place where death occurred and time elapsed since the death. The scores on the adapted TRIG were similar to scores on the American Spanish TRIG for Latins and higher than those on the original TRIG and the American Spanish TRIG for Anglo-saxons. Convergent validity: the 2 TRIG scales correlated positively (P<.05) with all the clinical scales on the Inventory of Grief Experiences of Sanders et al (1985) and García García et al (2001). CONCLUSIONS: In the evaluation of grief due to the death of the spouse, the TRIG adapted to Spanish is as reliable and valid as the original version.

Relationship between osteopenia, free testosterone, and vitamin D metabolite levels in HIV-infected patients with and without highly active antiretroviral therapy.

The prevalence of osteopenia in HIV-infected patients is high. However, the mechanisms implicated in bone mass loss in HIV infection are unclear. Because of this, we analyzed serum free testosterone and vitamin D3 hydroxylated metabolites in HIV-infected patients, with and without antiretroviral treatment, and the relation between them and osteopenia. Seventy-four HIV-infected patients were selected because they had frozen sera available at a date close to a DEXA evaluation. Free testosterone, 25(OH)D3, and 1,25(OH)2D3 were determined in frozen serum. There were no differences in free testosterone, 25(OH)D3, and 1,25(OH)2D3 levels between patients with and without osteopenia. 25(OH)D3 levels in naive and HAART-treated patients were 26.2 (10.3-32.8) and 33.1 (20.6-46.8) ng/ml, respectively (p = 0.04). 1,25(OH)2D3 levels in naive and HAART treated patients were 60.3 (49.2-80.8) and 85.5 (68-111.6) pmol/liter (p = 0.01). Free testosterone levels in 9 naive men and in 50 HAART-treated men were 42.6 (24.1-67.3) and 69.2 (47.5-112.1) pmol/liter, respectively (p = 0.04). In conclusion, HIV-infected patients with and without osteopenia showed similar levels of vitamin D metabolites and free testosterone. However, antiretroviral drug-naive patients showed lower serum levels of vitamin D metabolites and free testosterone than HAART-treated patients.