Search Results (67)

Introduction: Overactive bladder (OAB) and urinary incontinence (UI) are prevalent, particularly in older adults, and affect quality of life. OAB involves urgency, frequency, nocturia, and urgency incontinence, often linked to involuntary detrusor contractions. Treatment guidelines recommend a stepwise approach, starting with pelvic floor muscle training (PFMT), followed by pharmacological or minimally invasive therapies, such as neuromodulation. However, the combined effects of PFMT and neuromodulation have not been well established. This study aimed to evaluate the impact of combining pelvic floor exercises with neuromodulation versus PFMT with sham neuromodulation or standard physiotherapy after a 12-week intervention in individuals with OAB and UI. Methods/Materials: A double-blind, randomized controlled trial was designed with three groups: PFMT + neuromodulation, PFMT + sham, and conventional physiotherapy (control) in a 1:1:1 ratio. This study followed the CONSORT guidelines and was registered at ClinicalTrials.gov (NCT06783374). The sample size was calculated using GPower^® software, assuming a Cohen’s effect size of 1.04, a power of 0.80, an alpha of 0.05, and a 15% dropout rate, totaling 63 participants (21 per group). Participants attended 24 sessions over 12 weeks (2 sessions per week). The interventions were based on previously validated protocols. Outcomes: The primary outcomes included health-related quality of life, pelvic floor muscle function, pain, adherence, and general health. The secondary outcomes included Incontinence Quality of Life questionnaire, 3-day bladder diary, International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, kinesiophobia, and electromyographic data. Full article

Background/Objectives: The scientific literature shows that new scientific and social priorities regarding social impacts and co-creation are leading to profound transformations in all scientific and social contexts. In the field of mental health, one dimension of this transformation is the increasing visibility of dialogic models that support the improvement of mental health. While this is very positive, it carries a risk of deformations that can lead to negative outcomes for both society and science. There is a lack of scientific research about the errors related to the new visibility of the Successful Dialogues in Mental Health (SDMH) model. The objective of this research is to clarify a certain type of error, namely when the excellent results obtained through the use of this model in particular contexts are attributed to a supposed dialogic approach of psychiatric rehabilitation, made by researchers without a degree in medicine. Methods: In order to clarify this error, we use a communicative methodology through a qualitative research design, oriented to unveil the main steps in the original development of the model. Results: The results show that the SDMH model has never presented itself as psychiatric, but instead as a social–dialogic collaboration with psychiatrists with the aim of helping individuals to overcome mental health problems. Conclusions: This study clarifies the purpose of the SDMH model which contributes to benefiting citizens, particularly those with mental health conditions. Full article

There is much research on national and international statistical sources on analyses and trends of educational inequalities, which allow for a descriptive and analytical overview of a population’s educational status and trends—such as attainment levels, dropout rates, and sociodemographic variables. There is also research that has identified successful interventions across different countries that contribute to overcoming and reversing educational inequalities. However, the research on whether and how national and international statistical sources provide analyses on how to overcome and reverse educational inequalities remains underexplored. This article contributes to filling this gap by critically examining the available national and international statistical sources used in the educational field to analyze whether and how they include the necessary information for assessing the impact of specific educational interventions that overcome inequalities. Drawing on longitudinal and cohort studies within the European project REVERS-ED, the article highlights the need to move towards research models that incorporate explanatory variables and identify which interventions most effectively improve learning outcomes. Findings show that, despite widespread recognition of successful interventions, their impact is rarely reflected in official statistical systems, thereby limiting access to crucial information for teachers, policymakers, and educational institutions. Unlike disciplines such as medicine, education lacks systematic monitoring of the effects of successful interventions, making it difficult to establish clear correlations between them and learning outcomes. This paper advocates for greater accessibility to evaluative data and a shift towards applied, collaborative research that responds to the real needs of citizens, contributing to a more equitable, inclusive, and effective education system. Full article

