Mixed Reality in the Operating Room: A Systematic Review.

Mixed Reality is a technology that has gained attention due to its unique capabilities for accessing and visualizing information. When integrated with voice control mechanisms, gestures and even iris movement, it becomes a valuable tool for medicine. These features are particularly appealing for the operating room and surgical learning, where access to information and freedom of hand operation are fundamental. This study examines the most significant research on mixed reality in the operating room over the past five years, to identify the trends, use cases, its applications and limitations. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to answer the research questions established using the PICO (Population, Intervention, Comparator and Outcome) framework. Although implementation of Mixed Reality applications in the operations room presents some challenges, when used appropriately, it can yield remarkable results. It can make learning easier, flatten the learning curve for several procedures, and facilitate various aspects of the surgical processes. The articles' conclusions highlight the potential benefits of these innovations in surgical practice while acknowledging the challenges that must be addressed. Technical complexity, equipment costs, and steep learning curves present significant obstacles to the widespread adoption of Mixed Reality and computer-assisted evaluation. The need for more flexible approaches and comprehensive studies is underscored by the specificity of procedures and limited samples sizes. The integration of imaging modalities and innovative functionalities holds promise for clinical applications. However, it is important to consider issues related to usability, bias, and statistical analyses. Mixed Reality offers significant benefits, but there are still open challenges such as ergonomic issues, limited field of view, and battery autonomy that must be addressed to ensure widespread acceptance.

Using Immersive Environments in E-Mental Health Rehabilitation Programs Directed to Future Health Professionals to Promote Empathy and Health Literacy about Schizophrenia.

Rehabilitation involves all types of patients, including people with schizophrenia. Schizophrenia is considered a complex syndrome characterized in general by fundamental and characteristic distortions of thinking and perception. The quality of life of a person with schizophrenia can be compromised by difficulty in carrying out their daily tasks and by the social stigma of their condition. The importance of training and sensitizing students in rehabilitation areas to this type of problem to improve the rehabilitation processes in which they will participate as future professionals involves empathy and the ability to communicate with these populations. It is possible through virtual reality to create immersive environments to simulate some psychotic symptoms characteristic of people with schizophrenia, such as visual hallucinations and hearing voices. The aim of this study was to test the effect of exposure to experiences characteristic of schizophrenia through two different types of immersive environments, graphical computational virtual reality and 360° video, on students from areas of social rehabilitation regarding empathy, social distance, and attitudes towards people with schizophrenia. Although the results were positive for the three parameters under study, no significant differences were found for each of them between the environments to which the participants were exposed. This study concluded that the choice between the two types of immersive environments should be based on the project's objectives, the target audience's needs, and available resources, rather than the type of environment itself, as their impact was similar.

Southern marsh deer (Blastocerus dichotomus) populations assessed using Amplicon Sequencing on fecal samples.

Populations in isolated and small fragments lose genetic variability very fast and are usually of conservation concern because they are at greater risk of local extinction. The largest native deer in South America, Blastocerus dichotomus (Illiger, 1815), is a Vulnerable species according to the IUCN categorization, which inhabits tropical and subtropical swampy areas. In Argentina, its presence has been restricted to four isolated fragments. Here we examine the genetic diversity and differentiation among three of them, including the three different patches that form the southernmost population, using 18 microsatellite markers genotyped by Amplicon Sequencing of DNA extracted from fecal samples. Genetic diversity was low (HE < 0.45) in all three populations studied. We found three genetic clusters compatible with the geographic location of the samples. We also found a metapopulation dynamics that involves the patches that make up the southernmost population, with evidence of a barrier to gene flow between two of them. Our results point to the creation of a corridor as a necessary and urgent management action. This is the first study, at the population level, employing microsatellite genotyping by Amplicon Sequencing with non-invasive samples in an endangered species.

Management of C5 Palsy After Anterior Cervical Decompression Using Oberlin Nerve Transfer: A Case Report.

