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Dosimetrical and geometrical parameters in single-fraction lattice radiotherapy for the treatment of bulky tumors: Insights from initial clinical experience
No full textPurpose: This study aims to investigate lattice radiotherapy (LRT) for bulky tumor in 10 patients, analyzing geometrical and dosimetrical parameters and correlations among variables.
Methods: Patients were prescribed a single-fraction of 18 Gy to 50 % of each spherical vertex (1.5 cm diameter). Vertices were arranged in equidistant planes forming a triangular pattern. Center-to-center distance (Dc-c) between vertices was varied from 4 to 5 cm. A new method for calculating the valley-to-peak dose ratio (VPDR) was proposed and compared to other two from existing literature. GTV volumes (VGTV), vertex number (Nvert), low-dose related parameters and vertex D99%, D50%, and D1% were recorded. Beam-on time and Monitor Units (MU) were also evaluated. Correlations were assessed using Spearman's coefficient, with significant differences analyzed using Mann-Whitney U test.
Results: Tumor volumes ranged from 417 to 3615 cm3. Median vertex number was 14.5 (IQR:11.3-17.8). VPDR ranged from 0.16 to 0.28. Median D99% spanned from 10.0 to 13.7 Gy, median D50% exceeded 18.0 Gy, and median D1% surpassed 23.3 Gy. Periphery dose remained under 4.0 Gy. Plans exhibited high modulation, with median beam-on time and MU of 8.8 min (IQR:8.2-10.1) and 13,069 MU (IQR:11574-13639). Significant correlations were found between Nvert and VGTV (p < 0.01), MU (p < 0.02) and beam-on time (p < 0.01) and between Dc-c and two VPDR definitions (p < 0.02) and periphery dose (p < 0.01). Significant differences were observed among the three valley dose definitions (p < 0.01) and the three peak dose definitions (p < 0.01).
Conclusions: Reporting geometrical and dosimetrical parameters in LRT is crucial, alongside the need for unified definitions of valley and peak doses
Effects of a Short-Term Detraining Period on Neuromuscular Performance in Female Handball Players
No full textThe aim of this study was to determine the effects of a 3-week detraining period on lower limbs' neuromuscular performance in female handball players. Fourteen semi-professional players (age: 20.50 ± 2.98 years; height: 1.67 ± 0.06 m; body mass: 66.89 ± 8.75 kg) were evaluated using force plates on 3 separate occasions to assess the maximum and rapid force production by the isometric mid-thigh pull (IMTP) and the ballistic capabilities by countermovement jump (CMJ). The intraclass correlation coefficient, coefficient of variation, standard error of the measurement, and smallest detectable difference were calculated using the first 2 testing sessions. Pre- and postdetraining differences were calculated comparing the first and third testing sessions, using paired t-tests or Wilcoxon test when appropriate and Hedges g effect sizes (ES). The level of significance was set at ρ ≤ 0.05. There were no significant or meaningful differences in maximum and rapid force production capabilities assessed during the IMTP (p > 0.05). However, there was a significant detriment with small ES in CMJ jump height, modified reactive strength index, peak and mean propulsive force, peak and mean braking force, and braking phase duration (p < 0.05). These findings suggest that although maximum and rapid force production capabilities were not altered among female handball players after a 3-week detraining period, their ballistic capabilities decreased, especially those affecting the eccentric part of a fast dynamic task. They also highlight the importance of testing, planning, and programming in response to the fluctuations in handball players' physical performance over the season
Qualitative study about the perception of patients with inflammatory bowel disease: A descriptive observational study
Full text linkThe main aim of this study was to identify the perceptions of people suffering from inflammatory bowel diseases (IBD) regarding the need for specialised nursing care, based on their opinions from their own experience. A qualitative design with an inductive approach based on constructivist grounded theory was conducted using a questionnaire. Almost 63 % of respondents felt that a nursing intervention was necessary for the patient's self-care and supported the care of the environment of the patient with IBD in need of care. Approximately 75 % of respondents felt that the initial nursing consultation following diagnosis of IBD was essential to address all aspects of the patient's daily life and environment for quality care and follow-up. More than 87 % of respondents felt it was important for nurses to recognise the need for referral to other professionals when caring for IBD patients and their environment to maximise their wellbeing. The percentage of females who answered yes to this last question was significantly higher than that of males (p = 0.025). Some 67.1 % of respondents felt that nurses should be responsible for informing the patient and those around them of the steps to be taken following diagnosis and what these consist of. More than 94 % of all respondents felt that IBD patients and their carers should have a plan and time for specific and appropriate education on this topic. More than 80 % of respondents agreed that the progression, monitoring, and management of their IBD should be supervised by a nurse in addition to their specialist doctor to achieve an optimal level of quality. In conclusion, this study shows that patients suffering from IBD consider the role of the nurse to be crucial in the diagnosis, management and treatment of their disease and highlights the need for specialised nurses in inflammatory bowel disease who can provide patients with high-quality healthcare
