Cross-cultural adaptation, reliability, validity and responsiveness of the Michigan Hand Outcomes Questionnaire (MHQ-Sp) in Spain

Background: The Michigan Hand Outcomes Questionnaire (MHQ) is a self-report tool widely recognized for measuring the health status of patients with hand and wrist problems from a multidimensional perspective. The aim of this study is to translate and culturally adapt the MHQ and validate its psychometric properties of validity, reliability, and responsiveness for different hand problems in Spain. Methods: The MHQ was translated and culturally adapted following the recommendations of the American Association of Orthopaedic Surgeons. The validation process adhered to the current Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) group and was conducted on 262 hand patients. Reliability was assessed through internal consistency using Cronbach's alpha. The study evaluated the test-retest reliability of the measurements using the intraclass correlation coefficient (ICC). Additionally, the measurement error was calculated using the standard error of measurement (SEM) and smallest detectable change (SDC). To assess the structural validity, confirmatory factor analysis (CFA) was employed, while construct validity was evaluated using Pearson's correlation coefficient. Finally, responsiveness was assessed using effect size (ES), standardized response mean (SRM), and minimum clinically important difference (MCID). Results: The reliability of the test was confirmed through internal consistency analysis, with a good Crombach's Alpha (0.82-0.85), and test-retest analysis, with good values of ICC (0.74-0.91). The measurement error was also assessed, with low values of SEM (1.70-4.67) and SDC (4.71-12.94)). The CFA confirmed the unidimensionality of each scale with goodness of fit indices, while the MHQ showed a high and negative correlation with DASH (r=-0.75, P0.005) and grip strength (r=0.05, P>0.005). At week 5, all 222 patients across the three diagnosed hand subgroups showed moderate to high values above 0.92 for ES and SRM, with one MCID above 6.85. Conclusions: The MHQ-Sp was culturally adapted, and the results of this version showed good reliability and validity as well as high responsiveness for a wide range of hand conditions after surgical or conservative treatment in Spain.Funding: The authors declared that no source of funding, grants, or other support were received during the preparation of this manuscript. Acknowledgements: The authors would like to thank Karen Valish (OTR, CHT) and Dr J Sanchez Ruas (FEBHS) for their support and guidance in the early stages of this project. We thank all the patients for their participation in the study

Gestation by substitution in the spanish legal system: doctrinal, jurisprudential and comparative law analysis

En este trabajo vamos a realizar un análisis de la gestación por sustitución. Su primer apartado comienza con una exposición acerca de sus numerosas definiciones y sigue con los diferentes tipos de gestación por sustitución que existen en función de diferentes factores. Después analizaremos cómo se regula la gestación por sustitución en los diferentes países. En este apartado hemos diferenciado aquellos países que la prohíben, aquellos que la permiten de forma gratuita y comercial y aquellos que la permiten sólo de forma gratuita. Seguidamente llevaremos a cabo un breve estudio de la doctrina a favor y en contra de las técnicas de reproducción humana asistida en el que surgirán factores como la comercialización de los seres humanos y el principio de la voluntad de la mujer. Todo continua con un análisis de las proposiciones de ley que ha habido en el panorama normativo español, finalizando con la exposición de diferentes sentencias del TEDH sobre estas técnicas.In this work, we will conduct an analysis of surrogacy. Its first section begins with an exposition regarding its numerous definitions and continues with the different types of surrogacy based on various factors. Next, we will analyze how surrogacy is regulated in different countries. In this section, we have divided countries into those that prohibit it, those that allow it for free and commercial purposes, and those that permit it only for free. Following this, we will carry out a brief study of the doctrine in favor and against assisted human reproduction techniques, where factors such as the commercialization of human beings and the principle of a woman's will emerge. Everything continues with an analysis of the proposed laws that have been present in the Spanish regulatory framework, concluding with the exposition of different judgments from the European Court of Human Rights (ECHR) regarding these techniqueMáster en Acceso a la Abogacía y la Procura-Hasta 2023 Máster en Acceso a la Profesión de Abogad

