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The Augmented Reality as a resource for the development of social skills in students whit ASD. A systematic review
Full text linkEl trastorno de espectro autista (TEA) es un conjunto de alteraciones a nivel del neurodesarrollo caracterizado, principalmente, por dificultades en la interacción social y la comunicación. Las políticas de inclusión han favorecido el acceso de niños con TEA a las escuelas ordinarias y además el uso de las tecnologías de la información y la comunicación en las aulas, ha supuesto cambios importantes en el proceso de enseñanza-aprendizaje, especialmente en lo que respecta a estos niños. Con el fin de conocer, si, el uso de la RA con estos niños fomenta el desarrollo de habilidades sociales y habilidades básicas para la vida, en este artículo se ha llevado a cabo una revisión sistemática de diferentes investigaciones siguiendo las pautas PRISMA. Atendiendo a los criterios de inclusión y exclusión se han seleccionado 20 artículos, publicados del 2012 al 2022. Los resultados muestran que el uso de aplicaciones con RA con niños con trastorno de espectro autista favorece la motivación, la interacción con los demás, el desarrollo de algunas habilidades sociales y la adquisición de algunas competencias básicas de la vida diaria. Para su uso se utilizan aplicaciones diversas, así como dispositivos que van desde la tableta digital hasta gafas inteligentes.Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders characterized mainly by difficulties in social interaction and communication. The inclusion policies have been developed that have favored the access of children with ASD to ordinary schools and the use of the information and communication technologies, has meant important changes in the teaching-learning process, especially with regard to children with ASD. To find out if, in addition, the use of AR with children with ASD promotes the development of social skills and basic skills for life, in this article a systematic review of different investigations has been carried out following the PRISMA guidelines. Based on the inclusion and exclusion criteria, 20 articles have been selected, published from 2012 to 2022. The results show that the use of AR applications with children with autism spectrum disorder favors motivation, interaction with others, the development of some social skills and the acquisition of some basic skills of daily life.For its use, various applications are used, as well as devices ranging from digital tablets to smart glasses.Educació
Radiological and functional outcomes of Reverdin Isham osteotomy in moderate Hallux Valgus: a systematic review and meta‑analysis
Full text linkV.S.S.: Conceptualization, Investigation, Writing original draft. E.N.G.: Data curation, Formal analysis, Writing—
review & editing. E.N.-G.: Formal analysis, Writing – review & editing. N.F.-E.: Conceptualization, Data curation,
Writing—review & editing. J.F.T.: Conceptualization, Data curation, Formal analysis, Methodology, Writing—
review & editing. R.L.G.: Conceptualization, Data curation, Formal analysis, Writing—review & editing.This systematic review and meta‑analysis addresses the effects of minimally invasive surgical
techniques, specifically the Reverdin Isham osteotomy, on functional and radiological outcomes in
patients with moderate Hallux Valgus, a common foot deformity. The review included randomized
and non‑randomized controlled trials, as well as case reports, assessing the osteotomy in adults with
moderate to severe Hallux Valgus. Searches were conducted in electronic databases such as MEDLINE
and Web of Science up until July 2023, and the Joanna Briggs Institute’s critical appraisal tool was used
to assess the risk of bias. Meta‑analytical analyses employed a random‑effects model with small‑
sample correction, presenting results as standardized mean differences and mean differences with
95% confidence intervals. Seven studies involving 554 patients and 643 operated feet were included,
showing significant improvements in AOFAS scores (an average improvement of 36 points from 28.61
to 45.16) and reductions in radiological angles such as the distal metatarsal angle and hallux valgus
angle post‑surgery (IMA improved by − 3.07° from − 4.68 to − 1.46, DMAA by − 6.12° from − 9.52 to
− 2.71, and HVangle by − 15.27° from − 17.98 to − 12.57). Despite these positive outcomes, most
studies exhibited risks of bias and other methodological limitations, impacting the generalizability of
the results. Overall, the findings highlight the efficacy of the Reverdin Isham osteotomy in improving
both functional and radiological parameters in patients with moderate Hallux Valgus, although further
research is warranted to solidify these results. No specific funding was received for this study, and the
protocol was registered on PROSPERO with the number CRD‑42023445886.Medicin
