Multivariate exploratory data analysis: bias assessment

El objetivo de la presente investigación fue evaluar si el sesgo cometido por los sujetos en una tarea de clasificación de estímulos varió en función del formato de presentación (soles o estrellas) y la forma de asignar las variables (aleatoria, ordenadas según su correlación en 360 grados o representadas en el espacio mediante un biplot: soles o estrellas factoriales). Se encontró que hubo una interacción significativa entre el formato de presentación y la forma de asignar las variables. En concreto, se obtuvo que los sujetos cometieron menos errores cuando clasificaron los soles factoriales que las estrellas factoriales. Asimismo, también clasificaron mejor los soles ordenados que las estrellas ordenadas. Tampoco hubo diferencias significativas entre soles y estrellas cuando no se incluyó ningún tipo de información acerca de las correlaciones (asignación aleatoria), ni entre los soles factoriales y los soles ordenados. Por último, también se obtuvo que los sujetos tardaron más tiempo en completar la tarea en la condición de asignación aleatoria que en la representación factorial.The objective of this investigation was to evaluate if the bias of the subjects varied during a stimulus classification task in relation to the presentation form at (suns and stars) and to the way the variables were assigned (randomly, ordered according to their correlation in 360º or using a biplot: factorial suns or stars). It was found that there was a significant interaction between the presentation format and the method of assigning variables. In particular, it was found that the subjects made fewer mistakes classifying the factorial suns than the factorial stars. Likewise , they also classified better the ordered suns than the ordered stars. There were no significant differences between the suns and stars when no information regarding the correlation was included (random order) nor between the ordered suns and factorial suns. Lastly, it was also found that the subjects took longer to complete a task with random assignment than one with the factorial representation.Ministerio de Educación y Ciencia PB93117

Visual inspection and type of graphs used

El objetivo de la investigación fue estudiar si la evaluación de la efectividad de un tratamiento mediante inspección visual dependía del tipo de representación gráfica. Se estudiaron 3 sujetos a los que se les presentó 3.000 gráficos (1.000 de líneas, 1.000 de barras y 1.000 de caja), representando cada uno de ellos los resultados de un diseño A-B. Los resultados indicaron que los sujetos cometieron mayor número de errores cuando los datos se presentaban mediante líneas o barras.The objective of this research was to see if the evaluation of the effectiveness of a given treatment through visual inspection depends on the type of graphs used. Three subjects were studied with 3000 graphs (1.000 line, 1.000 bar and 1.000 box-plots), each one representing the results of an A-B design. The results indicate that the subjects committed more errors when the data was presented by lines or bars instead of box-plots.Ministerio de Educación y Ciencia PB93-117

Música y movimiento a través de los bailes caribeños en Educación Infantil

Este trabajo trata sobre la música y movimiento en la educación infantil, la metodología que voy a utilizar está basada en Emile Jacques – Dalcroze pero planteando una enseñanza a través de los bailes caribeños, trabajando así la expresión corporal, la educación musical y la interculturalidad.Grado en Educación Infanti

Clinical prediction of opioid use disorder in chronic pain patients: a cohort-retrospective study with a pharmacogenetic approach

BACKGROUND: opioids are widely used in chronic non-cancer pain (cNcP) management. However, they remain controversial due to serious risk of causing opioid use disorder (oUD). our main aim was to develop a predictive model for future clinical translation that include pharmacogenetic markers. METHODS: an observational study was conducted in 806 pre-screened spanish cNcP patients, under long-term use of opioids, to compare cases (with oUD, N.=137) with controls (without oUD, N.=669). Mu-opioid receptor 1 (OPRM1, a118g, rs1799971) and catechol-O-methyltransferase (COMT, g472a, rs4680) genetic variants plus cytochrome P4502D6 (cYP2D6) liver enzyme phenotypes were analyzed. socio-demographic, clinical and pharmacological outcomes were also registered. a logistic regression model was performed. the model performance and diagnostic accuracy were calculated. RESULTS: OPRM1-AA genotype and cYP2D6 poor and ultrarapid metabolizers together with three other potential predictors: 1) age; 2) work disability; 3) oral morphine equivalent daily dose (MeDD), were selected with a satisfactory diagnostic accuracy (sensitivity: 0.82 and specificity: 0.85), goodness of fit (P=0.87) and discrimination (0.89). Cases were ten-year younger with lower incomes, more sleep disturbances, benzodiazepines use, and history of substance use disorder in front of controls. CONCLUSIONS: Functional polymorphisms related to OPRM1 variant and cYP2D6 phenotypes may predict a higher OUD risk. Established risk factors such as young age, elevated MEDD and lower incomes were identified. A predictive model is expected to be implemented in clinical setting among cNcP patients under long-term opioids use

