Programa transdiagnóstico de intervención en regulación emocional para pacientes con trastornos emocionales en atención primaria

73 p.En las últimas décadas, los estudios acerca de la regulación emocional se han incrementado debido a las novedosas investigaciones que han hallado su influencia en el desarrollo de trastornos emocionales en las sociedades del primer mundo. Al mismo tiempo, se ha empezado a incluir el concepto de intervención sobre los trastornos de una manera transdiagnóstica, es decir, analizando cuales son los procesos cognitivos, conductuales y emocionales comunes a este tipo de desórdenes emocionales. Basada en las revisiones actuales de tratamientos para la regulación emocional, nuestro principal objetivo es ofrecer un programa de intervención que unifique la terapia cognitivo-conductual con terapias de tercera generación, dirigida a pacientes con trastornos del estado del ánimo, trastornos ansiosos y adaptativos, y somatizaciones, en la edad adulta, que son atendidos en su centro de Atención Primaria. La intervención se plantea en formato grupal, tanto en vivo como de forma telemática. Diversas escalas y cuestionarios se usarán tanto para evaluar constructos como la atención emocional, aceptación, modulación y reconocimiento emocional, afecto, estrategias adaptativas y desadaptativas, factores de protección y resiliencia antes y después de la intervención para, así, poder evaluar la eficacia de la misma.In the last decade, the studies about emotional regulation have increased due to novel researches that have found its influence on the rapid develpment of emotional disorders in first world societies. At the same time, it started to include systematically the conception of the intervention of disordes in a transdiagnostic way, that is, to find the processes cognitive, behavioral and emotional strategies common to this type of emotional disorders. Based on a review of current treatments of emotional regulation, our main work is to offer an intervention program that unites Cognitive Behavioral Therapy (CBT) and third generation therapies, aimed at patients with mood disorders, anxious, adaptative disorders and somatized, of legal age, who attend their primary care center. It will be done under a group format, live and telematically. Several scales and questionnaires are used to have pre- and post- intervention measures to measure emotional attention, emotional acceptance and recognition, emotional labeling and modulation, adaptive and maladaptive strategies, protective factors and resilience.Máster Universitario en Psicología General Sanitaria (M169

Segmented software cost estimation models based on fuzzy clustering

Parametric software cost estimation models are based on mathematical relations, obtained from the study of historical software projects databases, that intend to be useful to estimate the effort and time required to develop a software product. Those databases often integrate data coming from projects of a heterogeneous nature. This entails that it is difficult to obtain a reasonably reliable single parametric model for the range of diverging project sizes and characteristics. A solution proposed elsewhere for that problem was the use of segmented models in which several models combined into a single one contribute to the estimates depending on the concrete characteristic of the inputs. However, a second problem arises with the use of segmented models, since the belonging of concrete projects to segments or clusters is subject to a degree of fuzziness, i.e. a given project can be considered to belong to several segments with different degrees. This paper reports the first exploration of a possible solution for both problems together, using a segmented model based on fuzzy clusters of the project space. The use of fuzzy clustering allows obtaining different mathematical models for each cluster and also allows the items of a project database to contribute to more than one cluster, while preserving constant time execution of the estimation process. The results of an evaluation of a concrete model using the ISBSG 8 project database are reported, yielding better figures of adjustment than its crisp counterpart.Ministerio de Ciencia y Tecnología TIN2004-06689-C0

On the use of numerical models to predict/mitigate indoor radon levels in highly contaminated areas

