Effect of including a dietary supplement of raisins, a food rich in polyphenols, on cognitive function in healthy older adults; a study protocol for a randomized clinical trial.

BACKGROUND: Polyphenols have been shown to be effective against many chronic diseases, including neurodegenerative diseases. Specifically, the consumption of raisins, being a food rich in polyphenols, has been attributed with neuroprotective benefits. Therefore, our main objective is to evaluate the effect of including 50 g of raisins in the diet daily for 6 months, on the improvement of cognitive performance, cardiovascular risk factors and markers of inflammation in a population of older adults without cognitive impairment. METHODS: Design and intervention: This study will be a randomized controlled clinical trial of two parallel groups. Each subject included in the study will be randomly assigned to one of two study groups: control group (no supplement), intervention group (50 g of raisins daily during 6 months). STUDY POPULATION: The participants will be selected by consecutive sampling in the Primary Care consultations of urban health centers in Salamanca and Zamora (Spain), taking into account the selection criteria. STUDY VARIABLES: Two visits will be made, baseline and at 6 months. Cognitive performance will be evaluated (Mini-Mental State Examination test, Rey Auditory Verbal Learning Test, verbal fluency and montreal cognitive assessment (Moca)). It will also be analyzed the level of physical activity, quality of life, activities of daily living, energy and nutritional composition of the diet, body composition, blood pressure, heart rate, markers of inflammation and other laboratory tests of clinical relevance (glycaemia, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides). In addition, sociodemographic data, personal and family history, medication use and alcohol and tobacco consumption will be collected. DISCUSSION: In this project, it is intended to contribute to minimize the problems derived from cognitive deterioration in older people. TRIAL REGISTRATION: ClincalTrials.gov Identifier: NCT04966455 Registration date: July 1, 2021.

Evaluation of the danger of a tailings pile belonging to an active mine through its characterization and a dispersion model.

Mining is one of the principal economic activities in Mexico, which in addition to bringing benefits to the population, causes health and environmental problems. This activity produces a lot of wastes, but the main one is tailings. In Mexico, these wastes are disposed of in the open air, and there is no control over them, so the particles of these wastes are dispersed by wind currents to the surrounding population. In this research, tailings were characterized, finding in them particles smaller than 100 microns; in this way, tailings can enter into the respiratory system and hence can cause diseases. Furthermore, it is important to identify the toxic components. The present work does not have previous research in Mexico, and it shows a qualitative characterization of the tailings from an active mine using different analytical techniques. In addition to the data obtained from the characterization of the tailings, as well as the concentration of the toxic elements found, which were Pb and As, a dispersal model was generated and used to estimate the concentration of particles in the wind generated at the studied area. The air quality model used in this research is AERMOD, where it uses emission factors and available databases provided by Environmental Protection Agency (USEPA); Moreover, the model was coupled with meteorological information from the latest generation WRF model. The modeling results estimated that the dispersion of particles from the tailings dam can contribute up to 10.15 µg/m3 of PM10 to the air quality of the site, which, according to the characterization of the samples obtained, could be dangerous for human health and can be estimated up to a concentration of 0.04 µg/m3 of Pb and 10.90 ng/m3 of As. It is very important to make this kind of research to know the risk which people around this disposal sites are exposed to.

Retinal blood vessel calibre and vascular ageing in a general Spanish population: A EVA study.

INTRODUCTION: The aim of this work was to analyse the association of the retinal arteriolar calibre and the arteriole/venule index (AV index) with vascular ageing in a general population without previous cardiovascular disease. MATERIALS AND METHODS: Descriptive cross-sectional study. A total of 482 individuals without cardiovascular disease (mean age: 55.6 ± 14.2 years) were selected by random sampling, stratified by age and sex. The retinal arteriolar calibre was measured using digital fundus images of the back of the eye captured with a validated, semiautomatized and computer-assisted software (Index calculator). Vascular ageing was defined using three criteria based on the values of: (1) Carotid-femoral Pulse Wave Velocity (cfPWV), (2) Brachial-ankle Pulse Wave Velocity (baPWV) and (3) Carotid Intima-Media Thickness. RESULTS: The AV index and arteriolar calibre show a negative correlation with age, arterial pressure, cardiovascular risk and parameters of vascular structure and function (p < 0.001 in all cases). We found lower mean values of the AV index and arteriolar calibre in the individuals with early vascular ageing compared to those with healthy vascular ageing. AV index was negatively correlated with cfPWV ((ß=-2.9; 95% CI (-4.7; -1.1)), baPWV ((ß=-3.2; 95% CI (-5.4; -0.9)) and vascular ageing index ((ß=-1.7; 95% CI (-2.7; -0.7)). Arteriolar calibre showed a negative correlation with baPWV (ß=-0.1; 95% CI (-0.2; -0.1)). In the logistic regression analysis, lower values of AV index ((OR=0.01; 95% CI (0.01-0.10), OR=0.03; 95% CI (0.01-0.11) and OR=0.09; 95% CI (0.01-0.67)) were associated with EVA defined with cfPWV, baPWV and vascular ageing index respectively, and lower values of arteriolar calibre ((OR=0.71; 95% CI (0.55-0.91)) were associated with EVA defined with vascular ageing index. CONCLUSIONS: Lower values of AV index and retinal arteriolar calibre were associated with vascular ageing in a general Spanish population without previous cardiovascular disease.