Introduction: Preterm birth is the leading cause of perinatal mortality worldwide, with prevalence rates showing little reduction. Although mortality rates have decreased, morbidity rates remain concerningly high. In recent years, there has been a surge in studies examining the etiology, risk factors, and management of preterm birth. The use of vaginal probiotics in pregnant women at risk of preterm birth has garnered attention as a potential approach for improving perinatal outcomes and modulating the vaginal microbiota. However, the efficacy of this intervention remains unclear. Therefore, this study explored the impact of vaginal probiotics on perinatal outcomes and vaginal microbiota composition in pregnant women at risk of preterm birth. Materials and Methods: This was a randomized, prospective, longitudinal, double-blind, placebo-controlled, multicentric trial conducted across seven maternities in Spain from October 2017 to August 2022 in pregnant women at risk of preterm birth. Participants were randomly assigned to receive vaginal probiotics containing four lactobacilli strains or a placebo. The primary outcome was to explore a potential correlation between probiotic use among pregnant women at risk of preterm birth and the actual rate of preterm birth before 37 gestational weeks. Secondary outcomes included an evaluation of preterm birth rates, neonatal morbidity, the vaginal microbiota, and changes in the vaginal microbiota after receiving probiotics. Other secondary outcomes were identifying vaginal microbiota patterns associated with preterm birth and exploring potential therapeutic mechanisms involving probiotics. Trial registration: Clinicaltrials.gov, identifier: NCT03689166. Results: A total of 200 participants were included. Of those, birth data were obtained for 181 women. Demographics were similar between both groups. An analysis of perinatal outcomes found no significant differences in preterm birth rates, prematurity rates, gestational weeks at delivery, neonatal complications, time to birth, or latency time to delivery. Microbiota analysis showed no significant differences in vaginal microbiota changes between groups. No serious or unexpected adverse reactions were reported. Conclusions: There were no statistically significant differences for spontaneous preterm birth between pregnant women receiving probiotics and pregnant women receiving the placebo. Full article

Research on gender violence in Spanish universities began in 2003, 8 years after the first official denunciation. Conducting the first statewide survey on this issue was a significant step. This study provided essential data on gender violence in these institutions and reviewed effective prevention and response strategies from other countries. Further qualitative studies emerged that analyzed the behaviors of faculty, students, staff, decision-makers, and the media, which either perpetuated or prevented gender violence, along with the psychological and health impacts on victims and their supporters. After more than 20 years, a comprehensive literature review is needed to systematize these findings. To address this gap, a literature review was conducted to examine the behavioral changes within the university community and other relevant social actors regarding gender violence in universities. The results indicate that, although there is still some resistance, significant behavioral shifts have occurred, fostering a supportive network among faculty, researchers, staff, and students, which has contributed to an increased sense of safety. Full article

This work aims to evaluate students’ opinions on the materials normally used in anatomy practical classes (fixed and plastinated) compared to 3D anatomical prints. For this purpose, students of anatomy enrolled in the Degree in Veterinary Medicine from the University of Murcia filled out a satisfaction survey about both kinds of material. The students rated the fixed material with a satisfaction percentage close to 100% and the plastinated material with a percentage higher than 75%. Regarding the 3D prints, the percentage obtained was consistently higher than 50% except for two issues: the identification of the vascular structures of the dolphin’s head and the usefulness for surgery of the viscera and vascular structures of the cat, both of which scored less than 50%. This could be related to the lesser knowledge of dolphins of the veterinary students as well as the complexity of these structures. However, the other questions, such as usefulness for learning and exam preparation, the quality of the anatomical piece, the identification of the feline spleen and kidneys, etc. obtained a satisfaction percentage between 58 and 90.40%. This reflects the good acceptance by students of the 3D prints and may allow for a reduction in the number of cadavers used. Full article

Background: The aim of this study was to evaluate the serological response after the complete hepatitis B vaccination of patients according to the immunosuppressive treatment they underwent, and to identify potential factors associated with non-responders. Methods: A prospective cohort study was conducted, and patients under immunosuppressive therapies were considered exposed. The main outcome was non-response to hepatitis B vaccination. Bivariate analysis was conducted to detect differences between exposed and non-exposed patients. A multivariable log-binomial regression model was designed to analyze potential factors independently associated with non-responders. Results: A total of 289 patients were included. Immunosuppressive treatment was associated with non-response to hepatitis B vaccination (RR = 2.49, 95% CI: 1.26–4.96). Concretely, the use of cytotoxic therapies showed increased risk, although anti-CD20 and anti-JAK also showed a tendency to be associated with non-responders. Other variables associated with non-responders were older age (6–7% higher risk per year), smoking (RR = 3.08, 95% CI: 1.41–6.74) and certain vaccine regimens. These findings were similar for persistent non-responders despite an additional booster dose. Conclusions: Patients receiving immunosuppressive treatments, who are older in age or who are smokers have a higher risk of non-response to conventional hepatitis B vaccination. These data might serve to optimize hepatitis B vaccination in high-risk patients. Full article

