The objective of this study was to determine the conversion rate of human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR) between primary tumors and metastatic lesions in advanced breast cancer. Patients with suspected diagnosis of locally recurrent or metastatic breast cancer, either at first relapse or after successive disease progressions, who had an appropriately preserved sample from a primary tumor and were scheduled for a biopsy of the recurrent lesion, were included. Blinded determinations of receptor status on paired samples were performed by immunohistochemistry and fluorescence in situ hybridization at a central laboratory and compared with those performed locally. Overall, 196 patients were included and 184 patients were considered evaluable. Reasons for non-evaluability included the inability to perform biopsy (n = 4) or biopsy results showing normal tissue (n = 3), benign disease (n = 3) or a second neoplasia (n = 2). Conversion rates determined at local level were higher than those determined centrally (HER2: 16 vs. 3 %, ER: 21 vs. 13 %, PR: 35 vs. 28 %, respectively). There was substantial agreement regarding the expression of HER2 in primary tumors and metastases, and ER at metastases, between local and central laboratories. PR at any site and ER at primary site showed moderate agreement. Oncologists altered their treatment plans in 31 % of patients whose tumor subtype had changed. These results reinforce the recommendation for performing confirmatory biopsies of metastases, not only to avoid misdiagnosis of breast cancer relapse, but also to optimize treatment (clinicaltrials.gov identifier: NCT01377363).

Associations of the second-to-fourth digit ratio (2D:4D), a putative marker for prenatal androgen action, and of absolute finger length, a putative marker for pubertal-adolescent androgen action, with sport performance were examined in a multinational sample of 87 world-class women epee fencers. Lower (masculinized) digit ratios correlated, although not significantly so, with better current and highest past world rankings. These correlations were significant for right-hand 2D:4D with controls for the most salient factors for 2D:4D (ethnicity) and world rankings (years of international experience, height, and weight). Longer (masculinized) fingers correlated strongly with better current and highest past world rankings; these correlations became insignificant with the same controls. Replicating previous evidence for fencers, left-handedness was much more prevalent in this sample (21%) than in the female general population, and left-handers had somewhat, but not significantly so, lower 2D:4D as well as better world rankings than right-handers. These findings extend related evidence suggestive of prenatal programming of aptitude across a variety of sports, especially running and soccer. Some known extragenital effects of prenatal testosterone that contribute to the development of efficient cardiovascular systems, good visuospatial abilities, physical endurance and speed, and to the propensity for rough-and-tumble play, apparently promote sporting success in adult life.

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en situaciones reales como ficticias y a través de juegos con presencia o ausencia de competición. El estudio se realizó con 284 estudiantes de las universidades de Lleida y de Barcelona. Los resultados mostraron diferencias significativas (p < .001) al estudiar los dos colectivos de estudiantes, los tres tipos de emociones, los cuatro dominios de acción motriz, los juegos ficticios y reales, y los juegos con o sin competición. también se encontró que la cooperación, los juegos reales y, en general, los juegos competitivos registraron los valores más intensos de emociones positivas. Palabras clave: Juegos motores, conciencia emocional, dominios de acción motriz, competición, educación física.

Background There is an increasing need to integrate patient-generated health data (PGHD) into health information systems (HISs). The use of health information standards based on the dual model allows the achievement of semantic interoperability among systems. Although there is evidence in the use of the Substitutable Medical Applications and Reusable Technologies on Fast Healthcare Interoperability Resources (SMART on FHIR) framework for standardized communication between mobile apps and electronic health records (EHRs), the use of European Norm/International Organization for Standardization (EN/ISO) 13606 has not been explored yet, despite some advantages over FHIR in terms of modeling and formalization of clinical knowledge, as well as flexibility in the creation of new concepts. Objective This study aims to design and implement a methodology based on the dual-model paradigm to communicate clinical information between a patient mobile app (Xemio Research) and an institutional ontology-based clinical repository (OntoCR) without loss of meaning. Methods This paper is framed within Artificial intelligence Supporting CAncer Patients across Europe (ASCAPE), a project that aims to use artificial intelligence (AI)/machine learning (ML) mechanisms to support cancer patients’ health status and quality of life (QoL). First, the variables “side effect” and “daily steps” were defined and represented with EN/ISO 13606 archetypes. Next, ontologies that model archetyped concepts and map them to the standard were created and uploaded to OntoCR, where they were ready to receive instantiated patient data. Xemio Research used a conversion module in the ASCAPE Local Edge to transform data entered into the app to create EN/ISO 13606 extracts, which were sent to an Application Programming Interface (API) in OntoCR that maps each element in the normalized XML files to its corresponding location in the ontology. This way, instantiated data of patients are stored in the clinical repository. Results Between December 22, 2020, and April 4, 2022, 1100 extracts of 47 patients were successfully communicated (234/1100, 21.3%, extracts of side effects and 866/1100, 78.7%, extracts of daily activity). Furthermore, the creation of EN/ISO 13606–standardized archetypes allows the reuse of clinical information regarding daily activity and side effects, while with the creation of ontologies, we extended the knowledge representation of our clinical repository. Conclusions Health information interoperability is one of the requirements for continuity of health care. The dual model allows the separation of knowledge and information in HISs. EN/ISO 13606 was chosen for this project because of the operational mechanisms it offers for data exchange, as well as its flexibility for modeling knowledge and creating new concepts. To the best of our knowledge, this is the first experience reported in the literature of effective communication of EN/ISO 13606 EHR extracts between a patient mobile app and an institutional clinical repository using a scalable standard-agnostic methodology that can be applied to other projects, data sources, and institutions.