New targets and therapeutic strategies to treat human papillomavirus infection

La infección por el virus del papiloma humano (VPH) es la causa principal de la mayoría de los casos de cáncer de cuello de útero, un tipo de cáncer, que se dispone como el cuarto más frecuente en mujeres a nivel mundial y el octavo más común considerando ambos sexos. Además, el VPH es responsable de la mayoría de los casos de cáncer de cabeza y cuello, cuya incidencia ha aumentado de forma considerable en los últimos años. La profilaxis con vacunas, así como el diagnóstico molecular, son fundamentales para la eliminación del virus, que es una importante causa de morbilidad y mortalidad en todo el mundo, especialmente en países subdesarrollados con escasos medios para su erradicación y tratamiento. La creación de nuevos programas de diagnóstico molecular, la aparición de nuevas vacunas profilácticas y terapéuticas, la innovación en inmunoterapia, y las nuevas terapias génicas basadas en CRISPR-Cas están cambiando completamente el paradigma del virus y el tratamiento de las lesiones que produce, generando un futuro esperanzador.Human papillomavirus (HPV) infection is the leading cause of most cases of cervical cancer, a type of cancer that ranks as the fourth most common among women worldwide and the eighth most common overall. Additionally, HPV is responsible for the majority of head and neck cancer cases, whose incidence has increased significantly in recent years. Prophylaxis with vaccines and molecular diagnosis are essential for the elimination of the virus, which is a significant cause of morbidity and mortality worldwide, especially in underdeveloped countries with limited means for its eradication and treatment. The development of new molecular diagnostic programs, the emergence of new prophylactic and therapeutic vaccines, advances in immunotherapy, and new gene therapies based on CRISPR-Cas are completely changing the paradigm of the virus and the treatment of the lesions it causes, generating a hopeful future.Grado en Medicin

Studying the relationship between intelligence quotient and schizophrenia polygenic scores in a family design with first-episode psychosis population

Background: The intelligence quotient (IQ) of patients with first-episode psychosis (FEP) and their unaffected relatives may be related to the genetic burden of schizophrenia (SCZ). The polygenic score approach can be useful for testing this question. Aim: To assess the contribution of the polygenic risk scores for SCZ (PGS-SCZ) and polygenic scores for IQ (PGS-IQ) to the individual IQ and its difference from the mean IQ of the family (named family-IQ) through a family-based design in an FEP sample. Methods: The PAFIP-FAMILIES sample (Spain) consists of 122 FEP patients, 131 parents, 94 siblings, and 176 controls. They all completed the WAIS Vocabulary subtest for IQ estimation and provided a DNA sample. We calculated PGS-SCZ and PGS-IQ using the continuous shrinkage method. To account for relatedness in our sample, we performed linear mixed models. We controlled for covariates potentially related to IQ, including age, years of education, sex, and ancestry principal components. Results: FEP patients significantly deviated from their family-IQ. FEP patients had higher PGS-SCZ than other groups, whereas the relatives had intermediate scores between patients and controls. PGS-IQ did not differ between groups. PGS-SCZ significantly predicted the deviation from family-IQ, whereas PGS-IQ significantly predicted individual IQ. Conclusions: PGS-SCZ discriminated between different levels of genetic risk for the disorder and was specifically related to patients' lower IQ in relation to family-IQ. The genetic background of the disorder may affect neurocognition through complex pathological processes interacting with environmental factors that prevent the individual from reaching their familial cognitive potential.Funding support. The PAFIP-FAMILIES project was funded by the ISCIII (FIS PI17/00221). Genotyping was performed at the Human Genotyping laboratory (CeGen), supported by grant PT17/0019, of the PE I+D+i 2013- 2016, funded by ISCIII and FEDER. Rosa Ayesa-Arriola and Mar Fatjó-Vilas were funded by Miguel Servet contracts from ISCIII (CP18/00003 and CP20/00072). Nancy Murillo-Garcia was funded by a predoctoral contract from IDIVAL (PREVAL20/05) and a scientific exchange grant from EMBO (SEG9790). Additional sources of funding include ISCIII (PI20/00066, PI14/00639, PI14/00918, MS18-Ayuda) and IDIVAL (INNVAL20/02, INNVAL23/21). Acknowledgements. Thanks to all participants of PAFIP-FAMILIES. The authors thank the Biobank Valdecilla (PT20/00067), integrated into the Spanish Biobank Network, for its collaboration

