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A recent experimental literature shows that truth-telling is not always motivated by pecuniary motives, and several alternative motivations have been proposed. However, their relative importance in any given context is still not totally clear. This paper investigates the relevance of pure lie aversion, that is, a dislike for lies independent of their consequences. We propose a very simple design where other motives considered in the literature predict zero truth-telling, whereas pure lie aversion predicts a non-zero rate. Thus we interpret the finding that more than a third of the subjects tell the truth as evidence for pure lie aversion. Our design also prevents confounds with another motivation (a desire to act as others expect us to act) not frequently considered but consistent with much existing evidence. We also observe that subjects who tell the truth are more likely to believe that others will tell the truth as well.
Burkitt lymphoma (BL) is a rare and highly aggressive subtype of non-Hodgkin’s lymphoma. Several studies have identified prognostic factors (PFs) for disease progression and mortality among adults with BL. However, there is no consensus on risk stratification based on PFs. This study aims to identify, critically assess, and synthesize the available evidence on PFs for survival in adults with BL.
Methods
A systematic review of the literature was conducted. MEDLINE, Embase, and CENTRAL were searched from inception to 22 February 2022. Randomized or non-randomized clinical trials and longitudinal observational studies were eligible for inclusion. Reference screening, data extraction, and risk-of-bias assessment using the Quality in Prognosis Studies (QUIPS) tool for prognostic factor studies were conducted independently and in duplicate. Publication bias was examined by visual inspection of funnel plots. Effect measures and the corresponding 95% confidence intervals were pooled with an indirect variance estimation in meta-analyses using Review Manager 5, and sensitivity analyses were conducted. Certainty of evidence was assessed using GRADE.
Results
The search identified 1,119 references after duplicate removal. Of these, 76 potentially relevant papers were selected for full-text assessment and 36 studies (N=10,882) reported in 39 articles were eligible for inclusion. Older age, higher performance status, and central nervous system involvement were associated with poorer overall survival (OS) and progression-free survival (PFS). Black patients exhibited significantly lower OS and relative survival. Bone marrow involvement and higher albumin levels were associated with poorer OS. Treatment with rituximab and treatment with methotrexate were associated with better OS and PFS. No significant differences in survival were found for HIV status, sex, and risk stratification.
Conclusions
This study, framed within a collaboration with European Reference Network EuroBloodNet, provides a comprehensive and methodologically rigorous evidence review on PFs in adults with BL. Several significant associations of PFs and survival estimates were observed, providing data to inform treatment decisions and to improve patient care.
Electroanatomic mapping (EAM) has been shown to be an alternative procedure to fluoroscopy for the implantation of conduction system pacing (His-bundle pacing [HBP] and left bundle branch pacing [LBBP]) in patients with severe bradyarrhythmias, mainly those vulnerable to ionizing radiation. However, the evidence of its beneficial and harmful effects has not been assessed in a systematic review (SR).
Methods
An SR of the available scientific literature was conducted on the safety, effectiveness, and cost-effectiveness of implantation of the HBP and LBBP using EAM system versus fluoroscopy in patients with bradycardia with an indication for pacing therapy. Cochrane methodology and PRISMA statement for reporting were followed. A partial economic evaluation was carried out to compare the costs of both pacemaker implantation strategies from the perspective of the Spanish National Health System. A budget impact analysis was also conducted with a five-year horizon.
Results
Seven comparative observational studies (N=259) analyzing the use of EAM versus fluoroscopy were selected. Statistically significant differences were observed in total fluoroscopy time: −9.87 minutes (95% confidence interval [CI]: −14.20, −5.53; p<0.01; I2=95%; k=7; n=231); His-lead fluoroscopic time: −8.08 minutes (95% CI: −10.36, −5.81; p<0.01; I2=0%; k=2; n=50); and His-lead radiation dose: −17.21 mGy (95% CI: −24.08, −10.34; p<0.01; k=1; n=20). No differences in total radiation dose, procedural success, immediate procedure-related complications, electrode revision, or device infection were found. The use of EAM represents an increase of EUR1,397.81 (USD1,513.88) per patient and a net budget impact of EUR1.63 million (USD1.77 million).
