Trends in the incidence of hospital-treated suicide attempts during the COVID-19 pandemic in Oviedo, Spain.

BACKGROUND: The potential impact of the COVID-19 pandemic on suicidal behavior has generated predictions anticipating an increase in suicidal tendencies. The aim of this research is to study its influence on the incidence of hospital-treated suicide attempts throughout the year 2020 in Oviedo, Spain. METHODS: Data were collected on all patients admitted to the emergency department of Central University Hospital of Asturias in Oviedo for attempted suicide during 2020. Incidence rates were calculated for three lockdown periods. Suicide attempt trends in 2020 were compared with a non-COVID-19 year (2009) to avoid seasonal variations bias. Chi-square and Fisher's exact tests were performed. The influence of COVID-19 incidence in Oviedo was analyzed using Spearman's correlation coefficient. RESULTS: The cumulative incidence rate of attempted suicide per 100,000 person-years was 136.33 (pre-lockdown), 115.15 (lockdown), and 90.25 (post-lockdown) in adults (over 19 years old), and 43.63 (pre-lockdown), 32.72 (lockdown), and 72.72 (post-lockdown) in adolescents (10-19 years old). No association was found with COVID-19 incidence rates (Spearman's rho -0.222; p = 0.113). Comparing the years 2020 and 2009, statistically significant differences were observed in adolescents (Fisher's exact test; p = 0.024), but no differences were observed in adults (chi-square test = 3.0401; p = 0.218). CONCLUSIONS: Hospital-treated suicide rates attempted during the COVID-19 outbreak in Oviedo, Spain showed a similar trend compared with a non-COVID-19 year. In contrast, the number of adolescents hospital-treated for attempted suicide increased during lockdown, suggesting more vulnerability to COVID-19 restrictions after the initial lockdown period in this age group.

Popularidad de Neurología en España: análisis de la elección de la especialidad / The popularity of neurology in Spain: An analysis of specialty selection

INTRODUCCIÓN: Neurología es una de las especialidades ofertadas a los opositores que acceden a la formación sanitaria especializada cada año. Este proyecto analiza los datos de elección de Neurología en los últimos años. MATERIAL Y MÉTODOS: Los datos de la elección se han obtenido de la publicación oficial del Ministerio de Sanidad, Servicios Sociales e Igualdad. Se ha recabado información de los distintos centros docentes con relación a la disponibilidad de unidad de ictus, intervencionismo endovascular, consultas de referencia nacional relacionadas con Neurología, guardias específicas para residentes y vinculación con facultades de medicina o redes de investigación nacional. RESULTADOS: La mediana de elección de número de orden para Neurología ha descendido anualmente, situando la especialidad en la convocatoria 2016 entre las cuatro más populares. Los electores son mayoritariamente mujeres de nacionalidad española y baremo académico alto. La mediana de los hospitales con mayor número de camas, intervencionismo vascular, unidad de ictus o consultas de referencia nacional es significativamente menor. Lo mismo sucede al analizar los centros según guardias específicas de Neurología para residentes o vinculación con facultades de medicina o redes de investigación nacionales. Los centros con menor mediana de número de orden para el periodo 2012-2016 fueron los hospitales universitarios Clínico San Carlos, 12 de Octubre y Vall d'Hebron. CONCLUSIONES: Neurología ha ido mejorando de manera progresiva en la elección de plazas de especialización, situándose entre las cuatro más populares. Los electores se decantan por centros grandes, de mayor complejidad asistencial y con intensa actividad investigadora