Gifted adolescents in Cantabria : representations and motivations

El objetivo central de esta tesis es contribuir al conocimiento científico sobre los adolescentes con Altas Capacidades (AC) en Cantabria, ampliando la comprensión de las implicaciones socioeducativas asociadas a variables como la motivación y la representación social, con especial atención a la influencia del género. La investigación se estructura en cuatro estudios independientes, cada uno con objetivos específicos. Se destaca una tendencia en las tesis doctorales hacia la investigación vinculada a la creación y validación de herramientas digitales e instrumentos de evaluación. Esta dirección de estudio aporta beneficios tanto al grupo de jóvenes con AC como a los profesionales involucrados. Además, se identifican relaciones positivas entre formas de motivación más autónomas y estudiantes con AC, mientras se evidencian los efectos continuos de discriminación de género que afectan a generaciones de mujeres con AC. Dentro de la percepción colectiva de futuros docentes, se destacan mitos y estereotipos, especialmente la creencia en el innatismo de las AC, equiparándolas a una alta inteligencia estable. A través de expresiones personales, se logra identificar la conexión entre el concepto de "florecimiento humano" y las producciones individuales de un adolescente con AC en Amentúrate. En conclusión, se evidencian barreras que obstaculizan el pleno desarrollo del talento, como la confusión epistemológica del concepto, la subrepresentación femenina en programas específicos y la persistencia de mitos en las percepciones de los futuros docentes. Sin embargo, se reconoce la existencia de una red de apoyo en Cantabria que puede promover el desarrollo de los talentos juveniles, adoptando una perspectiva de "ecología de la equidad". Esta perspectiva subraya la interdependencia de diversos procesos que influyen en la escuela desde el exterior. La formación continua de los profesionales en educación se destaca como la estrategia más efectiva para superar las barreras identificadas, ya que mantener un estándar elevado requiere esfuerzos constantes y adaptativos.The central objective of this thesis is to contribute to scientific knowledge about gifted adolescents in Cantabria, enhancing the understanding of socio-educational implications associated with variables such as motivation and social representation, with special attention to gender influence. The research is structured into four independent studies, each with specific objectives. A prevailing trend in doctoral theses focuses on research related to the creation and validation of digital tools and assessment instruments. This research direction brings benefits to both the group of young gifted individuals and the involved professionals. Moreover, positive relationships between more autonomous forms of motivation and identified gifted students are established, while the lasting effects of gender discrimination affecting generations of gifted women are evident. Within the collective perception of future teachers, myths and stereotypes are highlighted, particularly the belief in the innateness of giftedness equating it with stable high intelligence. Through personal expressions, the connection between the concept of "human flourishing" and individual productions of a gifted adolescent in Amentúrate is identified. In conclusion, barriers hindering the full development of talent are evident, such as the epistemological confusion of the concept, female underrepresentation in specific programs, and the persistence of myths in the perceptions of future teachers. However, the existence of a support network in Cantabria that can promote the development of youth talents is recognized, adopting a perspective of "ecology of equity." This viewpoint emphasizes the interdependence of various processes influencing the school from the outside. Continuous education for education professionals is highlighted as the most effective strategy to overcome identified barriers, as maintaining a high standard requires constant and adaptive efforts

What they listen outside the classeroom: a research into musical preferences in childhood

