PsiOvi Staging Model for Schizophrenia (PsiOvi SMS): A New Internet Tool for Staging Patients with Schizophrenia.

BACKGROUND: One of the challenges of psychiatry is the staging of patients, especially those with severe mental disorders. Therefore, we aim to develop an empirical staging model for schizophrenia. METHODS: Data were obtained from 212 stable outpatients with schizophrenia: demographic, clinical, psychometric (PANSS, CAINS, CDSS, OSQ, CGI-S, PSP, MATRICS), inflammatory peripheral blood markers (C-reactive protein, interleukins-1RA and 6, and platelet/lymphocyte [PLR], neutrophil/lymphocyte [NLR], and monocyte/lymphocyte [MLR] ratios). We used machine learning techniques to develop the model (genetic algorithms, support vector machines) and applied a fitness function to measure the model's accuracy (% agreement between patient classification of our model and the CGI-S). RESULTS: Our model includes 12 variables from 5 dimensions: 1) psychopathology: positive, negative, depressive, general psychopathology symptoms; 2) clinical features: number of hospitalizations; 3) cognition: processing speed, visual learning, social cognition; 4) biomarkers: PLR, NLR, MLR; and 5) functioning: PSP total score. Accuracy was 62% (SD = 5.3), and sensitivity values were appropriate for mild, moderate, and marked severity (from 0.62106 to 0.6728). DISCUSSION: We present a multidimensional, accessible, and easy-to-apply model that goes beyond simply categorizing patients according to CGI-S score. It provides clinicians with a multifaceted patient profile that facilitates the design of personalized intervention plans.

Biomechanical Effects of Ti-Base Abutment Height on the Dental Implant System: A Finite Element Analysis.

This study aims to analyse, using a finite element analysis, the effects of Ti-base abutment height on the distribution and magnitude of transferred load and the resulting bone microstrain in the bone-implant system. A three-dimensional bone model of the mandibular premolar section was created with an implant placed in a juxta-osseous position. Three prosthetic models were designed: a 1 mm-high titanium-base (Ti-base) abutment with an 8 mm-high cemented monolithic zirconia crown was designed for model A, a 2 mm-high Ti-base abutment with a 7 mm-high crown for model B, and a 3 mm-high abutment with a 6 mm-high crown for model C. A static load of 150 N was applied to the central fossa at a six-degree angle with respect to the axial axis of the implant to evaluate the magnitude and distribution of load transfer and microstrain. The results showed a trend towards a direct linear association between the increase in the height of the Ti-base abutments and the increase in the transferred stress and the resulting microstrain to both the prosthetic elements and the bone/implant system. An increase in transferred stress and deformation of all elements of the system, within physiological ranges, was observed as the size of the Ti-base abutment increased.

Improving the ability to discriminate medical multiple-choice questions through the analysis of the competitive examination to assign residency positions in Spain.

INTRODUCTION: Psychometrics plays a vital role in evaluating educational research, including the analysis of multiple-choice exams. This study aims to improve the discriminatory ability of the "Médico Interno Residente" (MIR) medical exam in Spain, used to rank candidates for specialized healthcare training, through psychometric analysis. METHODS: We analyzed 2,890 MIR exam questions from 2009 to 2021 (totaling 147,214 exams), categorizing them based on methodology and response type. Evaluation employed classical test theory and item response theory (IRT). Classical test theory determined difficulty and discrimination indices, while IRT assessed the relationship between knowledge levels and question performance. RESULTS: Question distribution varied across categories and years. Frequently addressed knowledge areas included various medical specialties. Non-image-associated clinical cases were the easiest, while case-based clinical questions exhibited the highest discriminatory capacity, differing significantly from image-based case or negative questions. High-quality questions without images had longer stems but shorter answer choices. Adding images reduced discriminatory power and question difficulty, with image-based questions being easier. Clinical cases with images had shorter stems and longer answer choices. CONCLUSIONS: For improved exam performance, we recommend using a clinical case format followed by direct short-answer questions. Questions should be of low difficulty, providing clear and specific answers based on scientific evidence and avoiding ambiguity. Typical clinical cases with key characteristic features should be presented, excluding uncertain boundaries of medical knowledge. Questions should have lengthy stems and concise answer choices, minimizing speculation. If images are used, they should be typical, clear, consistent with the exam, and presented within clinical cases using clinical semiotics and propaedeutics.

