Effects of the older student in digital formats

To carry out this work, an educational evaluation has been used from the CIPP model proposed by Stufflebeam and Shinkfield (1987). The sample is made up of 55 elderly people of Spanish nationality, aged between 55 and 82 years. The distribu-tion in relation to gender groups 73% women and 27% men. Due to marital status, 36.3% are married, 45.4% are widowed, and 18.1% are single. The interpretation of pictograms in an EVEA is highlighted as an important visual and orientation ele-ment for correct handling by older students.Para poder realizar este trabajo se ha utilizado una evaluación educativa desde el modelo CIPP propuesto por Stufflebeam y Shinkfield (1987). La muestra está formada por 55 personas mayores de nacionalidad española, con edades comprendidas entre los 55 y los 82 años. La distribución con relación al género agrupa un 73% de mujeres y un 27% de hombres. En razón al estado civil, el 36,3% están casados, el 45,4% son viudos, y el 18,1% están solteros. Se destaca la interpretación de pictogramas en un EVEA como elemento visual y de orientación importante para una correcta manipulación por los alumnos mayores

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Competencia socioemocional en adolescentes de altas habilidades: un estudio comparativo

Este trabajo, titulado “Competencia socioemocional en adolescentes de altas habilidades: un estudio comparativo” tiene como objetivo analizar la relación entre la competencia socioemocional y la alta habilidad (superdotación o talento). La muestra estuvo compuesta por 566 estudiantes (386 con alta habilidad y 180 sin alta habilidad), con edades comprendidas entre los 11 y los 18 años. Además, han participado 535 padres y 443 profesores. Los instrumentos utilizados fueron: 1) las escalas de Percepción de Inteligencias Múltiples dirigidas a padres, profesores y estudiantes; 2) el Test de Aptitudes Diferenciales (DAT-5); 3) el Test de Pensamiento Creativo de Torrance (TTCT Figurativo); 4) el Cuestionario de Inteligencia Emocional para niños y adolescentes (Bar-On EQ-i:YV); y 5) el de padres y profesores (Bar-On EQ-i:YV-O). Algunos resultados mostraron que los padres y los profesores percibieron con mayor adaptabilidad a los estudiantes con alta habilidad. Además, los padres percibieron con mayor adaptabilidad a los chicos; y con mayores habilidades interpersonales a las chicas. This work, entitled Social-emotional Competence of high abilities adolescents: A comparative study, aims to analyse the relationship between social-emotional competences and high ability (giftedness or talent). The sample was composed of 566 students (386 high ability and 180 not high ability students) aged 11 to 18 years old. In addition, 535 parents and 443 teachers have taken part in this study. The instruments used were: 1) Scales of Perception of Multiple Intelligences by parents, teachers and students; 2) The Differential Aptitude Tests (DAT-Fifth Edition); 3) Torrance´s Tests of Creative Thinking (TTCT-Figural); 4) the Emotional Quotient Inventory by children and adolescents (Bar-On EQ-i:YV); and 5) the Emotional Quotient Inventory by parents and teachers (Bar-On EQ-i:YV-O). Some results showed that parents and teachers perceived students with high abilities as being more adaptable. Also, parents perceived boys as having greater adaptability; and girls as having greater interpersonal abilities

Psychometric properties of the Emotional Quotient Inventory: EQ-i:YV in gifted and talented students

El objetivo del estudio fue conocer las propiedades psicométricas del Emotional Quotient Inventory-Young Version (EQ-i:YV; Bar-On & Parker, 2000), utilizando una muestra de estudiantes superdotados y talentosos identificados de acuerdo al protocolo propuesto por Castelló y Batlle (1998). La muestra estuvo compuesta por 386 estudiantes con altas habilidades (superdotados y talentos), 58% chicos y 42% chicas, con edades comprendidas entre los 11 y los 18 años (M = 13.96; DT = 1.08). Un análisis de la dispersión de los ítems indicó que, de forma general, las respuestas se distribuyen en el rango de los cuatro valores de la escala tipo likert usada. Un análisis factorial exploratorio verificó que todos los ítems se agruparon en cinco cinco componentes, explicando un 41.1% de la varianza total. El primer componente se refierió al optimismo y a la habilidad para mantener una aptitud positiva (estado de ánimo); el segundo, a la capacidad para hacer frente a los problemas diarios (adaptabilidad); el tercero, a la capacidad para mantener la calma frente a situaciones estresantes (manejo del estrés); el cuarto, a la habilidad para escuchar, entender y apreciar los sentimientos de otros (interpersonal); y, finalmente, el quinto componente a la habilidad para expresar y comunicar sentimientos y necesidades de uno mismo (intrapersonal). Los índices de consistencia interna de las cinco dimensiones se situaron siempre por encima de .75.   The psychometric properties of the Emotional Quotient Inventory - Young Version (EQ-i:YV; Bar-On & Parker, 2000) was tested in a sample of gifted and talented students. The students were identified according to the guidelines proposed by Castelló and Batlle (1998). A sample of 386 gifted and talented students (58% boys and 42% girls), aged 11-18 years (M = 13.96; SD = 1.08), took part in the study. A dispersion analysis of item results showed that in every item included in the EQ-i:YV there is a distribution of individuals occupying the four points on a likert scale format. An exploratory factor analysis observed a five-components structure as in the original version. The model explained 41.1% of the variance based on five isolated components: the first component referred to optimism and the ability to maintain a positive attitude (mood); the second component was related to one's ability to deal with everyday problems (adaptability); the third one referred to the ability to keep calm and cope with stressful situations (stress management); the fourth component referred to the ability to listen, understand and appreciate the feelings of others (interpersonal); and the fifth component was associated with the ability to express and communicate one's feelings and needs (intrapersonal). The internal consistency of items was higher than .75 in the five dimensions

Percepción socioemocional de los profesores en adolescentes con altas habilidades versus habilidades medias

El objetivo de este trabajo es estudiar la percepción que los profesores tienen sobre las competencias socioemocionales de sus alumnos adolescentes, según la excepcionalidad (alta habilidad vs. no alta habilidad) y el género. La muestra estuvo compuesta por 443 profesores pertenecientes a 55 centros de Educación Secundaria Obligatoria de la Región de Murcia. El instrumento utilizado fue el EQ�i: YV�O dirigido a profesores (BAR�ON & PARKER, en prensa). Los resultados indicaron, según la excepcionalidad de los alumnos (alta habilidad vs. no alta habilidad), que los profesores percibieron al grupo de alumnos de alta habilidad más adaptados, con mayor estado de ánimo y con mayores habilidades interpersonales. Respecto al género, los profesores valoraron con mayor manejo del estrés a los chicos. Además, según la excepcionalidad (alta habilidad vs. no alta habilidad) y el género, los datos mostraron diferencias estadísticamente significativas para las dimensiones adaptabilidad, estado de ánimo e intrapersonal

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective

Role of age and comorbidities in mortality of patients with infective endocarditis.

The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups: A total of 3120 patients with IE (1327  There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in th