The proportional partitional Shapley value

A new coalitional value is proposed under the hypothesis of isolated unions. The main difference between this value and the Aumann–Drèze value is that the allocations within each union are not given by the Shapley value of the restricted game but proportionally to the Shapley value of the original game. Axiomatic characterizations of the new value, examples illustrating its application and a comparative discussion are provided.Peer ReviewedPostprint (author’s final draft

Physician-perceived utility of the EORTC QLQ-GINET21 questionnaire in the treatment of patients with gastrointestinal neuroendocrine tumours: a multicentre, cross-sectional survey (QUALINETS)

Qualitat de vida relacionada amb la salut; Tumors neuroendocrins; Qüestionari QLQ-GINET21Calidad de vida relacionada con la salud; Tumores neuroendocrinos; Cuestionario QLQ-GINET21Health-related quality of life; Neuroendocrine tumours; QLQ-GINET21 questionnaireBackground and objective Patient-reported outcome measures can provide clinicians with valuable information to improve doctor-patient communication and inform clinical decision-making. The aim of this study was to evaluate the physician-perceived utility of the QLQ-GINET21 in routine clinical practice in patients with gastrointestinal neuroendocrine tumours (GI-NETs). Secondary aims were to explore the patient, clinician, and/or centre-related variables potentially associated with perceived clinical utility. Methods Non-interventional, cross-sectional, multicentre study conducted at 34 hospitals in Spain and Portugal (NCT02853422). Patients diagnosed with GI-NETs completed two health-related quality of life (HRQoL) questionnaires (QLQ-C30, QLQ-GINET21) during a single routine visit. Physicians completed a 14-item ad hoc survey to rate the clinical utility of QLQ-GINET21 on three dimensions: 1)therapeutic and clinical decision-making, 2)doctor-patient communication, 3)questionnaire characteristics. Results A total of 199 patients at 34 centres were enrolled by 36 participating clinicians. The highest rated dimension on the QLQ-GINET21 was questionnaire characteristics (86.9% of responses indicating “high utility”), followed by doctor-patient communication (74.4%), and therapeutic and clinical decision-making (65.8%). One physician-related variable (GI-NET patient volume > 30 patients/year) was associated with high clinical utility and two variables (older age/less experience treating GI-NETs) with low clinical utility. Conclusions Clinician-perceived clinical utility of QLQ-GINET21 is high. Clinicians valued the instruments’ capacity to provide a better understanding of patient perspectives and to identify the factors that had the largest influence on patient HRQoL.This study was sponsored by Ipsen

Alcances y limitantes dentro del Proceso de Inconstitucionalidad por Vicio de Forma en el Proceso de Formación de Ley

El presente trabajo de investigación se enfoca sobre los alcances y limitantes dentro del proceso de Inconstitucionalidad por vicios de forma en el proceso de formación de ley, el trabajo se inicia con una descripción de un modo general de la demanda de inconstitucionalidad y que es una herramienta que cuenta todo ciudadano salvadoreño para defender la Constitución ya que esta como norma primaria y fundamental del estado debe de regir a todo el sistema normativo salvadoreño, garantizando todo tipo de Procedimiento, abarcando incluso el proceso de formación de Ley ya que si se incumple dicho proceso se está ante la presencia de un vicio de forma que trae como consecuencia la inconstitucionalidad de las ley. Ha sido la Jurisprudencia de la Sala de lo Constitucional de la Corte Suprema de Justicia, la que se ha encargado de abarcar ampliamente los criterios; cuando procede cada uno de los vicios de forma, estableciendo los límites de cada una de las fases del proceso de formación de ley, entre las que se encuentran las fases de iniciativa ley, fase legislativa, fase ejecutiva y fase de la vigencia u obligatoriedad. En algunos de los casos la sala ha mantenido y respetado los criterios Jurisprudenciales establecidos por Salas anteriores y en otros casos ha generado nuevos precedentes apartándose de los ya existentes, todo ello a manera de establecerlos límites de todo el Proceso de Formación de Ley

[en] inclusive educommunication and disability in andean region: Qualitative review of advances and achievements