New challenges of advanced therapies
Full text linkJuan Eduardo Megías-Vericat: Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Pro- ject administration, Resources, Visualization, Writing – original draft, Writing – review & editing. Ana Bonora-Centelles A: Conceptualiza- tion, Funding acquisition, Investigation, Methodology, Project adminis- tration, Resources, Supervision, Validation, Writing – original draft, Writing – review & editing. Tomás Palanques-Pastor: Investigation, Su- pervision, Validation, Visualization, Writing – original draft, Writing – re- view & editing. Cristóbal Eduardo Aguilar Gallardo: Conceptualization, Formal analysis, Investigation, Methodology, Resources, Validation, Vi- sualization, Writing – original draft, Writing – review & editing. Manuel Guerreiro: Conceptualization, Formal analysis, Investigation, Methodol- ogy, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing. Inés Gómez Seguí: Conceptualization, Inves- tigation, Methodology, Supervision, Validation, Visualization, Writing – review & editing. Javier De La Rubia: Supervision, Validation, Writing – original draft, Writing – review & editing. José Luis Poveda Andrés: Supervision, Validation, Visualization, Writing – review & editing.El enorme desarrollo que están experimentado en los últimos años los medicamentos de terapias avanzadas (MTA), tanto industriales como en investigación, suponen un reto para la farmacia hospitalaria a todos los niveles. El objetivo del trabajo es describir la puesta en marcha de una unidad de terapias avanzadas (UTA) y el proceso de elaboración de los MTA según las «normas de correcta fabricación» (NCF), así como los resultados obtenidos en un hospital terciario, como ejemplo de los retos que supone la producción académica de los MTA.
La UTA cumple los requisitos establecidos en las NCF garantizando que los medicamentos que en ella se producen son de la calidad requerida para el uso al que están destinados y, además, proporciona apoyo a diversos grupos de investigación involucrados en el desarrollo de MTA. La UTA está compuesta por un equipo multidisciplinario altamente calificado, capacitado y entrenado en las NCF y está autorizada para la elaboración de 5 tipos de MTA que consisten en linfocitos T virus-específicos (VST) alogénicos con diversas especificidades víricas. Se ha establecido un circuito en colaboración entre la UTA y el servicio de farmacia con el servicio de hematología para la valoración de la indicación clínica, la solicitud y la elaboración de VST, lo que permite el tratamiento de pacientes receptores de trasplante de progenitores hematopoyéticos que presenten reactivaciones víricas resistentes o refractarias al tratamiento farmacológico habitual o que no puedan tolerarlo debido a la toxicidad. Los resultados preliminares de estos MTA sugieren que las VST son una alternativa efectiva y segura.
Los MTA académicos tienen especial interés en indicaciones huérfanas o en ausencia de tratamientos alternativos y su producción a través de la «exención hospitalaria» puede favorecer su acceso precoz en las fases iniciales de desarrollo y a un menor coste. Es fundamental promover la formación de los farmacéuticos hospitalarios en NCF y su participación en colaboración con otros clínicos e investigadores para desarrollar MTA que cumplan con todos los requisitos logísticos y regulatorios.The huge development that Advanced Therapy Medicinal Products (AMTPs) have experienced in recent years, both commercial and research, represent a challenge for Hospital Pharmacy at all levels. The aim of this article is to describe the implementation of an Advanced Therapies Unit (AUT) and the process of preparation of the AMTPs according to the “good manufacturing practices” (GMP), as well as the results obtained in a tertiary hospital, as an example of the challenges posed by MTA's academic production.
The AUT meets the requirements established in the GMP by guaranteeing that the medicines produced therein are of the quality required for the use for which they are intended, and also provides support to various research groups involved in the development of AMTPs. The AUT is composed of a highly qualified multidisciplin- ary team, qualified and trained in GMP, and is authorized for the preparation of five types of AMTPs consisting of allogeneic virus-specific T cells (VST) with various viral specificities. A circuit has been established in collabora- tion between the UTA and the Pharmacy Service with the Hematology Service for the assessment of the clinical indication, the request and preparation of VST, which allows the treatment of patients receiving hematopoietic stem cell transplants who present viral reactivations resistant or refractory to standard treatment, or who cannot tolerate it due to toxicity. Preliminary results from these AMTPs suggest that VSTs are an effective and safe alternative.