Multimodal physical exercise and functional rehabilitation program in oncological patients with asthenia. study protocol.

BACKGROUND: The increase in the survival of oncology patients include multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. An implementation of the conventional clinical practice, developed through multimodal physical exercise and functional rehabilitation program intervention, may be useful in controlling dyspnoea. This study aims to evaluate the effects of a multimodal exercise and functional rehabilitation program on fatigue, pain, functional capacity, and quality of life in cancer patients with cancer-related asthenia. METHODS: This is a protocol for an experimental, prospective, randomised study using a parallel, fixed assignment scheme, with an experimental group and a control group in patients from the oncology hospitalisation unit at the Salamanca University Hospital Complex in Spain, using consecutive sampling to select 50 participants with oncological asthenia who are hospitalised at the time of inclusion. After the baseline evaluation, the participants will be randomised into two groups. Both groups will receive standard clinical practice care and the normal health education program at discharge, but in addition, the participants assigned to the experimental group will also complete a multimodal exercise and functional rehabilitation program lasting one month. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of asthenia (FACT-An scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the attention and executive functions (Trail-Making Test), fear/avoidance of movement (TAMPA scale), pain (VAS scale), and body composition (waist, hip, brachial, thigh, wrist, and ankle circumferences). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with asthenia. The current study addresses to improve the conventional clinical practice by proposing a multimodal physical exercise and functional rehabilitation program intervention, which will be implemented by an interdisciplinary team, to try to improve the autonomy of cancer patients with cancer-related asthenia. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04761289. (February 18, 2021).  https://clinicaltrials.gov/ct2/show/ NCT04761289.

Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol.

BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

The Relationship Between Alcohol Consumption With Vascular Structure and Arterial Stiffness in the Spanish Population: EVA Study.

BACKGROUND: Controversy exists regarding the way alcohol use is associated with vascular structure and arterial stiffness parameters. The purpose of this study is to evaluate the association between alcohol consumption with vascular structure and arterial stiffness in an adult population. METHODS: We conducted a cross-sectional study. Five hundred and one participants were recruited by random sampling from an urban population of 43,946 individuals aged 35 to 75 years, assigned from 5 healthcare centers located in Salamanca, Spain. This was a subanalysis of the EVA study. Arterial stiffness was assessed by measuring cardio-ankle vascular index (CAVI) and brachial-ankle pulse wave velocity (ba-PWV) with the VaSera VS-1500® device, and carotid-femoral pulse wave velocity (cf-PWV) with the Sphygmocor® . Vascular structure was evaluated by measuring the carotid intima-media thickness (c-IMT) with a Sonosite Micromax® ultrasound. Alcohol consumption was calculated using a standardized questionnaire and quantified in g/wk. RESULTS: In the multiple regression analysis adjusted for sex, age, smoking status, and systolic blood pressure, the c-IMT and cf-PWV values of individuals drinking > 70 g/wk were higher than those of the reference group (nondrinkers) by 0.02 mm (p = 0.030) and 0.42 m/s (p = 0.021), respectively. The association between alcohol consumption with vascular structure and arterial stiffness only attains statistical significance for cf-PWV (p = 0.039) and c-IMT (p = 0.019), showing an association which suggests a J-shaped association. This association was not statistically significant for ba-PWV and CAVI (p = 0.446 and p = 0.141, respectively), although a similar trend was observed with ba-PWV. CONCLUSIONS: The results of this study suggest that heavy alcohol consumption (>70 g/wk) is associated with increased c-IMT and cf-PWV. Moreover, we found a J-shaped association between alcohol consumption and c-IMT and cf-PWV values as markers of vascular structure and arterial stiffness, with no association with ba-PWV and CAVI being observed.

Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study).

BACKGROUND: The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance. METHODS: This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient's daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet. DISCUSSION: Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03574480 . Date of trial Registration July 2, 2018.

Effectiveness of an intensive intervention to improve lifestyles in people with intermediate cardiovascular risk (DATE study): Study protocol for a randomized controlled trial.