Long-term deprescription in chronic pain and opioid use disorder patients: Pharmacogenetic and sex differences

1 Neuropharmacology applied to Pain (NED), Alicante Institute for Health and Biomedical Research (ISABIAL), c/ Pintor Baeza, 12, 03010, Alicante, Spain 2 Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202, Elche, Spain 3 Pain Unit, Dr. Balmis General University Hospital, ISABIAL, c/ Pintor Baeza, 12, 03010, Alicante, Spain 4 Operations Research Centre, Miguel Hernández University, Avda. de la Universidad s/n, 03202, Elche, Spain 5 Clinical Pharmacology Department, Dr. Balmis General University Hospital, ISABIAL c/ Pintor Baeza, 12, 03010 Alicante, Spain More than half of patients with opioid use disorder for chronic non-cancer pain (CNCP) reduced their dose through a progressive opioid withdrawal supported by a rotation to buprenorphine and/or tramadol. The aim of this research is to analyse the long-term effectiveness of opioid deprescription taking into account the impact of sex and pharmacogenetics on the inter-individual variability. A cross-sectional study was carried out from October 2019 to June 2020 on CNCP patients who had previously undergone an opioid deprescription (n = 119 patients). Demographic, clinical (pain, relief and adverse events) and therapeutic (analgesic use) outcomes were collected. Effectiveness (< 50 mg per day of morphine equivalent daily dose without any aberrant opioid use behaviour) and safety (number of side-effects) were analysed in relation to sex differences and pharmacogenetic markers impact [OPRM1 genotype (rs1799971) and CYP2D6 phenotypes]. Long-term opioid deprescription was achieved in 49 % of the patients with an increase in pain relief and a reduction of adverse events. CYP2D6 poor metabolizers showed the lowest long-term opioid doses. Here, women showed a higher degree of opioid deprescription, but increased use of tramadol and neuromodulators, as well as an increased number of adverse events. Long-term deprescription was successful in half of the cases. Understanding sex and gender interaction plus a genetic impact could help to design more individualized strategies for opioid deprescription

Sex-Differences in Pain and Opioid Use Disorder Management: A Cross-Sectional Real-World Study

Background: It is essential to focus attention on sex-specific factors which are clinically relevant in pain management, especially with regards to opioid use disorder (OUD) risk. The aim of this study was to explore potential sex-differences in chronic non-cancer pain (CNCP) outpatients. (2) Methods: An observational cross-sectional study was conducted under CNCP outpatients with long-term prescribed opioids (n = 806), wherein 137 patients had an OUD diagnosis (cases, 64% females) and 669 did not (controls, 66% females). Socio-demographic, clinical, and pharmacological outcomes were analyzed. (3) Results: Female controls presented an older age and less intensive pain therapy but higher psychotropic prescriptions and emergency department visits compared to male controls. Meanwhile, cases demonstrated a younger age, higher work disability, double morphine equivalent daily dose, and benzodiazepine use compared with controls. Here, female cases showed an 8% greater substance use disorder (OR 2.04 [1.11-3.76]) and 24% lower tramadol use, while male cases presented a 22% higher fentanyl use (OR 2.97 [1.52-5.81]) and reported the highest number of adverse drug reactions (24%, OR 2.40 [1.12-5.16]) compared with controls. (4) Conclusions: An OUD individual risk profile was evidenced with sex-differences to take into consideration to design equal prevention programs

