Percepciones de los pacientes con enfermedades reumáticas tratados con biológicos subcutáneos sobre su nivel de información. encuesta RHEU-LIFE

[Abstract] Objective: To investigate, in Spanish patients with rheumatic diseases treated with subcutaneous biological drugs, their sources of information, which sources they consider most relevant, and their satisfaction with the information received in the hospital. Methods: Rheumatologists from 50 hospitals handed out an anonymous survey to 20 consecutive patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis treated with subcutaneous biologicals. The survey was developed ad hoc by 4 rheumatologists and 3 patients, and included questions with closed-ended responses on sources of information and satisfaction. Results: The survey was handed-out to 1,000 patients, 592 of whom completed it (response rate: 59.2%). The rheumatologist was mentioned as the most important source of information (75%), followed by the primary care physician, nurses, and electronic resources; 45.2% received oral and written information about the biological, 46.1% oral only, and 6.0% written only; 8.7% stated that they had not been taught to inject the biological. The percentage of patients satisfied with the information received was high (87.2%), although the satisfaction was lower in relation to safety. If the information came from the rheumatologist, the satisfaction was higher (89.6%) than when coming from other sources (59.6%; P<.001). Satisfaction was also higher if the information was provided orally and written (92.8%) than if provided only orally (86.1%; P=.013); 45.2% reported having sought information from sources outside the hospital. Conclusions: The rheumatologist is key in transmitting satisfactory information on biological treatment to patients. He or she must also act as a guide, since a high percentage of patients seeks information in other different sources.[Resumen] Objetivo. Conocer las fuentes de las que los pacientes españoles con enfermedades reumáticas tratados con fármacos biológicos subcutáneos obtienen información, cuáles consideran más relevantes y su satisfacción con la información recibida en el hospital. Métodos. Reumatólogos de 50 hospitales entregaron una encuesta anónima, desarrollada ad hoc por 4 reumatólogos y 3 pacientes, a 20 pacientes consecutivos con artritis reumatoide, espondiloartritis axial o artritis psoriásica tratados con biológicos subcutáneos. La encuesta incluyó preguntas con respuestas cerradas sobre los aspectos mencionados previamente. Resultados. Recibieron la encuesta 1.000 pacientes, 592 la devolvieron cumplimentada (tasa de respuesta: 59,2%). El reumatólogo fue mencionado como la fuente de información más importante (75%), seguido del médico de atención primaria, la enfermería y los recursos electrónicos. El 45,2% recibió información oral y por escrito sobre el biológico, el 46,1% solo oral, el 6% solo por escrito. Un 8,7% declaró no haber sido enseñado a inyectarse el biológico. El porcentaje de pacientes satisfechos con la información recibida fue elevado (87,2%), aunque la satisfacción fue menor en temas relacionados con la seguridad. Si la información provenía del reumatólogo, la satisfacción era mayor (89,6%) que cuando provenía de otras vías (59,6%; p < 0,001). La satisfacción también era mayor si se dio oral y por escrito (92,8%) frente a solo oral (86,1%; p = 0,013). Un 45,2% declaró haber buscado información en fuentes fuera del hospital. Conclusiones. El reumatólogo es clave a la hora de transmitir información satisfactoria al paciente en tratamiento biológico. Debe además actuar de guía, ya que un elevado porcentaje busca información en fuentes distintas

Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products

[Abstract] Objective: The aim of this study was to explore perceptions of patients with rheumatic diseases treated with subcutaneous (SC) biological drugs on the impact on daily life and satisfaction with current therapy, including preferred attributes. Methods: A survey was developed ad hoc by four rheumatologists and three patients, including Likert questions on the impact of disease and treatment on daily life and preferred attributes of treatment. Rheumatologists from 50 participating centers were instructed to handout the survey to 20 consecutive patients with rheumatoid arthritis (RA), axial spondyloarthritis (ax-SpA), or psoriatic arthritis (PsA) receiving SC biological drugs. Patients responded to the survey at home and sent it to a central facility by prepaid mail. Results: A total of 592 patients returned the survey (response rate: 59.2%), 51.4% of whom had RA, 23.8% had ax-SpA, and 19.6% had PsA. Patients reported moderate-to-severe impact of their disease on their quality of life (QoL) (51.9%), work/daily activities (49.2%), emotional well-being (41.0%), personal relationships (26.0%), and close relatives’ life (32.3%); 30%–50% patients reported seldom/never being inquired about these aspects by their rheumatologists. Treatment attributes ranked as most important were the normalization of QoL (43.6%) and the relief from symptoms (35.2%). The satisfaction with their current antirheumatic therapy was high (>80% were “satisfied” or “very satisfied”), despite moderate/severe impact of disease. Conclusion: Patients with rheumatic diseases on SC biological therapy perceive a high disease impact on different aspects of daily life, despite being highly satisfied with their treatment; the perception is that physicians do not frequently address personal problems. Normalization of QoL is the most important attribute of therapies to patients