Feminist studies have increasingly highlighted the contributions of women from various backgrounds; however, a gap remains in the research on conservative religious women. This article presents findings on Casilda Iturrizar, a bourgeois and religiously conservative woman who significantly influenced 19th-century Bilbao. Three surveys with 442 participants and five communicative interviews with educators were conducted using a communicative methodology, which has pioneered the current criteria for social impact and cocreation in the Horizon Europe scientific program. The results revealed that most people in Bilbao were unaware of Casilda’s contributions, with feminists and institutions neglecting her achievements. The findings from the communicative interviews suggested that Casilda’s contributions have been overlooked, contradicting recent efforts in education to address the invisibility of notable women. Such findings potentially have social impact by opening feminism to all women, including those made invisible for having conservative religious thinking. Full article

Background and Objective: To evaluate the effectiveness and safety of intradialytic parenteral nutrition (IDPN) on different nutritional outcomes. Methods: This was a retrospective analysis for a “routinely collected data bank” in a multicenter cohort, conducted on consecutive malnourished or at-risk of malnutrition patients with chronic kidney disease on hemodialysis who underwent IDPN with a three-in-one parenteral nutrition formula for a period ≥ 2 weeks. The primary endpoint was the mean change in the malnutrition inflammation score (MIS) score between baseline and the last follow-up visit on IDPN. Results: Fifty-six patients were included. The mean age was 72.4 ± 12.0 years, and 24 (42.9%) were women. In the overall study sample, MIS significantly decreased from 16.4 (95%CI: 15.3–17.65) at baseline to 14.3 (95%CI: 12.8–15.8) at the last follow-up visit on IDPN (p = 0.0019). Fifteen (26.8%) patients achieved a MIS reduction ≥ 5 points after IDPN. As compared to baseline, IDPN significantly reduced the proportion of patients with protein-energy wasting (PEW) (89.3% versus 66.1%, respectively, p = 0.0023). Regarding analytical parameters, serum albumin (p = 0.0003) and total proteins (p = 0.0024) significantly increased after IDPN administration. Throughout the study’s follow-up period, 45 (80.4%) patients reported experiencing some type of adverse event. Conclusions: IDPN was associated with a significant improvement in the nutritional profile. Notably, our research found that the administration of IDPN over a duration > 3 months significantly improved the nutritional status of patients evaluated by the MIS test. Full article

The serratus plane block is an ultrasound-guided anaesthetic technique that aims to provide analgesia to the lateral thoracic wall cranial to the 8th rib. This block can be performed in a superficial (between the latissimus dorsi and the serratus ventralis thoracis (SVT) muscles) or deep plane (between the intercostales externi and the SVT muscles). This study aimed to assess the distribution and nerve staining of a mixture of 0.4 mL kg⁻¹ of methylene blue and iopromide 50:50 performing a deep serratus plane (DSP) block at the level of the 5th rib. We hypothesise that this technique would be feasible and could stain the rami cutanei laterales (RCL) of the intercostales nerves cranial to the 8th rib in cat cadavers. This study was divided into two phases. Phase 1 consisted of an anatomical study of the thoracic wall (2 cadavers). Phase 2 consisted of the ultrasound-guided injection of the aforementioned mixture and the assessment of its distribution by computed tomography and anatomical dissection (12 cadavers). Contrast media spread a median of 5.5 (2.5–7.5) intercostal spaces. The dye stained a median of 3 (0–5) RCL, affecting RCL 2 (17.39%), RCL 3 (57.17%), RCL 4 (78.26%), RCL 5 (91.30%), RCL 6 (78.26%), and RCL 7 (8.70%) within the DSP. Occasionally, the rami dorsales laterales and the thoracicus longus nerve were stained. Based on these findings, the DSP block performed with a volume of 0.4 mL kg⁻¹ of an anaesthetic could provide analgesia in the area innervated from T4 to T6. Full article

The existing literature on sexual consent is extensive, but a new social approach to this topic is emerging, necessitating further research. This article addresses a gap in understanding how men’s interactions with other men, who are not their sexual partners, both before and during sexual encounters, influence their approach to consent beyond sexual cues. The study involved sixteen interviews and two focus groups with men aged 18–25. Conducted within the framework of the Consent project (PID2019-110466RB-100), this research aims to analyze how communicative acts, beyond verbal exchanges, shape relationships where either consent or coercion prevails. The findings reveal that when men engage in coercive interactions with non-sexual male peers, these interactions can encourage the violation of consent in their sexual relationships. Conversely, some men reject this coercive behavior, take a stand, and support others in avoiding situations that compromise consent. These results underscore the importance of addressing norms of masculinity and male interactions to ensure that all individuals can autonomously make decisions about their sexual lives. Full article

