Devices for Prevention of Atrial Tachyarrhythmias

Atrial fibrillation (AF) is the most frequent sustained cardiac arrhythmia in clinical practice and, although its importance has been underestimated even in recent years, we are now becoming aware of its clinical transcendence1,2,3. The classical treatment is pharmacological, but its efficacy is limited and it does have side effects4,5. Therefore, in recent years, there has been an increasing interest in other types of non-pharmacological treatments6,7. Physiologic cardiac pacing has proven to be more effective than VVI mode pacing to prevent the occurrence of AF during the follow-up of patients who have had a permanent pacemaker implanted 8,9,10. There are currently different lines of research that use different atrial pacing techniques to prevent and treat episodes of paroxysmal atrial fibrillation11,12. Techniques of multi-site pacing in the right atrium or both atria, new atrial pacing sites, prevention algorithms for paroxysmal atrial fibrillation episodes, and even high-frequency atrial tachyarrhythmia termination algorithms have all been proposed. In this article, we will try to synthesize the grounds for and findings of the different lines of research currently being developed

A Blended Learning System to Improve Motivation, Mood State, and Satisfaction in Undergraduate Students: Randomized Controlled Trial

Background: Smartphone-based learning, or mobile learning (m-learning), has become a popular learning-and-teaching strategy in educational environments. Blended learning combines strategies such as m-learning with conventional learning to offer continuous training, anytime and anywhere, via innovative learning activities. Objective: The main aim of this work was to examine the short-term (ie, 2-week) effects of a blended learning method using traditional materials plus a mobile app—the iPOT mobile learning app—on knowledge, motivation, mood state, and satisfaction among undergraduate students enrolled in a health science first-degree program. Methods: The study was designed as a two-armed, prospective, single-blind, randomized controlled trial. Subjects who met the inclusion criteria were randomly assigned to either the intervention group (ie, blended learning involving traditional lectures plus m-learning via the use of the iPOT app) or the control group (ie, traditional on-site learning). For both groups, the educational program involved 13 lessons on basic health science. The iPOT app is a hybrid, multiplatform (ie, iOS and Android) smartphone app with an interactive teacher-student interface. Outcomes were measured via multiple-choice questions (ie, knowledge), the Instructional Materials Motivation Survey (ie, motivation), the Profile of Mood States scale (ie, mood state), and Likert-type questionnaires (ie, satisfaction and linguistic competence). Results: A total of 99 students were enrolled, with 49 (49%) in the intervention group and 50 (51%) in the control group. No difference was seen between the two groups in terms of theoretical knowledge gain (P=.92). However, the intervention group subjects returned significantly higher scores than the control group subjects for all postintervention assessed items via the motivation questionnaire (all P<.001). Analysis of covariance (ANCOVA) revealed a significant difference in the confusion and bewilderment component in favor of the intervention group (P=.01), but only a trend toward significance in anger and hostility as well as total score. The intervention group subjects were more satisfied than the members of the control group with respect to five out of the six items evaluated: general satisfaction (P<.001), clarity of the instructions (P<.01), clarity with the use of the learning method (P<.001), enough time to complete the proposed exercises (P<.01), and improvement in the capacity to learn content (P<.001). Finally, the intervention group subjects who were frequent users of the app showed stronger motivation, as well as increased perception of greater gains in their English-language competence, than did infrequent users.Educational Innovation Unit of the University of Granada, Spain 16-54University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES

Caring fathers in Europe: Toward universal caregiver families?

Increasingly, men are challenging the assumption that care is a feminine task and are involving themselves in childcare and the care of dependent adults. However, this does not necessarily have consequences for their work, as they very rarely make costly adaptations in their working lives. In this study, we propose a definition of a man in care (MIC) as a working father who, in order to meet care needs, has adapted his working life in a way that potentially entails a financial penalty. We analyze the prevalence of men in care among men living with children below the age of 15 across the EU-27 plus Iceland, Norway, Switzerland, and the UK using recent representative data (the European Labour Survey and its 2018 ad hoc module on work-life balance). We find that although the number of men engaging in costly work adaptations is still very low when compared to their female counterparts, the characteristics of these men can be clearly outlined: they have a non-manual occupation (managers excluded), they have temporary contracts or are self-employed, they are partnered to women who hold jobs of 40 or more hours a week and have a high educational attainment, and they work in family-friendly companies. Also, at the context level, the prevalence of MIC is clearly related to gender equality and values. However, we do not find evidence of any country having reached the universal caregiver model proposed by Nancy Fraser, including those with more advanced gender and welfare regimes