Análisis del éxito de las números uno en la prueba MIR de 2022 y 2023. El impacto de la preparación y el efecto del azar / Analysis of the success of the highest scoring candidates in Spain’s Resident Medical Intern (MIR) examinations of 2022 and 2023. The impact of preparation and the effect of serendipity

Introducción: El examen de médico interno residente (examen MIR) es la prueba que permite el acceso a la formación médica especializada en España. Su objetivo es distribuir las plazas disponibles para las diferentes especialidades médicas entre los graduados en Medicina, teniendo en cuenta para ello tanto su expediente como los resultados de la prueba. La realización de un examen de test tiene un cierto componente de aleatoriedad.Objetivos: Analizar el rendimiento de las números uno de las convocatorias de 2021-2022 y 2022-2023 a lo largo de su preparación, así como conocer qué resultados podrían obtener en caso de que repitieran el mismo examen un millón de veces. Material y métodos: Se hizo uso de la información relativa al rendimiento de los estudiantes que prepararon las pruebas con cursos intensivos MIR Asturias, así como de los principios de la teoría de respuesta al ítem.Resultados. En 11 (33,3%) y 14 (42,4%) de las 33 pruebas realizadas a lo largo de la preparación, las números uno se clasificaron entre los 10 primeros. A partir de las simulaciones de las pruebas MIR de 2022 y 2023, se obtuvo que la primera clasificada de 2022 quedaría entre los 185 primeros de la prueba, y la de 2023, entre los 92 primeros.Conclusiones: Para obtener un número de orden entre los primeros clasificados es necesario disponer de un ability elevado, el cual se consigue a través de una preparación sólida. Además, el azar tiene un cierto nivel de influencia sobre los resultados de los opositores presentados a la prueba.(AU)

Introduction: The MIR exam is the test that allows access to specialized medical training in Spain. Its objective is to distribute the available places for the different medical specialties among Medicine graduates, taking into account both their record and the results of the test. Taking a test exam has a certain element of randomness.Objectives: Analyze the performance of the number ones of the 2021-2022 and 2022-2023 calls throughout their preparation, as well as know what results they could obtain if they repeated the same exam one million times. Material and methods: Information related to the performance of the students who prepared the tests with MIR Asturias Intensive Courses was used, as well as the principles of item response theory.Results. In 11 (33.3%) and 14 (42.4%) of the 33 tests carried out throughout the preparation, number one was classified among the top 10. From the simulations of the 2022 and 2023 MIR tests, it was obtained that the first classified in 2022 would be among the top 185 in the test and in 2023 among the top 92. Conclusions: To obtain an order number among the first classified it is necessary to have a high ability, which is achieved through solid preparation. In addition, randomness has a certain level of influence on the results of the opponents presented to the test.(AU)

Estudio psicométrico de la prueba MIR de 2022 / Psychometric analysis of the 2022 MIR test

Introducción: En España, para ejercer como especialista de cualquier especialidad médica es necesario tener la titulación correspondiente. Para poder acceder a la formación como especialista es obligatorio superar la prueba MIR. En este artículo se ha realizado un análisis psicométrico de la prueba MIR de 2022, celebrada en enero de 2023, utilizando tanto la teoría clásica de los test como la teoría de respuesta al ítem. Material y métodos: Se hizo uso de un subconjunto formado por 3.229 médicos que se presentaron a la prueba MIR de 2022 y que introdujeron su plantilla de respuestas en una aplicación informática puesta a su disposición para tal efecto. Los datos se analizaron mediante la teoría clásica de los test y la teoría de la respuesta al ítem. Concretamente, se calcularon el alfa de Cronbach, la fórmula número 21 de Kuder y Richardson, el índice de dificultad, el índice de dificultad con corrección de los efectos del azar, el índice de discriminación, el índice de correlación biserial puntual, así como los índices de dificultad y discriminación según la teoría de respuesta al ítem. Resultados: La prueba MIR de 2022, al igual que las de años anteriores, presenta una alta fiabilidad. Se analizan tanto los resultados globales de la prueba como detallados por asignaturas y bloques de asignaturas. Conclusión: Los resultados obtenidos en el presente estudio permiten afirmar que el examen MIR es un examen objetivo, de dificultad y discriminación adecuadas, así como relativamente estable de una convocatoria a otra.(AU)

