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Combined Merkel Cell Carcinoma and Squamous Cell Carcinoma: A Systematic Review
Full text linkConceptualization: E.R.-V., F.M.-M., D.M.-E., B.L. and C.R.; methodology:
E.R.-V., F.M.-M., B.L. and E.N.; validation: E.R.-V., F.M.-M., B.L. and E.N.; formal analysis: E.R.-V.,
F.M.-M. and B.L.; investigation: E.R.-V., F.M.-M. and B.L.; resources: E.R.-V., F.M.-M., B.L. and E.N.;
data curation, E.R.-V., writing—original draft preparation, E.R.-V.; writing—review and editing,
E.R.-V., B.L., C.R. and D.M.-E.; visualization, E.R.-V., F.M.-M. and B.L.; supervision, B.L., E.N. and
O.S. All authors have read and agreed to the published version of the manuscript.Combined Merkel cell carcinoma (MCC) and squamous cell carcinoma (SCC) have classically been regarded as more aggressive than conventional, pure, Merkel cell polyomavirus (MCPyV)-
positive MCC. It is still unknown whether combined MCC and SCC are more aggressive than pure,
MCPyV-negative MCC, and the origin of both the SCC and MCC elements of these combined tumors
has not been elucidated. The main objective of this systematic review was to assess whether combined
MCC and SCC tumors are associated with a worse prognosis than pure MCC; the secondary goals
were the characterization of the clinical and histopathological features of these combined neoplasms.
A total of 38 studies, including 152 patients, were selected for review. In total, 76% of the cases
were MCPyV-negative, whereas 4% were MCPyV-positive. The most frequent histopathological
pattern was that of an SCC in situ combined with a dermal MCC (36%), followed by both an in
situ and invasive SCC combined with a dermal MCC (20%). Forty-seven percent of all cases fitted
in the morphology of the so-called “collision tumors”. Three combined MCC cases that would fit
in the morphological category of collision tumors presented both squamous and neuroendocrine
elements in their respective nodal metastases. The mean overall survival was 36 months, comparable
to that of pure, MCPyV-negative MCC. This review found similarly aggressive behavior for combined MCC and SCC and pure, MCPyV-negative MCC. Preliminary data strongly suggest that all
MCPyV-negative MCC tumors, whether combined or pure, are part of a common spectrum.Medicin
Inclusión y aulas Montessori: proyecto de mejora en centros de educación infantil
No full textLa inclusión educativa, como uno de los principios que rigen nuestro actual sistema educativo,
se ha convertido en una prioridad a trabajar en las escuelas desde una doble vertiente, por una
parte, detectar para eliminar o minimizar las barreras a la inclusión, y por otra, identificar
aquellos aspectos que condicionan la implementación de buenas prácticas inclusivas.
Basándonos en esta premisa, este estudio exploratorio pretende, en primer lugar, determinar y
analizar cuáles son las principales barreras a la inclusión en tres centros de primer ciclo de
educación infantil con el objetivo de crear un primer borrador de plan de mejora para cada uno
de estos centros. Y, en segundo lugar, analizar si las actividades que se realizan en sus aulas
Montessori favorecen las prácticas inclusivas. Para poder dar respuesta a estos objetivos, se ha
optado por una metodología mixta, utilizando para la recopilación de información diferentes
cuestionarios adaptados del índice para la inclusión y un diario de observaciones. Tras el
análisis de los resultados se ha concluido, por una parte, que las principales barreras a la
inclusión detectadas son muy similares en los tres centros y están relacionadas con la apertura
del centro al entorno social y la relación entre la escuela y las familias; con la atención a la
diversidad y la mejora de la formación del profesorado en materia de inclusión; y, con el
incremento de actividades relacionadas con la comprensión de las diferencias entre las personas
y la utilización de estas como recurso de apoyo al juego, el aprendizaje y la participación. Por
otra parte, con relación a las actividades que se realizan en las aulas Montessori, se concluye
que estas sí que son inclusivas, y, por tanto, el trabajo que se realiza en estas favorece el
desarrollo de prácticas inclusivas en los centros educativos.Educational inclusion, as one of the principles that govern our current educational system, has
become a priority to be worked on in schools from a double perspective: on the one hand, to