Academic AMTPs have special interest in orphan indications or in the absence of alternative treatments, and their production through the “hospital exemption” can favor early access in the initial phases of development and at a lower cost. It is essential to promote the training of hospital pharmacists in GMP and their participation in collaboration with other clinicians and researchers to develop AMTPs that meet all logistical and regulatory requirements.Medicin
Cavotricuspid Isthmus-Dependent Atrial Flutter. Beyond Simple Linear Ablation
Full text linkJAL, JQO and AQ, designed the review study and
wrote the manuscript. JQO, JJB and BQO performed critical review, figures and table and analyzed the references
and data. All authors contributed to editorial changes in
the manuscript. All authors read and approved the final
manuscript. All authors have participated sufficiently in
the work and agreed to be accountable for all aspects of the
work.The demonstration of a peritricuspid circular movement with a zone of slow conduction in the cavotricuspid isthmus, together with the
high efficacy of linear ablation and widely accepted acute endpoints, has established typical flutter as a disease with a well-defined physiopathology and treatment. However, certain aspects regarding its deeper physiopathology, ablation targets, and methods for verifying
the results remain to be clarified. While current research efforts have primarily been focused on the advancement of effective ablation
techniques, it is crucial to continue exploring the intricate electrophysiological, ultrastructural, and pharmacological pathways that underlie the development of atrial flutter. This ongoing investigation is essential for the development of targeted preventive strategies that
can act upon the specific mechanisms responsible for the initiation and maintenance of this arrhythmia. In this work, we will discuss less
ascertained aspects alongside the most widely recognized general data, as well as the most recent or less commonly used contributions
regarding the electrophysiological evaluation and ablation of typical atrial flutter. Regarding electrophysiological characteristics, one of
the most intriguing findings is the presence of low voltage zones in some of these patients together with the presence of a functional,
unidirectional line of block between the two vena cava. It is theorized that episodes of paroxysmal atrial fibrillation can trigger this line
of block, which may then allow the onset of stable atrial flutter. Without this, the patient will either remain in atrial fibrillation or return
to sinus rhythm. Another of the most important pending tasks is identifying patients at risk of developing post-ablation atrial fibrillation. Discriminating between individuals who will experience a complete arrhythmia cure and those who will develop atrial fibrillation
after flutter ablation, remains essential given the important prognostic and therapeutic implications. From the initial X-ray guided linear
cavotricuspid ablation, several alternatives have arisen in the last decade: electrophysiological criteria-directed point applications based
on entrainment mapping, applications directed by maximum voltage criteria or by wavefront speed and maximum voltage criteria (omnipolar mapping). Electro-anatomical navigation systems offer substantial support in all three strategies. Finally, the electrophysiological
techniques to confirm the success of the procedure are reviewed.Medicin
The Best Current Research on Patellar Tendinopathy: A Review of Published Meta-Analyses
Full text linkPatellar tendinopathy is a frequent overuse injury in sports that can cause significant
pain and disability. It requires evidence-based guidelines on effective prevention and management.
However, optimal treatments remain uncertain. We aimed to analyze available meta-analyses to
summarize treatment recommendations, compare therapeutic modalities, examine included trials,
and offer methodological suggestions to improve future systematic reviews. Meta-analyses were
systematically searched for in PubMed (PROSPERO: CRD42023457963). A total of 21 meta-analyses
were included. The AMSTAR-2 scale assessed study quality, which was low, with only 23.8%
of the meta-analyses being of moderate quality, and none were considered to be of high quality.
Heterogeneous outcomes are reported. Multiple platelet-rich plasma (PRP) injections appear superior
to eccentric exercises and provide lasting improvements compared to eccentric exercises when
conservative treatments fail. Extracorporeal shockwave therapy (ESWT) also seems superior to
non-operative options and similar to surgery for patellar tendinopathy in the long term. However,
evidence for eccentric exercise efficacy remains unclear due to inconclusive findings. Preliminary
findings also emerged for genetic risk factors and diagnostic methods but require further confirmation.