C5 palsy is a potential complication of cervical decompression surgery from which many patients do not recover or partially recover function. We present the case of a 48-year-old patient who developed elbow flexion paralysis after anterior decompression surgery with fusion of the C5-C7 levels. Muscle function was not spontaneously restored until eight months after surgery. In this case, we performed an Oberlin procedure to restore the function of the arm. Muscle strength (5/5) and volume were obtained 13 months after surgery. A reasonable waiting period is required after C5 palsy in case spontaneous recovery occurs. Treatment decision should be based on the patient's symptoms. Nerve transfers have been shown to be effective when performed after six months, especially in Oberlin transfer.

Outcome measures applied to robotic assistive technology for people with cerebral palsy: a pilot study.

The application of robotic devices is being used as Assistive Technology (AT) for improving rehabilitation interventions. The purposes of this research were to (1) test a novel low-cost robotic AT to support interventions for people with Cerebral Palsy (CP); (2) determine its usability; and (3) analyze its impact. It was a pilot study with prospective, longitudinal and analytical cohorts was done. Intervention was developed in one association (NGO) of people with CP. Participants were 6 women and 3 men with CP, with a mean age of 51.67. Intervention with LOLA2 (a robotic platform, not wearable, equipped with artificial intelligence) was implemented for training some activities of daily life (ADL) of participants. Functional Independence Measure (FIM), Psychosocial Impact of Assistive Technology Scale (PIADS), and Assistive Technology Device Predisposition Assessment (ATPA) were used for outcome measures. Level of participants' independence was high (FIM = 98). Psychosocial impact of the robotic platform in terms of competence (M = 0.25), adaptability (M = 0.33), and self-esteem (M = 0.25), was positive, but low. The mean in ATDPA (M = 3) reflects a moderate match. No significant variations concerning the changes in functional independence were detected. The robotic platform is applicable and complementary AT for rehabilitation. This study leads to implementing some improvements in its design, proposed activities, human-robot interaction, and system for registering information.

Robotic devices such as LOLA2 show promise as complementary tools in rehabilitation for individuals with Cerebral Palsy (CP), highlighting the potential for improved outcomes in clinical practice.There is a clear need for enhancements in the usability, universal design, and technical specifications of robotic platforms like LOLA2 to ensure their full functionality and quality, underscoring the importance of ongoing development and refinement.Utilizing specific outcome measures tailored to assess the efficacy and applicability of assistive technologies (AT), including robotic devices, is crucial for comprehensive evaluation and informed decision-making in rehabilitation interventions.Further research with higher validity is necessary to expand the evidence base surrounding the use of robotic devices in assistive technology, guiding specialized technical decisions and enhancing their integration into rehabilitation practices.

Quality of Sleep Data Validation From the Xiaomi Mi Band 5 Against Polysomnography: Comparison Study.

BACKGROUND: Polysomnography is the gold standard for measuring and detecting sleep patterns. In recent years, activity wristbands have become popular because they record continuous data in real time. Hence, comprehensive validation studies are needed to analyze the performance and reliability of these devices in the recording of sleep parameters. OBJECTIVE: This study compared the performance of one of the best-selling activity wristbands, the Xiaomi Mi Band 5, against polysomnography in measuring sleep stages. METHODS: This study was carried out at a hospital in A Coruña, Spain. People who were participating in a polysomnography study at a sleep unit were recruited to wear a Xiaomi Mi Band 5 simultaneously for 1 night. The total sample consisted of 45 adults, 25 (56%) with sleep disorders (SDis) and 20 (44%) without SDis. RESULTS: Overall, the Xiaomi Mi Band 5 displayed 78% accuracy, 89% sensitivity, 35% specificity, and a Cohen κ value of 0.22. It significantly overestimated polysomnography total sleep time (P=.09), light sleep (N1+N2 stages of non-rapid eye movement [REM] sleep; P=.005), and deep sleep (N3 stage of non-REM sleep; P=.01). In addition, it underestimated polysomnography wake after sleep onset and REM sleep. Moreover, the Xiaomi Mi Band 5 performed better in people without sleep problems than in those with sleep problems, specifically in detecting total sleep time and deep sleep. CONCLUSIONS: The Xiaomi Mi Band 5 can be potentially used to monitor sleep and to detect changes in sleep patterns, especially for people without sleep problems. However, additional studies are necessary with this activity wristband in people with different types of SDis. TRIAL REGISTRATION: ClinicalTrials.gov NCT04568408; https://clinicaltrials.gov/ct2/show/NCT04568408. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph18031106.

