Prospective validation of the EASL management algorithm for acute kidney injury in cirrhosis.

BACKGROUND AND AIMS: The management of acute kidney injury (AKI) in cirrhosis is challenging. The EASL guidelines proposed an algorithm, but this has never been validated. We aimed to prospectively evaluate this algorithm in clinical practice. METHODS: Prospective cohort study of consecutive hospitalized patients with cirrhosis and AKI. EASL management algorithm includes identification/treatment of precipitating factors, 2-day albumin infusion in patients with AKI ≥ stage 1B, and treatment with terlipressin in patients with hepatorenal syndrome (HRS-AKI). Primary outcome was treatment response, which included both full and partial response. Secondary outcomes were survival and adverse events associated with terlipressin therapy. RESULTS: A total of 202 AKI episodes in 139 patients were included. Overall treatment response was 80%, while renal replacement therapy was required in only 8%. Response to albumin infusion was achieved in 1/3 of episodes. Of patients not responding to albumin, most (74%) did not meet the diagnostic criteria of HRS-AKI, with ATN being the most common phenotype. Response rate in patients not meeting criteria of HRS-AKI was 70%. Only 30 patients met the diagnostic criteria HRS-AKI, and response rate to terlipressin was 61%. Median time from AKI diagnosis to terlipressin initiation was only 2.5 days. While urinary neutrophil gelatinase-associated lipocalin (uNGAL) could differentiate acute tubular necrosis (ATN) vs other phenotypes (AUROC 0.78), it did not predict response to therapy in HRS-AKI. Ninety-day transplant-free survival was negatively associated with MELD-Na, ATN and HRS-AKI as well as uNGAL. Three patients treated with terlipressin developed pulmonary edema. CONCLUSIONS: The application of the EASL AKI algorithm is associated with very good response rates and does not significantly delay initiation of terlipressin therapy.

Adaptation and validation of a patient-reported compassion measure in the Spanish population: The Spanish version of the Sinclair Compassion Questionnaire (SCQesp).

International practice guidelines and policies recognize compassion as a fundamental dimension of quality care. A key element in enhancing compassion in healthcare settings is having reliable patient-reported experience measures. In the Spanish context, there is a need for a valid Spanish patient-reported compassion measure for use in both research and clinical practice. The Sinclair Compassion Questionnaire (SCQ) represents the gold standard for patient-reported compassion measures in English-speaking settings. The primary aim of this study is to culturally adapt and validate the SCQ in a Spanish population. A Spanish version of the SCQ (SCQesp) was used to collect data from 303 Spanish patients (in two contexts: hospitalized and medical visit). Confirmatory factor analysis confirmed a one-factor solution in the 15-item (SCQesp) and five-item (SCQesp-SF) short form version. The SCQesp showed excellent values of reliability: Cronbach's α = 0.98; composite variance = 0.98 (0.905-0.854); and stratified variance = 0.78. The SCQesp-SF showed similar values of reliability. The SCQesp has excellent psychometric properties, making it a valid and reliable measure for assessing compassion in healthcare research and clinical care. This scientifically rigorous and psychometrically robust compassion measure in Spanish could allow healthcare providers, researchers, and leaders to routinely assess compassion.

Combining thermal scanning probe lithography and dry etching for grayscale nanopattern amplification.

Grayscale structured surfaces with nanometer-scale features are used in a growing number of applications in optics and fluidics. Thermal scanning probe lithography achieves a lateral resolution below 10 nm and a vertical resolution below 1 nm, but its maximum depth in polymers is limited. Here, we present an innovative combination of nanowriting in thermal resist and plasma dry etching with substrate cooling, which achieves up to 10-fold amplification of polymer nanopatterns into SiO2 without proportionally increasing surface roughness. Sinusoidal nanopatterns in SiO2 with 400 nm pitch and 150 nm depth are fabricated free of shape distortion after dry etching. To exemplify the possible applications of the proposed method, grayscale dielectric nanostructures are used for scalable manufacturing through nanoimprint lithography and for strain nanoengineering of 2D materials. Such a method for aspect ratio amplification and smooth grayscale nanopatterning has the potential to find application in the fabrication of photonic and nanoelectronic devices.

