Pontifical Bolivarian University

BACKGROUND The incidence of fragility hip fractures (FHF) is increasing in older adults, and delirium often follows physical stress such as FHF. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is the reference standard for diagnosing delirium in Thailand but requires specialized expertise. The Delirium Diagnostic Tool-Provisional (DDT-Pro) - a reliable and valid alternative that does not require specialist training - has not been evaluated in older Thai patients with FHF. This study aimed to translate and cross-culturally adapt the DDT-Pro to create a Thai version (DDT-Pro-TH), then determine its validity and reliability. MATERIAL AND METHODS A multidisciplinary team of nonpsychiatrists (orthopedists, geriatricians, anesthesiologists, physiatrists) and 2 DDT-Pro psychiatry experts performed forward and backward translation. Patients with FHF were informed about and consented to participation in this cross-sectional validation study. The DDT-Pro-TH and DSM-5 were independently utilized for delirium assessment before surgery and on postoperative days 1 and 2. Delirium diagnosed by DSM-5 served as the reference standard; DDT-Pro-TH positivity was defined as a score of 6 or lower. Validity was assessed with the area under the curve (AUC); reliability was measured using Cronbach's alpha and Cohen's kappa statistics. RESULTS One hundred ten patients with FHF participated. Internal consistency reliability (Cronbach's alpha) was 0.819 (95% CI, 0.783-0.851). Inter-rater reliability (Cohen's kappa) was 0.974 (95% CI, 0.962-0.982). Concurrent validity (AUC vs Thai DSM-5) was 0.959 (95% CI, 0.903-0.987). CONCLUSIONS The Thai version of the DDT-Pro is a highly reliable and valid instrument for diagnosing delirium in older patients with FHF.

We read with great interest the article by Erdem et al .[1][1] on the efficacy of the erector spinae plane (ESP) block in lumbar disc herniation surgery for reducing postoperative nausea and vomiting (PONV). We acknowledge the rigorous methodological approach; however, we would like to highlight

ABSTRACTBackgroundCancer is one of the leading causes of death in Latin America. This study aims to compare the percentage of home and hospital deaths among cancer patients in 12 Latin American countries and to examine associated factors.MethodsWe carried out a population‐level observational study using death certificate data from Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, El Salvador, Guatemala, Mexico, Paraguay, Peru and Uruguay. Data from cancer decedents (ICD‐10 C00–C97) for a full year (January 1 to December 31) with available data (2016–2018) were included. We used descriptive statistics and multivariable binary logistic regression analysis in each country and between countries to describe the distribution in place of death and examine associated sociodemographic, clinical and ecological factors.ResultsCancer was the underlying cause of 491,929 deaths. An average of 31.1% occurred at home, from a range of 14.9% in Brazil to 81% in Guatemala. The variation remains after controlling for sociodemographic factors and cancer types. Patients who are older, live in rural areas, have lower educational levels, and a solid cancer history are more likely to die at home. Countries with more hospital beds and physicians, better Universal Health Coverage, higher Human Development Index, and higher health expenditure per capita had fewer home deaths.ConclusionFactors affecting place of death patterns in Latin America are country‐specific and the results can only partially be explained by sociodemographic, clinical and ecological factors. Our results may be used to improve palliative care according to the current country‐specific distribution of place of death.

A multifractal formalism relates multiscale quantities to the multifractal spectrum. The multifractal framework provides significant analytical advantages by incorporating a wide range of statistical moment orders (q), thereby enabling a more comprehensive characterization of the intrinsic structural variability embedded in the dataset. The scaling properties of the analyzed rainfall time series was studied using Legendre transformation. This tool is effective for detecting multifractality in the time series of interest and for extracting information on scaling behavior. The obtained parameters may ultimately aid in performing multifractal modeling. The 50-year-long daily rainfall time series shows multifractal properties. The analysis of the generalized Hurst exponent h(q) enabled the classification of time series’ temporal dynamics, distinguishing between persistent, anti-persistent, and uncorrelated behavior. The multifractal analysis proves to be an effective and robust tool to characterize precipitation time series in the context of climate change research. Ultimately, the parameters and features derived from the multifractal spectrum—such as singularity strengths and spectrum width—serve as both quantitative and qualitative metrics for characterizing the spatiotemporal dynamics of rainfall in the semi-arid region of the Central Mexican Plateau.