Use of the Xiaomi Mi Band for sleep monitoring and its influence on the daily life of older people living in a nursing home.

Background: Lower quantity and poorer sleep quality are common in most older adults, especially for those who live in a nursing home. The use of wearable devices, which measure some parameters such as the sleep stages, could help to determine the influence of sleep quality in daily activity among nursing home residents. Therefore, this study aims to analyse the influence of sleep and its changes concerning the health status and daily activity of older people who lived in a nursing home, by monitoring the participants for a year with Xiaomi Mi Band 2. Methods: This is a longitudinal study set in a nursing home in [Details omitted for double-anonymized peer reviewed]. The Xiaomi Mi Band 2 will be used to measure biomedical parameters and different assessment tools will be administered to participants for evaluating their quality of life, sleep quality, cognitive state, and daily functioning. Results: A total of 21 nursing home residents participated in the study, with a mean age of 86.38 ± 9.26. The main outcomes were that sleep may influence daily activity, cognitive state, quality of life, and level of dependence in activities of daily life. Moreover, environmental factors and the passage of time could also impact sleep. Conclusions: Xiaomi Mi Band 2 could be an objective tool to assess the sleep of older adults and know its impact on some factors related to health status and quality of life of older nursing homes residents. Trial Registration: NCT04592796 (Registered 16 October 2020) Available on: https://clinicaltrials.gov/ct2/show/NCT04592796.

Impact of a Virtual Reality-Based Simulation on Empathy and Attitudes Toward Schizophrenia.

Virtual Reality (VR) has been identified as one of the most promising resources for developing empathy towards stigmatized groups as it allows individuals to experience a situation close to reality from another person's perspective. This quasi-experimental study aimed to examine the impact on empathy, knowledge, and attitudes towards people with schizophrenia of a VR simulation that reproduces the experience of psychotic symptoms while performing a cognitive task compared with watching a 2D video and, thus, how these experiences could reduce stigma towards people diagnosed with schizophrenia. The sample comprised of 102 higher education health students, distributed by the experimental and control groups. The impact of the program was measured by completing multiple questionnaires on levels of empathy, attitudes, and mental health knowledge. Both methods (VR and 2D video) were, to a certain extent, effective. However, VR was more effective at eliciting attitudes and knowledge change compared to the control group. These findings suggest that not only VR but also 2D videos could be interesting strategies to enhance empathy and improve attitudes towards people with schizophrenia in higher education health students.

Biodiversity of vertebrates in Argentina: patterns of richness, endemism and conservation status.

Optimising conservation efforts requires an accurate record of the extant species as well as their geographic distributions. Nevertheless, most current conservation strategies start from an incomplete biodiversity inventory. Argentina has an extraordinary diversity of species, however, until now an updated inventory of its fauna has not been carried out. In this context, the main objective of this work is to present the results of the first national inventory of vertebrate species. Experts from each major vertebrate taxonomic group assembled and compiled its respective inventory. The information gathered included taxonomic rank, conservation status, endemism and geographic distribution. Species richness and representativeness were calculated for each taxonomic group, distinguishing between native, endemic and exotic, for each Argentinian province. Our results show Argentina harbours 3,303 species: 574 marine fish, 561 freshwater fish, 177 amphibians, 450 reptiles, 1,113 birds, and 428 mammals. Native species constitute 98.1% of the total taxa. The results achieved were spatially represented showing a pattern of higher richness from north to south and from east to west. Species considered as threatened account for 17.8% and 15.2% are endemic. There are five Extinct species. These results provide key information on developing strategies and public policies at the national and provincial levels and constitute a tool for the management and conservation of biodiversity.

