Sistema de observação paraavaliação técnica em dança clássica:exercício battement jeté

Los bailarines y las bailarinas de danza clásica entrenan rigurosamente para alcanzar el mayor grado técnico y artístico de calidad en sus ejercicios. Entre los que conforman sus entrenamientos están los de barra, siendo los battement jetéen sus diferentes formas de ejecución, los encargados del movimiento de acción de los pies-piernas.El objetivo del estudio es crear y validar una herramienta de observación ad hocque permita evaluar el ejercicio del battement jeté; en su diseño se utilizó una combinación de formato de campo y sistemas de categorías exhaustivas y mutuamente excluyentes (E/ME).El instrumento se compone de 5 criterios y un total de 66 categorías distribuidas de la siguiente forma: 31 en tren inferior, 8 en tren superior, 13 para cabeza/mirada, 5 en dirección espacial y 9 para las cuentas musicales. La muestra del estudio estuvo conformada por 10 bailarines/as, ocho mujeres y dos hombres, todos con estudios profesionales en danza clásica finalizados. Se llevó a cabo un análisis de Calidad del Dato y un análisis de Generalizabilidad con los programas HOISAN y SAGT v1.0 respectivamente. La fiabilidad de los observadores se obtuvo mediante el cálculo de los coeficientes de correlación Pearson, Spearman y Tau b de Kendall; y mediante el índice de concordancia Kappa de Cohen y concordancia canónica de Krippendorf. Los resultados mostraron índices adecuados de correlación, así como excelentes resultados de la Generalizabilidad con un valor G relativo y G absoluto de 1.00 en el acuerdo interobservador y 1.00 para el acuerdo intraobservador, demostrando que la herramienta de observación para el ejercicio del battement jetéen la danza clásica presenta una adecuada precisión, fiabilidad y validez. Se hace un análisis de invarianza y no se evidencian diferencias significativas en los resultados por razón de sexo en el uso de la herramienta de observación.Classical dancers train rigorously to achieve the highest technical and artistic quality in their exercises. Among those that make up his training are those of the barre, being the battement jeté in their different forms of execution, those in charge of the action movement of the feet-legs.The objective of the study is to create and validate an ad hoc observation tool that allows an evaluation of the exercise of the battement jeté; A combination of field format and exhaustive and mutually exclusive (E/ME) category systems was used in its design. The instrument is made up of 5 criteria and a total of 66 categories distributed as follows: 31 in the lower body, 8 in the upper body, 13 for head/gaze, 5 in spatial direction, and 9 for musical accounts. The studysample consisted of 10 dancers, eight women, and two men, all with completed professional studies in classical dance. A Data Quality analysis and a Generalizability analysis were carried out with the HOISAN and SAGT v1.0 programs respectively. Observer reliability was obtained by calculating the Pearson, Spearman, and Kendall's Tau b correlation coefficients; and using Cohen's Kappa concordance index and Krippendorf's canonical concordance. The results showed adequate correlation indices, as well as excellent Generalizability results with a relative G value and absolute G value of 1.00 for inter-observer agreement and 1.00 for intra-observer agreement, demonstrating that the observation tool for the battement jeté exercise in the Classical dance presents anadequate precision, reliability, and validity. An invariance analysis is made and no significant differences are found in the results due to the question of male or female gender in using the observation tool.Os bailarinos clássicos treinam rigorosamente para atingir o mais alto grau de qualidadetécnica e artística em seus exercícios. Entre os exercícios que compõem o seu treino estão os exercícios da barra, sendo o battement jeté nas suas diferentes formas de execução, os responsáveis pelo movimento de ação dos pés-pernas. O objetivo do estudoé criar e validar uma ferramenta de observação ad hoc que permita avaliar o exercício do battement jeté. Uma combinação de formato de campo e sistemas de categoria exaustiva e mutuamente exclusiva (E/ME) foram usadas no seu design. O instrumento é composto por 5 critérios e um total de 66 categoriasdistribuídas da seguinte forma: 31 na parte inferior do corpo, 8 na parte superior do corpo, 13 para cabeça/olhar, 5 para direção espacial e 9 para contas musicais. A amostra do estudo foi composta por 10 bailarinos, sendo oito mulheres e dois homens, todos com formação profissional em dança clássica concluída. Uma análise de qualidade de dados e uma análise de generalização foram realizadas com os programas HOISAN e SAGT v1.0, respectivamente. A confiabilidadedo observador foi obtida calculando-se os coeficientes de correlação Tau b de Pearson, Spearman e Kendall e o índice de concordância Kappa de Cohen, bem como a concordância canônica de Krippendorf. Os resultados mostraram índices de correlação adequados, bem como excelentes resultados de generalização com valor de G relativo e valor de G absoluto de 1,00 para concordância interobservador e 1,00 para concordância intraobservador, demonstrando que a ferramenta de observação para o exercício battement jeté nadança clássica apresenta precisão, confiabilidade e validade adequadas. Foi ainda realiazada uma análise de invariância e não foram encontradas diferenças significativas nos resultados em função do sexo no uso da ferramenta de observação