Conclusions
No differences between EAM and fluoroscopy in terms of procedure success and safety were found. Therefore, EAM is a valuable alternative for patients who should not be exposed to ionizing radiation. The inclusion of EAM systems, for the indication under study, in routine clinical practice would mean an increase in costs for the Spanish National Health System.
This study aims to outline Clostridioides difficile infection (CDI) trends and outcomes in Mexican healthcare facilities during the COVID-19 pandemic.
Design:
Observational study of case series.
Setting:
Sixteen public hospitals and private academic healthcare institutions across eight states in Mexico from January 2016 to December 2022.
Patients:
CDI patients.
Methods:
Demographic, clinical, and laboratory data of CDI patients were obtained from clinical records. Cases were classified as community or healthcare-associated infections, with incidence rates calculated as cases per 10,000 patient days. Risk factors for 30-day all-cause mortality were analyzed by multivariate logistic regression.
Results:
We identified 2,356 CDI cases: 2,118 (90%) were healthcare-associated, and 232 (10%) were community-associated. Common comorbidities included hypertension, diabetes, and cancer. Previous high use of proton-pump inhibitors, steroids, and antibiotics was observed. Recurrent infection occurred in 112 (5%) patients, and 30-day mortality in 371 (16%). Risk factors associated with death were a high Charlson score, prior use of steroids, concomitant use of antibiotics, leukopenia, leukocytosis, elevated serum creatine, hypoalbuminemia, septic shock or abdominal sepsis, and SARS-CoV-2 coinfection. The healthcare-associated CDI incidence remained stable at 4.78 cases per 10,000 patient days during the pre-and pandemic periods. However, the incidence was higher in public hospitals.
Conclusions:
Our study underscores the need for routine epidemiology surveillance and standardized CDI classification protocols in Mexican institutions. Though CDI rates in our country align with those in some European countries, disparities between public and private healthcare sectors emphasize the importance of targeted interventions.
This study aimed to determine the long-term mortality (one-year follow-up) associated with patients transferred by Emergency Medical Services (EMS), and to reveal the determinants (causes and risk factors).
Methods:
This was a multicenter, prospective, observational, controlled, ambulance-based study of adult patients transferred by ambulance to emergency departments (EDs) from October 2019 through July 2021 for any cause. A total of six Advanced Life Support (ALS) units, 38 Basic Life Support (BLS) units, and five hospitals from Spain were included. Physiological, biochemical, demographic, and reasons for transfer variables were collected. A longitudinal analysis was performed to determine the factors associated to long-term mortality (any cause).
Results:
The final cohort included 1,406 patients. The one-year mortality rate was 21.6% (n = 304). Mortality over the first two days reached 5.2% of all the patients; between Day 2 and Day 30, reached 5.3%; and between Day 31 and Day 365, reached 11.1%. Low Glasgow values, elevated lactate levels, elevated blood urea nitrogen (BUN) levels, low oxygen saturation, high respiratory rate, as well as being old and suffering from circulatory diseases and neurological diseases were risk factors for long-term mortality.
Conclusion:
The quick identification of patients at risk of long-term worsening could provide an opportunity to customize care through specific follow-up.
Frontline healthcare workers (FHCWs) exposed to COVID-19 patients are at an increased risk of developing psychological burden. This study aims to determine the prevalence of mental health symptoms and associated factors among Mexican FHCWs attending COVID-19 patients.
Methods:
FHCWs, including attending physicians, residents/fellows, and nurses providing care to COVID-19 patients at a private hospital in Monterrey, Mexico, were invited to answer an online survey between August 28, and November 30, 2020. Symptoms of depression, anxiety, post-traumatic stress, and insomnia were evaluated with the Patient Health Questionnaire (PHQ)-9, Generalized Anxiety Disorder (GAD)-7, Impact of Event Scale-Revised (IES-R), and Insomnia Severity Index (ISI). Multivariate analysis was performed to identify variables associated with each outcome.
Results:
131 FHCWs, 43.5% attending physicians, 19.8% residents/fellows, and 36.6% nurses were included. The overall prevalence of depression, anxiety, post-traumatic stress, and insomnia was 36%, 21%, 23%, and 24% respectively. Multivariate analysis revealed that residents/fellows and nurses reported more depression and insomnia than attending physicians. Although not significant, residents/fellows were more likely to experience all symptoms than nurses.