Evaluación del nivel de acceso a nuevas tecnologías y conocimiento del riesgo cardiovascular en pacientes cardiópatas hospitalizados / Evaluation of the level of access to new technologies and knowledge of cardiovascular risk in hospitalized patients with cardiac conditions

Objetivo: determinar el nivel de acceso a internet de los pacientes cardiópatas hospitalizados en el Área de Ferrol, Galicia (España) e indicar el grado de autoconocimiento del riesgo cardiovascular (RCV) en función del riesgo cardiovascular real calculado. Objetivos secundarios: evaluar los factores asociados a un mayor uso de recursos web y analizar los factores asociados a un mejor conocimiento del RCV.Métodos: estudio descriptivo transversal con pacientes ingresados en la unidad de cardiología en un mes (n= 106). Se recogieron variables sociodemográficas, de frecuencia de acceso a internet y de factores de RCV. Se calculó el RCV real y se comparó con el autopercibido. Se realizó un análisis descriptivo y se empleó el test Chi Cuadrado o test exacto de Fisher para analizar la asociación entre diferentes variables con el nivel de acceso a internet.Resultados: de los 89 pacientes incluidos, la edad media era de 64,6 (DE:12,3) años, el 76,4% era hombre, con formación básica (58,4%) y casado (75,3%). El 40,6% manifestó no acceder nunca a internet, el 18% hacerlo de forma ocasional, el 11,2% de forma frecuente y el 30,3% hacerlo diariamente. El uso de recursos web fue significativamente mayor en pacientes con mayor formación y más jóvenes. Únicamente el 19,1% estimó de forma correcta su RCV y no se halló ningún factor asociado a un mejor conocimiento del RCV.Conclusión: la Educación para la Salud es necesaria y debe mejorarse; sin embargo, el uso de recursos web no puede considerarse la única herramienta en esta área sanitaria en la actualidad.(AU)

Objective: to determine the level of access to internet among patients with cardiac conditions hospitalized at the Ferrol Area, Galicia (Spain), and to state their level of self-knowledge of cardiovascular risk (CVR) based on their estimated real cardiovascular risk. Secondary endpoints: To assess those factors related to a higher use of web resources, and to analyze those factors associated with a better knowledge of their CVR.Methods: a cross-sectional descriptive study with patients admitted to the Cardiology Unit in one month (n= 106). Sociodemographic variables were collected, as well as frequency of internet access and CVR factors. The real CVR was calculated, and compared with their self-perceived risk. Descriptive analysis was conducted, and the Chi Square test or Fisher’s Exact Test was used to analyze the association between different variables and their level of access to internet.Results: the age of the 89 patients included was 64.6 (SD:12.3) years, 76.4% were male, with basic education (58.4%) and married (75.3%). Out of these, 40.6% stated that they never accessed internet, 18% did it occasionally, 11.2% frequently, and 30.3% did it every day. The use of web resources was significantly higher in younger patients and those with higher education. Only 19.1% calculated their CVR correctly, and no factor was found to determine a higher knowledge of CVR.Conclusion: health Education is necessary and must be improved; however, the use of web resources cannot be considered currently the only tool in this health area.(AU)

Analysis of Older Adults in Spanish Care Facilities, Risk of Falling and Daily Activity Using Xiaomi Mi Band 2.

BACKGROUND: Presently the use of technological devices such as wearable devices has emerged. Physical activity monitoring with wearable sensors is an easy and non-intrusive approach to encourage preventive care for older adults. It may be useful to follow a continuous assessment of the risk of falling. The objective is to explore the relationship between the daily activity measured by Xiaomi Mi Band 2 and the risk of falling of older adults residing in or attending care facilities. METHODS: A cross-sectional study was conducted on three different institutions located in Galicia (autonomous community) (Spain). RESULTS: A total of 31 older adults were included in the study, with a mean age of 84 ± 8.71 years old. The main findings obtained were that a greater number of steps and distance could be related to a lower probability of falling, of dependency in basic activities of daily living, or of mobility problems. CONCLUSIONS: The importance of focusing on daily steps, intrinsically related to the objective assessment of daily physical activity, is that it is a modifiable factor that impacts different aspects of health and quality of life.