Resumen: Introducción. La educación para la inclusión social de personas con discapacidad en las últimas décadas incrementó el uso de la educomunicación para crear estrategias de cambio en las condiciones de marginalización vividas por esta población. En la investigación se propuso rastrear procesos comunicativos y/o educomunicativos inclusivos de las personas con discapacidad en la Región Andina, con el fin de identificar la comprensión que se hace sobre la comunicación para el cambio y la educomunicación en relación con procesos inclusivos de esta población. Método. Se realizó un estudio de caso configurado por 36 experiencias comunicativas y educomunicativas inclusivas de y para personas con discapacidad de los seis países de la Región Andina documentadas en la red. Resultados. Se encontró que los países andinos (Bolivia, Chile, Colombia, Ecuador, Perú y Venezuela) tienen estrategias de comunicación o educomunicación públicas y privadas enmarcadas en el modelo social y el enfoque de derechos para transformar estigmas y facilitar la inclusión social de personas con discapacidad. Discusión. Dichas estrategias hoy están en transición: de modelos difusionistas e institucionalizados a modelos con procesos transformadores y de cambio estructural con miradas holísticas hacia la discapacidad que involucran procesos interactivos y de construcción colectiva. La educomunicación en la Región Andina ha avanzado y alcanzado logros como estrategia de educación para la inclusión de personas con discapacidad, su reconocimiento y auto-reconocimiento y la facilitación de procesos de transformación social hacia sociedades capaces de reconocer su diversidad, no obstante, es necesario seguir desarrollando estrategias de este tipo para alcanzar definitivamente el propósito de inclusión.Abstract: Introduction. Education for social inclusion of people with disabilities in recent decades increased the use of educommunication to create strategies for change in the conditions of marginalization experienced by this population. The research aimed at tracking inclusive communication and/or educommunication processes of people with disabilities in the Andean Region, in order to identify in them the understanding of communication for change and educommunication in terms of the inclusion of this population. Method. A case study was made of 36 communication and educommunication inclusive experiences of and for people with disabilities in the six countries of the Andean Region documented online. Results. It was found that the Andean countries (Bolivia, Chile, Colombia, Ecuador, Perú and Venezuela) have public and private communication or educommunication strategies framed in the social model and the rights approach to transform stigmas and facilitate the social inclusion of people with disabilities. Discussion. These strategies are now in transition: from diffusionist and institutionalized models to models with transformative processes and structural change with holistic views of disability that involve interactive processes and collective construction. Educommunication in the Andean Region has advanced and achieved achievements as an education strategy for the inclusion of people with disabilities, the recognition and self-recognition of their voice and the facilitation of social transformation processes towards more inclusive societies capable of recognizing their diversity. However, it is necessary to continue to develop strategies of this kind in order to achieve this purpose once and for all.Este trabajo se ha elaborado en el marco del Proyecto I+D “ Youtubers e Instagrammers: la competencia mediática en los prosumidores emergentes” (RTI2018-093303-B-I00) financiado por el Ministerio de Ciencia, Innovación y Universidades de España; por el Grupo de Investigación en comunicación y cambio social del Departamento de Ciencias de la Comunicación (Programa de Comunicación Social – Periodismo) de la Universidad Autónoma de Occidente (Cali – Colombia); y por la Dirección General de Investigaciones y Facultad de Comunicación y Publicidad de la Universidad Santiago de Cali (Cali-Colombia)

Seroprevalence and genetic characterization of Toxoplasma gondii in domestic pigs intended for human consumption in Cuba

Domestic pigs are considered as one of the main intermediate hosts in the zoonotic transmission of Toxoplasma gondii in many countries. Serological and molecular studies are warranted to better understand the epidemiology and transmission patterns of this parasite worldwide. To date, seroepidemiological information on T. gondii in domestic pigs in Cuba is very scarce and there are no reports of T. gondii genotypes circulating in this country. Here, we aimed to estimate the seroprevalence of T. gondii and provide genetic characterization of the strains circulating in slaughtered pigs intended for human consumption in Central Cuba. Seroprevalence was determined in 450 serum samples from slaughtered pigs in Villa Clara province using ELISA. Anti-Toxoplasma gondii IgG antibodies were detected in 100 animals (22.2%, 95% CI: 18.5-26.2). Conventional PCR of the 529-bp marker of T. gondii was performed in hearts and diaphragm tissues of all ELISA-seropositive pigs. Toxoplasma gondii DNA was detected in four animals. Further genetic characterization of the positive DNA samples was performed by multilocus PCR-RFLP and PCR-sequencing typing tools. Molecular analysis revealed four different genetic profiles that were combinations of type I, II, III and u-1 alleles, suggesting the circulation of non-clonal genotypes of T. gondii in domestic pigs in Cuba. Our results indicate that T. gondii is widely distributed in slaughtered pigs in this country, which might have important implications for public health. To the best of our knowledge, this is the first report on genetic characterization of T. gondii in Cuba. Although preliminary, the results suggest a high genetic diversity of T. gondii in the study region. Further studies based on parasite isolation are needed to definitively identify the genotypes circulating and characterize the virulence of strains detected in pigs in Cuba, and to assess the risk of zoonotic transmission from pork products in this country