Introduction: In Spain, to practice as a specialist in any medical specialty, it is necessary to have the corresponding qualification. In order to access training as a specialist, it is mandatory to pass the MIR test. In this article, a psychometric analysis of the 2022 MIR test, held in January 2023, has been carried out using both classical test theory and item response theory. Materials and methods: A subset made up of 3,229 doctors who took the MIR test in 2022 and who entered their response template in a computer application made available for this purpose. Data were analyzed using classical test theory and item response theory. Specifically, Cronbach's alpha, Kuder and Richardson's formula number 21, the difficulty index, the difficulty index corrected for chance effects, the discrimination index, the biserial-point correlation index, as well as the difficulty and discrimination indices according to item response theory were calculated. Results: The 2022 MIR test, like those of previous years, shows high reliability. Both the overall results of the test and those detailed by subjects and subject blocks are analyzed. Conclusion: The results obtained in this study allow us to affirm that the MIR exam is an objective exam, of adequate difficulty and discrimination, as well as relatively stable from one call to another.(AU)

Estudio psicométrico de las pruebas MIR de 2020 y 2021 / Psychometric study of the MIR tests of 2020 and 2021

Introducción: En España, el ejercicio de cualquier especialidad médica exige disponer del título de especialista. El acceso a la formación como especialista se realiza a través de la prueba MIR. Esta prueba es obligatoria para poder optar a una plaza de formación en cualquier especialidad médica. El presente artículo realiza un estudio psicométrico tanto a través de la teoría clásica de los test como de la teoría de la respuesta al ítem de las pruebas MIR de 2020 y 2021 (de 175 y 200 preguntas, respectivamente).Material y métodos.La base de datos utilizada en el presente trabajo contiene las respuestas de un total de 4.810 opositores que se examinaron en 2020 y 3.888 que lo hicieron en 2021. La información disponible se analizó haciendo uso de indicadores como el alfa de Cronbach, la fórmula número 21 de Kuder y Richardson, el índice de dificultad, el índice de dificultad con corrección de los efectos del azar, el índice de discriminación, el índice de correlación biserial puntual, así como los índices de dificultad y discriminación según la teoría de respuesta al ítem.Resultados.Las pruebas MIR de 2020 y 2021 presentan una alta fiabilidad, con variaciones pequeñas de un año a otro en el comportamiento de las distintas asignaturas y bloques de preguntas en lo relativo a los índices utilizados en el presente estudio.Conclusiones.Los resultados obtenidos en el presente estudio permiten afirmar que el examen MIR es un examen objetivo, de dificultad y discriminación adecuadas, así como estable de una convocatoria a otra. (AU)

Introduction: In Spain, in order to practise any medical speciality, it is necessary to have qualified as a specialist. Access to training as a specialist is gained through the MIR test. This test is mandatory to qualify for a training position in any medical specialty. This article carries out a psychometric study of the 2020 and 2021 MIR tests (with 175 and 200 questions, respectively) through both the classical test theory and the item response theory.Material and methods.The database used in this study contains the responses from a total of 4,810 individuals who took the exam in 2020 and 3,888 who did so in 2021. The information available was analysed using indicators such as Cronbach's alpha, the formula number 21 of Kuder and Richardson, the difficulty index, the difficulty index corrected for random effects, the discrimination index and the point biserial correlation index. The difficulty and discrimination indices were also used, according to item response theory.Results.The MIR tests of 2020 and 2021 present high reliability, with only slight variations from one year to another in the behaviour of the different subjects and question blocks in terms of the indices used in the present study.Conclusions.The results obtained in the present study allow us to affirm that the MIR exam is objective, of appropriate difficulty and discrimination, as well as stable from one year to another. (AU)

A 35-year follow-up study of patients admitted to methadone treatment between 1982-1984 in Asturias, Spain. / Estudio de seguimiento de 35 años de pacientes admitidos a tratamiento con metadona entre 1982-1984 en Asturias, España.

The objective was to evaluate outcomes in a heroin-dependent population 35 years after first enrolment in methadone maintenance treatment (MMT).  An ad hoc protocol was used to assess drug misuse, treatment, and drug-related morbidity in the survivor sample. The standardized mortality ratio (SMR) and 95% confidence interval (CI) were calculated.  A total of 214 heroin-dependent patients entered MMT between 1982 and 1984 in the Asturias Public Health Service. Information was received on 195 subjects, of whom 146 were deceased.  Men accounted for 77.5% of the study cohort. Over the 35-year follow-up period, the SMR was 11.75 (95% CI = 9.95 - 13.77). In the survivor sample, 5.7% were still enrolled in MMT; human immunodeficiency virus (HIV) was diagnosed in 38.77% and hepatitis B/C in 73.46%. No differences were found between sexes in mortality or HIV and hepatitis B/C status. None of the female survivors were using heroin at the 35-year follow-up compared with 5.26% of males. In conclusion, our study confirms the high long-term mortality rate of heroin addicts, even after enrollment in MMT.