Effects of Hypopressive Exercise on Dynamic Neuromuscular Control in Female Roller-Skaters
Full text linkThe effects of hypopressive exercise (HE) on dynamic balance have never been studied. We aimed to study the effects of a HE program on dynamic balance, posterior chain kinematics and expiratory peak flow on female competitive roller skaters over a 6-week training period. Twenty competitive female roller-skaters (13-22 years of age, SD 2.25) performed a 30-minute HE session once weekly before the regular roller-skating practice for 6 weeks. The HE program consisted of breathing and postural awareness exercises in addition to 5 basic HE poses performed three times each. Dynamic neuromuscular control was assessed with the Y-Balance Test (YBT), posterior back chain kinematics with the sit and reach test and peak expiratory flow rate with a digital spirometer. Paired t-test revealed significant differences between the measurement periods for all YBT leg directions and composite score (p ≤ 0.01). Significant differences were also revealed between baseline and after the intervention for the sit and reach test (p ≤ 0.01) and peak expiratory flow (p = 0.01). No differences in forced expiratory volume in the first second were found (p = 0.04). These preliminary findings suggest that a 6-week HE program could be a feasible neuromuscular option for training dynamic balance, posterior back chain kinematics and peak expiratory flow in female roller-skaters
Candida spp. colonization: a genotype source found in blood cultures that can become widespread
Full text linkObjective: Our previous genotyping studies suggest that some anatomical locations act as reservoirs of genotypes that may cause further candidemia, since we found identical genotypes in gastrointestinal tract or catheter tip isolates and blood cultures, in contrast, we did not find blood culture genotypes in vagina samples. We observed that some genotypes can be found in blood cultures more frequently than others, some of them being called widespread genotypes because have been found in unrelated patients admitted to different hospitals. The presence of widespread genotypes may be more frequently found because of their predisposition to cause candidemia. It is unclear whether genotypes colonizing other anatomical sites different from the gastrointestinal tract can also be detected in this way; we studied C. albicans, C. parapsilosis, and C. tropicalis colonizing genotypes to assess what proportion could be found in blood cultures and the proportion of widespread genotypes.
Methods: The isolates (n= 640 Candida isolates from 323 patients) studied herein were obtained from samples processed at the Clinical Microbiology and Infectious Diseases Department of the Gregorio Marañón Hospital (Madrid, Spain) from July 1, 2016, to June 30, 2019. C. albicans (n=486), C. parapsilosis
(n=94), and C. tropicalis (n=60) isolates were genotyped using species-specific microsatellite markers and sourced from blood (n=120) and colonized anatomical sites (n=520; catheter [n=50], lower respiratory tract [n=227], skin/mucosa [n=132], and urinary tract [n=111]). Isolates with identical genotypes were those presenting the same alleles for all markers or with only differences at one locus of a given marker. Identical genotypes were further classified as a match (identical genotype found in different groups of samples from a given patient) or as a cluster (identical genotype found in ≥2 patients). Finally, singletons were genotypes detected once. The genotypes found were then compared with our in-house database containing 587 blood genotypes from patients admitted to the Gregorio Marañón Hospital (2007-2023) to assess the proportion of genotypes found in colonized samples that were also found in blood cultures. Moreover, since some of our in-house database genotypes had been tagged as widespread genotypes, we compared the proportions of widespread genotypes as well as the proportions of matches, clusters, and patients involved in clusters found among exclusively colonizing genotypes, exclusively blood culture genotypes, and both colonizing and blood culture genotypes using a standard binomial method.
Results: Intra-patient analysis was conducted exclusively on those patients (n=225; 69.7%) who had ≥2 isolates from a given species; the proportion of patients with matches was lower in exclusively colonized patients than in patients with candidemia and colonizing genotypes (87.3% vs. 94.1%; p = 0.126). Interpatient analysis was conducted considering all patients (n=323) and isolates from groups 1, 2, and 3 (n=640). Overall, we detected 341 genotypes, of which 320 were singletons and 21 were clusters (6.16%). Clusters involving blood cultures and colonizing isolates sourced from catheter tips (14.6%), skin and mucosa (7.5%), urine (7.4%), and lower respiratory tract (4.6%). Cluster-involved patients had not been admitted to the same ward at the same time. Of the 290 colonizing genotypes, 91 (31.1%) were also found in blood cultures, the highest proportion being C. parapsilosis (p < 0.05); proportions of identical genotypes found in blood cultures and catheter tips were higher than those found in blood cultures and other colonized samples (79.2% vs. 26.7%; p < 0.001). Widespread genotype ratios were significantly higher among genotypes found in both blood and colonized samples than among genotypes found exclusively in either blood culture or other colonizing genotypes (31.9% vs. 7.1% vs. 3.7%, respectively; p < 0.001).