Effectiveness and persistence of golimumab as a second biological drug in patients with spondyloarthritis

This observational, longitudinal retrospective, noncomparative study was designed to assess the persistence and effectiveness of golimumab as a second anti-tumor necrosis factor (TNF) drug in patients with spondyloarthritis requiring discontinuation from a first anti-TNF drug.Data were collected retrospectively for all patients with axial spondyloarthritis or psoriatic arthritis from 20 rheumatology clinics in Spain who started golimumab as a second anti-TNF drug between January 2013 and December 2015. Golimumab persistence was assessed with Kaplan-Meier survival analysis, and associated factors were assessed with Cox regression analysis.210 patients started golimumab as a second anti-TNF drug: 131 with axial spondyloarthritis and 79 with psoriatic arthritis. In axial spondyloarthritis patients, the mean (standard deviation) Bath Ankylosing Spondylitis Disease Activity Index score at baseline was 5.5 (2.1), decreasing to 3.9 (2.0) at month 3 and 3.5 (2.0) at year 1, and remaining stable thereafter. In psoriatic arthritis patients, mean (standard deviation) baseline Disease Activity Score was 4.0 (1.3), reducing to 2.5 (1.2) at month 3 and to 2.2 (1.3) at year 1. Corresponding improvements were recorded from baseline in C-reactive protein levels and erythrocyte sedimentation rates. The probability of persistence of treatment with golimumab was 80% at year 1, 70% at year 2 and 65% at years 3 and year 4, and was similar in those who had stopped the first anti-TNF due to loss of efficacy or other reasons. Cox regression analysis showed that the probability of survival with golimumab was higher in patients with higher erythrocyte sedimentation rate, in patients with axial spondyloarthritis than with psoriatic arthritis, and in those who had discontinued adalimumab as first anti-TNF. Seventy-two patients (34.3%) discontinued golimumab during follow-up, 50 of them due to lack of efficacy.In patients with spondyloarthritis requiring discontinuation from a first anti-TNF drug, treatment with golimumab was effective and showed a high probability of persistence up to 4 years of treatment

Patients' perceptions on shared decision making during prescription of subcutaneous biological drug treatments for inflammatory arthritis: the RHEU-LIFE survey

Short report[Abstract] Objectives: The aim of this study was to explore the preferences of patients with rheumatic diseases and their perceived experience regarding participation in shared decision making (SDM) when they were prescribed a subcutaneous (SC) biological drug. Methods: A printed survey was handed to 1,000 patients with inflammatory rheumatic diseases treated with SC biological drug. The survey included closed questions about preferences regarding decision making and about patients' experience when they were prescribed an SC biological drug. Descriptive statistics were performed with stratification by patient profiles, using chi-square for comparisons between groups. Results: A total of 592 surveys were received (response rate 59.2%, mean age 51.7 years, 57.6% women). Some 28.2% of patients reported preferring to take part in treatment selection, a percentage that was higher in younger patients, in those with higher academic degree and in those who search information in sources different to that of health care professionals. Over half of patients (56.3%) perceived that the rheumatologist considered their opinion when prescribing an SC biological drug, a percentage higher in younger people. Only in 40.8% of cases did the patients' preference match their perception of their participation in the process. No differences were observed by sex, disease or number of biologics. Conclusions: Patients with inflammatory rheumatic diseases want information about their treatments but mostly leave the prescription decision to the rheumatologist. Younger people, or those with higher academic degree, more often want to participate in the SDM. There are discrepancies between patient preferences and perceptions of this process

Estudio y análisis de Zonas Económicas Especiales. Propuestas de mejora para las Zonas Francas españolas actuales