Sistema de observação para avaliação técnica em dança clássica: exercício battement jeté

Classical dancers train rigorously to achieve the highest technical and artistic quality in their exercises. Among those that make up his training are those of the barre, being the battement jeté in their different forms of execution, those in charge of the action movement of the feet-legs. The objective of the study is to create and validate an ad hoc observation tool that allows an evaluation of the exercise of the battement jeté; A combination of field format and exhaustive and mutually exclusive (E/ME) category systems was used in its design. The instrument is made up of 5 criteria and a total of 66 categories distributed as follows: 31 in the lower body, 8 in the upper body, 13 for head/gaze, 5 in spatial direction, and 9 for musical accounts. The study sample consisted of 10 dancers, eight women, and two men, all with completed professional studies in classical dance. A Data Quality analysis and a Generalizability analysis were carried out with the HOISAN and SAGT v1.0 programs respectively. Observer reliability was obtained by calculating the Pearson, Spearman, and Kendall's Tau b correlation coefficients; and using Cohen's Kappa concordance index and Krippendorf's canonical concordance. The results showed adequate correlation indices, as well as excellent Generalizability results with a relative G value and absolute G value of 1.00 for inter-observer agreement and 1.00 for intra-observer agreement, demonstrating that the observation tool for the battement jeté exercise in the Classical dance presents an adequate precision, reliability, and validity. An invariance analysis is made and no significant differences are found in the results due to the question of male or female gender in using the observation tool.Los bailarines y las bailarinas de danza clásica entrenan rigurosamente para alcanzar el mayor grado técnico y artístico de calidad en sus ejercicios. Entre los que conforman sus entrenamientos están los de barra, siendo los battement  jeté en sus diferentes formas de ejecución, los encargados del movimiento de acción de los pies-piernas. El objetivo del estudio es crear y validar una herramienta de observación ad hoc que permita evaluar el  ejercicio del battement jeté; en su diseño se utilizó una combinación de formato de campo y sistemas de categorías exhaustivas y mutuamente excluyentes (E/ME). El instrumento se compone de 5 criterios y un total de 66 categorías distribuidas de la siguiente forma: 31 en tren inferior, 8 en tren superior, 13 para cabeza/mirada, 5 en dirección espacial y 9 para las cuentas musicales. La muestra del estudio estuvo conformada por 10 bailarines/as, ocho mujeres y dos hombres, todos con estudios profesionales en danza clásica finalizados. Se llevó a cabo un análisis de Calidad del Dato y un análisis de Generalizabilidad con los programas HOISAN y SAGT v1.0 respectivamente. La fiabilidad de los observadores se obtuvo mediante el cálculo de los coeficientes de correlación Pearson, Spearman y Tau b de Kendall; y mediante el índice de concordancia Kappa de Cohen y concordancia canónica de Krippendorf. Los resultados mostraron índices adecuados de correlación, así como excelentes resultados de la Generalizabilidad con un valor G relativo y G absoluto de 1.00 en el acuerdo interobservador y 1.00 para el acuerdo intraobservador, demostrando que la herramienta de observación para el ejercicio del battement jeté en la danza clásica presenta una adecuada precisión, fiabilidad y validez. Se hace un análisis de invarianza y no se evidencian diferencias significativas en los resultados por razón de sexo en el uso de la herramienta de observación.Os bailarinos clássicos treinam rigorosamente para atingir o mais alto grau de qualidade técnica e artística em seus exercícios. Entre os exercícios que compõem o seu treino estão os exercícios da barra, sendo o battement jeté nas suas diferentes formas de execução, os responsáveis ​​pelo movimento de ação dos pés-pernas. O objetivo do estudo é criar e validar uma ferramenta de observação ad hoc que permita avaliar o exercício do battement jeté. Uma combinação de formato de campo e sistemas de categoria exaustiva e mutuamente exclusiva (E/ME) foram usadas no seu design. O instrumento é composto por 5 critérios e um total de 66 categorias  distribuídas da seguinte forma: 31 na parte inferior do corpo, 8 na parte superior do corpo, 13 para cabeça/olhar, 5 para direção espacial e 9 para contas musicais. A amostra do estudo foi composta por 10 bailarinos, sendo oito mulheres e dois homens, todos com formação profissional em dança clássica concluída. Uma análise de qualidade de dados e uma análise de generalização foram realizadas com os programas HOISAN e SAGT v1.0, respectivamente. A confiabilidade do observador foi obtida calculando-se os coeficientes de correlação Tau b de Pearson, Spearman e Kendall e o índice de concordância Kappa de Cohen, bem como a concordância canônica de Krippendorf. Os resultados mostraram índices de correlação adequados, bem como excelentes resultados de generalização com valor de G relativo e valor de G absoluto de 1,00 para concordância interobservador e 1,00 para concordância intraobservador, demonstrando que a ferramenta de observação para o exercício battement jeté na dança clássica apresenta precisão, confiabilidade e validade adequadas. Foi ainda realiazada uma análise de invariância e não foram encontradas diferenças significativas nos resultados em função do sexo no uso da ferramenta de observação