INTRODUCTION: Neurology is one of the medical specialties offered each year to residency training candidates. This project analyses the data associated with candidates choosing neurology residency programmes in recent years. METHODS: Data related to specialty selection were obtained from official reports by the Spanish Ministry of Health, Social Services, and Equality. Information was collected on several characteristics of teaching centres: availability of stroke units, endovascular intervention, national reference clinics for neurology, specific on-call shifts for neurology residents, and links with medical schools or national research networks. RESULTS: The median selection list position of candidates selecting neurology training has been higher year on year; neurology was among the 4 most popular residency programmes in 2016. Potential residents were mainly female, Spanish, and had good academic results. The median number of hospitals with higher numbers of beds, endovascular intervention, stroke units, and national reference clinics for neurology is significantly lower. This is also true when centers are analysed by presence of specific on-call shifts for neurology residents and association with medical schools or national research networks. The centres selected by candidates with the highest median selection list position in 2012-2016 were the Clínico San Carlos, 12 de Octubre, and Vall d'Hebron university hospitals. CONCLUSIONS: Neurology has gradually improved in residency selection choices and is now one of the 4 most popular options. Potential residents prefer larger centres which are more demanding in terms of patient care and which perform more research activity

Identification of gender differences in the factors influencing shoulders, neck and upper limb MSD by means of multivariate adaptive regression splines (MARS).

In the present research, models based on multivariate adaptive regression splines (MARS) are proposed to study the influence of gender in the factors affecting the development of shoulders, neck and upper limb MSD. Two different MARS models, corresponding to men and women, are constructed to identify variables with the strongest effect on the target MSD. Both models are capable to predict successfully the occurrence of the studied disorders. Men seem to be more vulnerable to physical risk factors and some other working conditions, whereas women appear to be more affected by psychosocial risk factors and activities carried out outside their working hours. According to the results, gender needs to be considered to ensure the success and effectiveness of ergonomic interventions on the whole working population.

The popularity of neurology in Spain: An analysis of specialty selection. / Popularidad de Neurología en España: análisis de la elección de la especialidad.

INTRODUCTION: Neurology is one of the medical specialties offered each year to residency training candidates. This project analyses the data associated with candidates choosing neurology residency programmes in recent years. METHODS: Data related to specialty selection were obtained from official reports by the Spanish Ministry of Health, Social Services, and Equality. Information was collected on several characteristics of teaching centres: availability of stroke units, endovascular intervention, national reference clinics for neurology, specific on-call shifts for neurology residents, and links with medical schools or national research networks. RESULTS: The median selection list position of candidates selecting neurology training has been higher year on year; neurology was among the 4 most popular residency programmes in 2016. Potential residents were mainly female, Spanish, and had good academic results. The median number of hospitals with higher numbers of beds, endovascular intervention, stroke units, and national reference clinics for neurology is significantly lower. This is also true when centers are analysed by presence of specific on-call shifts for neurology residents and association with medical schools or national research networks. The centres selected by candidates with the highest median selection list position in 2012-2016 were the Clínico San Carlos, 12 de Octubre, and Vall d'Hebron university hospitals. CONCLUSIONS: Neurology has gradually improved in residency selection choices and is now one of the 4 most popular options. Potential residents prefer larger centres which are more demanding in terms of patient care and which perform more research activity.

Análisis psicométrico de las preguntas asociadas a imágenes radiológicas en el examen para médico interno residente en España / Psychometric analysis of questions associated with radiological images in the competitive examination for access to residency programs in Spain

ANTECEDENTES Y OBJETIVO: La psicometría es una técnica sencilla e intuitiva que se utiliza en el campo de la docencia y en el de los cuestionarios de respuesta múltiple. El examen MIR incluye desde el año 2009 preguntas asociadas a imagen radiológica. El objetivo de este trabajo es mostrar los resultados del análisis psicométrico de estas preguntas con objeto de comparar el grado de dificultad, la capacidad de discriminación y la estructura interna respecto al resto de preguntas. MATERIAL Y MÉTODOS: Se seleccionaron todas las preguntas del examen desde el año 2009 y se clasificaron en casos clínicos sin y con imagen radiológica, casos clínicos con imagen no radiológica, preguntas test y preguntas negativas. Se utilizó la teoría clásica de test y la teoría de respuesta al ítem para valorar la dificultad y el grado de discriminación de las preguntas. RESULTADOS: Sobre 225 preguntas, los exámenes incluyen entre un 11% y un 15% de preguntas asociadas a imágenes. Las preguntas asociadas a imagen radiológica son más difíciles (grado de dificultad corregida [IDc] 0,51), con una menor capacidad de discriminación. El aumento de la dificultad de la pregunta radiológica se relaciona con una menor discriminación, sobre todo si la información clínica no es adecuada, o es contraria al concepto radiológico, o el concepto nunca ha sido preguntado a lo largo de la historia del MIR. CONCLUSIONES: Para poder igualar los estándares del examen MIR, es necesario mantener una adecuada estructura en la confección de las preguntas de radiología, en términos de entorno clínico, un adecuado uso de distractores y un menor nivel de dificultad, que se puede lograr mediante el uso de imágenes con hallazgos radiológicos típicos