Formación en sexología y su influencia en las actitudes de las enfermeras hacia la sexualidad / Sexology training and its influence on nurses’ attitudes toward sexuality

Introducción: Tener unas actitudes tolerantes hacia la sexualidad, junto con la formación en sexología son aspectos clave para favorecer el abordaje de la sexualidad en la práctica profesional de las enfermeras. Por ello, el objetivo principal de este estudio fue comprobar si recibir formación en sexología durante los estudios de Grado en Enfermería influye sobre las actitudes hacia la sexualidad del alumnado. Método: Se realizó un estudio caso-control en 127 estudiantes de la Facultad de Enfermería de Gijón, dividiendo a la muestra en función de si habían recibido o no formación específica en sexología. Para medir dichas actitudes se utilizó una versión adaptada al castellano del Trueblood Sexual Attitude Questionnaire (TSAQ), analizándose los datos mediante el programa SPSS. Resultados: Existen diferencias estadísticamente significativas (p=0,015) entre la puntuación media total obtenida en el TSAQ por los estudiantes que sí habían recibido formación en sexología (6,53 ± 0,81) comparada con los que no (6,13 ± 1,06). De igual modo, las actitudes de las personas integrantes de ambos grupos son más liberales para los comportamientos ajenos (7,53 ± 0,76 frente a 7,25 ± 1,06) que para los propios (5,54 ± 1,03 frente a 5,00 ± 1,28), respectivamente. Conclusiones: Se verifica que recibir formación en sexología se relaciona con la tenencia de unas actitudes hacia la sexualidad más liberales. Sólo un 24,8% de las Facultades de Enfermería españolas ofertan asignaturas específicas en sexología (AU)

Background: Sexology training and a tolerant attitude towards sexuality are key for nurses to be able to approach the topic appropriately at work. Therefore, the main goal of this study is to determine whether sexology training as part of the nursing degree affects students’ attitudes towards sexuality. Method: A case-control study was performed on 127 students and postgraduates from Facultad de Enfermería de Gijón, dividing the sample in two groups according to their attendance to specific sexology training. The attitudes were assessed using a translated version of Trueblood Sexual Attitude Questionnaire, and data analysis was performed using SPSS software. Results: There are statistically significant differences (p= 0.015) between the mean total score from the group that had received the training (6.53 ± 0.81) and the mean total score from the group that hadn’t (6.13 ± 1.06). Attitudes from members of both groups were more open towards other people’s behaviour (7.53 ± 0.76 versus 7.25 ± 1.06) than towards their own (5.54 ± 1.03 versus 5.00 ± 1.28), respectively. Conclusions: It is verified that receiving sexology training correlates with more liberal attitudes towards sexuality. Only 24.8% of nursing faculties in Spain offer specific sexology courses (AU)

Exploring a holistic training program on tactical behavior and psychological components of elite soccer players throughout competition season: a pilot study.

This study aimed to assess the effects of a training program, considering an ecological/holistic perspective, on both tactical behavior (i.e., principles of play; PP) and psychological aspects (i.e., emotional, and cognitive components) in elite soccer teams consisting of players from the U23 and U21 age groups. The participants were 46 players from the under U-23 and U-21 teams from the same club and the first division of Argentina. A quasi-experimental design was examined after five weeks of intervention through integrated training tasks, where psychological factors were used for the development of the tactical principles of the game. Two evaluations of the improvement of game principles were performed before and after the intervention. The results showed significant changes and differences in both teams concerning the PP during the post-intervention period. Specifically, the results show significant group-by-time interactions with an increase in the percentage of tactical actions and behaviors performed during the competitions in two game principles analyzed in both teams. There were significant in the group-by-time interactions for PP 3 (i.e., the first option to pass forward; p ≤ 0.001, F = 58.96, ηp2 = 0.88) and also, significant changes were in PP 4 (i.e., immediate pressure when losing the ball) through the main effect of time (p ≤ 0.001, F = 105.41, ηp2 = 0.93) and group by time interactions (p = 0.002, F = 20.08, ηp2 = 0.72). In both groups, there were significant changes in post hoc analysis (PP3: U21: p = 0.039 vs. U23: p ≤ 0.001) and (PP4: U21: p = 0.006 vs. U23: p = 0.001). It seems the strategies and constraints used, tactical components, and integrated into the psychological aspects during specific soccer training tasks can help improve the tactical behaviors of both teams in a competition associated with the PP of a soccer team.

Alcoholic Foamy Degeneration, an Entity Resembling Alcohol-Associated Hepatitis: Diagnosis, Prognosis, and Molecular Profiling.

