Trends in pulmonary embolism in patients infected with HIV during the combination antiretroviral therapy era in Spain: A nationwide population-based study

Chronic infections are a major factor in the development of pulmonary embolism (PE). We aimed to evaluate the trends of PE-related hospitalizations and PE-related deaths in people living with HIV (PLWH) during the era of combination antiretroviral therapy (cART) through a retrospective study in Spain. Data were collected from the Minimum Basic Data Set (MBDS) between 1997 and 2013. The study period was fragmented into four calendar periods (1997-1999, 2000-2003, 2004-2007, and 2008-2013). The rate of PE-related hospitalizations remained stable in PLWH (P = 0.361). HIV-monoinfected patients had a higher incidence than HIV/HCV-coinfected patients during all follow-up [(98.7 (95%CI = 92.2; 105.1); P < 0.001], but PE incidence decreased in HIV-monoinfected patients (P < 0.001) and increased in HIV/HCV-coinfected patients (P < 0.001). Concretely, the rate of PE-related hospitalizations decreased significantly in patients monoinfected with HIV [from 203.6 (95%CI = 175.7; 231.6) events per 100,000 patient-years in 1997-1999 to 74.3 (95%CI = 66.1; 82.3) in 2008-2013; P < 0.001], while patients coinfected with HIV/HCV had a significant increase [from 16.3 (95%CI = 11; 21.6) in 1997-1999 to 53.3 (95%CI = 45.9; 60.6) in 2008-2013; P < 0.001]. The mortality rate of PE-related hospitalizations showed a similar trend as PE incidence. In conclusion, the epidemiological trends of PE in PLWH changed during the cART era, with decreases in incidence and mortality in HIV-monoinfected and increases in both variables in patients coinfected with HIV/HCV.We thank the National Centre for Epidemiology (Institute of Health Carlos III, ISCIII, Spain) for supplying the number of people living with HIV/AIDS in Spain. We also thank the Ministry of Health, Consumption and Social Welfare for providing the records of the Minimum Basic Data Set (MBDS). This work has been supported by a grant from “Instituto de Salud Carlos III” (grant numbers PI14/01094 and PI17/00657 to JB, and PI14CIII/00011 and PI17CIII/00003 to SR). The RD16CIII/0002/0002 and RD16/0025/0017 projects also funded the study as part of the Plan Nacional R + D + I and co-funded by ISCIII- Subdirección General de Evaluación y el Fondo Europeo de Desarrollo Regional (FEDER). JB is supported by the “Programa de Intensificación de la Actividad Investigadora en el Sistema Nacional de Salud (I3SNS)”, Refs INT15/00079 and INT16/00100.S

Exploiting visual saliency for assessing the impact of car commercials upon viewers

Content based video indexing and retrieval (CBVIR) is a lively area of research which focuses on automating the indexing, retrieval and management of videos. This area has a wide spectrum of promising applications where assessing the impact of audiovisual productions emerges as a particularly interesting and motivating one. In this paper we present a computational model capable to predict the impact (i.e. positive or negative) upon viewers of car advertisements videos by using a set of visual saliency descriptors. Visual saliency provides information about parts of the image perceived as most important, which are instinctively targeted by humans when looking at a picture or watching a video. For this reason we propose to exploit visual information, introducing it as a new feature which reflects high-level semantics objectively, to improve the video impact categorization results. The suggested salience descriptors are inspired by the mechanisms that underlie the attentional abilities of the human visual system and organized into seven distinct families according to different measurements over the identified salient areas in the video frames, namely population, size, location, geometry, orientation, movement and photographic composition. Proposed approach starts by computing saliency maps for all the video frames, where two different visual saliency detection frameworks have been considered and evaluated: the popular graph based visual saliency (GBVS) algorithm, and a state-of-the-art DNN-based approach.This work has been partially supported by the National Grants RTC-2016-5305-7 and TEC2014-53390-P of the Spanish Ministry of Economy and Competitiveness.Publicad