This study aims to develop three-dimensional printing models of the bony nasal cavity and paranasal sinuses of big and domestic cats using reconstructed computed tomographic images. This work included an exhaustive study of the osseous nasal anatomy of the domestic cat carried out through dissections, bone trepanations and sectional anatomy. With the use of OsiriX viewer, the DICOM images were postprocessed to obtaining maximum-intensity projection and volume-rendering reconstructions, which allowed for the visualization of the nasal cavity structures and the paranasal sinuses, providing an improvement in the future anatomical studies and diagnosis of pathologies. DICOM images were also processed with AMIRA software to obtain three-dimensional images using semiautomatic segmentation application. These images were then exported using 3D Slicer software for three-dimensional printing. Molds were printed with the Stratasys 3D printer. In human medicine, three-dimensional printing is already of great importance in the clinical field; however, it has not yet been implemented in veterinary medicine and is a technique that will, in the future, in addition to facilitating the anatomical study and diagnosis of diseases, allow for the development of implants that will improve the treatment of pathologies and the survival of big felids. Full article

The rectus sheath block is an ultrasound-guided anaesthetic technique which aims to provide analgesia to the abdominal midline. This study aimed to assess the distribution of 0.4 mL kg⁻¹ of a mixture of methylene blue and iopromide injected into each hemiabdomen in the internal rectus sheath in cat cadavers. We hypothesise that this technique would be feasible and would cover the rami ventrales of the last thoracic and the first lumbar spinal nerves. The study was divided into two phases. Phase 1 aimed to study the anatomical structures of the ventral abdominal wall (four cats were dissected). Phase 2 (ten cadavers) consisted of an ultrasound-guided injection of the mixture mentioned above and the assessment of its distribution by computed tomography and anatomical dissection. The results showed the staining of the cranioventral abdominal wall with a craniocaudal spread of four (three to eight) vertebral bodies. Methylene blue stained three (one to four) rami ventrales, affecting T10 (60%), T11 (100%), T12 (90%), T13 (50%) and L1 (5%). Based on these results, it could be stated that this technique could supply anaesthesia to the midline of the abdominal midline cranial to the umbilicus in clinical patients, but it may not be able to provide anaesthesia to the middle and caudal midline abdominal region. Full article

Background: For biliary tract cancer (BTC), the addition of immunotherapy (durvalumab or pembrolizumab) to gemcitabine and cisplatin (GemCis) significantly improved overall survival (OS) in phase 3 clinical trials (RCTs). However, the interpretation and magnitude of the treatment effect is challenging because OS Kaplan–Meier curves violate the proportional hazards (PH) assumption. Analysis using restricted mean survival time (RMST) allows quantification of the benefits in the absence of PH. This systematic review and meta-analysis aims to assess the benefit of immunotherapy-based regimens for OS at 24 months using RMST analysis. Methods: A systematic review was conducted using studies published up to 8 November 2023. Only phase 3 RCTs evaluating the use of anti-PD-1/PD-L1 combined with GemCis and reporting OS were included. KM curves for OS were digitized, and the data were reconstructed. A meta-analysis for OS by RMST at 24 months was performed. Results: A total of 1754 participants from the TOPAZ-1 and KEYNOTE-966 trials were included. In TOPAZ-1, RMSTs at 24 months were 13.52 (7.92) and 12.21 (7.22) months with GemCis plus durvalumab and GemCis alone, respectively. In KEYNOTE-966, RMSTs at 24 months were 13.60 (7.76) and 12.45 (7.73) months with GemCis plus pembrolizumab and GemCis alone, respectively. Immunotherapy-based regimens showed a mean OS difference at 24 months by an RMST of 1.21 months [(95% CI: 0.49–1.93), p < 0.001, I² = 0%]. Conclusions: Immunotherapy-based regimens improve OS in advanced BTC. Given this magnitude of benefit, it is essential to weigh up individual patient factors, preferences, and potential risks. RMST analysis provides valuable information to patients and physicians, facilitating decision-making in a value-based medical environment. Full article

The objective of this work was to study the normal anatomy of the nasal cavity of the three species of big cats (leopard, lion, and cheetah) compared to the domestic cat through the use of computed tomography, magnetic resonance imaging, and rhinoscopy. Computed tomography allowed us to clearly visualize the entire bony and cartilaginous framework that supports the nasal cavity. Magnetic resonance imaging permitted better visualization of the soft tissues of this cavity. On the other hand, rhinoscopy enabled the direct visualization of the mucosa of the vestibule and nasal cavity, which is very useful in the diagnosis of masses or foreign bodies. Furthermore, with this technique, it has been possible to observe several small orifices from the nasolacrimal duct, the pharyngeal auditory tube, and the lateral nasal gland. Computed tomography, magnetic resonance imaging, and rhinoscopy are useful tools in analysis of the anatomical characteristics of the nasal cavity in these species. Full article