Feasibility of a wearable inertial sensor to assess motor complications and treatment in Parkinson's disease

Wearable sensors-based systems have emerged as a potential tool to continuously monitor Parkinson's Disease (PD) motor features in free-living environments. To analyse the responsivity of wearable inertial sensor (WIS) measures (On/Off-Time, dyskinesia, freezing of gait (FoG) and gait parameters) after treatment adjustments. We also aim to study the ability of the sensor in the detection of MF, dyskinesia, FoG and the percentage of Off-Time, under ambulatory conditions of use. We conducted an observational, open-label study. PD patients wore a validated WIS (STAT-ON TM) for one week (before treatment), and one week, three months after therapeutic changes. The patients were analyzed into two groups according to whether treatment changes had been indicated or not. Thirty-nine PD patients were included in the study (PD duration 8 ± 3.5 years). Treatment changes were made in 29 patients (85%). When comparing the two groups (treatment intervention vs no intervention), the WIS detected significant changes in the mean percentage of Off-Time (p = 0.007), the mean percentage of On-Time (p = 0.002), the number of steps (p = 0.008) and the gait fluidity (p = 0.004). The mean percentage of Off-Time among the patients who decreased their Off-Time (79% of patients) was -7.54 ± 5.26. The mean percentage of On-Time among the patients that increased their On-Time (59% of patients) was 8.9 ± 6.46. The Spearman correlation between the mean fluidity of the stride and the UPDRS-III- Factor I was 0.6 (p = <0.001). The system detected motor fluctuations (MF) in thirty-seven patients (95%), whilst dyskinesia and FoG were detected in fifteen (41%), and nine PD patients (23%), respectively. However, the kappa agreement analysis between the UPDRS-IV/clinical interview and the sensor was 0.089 for MF, 0.318 for dyskinesia and 0.481 for FoG. It's feasible to use this sensor for monitoring PD treatment under ambulatory conditions. This system could serve as a complementary tool to assess PD motor complications and treatment adjustments, although more studies are required

La edición de revistas científicas en España: una aproximación descriptiva

El objetivo principal de este artículo es describir el perfil de las revistas científicas españolas. Los resultados que se presentan proceden de una encuesta a 1.280 revistas científicas españolas incluidas en la base de datos Dulcinea (edición 2012), obteniendo una tasa de respuesta del 43,8% (n=561). Como objetivos específicos, el estudio se planteó caracterizar las revistas científicas y analizar las peculiaridades de las mismas en torno a una serie de parámetros que conforman las dimensiones económico-financiera, estratégica y operativa de las revistas en el periodo observado. El análisis ha permitido observar cómo el modelo de financiación de las revistas científicas españolas se sostiene principalmente de las ayudas institucionales, cómo la mayoría de las revistas carece de una estructura organizativa estable y depende, en gran medida, del trabajo voluntario y cómo el debate sobre las limitaciones y dificultades que afectan al desarrollo del acceso abierto sigue vigente

Systematic review of population-based bladder cancer registries : How criteria heterogeneity affects the comparison of incidences

The population-based registry of bladder cancer (BC) raises specific problems intrinsic to the tumor, as the inclusion of noninfiltrating, potentially malignant and multiple tumors. We performed a systematic review (PRISMA guidelines) of population-based BC registries to obtain information on their geographic areas involved, last dates of real incidence of BC, and rules coding used in BC for uncertain behavior, in situ and multiple tumors. Using MEDLINE and Google Scholar, we identified scientific publications of in the last 10 years in English or Spanish, whether they were related to a national or international cancer registry, provided information on registry rules, and provided data on the incidence of BC. After the first screening, a total of 194 references were obtained. After a second analysis, three registries were selected: International Agency for Research on Cancer (IARC) is a world registry providing real incidence of BC in the period 2008-2012. Surveillance, Epidemiology, and End Results (SEER) Program registered incidence until 2017 in more than 90% of the US population. Spanish Network of Cancer Registries (REDECAN) unifies 14 Spanish registries (27.4% of the population) with real incidence data from 2010 to 2015. The coding and inclusion rules have been modified, but currently, most registries include BC in situ and uncertain behavior tumors. Whenever a new case occurs 36 months after a previous diagnosis, SEER registers those as multiple incident cancers in the same location, while IARC and REDECAN only allow one cancer per location during the lifespan of the patient. Comparison of the incidence of BC among different population-based cancer registries is prone to bias due to the methodological differences regarding the inclusion of carcinomas in situ, indeterminate, and multiple tumors. A good cancer registry could provide better surveillance strategies for BC patients. The bladder cancer registry is complex due to the peculiarities of urothelial tumors. The heterogeneity in the rules to define carcinomas in situ, indeterminate and multiple tumors interfere with the comparability of incidence of bladder cancer