Conclusions:
Mexican FHCWs, especially nurses and residents/fellows, experienced a significant psychological burden while attending to COVID-19 patients. Tailored interventions providing support to FHCWs during future outbreaks are required.
The Catholic Church of Peru supported the use of oral contraceptives between 1967 and 1976, believing that doctrine was compatible with controlling one's fertility. Yet the church did not treat fertility control only as a means to limit births or as an individual prerogative. Rather, it framed distribution of the pill within an education plan to promote the duties of responsible parenting. Joseph Kerrins, a U.S. Catholic physician, began the program in a poor area of Lima. By the late 1970s, the program operated in nineteen parishes. The program thrived even after the 1968 encyclical De Humanae Vitae, thanks to the support of priests, Peruvian and U.S. government agencies, physicians, and users of the program's services. Catholic family planning has been a more pragmatic and creative enterprise than hitherto believed. This article explores these developments within the context of the cold war and the transformations of the Catholic Church in 1960s Latin America.
Health benefits among the members of state-level societies may vary depending on sex, social privilege, and whether the individual resides in an urban or rural setting. Human skeletal remains are prone to express individual life experiences and, ultimately, well-being. This research elaborates on these correlates by contextualizing the physiological stresses among Classic Maya hinterland populations in comparison to their urban peers. Comparisons are made using the frequencies and expression of enamel hypoplasia, caries, porotic hyperostosis, infectious osteomyelitis/subperiosteal reaction and osteoporosis in 842 adult skeletons of both sexes from 63 peripheral and centric, inland, lowland settlements. The results suggest problematic inland weaning diets and higher infectious load among rural populations. While comparisons between urban and rural lifeways show inconsistent load differences, our results indicate repeated distinctions between the sexes. We cautiously interpret this pattern as an indication of a physically demanding regime of rural life compared to a more sedentary routine among urban peers and gendered lifestyles in general. We conclude that apart from these distinctions (and potential sample biases), the health costs versus benefits impacted rural lifestyles in a complex and non-uniform fashion during the first millennium a.d., rejecting clear-cut hierarchical conceptualizations while inviting more nuanced causal explorations.
This article presents a review of the earliest Maya skeletal remains thus far found, including a list of 398 burials dating to the Early (1800–900 b.c.) and Middle Preclassic periods (900–300 b.c.) and adjacent regions. These sites are spread throughout the Maya region and the data allow basic descriptive syntheses about early mortuary behavior and aspects of health and diet. Poor preservation and differences in scoring and reporting severely limit the scope of interpretation possible at this point, but it is hoped that this review stimulates coordinated research into the biology of early groups.
Este artículo analiza las trayectorias de modernización estructural para la industria de ocho países latinoamericanos (Bolivia, Brasil, Colombia, Costa Rica, Ecuador, México, Perú, Uruguay) desde 1970 hasta la fecha. Desde una perspectiva teórica estructuralista que explora las interacciones dinámicas entre el cambio estructural y el escalamiento tecnológico, se construye un índice de modernización. Los hallazgos muestran que el establecimiento de modelos económicos neoliberales en Latinoamérica a partir de los años ochenta, significó un punto de ruptura en estas trayectorias. Mientras la racionalización de procesos productivos por parte de las empresas implicó un desplazamiento del empleo en dirección de usos de baja productividad relativa, el desarrollo de industrias intensivas en capital e insertas en dinámicas globales, no impulsó la modernización estructural debido a la naturaleza de las tareas efectuadas. Los ejercicios permiten esbozar una primera tipología en términos de las carencias más apremiantes de cada caso.
This paper presents a novel method for modeling a 3-degree of freedom open kinematic chain using quaternions algebra and neural network to solve the inverse kinematic problem. The structure of the network was composed of 3 hidden layers with 25 neurons per layer and 1 output layer. The network was trained using the Bayesian regularization backpropagation. The inverse kinematic problem was modeled as a system of six nonlinear equations and six unknowns. Finally, both models were tested using a straight path to compare the results between the Newton–Raphson method and the network training.