Virtual Reality Systems for Upper Limb Motor Function Recovery in Patients With Spinal Cord Injury: Systematic Review and Meta-Analysis

Background: Patients with spinal cord injury (SCI) usually present with different motor impairments, including a deterioration of upper limb motor function (ULMF), that limit their performance of activities of daily living and reduce their quality of life. Virtual reality (VR) is being used in neurological rehabilitation for the assessment and treatment of the physical impairments of this condition. Objective: A systematic review and meta-analysis was conducted to evaluate the effectiveness of VR on ULMF in patients with SCI compared with conventional physical therapy. Methods: The search was performed from October to December 2019 in Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, Physiotherapy Evidence Database (PEDro), PubMed, and Cochrane Central Register of Controlled Trials. The inclusion criteria of selected studies were as follows: (1) comprised adults with SCI, (2) included an intervention with VR, (3) compared VR intervention with conventional physical therapy, (4) reported outcomes related to ULMF, and (5) was a controlled clinical trial. The Cochrane Collaboration's tool was used to evaluate the risk of bias. The RevMan 5.3 statistical software was used to obtain the meta-analysis according to the standardized mean difference (SMD) and 95% CIs. Results: Six articles were included in this systematic review. Four of them contributed information to the meta-analysis. A total of 105 subjects were analyzed. All of the studies used semi-immersive or nonimmersive VR systems. The statistical analysis showed nonsignificant results for the Nine-Hole Peg Test (SMD -0.93, 95% CI -1.95 to 0.09), muscle balance test (SMD -0.27, 95% CI -0.82 to 0.27), Motricity Index (SMD 0.16, 95% CI -0.37 to 0.68), Jebsen-Taylor Hand Function Test (JTHFT) subtests (writing, SMD -0.10, 95% CI -4.01 to 3.82; simulated page turning, SMD -0.99, 95% CI -2.01 to 0.02; simulated feeding, SMD -0.64, 95% CI -1.61 to 0.32; stacking checkers, SMD 0.99, 95% CI -0.02 to 2.00; picking up large light objects, SMD -0.42, 95% CI -1.37 to 0.54; and picking up large heavy objects, SMD 0.52, 95% CI -0.44 to 1.49), range of motion of shoulder abduction/adduction (SMD -0.23, 95% CI -1.48 to 1.03), shoulder flexion/extension (SMD 0.56, 95% CI -1.24 to 2.36), elbow flexion (SMD -0.36, 95% CI -1.14 to 0.42), elbow extension (SMD -0.21, 95% CI -0.99 to 0.57), wrist extension (SMD 1.44, 95% CI -2.19 to 5.06), and elbow supination (SMD -0.18, 95% CI -1.80 to 1.44). Favorable results were found for the JTHFT subtest picking up small common objects (SMD -1.33, 95% CI -2.42 to -0.24). Conclusions: The current evidence for VR interventions to improve ULMF in patients with SCI is limited. Future studies employing immersive systems to identify the key aspects that increase the clinical impact of VR interventions are needed, as well as research to prove the benefits of the use of VR in the rehabilitation of patients with SCI in the clinical setting

Implementation and Effects of the Broad‑Minded Affective Coping (BMAC) Technique: a Pilot Study

This study aims to develop and test a 3-session version of the Broad-Minded Affective Coping (BMAC) technique and to explore the relationship between implementation (features of the positive memory evoked, satisfaction, and engagement) and outcome. The BMAC was delivered to 31 female university students in three sessions over 7–10 days. Positive and negative affect, and difficulties in regulation of negative and positive emotions were assessed pre-treatment and post-treatment. The intervention resulted in a significant reduction in negative affect and in difficulties in negative emotion regulation. No significant effects were found on positive affect or on difficulties in positive emotion regulation. Moreover, the memories chosen were found to be highly central, and patient and therapist levels of satisfaction and engagement in the technique were very high throughout the three sessions. No significant relationships were found between implementation and outcome. This leads to the conclusion that the technique may be suitable for inclusion in broader treatment packages