BACKGROUND AND OBJECTIVE: Psychometrics is a simple, intuitive approach used in educational research and in multiple-choice questionnaires. Since 2009, the competitive examination through which access to residency programs in Spain is determined (MIR) has included questions related to radiological images. The objective of this paper is to show the results of the psychometric analysis of these questions with the aim of comparing their degree of difficulty, discriminative capacity, and internal structure with respect to those of the other questions on the examination. MATERIAL AND METHODS: We analyzed all questions on the examination since 2009, classifying them as clinical cases with and without radiological images, clinical cases with and without non-radiological images, multiple choice questions, and negative questions. We used classical test theory and item response theory to assess the difficulty and degree of discrimination of the questions. RESULTS: Of 225 questions, between 11% and 15% of the questions included in the examinations were associated with images. The questions associated with radiological images were more difficult (corrected difficulty index, 0.51) and had worse discriminative capacity. The increased difficulty of radiological questions was associated with worse discriminative capacity, especially if the clinical information provided was inadequate or if the clinical information was contrary to the radiological concept or if there had never been any questions about the concept in previoous MIR examinations. CONCLUSIONS: To equalize the standards of the MIR examination, it is necessary to maintain an appropriate structure in devising radiology questions, with terms from the clinical context, appropriate use of distracters, and a lower level of difficulty, which could be achieved by using radiological images with typical radiological findings

Psychometric analysis of questions associated with radiological images in the competitive examination for access to residency programs in Spain. / Análisis psicométrico de las preguntas asociadas a imágenes radiológicas en el examen para médico interno residente en España.

BACKGROUND AND OBJECTIVE: Psychometrics is a simple, intuitive approach used in educational research and in multiple-choice questionnaires. Since 2009, the competitive examination through which access to residency programs in Spain is determined (MIR) has included questions related to radiological images. The objective of this paper is to show the results of the psychometric analysis of these questions with the aim of comparing their degree of difficulty, discriminative capacity, and internal structure with respect to those of the other questions on the examination. MATERIAL AND METHODS: We analyzed all questions on the examination since 2009, classifying them as clinical cases with and without radiological images, clinical cases with and without non-radiological images, multiple choice questions, and negative questions. We used classical test theory and item response theory to assess the difficulty and degree of discrimination of the questions. RESULTS: Of 225 questions, between 11% and 15% of the questions included in the examinations were associated with images. The questions associated with radiological images were more difficult (corrected difficulty index, 0.51) and had worse discriminative capacity. The increased difficulty of radiological questions was associated with worse discriminative capacity, especially if the clinical information provided was inadequate or if the clinical information was contrary to the radiological concept or if there had never been any questions about the concept in previoous MIR examinations. CONCLUSIONS: To equalize the standards of the MIR examination, it is necessary to maintain an appropriate structure in devising radiology questions, with terms from the clinical context, appropriate use of distracters, and a lower level of difficulty, which could be achieved by using radiological images with typical radiological findings.

La elección de la especialidad medicina intensiva: análisis de los últimos 10 años / Choice of critical care medicine: Analysis of the last 10 years

No disponible

PM10 concentration forecasting in the metropolitan area of Oviedo (Northern Spain) using models based on SVM, MLP, VARMA and ARIMA: A case study.