The publication of the EURATOM directive BSS 2013/59 [1] has increased considerably the interest on radon studies in all EU countries. Certainly each member state has to establish a national action plan addressing long-term risks from radon exposures in dwellings, buildings with public access and workplaces for any source of radon ingress, whether from soil, building materials or water. The complexity generated by the number of parameters and processes affecting radon generation in the source, transport in source media, entry into dwellings, and its accumulation in the different rooms of the dwelling, makes the development of numerical models a very challenging exercise that might take also into account that the detailed information of the building-soil interface in an existing dwelling is normally not available. A new project funded by the Spanish Nuclear Safety Board (CSN) started in 2020. Its main goal is to establish and validate a numerical tool to predict and mitigate indoor radon levels in new and existing buildings in general, but paying special attention to the case of areas contaminated due to NORM industrial activities. Such a numerical tool might be of interest for Radiation Protection authorities to manage highly contaminated areas. In particular, 2 different numerical modelling strategies will be adapted to real sites and compared. The RAGENA [2] code, which was developed in the late 90s, will be updated with the last findings from experimental studies. This code allows modelling all radon sources and processes affecting radon accumulation indoors from a dynamic point of view in a very simple way, but lacks from spatial resolution. On the other hand, a CFD (computational fluid dynamics) model recently developed in Spain [3] numerically solves radon transport equation by finite elements with a good spatial resolution. The project focuses also on the experimental characterization of real sites. In this talk we will introduce the project, discuss the main features of both modelling approaches and describe in more detail the current status of the RAGENA code updating

In Vitro Antifungal Activity of Ibrexafungerp (SCY-078) Against Contemporary Blood Isolates From Medically Relevant Species of Candida: A European Study

BackgroundIbrexafungerp (SCY-078) is the newest oral and intravenous antifungal drug with broad activity, currently undergoing clinical trials for invasive candidiasis. ObjectiveThe aim of this study was to assess the in vitro activity of ibrexafungerp and comparators against a collection of 434 European blood isolates of Candida. MethodsIbrexafungerp, caspofungin, fluconazole, and micafungin minimum inhibitory concentrations (MICs) were collected from 12 European laboratories for 434 blood isolates, including 163 Candida albicans, 108 Candida parapsilosis, 60 Candida glabrata, 40 Candida tropicalis, 29 Candida krusei, 20 Candida orthopsilosis, 6 Candida guilliermondii, 2 Candida famata, 2 Candida lusitaniae, and 1 isolate each of Candida bracarensis, Candida catenulata, Candida dubliniensis, and Candida kefyr. MICs were determined by the EUCAST broth microdilution method, and isolates were classified according to recommended clinical breakpoints and epidemiological cutoffs. Additionally, 22 Candida auris from different clinical specimens were evaluated. ResultsIbrexafungerp MICs ranged from 0.016 to >= 8 mg/L. The lowest ibrexafungerp MICs were observed for C. albicans (geometric MIC 0.062 mg/L, MIC range 0.016-0.5 mg/L) and the highest ibrexafungerp MICs were observed for C. tropicalis (geometric MIC 0.517 mg/L, MIC range 0.06->= 8 mg/L). Modal MICs/MIC(50)s (mg/L) against Candida spp. were 0.125/0.06 for C. albicans, 0.5/0.5 for C. parapsilosis, 0.25/0.25 for C. glabrata, 0.5/0.5 for C. tropicalis, 1/1 for C. krusei, 4/2 for C. orthopsilosis, and 0.5/0.5 for C. auris. Ibrexafungerp showed activity against fluconazole- and echinocandin-resistant isolates. If adopting wild-type upper limits, a non-wild-type phenotype for ibrexafungerp was only observed for 16/434 (3.7%) isolates: 11 (4.6%) C. parapsilosis, 4 (5%) C. glabrata, and 1 (2.5%) C. tropicalis. ConclusionIbrexafungerp showed a potent in vitro activity against Candida.This study received funding from SCYNEXIS. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of the article, or the decision to submit it for publication. CM-A is a recipient of a grant from Fundació n ONCE (Oportunidad al Talento). EE, AG, NJ, CM-A, and GQ have received grant support from Consejerı́a de Educación, Universidades e Investigación del Gobierno Vasco (GIC15 IT-990-16), Fondo de Investigación Sanitaria del Gobierno de España (FIS PI11/00203), and UPV/EHU (UFI 11/25). All authors declare no other competing interests

