Oral Anticoagulation and Risk of Symptomatic Hemorrhagic Transformation in Stroke Patients Treated With Mechanical Thrombectomy: Data From the Nordictus Registry

Introduction: We aimed to evaluate if prior oral anticoagulation (OAC) and its type determines a greater risk of symptomatic hemorrhagic transformation in patients with acute ischemic stroke (AIS) subjected to mechanical thrombectomy. Materials and Methods: Consecutive patients with AIS included in the prospective reperfusion registry NORDICTUS, a network of tertiary stroke centers in Northern Spain, from January 2017 to December 2019 were included. Prior use of oral anticoagulants, baseline variables, and international normalized ratio (INR) on admission were recorded. Symptomatic intracranial hemorrhage (sICH) was the primary outcome measure. Secondary outcome was the relation between INR and sICH, and we evaluated mortality and functional outcome at 3 months by modified Rankin scale. We compared patients with and without previous OAC and also considered the type of oral anticoagulants. Results: About 1.455 AIS patients were included, of whom 274 (19%) were on OAC, 193 (70%) on vitamin K antagonists (VKA), and 81 (30%) on direct oral anticoagulants (DOACs). Anticoagulated patients were older and had more comorbidities. Eighty-one (5.6%) developed sICH, which was more frequent in the VKA group, but not in DOAC group. OAC with VKA emerged as a predictor of sICH in a multivariate regression model (OR, 1.89 [95% CI, 1.01–3.51], p = 0.04) and was not related to INR level on admission. Prior VKA use was not associated with worse outcome in the multivariate regression model nor with mortality at 3 months. Conclusions: OAC with VKA, but not with DOACs, was an independent predictor of sICH after mechanical thrombectomy. This excess risk was associated neither with INR value by the time thrombectomy was performed, nor with a worse functional outcome or mortality at 3 months

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

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

Social knowledge employee: Notion from the theory of intellectual capital [Colaborador social del conocimiento: Noción desde la teoría del capital intelectual]

The following article aims to conceptualize the social collaborator of knowledge from the notion of intellectual capital. In this sense, several knowledge management models for companies are reviewed and the concept of knowledge worker is defined. Then, the current status of the discussion about the creation and management of knowledge is examined. Finally, the social collaborator of knowledge is conceptualized as a person who, besides comprising the human capital, is integrated into the relational and structural capital through the social relations and the exchange represented by networks

Interfaz cerebro computador basada en P300 para la comunicación alternativa: estudio de caso en dos adolescentes en situación de discapacidad motora [P300 based Brain Computer Interface for alternative communication: a case study with two teenagers with motor disabilities]

Contains fulltext : 129968.pdf (publisher's version ) (Open Access)Brain computer interface systems use brain signals to enable the control of external devices, such as: wheelchairs, communicators, neuro-prosthesis, among others; in people with severe motor disabilities. In this study two young men with motor disabilities were trained to learn how to control a brain computer interface (BCI) using the P300 evoked potential recorded by electroencephalography (EEG). This interface enables the verbal communication through a stimulation matrix (4x3 rows and columns) that contains the picture of current football players and a sound related to each one which reproduced the name of them. Initially, we did the preparation stage that allowed the users to learn how to control the BCI. After this, the real probes were performed in two stages: the training tests and the online tests, where the participant could select the icons that he wanted through his brain signals. The average percentages of success for each participant were: 95% and 85%, respectively. The average time for an icon selection was 36 seconds (i.e.1.67 letters/minute).11 p

Evaluation of personal and social skills (effective personality) in Chilean university teacher training students