La actual coyuntura global, con el decrecimiento del comercio y los nuevos acuerdos de libre comercio, hace que las Zonas Económicas Especiales sean un tema extremadamente vigente, con una importancia estratégica y económica creciente. Dentro del área de comercio internacional, juegan un papel muy importante en las políticas económicas de fomento y desarrollo de zonas deprimidas. El artículo pretende ser una ayuda para la gerencia de empresas vinculadas al comercio, una aportación para el mundo académico e incluso para el gubernamental. Utilizando clasificaciones existentes en la literatura, se han estudiado y analizado algunas de las principales Zonas Económicas Especiales existentes en el mundo, ya que su crecimiento ha sido exponencial. Existen grandes diferencias según el país y la región en la que se encuentran, pero su tipología tiende a ser similar por región. En este sentido, las Zonas Francas europeas se podrían clasificar como regímenes exclusivamente aduaneros, presentando sólo ocasionalmente ventajas fiscales cuando coexistan con regímenes fiscales compatibles con estas áreas. Este trabajo permite comparar las ventajas que Zonas Económicas Especiales puedan poseer con respecto a las Zonas Francas españolas y plantea propuestas para mejorar su competitividad. Aunque no hay una única fórmula, se puede afirmar que cuanto mayor sea la vinculación de la zona con la economía doméstica mayor será el éxito.The existing global situation shows a sharp decline in global trade; this together with new free trade agreements under discussion, makes the debate of Special Economic Zones an extremely current topic. Promoting and developing special economic zones play an important role in policies to promote deprived areas. This article aims to support the management of organizations involved in trade, the academic world as well as government. Employing classifications that exist in current literature, since Special Economic Zones have been showing an exponential increase some of the existing ones around the world have been studied and analyzed. Numerous differences exist depending upon the country or region where the Special Economic Zones are located, but its typology tends to be similar by region. The Special Economic Zones in Europe could be classified as Free Trade Zones, exhibiting tax advantages only when they coexist with other compatible regimes. This study allows a comparison of the advantages different special economic zones may have with those located in Spain and puts forward proposals to improve its competitiveness. Even though there is not a single formula for success, we can say that the greater the relationship the area with the economic zone the bigger the success

Evaluación de la falacia de comparaciones en valores absolutos en futuros profesores de educación primaria

Este trabajo evalúa un sesgo relacionado con la heurística de la representatividad, la denominada “falacia de las comparaciones en valor absoluto”, en una muestra de 75 futuros profesores de educación primaria de la Universidad de Granada. Esta falacia, común en los medios de comunicación, trata de impresionar al lector, utilizando valores absolutos, al comparar poblaciones seleccionando parte de la información disponible

Evaluación de las destrezas matemáticas de la competencia gráfica en futuros profesores

En este trabajo se evalúan las destrezas matemáticas de 75 futuros profesores de educación primaria, que serán en el futuro los encargados de formar ciudadanos estadísticamente cultos, respecto de un gráfico de líneas sesgado. Los estudiantes, para interpretar correctamente la información, han de calcular el porcentaje de incremento representado en la gráfica y extraer conclusiones a partir de los datos presentados. Los resultados obtenidos evidencian que el grupo de futuros docentes presenta grandes dificultades en el análisis del gráfico, en especial a la hora de especificar la proporcionalidad respecto al total

Effect of organic and chemical fertilization on the onion crop (Allium cepa L.)

The bulb onion (Allium cepa L.) is a vegetable widely cultivated and in high demand in national and international markets. Due to the risks that the indiscriminate use of agrochemicals represents for human health and the environment, the present study aimed to make a comparative analysis of the effects of organic vs chemical fertilization currently used in the cropping of red hybrid bulb onion (Eureka). Three organic fertilizers (Zumsil®, ComCat® and EcoFungi®) were compared to three chemical fertilizers (15-15-15®, Muriate of Potash® and Nitrofoska®). The response variables were: plant height at 30 and 60 days after transplanting (DAT), length, diameter and average weight of bulbs, yield in tons per hectare and the relationship between height at 30 and 60 DAT. The experiment was carried out under a completely randomized design with four replicates, seven treatments and 28 experimental units. The statistics used include an analysis of variance and a Canonical Biplot that allowed to obtain groups of variables and to determine their correlation with each one of the treatments. Additionally, a marginal analysis of dominant treatments was performed. Positive response of variables was strongly associated with organic fertilizers. From the economic point of view, the ComCat® organic fertilizer represented an ecological alternative with excellent benefits for the producer. This research is in line with the trends for agrochemical-free foods

Proctitis in patients with monkeypox infection: a single‑center analysis of 42 consecutive cases from a multidisciplinary observational study on monkeypox proctitis

Background: The current monkeypox (MP) virus outbreak was declared an international emergency in July 2022. The aim of this report is to describe our initial experience with patients with MP, focusing on proctitis. Methods: We conducted an observational study between 20 May and 31 July 2022, on patients with MP at a reference tertiary center in Madrid, Spain. A descriptive analysis on MP was performed, focusing on its characteristics, symptoms, diagnosis, and outcomes. Results: A total of 143 positive MP cases were diagnosed in our center; 42 of them [all male, median age 39 years (range: 22–57 years)] had proctitis (29.37%), and 3 patients (2.09%/MP total cases and 7.14%/MP proctitis) required surgical drainage of a perianal abscess. Conclusions: General and digestive surgeons must be aware of the presence of proctological impairment and complications due to MP viru