Atmospheric particulate matter (PM) is one of the pollutants that may have a significant impact on human health. Data collected over seven years in a city of the north of Spain is analyzed using four different mathematical models: vector autoregressive moving-average (VARMA), autoregressive integrated moving-average (ARIMA), multilayer perceptron (MLP) neural networks and support vector machines (SVMs) with regression. Measured monthly average pollutants and PM10 (particles with a diameter less than 10µm) concentration are used as input to forecast the monthly averaged concentration of PM10 from one to seven months ahead. Simulations showed that the SVM model performs better than the other models when forecasting one month ahead and also for the following seven months.

Análisis de la elección de la especialidad de radiodiagnóstico en el examen MIR desde el año 2006 hasta 2015 / Choice of the specialty of diagnostic radiology by results of the competitive examination to assign residency positions from 2006 to 2015

Objetivo. Analizar el perfil del opositor que ha escogido la especialidad de radiodiagnóstico, analizando variables relacionadas con las plazas convocadas a lo largo de la historia. Material y métodos. Se recogen los datos publicados por el Ministerio de Sanidad español en su página web durante los actos de elección de plaza en el examen MIR desde el año 2006 hasta 2015, comparando la especialidad de radiodiagnóstico con el resto de las ofertadas en términos de plaza, preguntas netas, sexo, nacionalidad y lugar de elección de la plaza. Resultados. La especialidad de radiodiagnóstico ocupa la posición número 16 en el ranking de especialidades ordenadas según la mediana de número de orden con la que se escogió cada una de sus plazas desde el año 2006 hasta 2015. La primera plaza se suele escoger por debajo del número de orden 75 y la elección de la especialidad se suele terminar entre los números de orden 3.700 y 4.100. Durante el periodo estudiado, un 58% de los electores de radiodiagnóstico fueron mujeres y un 76%, españoles. Los opositores prefieren los hospitales de la comunidad de Madrid, y el hospital elegido con la mediana más baja (mejor número de orden) es el Hospital Clínic de Barcelona. Conclusiones. Radiodiagnóstico se escoge en el MIR con buenos números de orden, con menor tendencia a ser elegida por mujeres que otras especialidades y escogida en su mayoría por médicos españoles. Se prefieren hospitales grandes en capitales de provincia (AU)

Objective. To analyze the profile of residency candidates choosing the specialty of diagnostic radiology in function of variables related to the positions available in different years. Material and methods. We compiled the data published on the Spanish Ministry of Health's website during the acts celebrated to allow residency candidates to choose positions based on the results of the competitive examinations held from 2006 to 2015, comparing the specialty of diagnostic radiology with the other specialties available in terms of positions available, net questions, sex, nationality, and order of choice of the position. Results. The specialty of diagnostic radiology occupied the 16th position in the ranking of specialties according to the median number of order in the choice for each of the positions offered in the years studied. The first diagnostic radiology residency position was usually assigned after 75 candidates had chosen other specialties, and the last position was usually assigned after 3700 to 4100 candidates had chosen their positions. During the period studied, of those who chose diagnostic radiology 58% were women and 76% were Spanish nationality. Candidates preferred hospitals in the Autonomous Community of Madrid, and the hospital chosen with the lowest median position (highest score on the competitive examination) was the Hospital Clínic de Barcelona. Conclusions. Diagnostic radiology is chosen by candidates with good positioning in the ranking according to official examination results, is less likely than other specialties to be chosen by women, and is chosen mostly by Spanish physicians. Candidates prefer large hospitals in provincial capitals (AU)

Choice of the specialty of diagnostic radiology by results of the competitive examination to assign residency positions from 2006 to 2015. / Análisis de la elección de la especialidad de radiodiagnóstico en el examen MIR desde el año 2006 hasta 2015.