detect in order to eliminate or minimize barriers to inclusion, and on the other hand, to identify
those aspects that condition the implementation of good inclusive practices. Based on this
premise, this exploratory study aims, firstly, to determine and analyze the main barriers to
inclusion in three early childhood education centers with the aim of creating a first draft of an
improvement plan for each of these centers. And, secondly, to analyze whether the activities
carried out in their Montessori classrooms are inclusive practices. In order to respond to these
objectives, a mixed methodology was chosen, using different questionnaires adapted from the
index for inclusion and a diary of observations to collect information. After analysing the
results, it was concluded, on the one hand, that the main barriers to inclusion detected are very
similar in the three centres and are related to the opening of the centre to the social environment
and the relationship between the school and families; to the attention to diversity and the
improvement of teacher training on inclusion; and to the increase in activities related to the
understanding of the differences between people and the use of these as a resource to support
play, learning and participation. On the other hand, with regard to the activities carried out in
Montessori classrooms, it is concluded that these are indeed inclusive and, therefore, the work
carried out in these classrooms favours the development of inclusive practices in educational
centers.PedagogíaPrograma de Doctorado en los Retos de las Ciencias Sociales y Humanas en la Sociedad del Siglo XX
Impact of repetitive negative thinking on subjective cognitive decline: insights into cognition and brain structure
Full text linkLM-P: Conceptualization, Data curation, Formal analysis,
Investigation, Methodology, Visualization, Writing – original draft,
Writing – review & editing. CS-P: Conceptualization, Investigation,
Supervision, Writing – review & editing. MC-T: Data curation, Formal
analysis, Methodology, Project administration, Software, Writing –
review & editing. KA-P: Project administration, Writing – review &
editing. RP-A: Project administration, Writing – review & editing. GC:
Data curation, Funding acquisition, Project administration, Resources,
Validation, Writing – review & editing. JS: Data curation, Funding
acquisition, Project administration, Resources, Validation, Writing –
review & editing. VA-S: Data curation, Project administration, Writing
– review & editing. NB: Data curation, Resources, Writing – review &
editing. JT-M: Writing – review & editing, Funding acquisition, Project
administration, Resources, Validation. AP-L: Funding acquisition,
Project administration, Resources, Validation, Writing – review &
editing. DB-F: Conceptualization, Data curation, Formal analysis,
Funding acquisition, Investigation, Methodology, Project administration,
Resources, Supervision, Validation, Writing – review & editing. LV-A:
Formal analysis, Investigation, Methodology, Supervision, Validation,
Writing – review & editing, Conceptualization, Data curationIntroduction: Individuals with subjective cognitive decline (SCD) express
concern about self-perceived cognitive decline despite no objective impairment
and are at higher risk of developing Alzheimer’s disease. Despite documented
links between SCD and repetitive negative thinking (RNT), the specific impact of
RNT on brain integrity and cognition in exacerbating the SCD condition remains
unclear. We aimed to investigate the influence of RNT on global cognition and
brain integrity, and their interrelationships among healthy middle-aged and
older adults experiencing SCD.
Methods: Out of 616 individuals with neuroimaging and neuropsychological
data available, 89 (mean age = 56.18 years; 68.54% females) met SCD criteria.
Eighty-nine non-SCD individuals matched by age, sex, and education were also
selected and represented the control group (mean age = 56.09 years; 68.54%
females). Global cognition was measured using the preclinical Alzheimer’s
cognitive composite (PACC5), which includes dementia screening, episodic
memory, processing speed, and category fluency tests. RNT was calculated
through three questionnaires assessing intrusive thoughts, persistent worry,
and rumination. We generated cortical thickness (CTh) maps and quantified the
volume of white matter lesions (WML) in the whole brain, as grey and white
matter integrity measures, respectively.