Convective storms in closed cyclones in Jupiter's South Temperate Belt: (I) observations

On May 31, 2020 a short-lived convective storm appeared in one of the small cyclones of Jupiter's South Temperate Belt (STB) at planetographic latitude 30.8S. The outbreak was captured by amateur astronomer Clyde Foster in methane-band images, became widely known as Clyde's Spot, and was imaged at very high resolution by the Junocam instrument on board the Juno mission 2.5 days later. Junocam images showed a white two-lobed cyclonic system with high clouds observed in the methane-band at 890 nm. The storm evolved over a few days to become a dark feature that showed turbulence for months, presented oscillations in its drift rate, and slowly expanded, first into a Folded Filamentary Region (FFR), and later into a turbulent segment of the STB over a timescale of one year. On August 7, 2021, a new storm strikingly similar to Clyde's Spot erupted in a cyclone of the STB. The new storm exhibited first a similar transformation into a turbulent dark feature, and later transformed into a dark cyclone fully formed by January 2022. We compare the evolution into a FFR of Clyde's Spot with the formation of a FFR observed by Voyager 2 in 1979 in the South South Temperate Belt (SSTB) after a convective outburst in a cyclone that also developed a two-lobed shape. We also discuss the contemporaneous evolution of an additional cyclone of the STB, which was similar to the one were Clyde's Spot developed. This cyclone did not exhibit visible internal convective activity, and transformed from pale white in 2019, with low contrast with the environment, to dark red in 2020, and thus, was very similar to the outcome of the second storm. This cyclone became bright again in 2021 after interacting with Oval BA. We present observations of these phenomena obtained by amateur astronomers, ground-based telescopes, Hubble Space Telescope and Junocam. This study reveals that short-lived small storms that are active for only a few days can produce complex longterm changes that extend over much larger areas than those initially covered by the storms. In a second paper [In tilde urrigarro et al., 2022] we use the EPIC numerical model to simulate these storms and study moist convection in closed cyclones.We are very thankful to the large community of amateur observers operating small telescopes that submit their Jupiter observations to databases such as PVOL and ALPO-Japan. We are also grateful to two anonymous reviewers for their comments that improved the clarity of this paper. This work has been supported by Grant PID2019-109467GB-I00 funded by MCIN/AEI/10.13039/501100011033/and by Grupos Gobierno Vasco IT1366-19. PI acknowledges a PhD scholarship from Gobierno Vasco. GSO and TM were supported by NASA with funds distributed to the Jet Propulsion Laboratory, California Institute of Technology under contract 80NM0018D0004. C. J. Hansen was sup-ported by funds from NASA, USA to the Juno mission via the Planetary Science Institute. IOE was supported by a contract funded by Europlanet 2024 RI to navigate Junocam images, now available as maps in PVOL at http://pvol2.ehu.eus. Europlanet 2024 RI has received funding from the European Unions Horizon 2020 research and innovation programme under grant agreement No 871149. G.S. Orton, S. R. Brueshaber, T. W. Momary, K. H. Baines and E. K. Dahl were visiting Astronomers at the Infrared Telescope Facility, which is operated by the University of Hawaii under contract 80HQTR19D0030 with the National Aeronautics and Space Administration. In addition, support from NASA Juno Participating Scientist award 80NSSC19K1265 was provided to M.H. Wong. This work has used data acquired from the NASA/ESA Hubble Space Telescope (HST) , which is operated by the Association of 807 Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. These HST observations are associated with several HST observing programs: GO/DD 14661 (PI: M.H. Wong) , GO/DD 15665 (PI: I. de Pater) , GO/DD 15159 (PI: M. H. Wong) , GO/DD 15502 (PI: A. Simon) , GO/DD 14661 (PI: M. H. Wong) , GO/DD 16074 (PI: M.H. Wong) , GO/DD 16053 (PI: I. de Pater) , GO/DD 15929 (PI: A. Simon) , GO/DD 16269 (PI: A. Simon) . PlanetCam observations were collected at the Centro Astronomico Hispanico en Andalucia (CAHA) , operated jointly by the Instituto de Astrofisica de Andalucia (CSIC) and the Andalusian Universities (Junta de Andalucia) . This work was enabled by the location of the IRTF and Gemini North telescopes within the Mauakea Science Reserve, adjacent to the summit of Maunakea. We are grateful for the privilege of observing Kaawela (Jupiter) from a place that is unique in both its astronomical quality and its cultural signifi-cance. This research has made use of the USGS Integrated Software for Imagers and Spectrometers (ISIS) . Voyager 2 images were accessed through The PDS Ring-Moon Systems Nodes OPUS search service