Multifactor implicit measures to assess enterprising personality dimensions

Background: Several implicit measures have been proposed to overcome limitations of self-reports. The present study aimed to develop a new implicit association test (MFT-IAT) to assess enterprising-related traits, exploring its reliability and validity evidence. Method: A total of 1,142 individuals (Mean age 42.36 years, SD = 13.17) from the general population were assessed. Participants were asked about sociodemographic data, employment status, and personality traits using the Battery for the Assessment of the Enterprising Personality (BEPE). They completed an MFT-IAT designed to assess the BEPE’s traits (achievement motivation, autonomy, innovativeness, self-effi cacy, locus of control, optimism, stress tolerance and risk taking). Reliability was estimated using Cronbach’s alpha. Exploratory Factor Analyses (EFAs) were performed to assess the internal structure of the MFT-IAT. Correlations and a Multiple Analysis of Variance were used to estimate validity evidence based on the relationship towith participants’ employment status. Results: EFAs provided validity evidence for all dimensions with high internal consistency (a = .92-.93). Correlations between implicit and explicit measures were non-signifi cant. Non- implicit measures yielded signifi cant differences between employment statuses. Discussion: This is a pioneering study in this fi eld and more research is needed to improve the feasibility and practicality of implicit measures in applied assessment settings.The present study was funded by the Ministry of Economy and Competitiveness (Refs: PSI2014-56114-P and PSI2017-85724-P) and a predoctoral grant (Ref: BES- 2015-073327). Both funding sources played no role in the study design, data collection, analysis or interpretation of the result

Atrial fibrosis hampers non-invasive localization of atrial ectopic foci from multi-electrode signals: A 3D simulation study

Introduction: Focal atrial tachycardia is commonly treated by radio frequency ablation with an acceptable long-term success. Although the location of ectopic foci tends to appear in specific hot-spots, they can be located virtually in any atrial region. Multi-electrode surface ECG systems allow acquiring dense body surface potential maps (BSPM) for non-invasive therapy planning of cardiac arrhythmia. However, the activation of the atria could be affected by fibrosis and therefore biomarkers based on BSPM need to take these effects into account. We aim to analyze the effect of fibrosis on a BSPM derived index, and its potential application to predict the location of ectopic foci in the atria

El uso de ítems inversos en las escalas tipo Likert: una práctica cuestionable

The use of positively worded items and reversed forms aims to reduce response bias and is a commonly used practice nowadays. The main goal of this research is to analyze the psychometric implications of the use of positive and reversed items in measurement instruments. Method: A sample of 374 participants was tested aged between 18 and 73 (M=33.98; SD=14.12), 62.60% were women. A repeated measures design was used, evaluating the participants with positive, reversed, and combined forms of a self-effi cacy test. Results: When combinations of positive and reversed items are used in the same test the reliability of the test is fl awed and the unidimensionality of the test is jeopardized by secondary sources of variance. In addition, the variance of the scores is reduced, and the means differ signifi cantly from those in tests in which all items are either positive or reversed, but not combined. Conclusions: The results of this study present a trade-off between a potential acquiescence bias when items are positively worded and a potential different understanding when combining regular and reversed items in the same test. The specialized literature recommends combining regular and reversed items for controlling for response style bias, but these results caution researchers in using them as well after accounting for the potential effect of linguistic skills and the fi ndings presented in this study.Antecedentes: el uso de ítems formulados positivamente junto con otros inversos es una práctica habitual para tratar de evitar sesgos de respuesta. El objetivo del presente trabajo es analizar las implicaciones psicométricas de utilizar ítems directos e inversos en la misma prueba. Método: se utilizó una muestra de 374 participantes con edades comprendidas entre 18 y 73 años (M=33.98; DT=14.12), con un 62,60% de mujeres. Mediante un diseño de medidas repetidas se evaluó a los participantes en una prueba de autoefi cacia con tres condiciones: todos los ítems positivos, todos negativos y un combinado de ambos. Resultados: cuando se utilizan en la misma prueba tanto ítems positivos como negativos su fi abilidad se deteriora, y la unidimensionalidad de la prueba se ve comprometida por fuentes secundarias de varianza. La varianza de las puntuaciones disminuye, y las medias difi eren signifi cativamente respecto de las pruebas en las que todos los ítems están formulados positiva o negativamente. Conclusiones: los resultados de este estudio presentan una disyuntiva entre un posible sesgo de aquiescencia cuando los ítems tienen una redacción positiva y una comprensión potencialmente diferente cuando se combinan ítems regulares e invertidos en la misma prueba. La literatura especializada recomienda combinar ítems regulares e invertidos para poder controlar el sesgo del estilo de respuesta, pero estos resultados advierten a los investigadores que los usen también después de tener en cuenta el potencial efecto de las habilidades lingüísticas y de los hallazgos presentados en este estudio.This research was funded by the Spanish Association of Methodology of Behavioral Sciences and Health (AEMCCO), member of the European Association of Methodology (EAM), and by the FPI programme from the Ministry of Economy and Competitiveness of the Government of Spain (PSI2014-56114-P, BES2012-053488, and PSI2017-85724-P)