Results: SCD individuals exhibited higher RNT scores, and thinner right
temporal cortex compared to controls. No differences were observed in PACC5
and WML burden between groups. Only the SCD group demonstrated positive
associations in the CTh-PACC5, CTh-RNT, and WML-RNT relationships Discussion: In this cross-sectional study, RNT was exclusively associated
with brain integrity in SCD. Even though our findings align with the broader
importance of investigating treatable psychological factors in SCD, further
research may reveal a modulatory effect of RNT on the relationship between
cognition and brain integrity in SCD.Medicin
Manual Therapy Improves Fibromyalgia Symptoms by Downregulating SIK1
Full text linkConceptualization, J.B.-F. and E.O.; methodology, J.B.-F. and F.J.F.-V.; software,
J.B.-F. and K.G.-O.; validation, J.B.-F. and K.G.-O.; formal analysis, J.B.-F. and K.G.-O.; investigation,
resources, M.G.-E. and E.O.; data curation, J.B.-F. and K.G.-O.; writing—original draft preparation,
J.B.-F., K.G.-O., and E.O.; writing—review and editing, all authors; visualization, J.B.-F. and K.G.-O.;
supervision, M.G.-E. and E.O.; project administration, E.O.; funding acquisition, M.G.-E. and E.O. All
authors have read and agreed to the published version of the manuscript.Fibromyalgia (FM), classified by ICD-11 with code MG30.0, is a chronic debilitating
disease characterized by widespread pain, fatigue, cognitive impairment, sleep, and intestinal
alterations, among others. FM affects a large proportion of the worldwide population, with increased
prevalence among women. The lack of understanding of its etiology and pathophysiology hampers
the development of effective treatments. Our group had developed a manual therapy (MT) pressurecontrolled
custom manual protocol on FM showing hyperalgesia/allodynia, fatigue, and patient’s
quality of life benefits in a cohort of 38 FM cases (NCT04174300). With the aim of understanding
the therapeutic molecular mechanisms triggered by MT, this study interrogated Peripheral Blood
Mononuclear Cell (PBMC) transcriptomes from FM participants in this clinical trial using whole
RNA sequencing (RNAseq) and reverse transcription followed by quantitative Polymerase Chain
Reaction (RT-qPCR) technologies. The results show that the salt-induced kinase SIK1 gene was
consistently downregulated by MT in FM, correlating with improvement of patient symptoms. In
addition, this study compared the findings in a non-FM control cohort subjected to the same MT
protocol, evidencing that those changes in SIK1 expression with MT only occurred in individuals
with FM. This positions SIK1 as a potential biomarker to monitor response to MT and as a therapeutic
target of FM, which will be further explored by continuation studies.This research was funded by Universidad Católica de Valencia San Vicente Mártir, grant
numbers 2019-266-001 to M.G.-E. and 2019-270-002 to E.O. KG-O is supported by the Generalitat
Valenciana ACIF2021/179 grant. Funders were not involved in any of the research stages.Medicin
Variabilidad interobservador en el análisis histológico del melanoma: análisis de 60 casos
Full text linkIntroduction: Since the field of dermatopathology is not an exact science, it is prone to personal
subjectivity, which sometimes causes disagreements on the diagnosis and assessment of some
histological features. In the case of melanoma, some variables such as regression are associated
with low interobserver agreement. On the contrary, other variables such as the measurement
of Breslow thickness show high reproducibility.
Objective: The main objective of our study was to investigate multiple features of 60 consecutive cases of melanoma to establish interobserver reproducibility.
Methods and main results: We conducted an observational and descriptive study at Hospital
de Manises, Valencia, Spain, IVO Foundation, Valencia, Spain, and Hospital 12 de Octubre,
Madrid, Spain. The mean level of agreement of all study variables was moderate (Cohen’s
kappa coefficient statistic = 0.5). The highest agreement corresponded to polypoid morphology,
pigmentation, ulceration, and solar elastosis. On the other hand, the lowest level agreement
was reached for the presence of cellular pleomorphism and tumor necrosis.