Conclusion: We observed that 94% of patients with candidemia were colonized by a genotype causing the infection; likewise, a total of 31% of colonizing genotypes were detectable in blood cultures. Finally, identical genotypes found in both colonized samples and blood cultures had a higher probability of
being widespread.The author(s) declare financial support was received for the
research, authorship, and/or publication of this article. This study
was supported by grants PI22/00005 from the Fondo de
Investigación Sanitaria (FIS. Instituto de Salud Carlos III; Plan
Estatal de Investigación Cientı́fica, Técnica y de Innovación 2021-
2023). The study was co-funded by the European Regional
Development Fund (FEDER) ‘A way of making Europe.
Critical analysis of the situation of Spanish as a language of integration for adult immigrant population. A specific case for public Official Languages Schools (OLS) in Spain
Full text linkLa continua llegada de inmigrantes no hispanos a España marca la importancia de la enseñanza del español como una herramienta esencial para lograr una integración
lingüística efectiva. Este proyecto de investigación explora posibles vías de colaboración
entre las Escuelas Oficiales de Idiomas (EOI) y las Organizaciones No Gubernamentales (ONG) en aras de mejorar la integración lingüística de la población inmigrante adulta. A
través de un enfoque mixto mediante la aplicación de un análisis cuantitativo y
cualitativo, se ha encuestado al 62% de las EOI que imparte cursos de español como
lengua extranjera (ELE). Por otro lado, se han entrevistado a 12 profesionales de la enseñanza del español de las EOI y las ONG con el propósito de explorar acciones colaborativas entre ambas partes. Los resultados analizados desde el prisma del análisis crítico del discurso revelan, en primera instancia, la necesidad de promover las
enseñanzas de ELE en las EOI como una vía útil y lógica para facilitar una integración
lingüística de calidad. En segundo lugar, se ha detectado la ausencia de colaboraciones
efectivas entre ambas partes por el momento, lo que señala la necesidad de impulsar
propuestas interinstitucionales en busca de una sociedad más justa e integradora.
Finalmente, este proyecto de tesis doctoral concluye con una reflexión profesional y
personal a modo de conclusión sobre el impacto educativo que esta tesis doctoral podría tener, no solo sobre la enseñanza del español para inmigrantes en una institución pública,
sino también desde una perspectiva social e interdisciplinar que responda a las necesidades demandadas por este colectivo.The continuous arrival of non-Hispanic immigrants to Spain marks the importance of Spanish teaching as an essential measure for achieving effective linguistic integration.
This research project explores, the viable means of cooperation between public Official Language School (OLS) and Non-Governmental Organizations (NGO) in the interest of
enhancing Spanish learning for the immigrant population. Through a mixed-methods approach involving both quantitative and qualitative analysis, 62% of EOI offering
Spanish as a Foreign Language (SFL) have been surveyed. Furthermore, 12 professionals in Spanish language teaching from EOI and NGO have been interviewed to explore collaborative actions between both parties. The findings, analyzed through the lens of
critical analysis discourse, firstly reveal the needs to promote SFL teachings in OLS as a
useful and logical way to facilitate high-quality linguistic integration. Secondly, the lack
of effective collaborations between both parties have been identified, denoting the necessity to promote inter-institutional proposal to pursuit of a fairer and more inclusive society. ground-breaking findings reveal the absence of effective collaborative efforts thus far. These findings could determine the course to tackle this social challenge from a perspective and multidisciplinary viewpoint. Finally, this doctoral thesis concludes with
a professional and personal reflection serving as a conclusion on the educational impact that this project could have, not only emphasizing on the importance of teaching Spanish
for immigrants in a public institution, but also from a sociolinguistic perspective that tackle the needs demanded by non-Spanish-speaker immigrants
La estabilidad postural como indicador multimodal en entornos académicos, deportivos y clínicos
No full textLa estabilidad postural como indicador multimodal en entornos académicos, deportivos y clínico
From Bentham's Theory to "Pseudopanopticon": A Model of Psycho-Historical Analysis From the Failure of the Spanish Prison Reform in the 19th Century to the "Digital Panopticon" of the 21st Century
Full text linkMichel Foucault ya hizo del panoptismo benthamiano piedra angular de su crítica a la tecnologización moderna del castigo pretendidamente “humanitario” y “rehabilitador” defendido por la Ilustración, cuya máxima expresión adquirió se manifestó como “reforma constante de las prisiones”, no es menos cierto que el modelo panóptico de Jeremy Bentham, al que durante décadas se contempló como epítome de un sistema correccional moderno, positivo, eficiente, económicamente productivo, psicológicamente certero y moralmente saludable, tuvo en realidad un impacto más teórico que real en los sistemas carcelarios occidentales. La teoría del panóptico topaba con dificultades económicas y técnicas que hacían de ella un imaginativo experimento psicosocial sin posibilidad de implantación real. Así pues, el concepto mismo de “panóptico” terminó pasando del sustantivo al adjetivo, y toda la literatura construida en torno al mitológico “ojo que todo lo ve” fue desvelándose como una mera ficción intelectual.