BACKGROUND & AIMS: Alcoholic foamy degeneration (AFD) is a condition with similar clinical presentation to alcohol-associated hepatitis (AH), but with a specific histologic pattern. Information regarding the prevalence and prognosis of AFD is scarce and there are no tools for a noninvasive diagnosis. METHODS: A cohort of patients admitted to the Hospital Clinic of Barcelona for clinical suspicion of AH who underwent liver biopsy was included. Patients were classified as AFD, AH, or other findings, according to histology. Clinical features, histology, and genetic expression of liver biopsy specimens were analyzed. The accuracy of National Institute on Alcohol Abuse and Alcoholism criteria and laboratory parameters for differential diagnosis were investigated. RESULTS: Of 230 patients with a suspicion of AH, 18 (8%) met histologic criteria for AFD, 184 (80%) had definite AH, and 28 (12%) had other findings. In patients with AFD, massive steatosis was more frequent and the fibrosis stage was lower. AFD was characterized by down-regulation of liver fibrosis and inflammation genes and up-regulation of lipid metabolism and mitochondrial function genes. Patients with AFD had markedly better long-term survival (100% vs 57% in AFD vs AH; P = .002) despite not receiving corticosteroid treatment, even in a model for end-stage liver disease-matched sensitivity analysis. Serum triglyceride levels had an area under the receiver operating characteristic of 0.886 (95% CI, 0.807-0.964) for the diagnosis of AFD, whereas the National Institute on Alcohol Abuse and Alcoholism criteria performed poorly. A 1-step algorithm using triglyceride levels of 225 mg/dL (sensitivity, 0.77; specificity, 0.90; and Youden index, 0.67) is proposed for differential diagnosis. CONCLUSIONS: AFD in the setting of suspicion of AH is not uncommon. A differential diagnosis is important because prognosis and treatment differ largely. Triglyceride levels successfully identify most patients with AFD and may be helpful in decision making.

Detection of doping control sample substitutions via single nucleotide polymorphism-based ID typing.

The authenticity of a doping control sample is a key element of sports drug testing programmes. Doping control sample manipulation by providing another individual's urine or blood (instead of the tested athlete's sample) has been observed in the past and is an unequivocal violation of the World Anti-Doping Agency anti-doping rules. To determine attempts of manipulations by sample swapping, the utility of a single nucleotide polymorphism (SNP)-based sample authentication with a multi-target SNP panel was assessed. The panel comprises detection assays for 44 different SNPs, 3 gender markers and 5 quality control markers for DNA-profile determination. Sample analysis is based on a multiplex polymerase chain reaction step followed by a multiplex single base extension (SBE) reaction and subsequent SBE-product detection by MALDI-TOF MS. Panel performance was evaluated for urine and dried blood spot (DBS) samples. Urine (8 ml) and DBS (20 µl) test samples were reliably typed and matched to whole blood reference samples, while efficient typing of urine samples correlated with sample quality and input amounts. Robust profiling of urine doping control specimens was confirmed with an assay input of 12 ml. Samples can be processed in a high-throughput format with an overall assay turnaround time of approximately 11 h. SNP-based DNA typing via MALDI-TOF MS thus represents a high throughput-capable possibility for doping control sample authentication. SNP profiling of samples could offer the opportunity to complement existing steroid profile analytics to substantiate sample manipulations and to support quality control processes in high throughput routine settings.

Investigations into Annona fruit consumption as a potential source of dietary higenamine intake in the context of sports drug testing.

Higenamine is prohibited in sports as a ß2 -agonist by the World Anti-Doping Agency. As a key component of a great variety of plants, including the Annonaceae family, one aim of this research project was to evaluate whether the ingestion of Annona fruit could lead to higenamine adverse analytical findings. Single-dose administration studies including three Annona species (i.e., Annona muricata, Annona cherimola, and Annona squamosa) were conducted, leading to higenamine findings below the established minimum reporting level (MRL) of 10 ng/mL in urine. In consideration of cmax values (7.8 ng/mL) observed for higenamine up to 24 h, a multidose administration study was also conducted, indicating cumulative effects, which can increase the risk of exceeding the applicable MRL doping after Annona fruit ingestion. In this study, however, the MRL was not exceeded at any time point. Further, the major urinary excretion of higenamine in its sulfo-conjugated form was corroborated, its stability in urine was assessed, and in the absence of reference material, higenamine sulfo-conjugates were synthesized and comprehensively characterized, suggesting the predominant presence of higenamine 7-sulfate. In addition, the option to include complementary biomarkers of diet-related higenamine intake into routine doping controls was investigated. A characteristic urinary pattern attributed to isococlaurine, reticuline, and a yet not fully characterized bismethylated higenamine glucuronide was observed after Annona ingestion but not after supplement use, providing a promising dataset of urinary biomarkers, which supports the discrimination between different sources of urinary higenamine detected in sports drug testing programs.