Conclusions: Our mean level of agreement was moderate, which reflects that some of the
measured characteristics such as cellular pleomorphism or the presence of necrosis cannot be
used for future studies or must be redefined and their reproducibility, reestablished. When
conducting a research study, it is necessary to analyze the study variables to demonstrate their
validity to measure or classify a certain feature. It is also advisable to warrant that that the variables are reproducible to be able to use them for other studies or in the routine clinical practice.Introducción: La dermatopatología no es una ciencia exacta estando sujeta a la subjetividad
personal, lo que en ocasiones provoca variabilidad interobservador en cuanto al diagnóstico
y la valoración de determinadas características histológicas. Respecto al melanoma, algunas
variables como la regresión presentan baja concordancia interobservador. Por el contrario,
otras variables como la medición del espesor de Breslow muestran una alta reproducibilidad.
Objetivo: El principal objetivo de nuestro estudio fue investigar la reproducibilidad interobservador de múltiples características sobre un total de 60 casos consecutivos de melanoma.
Métodos y resultados principales Se realizó un estudio observacional y descriptivo en el Hospital de Manises (Manises), la Fundación IVO (Valencia) y el Hospital 12 de Octubre (Madrid). La
concordancia media de las variables del estudio fue moderada. Las mayores tasas de concordancia se obtuvieron para la morfología polipoide, la pigmentación, la ulceración y la elastosis
solar. Por el contrario, la concordancia más baja se dio para la presencia de pleomorfismo celular
y la necrosis tumoral. Es necesario al realizar un estudio de investigación, analizar las variables de estudio y demostrar su validez para medir o clasificar una determinada característica.
Adicionalmente, es recomendable garantizar que las variables sean reproducibles para poder
utilizarlas en otros estudios o en la práctica clínica habitual.
Conclusiones: Nuestra concordancia media fue moderada, lo que refleja que algunas de las
características medidas como el pleomorfismo celular o la presencia de necrosis no pueden
ser utilizadas para futuros estudios o, por el contrario, deben ser redefinidas y restablecida su
reproducibilidad.Pre-proofMedicin
Maltrato infantil intrafamiliar: factores de riesgo en madres
Full text linkEl maltrato infantil es un fenómeno universal y con graves consecuencias para la salud y la sociedad. La manera de definirlo, percibirlo y abordarlo se ha ido transformando a lo largo de los años. El objetivo de esta revisión bibliográfica ha sido examinar rigurosamente los factores de riesgo para el maltrato infantil asociados a la madre, así como estudiar las características sociodemográficas más comunes en las madres maltratadoras y la posible relación entre el ejercicio de maltrato sobre sus hijos e hijas y haber sufrido maltrato en la infancia. Como factores de riesgo se han encontrado algunas variables sociodemográficas como la menor edad de la madre, la condición de monoparentalidad, el bajo nivel de estudios y el bajo nivel socioeconómico. Además, se ha encontrado una existente relación entre la historia de malos tratos en la infancia y el ejercicio de maltrato hacia los hijos e hijas. Para futuras investigaciones, sería interesante tener en cuenta las diferencias en las distintas condiciones sociodemográficas, y, por ende, diferencias culturales, así como las variables moduladoras para la transmisión o no la violencia intergeneracional con la intención de poder proponer programas de prevención e intervención que promuevan la protección integral de los/las menores.Psicologí
How second nature becomes first nature. Philosophy as a transformative practice (Plato, Nietzsche, Malabou)
Full text linkEl artículo comienza explorando la peculiar función política y legislativa que Nietzsche otorga a los filósofos y a la filosofía. A continuación, se explora la nítida inspiración platónica de estas ideas y se localizan ejemplos directos en los textos de Platón, de tal manera que se desvela el origen griego de muchos términos intempestivos y fisiológicos de la filosofía nietzscheana. La filosofía y la cultura se presentan como sistemas de culturización, estableciendo paralelismos entre la cría de animales y la cultura humana. Construyendo sobre la base de las conexiones Nietzsche-Platón, se incide en las tensiones entre 'primera' y 'segunda naturaleza'. Los aportes finales de Catherine Mala-bou se muestran cruciales para captar los circuitos de retroalimentación miméticos entre organismo y entorno, que se descubren como vínculos genealógicos entre lo biológico y lo simbólico. Platón, Nietzsche y Malabou comparten una preocupación en torno a procesos formativos ya en marcha en la sociedad. En último término, se trata de desvelar y tomar poder sobre la función ‘selectiva’ de la filosofía en su proceso de culturización.The article begins by exploring the peculiar political and legislative function that Nietzsche grants to philosophers and philos-ophy. Next, it explores Plato’s philosophy as a direct example and inspiration of many untimely, physiological terms of Nietzschean phi-losophy. Philosophy and culture become systems of enculturation based on parallels between the breeding of animals and human culture. These connections between Plato and Nietzsche emphasize tensions between ‘first’ and ‘second nature.’ Catherine Malabou’s final contributions are crucial to capturing mimetic feedback loops between organism and environment, and genealogical links between the biological and the symbolic. Plato, Nietzsche, and Malabou share a concern about shaping processes already underway in society. Ultimately, the goal is to reveal and channel philosophy’s ‘selective’ power in its process of enculturation.Proyecto de Investigación Científica y Desarrollo “Ética cordial y democracia inclusiva en una sociedad tecnologizada” (ETICORDIAL), con referencia PID2022-139000OB-C21, financiado por el Ministerio de Ciencia e Innovación y la Agencia Estatal de Innovación.Filosofí
Teaching difficulties. An analysis of the perceptions of Master's Degree Teacher Education students.
Full text linkEl profesorado es un elemento clave en la educación y su formación y concepción de la enseñanza determinan el éxito escolar. Este artículo trata de analizar las dificultades que autoperciben los estudiantes del Máster del Profesorado en su futuro desempeño profesional y establecer propuestas de mejora para su formación. Se analiza el patrón de puntuaciones de los estudiantes y las diferencias en función de la universidad de procedencia y del sexo. Se estudia la relación de predicción entre las Dificultades académicas y sociales en las Dificultades organizacionales, con las Dificultades materiales como mediadoras y la edad como factor influyente en esta relación. Es un estudio descriptivo y predictivo de las Dificultades organizacionales y materiales, donde se presta especial atención a las variables universidad de procedencia, edad y sexo. Participan 409 estudiantes, de distintas universidades valencianas. Se utiliza el Inventario de Problemas de Enseñanza. Entre los resultados destacan las dificultades para: relacionarse con las familias de los alumnos, organizar el tiempo de clase y gestionar el aula y la disciplina. Estos resultados coinciden con los de otras investigaciones. Además, las alumnas más mayores perciben mayores dificultades materiales; y aquellas que declaran mayores dificultades académicas también presentan mayores dificultades organizacionales. Se plantea la necesidad de implantar ciertas metodologías, potenciar la relación Universidad-escuela y mejorar el periodo de prácticas. Por lo que respecta al modelo causal analizado, se concluye que las Dificultades académicas y sociales influyen de forma directa sobre las organizacionales y que las materiales tienen un efecto mediador en esta relación.Teachers are one of the key elements in education and their training and conception of teaching
influence school success. This article tries to analyze the difficulties self-perceived by the students
of the master’s degree in teaching in their future professional performance and to establish
proposals for improvement in their training. The pattern of students' scores and the differences
according to the university of origin and gender are analyzed. The predictive relationship between
academic and social difficulties in organizational difficulties is studied, with material difficulties as
mediators and age as an influential factor in this relationship. It is a descriptive and predictive study
of organizational and material difficulties, where special attention is paid to the variable’s
university of origin, age, and gender. A total of 409 students from different Valencian universities
participated. The Teaching Problems Inventory was used. Among the results, the following
difficulties stand out: difficulties in relating with the students' families, organizing class time, and
managing the classroom and discipline. These results coincide with those of other research. In
addition, older students perceive greater material difficulties; and those who report greater
academic difficulties also present greater organizational difficulties. There is a need to implement
certain methodologies, to strengthen the university-school relationship and to improve the
internship period. About the causal model analyzed, it is concluded that academic and social
difficulties have a direct influence on organizational difficulties and that material difficulties have a
mediating effect on this relationship.Pedagogí
Philosophical analysis of fake news as intentional communicative acts and use of experimental economics as fact-checking
Full text linkLas fake news se suelen caracterizar como contenidos,
de modo que prevalece el planteamiento semántico. Aquí se propone
un enfoque pragmático, donde son actos comunicativos intencionales.