El objetivo fue evaluar el estado de una población dependiente a la heroína 35 años después de su primera inscripción en un tratamiento de mantenimiento con metadona (TMM). Se utilizó un protocolo ad hoc para evaluar morbilidad, consumo y tratamiento de la adicción en la muestra de supervivientes. Se calculó la razón de mortalidad estandarizada (RME) con un intervalo de confianza (IC) del 95%. Un total de 214 pacientes ingresaron en TMM entre 1982 y 1984 en el Servicio de Salud Pública de Asturias. Se recibió información sobre 195 sujetos, de los cuales 146 habían fallecido. Los hombres representaron el 77,5% de la cohorte del estudio. Durante el período de seguimiento de 35 años, la RME fue de 11,75 (IC 95% = 9,95 ­ 13,77). En la muestra de supervivientes, el 5,7% todavía estaba inscrito en TMM; el virus de inmunodeficiencia humana (VIH) se diagnosticó en un 38,77% y la hepatitis B/C en un 73,46%; el consumo actual de heroína se informó en un 4,1%. No hubo diferencias de género en la mortalidad o la condición de VIH y hepatitis B/C. Ninguna de las mujeres consumía heroína en el seguimiento de 35 años en comparación con el 5,26% de los hombres. En conclusión, nuestro estudio confirma la alta tasa de mortalidad a largo plazo, incluso después de la inscripción en TMM.

Increased incidence of Graves' disease during the SARS-CoV2 pandemic.

INTRODUCTION: COVID-19 has a wide spectrum of clinical severity and there is evidence that SARS-Cov2 affects several organs and systems. Among the organs affected since the beginning of the pandemic, the relationship between SARS-CoV-2 infection and thyroid involvement has been demonstrated. Novel and highly effective messenger RNA and DNA-based vaccines have been rapidly developed to decrease SARS-CoV-2 morbidity and mortality. Early after mass vaccinations, cases of thyroid dysfunction mainly including episodes of subacute thyroiditis, began to be reported like adverse effects. The objective of this study is to determine the impact of the pandemic, both due to SARS-CoV2 infections and vaccinations, on the incidence of Graves' disease (GD). METHODS: Cross-sectional, observational study comparing incidence of GD in adult population (over 18 years) before (2017-2019) and after (2020-2021) Covid-19 pandemic. Only patients with new cases of GD, no relapsed diseases, were included. SARS-CoV-2 diagnosis was based on nucleic acid amplification tests on nasopharyngeal swabs or measurement of class M and class G antibodies to SARS-CoV-2 by highly specific assays. Data on incidence and vaccination related to SARS-CoV-2 infection were obtained from the public records from Castilla y León autonomous regional government. RESULTS: A total of 180 subjects were diagnosed and treated for GD during the study period. We observed a notable increase in expected GD cases in 2021 compared to 2017-19. The number of GD cases was higher in the second (Q2) quarter. Among 2021 GD cases, 42/66 patients (63.6%) had been vaccinated in the 90 days before symptom onset, but none of them in the first quarter of the year. A total of 97.7% were women with a mean age of 48.9 (SD 15.6) years. On average they were diagnosed 19.9 (SD 17.6) days after receiving the vaccine. A total of 7/42 (16.67%) had another previously diagnosed autoimmune disease and 11/42 (26.19%) were smokers. DISCUSSION: Our results show a notable increase in the incidence of GD during the year 2021, specially in women with a history of smoking. Hyper activation of the immune system induced by SARS-CoV2 and by the recently released SARS-COV-2 vaccines has been highlighted in recent months. To assess whether this observed increase in the incidence of GD is sustained in the coming years or has simply been a precipitous trigger for individuals who were already predisposed to develop the disease, future studies will be needed.