Stakeholder Perspectives to Support Graphical User Interface Design for Children with Autism Spectrum Disorder: A Qualitative Study.

The development of digital supports for people with autism has increased considerably in recent years. Technology designers and developers have interpreted the needs and learning styles of people with autism in different ways. As a result, there are generic, non-specific or heterogeneous guidelines for the design and development of technology for people with autism. This study aims to identify and describe the recommended elements to support graphical user interface design for children with Autism Spectrum Disorder (ASD), considering the stakeholders' perspective, engaged in a computer application development. A qualitative, longitudinal, multicentre study was carried out. A sample of 39 participants belonging to four groups of stakeholders participated: children with autism, family members, professionals with experience in the intervention with children with autism, and professionals with expertise in the design and development of assistive technology. The techniques used to formalise the collection of information from participants were semi-structured interviews and observation. MAXQDA 2020 software (Verbi Software, Berlin, Germany) was used to analyse the data. The result is a guide with suggestions to support an interface design that emerges from the stakeholder perspectives. This study provides useful information to offer alternatives for children with ASD and facilitate the understanding of daily life.

Study for the Design of a Protocol to Assess the Impact of Stress in the Quality of Life of Workers.

(1) Background: Work stress is one of the most relevant issues in public health. It has a significant impact on health, especially the development of mental disorders, causing occupational imbalance. There is a growing interest in the development of tools with a positive effect on workers. To this end, wearable technology is becoming increasingly popular, as it measures biometric variables like heartbeat, activity, and sleep. This information may be used to assess the stress a person is suffering, which could allow the development of stress coping strategies, both at a professional and personal level. (2) Methods: This paper describes an observational, analytical, and longitudinal study which will be set at a research center in A Coruña, Spain. Various scales and questionnaires will be filled in by the participants throughout the study. For the statistical analysis, specific methods will be used to evaluate the association between numerical and categorical variables. (3) Discussion: This study will lay the foundation for a bigger, more complete study to assess occupational stress in different work environments. This will allow us to begin to understand how occupational stress influences daily life activity and occupational balance, which could directly enhance the quality of life of workers if the necessary measures are taken.

Study Protocol on the Validation of the Quality of Sleep Data from Xiaomi Domestic Wristbands.

(1) Background: Sleep disorders are a common problem for public health since they are considered potential triggers and predictors of some mental and physical diseases. Evaluating the sleep quality of a person may be a first step to prevent further health issues that diminish their independence and quality of life. Polysomnography (PSG) is the "gold standard" for sleep studies, but this technique presents some drawbacks. Thus, this study intends to assess the capability of the new Xiaomi Mi Smart Band 5 to be used as a tool for sleep self-assessment. (2) Methods: This study will be an observational and prospective study set at the sleep unit of a hospital in A Coruña, Spain. Forty-three participants who meet the inclusion criteria will be asked to participate. Specific statistical methods will be used to analyze the data collected using the Xiaomi Mi Smart Band 5 and PSG. (3) Discussion: This study offers a promising approach to assess whether the Xiaomi Mi Smart Band 5 correctly records our sleep. Even though these devices are not expected to replace PSG, they may be used as an initial evaluation tool for users to manage their own sleep quality and, if necessary, consult a health professional. Further, the device may help users make simple changes to their habits to improve other health issues as well. Trial registration: NCT04568408 (Registered 23 September 2020).

How Loan Bank of Assistive Technology Impacts on Life of Persons with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases: A Collaborative Initiative.