Case-Control Analysis of the Impact of Anemia on Quality of Life in Patients with Cancer: A Qca Study Analysis

Anemia is a common condition in cancer patients and is associated with a wide variety of symptoms that impair quality of life (QoL). However, exactly how anemia affects QoL in cancer patients is unclear because of the inconsistencies in its definition in previous reports. We aimed to examine the clinical impact of anemia on the QoL of cancer patients using specific questionnaires. We performed a post-hoc analysis of a multicenter, prospective, case-control study. We included patients with cancer with (cases) or without (controls) anemia. Participants completed the European Organization for Research and Treatment of Cancer Quality of Life questionnaire version 3.0 (EORTC QLQ-C30) and Euro QoL 5-dimension 3-level (EQ–5D–3L) questionnaire. Statistically significant and clinically relevant differences in the global health status were examined. From 2015 to 2018, 365 patients were included (90 cases and 275 controls). We found minimally important differences in global health status according to the EORTC QLQ-C30 questionnaire (case vs. controls: 45.6 vs. 58%, respectively; mean difference: −12.4, p < 0.001). Regarding symptoms, cancer patients with anemia had more pronounced symptoms in six out of nine scales in comparison with those without anemia. In conclusion, cancer patients with anemia had a worse QoL both clinically and statistically

Physician-perceived utility of the EORTC QLQ-GINET21 questionnaire in the treatment of patients with gastrointestinal neuroendocrine tumours: a multicentre, cross-sectional survey (QUALINETS)

[Background and objective] Patient-reported outcome measures can provide clinicians with valuable information to improve doctor-patient communication and inform clinical decision-making. The aim of this study was to evaluate the physician-perceived utility of the QLQ-GINET21 in routine clinical practice in patients with gastrointestinal neuroendocrine tumours (GI-NETs). Secondary aims were to explore the patient, clinician, and/or centre-related variables potentially associated with perceived clinical utility.[Methods] Non-interventional, cross-sectional, multicentre study conducted at 34 hospitals in Spain and Portugal (NCT02853422). Patients diagnosed with GI-NETs completed two health-related quality of life (HRQoL) questionnaires (QLQ-C30, QLQ-GINET21) during a single routine visit. Physicians completed a 14-item ad hoc survey to rate the clinical utility of QLQ-GINET21 on three dimensions: 1)therapeutic and clinical decision-making, 2)doctor-patient communication, 3)questionnaire characteristics.[Results] A total of 199 patients at 34 centres were enrolled by 36 participating clinicians. The highest rated dimension on the QLQ-GINET21 was questionnaire characteristics (86.9% of responses indicating “high utility”), followed by doctor-patient communication (74.4%), and therapeutic and clinical decision-making (65.8%). One physician-related variable (GI-NET patient volume > 30 patients/year) was associated with high clinical utility and two variables (older age/less experience treating GI-NETs) with low clinical utility.[Conclusions] Clinician-perceived clinical utility of QLQ-GINET21 is high. Clinicians valued the instruments’ capacity to provide a better understanding of patient perspectives and to identify the factors that had the largest influence on patient HRQoL.This study was sponsored by Ipsen.Peer reviewe