(analytical)This article examines the differentiating aspects in the production of school media, which transcend the informative and traditional vision of these experiences in educational institutions in Valle de Aburrá (Antioquia) and Montería (Córdoba). From a theoretical point of view, he topic of school media is addressed from the field of communication/education. The research is qualitative and based on the testimonies and reflections of students consulted through focus groups. The research results are structured using two emerging categories: own topics and attribution of meaning. The main finding indicates that school media constitute a space / process that facilitates discussion, deliberation and the establishment of agreements for media production, construction of meanings and circulation of content related to the contexts of students. Keywords: School media; media communication; educational process; communication; communication and education.

Introduction. Multiple genetic and environmental factors interact with the development of acute coronary syndrome. Smoking is one of the environmental factors that might alter the metabolic pathways shared by genes associated with this condition.Objective. To investigate the association of acute coronary syndrome with genetic variants related to inflammation, lipid metabolism, and platelet aggregation among subjects from the northeastern region of Colombia. The effects of interactions between polymorphisms and smoking were also evaluated.Materials and methods. We analyzed data from 330 acute coronary syndrome cases and 430 controls. Associations between 20 polymorphisms and acute coronary syndrome were evaluated using logistic regression, adjusting for confounders. Gene and smoking interaction terms were calculated, and variants were analyzed separately in smokers and non-smokers for their association with acute coronary syndrome.Results. Two variants were associated with acute coronary syndrome, rs10455872 in the LPA gene (OR = 2.69; 95% CI: 1.61-4.49) and rs429358 in the APOE gene (OR = 1.93; 95% CI: 1.30-2.87). We identified smoking interactions with the variants rs6511720 in the LDLR gene (p = 0.04) and rs2227631 in the SERPINE1 gene (p = 0.02), with significant effects in non-smokers (rs6511720: OR = 0.40; 95% CI: 0.19-0.88; and rs2227631: OR = 0.69; 95% CI: 0.48-1.00), but not in smokers (rs6511720: OR = 1.28; 95% CI: 0.66-2.46; and rs2227631: OR = 1.30; 95% CI: 0.91-1.87).Conclusions. Variants in the candidate genes LPA and APOE are associated with an increased risk of acute coronary syndrome in a population from northeastern Colombia. The effects of rs6511720 in LDLR and rs2227631 in SERPINE1 differ according to smoking habits and are significant in non-smokers. These results are helpful for early risk screening of acute coronary syndrome, mainly in individuals without defined conventional risk factors.

Environmental noise is an urban air pollutant in metropolises. This study aimed to identify the association between differential exposure to environmental noise and sleep quality in adults. This cross-sectional study used stratified random sampling of households according to two noise exposure categories (high [≥ 65dBA] and low [≤ 50dBA]), as specified by the urban noise map. People aged over 18 years, who slept and spent most of their time in the place during the last six months were selected, and people undergoing treatment for mental or communication disorders were excluded. A self-administered questionnaire was used to collect sociodemographic, clinical, lifestyle, noise exposure, and subjective sleep quality characteristics (Pittsburgh Sleep Quality Index). Statistical analysis included chi-squared tests and Spearman's correlations, and a Poisson regression model with robust variance was used. The analyses were performed in Stata v12. A total of 221 participants were included, 53.4% female, with a mean age of 57 years (IQR: 35-67), 52.9% workers and 45.9% with higher education. It was observed that 47.5% of the participants had some underlying pathology. Residents of places with high noise exposure had a 13% higher prevalence of poor sleep quality compared to those in places with low exposure (PR = 1.13; 95%CI: 0.99-1.28). Although affecting sleep quality, the ways and extent with which environmental noise affects individuals seems to be influenced by noise sensitivity, length of exposure, sociodemographic variables, lifestyle habits, and mental health disorders.