En este Trabajo fin de Grado presentamos una investigación a pequeña escala sobre los gustos musicales de un grupo de niños y niñas en las etapas de Infantil y Primaria que pertenecen a la escuela de baile Bendita Locura (Santander). Aunque la investigación se centre principalmente en los gustos musicales, se analizarán también otros aspectos relacionados con las canciones más escuchadas para profundizar en los efectos que la música tiene en la infancia. Se examinará también el impacto significativo de la música en diversos aspectos del desarrollo humano, subrayando el papel fundamental que desempeña en la educación, la terapia y la formación de la identidad cultural. Finalmente, se remarcará la importancia de que los niños escuchen música acorde a unos valores y mensajes destinados a su edad y a su punto de crecimiento para que se puedan identificar con la idea que transmite cada canción.In this Final Degree Project, we present a small-scale research into the musical preferences of a group of boys and girls in the Kindergarten and Primary stages who belong to the Bendita Locura dance school (Santander). Although the research mainly focuses on musical preferences, other aspects related to the most listened-to songs will also be analyzed to delve deeper into the effects that music has on childhood. The significant impact of music on various aspects of human development will also be examined, highlighting the fundamental role it plays in education, therapy, and the formation of cultural identity. Finally, the importance of children listening to music that aligns with values and messages appropriate for their age and stage of growth will be emphasized, so they can identify with the idea conveyed by each song.Grado en Magisterio en Educación Primari

El uso BIM de análisis de procesos de ingeniería para el equipo BIM del adjudicador: aplicación en los proyectos constructivos de Raos 6 y Raos 9 para la Autoridad Portuaria de Santander

El objetivo de este TFM es desarrollar un proceso BIM que permita al adjudicador revisar y verificar en base al Modelo 3D BIM condiciones críticas de proyecto y en base a ello, autorizarlas o no. Se trata por tanto de desarrollar un uso BIM fundamentalmente orientado a la ingeniería. Esto quiere decir que no es el estado o la calidad de la información sino su calidad técnica la que se estudia en este uso BIM. Este uso BIM y con ello este TFM es un conector fundamental entre el BIM y la ingeniería como actividad cuyo objetivo (más allá del propio BIM) es construir de manera técnicamente adecuada y sostenible. Las condiciones BIM del TFM son estas: - Se está trabajando en la fase de elaboración del proyecto constructivo de Raos 6. - El director de obra recibe información BIM del desarrollo del proyecto para su revisión. - El director necesita contrastar el modelo 3D BIM en aspectos técnicos críticos. - El volumen y naturaleza de los datos recibidos hace imposible llevar a cabo revisiones convencionales (sobre planos). - El entorno de automatización Dynamo (Programación Visual) resuelve este tipo de revisiones. El desarrollo del TFM consiste fundamentalmente en automatizar mediante Dynamo un proceso de control de hinca de pilotes en toda la superficie del muelle de Raos 6, involucrando más de 900 pilotes que deben hincar en una superficie de suelo resistente (capa Keuper) una longitud dada. Cada pilote tiene una profundidad de hinca diferente y se desea confirmar que el diseño cumple condiciones de hinca antes de su aprobación. El resultado del TFM es un proceso BIM completamente automático de tratamiento de datos masivos para la verificación de condiciones (geotécnicas) en base a los modelos 3D. El contexto del trabajo es completamente profesional y completamente BIM. La Autoridad Portuaria de Santander acomete, con el soporte de la UC, sus procesos de implantación BIM; crea su propio equipo BIM y desarrolla el proyecto constructivo de Raos 6 en el que este trabajo se enmarca. Se trata por tanto de un trabajo completamente adaptado a un equipo BIM y a una organización (APS). El desarrollo del documento es el siguiente. El capítulo 1 desarrolla el estado del conocimiento, enmarcando el trabajo desde el punto de vista científico, técnico y de los estándares ISO. El capítulo 2 determina la metodología por medio de un mapa de proceso BIM que a continuación se desarrolla (dentro de este mismo capítulo). Se detallan en particular los tratamientos Dynamo que han permitido resolver los objetivos propuestos. El capítulo 3 ofrece y explica los resultados obtenidos, extendiéndose, más allá de los objetivos propuestos, a otros ámbitos análogos en el control de infraestructuras BIM de la Autoridad Portuaria de Santander. El capítulo 4 trata sobre la validación y discusión de dichos resultados, determinándose los límites y limitaciones de la solución, propiciando con ello el contenido del capítulo siguiente. El capítulo 5 muestra posibles vías de continuación. Finalmente se redactan las concusiones.The objective of this TFM is to develop a BIM process that allows the contracting authority to review and verify critical project conditions based on the 3D BIM model and, based on this, to authorize them or not. It is therefore a question of developing a BIM use fundamentally oriented to engineering. This means that it is not the status or the quality of the information but its technical quality that is studied in this BIM use. This BIM use and thus this TFM is a fundamental connector between BIM and engineering as an activity whose objective (beyond BIM itself) is to build in a technically adequate and sustainable manner. The BIM conditions of the TFM are these: - Work is being carried out in the development phase of the Raos 6 construction project. - The construction manager receives BIM information from the project development for review. - The project manager needs to check the 3D BIM model on critical technical aspects. - The volume and nature of the data received makes it impossible to carry out conventional reviews (on drawings). - The Dynamo automation environment (Visual Programming) solves this type of reviews. The development of the TFM consists basically in automating by means of Dynamo a pile driving control process in the whole surface of the Raos 6 pier, involving more than 900 piles that must drive in a resistant soil surface (Keuper layer) for a given length. Each pile has a different driving depth and it is desired to confirm that the design meets driving conditions before approval. The result of the TFM is a fully automatic BIM process of massive data processing for the verification of (geotechnical) conditions based on the 3D models. The context of the work is fully professional and fully BIM. The Port Authority of Santander undertakes, with the support of the UC, its BIM implementation processes; it creates its own BIM team and develops the Raos 6 construction project in which this work is framed. It is therefore a work completely adapted to a BIM team and an organization (APS). The development of the document is as follows. Chapter 1 develops the state of knowledge, framing the work from a scientific, technical and ISO standards point of view. Chapter 2 determines the methodology by means of a BIM process map which is then developed (within this same chapter). It details in particular the Dynamo treatments that have allowed to solve the proposed objectives. Chapter 3 offers and explains the results obtained, extending, beyond the proposed objectives, to other similar areas in the BIM infrastructure control of the Port Authority of Santander. Chapter 4 deals with the validation and discussion of these results, determining the limits and limitations of the solution, thus leading to the content of the following chapter. Chapter 5 shows possible ways of continuation. Finally, the conclusions are drawn.Máster en Ingeniería de Caminos, Canales y Puertos (Plan 2020