Estudio de seguimiento de 35 años de pacientes admitidos a tratamiento con metadona entre 1982-1984 en Asturias, España / A 35-year follow-up study of patients admitted to methadone treatment between 1982-1984 in Asturias, Spain

El objetivo fue evaluar el estado de una población dependiente a la heroína 35 años después de su primera inscripción en un tratamiento de mantenimiento con metadona (TMM). Se utilizó un protocolo ad hoc para evaluar morbilidad, consumo y tratamiento de la adicción en la muestra de supervivientes. Se calculó la razón de mortalidad estandarizada (RME) con un intervalo de confianza (IC) del 95%. Un total de 214 pacientes ingresaron en TMM entre 1982 y 1984 en el Servicio de Salud Pública de Asturias. Se recibió información sobre 195 sujetos, de los cuales 146 habían fallecido. Los hombres representaron el 77,5% de la cohorte del estudio. Durante el período de seguimiento de 35 años, la RME fue de 11,75 (IC 95% = 9,95 – 13,77). En la muestra de supervivientes, el 5,7% todavía estaba inscrito en TMM; el virus de inmunodeficiencia humana (VIH) se diagnosticó en un 38,77% y la hepatitis B/C en un 73,46%; el consumo actual de heroína se informó en un 4,1%. No hubo diferencias de género en la mortalidad o la condición de VIH y hepatitis B/C. Ninguna de las mujeres consumía heroína en el seguimiento de 35 años en comparación con el 5,26% de los hombres. En conclusión, nuestro estudio confirma la alta tasa de mortalidad a largo plazo, incluso después de la inscripción en TMM. (AU)

The objective was to evaluate outcomes in a heroin-dependent population 35 years after first enrolment in methadone maintenance treatment (MMT). An ad hoc protocol was used to assess drug misuse, treatment, and drug-related morbidity in the survivor sample. The standardized mortality ratio (SMR) and 95% confidence interval (CI) were calculated. A total of 214 heroin-dependent patients entered MMT between 1982 and 1984 in the Asturias Public Health Service. Information was received on 195 subjects, of whom 146 were deceased. Men accounted for 77.5% of the study cohort. Over the 35-year follow-up period, the SMR was 11.75 (95% CI = 9.95 – 13.77). In the survivor sample, 5.7% were still enrolled in MMT; human immunodeficiency virus (HIV) was diagnosed in 38.77% and hepatitis B/C in 73.46%. No differences were found between sexes in mortality or HIV and hepatitis B/C status. None of the female survivors were using heroin at the 35-year follow-up compared with 5.26% of males. In conclusion, our study confirms the high long-term mortality rate of heroin addicts, even after enrollment in MMT. (AU)

A Biomechanical Analysis of the Influence of the Morfology of the Bone Blocks Grafts on the Transfer of Tension or Load to the Soft Tissue by Means of the Finite Elements Method.

Edentulism produces resorption of alveolar bone processes, which can complicate placement of dental implants. Guided bone regeneration techniques aim to recover the volume of bone. These treatments are susceptible to the surgical technique employed, the design of the autologous block or the tension of the suture. These factors can relate to major complications as the lack of primary closure and dehiscence. The present study, using finite element analysis, aimed to determine differences in terms of displacement of the oral mucosa, transferred stress according to Von Mises and deformation of soft tissue when two block graft designs (right-angled and rounded) and two levels of suture tension (0.05 and 0.2 N) were combined. The results showed that all the variables analyzed were greater with 0.2 N. Regarding the design of the block, no difference was found in the transferred stress and deformation of the soft tissue. However, displacement was related to a tendency to dehiscence (25% greater in the right-angled/chamfer design). In conclusion different biomechanical behavior was observed in the block graft depending on the design and suture tension, so it is recommended to use low suture tension and rounded design. A novel finite element analysis model is presented for future investigations.

Resultados obtenidos en la prueba MIR de 2021, según nacionalidad y baremo académico / Results obtained in the 2021 MIR test according to nationality and academic scale

Introducción: En España, el acceso a la formación médica especializada se hace a través de la prueba MIR. Esta prueba la convocan anualmente desde 1978 los Ministerios de Sanidad, y Educación y Formación Profesional. Así, teniendo en cuenta tanto el resultado que se obtiene en la prueba como el baremo promedio del grado, se asigna un número de orden a los médicos que quieren acceder a una plaza de formación como especialistas. El objetivo de este trabajo es el análisis de los resultados obtenidos por los médicos que se presentaron a la prueba de 2021 en función de su baremo académico y de si son españoles o extranjeros.Materiales y métodos.Para esta investigación se ha hecho uso de la información oficial pública relativa al baremo académico, la nacionalidad y los resultados obtenidos en la prueba por todos los aspirantes presentados a ella.Resultados.Entre los 5.000 primeros números de orden se situaron el 90,61% de los médicos presentados con un baremo de sobresaliente, el 79,59% de los baremos de notable igual o superior a 8, el 42,21% de los baremos de notable inferior a 8 y únicamente un 7,16% de los médicos con baremo de aprobado.Conclusiones.Este estudio confirma que existe una relación directa entre el baremo de los médicos aspirantes a una plaza de formación médica especializada y el resultado que obtienen en la prueba MIR, más allá de la ponderación de éste sobre la nota final de la prueba MIR. (AU)