Acute stress disorder (ASD) refers to the symptoms associated with posttraumatic stress disorder (PTSD) within the first four weeks following the traumatic event. Recent theoretical models suggest that early detection of ASD provides an opportunity to implement early interventions to prevent the development of PTSD or ameliorate its symptomatology. The aim of the present study was the evaluation of the efficacy of an ASD treatment for earthquake victims, which would serve as an early intervention for PTSD. A single-case (n = 1) quasi-experimental design was used, with pre and post-assessments, as well as one, three and six-month follow-ups, with direct treatment replications. Fourteen participants completed the treatment and the follow-up measurements. The results obtained using a single-case analysis showed significant clinical improvement and clinically significant change when employing a clinical significance analysis and the reliable index of change. Statistical analyses of the dataset displayed statistically significant differences between the pre and post-assessments and the follow-up measures, as well as large effect sizes in all clinical measures. These results suggest that the treatment was an efficacious early intervention for PTSD during the months following the traumatic event, although some relevant study limitations are discussed in the text.
This study aimed at identifying linguistic factors that could contribute to understanding individual differences in executive control among bilinguals. Directionality and type of natural language switching, age of second language acquisition, and language proficiency were evaluated in a sample of 112 early bilingual adults. Participants performed several computerized tasks tapping into three dimensions of executive control: inhibition of interference, working memory updating, and shifting. Regression analyses showed that frequent switching to the second language was associated with more efficient executive processing, enhanced working memory updating processes, and better shifting ability. Moreover, higher frequency of unintended language switches was associated with lower interference control abilities. Frequency of language switching behavior was the principal predictor of executive control, beyond age of second language acquisition and language proficiency. Results suggest that frequent language switching is related to enhanced executive control, while the unintended switching of languages could be associated with low interference control.
Tibraca limbativentris (Hemiptera: Pentatomidae) is a major pest in Neotropical rice agroecosystems. In autumn–winter, this pest takes refuge in rice stubble and in native vegetation, which allows it to re-colonize the crop during the rice growing season. However, it is still unknown whether this vegetation is a pest sink or is actually a natural trap that contributes to pest population biocontrol. Here we present information on the insect's alternative host plants, a preliminary outline of the relationship between plant phylogeny and insect abundance, and the impact that winter natural enemies have in pest population. Also, we include a proposed methodology for pest density analysis in winter hosts. Our results show significant differences in the abundance/density that T. limbativentris reaches in the 12 host plant species present in our study areas, with a plant-use pattern significantly related to the phylogenetic clade of Poales. Stink bug winter populations mainly comprised diapause adults, and 40% of insect digestive tracts had content. Survival of T. limbativentris was 56.92% in winter hosts. About mortality, 10% was due to undetermined causes and 33.08% due to entomopathogenic fungi, showing a natural regulation of the pest population. Our results suggest that native vegetation impacts winter survival of T. limbativentris. Although these plants offer shelter, they offer a greater contribution to Integrated Pest Management: the natural regulation of winter pest populations through entomopathogenic attack. Further studies on T. limbativentris population dynamics and the preservation of native areas near rice fields will be required for the development of best control practices.
In cases of mass-casualty incidents (MCIs), triage represents a fundamental tool for the management of and assistance to the wounded, which helps discriminate not only the priority of attention, but also the priority of referral to the most suitable center.
Hypothesis/Problem:
The objective of this study was to evaluate the capacity of different prehospital triage systems based on physiological parameters (Shock Index [SI], Glasgow-Age-Pressure Score [GAP], Revised Trauma Score [RTS], and National Early Warning Score 2 [NEWS2]) to predict early mortality (within 48 hours) from the index event for use in MCIs.
Methods:
This was a longitudinal prospective observational multi-center study on patients who were attended by Advanced Life Support (ALS) units and transferred to the emergency department (ED) of their reference hospital. Collected were: demographic, physiological, and clinical variables; main diagnosis; and data on early mortality. The main outcome variable was mortality from any cause within 48 hours.