Combined use of QRISK3 and SCORE2 increases identification of ankylosing spondylitis patients at high cardiovascular risk: results from the CARMA Project cohort after 7.5 years of follow-up

Objective: To establish the predictive value of the QRESEARCH risk estimator version 3 (QRISK3) algorithm in identifying Spanish patients with ankylosing spondylitis (AS) at high risk of cardiovascular (CV) events and CV mortality. We also sought to determine whether to combine QRISK3 with another CV risk algorithm: the traditional SCORE, the modified SCORE (mSCORE) EULAR 2015/2016 or the SCORE2 may increase the identification of AS patients with high-risk CV disease. Methods: Information of 684 patients with AS from the Spanish prospective CARdiovascular in ReuMAtology (CARMA) project who at the time of the initial visit had no history of CV events and were followed in rheumatology outpatient clinics of tertiary centers for 7.5 years was reviewed. The risk chart algorithms were retrospectively tested using baseline data. Results: After 4,907 years of follow-up, 33 AS patients had experienced CV events. Linearized rate=6.73 per 1000 person-years (95 % CI: 4.63, 9.44). The four CV risk scales were strongly correlated. QRISK3 correctly discriminated between people with lower and higher CV risk, although the percentage of accumulated events over 7.5 years was clearly lower than expected according to the risk established by QRISK3. Also, mSCORE EULAR 2015/2016 showed the same discrimination ability as SCORE, although the percentage of predicted events was clearly higher than the percentage of actual events. SCORE2 also had a strong discrimination capacity according to CV risk. Combining QRISK3 with any other scale improved the model. This was especially true for the combination of QRISK3 and SCORE2 which achieved the lowest AIC (406.70) and BIC (415.66), so this combination would be the best predictive model. Conclusions: In patients from the Spanish CARMA project, the four algorithms tested accurately discriminated those AS patients with higher CV risk and those with lower CV risk. Moreover, a model that includes QRISK3 and SCORE2 combined the best discrimination ability of QRISK3 with the best calibration of SCORE2