OBJECTIVE: To analyze the profile of residency candidates choosing the specialty of diagnostic radiology in function of variables related to the positions available in different years. MATERIAL AND METHODS: We compiled the data published on the Spanish Ministry of Health's website during the acts celebrated to allow residency candidates to choose positions based on the results of the competitive examinations held from 2006 to 2015, comparing the specialty of diagnostic radiology with the other specialties available in terms of positions available, net questions, sex, nationality, and order of choice of the position. RESULTS: The specialty of diagnostic radiology occupied the 16th position in the ranking of specialties according to the median number of order in the choice for each of the positions offered in the years studied. The first diagnostic radiology residency position was usually assigned after 75 candidates had chosen other specialties, and the last position was usually assigned after 3700 to 4100 candidates had chosen their positions. During the period studied, of those who chose diagnostic radiology 58% were women and 76% were Spanish nationality. Candidates preferred hospitals in the Autonomous Community of Madrid, and the hospital chosen with the lowest median position (highest score on the competitive examination) was the Hospital Clínic de Barcelona. CONCLUSIONS: Diagnostic radiology is chosen by candidates with good positioning in the ranking according to official examination results, is less likely than other specialties to be chosen by women, and is chosen mostly by Spanish physicians. Candidates prefer large hospitals in provincial capitals.

Hybrid modelling based on support vector regression with genetic algorithms in forecasting the cyanotoxins presence in the Trasona reservoir (Northern Spain).

Cyanotoxins, a kind of poisonous substances produced by cyanobacteria, are responsible for health risks in drinking and recreational waters. As a result, anticipate its presence is a matter of importance to prevent risks. The aim of this study is to use a hybrid approach based on support vector regression (SVR) in combination with genetic algorithms (GAs), known as a genetic algorithm support vector regression (GA-SVR) model, in forecasting the cyanotoxins presence in the Trasona reservoir (Northern Spain). The GA-SVR approach is aimed at highly nonlinear biological problems with sharp peaks and the tests carried out proved its high performance. Some physical-chemical parameters have been considered along with the biological ones. The results obtained are two-fold. In the first place, the significance of each biological and physical-chemical variable on the cyanotoxins presence in the reservoir is determined with success. Finally, a predictive model able to forecast the possible presence of cyanotoxins in a short term was obtained.

A new improved study of cyanotoxins presence from experimental cyanobacteria concentrations in the Trasona reservoir (Northern Spain) using the MARS technique.

Cyanotoxins, a kind of poisonous substances produced by cyanobacteria, are responsible for health risks in drinking and recreational water uses. The aim of this study is to improve our previous and successful work about cyanotoxins prediction from some experimental cyanobacteria concentrations in the Trasona reservoir (Asturias, Northern Spain) using the multivariate adaptive regression splines (MARS) technique at a local scale. In fact, this new improvement consists of using not only biological variables, but also the physical-chemical ones. As a result, the coefficient of determination has improved from 0.84 to 0.94, that is to say, more accurate predictive calculations and a better approximation to the real problem were obtained. Finally the agreement of the MARS model with experimental data confirmed the good performance.

Study of cyanotoxins presence from experimental cyanobacteria concentrations using a new data mining methodology based on multivariate adaptive regression splines in Trasona reservoir (Northern Spain).

There is an increasing need to describe cyanobacteria blooms since some cyanobacteria produce toxins, termed cyanotoxins. These latter can be toxic and dangerous to humans as well as other animals and life in general. It must be remarked that the cyanobacteria are reproduced explosively under certain conditions. This results in algae blooms, which can become harmful to other species if the cyanobacteria involved produce cyanotoxins. In this research work, the evolution of cyanotoxins in Trasona reservoir (Principality of Asturias, Northern Spain) was studied with success using the data mining methodology based on multivariate adaptive regression splines (MARS) technique. The results of the present study are two-fold. On one hand, the importance of the different kind of cyanobacteria over the presence of cyanotoxins in the reservoir is presented through the MARS model and on the other hand a predictive model able to forecast the possible presence of cyanotoxins in a short term was obtained. The agreement of the MARS model with experimental data confirmed the good performance of the same one. Finally, conclusions of this innovative research are exposed.