Results:
From April 1, 2018 through February 28, 2019, a total of 1,288 patients were included in this study. Of these, 262 (20.3%) participants required assistance for trauma and injuries by external agents. Early mortality within the first 48 hours due to any cause affected 69 patients (5.4%). The system with the best predictive capacity was the NEWS2 with an area under the curve (AUC) of 0.891 (95% CI, 0.84-0.94); a sensitivity of 79.7% (95% CI, 68.8-87.5); and a specificity of 84.5% (95% CI, 82.4-86.4) for a cut-off point of nine points, with a positive likelihood ratio of 5.14 (95% CI, 4.31-6.14) and a negative predictive value of 98.7% (95% CI, 97.8-99.2).
Conclusion:
Prehospital scores of the NEWS2 are easy to obtain and represent a reliable test, which make it an ideal system to help in the initial assessment of high-risk patients, and to determine their level of triage effectively and efficiently. The Prehospital Emergency Medical System (PhEMS) should evaluate the inclusion of the NEWS2 as a triage system, which is especially useful for the second triage (evacuation priority).
The J-PAS survey will soon start observing thousands of square degrees of the Northern Sky with its unique set of 56 narrow band filters covering the entire optical wavelength range, providing, effectively, a low resolution spectra for every object detected. Active galaxies and quasars, thanks to their strong emission lines, can be easily identified and characterized with J-PAS data. A variety of studies can be performed, from IFU-like analysis of local AGN, to clustering of high-z quasars. We also expect to be able to extract intrinsic physical quasar properties from the J-PAS pseudo-spectra, including continuum slope and emission line luminosities. Here we show the first attempts of using the QSFit software package to derive the properties for 22 quasars at 0.8 < z < 2 observed by the miniJPAS survey, the first deg2 of J-PAS data obtained with an interim camera. Results are compared with the ones obtained by applying the same software to SDSS quasar spectra.
This paper presents the translation, adaptation and validation of a broadly used scale to measure emotion regulation strategies (i.e. The Emotion Regulation Questionnaire Children and Adolescents –ERQ-CA; Gullone & Taffe, 2012) in a sample of early adolescents. The 10-item scale was applied to a sample of 248 adolescents (128 boys) aged 13 to 14 years. Semi-confirmatory factor analysis supported the original two-factor structure: Cognitive Reappraisal and Expressive Suppression (SRMR = .05; RMSEA = .06; CFI = .96). These two factors demonstrate adequate internal consistency and evidence for convergent validity with other scales that refer to emotional intelligence, affect, and behavior. Thus, Cognitive Reappraisal scores were associated with higher self-perceived emotional abilities, positive affect and personal adjustment (ps < .05). Conversely, Expressive Suppression scores were associated with lower self-perceived emotional abilities, positive affect, and personal adjustment (ps < .01), with higher scores on negative affect, school and clinical maladjustment (ps < .01), as well as stress and depression symptoms (ps < .001). Overall, these findings suggest that the questionnaire may be a useful and reliable instrument for the assessment of emotion regulation strategies in early adolescents for future research in Spanish speaking countries.
Objective: Relative to the vast literature that employs measures of decision-making (DM), rigorous examination of their psychometric properties is sparse. This study aimed to determine whether three measures of DM assess the same construct, and to measure invariance of this construct across relevant covariates. Method: Participants were 372 adolescents at risk of escalation in cannabis use. DM was assessed via four indices from the Cups Task, Game of Dice Task (GDT), and Iowa Gambling Task (IGT). We used confirmatory factor analysis to assess unidimensionality of the DM construct, and moderated nonlinear factor analysis (MNLFA) to examine its measurement invariance. Results: The unidimensional model of DM demonstrated good fit. MNLFA results revealed that sex influenced mean DM scores, such that boys had lower risk-taking behaviors. There was evidence of differential item functioning (DIF), such that IQ and age moderated the IGT intercept and GDT factor loading, respectively. Significant effects were retained in the final model, which produced participant-specific DM factor scores. These scores showed moderate stability over time. Conclusions: Indices from three DM tasks loaded significantly onto a single factor, suggesting that these DM tasks assess a single underlying construct. We suggest that this construct represents the ability to make optimal choices that maximize rewards in the presence of risk. Our final DM factor accounts for DIF caused by covariates, making it comparable across adolescents with different characteristics. (JINS, 2019, 25, 661–667)