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

El mindfulness y el estrés en el corredor de ultra trail

The field of sport psychology is gaining ground, becoming more and more integrated in the world of sport in general and in the world of ultra trail running in particular. Although this sport is booming, little is known about the psychological characteristics of these athletes, who dare to challenge long distances in extremely hostile natural terrain and riddled with obstacles. These challenges can lead, under certain conditions, ultra trail runners to be immersed in stress processes that, if prolonged over time, can turn into distress and lead to more suffering than enjoyment for an activity that, in the beginning, was chosen to develop. In order to counteract stress in the ultra trail runner, there are several strategies. In this paper, far from pretending to exhaust the existing possibilities, but simply to outline various proposals, we will take the contributions of a systemic view, cognitive behavioral therapies, contextual therapies and neurosciences applied to sport, from an eclectic perspective, embodied in multiple intervention strategies with athletes. Among the tools to be built with the athlete, Mindfulness will be presented as a resource that nourishes and amplifies psychology in general and sport psychology in particular, being considered a key for the specific practice of the athlete, as well as for his daily life.El campo de la psicología del deporte se encuentra ganando terreno, integrándose cada vez más en el mundo del deporte en general y en el mundo del ultra trail running en particular. Más allá de que esta modalidad deportiva está en pleno auge, poco se conoce acerca de las características psicológicas que poseen estos atletas, quienes se atreven a desafiar grandes distancias en terrenos naturales sumamente hostiles y plagados de obstáculos. Estos desafíos pueden conllevar a que, en determinadas condiciones, los corredores de ultra trail se encuentren inmersos en procesos de estrés que, en caso de prolongarse en el tiempo, se conviertan en distrés y conlleven más sufrimiento que disfrute por una actividad que, de inicio, se eligió desarrollar. Para contrarrestar el distrés en el corredor de ultra trail, existen diversas estrategias. En este escrito, lejos de pretender agotar las posibilidades existentes, simplemente se esbozan diversas propuestas, tomando los aportes de una mirada sistémica, las terapias cognitivo conductuales, las terapias contextuales y las neurociencias aplicadas al deporte, desde una perspectiva ecléctica, plasmada en múltiples estrategias de intervención con los atletas. Dentro de las herramientas a construir con el deportista, el mindfulness se presentará como un recurso que nutre y amplifica a la psicología en general y a la psicología del deporte en particular, considerándose una clave para la práctica específica del atleta, como para su vida cotidiana

Current state-of-the-art and gaps in platform trials: 10 things you should know, insights from EU-PEARL

Summary: Platform trials bring the promise of making clinical research more efficient and more patient centric. While their use has become more widespread, including their prominent role during the COVID-19 pandemic response, broader adoption of platform trials has been limited by the lack of experience and tools to navigate the critical upfront planning required to launch such collaborative studies. The European Union-Patient-cEntric clinicAl tRial pLatform (EU-PEARL) initiative has produced new methodologies to expand the use of platform trials with an overarching infrastructure and services embedded into Integrated Research Platforms (IRPs), in collaboration with patient representatives and through consultation with U.S. Food and Drug Administration and European Medicines Agency stakeholders. In this narrative review, we discuss the outlook for platform trials in Europe, including challenges related to infrastructure, design, adaptations, data sharing and regulation. Documents derived from the EU-PEARL project, alongside a literature search including PubMed and relevant grey literature (e.g., guidance from regulatory agencies and health technology agencies) were used as sources for a multi-stage collaborative process through which the 10 more important points based on lessons drawn from the EU-PEARL project were developed and summarised as guidance for the setup of platform trials. We conclude that early involvement of critical stakeholder such as regulatory agencies or patients are critical steps in the implementation and later acceptance of platform trials. Addressing these gaps will be critical for attaining the full potential of platform trials for patients. Funding: Innovative Medicines Initiative 2 Joint Undertaking with support from the European Union’s Horizon 2020 research and innovation programme and EFPIA

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

International audienceAbstract Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

: Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

International audienceSummaryBackground Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension.MethodsWe used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20–64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson’s correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI).FindingsThe correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m² (95% CI 2·31–3·28) lower for women and 1·28 kg/m² (1·02–1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone.InterpretationBMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions