Academic integrity policies against assessment fraud in postgraduate studies: An analysis of the situation in Spanish universities.

We aimed to analyse the strategies and policies of academic integrity in the face of assessment fraud in postgraduate studies in Spain. To this end, we examined the three strategies most commonly used by higher education institutions to address and prevent dishonest behaviour among students: (1) the use of technological mechanisms to detect plagiarism and identity control on assessment tests; (2) regulatory devices and resources (academic regulations and codes of conduct); and (3) training and awareness-raising activities. We scrutinised the results by means of a questionnaire administered to 102 academic heads of postgraduate studies at 42 Spanish universities. We found that almost all universities have plagiarism detection tools, the majority have academic regulations or specific codes of conduct for postgraduate students that address the issue of fraud or dishonesty. It was also found that specific training programmes on academic and research integrity for PhD students are more frequent than those for master's students, and the least used strategies to deal with dishonest student behaviour are the use of awareness-raising mechanisms and the use of an identity control system for online assessable activities. Moreover, there are some significant differences in the outcomes between public and private universities. Our findings highlight the need for Spanish universities to address the development of a clear academic integrity policy.

[Mental health consequences of isolation of patients with COVID-19.] / Consecuencias en la salud mental del aislamiento de pacientes con COVID-19.

OBJECTIVE: The COVID-19 pandemic has had a negative effect on the mental health on the population. It is unknown if the different types of patient isolation affect them equally. The objective of the study was to determine if the effect on the psychological discomfort caused by the isolation of the population with COVID-19 in a hotel supervised by health professionals was different compared with those who were isolated at home. METHODS: Patients diagnosed with COVID-19 during the first pandemic wave in Barcelona, consecutively selected from the Primary Care lists. A telephone survey was carried out to collect information about mental health in patients who were isolated in a hotel compared to those isolated at their homes. Descriptive statistics were performed and the study variables were analyzed using mean and standard deviation, count (percentage), Chi-square test, and Student's t-test. Logistic regression models were carried out selecting frustration and anger/irritability as response variables. RESULTS: Of the 89 patients included, 45 (50.6%) were isolated at their homes and 44 (49.4%) at the hotel. Frustration was identified in 48.3% and irritability in 29.2% of the most patients. Most of those who presented frustration were between 45 and 65 years old, while 50% of those who felt irritability were younger. Multivariate models confirmed that patients isolated at home showed a higher risk of frustration (Odds ratio 4,12; 95% Confidence interval 1,60-11,49) and irritability (Odds ratio 3,81; 95% Confidence interval 1,32-12,10), respectively. CONCLUSIONS: Patients isolated at home show a higher risk of presenting feelings of frustration and irritability than isolated patients in supervised hotels.

OBJETIVO: La pandemia de la COVID-19 ha tenido un efecto negativo en la salud mental de la población. Se desconoce si los distintos tipos de aislamiento de los pacientes afecta a estos por igual. El objetivo del estudio fue determinar si el efecto sobre el malestar psíquico originado por el aislamiento de la población con COVID-19 en un hotel supervisado por profesionales sanitarios fue diferente respecto al de las personas aisladas en su domicilio. METODOS: Los sujetos a estudio fueron pacientes diagnosticados de la COVID-19 durante la primera ola pandémica en Barcelona, seleccionados consecutivamente de los listados de Atención Primaria. Se realizó una encuesta telefónica para recoger información sobre salud mental en los pacientes que fueron aislados en un hotel frente a los aislados en sus domicilios. Se realizó estadística descriptiva y las variables de estudio fueron analizadas mediante media y desviación estándar, contaje (porcentaje), test Chi-cuadrado y t-Student. Se llevaron a cabo modelos de regresión logística seleccionando frustración e ira/irritabilidad como variables respuesta. RESULTADOS: De los 89 pacientes incluidos, 45 (50,6%) fueron aislados en sus domicilios y 44 (49,4%) en el hotel. Se identificó frustración en el 48,3% e irritabilidad en el 29,2% de los pacientes. El sentimiento de frustración se concentraba principalmente en la franja de edad entre 45 y 65 años, mientras que el 50% de los que sentían irritabilidad eran todavía más jóvenes. Los modelos multivariados confirmaron que los pacientes en aislamiento domiciliario mostraron mayor riesgo de frustración (Odds ratio 4,12; 95% Intervalo de confianza 1,60-11,49) y de ira (Odds ratio 3,81; 95% Intervalo de confianza 1,32-12,10), respectivamente. CONCLUSIONES: Los pacientes con COVID-19 aislados en su domicilio tienen mayor riesgo de presentar sentimientos de frustración e ira que los aislados en hoteles supervisados por profesionales sanitarios.

Consecuencias en la saludmental del aislamientode pacientes con COVID-19 / Mental health consequences of isolation of patients with COVID-19

FUNDAMENTOS: La pandemia de la COVID-19 ha tenido un efecto negativo en la salud mental de la población. Se desconoce si los distintos tipos de aislamiento de los pacientes afecta a estos por igual. El objetivo del estudio fue determinar si el efecto sobre el malestar psíquico originado por el aislamiento de la población con COVID-19 en un hotel supervisado por profesionales sanitarios fue diferente respecto al de las personas aisladas en su domicilio. MÉTODOS: Los sujetos a estudio fueron pacientes diagnosticados de la COVID-19 durante la primera ola pandémica en Barcelona, seleccionados consecutivamente de los listados de Atención Primaria. Se realizó una encuesta telefónica para recoger información sobre salud mental en los pacientes que fueron aislados en un hotel frente a los aislados en sus domicilios. Se realizó estadística descriptiva y las variables de estudio fueron analizadas mediante media y desviación estándar, contaje (porcentaje), test Chi-cuadrado y t-Student. Se llevaron a cabo modelos de regresión logística seleccionando frustración e ira/irritabilidad como variables respuesta. RESULTADOS: De los 89 pacientes incluidos, 45 (50,6%) fueron aislados en sus domicilios y 44 (49,4%) en el hotel. Se identificó frustración en el 48,3% e irritabilidad en el 29,2% de los pacientes. El sentimiento de frustración se concentraba principalmente en la franja de edad entre 45 y 65 años, mientras que el 50% de los que sentían irritabilidad eran todavía más jóvenes. Los modelos multivariados confirmaron que los pacientes en aislamiento domiciliario mostraron mayor riesgo de frustración (Odds ratio 4,12; 95%Intervalo de confianza 1,60-11,49) y de ira (Odds ratio 3,81; 95% Intervalo de confianza 1,32-12,10), respectivamente. CONCLUSIONES: Los pacientes con COVID-19 aislados en su domicilio tienen mayor riesgo de presentar sentimientos de frustración e ira que los aislados en hoteles supervisados por profesionales sanitarios.(AU)

BACKGROUND: The COVID-19 pandemic has had a negative effect on the mental health on the population. It is unknown if the different types of patient isolation affect them equally. The objective of the study was to determine if the effect on the psychological discomfort caused by the isolation of the population with COVID-19 in a hotel supervised by health professionals was different compared with those who were isolated at home. METHODS: Patients diagnosed with COVID-19 during the first pandemic wave in Barcelona, consecutively selected from the Primary Care lists. A telephone survey was carried out to collect information about mental health in patients who were isolated in a hotel compared to those isolated at their homes. Descriptive statistics were performed and the study variables were analyzed using mean and standard deviation, count (percentage), Chi-square test, and Student’s t-test. Logistic regression models were carried out selecting frustration and anger/irritability as response variables. RESULTS: Of the 89 patients included, 45 (50.6%) were isolated at their homes and 44 (49.4%) at the hotel. Frustration was identified in 48.3% and irritability in 29.2% of the most patients. Most of those who presented frustration were between 45 and 65 years old, while 50% of those who felt irritability were younger. Multivariate models confirmed that patients isolated at home showed a higher risk of frustration (Odds ratio 4,12; 95% Confidence interval 1,60-11,49) and irritability (Odds ratio 3,81; 95% Confidence interval 1,32-12,10), respectively. CONCLUSIONS: Patients isolated at home show a higher risk of presenting feelings of frustration and irritability than isolated patients in supervised hotels.(AU)

Bottlenecks in the Acute Stroke Care System during the COVID-19 Pandemic in Catalonia.

INTRODUCTION: The COVID-19 pandemic resulted in significant healthcare reorganizations, potentially striking standard medical care. We investigated the impact of the COVID-19 pandemic on acute stroke care quality and clinical outcomes to detect healthcare system's bottlenecks from a territorial point of view. METHODS: Crossed-data analysis between a prospective nation-based mandatory registry of acute stroke, Emergency Medical System (EMS) records, and daily incidence of COVID-19 in Catalonia (Spain). We included all stroke code activations during the pandemic (March 15-May 2, 2020) and an immediate prepandemic period (January 26-March 14, 2020). Primary outcomes were stroke code activations and reperfusion therapies in both periods. Secondary outcomes included clinical characteristics, workflow metrics, differences across types of stroke centers, correlation analysis between weekly EMS alerts, COVID-19 cases, and workflow metrics, and impact on mortality and clinical outcome at 90 days. RESULTS: Stroke code activations decreased by 22% and reperfusion therapies dropped by 29% during the pandemic period, with no differences in age, stroke severity, or large vessel occlusion. Calls to EMS were handled 42 min later, and time from onset to hospital arrival increased by 53 min, with significant correlations between weekly COVID-19 cases and more EMS calls (rho = 0.81), less stroke code activations (rho = -0.37), and longer prehospital delays (rho = 0.25). Telestroke centers were afflicted with higher reductions in stroke code activations, reperfusion treatments, referrals to endovascular centers, and increased delays to thrombolytics. The independent odds of death increased (OR 1.6 [1.05-2.4], p 0.03) and good functional outcome decreased (mRS ≤2 at 90 days: OR 0.6 [0.4-0.9], p 0.015) during the pandemic period. CONCLUSION: During the COVID-19 pandemic, Catalonia's stroke system's weakest points were the delay to EMS alert and a decline of stroke code activations, reperfusion treatments, and interhospital transfers, mostly at local centers. Patients suffering an acute stroke during the pandemic period had higher odds of poor functional outcome and death. The complete stroke care system's analysis is crucial to allocate resources appropriately.

Impact of isolating COVID-19 patients in a supervised community facility on transmission reduction among household members.

BACKGROUND: Isolation of COVID-19 patients has been universally implemented to control transmission of the outbreak. Hotels and other facilities have been adapted to help appropriate isolation be achieved. Our study tested the efficacy of isolating patients in a reconditioned hotel versus isolation in their domiciles to reduce infection transmission. METHODS: Observational cohort study based on a survey to COVID-19 patients between April and June 2020. One cohort had been isolated in a hotel and the other in their domiciles. Multivariate regression models analyzed the factors related to the occurrence of COVID-19 infection among the household members. RESULTS: A total of 229 household members of COVID-19 patients were analyzed, 139 of them belonging to the group of hotel-isolated patients and 90 in the group of domicile-isolated ones. More than half of the household members became infected (53.7%). Higher risk of infection was found in the household members of domicile-isolated patients isolated and in those reporting overcrowding at home, (odds ratio [OR] 1.67, 95% confidence interval [CI] 0.89-3.12) and (OR 1.44, 95% CI 0.81; 2.56), respectively. CONCLUSIONS: The isolation of COVID-19 patients in community-supervised facilities may protect their household members from transmission of the disease. Overcrowded homes may contribute to the transmission of the infection.

A Novel Missense Variant Associated with A Splicing Defect in A Myopathic Form of PGK1 Deficiency in The Spanish Population.

Phosphoglycerate kinase (PGK)1 deficiency is an X-linked inherited disease associated with different clinical presentations, sometimes as myopathic affectation without hemolytic anemia. We present a 40-year-old male with a mild psychomotor delay and mild mental retardation, who developed progressive exercise intolerance, cramps and sporadic episodes of rhabdomyolysis but no hematological features. A genetic study was carried out by a next-generation sequencing (NGS) panel of 32 genes associated with inherited metabolic myopathies. We identified a missense variant in the PGK1 gene c.1114G > A (p.Gly372Ser) located in the last nucleotide of exon 9. cDNA studies demonstrated abnormalities in mRNA splicing because this change abolishes the exon 9 donor site. This novel variant is the first variant associated with a myopathic form of PGK1 deficiency in the Spanish population.

Telestroke in Catalonia: Increasing Thrombolysis Rate and Avoiding Interhospital Transfers.

OBJECTIVES: The study aimed to evaluate the impact of a telestroke network on acute stroke care in Catalonia, by measuring thrombolysis rates, access to endovascular treatment, and clinical outcome of telestroke patients in a population-based study. METHODS: Telestroke network was implemented on March 2013 and consists of 12 community hospitals and 1 expert stroke neurologist 24 h/7 day, covering a population of 1.3 million inhabitants. Rest of the population (6.2 million) of Catalonia is covered by 8 primary stroke centers (PSC) and 6 comprehensive stroke centers (CSC). After a 2-way videoconference and visualization of neuroimaging on a web platform, the stroke neurologist decides the therapeutic approach and/or to transfer the patient to another facility, entering these data in a mandatory registry. Simultaneously, all patients treated with reperfusion therapies in all centers of Catalonia are prospectively recorded in a mandatory and audited registry. RESULTS: From March 2013 to December 2015, 1,206 patients were assessed by telestroke videoconference, of whom 322 received intravenous thrombolysis (IVT; 33.8% of ischemic strokes). Baseline and 24 h NIHSS, rate of symptomatic hemorrhage, mortality, and good outcome at 3 months were similar compared to those who received IVT in PSC or CSC (2,897 patients in the same period). The door-to-needle time was longer in patients treated through telestroke, but was progressively reduced from 2013 to 2015. Percentage of patients receiving thrombectomy after IVT was similar in patients treated through telestroke circuit, compared to those treated in PSC or CSC (conventional circuit). Population rates of IVT*100,000 inhabitants in Catalonia increased from 2011 to 2015, especially in areas affected by the implementation of telestroke network, achieving rates as high as 16 per 100,000 inhabitants. Transfers to another facility were avoided after telestroke consultation in 46.8% of ischemic, 76.5% of transient ischemic attacks, and 23.5% of hemorrhages. CONCLUSIONS: Telestroke favors safe and effective thrombolysis, helps to increase the population rate of IVT, and avoids a large number of interhospital transfers.

Delineation of a recognizable phenotype for the recurrent LCR22-C to D/E atypical 22q11.2 deletion.

The 22q11.2 deletion syndrome is typically caused by haploinsufficiency of a 3 Mb region that extends from LCR22-A until LCR22-D, while the recurrent recombination between any of the LCR22-D to H causes the 22q11.2 distal deletion syndrome. Here, we describe three patients with a de novo atypical ∼1.4 Mb 22q11.2 deletion that involves LCR22-C to a region beyond D (LCR22-C to D/E), encompassing the distal portion of the typical deleted region and the proximal portion of the distal deletion. We also review six previous published patients with the same rearrangement and compare their features with those found in patients with overlapping deletions. Patients with LCR22-C to D/E deletion present a recognizable phenotype characterized by facial dysmorphic features, high frequency of cardiac defects, including conotruncal defects, prematurity, growth restriction, microcephaly, and mild developmental delay. Genotype-phenotype analysis of the patients indicates that CRKL and MAPK1 genes play an important role as causative factors for the main clinical features of the syndrome. In particular, CRKL gene seems to be involved in the occurrence of conotruncal cardiac anomalies, mainly tetralogy of Fallot. © 2016 Wiley Periodicals, Inc.

Two novel SCN1A mutations identified in families with familial hemiplegic migraine.