(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse the correct matching between the person and technology, derived from the counselling of an occupational therapist. (2) Methods: Cross-sectional study. The sample was formed by 28 people with rare neurodegenerative disorders. A specific questionnaire, the Psychosocial Impact of Assistive Device Scale (PIADS), and the Matching Person and Technology (MPT) tool were applied to collect the data. (3) Results: The dimension of the PIADS with the best score was competence, and the variations according to gender were not remarkable. The three dimensions of the PIADS (competence, adaptability, and self-esteem) were correlated positively between them and with the mean score of the MPT tool (p < 0.01). The type of assistive technology (AT), diagnosis, and correct match between person-technology are the main factors that condition a positive impact. (4) Conclusions: The results noted the importance of assessing the needs, demands, and contexts of people with rare neurodegenerative diseases to prescribe the best AT. Loan banks of AT have to be considered a valid service that complements their lack in public health services.

The role of the environment in the spatial dynamics of an extensive hybrid zone between two neotropical cats.

Identifying factors that create and maintain a hybrid zone is of great interest to ecology, evolution and, more recently, conservation biology. Here, we investigated the role of environmental features in shaping the spatial dynamics of a hybrid zone between the southern tigrina, Leopardus guttulus, and Geoffroy's cat, L. geoffroyi, testing for exogenous selection as the main force acting on its maintenance. These Neotropical felid species are mainly allopatric, with a restricted area of sympatry in the ecotone between the Atlantic Forest and Pampa biomes. As both biomes have experienced high rates of anthropogenic habitat alteration, we also analysed the influence of habitat conversion on the hybrid zone structure. To do this, we used 13 microsatellite loci to identify potential hybrids and generated ecological niche models for them and their parental species. We compared the influence of variables on parental species and hybrid occurrence and calculated the amount of niche overlap among them. Parental species showed different habitat requirements and predicted co-occurrence was restricted to the forest-grassland mosaic of the ecotone. However, hybrids were found beyond this area, mainly in the range of L. geoffroyi. Hybrids demonstrated higher tolerance to habitat alteration than parental types, with a probability of occurrence that was positively related with mosaics of cropland areas and remnants of natural vegetation. These results indicate that exogenous selection alone does not drive the dynamics of the hybrid zone, and that habitat conversion influences its structure, potentially favouring hybrids over parental species.

Occupational Therapy and the Use of Technology on Older Adult Fall Prevention: A Scoping Review.

Introduction: Falls are the second leading cause of accidental or non-intentional deaths worldwide and are the most common problem as people age. The primary purpose of addressing falls is to detect, prevent, treat, and reduce their incidence and consequences. Previous studies identified that multifactorial programs, an interprofessional team, and assistive technology are required to address falls in older adults effectively. Accordingly, the research question is as follows: what are the scope, type of studies, and approaches and strategies to fall risk using technology in the existing occupational therapy literature regarding interventions to address the effects of falls in older adults on daily living? Methods: This scoping review was carried out in January 2020 through Biblioteca Virtual de Salud España, C.I.N.A.H.L., Cochrane Plus, OTSeeker, PubMed, Scopus, and Web of Science. Results: Twelve papers were included. We analyzed the year and journal of publication, authors' affiliation, and design of the study, and thematic categories. There were three themes: participants' characteristics, type of intervention, and fall approach and type of technology used. Discussion and Conclusions: The literature obtained is scarce. It is considered to still be an emerging theme, especially when considering the use of technology for occupational therapy.

Deer damage: A review of repellents to reduce impacts worldwide.

Mammal herbivores, and specially deer, can cause severe damages to agriculture, producing economic losses. Repellents based on odor, visual and/or taste stimuli have been tested to minimize these damages, but their global effectiveness has not been quantified. A systematic literature review on the use of repellents to reduce damage by deer was carried out, and an evaluation of the effectiveness of different repellents and application methods was performed. A Beta regression was employed considering the percentage of vegetation unbrowsed at the end of the essay as the response variable. A total of 246 essays testing ten different repellents and 236 essays testing four different application methods were extracted from 58 articles. Odor-based repellents, such as those including "meat and blood" and "urine, hair and feces of predators", were found to be the most effective to reduce damage. Non-lethal methods, such as repellents, could be valuable tools to manage this human-wildlife conflict.

Cross-Cultural Adaptation and Preliminary Validation of the European Spanish Version of the Developmental Coordination Disorder Questionnaire (DCDQ-ES).