Entrenamiento en habilidades básicas de gestión de grupos para la mejora de la competencia transversal de hablar en público: protocolo para alumnos de posgrado de Psicología

El presente proyecto se enmarca en la mejora educativa de dos grandes bloques: 1)La mejora de competencias transversales indispensables en la carrera académica de cualquier alumno universitario. En este proyecto en concreto, se abordará la tarea de hablar en público, que ostenta un papel central en el desempeño de los alumnos en la práctica totalidad de asignaturas y en la potenciación de sus destrezas básicas a ofrecer en su futuro profesional. 2)La mejora educativa de alumnos del Master Oficial en Psicología General Sanitaria, como parte aplicada de su formación. Atendiendo al primer bloque, son múltiples las situaciones en las que los alumnos han de enfrentarse a un público y exponer o defender un trabajo, opinión etc… Ante esta situación, tradicionalmente se ha dado mayor peso a cuestiones de contenido (lo que se expone) y no tanto a cuestiones de forma (cómo se hace). La demanda de servicios que presten atención y ayuda en este ámbito va en aumento. Desde un punto de vista comunitario cada vez son más las asociaciones, fundaciones, escuelas que se dirigen a potenciar esta destreza (p. ej. ToastMaster). En el mismo sentido, desde un contexto clínico, se observa la misma tendencia de demanda de ayuda, en este caso profesional, para hacer frente a este tipo de situaciones, fundamentalmente por parte de alumnos universitarios. La ansiedad a exponer es un fenómeno ampliamente estudiado y relacionados con síndromes clínicos, como por ejemplo la Fobia Social. La carrera universitaria exige a sus alumnos tareas, ejercicios, exámenes… que requieren la puesta en práctica de esta competencia. Además, no es un fenómeno exclusivo de ninguna disciplina concreta, por lo que esta competencia es transversal a diferentes asignaturas y ramas del conocimiento. Un enfoque comunitario (desde la universidad) y focalizado (para universitarios) supondría atender a la competencia transversal de hablar en público de una manera formal y sistematizada, centrándose en el aprendizaje de la forma (cómo se hace) y de aquellos factores que pudieran interferir (ansiedad, timidez…). El segundo bloque que define este proyecto va dirigido a la mejora educativa de los alumnos del Máster Oficial en Psicología General Sanitaria. Parte de su formación práctica supone la confección, planificación y ejecución de planes de psicoeducativos de salud. Todos los miembros de este proyecto guardamos relación, de una u otra manera con la Clínica Universitaria de Psicología de la UCM (CUP-UCM), centro de prácticas del itinerario del citado master. Esto supone una excepcional oportunidad de añadir a su plan formativo de rotación por la CUP-UCM, el diseño y ejecución de estos talleres, siempre bajo estrecha supervisión y acompañamiento de miembros del proyecto

Hospitalizations associated with rotavirus gastroenteritis in Spain, 2001–2005

<p>Abstract</p> <p>Background</p> <p>This study aims to describe and analyze hospital admissions in Spain due to rotavirus infections among children aged 5 years or under during the period 2001–2005, along with the associated health cost.</p> <p>Methods</p> <p>To update estimates of rotavirus hospitalizations rates in Spain, we conducted a retrospective study of 5 years of national hospitalization data associated with acute gastroenteritis using the Minimum Basic Data Set.</p> <p>Results</p> <p>During the study period, a total of 17.1% of all admissions due to acute gastroenteritis of any etiology in children aged ≤ 5 years were attributable to rotavirus infection as determined by the rotavirus-specific International Classification of Diseases, ninth revision, Clinical Modification code. A mean incidence of 135 hospital admissions attributable to rotavirus per 100,000 children aged ≤ 5 years was found. Hospitalizations associated with rotavirus had a marked winter-time seasonality. The estimated cost of hospital admission attributable to rotavirus has risen from 3 million euros estimated for 2001 to almost 7 million euros estimated in 2005.</p> <p>Conclusion</p> <p>Rotavirus gastroenteritis remains an important cause of hospitalizations in Spanish children, mostly during the winter season.</p

Prognosis Stratification Tools in Early-Stage Endometrial Cancer: Could We Improve Their Accuracy?