Environmental Factors Involved in the High Incidence of Bladder Cancer in an Industrialized Area in North-Eastern Spain

Neoplasias de la vejiga; Contaminantes atmosféricos; Exposición ambientalUrinary bladder neoplasms; Air pollutants; Environmental exposureCàncer de bufeta; Contaminants atmosfèrics; Exposició ambientalBackground: Bladder cancer (BC) is the most common of those affecting the urinary tract, and a significant proportion of the cases are attributable to tobacco use as well as occupational and environmental factors. Objective: The aim of this study is to estimate the current incidence of BC in an industrialized area in northeastern Spain and to analyze its time trends over three decades from an ecological perspective. Methods: Patients diagnosed with histologically confirmed primary BC, during 2018-2019, in an area in northeastern Spain (430,883 inhabitants) were included. Crude and age-standardized incidence rates were estimated per 100,000 person-years based on the number of individuals getting their first diagnosis. An exploratory time trend analysis was carried out to describe the evolution in tobacco use and occupational or environmental risk factors and the incidence of BC in the same area from the 1990s. Results: 295 patients were included (age 72.5 ± 10.3 years; 89.8% men). The crude rate was 62.6 (95% CI: 51.9-73.2) for men and 6.8 (95% CI: 3.4-10.3) for women. The annual rate adjusted to the European Standard Population was 85.3 (95% CI:75.0-95.5) for men and 7.0 (95% CI:4.5-9.5) for women. From 1994 to 2018, the prevalence of smokers decreased in men (42.3% to 30.9%) as well as in the active population working in the industry (44.36% to 22.59%). Nevertheless, the car fleet, especially diesel, has increased considerably. The annual mean concentrations of air (PM10, PM2.5, O3, and NO2) and water (nitrates, arsenic, trihalomethanes) pollutants were within the regulatory limit values, but not the maximum levels. Conclusions: The incidence of BC is one of the highest in men but not in women, despite the decrease in tobacco use and industrial activity (perhaps related to high latency after carcinogen exposure cessation) and despite the control of environmental pollution (the maximum regulatory limit probably needs to be lowered). Finally, a similar exposure to the carcinogen would result in a gender-specific differential incidence

Traumatismo de la fisis distal de la tibia: tratamiento y resultados

Hemos realizado un estudio retrospectivo de 206 fracturas fisiarias distales de tibia. Se excluyeron las lesiones fisiarias aisladas de peroné y los arrancamientos óseos de tibia o peroné sin afectación de la placa fisiaria. Se recopilaron variables de 199 casos relativas al diagnóstico, tratamiento y evolución. La clasificación utilizada fue la de Salter y Harris para los traumatismos fisiarios. El tiempo de seguimiento medio fue de 7,73 meses (rango de 1,36 a 126 meses). Se trataba de 115 varones y 84 hembras. El tipo más frecuente fue el II (n=82, 41,2%). La media de edad fue de 12,1 ± 2,6 años. La causa más frecuente fue el accidente casual. Se realizó tratamiento conservador en 121 casos (60,8%). Los resultados se valoraron en función de las complicaciones aparecidas. En 169 casos (90,7%) el resultado fue satisfactorio, encontrando sólo 17 casos (9,3%) de malos resultados por presentar desalineación de los ejes (de 5 o más grados) y/o acortamiento (de 1 cm o más). Se presentó malposición en 9 casos (12%) en el tipo II, 4 casos (10,8%) en el tipo III, 1 caso (4%) en el tipo IV y 3 casos (100%) en el tipo V. La relación entre el grado de reducción obtenido y aparición de malposición sólo presentó diferencias significativas en los casos aparecidos del tipo II. La aparición de alteraciones de crecimiento en los tipos III y IV suele tener poca trascendencia clínica por ocurrir en pacientes con cartílagos en fase avanzada de cierre, no así en el tipo II donde pueden estar asociadas lesiones de tipo V, aconsejando realizar reducciones mediante maniobras cuidadosas para intentar evitar alteraciones.This is a retrospective study of 206 physeal fractures of the distal tibia. Isolated physeal injuries to the fibula and dislocations of the tibia or fibula without involvement of the growth plate were excluded. Variables from 199 cases relative to the diagnosis, treatment and evolution were recorded. The Salter-Harris classification was used for physeal fractures. The mean follow-up period was 7.73 months (range: 1.36 to 126 months), and 115 male and 84 female patients were treated. The most frequented type of fracture was type II (n=82, 41.2%). The mean age of the patients was 12.1 ± 2.6 years. The most frequented cause of injury was accident. In 121 cases (60.8%) the injury was treated conservatively. The results were evaluated in terms of subsequent complications. In 169 cases (90.7%) the results were satisfactory, and in only 17 cases (9.3%) the results were poor as a consequence of misalignment of the axes (5 or more degrees) and/or shortening (1 cm or more). Misalignment was found in 9 cases (12%) of type II, 4 cases (10.8%) of type III, 1 case (4%) of type IV and 3 cases (100%) of type V. The correlation between the degree of reduction obtained and the appearance of misalignment was statistically significant only in the cases of type II fracture. The appearance of growth disturbance in type III and type IV fractures is usually of minor clinical importance because it occurs in patients whose cartilage is at an advanced stage of closure, unlike type II fractures, which may be associated with type V injuries. In these cases reduction must be performed with special care in order to avoid growth disturbance

La edición de revistas científicas en España: una aproximación descriptiva

The main objective of this article is to present a broad description of Spanish scientific journals. The results were obtained from a survey distributed to 1,280 editors of Spanish scientific journals included in Dulcinea database (2012 edition). The response rate was 43,8%. As specific objectives, the study aimed to characterize scientific journals and to analyze the particularities of a set of parameters that make up the economic, strategic and operational dimensions of the journals in the period studied. The results show that the funding model of the Spanish scientific journals depends mainly on institutional support, that many journals lack a stable organizational structure and rely heavily on volunteer work, and that the debate on the limitations and difficulties affecting the development of open access remains open.El objetivo principal de este artículo es describir el perfil de las revistas científicas españolas. Los resultados que se presentan proceden de una encuesta a 1.280 revistas científicas españolas incluidas en la base de datos Dulcinea (edición 2012), obteniendo una tasa de respuesta del 43,8% (n=561). Como objetivos específicos, el estudio se planteó caracterizar las revistas científicas y analizar las peculiaridades de las mismas en torno a una serie de parámetros que conforman las dimensiones económico-financiera, estratégica y operativa de las revistas en el periodo observado. El análisis ha permitido observar cómo el modelo de financiación de las revistas científicas españolas se sostiene principalmente de las ayudas institucionales, cómo la mayoría de las revistas carece de una estructura organizativa estable y depende, en gran medida, del trabajo voluntario y cómo el debate sobre las limitaciones y dificultades que afectan al desarrollo del acceso abierto sigue vigente

The Spanish scientific journals: A descriptive approach.

El objetivo principal de este artículo es describir el perfil de las revistas científicas españolas. Los resultados que se presentan proceden de una encuesta a 1.280 revistas científicas españolas incluidas en la base de datos Dulcinea (edición 2012), obteniendo una tasa de respuesta del 43,8% (n=561). Como objetivos específicos, el estudio se planteó caracterizar las revistas científicas y analizar las peculiaridades de las mismas en torno a una serie de parámetros que conforman las dimensiones económico-financiera, estratégica y operativa de las revistas en el periodo observado. El análisis ha permitido observar cómo el modelo de financiación de las revistas científicas españolas se sostiene principalmente de las ayudas institucionales, cómo la mayoría de las revistas carece de una estructura organizativa estable y depende, en gran medida, del trabajo voluntario y cómo el debate sobre las limitaciones y dificultades que afectan al desarrollo del acceso abierto sigue vigente.Abstract: The main objective of this article is to present a broad description of Spanish scientific journals. The results were obtained from a survey distributed to 1,280 editors of Spanish scientific journals included in Dulcinea database (2012 edition). The response rate was 43,8%. As specific objectives, the study aimed to characterize scientific journals and to analyze the particularities of a set of parameters that make up the economic, strategic and operational dimensions of the journals in the period studied. The results show that the funding model of the Spanish scientific journals depends mainly on institutional support, that many journals lack a stable organizational structure and rely heavily on volunteer work, and that the debate on the limitations and difficulties affecting the development of open access remains open