Introduction: In Spain, access to specialized medical training is done through the MIR test. This test is convened annually since 1978 by the Ministries of Health and Education and Vocational Training. Thus, taking into account both the result obtained in the test and the average degree scale, an order number is assigned to doctors who want to access a training position as specialists. The objective of this work is the analysis of the results obtained by the doctors who took the 2021 test based on their academic scale and whether they are Spanish or foreign.Materials and methods.For this research, the official public information regarding the academic scale, nationality and the results obtained in the test by all the applicants presented to has been employed.Results.The 90.61% of those doctors that obtained in their degrees an average mark of 9 or more can be found among the 5,000 first order numbers, the same happen to the 79.59% of those who obtained a mark from 8 to 8.99, the 42.21% of those with a mark from 7 to 7.00 and only the 7.16% of those doctors with an average mark in their degrees under 7.Conclusions.This study confirms that there is a direct relationship between the marks obtained in their degree of doctors aspiring to a specialized medical training position and the result they obtain in the MIR test, beyond the weighting of this on the final grade of the MIR test. (AU)

Work-related overexertion injuries in cleaning occupations: An exploration of the factors to predict the days of absence by means of machine learning methodologies.

The special characteristics of the cleaning industry have an important impact on the health and safety of its workforce. Making use of data from more than 79,000 occupational accidents, the aim of the present research is to use machine learning techniques to develop a model to predict incapacity for work (expressed in days of absence) due to work-related overexertion injuries among service sector cleaners in Spain. The severity of accidents caused by overexertion depends on several factors that can be classified into the following categories: injury typology, individual factors, employment conditions, accident circumstances and health and safety management and standards in the company.

Computer vision syndrome in healthcare workers using video display terminals: an exploration of the risk factors.

AIMS: To estimate the prevalence of computer vision syndrome (CVS) in healthcare workers and its relationship to video display terminal (VDT) exposure, sociodemographic, optical correction and work characteristics, and to analyse whether there are differences among occupational groups. DESIGN: Cross-sectional study. METHODS: A sample of 1179 physicians and surgeons, nurses, and nursing assistants from two hospitals in Spain between January 2017 and February 2018 were invited to participate in this study. Of these, 622 workers from both hospitals were finally included. CVS was measured using a questionnaire, the CVS-Q© . Logistic regression was used to identify the factors associated with CVS. All the results were stratified by occupational group. RESULTS: The prevalence of CVS was 56.75% with nurses being the most affected occupational group (61.75%). It was associated significantly with female sex (aOR = 2.57; 95% CI 1.36-4.88) and morning shifts plus on-call (aOR = 2.33; 95% CI 1.11-4.88) in the physicians and surgeons group. Among the nurses, it was associated with female sex (aOR = 2.35; 95% CI 1.03-5.37), seniority between 10 and 20 years (aOR = 2.17; 95% CI 1.03-4.59), VDT exposure at work of 2-4 h/day (aOR = 6.14; 95% CI 1.08-35.02), VDT exposure at work >4 h/day (aOR = 7.14; 95% CI 1.29-39.62) and self-perception that using the software application was not easy (aOR = 2.49; 95% CI 1.23-5.01). CONCLUSIONS: A high prevalence of CVS among healthcare workers was observed. The risk factors that increased the likelihood of suffering from this syndrome depended on the occupation. IMPACT: The findings may be used as a reference for occupational health services to implement specific preventive measures to reduce CVS for each occupational group. Such measures should consider both individual factors and the working conditions.