There are three prognostic stratification tools used for endometrial cancer: ESMO-ESGO-ESTRO 2016, ProMisE, and ESGO-ESTRO-ESP 2020. However, these methods are not sufficiently accurate to address prognosis. The aim of this study was to investigate whether the integration of molecular classification and other biomarkers could be used to improve the prognosis stratification in early-stage endometrial cancer. Relapse-free and overall survival of each classifier were analyzed, and the c-index was employed to assess accuracy. Other biomarkers were explored to improve the precision of risk classifiers. We analyzed 293 patients. A comparison between the three classifiers showed an improved accuracy in ESGO-ESTRO-ESP 2020 when RFS was evaluated (c-index = 0.78), although we did not find broad differences between intermediate prognostic groups. Prognosis of these patients was better stratified with the incorporation of CTNNB1 status to the 2020 classifier (c-index 0.81), with statistically significant and clinically relevant differences in 5-year RFS: 93.9% for low risk, 79.1% for intermediate merged group/CTNNB1 wild type, and 42.7% for high risk (including patients with CTNNB1 mutation). The incorporation of molecular classification in risk stratification resulted in better discriminatory capability, which could be improved even further with the addition of CTNNB1 mutational evaluation.Peer reviewe

Prognosis Stratification Tools in Early-Stage Endometrial Cancer: Could We Improve Their Accuracy?

There are three prognostic stratification tools used for endometrial cancer: ESMO-ESGO-ESTRO 2016, ProMisE, and ESGO-ESTRO-ESP 2020. However, these methods are not sufficiently accurate to address prognosis. The aim of this study was to investigate whether the integration of molecular classification and other biomarkers could be used to improve the prognosis stratification in early-stage endometrial cancer. Relapse-free and overall survival of each classifier were analyzed, and the c-index was employed to assess accuracy. Other biomarkers were explored to improve the precision of risk classifiers. We analyzed 293 patients. A comparison between the three classifiers showed an improved accuracy in ESGO-ESTRO-ESP 2020 when RFS was evaluated (c-index = 0.78), although we did not find broad differences between intermediate prognostic groups. Prognosis of these patients was better stratified with the incorporation of CTNNB1 status to the 2020 classifier (c-index 0.81), with statistically significant and clinically relevant differences in 5-year RFS: 93.9% for low risk, 79.1% for intermediate merged group/CTNNB1 wild type, and 42.7% for high risk (including patients with CTNNB1 mutation). The incorporation of molecular classification in risk stratification resulted in better discriminatory capability, which could be improved even further with the addition of CTNNB1 mutational evaluation.Peer reviewe

Prognosis Stratification Tools in Early-Stage Endometrial Cancer: Could We Improve Their Accuracy?

There are three prognostic stratification tools used for endometrial cancer: ESMO-ESGO-ESTRO 2016, ProMisE, and ESGO-ESTRO-ESP 2020. However, these methods are not sufficiently accurate to address prognosis. The aim of this study was to investigate whether the integration of molecular classification and other biomarkers could be used to improve the prognosis stratification in early-stage endometrial cancer. Relapse-free and overall survival of each classifier were analyzed, and the c-index was employed to assess accuracy. Other biomarkers were explored to improve the precision of risk classifiers. We analyzed 293 patients. A comparison between the three classifiers showed an improved accuracy in ESGO-ESTRO-ESP 2020 when RFS was evaluated (c-index = 0.78), although we did not find broad differences between intermediate prognostic groups. Prognosis of these patients was better stratified with the incorporation of CTNNB1 status to the 2020 classifier (c-index 0.81), with statistically significant and clinically relevant differences in 5-year RFS: 93.9% for low risk, 79.1% for intermediate merged group/CTNNB1 wild type, and 42.7% for high risk (including patients with CTNNB1 mutation). The incorporation of molecular classification in risk stratification resulted in better discriminatory capability, which could be improved even further with the addition of CTNNB1 mutational evaluation