IMPORTANCE: The Developmental Coordination Disorder Questionnaire (DCDQ) is the most widely used measure of difficulties with activities of daily living and academic performance in children with developmental coordination disorder, but this tool has not been adapted for use in Spain. OBJECTIVE: To translate and cross-culturally adapt the DCDQ into European Spanish (DCDQ-ES) for use in assessing motor coordination in Spanish children. DESIGN: Cross-cultural adaptation and preliminary validation study. SETTING: Community and mainstream schools in Spain. PARTICIPANTS: A committee of five experts oversaw the cross-cultural adaptation process. A community-based convenience sample of 31 parents of children ages 5-14 yr was used to test the comprehensibility of the DCDQ-ES. Preliminary reliability was tested with 35 randomly selected parents of children ages 6-12 yr. OUTCOMES AND MEASURES: The DCDQ was translated into European Spanish and cross-culturally adapted following international guidelines. Comprehensibility was assessed using cognitive debriefing interviews. The final version of the DCDQ-ES was used for the reliability analysis. RESULTS: Cultural relevance and equivalence and idiomatic differences between the DCDQ and DCDQ-ES were evaluated. Comprehensibility analysis led to minor modifications that facilitated comprehension and interpretation. Internal consistency and homogeneity of the DCDQ-ES were good (Cronbach's α = .857, corrected item-total correlations = .268-.692). CONCLUSIONS AND RELEVANCE: The DCDQ-ES is conceptually and semantically equivalent to DCDQ and was successfully cross-culturally adapted for the European Spanish context. Preliminary data suggest that the DCDQ-ES is a reliable measure of motor coordination in Spanish children. WHAT THIS ARTICLE ADDS: This study provides evidence of the cultural equivalence of the DCDQ-ES for use with Spanish children. Occupational therapists in Spain can use the DCDQ-ES to evaluate children's motor coordination difficulties in everyday activities.

Long-term outcome of adjustable transobturator male system for stress urinary incontinence in the Iberian multicentre study.

AIM: The aim of this study is to evaluate long-term durability and effectiveness of the adjustable transobturator male system (ATOMS). MATERIALS AND METHODS: The retrospective multicenter Iberian ATOMS study (n = 215) was updated to evaluate long-term continence status, complications, explants, and secondary treatments. Mean follow-up from surgery to March 2020 was 60.6 ± 18.4 months (range, 39-91). Eleven patients deceased of an unrelated causes. Kaplan-Meier curves were performed to evaluate device durability and incontinence free of recurrence interval. The multivariate analysis defined the population at risk of device explant. RESULTS: A total of 155 patients were dry at the last follow-up visit (72.1%); 99 (46%) used no pads and 56 (26%) used a security pad/day with urine loss less than 10 mL; 96% of dry patients after adjustment remained free of incontinence 1 year later, 93.6% 2 years later, 91.1% 3 years later, 89.2% 5 years later, and 86.7% 8 years later. Complications during follow-up occurred in 43 of 215 (20%). In total, 25 (11.6%) devices were explanted and causes were inefficacy 11 (44%), inefficacy and pain 3 (12%), port erosion 10 (40%), and wound infection 1 (4%). The secondary implant was performed in 11 (5.1%) cases, 6 artificial urinary sphincter and 5 repeated ATOMS. Time to explant was associated to complications (P < .0001), baseline stress urinary incontinence (SUI) severity (P = .01), and former irradiation (P = .03). Multivariate analysis revealed complications (hazard ratio [HR] = 8.71; 3.83-19.82), baseline SUI severity (>5 compared to 1-2 pads/day; HR = 14.9; 1.87-125), and irradiation before ATOMS (HR = 2.26; 1.02-5.18) predicted earlier ATOMS explant. Three cases received radiation after implant without complication. CONCLUSIONS: ATOMS device is efficacious and safe in the long term. Determinants for device explant include complications, baseline severity of incontinence, and previous irradiation. Currently, the durability of the device after 5 years is reassuring.