Análisis psicométrico de las preguntas repetidas en los simulacros de la prueba MIR / Psychometric analysis of the questions repeated in the MIR test mockups

Introducción: El presente trabajo analiza 13 preguntas que se repitieron dos veces en distintas pruebas que simulan el examen MIR, separadas en el tiempo entre dos y 15 semanas. A partir de los resultados obtenidos, se ha analizado el proceso de aprendizaje de los estudiantes que se preparan para la prueba MIR.Material y métodos.Para el presente estudio se hizo uso de una base de datos formada por un total de 2.600 preguntas respondidas en promedio por 1.585 alumnos de características relativamente homogéneas.Resultados.En general, resulta posible afirmar que entre la primera y la segunda exposición de los alumnos a la misma pregunta se produjo una mejora de los índices analizados. De los resultados obtenidos, se observa que, en promedio, a lo largo de la preparación, la dificultad de las preguntas para el grupo de estudiantes se reduce a la mitad. En lo referente al índice de discriminación, éste se incrementa cerca del 60%, lo que supone que, según transcurre la preparación, aumenta la proporción de personas que aciertan la pregunta en el grupo fuerte con respecto a las que la aciertan en el grupo débil. Finalmente, también se produce una mejora en el valor del coeficiente de correlación biserial puntual, lo que supone una mejora de la capacidad discriminativa de las preguntas.Conclusiones.Según transcurre la preparación, las preguntas analizadas se vuelven más fáciles y más discriminativas. Además, se observa cómo no todos los alumnos consiguen el mismo aprovechamiento del proceso de aprendizaje. (AU)

Introduction: The present work analyses 13 questions that were repeated twice in different tests that simulate the MIR exam, separated in time between 2 and 15 weeks. From the results obtained, the learning process of the students preparing for the MIR test has been analysed.Material and methods.For the present study, a database made up of a total of 2,600 questions which were answered on average by 1,585 students with relatively homogeneous characteristics was employed.Results.In general, it is possible to affirm that between the first and second exposure of the students to the same question there was an improvement in the indexes analysed. From the results obtained, it is observed that, on average, throughout the preparation, the difficulty of the questions for the group of students is reduced by half. Regarding the discrimination index, this increases by about 60%, which means that as the preparation progresses, the proportion of people who get the question right in the strong group increases with respect to those who get it right in the weak group. Finally, there is also an improvement in the value of the biserial point correlation coefficient, which implies an improvement in the discriminative capacity of the questions.Conclusions.As the preparation progresses, the analysed questions become easier and discriminating. In addition, it is observed how not all students obtained the same performance. (AU)

Zirconia vs. Titanium Dental Implants: Primary Stability In-Vitro Analysis.

The present experimental trial uses two types of dental implants, one made of titanium (Ti6Al4V) and the other one of zirconia (ZrO2), but both of identical design, to compare their stability and micro-movements values under load. One of each type of implant (n = 42) was placed into 21 cow ribs, recording the insertion torque and the resonance frequency using a specific transducer. Subsequently, a prosthetic crown made of PMMA was screwed onto each of the implants in the sample. They were then subjected to a static compression load on the vestibular cusp of the crown. The resulting micromovements were measured. The zirconia implants obtained a higher mean of both IT and RFA when compared with those of titanium, with statistically significant differences in both cases (p = 0.0483 and p = 0.0296). However, the micromovement values when load was applied were very similar for both types, with the differences between them (p = 0.3867) not found to be statistically significant. The results show that zirconia implants have higher implant stability values than titanium implants. However, the fact that there are no differences in micromobility values implies that caution should be exercised when applying clinical protocols for zirconia based on RFA, which only has evidence for titanium.

Effect of Different Implant Designs on Strain and Stress Distribution under Non-Axial Loading: A Three-Dimensional Finite Element Analysis.

Implant design evolved alongside the development of implant therapy. The purpose of this finite element analysis (FEA) study was to analyze the influence of different implant designs on the stress and strain distribution to the implants and surrounding bone. Three implant designs with the same length and diameter were used. The three-dimensional geometry of the bone was simulated with a cortical bone of three different thicknesses and two medullar bone densities: low density (150 Hounsfield units) and high density (850 Hounsfield units). A 30° oblique load of 150 N was applied to the implant restoration. Displacement and stress (von Mises) results were obtained for bone and dental implants. The strain and stress distributions to the bone were higher for the tissue-level implant for all types of bone. The maximum principal strain and stress decreased with an increase in cortical bone thickness for both cancellous bone densities. The distribution of the load was concentrated at the coronal portion of the bone and implants. All implants showed a good distribution of forces for non-axial loads, with higher forces concentrated at the crestal region of the bone-implant interface. Decrease in medullar bone density negatively affects the strain and stress produced by the implants.

Evolution and forecasting of PM10 concentration at the Port of Gijon (Spain).