Development of multifunctional treatments for the protection of cultural heritage outdoors

En este Trabajo Fin de Máster, se propone desarrollar tratamientos de protección de patrimonio cultural hidrofóbicos, protectores frente a la luz ultravioleta y con efecto biocida, con una cantidad reducida de nanopartículas. Para ello, se han buscado alternativas a los componentes hidrofóbicos empleados en formulaciones desarrolladas en trabajos anteriores (Solana de María, 2023). Como nuevos compuestos hidrofóbicos se han propuesto el ácido esteárico y el polidimetilsiloxano (PDMS). Se ha estudiado el comportamiento de las nuevas formulaciones en dos tipos de sustratos: piedra caliza, típicamente empleada en construcciones civiles, y pintura acrílica, empleada en pinturas murales. En primer lugar, se tomaron medidas de ángulo de contacto para evaluar la capacidad hidrofóbica y de cambio de color para minimizar posibles cambios estéticos. Después, las muestras se sometieron a un ensayo de envejecimiento ambiental acelerado para evaluar su durabilidadThis Master's Thesis proposes developing cultural heritage protection treatments that are hydrophobic, UV-resistant, and biocidal, while using a reduced amount of nanoparticles. Alternatives to the hydrophobic components used in previous formulations (Solana de María, 2023) have been studied, proposing stearic acid and polydimethylsiloxane (PDMS) as hydrophobic compounds. The behavior of the new formulations was studied on two types of substrates: limestone, commonly used in civil constructions, and acrylic paint, used in murals. Contact angle measurements were initially taken to assess hydrophobicity and color change to minimize aesthetic alterations. Subsequently, the samples underwent accelerated environmental aging tests to evaluate their durabilityMáster en Investigación en Ingeniería Industria

Breast cancer resistance

El cáncer de mama continúa siendo la neoplasia más frecuente en la población femenina. A pesar de los avances diagnósticos y terapéuticos recientes, los diversos subtipos de tumores mamarios continúan siendo un problema de salud pública debido a su elevada incidencia y mortalidad. Este fenómeno se atribuye principalmente al desarrollo de mecanismos de resistencia por parte de las células tumorales frente a las distintas modalidades de tratamientos sistémicos disponibles en la actualidad, que incluyen la hormonoterapia, la quimioterapia, la inmunoterapia y las terapias dirigidas. La comprensión de estos mecanismos es crucial para diseñar nuevas estrategias terapéuticas que mejoren la sensibilidad a los fármacos mencionados, lo que provocaría una disminución de la mortalidad y una mejora en el pronóstico del cáncer de mama. En el presente documento, se ha realizado una revisión bibliográfica sobre los puntos de más interés relacionados con el cáncer de mama, prestando especial atención a los mecanismos implicados en la tumorogénesis, las opciones terapéuticas que existen en la actualidad, y los principales mecanismos de resistencia implicados.Breast cancer continues to be the most frequent neoplasm in the female population. Despite recent diagnostic and therapeutic advancement, the various subtypes of breast tumors continue to be a public health problem due to their high incidence and mortality. This phenomenon is mainly attributed to the development of resistance mechanisms by tumor cells against the various systemic treatment modalities currently available, including hormone therapy, chemotherapy, inmunotherapy and targeted therapies. Understanding these mechanisms is crucial for designing new therapeutic strategies to enhance sensibity to the mentioned drugs, leading to a reduction in mortality and an improvement in breast cancer prognosis. In the present document, a bibliographic review has been carried out on the most relevant points related to breast cancer, paying special attention to the mechanisms involved in tumorogenesis, the therapeutic options currently available and the main resistance mechanisms implicated.Grado en Medicin