This review reveals a lack of high-quality evidence on optimal patellar tendinopathy treatments.
While PRP and ESWT show promise, limitations persist. Further rigorous meta-analyses and trials
are needed to strengthen the evidence base and guide clinical practice. Methodological enhancements
are proposed to improve future meta-analyses.Medicin
Effect of goalkeepers’ offensive participation on team performance in the women Spanish La Liga: a multinomial logistic regression analysis
Full text linkThis study aimed to examine the effect of goalkeeper distribution on offensive team performance,
during the 2018/2019 and 2019–2020 seasons of the Women Spanish La Liga. A total of 10,868 distributions,
during 376 matches were analyzed by systematic observation. Two UEFA PRO coaches designed an ad hoc
observation instrument “GOALDFOOT” and one observer coded the data after a training process. An intra-
observer reliability kappa index of 0.94 was established. Results show how the offensive effectiveness of the
goalkeepers was similar to outfield players, with 0.4% of possessions ending in a goal, 2.2% ending in an
attempt on goal, with 79.4% ending unsuccessfully. The goalkeeper lost possession from their distribution
32.5% of the time. Multivariate analysis identified several predictors of goalkeepers’ distributions. The results
show that teams classified in the middle zone of the final classification of the regular league had 1.2 times
more probability of being successful compared with the lowest ranked teams (p < 0.05). Goalkeeper’s distribution
beginning during Open play after a transition, represented an increase success rate of almost 3 times compared
to being performed from a free kick (p < 0.05). Passes from outfield players to a goalkeeper made from distant
zones to the own goal, decreased the probability of success (p < 0.001). The pitch location of the distribution
outcome near to the opponent goal offered the best probability of success. In conclusion, the most effective
offensive sequences occur with dynamic transitions initiated with short passes. This information can provide
coaches and players with insights to improve the offensive performance of goalkeepers.Ciencias de la Actividad Física y del Deport
Disparities in the EU-27 Regarding Pollution and Generated Waste
Full text linkProceedings of the 18th International Conference on Business Excellence 2024The paper explores the transition to a circular economy within the European Union, focusing on
maintaining the value of products and resources in the economic cycle and reducing waste production
(pollution and generated waste). EU environmental policy emphasizes ecologically sound waste
management and responsible use of secondary materials, forming the basis for a circular economy. While
viewing waste as future resources remains challenging, the concept of "waste management, prevention, and
utilization" is the cornerstone of this approach, requiring significant investments in innovation, research,
and economic development. The article underscores the impact of pollution as a barrier to socio-economic
development and highlights the importance of efficient waste management for environmental protection.
The economic analysis, based on simple linear regression, reveals disparities among EU member states
regarding pollution levels and waste generation. The increasing quantities and diverse nature of waste
generated in the EU pose growing challenges. Municipal waste, representing a substantial proportion,
exhibits significant variations in management practices among member states. To achieve sustainability, an
integrated approach within the EU is essential, requiring substantial efforts from member states to
accelerate the transition to a circular economy. The conclusions highlights the importance of efficient waste
management and the need for concrete measures to reduce pollution and promote a sustainable economy.Marketing y Empres
Avelumab to treat Merkel cell carcinoma: real-life experience in a dedicated oncology center.