Este trabajo, de investigación psicohistórica, trata de pergeñar la introducción en España de ese proyecto tecnológico reformador de los presidios que fue el ideario panoptista, y de cómo se materializó su fracaso, pese al entusiasmo de sus defensores. Sin embargo, y paradójicamente, lejos de implicar tal fracaso una renuncia al modelo mismo, éste sirvió como acicate para reconducirlo hacia la reformulación de una genuina “teoría de la prisión” -y “del prisionero”- que encontró articulación en toda una filosofía de la reforma penitenciaria y del tratamiento del recluso que fraguó en los cambios jurídicos y en los proyectos arquitectónicos, así como en el ideal mismo de la “reinserción”
Quality of life in long-term cervical cancer survivors compared with healthy women and women with benign gynecological disorders
No full textObjective: The impact of cervical cancer treatment on the quality of life of long-term survivors compared with the general female population is controversial, and no studies have been conducted comparing patients with benign gynecological diseases. The aim of this study was to compare the quality of life of cervical cancer survivors with that of healthy controls.
Study design: A case-control study was conducted to compare the quality of life of 106 cervical cancer survivors from a tertiary hospital and 185 women admitted to a gynecological outpatient clinic from the same health area for a healthy woman check-up (n 46) or for a benign gynecological disorder (symptomatic, n 113; asymptomatic, n 26). To measure quality of life, self-administered questionnaires, such as the Functional Assessment Cancer Therapy-cervix and World Health Organization quality of life-brief version, were employed. Baseline scores were collected when patients first reported, and further evaluations were completed at 0-6, 7-12, 13-24, 25-60, and more than 60 months. For the contrastive analysis hypothesis, we employed R statistical software.
Results: Except for the environment domain at 0-6, 7-12, and 13-24 months (51.52 vs. 60.73, p < 0.0001; 52 vs. 60.73, p < 0.0001; 49.81 vs. 60.73, p < 0.0001, respectively), we found no statistically significant differences in the quality of life between cervical cancer survivors and controls. We did find differences in the physical health domain scores at 0-6 months (60.22 vs. 72.42, p = 0.039) and the social relationships domain scores at 13-24 months (54 vs. 71.42, p = 0.017) between cases and asymptomatic controls.
Conclusion: Except for physical well-being, environment and social relationships, which were substantially better for controls, especially in the asymptomatic, long-term cervical cancer survivorśquality of life did not vary from that of controls.
Keywords: Case-Control Studies; Genital Diseases, Female; Long-Term Survivors; Quality of Life; Surveys and Questionnaires; Uterine Cervical Neoplasms
Estilos de aprendizaje, autoconcepto y rendimiento académico en Formación Profesional sanitaria
Full text linkLa atención a la diversidad es fundamental en la reforma educativa actual. Para el docente es crucial determinar qué métodos o variables mejoran los aprendizajes. Sobre esta base, estudiamos la relación entre estilos de aprendizaje, autoconcepto y rendimiento académico. La metodología fue no experimental, transversal, correlacional y predictiva. La muestra estuvo constituida por 67 alumnos españoles de Formación Profesional sanitaria, seleccionados de manera no aleatoria e intencional. Evaluamos los estilos de aprendizaje con el CHAEA-36 (Maureira, 2015), el autoconcepto con el AF-5 (García y Musitu, 1999), y el rendimiento, con las actas de calificaciones del centro. Los resultados indican una preferencia moderada por los estilos de aprendizaje reflexivos y teóricos, y baja, por los activos y pragmáticos. Predomina el autoconcepto familiar, seguido del académico, social, físico y emocional. El rendimiento académico promedio es notable. Correlacionan con el rendimiento, de manera positiva y baja el autoconcepto académico y físico, y negativa y baja, el estilo pragmático. Finalmente, el estilo pragmático y el autoconcepto académico predicen el rendimiento (en un 7,1% y un 9,8%, respectivamente, de manera aislada, y en un 10,6% conjuntamente). Los datos se discuten por sus implicaciones educativas