CB1 receptor expression and signaling are required for dexamethasone-induced aversive memory consolidation.

The molecular processes that underlie long-term memory formation involve signaling pathway activation by neurotransmitter release, which induces the expression of immediate early genes, such as Zif268, having a key role in memory formation. In this work, we show that the cannabinoid CB1 receptor signaling is necessary for the effects of dexamethasone on the behavioral response in an inhibitory avoidance task, on dexamethasone-induced ERK phosphorylation, and on dexamethasone-dependent Zif268 expression. Furthermore, we provide primary evidence for the mechanism responsible for this crosstalk between cannabinoid and glucocorticoid-mediated signaling pathways, showing that dexamethasone regulates endocannabinoid metabolism by inhibiting the activity of the Fatty acid amide hydrolase (FAAH), an integral membrane enzyme that hydrolyzes endocannabinoids and related amidated signaling lipids. Our results provide novel evidence regarding the role of the endocannabinoid system, and in particular of the CB1 receptor, as a mediator of the effects of glucocorticoids on the consolidation of aversive memories.

Spirometry and respiratory oscillometry: Feasibility and concordance in schoolchildren with asthma.

OBJECTIVE: The purpose of this study was to describe the feasibility of respiratory oscillometry (RO) in schoolchildren with asthma, and the concordance of its results with those of spirometry, to determine its clinical usefulness. METHODS: RO and spirometry were performed in 154 children (6 to 14-year-old) with asthma, following strict quality criteria for the tests. Their feasibility (probability of valid test, time of execution, number of maneuvers needed to achieve a valid test, and perceived difficulty) was compared. The factors that influence feasibility were analyzed with multivariate methods. FEV1, FEV1/FVC, FVC and FEF25-75 for spirometry, and R5, AX and R5-19 for RO, were converted into z-scores and their concordance was investigated through intraclass correlation coefficients (ICC) and kappa indices for normal/abnormal values. RESULTS: There were no differences in the probability of obtaining a valid RO or spirometry (83.1% vs. 81.8%, p = 0.868). RO required a lower number of maneuvers [mean (SD) 4.2 (1.8) versus 6.0 (1.6), p < 0.001] and less execution time [5.1 (2.7) versus 7.6 (2.4) minutes, p < 0.001], and patients considered it less difficult. Age increased the probability of obtaining valid RO and spirometry. The concordance of results between RO and spirometry was low, and only between zFEV1 and zAX could it be considered moderate (ICC = 0.412, kappa = 0.427). CONCLUSION: RO and spirometry are feasible in children with asthma. RO has some practical advantages, but the concordance of its results with spirometry is low.

Returning to work in cancer survivors: a multi-center cross-sectional study in Spain / La vuelta al trabajo en supervivientes de cáncer: un estudio transversal multicéntrico en España

Objetivo: Analizar la situación laboral, así como variables sociodemográficas (edad, sexo, estado civil y titulación) relacionadas con el cáncer (tipo de cáncer, estrategia de tratamiento primario y fase de supervivencia) en supervivientes españoles de cáncer. Método y procedimiento: Estudio transversal sobre una muestra heterogénea de 772 supervivientes de cáncer de inicio en la edad adulta en edad laboral. Se realizaron análisis correlacionales y de regresión logística para estudiar la capacidad predictiva de las variables sociodemográficas y relacionadas con el cáncer sobre la situación laboral y la posible modulación de los resultados por la CVRS evaluada mediante el QLACS. Resultados: Sólo el 55% de los supervivientes de cáncer estaban empleados. La edad, la cualificación y el tipo de cáncer fueron predictores independientes de la situación laboral, así como de la fase de supervivencia en los supervivientes con una CVRS baja. Conclusiones: Un alto porcentaje de supervivientes en edad laboral no vuelve a trabajar tras la experiencia oncológica. Algunas variables sociodemográficas y relacionadas con la enfermedad pueden ayudar a la identificación precoz de la población de riesgo en la que centrar la atención (AU)