Full text linkLa introducción de la inmunoterapia ha supuesto un gran avance en el manejo de
los pacientes con carcinoma de células de Merkel (CCM) metastásico. Realizamos un estudio
observacional retrospectivo de 14 casos de CCM metastásico tratados con avelumab. La tasa
de respuesta fue de 57%, con una completa de 29% y otra parcial de 29%. El fármaco fue efectivo en 83% (5/6) de los sujetos que presentaron una única localización metastásica, pero la
enfermedad progresó en 75% (3/4) de aquellos con metástasis óseas. No se detectaron efectos
adversos graves en ninguno. No se relacionaron la expresión de PD1-L, la presencia de poliomavirus del CCM (MCPyV), ni la alteración del índice neutrófilo-linfocito (INL) con la respuesta
al tratamiento. El avelumab es efectivo y seguro en el CCM en estadios avanzados, con una
posible influencia del número y la localización de las metástasis en su efectividad.The arrival of immunotherapy has revolutioned the management of patients with
metastatic Merkel cell carcinoma (MCC). We conducted an observational, retrospective study
of 14 cases treated with avelumab. The response rate was 57%: complete response was reached
in 29% of patients, and partial responses in 29%. The drug proved effective in 83% (5/6) of
the patients with a single metastatic site. However, the disease progressed in 75% (3/4) of the
patients with bone metastases. PD1-L expression, MCC polyomavirus (MCPyV) positivity, and an impaired neutrophil-to-lypmhocyte ratio (NLR) could not be associated with responses to the
therapy. Avelumab is an effective and safe drug for the management of advanced MCC, and its
effectiveness appears to be impacted by the number and location of metastases.Medicin
Specific indicators for detection of dyslexia simulation
Full text linkEl fingimiento de la discapacidad aumenta cuando los sistemas educativos y sanitarios proporcionan ayudas compensatorias. Aunque contamos con pruebas para evaluar la dislexia, la observación directa no es suficiente para detectar conductas de engaño. Para proteger a las personas que padecen esta dificultad de aprendizaje es necesario usar estrategias específicas de detección de la simulación en caso de duda. Esta investigación busca indicadores fiables que permitan asegurar que la persona tiene dislexia o la finge.Disability faking increases when health and education systems provide compensatory aids to pupils or patients. Although tests are available to assess dyslexia, direct observation is not sufficient to detect cheating behaviour. In order to protect people with this learning disability, it is necessary to use specific strategies to detect deception in case of doubt. This research looks for reliable indicators to ensure that the person has dyslexia or is faking it.Psicologí
Impact of coadministration of proton-pump inhibitors and palbociclib in hormone receptor-positive/HER2-negative advanced breast cancer
Full text linkSerena Di Cosimo: Writing – original draft, Investigation. Jose ́ Manuel Pe ́rez-García: Writing – review & editing, Investigation, Conceptualization. Meritxell Bellet: Writing – review & editing, Investigation. Florence Dalenc: Writing – review & editing, Investiga- tion. Miguel J. Gil Gil: Writing – review & editing, Supervision, Investigation. Manuel Ruiz-Borrego: Writing – review & editing, Su- pervision, Investigation. Joaquín Gavila ́: Writing – review & editing, Investigation. Elena Aguirre: Writing – review & editing, Supervision, Conceptualization. Peter Schmid: Writing – review & editing, Super- vision. Frederik Marme ́: Writing – review & editing, Investigation. Joseph Gligorov: Writing – review & editing, Investigation. Andreas Schneeweiss: Writing – review & editing, Project administration, Investigation, Conceptualization. Joan Albanell: Writing – review & editing, Investigation. Pilar Zamora: Writing – review & editing, Su- pervision, Investigation, Conceptualization. Duncan Wheatley: Writing – review & editing, Supervision, Project administration, Investigation. Eduardo Martínez de Duen ̃as: Writing – review & editing, Investiga- tion. Kepa Amillano: Writing – review & editing, Supervision, Inves- tigation, Conceptualization. Eileen Shimizu: Writing – review & editing. Miguel Sampayo-Cordero: Writing – review & editing, Writing – original draft, Visualization, Methodology, Formal analysis. Javier Corte ́s: Writing – review & editing, Validation, Supervision, Method- ology, Investigation, Conceptualization. Antonio Llombart-Cussac: Writing – review & editing, Supervision, Methodology, Investigation, Funding acquisition, Conceptualization.The capsule formulation of CDK4/6 inhibitor palbociclib has reduced solubility at gastric pH > 4.5 and may have decreased activity when used with proton-pump inhibitors (PPI). Herein, we report the effect of PPI on palbociclib capsule activity and safety in the PARSIFAL study.The PARSIFAL study was supported by Medica Scientia Innovation Research (MEDSIR) who sponsored the study; and funded by Pfizer. Fulvestrant was provided by AstraZeneca.Medicin