Esto permite entender las fake news desde los actos locucionarios, ilocucionarios
y perlocucionarios. Esta triple versión de intencionalidad
comunicativa permite una mejor intelección de la mala información
(misinformation) y de la desinformación (disinformation), que se refleja
con claridad en el caso económico. Para mitigar o neutralizar los daños
causados por las fake news en el tejido social, se suele recomendar la
contrastación de hechos (fact-checking). La contribución de la Economía
Experimental —y, en concreto, la aportación de Alvin Roth (Premio
Nobel de Economía 2012)— puede ser especialmente relevante en dos direcciones: (a) la actividad económica y (b) la Economía como actividad
entrelazada con otras. Esto supone el contrastar hechos partiendo de la
intencionalidad en la actividad económica, en cuanto tal y en su nexo
con otras actividades humanas. A este respecto, las fake news convergen
con la toma de decisiones económicas, en cuanto que ambas están
surcadas por la intencionalidad y, además, tienen lugar en un contexto
donde adquieren un perfil orientado a fines.Fake news are often characterized as content where semantic
aspects prevail. Here, a pragmatic approach is proposed, where they
are intentional communicative acts. This allows understanding fake news
through locutionary, illocutionary, and perlocutionary acts. This threefold
version of communicative intentionality provides a better understanding
of misinformation and disinformation, which is clearly reflected in the
economic case. To mitigate or neutralize the damage caused by fake news
in the social fabric, fact-checking is often recommended. The contribution
of Experimental Economics — and specifically the contribution
of Alvin Roth (2012 Nobel Prize in Economics) — can be especially
relevant in two directions: (a) economic activity, and (b) Economics as
an activity intertwined with others. This involves fact-checking based on
intentionality in economic activity, as such, and in its connection with
other human activities. In this regard, fake news converge with economic
decision-making, as both are marked by intentionality and also take place
in a context where they acquire a goal-oriented profile.Filosofí
Coping strategies in mothers of children with autism and attention deficit hyperactivity disorder: latent profile analysis
No full textObjectives: Mothers of children with autism and children with attention deficit hyperactivity disorder employ distinct coping strategies when confronted with stressful situations related to the
parenting process. The current study aimed to identify distinct coping profiles among mothers,
based on four indicators: problem-focused coping, active avoidance coping, positive coping, and
religious/denial coping. The second objective was to examine the differences between the identified profiles in terms of the mother and children’s outcomes.
Methods: Participants were 90 mothers of children with autism and attention deficit hyperactivity disorder. Latent profile analysis revealed three coping profiles based on different coping
strategies: ‘Adaptative coping’ (42.22%), ‘Avoidance coping’ (40%), and ‘Low coping’ (17.77%).
Results: The ‘Low coping’ profile showed more dysfunctionality than the others and it evidenced significant differences with the other two profiles on parenting stress, social support
and children social, behavioral and sleep problems.
Conclusions: The findings emphasize the importance of exploring coping skills employed by
mothers of children with these neurodevelopmental disorders and developing interventions for
those who adopt ineffective coping strategies.Educació