Burnout in family medicine residents

El burnout, también conocido como desgaste profesional, es un estado de agotamiento que se presenta como resultado de exigencias agobiantes, estrés crónico o insatisfacción laboral. La residencia médica, curso de posgrado en el que se adquiere gran cantidad de conocimientos, suele implicar jornadas académicas y asistenciales extenuantes.&nbsp; El presente estudio tuvo como objetivo identificar el burnout en residentes de Medicina Familiar de una unidad de la Ciudad de México y evaluar factores asociados. Se realizó una encuesta transversal a 34 médicos residentes (26 mujeres y 8 hombres), encontrando en un 65% Síndrome de Burnout. Según los grados académicos se encontró la siguiente prevalencia, primer año: 56%, segundo año: 64% y tercer año: 73%. En lo concerniente al salario el 71% reportó estar insatisfecho. Sobre la satisfacción con las actividades realizadas el 62% está conforme y el 59% reportó un ambiente laboral adecuado.&nbsp; Con respecto a la prueba exacta de Fisher relacionando el síndrome de burnout, satisfacción salarial y clima laboral se obtuvieron resultados no significativos. El burnout durante la residencia médica puede tener graves repercusiones en la salud mental de los afectados y en la calidad de la atención médica que prestan. Es importante generar estrategias para prevenirlo.Burnout is a state of exhaustion that occurs as a result of overwhelming demands, chronic stress or job dissatisfaction. Medical residency, a postgraduate course in which a large amount of knowledge is acquired, usually implies long academic days and heavy healthcare burden. The objective of this study was to identify burnout in Family Medicine residents of a unit in Mexico City and to evaluate associated factors. A cross-sectional survey was carried out on 34 resident physicians (26 women and 8 men), finding Burnout Syndrome in 65%. According to academic grades, the following prevalence was found: first year: 56%, second year: 64% and third year: 73%. Regarding salary, 71% reported being dissatisfied. Regarding satisfaction with the activities carried out, 62% are satisfied and 59% reported an adequate work environment. With respect to Fisher's exact test relating burnout syndrome, salary satisfaction and work environment, non-significant results were obtained. Burnout during medical residency can have serious repercussions on the mental health of those affected and on the quality of medical care they provide. It is important to generate strategies to prevent it

A Comparison of Total Thoracoscopic and Robotic Surgery for Lung Cancer Lymphadenectomy

Background: Robotic-assisted thoracic surgery (RATS) is used increasingly frequently in major lung resection for early stage non-small-cell lung cancer (NSCLC) but has not yet been fully evaluated. The aim of this study was to compare the surgical outcomes of lymph node dissection (LND) performed via RATS with those from totally thoracoscopic (TT) four-port videothoracoscopy. Methods: Clinical and pathological data were collected retrospectively from patients with clinical stage N0 NSCLC who underwent pulmonary resection in the form of lobectomy or segmental resection between June 2010 and November 2022. The assessment criteria were number of mediastinal lymph nodes and number of mediastinal stations dissected via the RATS approach compared with the four-port TT approach. Results: A total of 246 pulmonary resections with LND for clinical stages I-II NSCLC were performed: 85 via TT and 161 via RATS. The clinical characteristics of the patients were similar in both groups. The number of mediastinal nodes dissected and mediastinal stations dissected was significantly higher in the RATS group (TT: mean ± SD, 10.72 ± 3.7; RATS, 14.74 ± 6.3 [p < 0.001]), except in the inferior mediastinal stations. There was no difference in terms of postoperative complications. Conclusions: In patients with early stage NSCLC undergoing major lung resection, the quality of hilomediastinal LND performed using RATS was superior to that performed using TT

Modeling and Hourly Time-Scale Characterization of the Main Energy Parameters of Parabolic-Trough Solar Thermal Power Plants Using a Simplified Quasi-Dynamic Model

A simplified mathematical model of parabolic-trough solar thermal power plants, which allow one to carry out an energetic characterization of the main thermal parameters that influence the solar field performance, was evaluated through a comparison of simulation results. Two geographical locations were selected to evaluate the mathematical model proposed in this work—one in each hemisphere—and design considerations according with the practical/operational experience were taken. Furthermore, independent simulations were performed using the System Advisor Model (SAM) software, their results were compared with those obtained by the simplified model. According with the above, the mathematical model allows one to carry out simulations with a high degree of flexibility and adaptability, in which the equations that allow the plant to be energetically characterized are composed of a series of logical conditions that help identify boundary conditions between dawn and sunset, direct normal irradiance transients, and when the thermal energy storage system must compensate the solar field energy deficits to maintain the full load operation of the plant. Due to the above, the developed model allows one to obtain satisfactory simulation results; referring to the net electric power production, this model provides results in both hemispheres with a relative percentage error in the range of [0.28–8.38%] compared with the results obtained with the SAM, with mean square values of 4.57% and 4.21% for sites 1 and 2, respectivel