BACKGROUND: Familial hemiplegic migraine (FHM) is a rare monogenic subtype of migraine with aura, characterized by motor auras. The majority of FHM families have mutations in the CACNA1A and ATP1A2 genes; less than 5% of FHM families are explained by mutations in the SCN1A gene. Here we screened two Spanish FHM families for mutations in the FHM genes. METHODS: We assessed the clinical features of both FHM families and performed direct sequencing of all coding exons (and adjacent sequences) of the CACNA1A, ATP1A2, PRRT2 and SCN1A genes. RESULTS: FHM patients in both families had pure hemiplegic migraine with highly variable severity and frequency of attacks. We identified a novel SCN1A missense mutation p.Ile1498Met in all three tested hemiplegic migraine patients of one family. In the other family, novel SCN1A missense mutation p.Phe1661Leu was identified in six out of eight tested hemiplegic migraine patients. Both mutations affect amino acid residues that either reside in an important functional domain (in the case of Ile(1498)) or are known to be important for kinetic properties of the NaV1.1 channel (in the case of Phe(1661)). CONCLUSIONS: We identified two mutations in families with FHM. SCN1A mutations are an infrequent but important cause of FHM. Genetic testing is indicated in families when no mutations are found in other FHM genes.

Urinary di-(2-ethylhexyl)phthalate metabolites in athletes as screening measure for illicit blood doping: a comparison study with patients receiving blood transfusion.

BACKGROUND: Subjects submitted to intravenous (IV) blood transfusions for medical reasons or blood doping to increase athletic performance are potentially exposed to the plasticizer di-(2-ethylhexyl)phthalate (DEHP) found in IV bags. Exposure to DEHP has been evaluated by measuring DEHP metabolites in selected groups of subjects. STUDY DESIGN AND METHODS: Urinary DEHP metabolites, mono-(2-ethylhexyl)phthalate, mono-(2-ethyl-5-hydroxyhexyl)phthalate (MEHHP), and mono-(2-ethyl-5-oxohexyl)phthalate (MEOHP) were measured in a control group with no explicit known exposure to DEHP (n = 30), hospitalized patients receiving blood transfusions (n = 25), nontransfused hospitalized patients receiving other medical care involving plastic materials (n = 39), and athletes (n = 127). Patients were tested in the periods 0 to 24 and 24 to 48 hours after exposition. RESULTS: Urinary concentrations of all three DEHP metabolites were significantly higher in patients receiving blood transfusion than in nontransfused patients and the control group, except for MEHHP and MEOHP in the period 24 to 48 hours. Samples from four athletes showed increased concentrations of DEHP metabolites comparable to urinary concentrations of patients receiving blood transfusion. CONCLUSION: Elevated concentrations of urinary DEHP metabolites represent increased exposure to DEHP. High concentrations of DEHP metabolites present in urine collected from athletes may suggest illegal blood transfusion and can be used as a qualitative screening measure for blood doping.

Self-incompatibility genotypes in almond re-evaluated by PCR, stylar ribonucleases, sequencing analysis and controlled pollinations.

As part of the almond breeding programme at IRTA, we investigated the S genotypes of several cultivars using a combination of RNase zymograms, testcrosses, pollen-tube growth analysis and molecular identification by PCR analysis. For some of the cultivars examined, discrepancies appeared between their S alleles as reported in the literature and those found in this investigation, leading to a re-evaluation of their S genotypes. Analysis of the stylar ribonucleases (RNases), which are known to correlate with S alleles, of cvs. Achaak, Ardechoise, Desmayo Largueta, Ferrastar, Gabaix, Garbi, Glorieta, Languedoc, Primorskiy and Texas revealed inconsistencies with respect to the S5 and S10 alleles. However, PCR with the conserved primer pair AS1II/AmyC5R failed to detect any of these inconsistencies. When the S alleles from Desmayo Largueta, Gabaix, Primorskiy and Texas were sequenced, Texas and Primorskiy were found to carry the reported S5 allele, while Desmayo Largueta and Gabaix carried a new allele, which has been tentatively denoted as S25 This new S allele, previously reported to be S10, was also identified in Achaak, Ardechoise and Ferrastar. The proposed new S genotypes are Achaak (S2S25), Ardechoise (S1S25), Desmayo Largueta (S1S25), Ferrastar (S2S25) and Gabaix (S10S25). The S alleles of Garbi, Glorieta, Languedoc, Texas and Primorskiy remain as reported in the literature. Testcrosses in the field and laboratory confirmed the new S genotypes. One cultivar (Gabaix) could be assigned to the existing cross-incompatibility group O of unique genotypes, and two new groups were established (XVI and XVII) consisting of two cultivars each. The clarification of these S alleles will be useful in almond breeding programmes and for planning new commercial orchards in the future.