Task force IRSPM A&A SIG, CIGAR Network, EGPA PSG XII

The IPSAS CP asks the following questions in its REQUEST FOR COMMENTS. The responses prepared by the Task Force IRSPM A&A SIG, CIGAR Network and EGPA PSG XII are presented hereafter. The IRSPM A&A SIG, CIGAR Network and EGPA PSG XII are three research networks that focus on Public Sector Accounting. The Task Force is made up of 16 researchers from these networks. The responses being presented are based on an analysis of the Consultation Paper, the IPSASB Conceptual Framework, relevant IPSAS, and various published research papers on the subject. Following various meetings and discussions, the members of the Task Force have reached the following common conclusions and suggestions. The views expressed in this document represent those of the members of the Task Force and not of the whole research community represented by the networks, and neither of the Institutions/Universities with which they are affiliated

Performance of Screening Strategies for Latent Tuberculosis Infection in Patients with Inflammatory Bowel Disease: Results from the ENEIDA Registry of GETECCU

(1) Aims: Patients receiving antitumor necrosis factor (anti-TNF) therapy are at risk of developing tuberculosis (TB), usually due to the reactivation of a latent TB infection (LTBI). LTBI screening and treatment decreases the risk of TB. This study evaluated the diagnostic performance of different LTBI screening strategies in patients with inflammatory bowel disease (IBD). (2) Methods: Patients in the Spanish ENEIDA registry with IBD screened for LTBI between January 2003 and January 2018 were included. The diagnostic yield of different strategies (dual screening with tuberculin skin test [TST] and interferon-gamma-release assay [IGRA], two-step TST, and early screening performed at least 12 months before starting biological treatment) was analyzed. (3) Results: Out of 7594 screened patients, 1445 (19%; 95% CI 18-20%) had LTBI. Immunomodulator (IMM) treatment at screening decreased the probability of detecting LTBI (20% vs. 17%, p = 0.001). Regarding screening strategies, LTBI was more frequently diagnosed by dual screening than by a single screening strategy (IGRA, OR 0.60; 95% CI 0.50-0.73, p < 0.001; TST, OR 0.76; 95% CI 0.66-0.88, p < 0.001). Two-step TST increased the diagnostic yield of a single TST by 24%. More cases of LTBI were diagnosed by early screening than by routine screening before starting anti-TNF agents (21% [95% CI 20-22%] vs. 14% [95% CI 13-16%], p < 0.001). The highest diagnostic performance for LTBI (29%) was obtained by combining early and TST/IGRA dual screening strategies in patients without IMM. (4): Conclusions: Both early screening and TST/IGRA dual screening strategies significantly increased diagnostic performance for LTBI in patients with IBD, with optimal performance achieved when they are used together in the absence of IMM

Risk Factors for COVID-19 in Inflammatory Bowel Disease: A National, ENEIDA-Based Case–Control Study (COVID-19-EII)

(1) Scant information is available concerning the characteristics that may favour the acquisition of COVID-19 in patients with inflammatory bowel disease (IBD). Therefore, the aim of this study was to assess these differences between infected and noninfected patients with IBD. (2) This nationwide case-control study evaluated patients with inflammatory bowel disease with COVID-19 (cases) and without COVID-19 (controls) during the period March-July 2020 included in the ENEIDA of GETECCU. (3) A total of 496 cases and 964 controls from 73 Spanish centres were included. No differences were found in the basal characteristics between cases and controls. Cases had higher comorbidity Charlson scores (24% vs. 19%; p = 0.02) and occupational risk (28% vs. 10.5%; p < 0.0001) more frequently than did controls. Lockdown was the only protective measure against COVID-19 (50% vs. 70%; p < 0.0001). No differences were found in the use of systemic steroids, immunosuppressants or biologics between cases and controls. Cases were more often treated with 5-aminosalicylates (42% vs. 34%; p = 0.003). Having a moderate Charlson score (OR: 2.7; 95%CI: 1.3-5.9), occupational risk (OR: 2.9; 95%CI: 1.8-4.4) and the use of 5-aminosalicylates (OR: 1.7; 95%CI: 1.2-2.5) were factors for COVID-19. The strict lockdown was the only protective factor (OR: 0.1; 95%CI: 0.09-0.2). (4) Comorbidities and occupational exposure are the most relevant factors for COVID-19 in patients with IBD. The risk of COVID-19 seems not to be increased by immunosuppressants or biologics, with a potential effect of 5-aminosalicylates, which should be investigated further and interpreted with caution

