Validation of a computer-adaptive test to evaluate generic health-related quality of life

<p>Abstract</p> <p>Background</p> <p>Health Related Quality of Life (HRQoL) is a relevant variable in the evaluation of health outcomes. Questionnaires based on Classical Test Theory typically require a large number of items to evaluate HRQoL. Computer Adaptive Testing (CAT) can be used to reduce tests length while maintaining and, in some cases, improving accuracy. This study aimed at validating a CAT based on Item Response Theory (IRT) for evaluation of generic HRQoL: the CAT-Health instrument.</p> <p>Methods</p> <p>Cross-sectional study of subjects aged over 18 attending Primary Care Centres for any reason. CAT-Health was administered along with the SF-12 Health Survey. Age, gender and a checklist of chronic conditions were also collected. CAT-Health was evaluated considering: 1) feasibility: completion time and test length; 2) content range coverage, Item Exposure Rate (IER) and test precision; and 3) construct validity: differences in the CAT-Health scores according to clinical variables and correlations between both questionnaires.</p> <p>Results</p> <p>396 subjects answered CAT-Health and SF-12, 67.2% females, mean age (SD) 48.6 (17.7) years. 36.9% did not report any chronic condition. Median completion time for CAT-Health was 81 seconds (IQ range = 59-118) and it increased with age (p < 0.001). The median number of items administered was 8 (IQ range = 6-10). Neither ceiling nor floor effects were found for the score. None of the items in the pool had an IER of 100% and it was over 5% for 27.1% of the items. Test Information Function (TIF) peaked between levels -1 and 0 of HRQoL. Statistically significant differences were observed in the CAT-Health scores according to the number and type of conditions.</p> <p>Conclusions</p> <p>Although domain-specific CATs exist for various areas of HRQoL, CAT-Health is one of the first IRT-based CATs designed to evaluate generic HRQoL and it has proven feasible, valid and efficient, when administered to a broad sample of individuals attending primary care settings.</p

Multiplexed neural sensor array of graphene solution-gated field-effect transistors

Altres ajuts: this work has made use of the Spanish ICTS Network MICRONANOFABS partially supported by MICINN and the ICTS 'NANBIOSIS', more specifically by the Micro-NanoTechnology Unit of the CIBER in Bioengineering, Biomaterials and Nanomedicine (CIBERBBN) at the IMB-CNM.Electrocorticography (ECoG) is a well-established technique to monitor electrophysiological activity from the surface of the brain and has proved crucial for the current generation of neural prostheses and brain-computer interfaces. However, existing ECoG technologies still fail to provide the resolution necessary to accurately map highly localized activity across large brain areas, due to the rapidly increasing size of connector footprint with sensor count. This work demonstrates the use of a flexible array of graphene solution-gated field-effect transistors (gSGFET), exploring the concept of multiplexed readout using an external switching matrix. This approach does not only allow for an increased sensor count, but due to the use of active sensing devices (i.e. transistors) over microelectrodes it makes additional buffer transistors redundant, which drastically eases the complexity of device fabrication on flexible substrates. The presented results pave the way for upscaling the gSGFET technology towards large-scale, high-density μECoG-arrays, eventually capable of resolving neural activity down to a single neuron level, while simultaneously mapping large brain regions

Distortion-free sensing of neural activity using graphene transistors

Graphene solution-gated field-effect transistors (g-SGFETs) are promising sensing devices to transduce electrochemical potential signals in an electrolyte bath. However, distortion mechanisms in g-SGFET, which can affect signals of large amplitude or high frequency, have not been evaluated. Here, a detailed characterization and modeling of the harmonic distortion and non-ideal frequency response in g-SGFETs is presented. This accurate description of the input-output relation of the g-SGFETs allows to define the voltage- and frequency-dependent transfer functions, which can be used to correct distortions in the transduced signals. The effect of signal distortion and its subsequent calibration are shown for different types of electrophysiological signals, spanning from large amplitude and low frequency cortical spreading depression events to low amplitude and high frequency action potentials. The thorough description of the distortion mechanisms presented in this article demonstrates that g-SGFETs can be used as distortion-free signal transducers not only for neural sensing, but also for a broader range of applications in which g-SGFET sensors are used

Aplicación de la metodología “Case-Based Collaborative Learning (CBCL)” en la enseñanza de Nefrología

La metodología de aprendizaje centrada en el alumno facilita el aprendizaje de la Medicina. Recientemente se ha validado en Medicina la denominada: Case-Based Collaborative Learning. El proceso de aprendizaje implica en un 1º tiempo, un trabajo individual del alumno (en casa y antes de ir al aula), con revisión de un material bien preparado y un test de autoevaluación sobre lo aprendido, y en un 2º tiempo, en el aula (con 6 grupos de 5 alumnos), una discusión de un caso clínico, primero en cada grupo aplicando el conocimiento adquirido en el trabajo individual previo, y luego entre grupos, para finalizar, con un cierre conclusivo del profesor. El contenido fue sobre glomerulonefritis que cursan con síndrome nefrótico. La práctica tuvo lugar tantas veces hasta que lo hicieran los 180 alumnos de 5º de Medicina. Los resultados fueron satisfactorios en el aprendizaje tanto en términos objetivos (mediante respuestas a preguntas MIR) como subjetivos, valorando el grado de satisfacción del alumn

Emery-Dreifuss muscular dystrophy Type 1 is associated with a high risk of malignant ventricular arrhythmias and end-stage heart failure

BACKGROUND AND AIMS: Emery-Dreifuss muscular dystrophy (EDMD) is caused by variants in EMD (EDMD1) and LMNA (EDMD2). Cardiac conduction defects and atrial arrhythmia are common to both, but LMNA variants also cause end-stage heart failure (ESHF) and malignant ventricular arrhythmia (MVA). This study aimed to better characterise the cardiac complications of EMD variants. METHODS: Consecutively referred EMD variant-carriers were retrospectively recruited from 12 international cardiomyopathy units. MVA and ESHF incidence in male and female variant-carriers was determined. Male EMD variant-carriers with a cardiac phenotype at baseline (EMDCARDIAC) were compared to consecutively recruited male LMNA variant-carriers with a cardiac phenotype at baseline (LMNACARDIAC). RESULTS: Longitudinal follow-up data were available for 38 male and 21 female EMD variant-carriers (mean [SD] ages 33.4 [13.3] and 43.3 [16.8] years, respectively). Nine (23.6%) males developed MVA and five (13.2%) developed ESHF during a median [IQR] follow-up of 65.0 [24.3, 109.5] months. No female EMD variant-carrier had MVA or ESHF, but nine (42.8%) developed a cardiac phenotype at a median [IQR] age of 58.6 [53.2, 60.4] years. Incidence rates for MVA were similar for EMDCARDIAC and LMNACARDIAC (4.8 and 6.6 per 100 person-years, respectively; log-rank p = 0.49). Incidence rates for ESHF were 2.4 and 5.9 per 100 person-years for EMDCARDIAC and LMNACARDIAC, respectively (log-rank p = 0.09). CONCLUSIONS: Male EMD variant-carriers have a risk of progressive heart failure and ventricular arrhythmias similar to that of male LMNA variant-carriers. Early implantable cardioverter defibrillator implantation and heart failure drug therapy should be considered in male EMD variant-carriers with cardiac disease