Objective: To analyze the employment status as well as sociodemographic (age, gender, marital status, and qualification) and cancer-related variables (cancer type, primary treatment strategy, and survival phase) in Spanish cancer survivors. Method and procedure: Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. Correlational and logistic regression analyses were performed to study the predictive ability of sociodemographic and cancer-related variables on employment status and the possible modulation of results by HRQOL assessed by the QLACS. Results: Only 55% of cancer survivors were employed. Age, qualification, and type of cancer were independent predictors of employment status as well as the survival phase in survivors with a low HRQOL. Conclusions: A high percentage of working-age survivors do not return to work after the cancer experience. Some sociodemographic and disease-related variables can help in the early identification of the risk population on which to focus attention (AU)

Impact of genetic structural variants in factor XI deficiency: identification, accurate characterization, and inferred mechanism by long-read sequencing.

BACKGROUND: Congenital factor XI (FXI) deficiency is a probably underestimated coagulopathy that confers antithrombotic protection. Characterization of genetic defects in F11 is mainly focused on the identification of single-nucleotide variants and small insertion/deletions because they represent up to 99% of the alterations accounting for factor deficiency, with only 3 gross gene defects of structural variants (SVs) having been described. OBJECTIVES: To identify and characterize the SVs affecting F11. METHODS: The study was performed in 93 unrelated subjects with FXI deficiency recruited in Spanish hospitals over a period of 25 years (1997-2022). F11 was analyzed by next-generation sequencing, multiplex ligand probe amplification, and long-read sequencing. RESULTS: Our study identified 30 different genetic variants. Interestingly, we found 3 SVs, all heterozygous: a complex duplication affecting exons 8 and 9, a tandem duplication of exon 14, and a large deletion affecting the whole gene. Nucleotide resolution obtained by long-read sequencing revealed Alu repetitive elements involved in all breakpoints. The large deletion was probably generated de novo in the paternal allele during gametogenesis, and despite affecting 30 additional genes, no syndromic features were described. CONCLUSION: SVs may account for a high proportion of F11 genetic defects implicated in the molecular pathology of congenital FXI deficiency. These SVs, likely caused by a nonallelic homologous recombination involving repetitive elements, are heterogeneous in both type and length and may be de novo. These data support the inclusion of methods to detect SVs in this disorder, with long-read-based methods being the most appropriate because they detect all SVs and achieve adequate nucleotide resolution.

Compassion in Spanish-speaking health care: A systematic review.

Altought compassionate care is an important factor in health care, remains an unmet need in patients. The studies have been carried out in Anglo-Saxon countries with cultural environments and health systems that are very different from Spanish-speaking contexts. The aim of this study to understand the conceptual, evaluation and clinical application nuances of compassion and compassionate care in Spanish-speaking health care settings, through a systematic review. A search of the scientific literature was carried out following the PRISMA guidelines in ProQuest Central, PubMed and Web Of Science, resulting in 295 studies, of which 27 were selected, based on the following inclusion criteria: the article studied or analyzed the construct of compassion in healthcare setting and the participants were Spanish speakers or the authors spoke of the construct in Spanish. Two blinded evaluators performed the study selection process using the Covidence tool. The agreement between evaluators was in all cases satisfactory. Different definitions of the construct have been identified, that they generally share: the recognition of suffering and the attempt to alleviate it. There are few studies that focus solely on the analysis of compassion, since other concepts appear that are associated with it, such as empathy and self-compassion. Further research is needed to obtain a better and greater understanding of compassionate care adapted to the perceptions of patients and health professionals in different socio-cultural contexts. In this way, instruments that measure compassionate care can be better developed and adjusted, and interventions aimed at promoting compassion can be properly assessed.

Parental stress and life satisfaction: A comparative study of social services users and nonusers from a gender perspective.

The psychometric properties of the Spanish version of the Parental Stress Scale (PSS) scale have not been verified on the Spanish population. Similarly, the literature on gender differences and parental stress is inconclusive, and there is little evidence of their relationship with life satisfaction. To analyze the psychometric properties of the Spanish version of the PSS scale, (2) to examine possible gender differences, and (3) to study the relationship between parental stress (PS) and parental rewards (PR) and satisfaction with life (SWL) attending to the possible moderating effect of gender. These objectives were examined in samples comprising Social Services Users (SSU) (N = 525; 78.3% female; Mage = 38.3) and non-SSU users (N = 421; 41.1% male; Mage = 37.08). A CFA corroborated a two-factor structure: PS and PR. In the SSU sample, mothers showed higher PS and lower PR. However, PR was also higher in mothers from the non-SSU sample compared to fathers. PR and PS were directly related to SWL in the SSU sample. However, gender moderated the relationship between PR and SWL in the non-SSU sample in the case of mothers. The results are discussed considering gender roles and the characteristics of both samples.

TIC en tiempos del COVID-19. Un análisis Dafo desde la perspectiva de enfermería / ICT in times of COVID-19. A SWOT analysis from a nursing perspective

La pandemia provocada por el COVID-19, ha generado cambios en el saber y saber hacer de la enfermería, precisándose de una continua capacidad de adaptación y no solo a los cambios previsibles en la atención diaria sino también, en la prevención y la promoción de la salud. Sensibles a esta nueva realidad se procede a realizar un Análisis DAFO, permitiéndonos analizar el contexto actual de la organización, institución o servicio del cual se parte; accediendo a identificar y analizar sus Dificultades, Amenazas, Fortalezas y Oportunidades. La finalidad es determinar y esclarecer los factores facilitadores y las barreras que facilitan u obstaculizan el desarrollo de la enfermería durante la pandemia. Lo ocurrido en el devenir de la pandemia debe interpretarse como una invitación a mirar desde otra perspectiva el modelo de atención que se está ofreciendo a través de los servicios de enfermería. Ya no podemos ser fiel a un modelo asistencial único y exclusivo, sino que tenemos que incorporar modelos diferentes enfocados al autocuidado, la adaptación a la realidad asistencial cambiante y la humanización, sustentándose como eje estructural de esta integración la incorporación y aplicación de las TIC de una forma paulatina y transversal, en el modo de actuación diario.(AU)

Patient-reported experience in lung and breast cancer through a patient journey.

OBJECTIVE: To analyse a patient journey based on the experience reported by  breast and lung cancer patients at Spanish hospital. Method: A mixed design was used, with interviews with 16 health  professionals and 25 patients (qualitative method) and a Net Promoter Score questionnaire to 127 patients (quantitative method). INCLUSION CRITERIA: oncology patients > 18 years treated in hospital between February-  May 2019. EXCLUSION CRITERIA: paediatric patients, in palliative care or who were  hospitalised at the time of the study. RESULTS: Six phases were identified from the data obtained in the qualitative method: my life before diagnosis; discovery; initiation; treatment;  followup; and my current life. In the my life before diagnosis phase, a  functional level of experience was established, as patients' lives met their  expectations. In the discovery phase, patients' expectations were observed to  be met, although several satellite experiences were found. In the initiation  phase, the experience tended to be negative due to long waiting times and  emotional and physical stress. The treatment phase was defined as a basic- poor experience, due to waiting times and lack of institutional support. The  experience in the follow-up phase was positive in terms of tests and visits, but  critical points were observed in waiting times. In the current phase, the effort  made by health professionals to ensure the best possible treatment and care  was mentioned. In terms of quantitative analysis, a positive score (46%) was obtained for the Net Promoter Score indicator, as 60% of patients were promoters, i.e. they were satisfied with the service offered by the hospital. CONCLUSIONS: This study provides insight into the experience of cancer patients in the six main stages of the disease. The most positive phases were "my life before diagnosis" and "follow-up" while the phases with a negative trend were "initiation" and "treatment" due to the waiting times  and the emotional burden on the patient.

OBJETIVO: Analizar la experiencia aportada por los pacientes con cáncer de  mama y pulmón utilizando la metodología del recorrido del paciente en un  hospital español. Método: Se empleó un diseño mixto, con entrevistas a 16 profesionales sanitarios y 25 pacientes (método cualitativo), y un cuestionario  basado en el indicador Net Promoter Score a 127 pacientes (método  cuantitativo). Criterios de inclusión: pacientes oncológicos > 18 años tratados  en el hospital entre febrero y mayo de 2019. Criterios de exclusión: pacientes pediátricos, en cuidados paliativos o que estaban hospitalizados en el  momento del estudio. RESULTADOS: Se identificaron seis fases a partir de los datos obtenidos en  el  método cualitativo: mi vida antes del diagnóstico, descubrir, comenzar, tratamiento, seguimiento y mi vida hoy. En la fase mi vida antes del  diagnóstico se estableció un nivel de experiencia funcional, ya que la vida  cumplía las expectativas de los pacientes. En la fase de descubrir se observó  que las expectativas de los pacientes se cumplían, aunque se  encontraron varias experiencias satélite. En la fase comenzar, la experiencia  tendió a ser negativa debido a los largos tiempos de espera y al estrés  emocional y físico. La fase de tratamiento se consideró como una experiencia  de nivel básico-deficiente, debido a los tiempos de espera y a la falta de apoyo  institucional. La experiencia en la fase de seguimiento fue positiva respecto   las pruebas y las visitas, pero se observaron puntos críticos en los tiempos de espera. en la fase mi vida hoy se mencionó el esfuerzo realizado  por  los profesionales sanitarios para garantizar el mejor tratamiento y  atención posibles. En cuanto al análisis cuantitativo, se obtuvo una puntuación positiva (46%) para el indicador Net Promoter Score, ya que el 60% de los  pacientes pertenecían a la categoría de promotores, es decir, estaban satisfechos con el servicio ofrecido por el hospital. CONCLUSIONES: Este estudio permite conocer la experiencia de los pacientes  oncológicos en las seis etapas principales de la enfermedad. Las fases más  positivas fueron "mi vida antes del diagnóstico" y "seguimiento", mientras que  las fases con tendencia negativa fueron "inicio" y "tratamiento" debido a los  tiempos de espera y la carga emocional que suponen para el paciente.

Quality of life in cancer survivorship: Sociodemographic and disease-related moderators.

RATIONALE: To identify high-risk survivors in order to provide appropriate care. PURPOSE: To analyse the quality of life (QOL) of cancer survivors using an instrument designed specifically for this population and considering different sociodemographic and disease-related characteristics as possible modulating variables. METHODS: The Quality of Life in Adult Cancer Survivors (QLACS) was filled out by a large and heterogeneous sample of disease-free post-treatment Spanish cancer survivors (N = 1862). RESULTS: QLACS scores were comparable to those obtained in other studies and indicative of worse QOL as a function of shorter elapsed time since the end of primary treatment. The best QOL was shown by prostate, and the worst by hematologic cancer survivors. Both systemic treatments (chemotherapy and hormone therapy) and the combination of radiotherapy and chemotherapy were associated with worse QOL. Likewise, younger age, female sex, unemployment status and not having a stable partner were associated with worse QOL. CONCLUSION: Greater understanding of the QOL experienced by the already large and continuously growing population of cancer survivors is relevant for guiding both clinical practice and health policy. In addition, knowing the risk factors associated with worse QOL facilitates the development of targeted prevention programmes for those survivors who need it the most.

Edge-Contact MoS2 Transistors Fabricated Using Thermal Scanning Probe Lithography.

The science and engineering of two-dimensional materials (2DMs), in particular, of 2D semiconductors, is advancing at a thriving pace. It is well known that these delicate few-atoms thick materials can be damaged during the processing toward their integration into final devices. Thermal scanning probe lithography (t-SPL) is a gentle alternative to the typically used electron beam lithography to fabricate these devices avoiding the use of electrons, which are well known to deteriorate the 2DMs' properties. Here, t-SPL is used for the fabrication of MoS2-based field effect transistors (FETs). In particular, the use of t-SPL is demonstrated for the first time for the fabrication of edge-contact MoS2 FETs, combining the hot-tip patterning and Ar+ milling to etch the 2DM. To avoid contamination of the contact interface by atmospheric gas molecules, etching and metal deposition are performed without breaking the vacuum conditions in between. With this process, edge-contact MoS2 FETs are successfully fabricated and characterized. On/off ratios up to 108 and 109 are obtained at room temperature in air and vacuum, respectively, i.e., comparable with the best values reported in the literature.

Sensibilidad del test de diagnóstico rápido SARS-CoV-2 Panbio en Atención Primaria / Sensitivity of the Panbio COVID-19 rapid antigen detection test in primary care

Introducción y objetivos: los pediatras de Atención Primaria necesitamos técnicas de diagnóstico rápido (TDR) fiables para prevenir la propagación de la enfermedad COVID-19 mediante un cribado temprano y eficaz a la espera de una vacuna. El objetivo de este trabajo fue evaluar como novedad en Atención Primaria, tanto en adultos como niños, sintomáticos y contactos asintomáticos, la sensibilidad (S) de los test de antígeno SARS-CoV-2 Panbio del laboratorio Abbott respecto a la reacción en cadena de la polimerasa (PCR).Pacientes y métodos: se incluyeron 591 pacientes (222 menores de 14 años) (249 sintomáticos y 342 contactos). Se calculó la sensibilidad (S) y la especificidad (E) junto con sus intervalos de confianza (IC) del 95%. La independencia de los dos resultados ha sido analizada mediante el test de McNemar.Resultados: la S del test en adultos fue del 81% (IC 95%: 66,16-96,34) y en niños del 80% (IC 95%: 34,94-100) dentro de los 5 primeros días. En contactos se evaluó la S en los cinco primeros días, en adultos (68%; IC 95%: 51,13-86,37), del 5.º al 9.º día (85%) y en niños (66%; IC 95%: 30,31-100). El tipo de contacto más frecuente fue domiciliario en un 52% de los casos. La E fue 100% en todos los casos.Conclusiones: el test rápido de antígeno SARS-CoV-2 Panbio puede ser útil para diagnóstico de adultos y niños los primeros cinco días de inicio de síntomas, así como entre el 5.º y 9.º día tras el contacto con positivo COVID-19 confirmado, pendiente de interpretar en futuros estudios. (AU)

Introduction and objectives: primary care paediatricians need reliable rapid diagnostic techniques (RDTs) to prevent the spread of coronavirus disease 19 (COVID-19) through early and effective screening while awaiting a vaccine. The objective of this study was to evaluate the sensitivity (Sen) of the Abbott laboratory SARS-CoV-2 Panbio antigen test, newly introduced in primary care, in both adults and children (symptomatic and asymptomatic contacts) in comparison to the polymerase chain reaction (PCR) test.Sample and methods: the study included 591 patients (222 aged less than 14 years) from 7 primary care centres; of who 249 were symptomatic and 342 asymptomatic contacts. We calculated the Sen and specificity (Spe) with their 95% confidence intervals (CIs). We assessed the independence of the two results with the McNemar test.Results: the Sen of the test within 5 days from onset was 81% in adults (95% CI, 66.16-96.34) and 80% in children (95% CI: 34.94-100). In contacts, we assessed the Sen within 5 days, in adults (68%; 95% CI: 51.13- 86.37), in 5 to 9 days (85%) and in children (66%; 95% CI: 30.31-100). The most frequent source of exposure were household contacts (52% of the cases). The Spe was 100% in every case.Conclusions: the Panbio SARS-CoV-2 rapid antigen test can be useful for diagnosis in adults and children within 5 days of onset, and from days 5 to 9 in contacts of confirmed COVID 19 cases. Further studies are required for adequate interpretation of the latter result. (AU)

Contact pathway in surgical and transcatheter aortic valve replacement.

Background: Aortic valve replacement is the gold standard treatment for severe symptomatic aortic stenosis, but thrombosis of bioprosthetic valves (PVT) remains a concern. Objective: To analyze the factors involved in the contact pathway during aortic valve replacement and to assess their impact on the development of thromboembolic complications. Methods: The study was conducted in 232 consecutive patients who underwent: transcatheter aortic valve replacement (TAVR, N = 155), and surgical valve replacement (SAVR, N = 77) (MUVITAVI project). Demographic and clinical data, outcomes including a combined end point (CEP) of thrombotic events, and imaging controls were recruited. Samples were collected 24 h before and 48 h after valve replacement. FXII, FXI and (pre)kallikrein were evaluated by Western Blot and specific ELISA with nanobodies. Results: The CEP of thrombotic events was reached by 19 patients: 13 patients presented systemic embolic events and 6 patients subclinical PVT. Valve replacement did not cause FXII activation or generation of kallikrein. There was a significant reduction of FXI levels associated with the procedure, which was statistically more pronounced in SAVR than in TAVR. Cases with reductions of FXI below 80% of basal values had a lower incidence of embolic events during the procedure than patients in whom FXI increased above 150%: 2.7 vs. 16.7%; p: 0.04. Conclusion: TAVR or SAVR did not significantly activate the contact pathway. A significant reduction of FXI, was observed, particularly in SAVR, associated with lower incidence of thrombotic events. These results encourage evaluating the usefulness and safety of FXI-directed antithrombotic treatments in these patients.