The name PM10 refers to small particles with a diameter of less than 10 microns. The present research analyses different models capable of predicting PM10 concentration using the previous values of PM10, SO2, NO, NO2, CO and O3 as input variables. The information for model training uses data from January 2010 to December 2017. The models trained were autoregressive integrated moving average (ARIMA), vector autoregressive moving average (VARMA), multilayer perceptron neural networks (MLP), support vector machines as regressor (SVMR) and multivariate adaptive regression splines. Predictions were performed from 1 to 6 months in advance. The performance of the different models was measured in terms of root mean squared errors (RMSE). For forecasting 1 month ahead, the best results were obtained with the help of a SVMR model of six variables that gave a RMSE of 4.2649, but MLP results were very close, with a RMSE value of 4.3402. In the case of forecasts 6 months in advance, the best results correspond to an MLP model of six variables with a RMSE of 6.0873 followed by a SVMR also with six variables that gave an RMSE result of 6.1010. For forecasts both 1 and 6 months ahead, ARIMA outperformed VARMA models.

Detection of outliers in pollutant emissions from the Soto de Ribera coal-fired power plant using functional data analysis: a case study in northern Spain.

For more than a century, air pollution has been one of the most important environmental problems in cities. Pollution is a threat to human health and is responsible for many deaths every year all over the world. This paper deals with the topic of functional outlier detection. Functional analysis is a novel mathematical tool employed for the recognition of outliers. This methodology is applied here to the emissions of a coal-fired power plant. This research uses two different methods, called functional high-density region (HDR) boxplot and functional bagplot. Please note that functional bagplots were developed using bivariate bagplots as a starting point. Indeed, they are applied to the first two robust principal component scores. Both methodologies were applied for the detection of outliers in the time pollutant emission curves that were built using, as inputs, the discrete information available from an air quality monitoring data record station and the subsequent smoothing of this dataset for each pollutant. In this research, both new methodologies are tested to detect outliers in pollutant emissions performed over a long period of time in an urban area. These pollutant emissions have been treated in order to use them as vectors whose components are pollutant concentration values for each observation made. Note that although the recording of pollutant emissions is made in a discrete way, these methodologies use pollutants as curves, identifying the outliers by a comparison of curves rather than vectors. Then, the concept of outlier goes from being a point to a curve that employs the functional depth as the indicator of curve distance. In this study, it is applied to the detection of outliers in pollutant emissions from a coal-fired power plant located on the outskirts of the city of Oviedo, located in the north of Spain and capital of the Principality of Asturias. Also, strengths of the functional methods are explained.

The MIR 2018 Exam: Psychometric Study and Comparison with the Previous Nine Years.

Background and Objectives: The aim of the present research is to study the questions used in the 2018 MIR exam (a test that allows access to specialized medical training in Spain), describe their psychometric properties, and evaluate their quality. Materials and Methods: This analysis is performed with the help of classical test theory (CTT) and item response theory (IRT). The answers given to the test questions by a total of 3868 physicians are analyzed. Results: According to CTT, the average difficulty index for all of the test questions was 0.629, which falls into the acceptable category. The average difficulty index with correction for random effects was 0.515, which corresponds to a value within the optimal range. The mean discrimination index was 0.277, which is in the good category, while the mean point biserial correlation coefficient, with a value of 0.275 fits in the regular category. The values of difficulty and discrimination calculated according to the model of two parameters of the IRT seem adequate with average values of -0.389 and 0.677. The Cronbach alpha score obtained for the overall test was 0.944. This value is considered as very good. Conclusions: A decrease was observed in the average values of discrimination in the last three calls, which may be related to the greater proportion of Spanish graduates that take the exam in the same year of finalization of their studies in Medicine.

Prediction of Computer Vision Syndrome in Health Personnel by Means of Genetic Algorithms and Binary Regression Trees.

One of the major consequences of the digital revolution has been the increase in the use of electronic devices in health services. Despite their remarkable advantages, though, the use of computers and other visual display terminals for a prolonged time may have negative effects on vision, leading to a greater risk of Computer Vision Syndrome (CVS) among their users. In this study, the importance of ocular and visual symptoms related to CVS was evaluated, and the factors associated with CVS were studied, with the help of an algorithm based on regression trees and genetic algorithms. The performance of this proposed model was also tested to check its ability to predict how prone a worker is to suffering from CVS. The findings of the present research confirm a high prevalence of CVS in healthcare workers, and associate CVS with a longer duration of occupation and higher daily computer usage.