Optimisation of mortar with Mg-Al-Hydrotalcite as sustainable management strategy lead waste

This study analyses how a Mg-Al-Hydrotalcite with carbonate in the interlayer influences the hydration of mortar allowing the management of lead waste (solid or liquid) in a cement-based material. First, the compatibility of hydrotalcite with the cementitious matrix was studied through heat of hydration, workability, consistency, compressive strength and mineralogical phase formation. The changes produced by the incorporation of hydrotalcite were not drastic and the compatibility with the cement was verified. Lead was added in oxide and nitrate form to mortar with or without hydrotalcite and the same properties were evaluated, including a leaching test. The incorporation of lead delayed the hydration, this effect being increased by the hydrotalcite, which happened in the first instants of hydration. The addition of hydrotalcite counteracted the negative effect of lead in compressive strength values. The interaction between the hydrotalcite and the lead waste was favoured by the formation of plumbites under the pH conditions of cement hydration. Consequently, this interaction would seem to be superficial. The lead leaching decreased to values included in the “Non-Hazardous” limit of the environmental classification, very close to “Inert”. All mortars were produced by two mixing procedures to establish differences. When hydrotalcite was included, the compressive strength was higher in the second procedure and lead leaching showed better behaviour in the first procedure. This research expands the possibilities of the management of solid and liquid waste contaminated with lead by using a Mg-Al-Hydrotalcite in cement-based matrices

Using Inverse Reinforcement Learning with Real Trajectories to Get More Trustworthy Pedestrian Simulation

Reinforcement learning is one of the most promising machine learning techniques to get intelligent behaviors for embodied agents in simulations. The output of the classic Temporal Difference family of Reinforcement Learning algorithms adopts the form of a value function expressed as a numeric table or a function approximator. The learned behavior is then derived using a greedy policy with respect to this value function. Nevertheless, sometimes the learned policy does not meet expectations, and the task of authoring is difficult and unsafe because the modification of one value or parameter in the learned value function has unpredictable consequences in the space of the policies it represents. This invalidates direct manipulation of the learned value function as a method to modify the derived behaviors. In this paper, we propose the use of Inverse Reinforcement Learning to incorporate real behavior traces in the learning process to shape the learned behaviors, thus increasing their trustworthiness (in terms of conformance to reality). To do so, we adapt the Inverse Reinforcement Learning framework to the navigation problem domain. Specifically, we use Soft Q-learning, an algorithm based on the maximum causal entropy principle, with MARL-Ped (a Reinforcement Learning-based pedestrian simulator) to include information from trajectories of real pedestrians in the process of learning how to navigate inside a virtual 3D space that represents the real environment. A comparison with the behaviors learned using a Reinforcement Learning classic algorithm (Sarsa(λ)) shows that the Inverse Reinforcement Learning behaviors adjust significantly better to the real trajectories

Aplicación experimental del programa informático “Gallito-Api” como guía para la auto-corrección por parte del alumno de sus ejercicios escritos (segunda fase).

Memoria del Proyecto de Innovación Docente 2017-2018 basado en la aplicación experimental del programa "Gallito" para la corrección de breves ejercicios escritos