Sex Bias and Genotype Influence on Opioid Safety Profile in Chronic Low Back Pain

Objectives: The use of opioids to relieve pain is a challenge because of the high variability in dose requirements and tolerance profiles. Among potential modulators are the individual’s genetic background and being female. Our aim was to evaluate sex bias and genotype-related influence on opioid titration safety, in chronic low back pain (CLBP), the most frequent chronic noncancer pain. Methods: A 3-year prospective study was developed in opioid-naive CLBP patients. Data were self-reported by patients (pain [Visual Analogy Scale], adverse events [AEs], and health care resource utilization) and physicians (analgesic prescription, morphine equivalent daily dose, and suspected adverse drug reactions [ADRs]). Outcomes were analyzed as patients with AEs (case) or without (control) together with patients’ sex and genotype. Gene variants in OPRM1 (rs1799971), COMT (rs4680), ABCB1 (rs1045642), UGT2B7 (rs12233719 and rs7438135), KCNJ6 (rs2070995 and rs6517442), and CYP3A5*3 (rs776746) were assessed. The hospital ethics committee approved the study, and statistical analyses were performed with R, v.3.2.4. Results: A total of 179 patients were included (64% female, mean pain intensity 73±16mm), and 90% of them presented at least 1 AE (median of 3 (1 to 6) AEs/patient) with a rate of 5 AEs: 1 ADR without differences due to sex. However, there is a significant delay in referral of female patients (a mean of 6 years) to the Pain Unit, being significantly 3 to 5 times more likely to present sleep or psychiatric disorders. Meanwhile male individuals showed more sexual and reproductive system disorders. Genotypes influenced skin (COMT, G472A-GG) and gastrointestinal (ABCB1, C3435T-CC) related problems. Conclusions: Sex bias affects female patients resulting in a CLBP diagnostic delay and a different analgesic safety profile. Moreover, the individual’s genetic background might be useful to predict certain AEs in opioid-naive patients under an opioid titration procedure. Addressing sex in necessary to resolve inequalities in health care access

Stomatal control and hydraulic conductivity in 'Manzanilla' olive trees under different water regimes

Ministry of Education and Science (España) No.AGL2006-04666/AGREU, research project ref. STREP 02312

A new indicator approach to reconstruct agricultural land use in Europe from sedimentary pollen assemblages

The reconstruction of human impact is pivotal in palaeoecological studies, as humans are among the most important drivers of Holocene vegetation and ecosystem change. Nevertheless, separating the anthropogenic footprint on vegetation dynamics from the impact of climate and other environmental factors (disturbances such as fire, erosion, floods, landslides, avalanches, volcanic eruptions) is a challenging and still largely open issue. For this purpose, palynologists mostly rely on cultural indicator pollen types and related indices that consist of sums or ratios of these pollen types. However, the high environmental and biogeographical specificity of cultural indicator plants hinders the application of the currently available indices to wide geographical settings. Furthermore, the achievable taxonomic resolution of cultural indicator pollen types may hamper their indicative capacity. In this study, we propose the agricultural land use probability (LUP) index, a novel approach to quantify human impact intensity on European ecosystems based on cultural indicator pollen types. From the ‘classic’ cultural indicators, we construct the LUP index by selecting those with the best indicator capacity based on bioindication criteria. We first train the LUP index using twenty palynological sequences along a broad environmental gradient, spanning from treeless alpine to subtropical mediterranean evergreen plant communities. We then validate the LUP index using independent pollen datasets and archaeological proxies. Finally, we discuss the suitability of the selected pollen types and the potential of the LUP index for quantifying Holocene human impact in Europe, concluding that careful application of the LUP index may significantly contribute to refining pollen-based land-use reconstructions