La versión del instrumento “Personalidad Eficaz” utilizada en este estudio evalúa la Personalidad Eficaz en contextos de estudiantes universitarios chilenos, publicado por Dapelo y Martín del Buey (2006) “Estudiante Eficaz en el contexto de formación de profesores. Adaptación del Cuestionario de Personalidad Eficaz al ámbito universitario”. El instrumento consta de 30 reactivos y su finalidad es evaluar las competencias personales y sociales constituyentes del constructo Personalidad Eficaz. En esta comunicación se ha procedido a una revisión de sus características psicométricas en ámbito universitario chileno. Para ello se contó con una muestra de 306 estudiantes de las carreras de formación del profesorado y se obtuvo una fiabilidad alfa de Croncach de 0,897. El Análisis Factorial Exploratorio arrojó cinco factores que explican el 57,04% de la varianza. La estructura de estos factores se distribuye de manera similar a la original, con la salvedad de que la esfera de Relaciones del yo se dividió en autorrealización social positiva y negativa. Por otra parte, el Análisis Factorial Confirmatorio indicó un mejor ajuste de la estructura original de cuatro factores. Estos factores confirman nuevamente la validez del constructo de personalidad eficaz centrada en Fortalezas del yo (Autoconcepto y autoestima), Demandas del yo (motivación expectativas y atribución) Retos del yo (afrontamiento y toma de decisiones) y Relaciones del yo (empatía, asertividad y comunicación). Este instrumento hace posible el análisis de las relaciones de los sistemas ambientales universitarios con el desarrollo de las competencias personales y sociales objetivo de este simposio, realizado por primera vez en contextos universitarios chilenos.The version of the instrument “Effective Personality” used in this study evalues the Personality Effective in contexts of Chilean university students, published by Dapelo and Martín del Buey (2006) “Student Effective in the context of training teachers. Adaptation of Personality Questionnaire Effective at university”. The instrument has 30 items and its purpose is evaluate the personal and social skills constituents the effective personality construct. This communication has undertaken a review of its psychometric characteristics in Chilean universities. The sample of the study was 306 university students majoring in teacher training. It was obtained an alpha reliability of Croncach of 0,897. Exploratory Factor Analysis showed five factors explaining 57,04% of variance. The structure of these factors is distributed similary than the original, except that the dimension of Relations of self was divided into positive and negative social self-realization. Moreover, Confirmatory Factor Analysis indicated a better fit of the original structure of four factors. These factors reconfirm the validity of construct effective centered personality strengths of self (self-concept and self-esteem) Claims of self (expectations motivation and attribution) Challenges of self (coping and decision making) and Relations of self (empathy, assertiveness and communication). This instrument makes it possible to analyze the relationship of university environmental systems with the development of personal and social skills objective of this symposium and performed for the first time in Chilean university contexts

Questionnaire for the evaluation of university environmental system

Se presenta el instrumento “Sistemas Ambientales del Profesor en Formación” (SAPF) adaptado para su aplicación específica en el campo de la formación docente. Se describe el proceso desarrollado para su adaptación y las características psicométricas obtenidas (Fiabilidad, Validez y normalización). Recoge información sobre distintos aspectos del sistema ambiental universitario percibido por estudiantes de profesores en formación de la Universidad de Playa Ancha. El instrumento se nutre de dos cuestionarios: “Ambiente Organizacional” (Góngora, 2010) y “Gestión de la Inclusión” (Orrego, 2012). Ambos determinan el ambiente organizacional desde una posición teórica fundamentada en la teoría Ecológica de Bronfenbrenner (1987), la Teoría de Catálisis Fractal (Davia, 2002 y 2006) y la Teoría Catalítica de la Personificación (Carpenter y Davia, 2005). La estructura del instrumento SAPF comprende cuatro partes: Parte I. Antecedentes personales y grupos de pertenencia, Parte II. Organización educativa Universidad de Playa Ancha (UPLA), Parte III. Formación de Profesores en Chile y Parte IV. Formación Profesional Universitaria General en Chile. En el presente estudio se presenta únicamente las características psicométricas de la parte II del Instrumento. La fiabilidad del instrumento SAPF es un Alfa de Cronbach de 0,972. El análisis confirmatorio de la estructura de ocho dimensiones presenta unos índices adecuados. Se han obtenidos baremos generales y por cada una de las dimensiones.This paper describes the unpublished “Environmental Systems Professor in Training” (SAPF) test, its psychometric characteristics (reliability, validity, standardization) and the process for obtaining them. The instrument “Environmental Systems Professor in Training” was adapted for specific application in the field of initial teacher training. This instrument collects information of environmental systems from the perception of teachers in training at the University of Playa Ancha. The adaptation of the instrument was based on previous instruments: Instrument “Organizational Environment” (Góngora, 2010) and the Instrument “Managing Inclusion” (Orrego, 2012). Both instruments determine the organizational environment from a theoretical position based on ecological theory of Bronfenbrenner (1987), Theory of Catalysis Fractal (Davia, 2002 and 2006) and Catalytic Theory of Personification (Carpenter and Davia, 2005). The structure of SAPF instrument comprises four parts: Part I. Personal history and membership group; Part II. Educational organization of Playa Ancha University (UPLA); Part III. Training of teachers in Chile; and Part IV. Professional univerversity general training in Chile. Regarding the psychometric characteristics, reliability SAPF instrument is a Cronbach’s alpha of 0.972. The total variance analysis indicates that four factors explain the variance 0.5214. The analysis determines for each dimension of the instrument unifactorial, or two or three factors structure. Based on this instrument environmental systems teacher training and the perception of “environmental organization UPLA System have been characterized. The differences in perception of teachers in intermediate training and end training on “Environmental System UPLA organization” are not significant

Questionnaire for the evaluation of university environmental system

Se presenta el instrumento “Sistemas Ambientales del Profesor en Formación” (SAPF) adaptado para su aplicación específica en el campo de la formación docente. Se describe el proceso desarrollado para su adaptación y las características psicométricas obtenidas (Fiabilidad, Validez y normalización). Recoge información sobre distintos aspectos del sistema ambiental universitario percibido por estudiantes de profesores en formación de la Universidad de Playa Ancha. El instrumento se nutre de dos cuestionarios: “Ambiente Organizacional” (Góngora, 2010) y “Gestión de la Inclusión” (Orrego, 2012). Ambos determinan el ambiente organizacional desde una posición teórica fundamentada en la teoría Ecológica de Bronfenbrenner (1987), la Teoría de Catálisis Fractal (Davia, 2002 y 2006) y la Teoría Catalítica de la Personificación (Carpenter y Davia, 2005). La estructura del instrumento SAPF comprende cuatro partes: Parte I. Antecedentes personales y grupos de pertenencia, Parte II. Organización educativa Universidad de Playa Ancha (UPLA), Parte III. Formación de Profesores en Chile y Parte IV. Formación Profesional Universitaria General en Chile. En el presente estudio se presenta únicamente las características psicométricas de la parte II del Instrumento. La fiabilidad del instrumento SAPF es un Alfa de Cronbach de 0,972. El análisis confirmatorio de la estructura de ocho dimensiones presenta unos índices adecuados. Se han obtenidos baremos generales y por cada una de las dimensiones.This paper describes the unpublished “Environmental Systems Professor in Training” (SAPF) test, its psychometric characteristics (reliability, validity, standardization) and the process for obtaining them. The instrument “Environmental Systems Professor in Training” was adapted for specific application in the field of initial teacher training. This instrument collects information of environmental systems from the perception of teachers in training at the University of Playa Ancha. The adaptation of the instrument was based on previous instruments: Instrument “Organizational Environment” (Góngora, 2010) and the Instrument “Managing Inclusion” (Orrego, 2012). Both instruments determine the organizational environment from a theoretical position based on ecological theory of Bronfenbrenner (1987), Theory of Catalysis Fractal (Davia, 2002 and 2006) and Catalytic Theory of Personification (Carpenter and Davia, 2005). The structure of SAPF instrument comprises four parts: Part I. Personal history and membership group; Part II. Educational organization of Playa Ancha University (UPLA); Part III. Training of teachers in Chile; and Part IV. Professional univerversity general training in Chile. Regarding the psychometric characteristics, reliability SAPF instrument is a Cronbach’s alpha of 0.972. The total variance analysis indicates that four factors explain the variance 0.5214. The analysis determines for each dimension of the instrument unifactorial, or two or three factors structure. Based on this instrument environmental systems teacher training and the perception of “environmental organization UPLA System have been characterized. The differences in perception of teachers in intermediate training and end training on “Environmental System UPLA organization” are not significant

Evaluation of the Feasibility, Safety and Efficacy of the Use of Intravenous Infusions of Adenosine Triphosphate (ATP) in People Affected by Moderate to Severe Alzheimer's Disease: A Double-Blind Masked Clinical Trial for Dose Finding

Background There are currently no drug therapies modifying the natural history of patients suffering Alzheimer's disease (AD). Most recent clinical trials in the field include only subjects in early stage of the disease, while patients with advanced AD are usually not represented. Objectives To evaluate the feasibility, safety and efficacy of systemic infusions of adenosine triphosphate (ATP) in patients with moderate to severe AD, and to select the minimum effective dose of infusion. Design A phase IIb, randomized, double-blind, placebo-controlled clinical trial investigates. Participants A total of 20 subjects with moderate or severe AD were included, 16 in the treatment group and 4 in the placebo group (4:1 randomization) at two dosage regimens, 6-hour or 24-hour infusions. Results The proof-of-concept study was successfully conducted, with no significant deviations from the study protocol and no serious adverse events reported. Regarding efficacy, only marginal differences were observed between ATP and placebo arms for H-MRS and MMSE variables. Conclusions Our study demonstrates that the use of ATP infusion as therapy is feasible and safe. Larger studies are however needed to assess the efficacy of ATP in moderate to severe AD