Effectiveness and Safety of the Sequential Use of a Second and Third Anti-TNF Agent in Patients With Inflammatory Bowel Disease: Results From the Eneida Registry

Background: The effectiveness of the switch to another anti-tumor necrosis factor (anti-TNF) agent is not known. The aim of this study was to analyze the effectiveness and safety of treatment with a second and third anti-TNF drug after intolerance to or failure of a previous anti-TNF agent in inflammatory bowel disease (IBD) patients. Methods: We included patients diagnosed with IBD from the ENEIDA registry who received another anti-TNF after intolerance to or failure of a prior anti-TNF agent. Results: A total of 1122 patients were included. In the short term, remission was achieved in 55% of the patients with the second anti-TNF. The incidence of loss of response was 19% per patient-year with the second anti-TNF. Combination therapy (hazard ratio [HR], 2.4; 95% confidence interval [CI], 1.8-3; P < 0.0001) and ulcerative colitis vs Crohn's disease (HR, 1.6; 95% CI, 1.1-2.1; P = 0.005) were associated with a higher probability of loss of response. Fifteen percent of the patients had adverse events, and 10% had to discontinue the second anti-TNF. Of the 71 patients who received a third anti-TNF, 55% achieved remission. The incidence of loss of response was 22% per patient-year with a third anti-TNF. Adverse events occurred in 7 patients (11%), but only 1 stopped the drug. Conclusions: Approximately half of the patients who received a second anti-TNF achieved remission; nevertheless, a significant proportion of them subsequently lost response. Combination therapy and type of IBD were associated with loss of response. Remission was achieved in almost 50% of patients who received a third anti-TNF; nevertheless, a significant proportion of them subsequently lost response

Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain : Large-Scale Epidemiological Study

(1) Aims: To assess the incidence of inflammatory bowel disease (IBD) in Spain, to describe the main epidemiological and clinical characteristics at diagnosis and the evolution of the disease, and to explore the use of drug treatments. (2) Methods: Prospective, population-based nationwide registry. Adult patients diagnosed with IBD-Crohn's disease (CD), ulcerative colitis (UC) or IBD unclassified (IBD-U)-during 2017 in Spain were included and were followed-up for 1 year. (3) Results: We identified 3611 incident cases of IBD diagnosed during 2017 in 108 hospitals covering over 22 million inhabitants. The overall incidence (cases/100,000 person-years) was 16 for IBD, 7.5 for CD, 8 for UC, and 0.5 for IBD-U; 53% of patients were male and median age was 43 years (interquartile range = 31-56 years). During a median 12-month follow-up, 34% of patients were treated with systemic steroids, 25% with immunomodulators, 15% with biologics and 5.6% underwent surgery. The percentage of patients under these treatments was significantly higher in CD than UC and IBD-U. Use of systemic steroids and biologics was significantly higher in hospitals with high resources. In total, 28% of patients were hospitalized (35% CD and 22% UC patients, p < 0.01). (4) Conclusion: The incidence of IBD in Spain is rather high and similar to that reported in Northern Europe. IBD patients require substantial therapeutic resources, which are greater in CD and in hospitals with high resources, and much higher than previously reported. One third of patients are hospitalized in the first year after diagnosis and a relevant proportion undergo surgery

Correction : Chaparro et al. Incidence, Clinical Characteristics and Management of Inflammatory Bowel Disease in Spain: Large-Scale Epidemiological Study. J. Clin. Med. 2021, 10, 2885

The authors wish to make the following corrections to this paper [...]