AIM: The aim of this study was to evaluate the effectiveness of an intensive intervention led by primary care nurses for lifestyle modification among people with intermediate cardiovascular risk. BACKGROUND: Cardiovascular diseases may be prevented by adopting healthy lifestyles. Interventions focused on populations at risk are more efficient than those aimed at the general population. More than 50 per cent of cardiovascular events occur in people with intermediate cardiovascular risk, but only a few studies have targeted this population. DESIGN: A randomized controlled trial approved in January 2017. METHODS: We will recruit 208 participants aged 35-74 years who have intermediate cardiovascular risk. They will be selected by consecutive sampling and will be randomized into a control group or intervention group. Individual standardized brief counselling on healthy lifestyles will be provided to both groups. Additionally, individuals from the intervention group will receive four weekly group sessions focusing on cardiovascular risk, healthy diet, moderation in alcohol consumption, daily physical activity, stress management and smoking cessation and two motivational follow-up calls. The primary outcome will be the lifestyle modification measured by total steps recorded by a pedometer, total score on the Mediterranean Diet Adherence Screener and percentage of current smokers. DISCUSSION: This study will allow us to investigate whether an intensive intervention based on a multifactorial group approach is more effective in lifestyle modification than individual standardized brief counseling among adults with intermediate cardiovascular risk. Our results could lead to the establishment of new strategies for cardiovascular risk management.

Behavioural intervention to reduce resistance in those attending adult day care centres: PROCENDIAS study protocol for a randomized clinical trial.

AIM: This study evaluates the effectiveness of a behavioural intervention programme aimed at reducing the reluctance of dependent people to attend Adult Day Care Centres. We hope that reducing resistance will have a positive influence on the mental health of caregivers. BACKGROUND: Care centres offer important relief and rest services for family caregivers. Some caregivers report being affected by behavioural and psychological symptoms of dementia when they prepare dependents for the Care Centres, especially when these have dementia. Caregivers often report the need for information about how to manage the behaviour of the sick. Nurses in community healthcare units can investigate cases of patients who present resistance when attending care centres and can promote the use of interventions aimed at reducing this problem. DESIGN: Randomised controlled clinical trial. METHODS: The reference population will be care centre users in Salamanca (Spain) to select 120 family members responsible for the preparation and transfer of the care-recipient. Each participant will be randomised to an intervention group or control group (standard care). A baseline assessment and 6 months follow-up assessment will be performed (study approved in September 2016). INTERVENTION: The intervention group will consist of 8 sessions, one per week, each lasting 90 min. Each session will be run by a psychologist trained in behaviour analysis and will be tailored to the specific behavioural problems reported by the caregivers. DISCUSSION: The results of a previously published pilot study allow us to be optimistic about the possibilities of a brief intervention.

Effect and usability of the use of twitter as a complementary teaching tool in different subjects of nursing studies: Educational intervention study.

BACKGROUND: Some social networks, such as Twitter (now known as X), have proven to be very useful for sharing and discussing multiple aspects related to the healthcare field. However, the use of Twitter as a method of communication and knowledge transfer to nursing students has been limited. OBJECTIVES: To evaluate the usability and effect of an educational intervention for monitoring additional content, through the social network Twitter, of various subjects of nursing studies (clinical nursing, community nursing, and nursing fundamentals). DESIGN: An exploratory experimental study was carried out through an educational intervention during the 2020-2021 and 2021-2022 academic years. SETTINGS: Faculty of Nursing at the University of Salamanca, Spain. Participants were 308 students. METHODS: Students used Twitter to receive tweets about news or links to subject-related content. They also completed a pre-post questionnaire. RESULTS: A high degree of visualization and interaction of the study's Twitter account stands out, mainly in the subject clinical nursing. In relation to usability, the participants stated that they strongly agreed with aspects such as "thinking that it was easy to use the account" (59.4 %) as well as "imagining that the majority of colleagues would learn very quickly to use said account" (46.5 %). Students who used the account at least once a day obtained higher scores on the post-study knowledge questionnaire than those who used it less than once a day (p < 0.05), or those who used it 2 or 3 times during the study (p = 0.010). CONCLUSIONS: The group of participants who used the Twitter account at least once a day stated that using the account was easy and that they would like to use it more frequently. Likewise, greater use of this tool was associated with a better score on a post-study knowledge questionnaire.

Effects of a Raisin Supplement on Cognitive Performance, Quality of Life, and Functional Activities in Healthy Older Adults-Randomized Clinical Trial.

The objective of this study was to evaluate the effects of consuming 50 g of raisins on cognitive performance, quality of life, and functional activities in healthy older adults. This is a parallel randomized controlled clinical trial, in which 80 subjects over 70 years of age participated. For 6 months, the intervention group (IG; n = 40) consumed 50 g of raisins per day added to their usual diet, whereas the control group (CG; n = 40) received no supplement. All variables were measured at baseline and at 6 months. Cognitive performance assessed with the Montreal Cognitive Assessment (MOCA) test shows a difference of 3.27 points (95% CI 1.59 to 4.96), p ≤ 0.001, favorable to the IG, after the intervention. Among the cognitive performances, an improvement is observed in the IG in orientation, assessed both with the MOCA test 0.49 (95% CI 0.10 to 0.87), p = 0.014, and with the Mini-Mental State Examination (MMSE) test, 0.36 (95% CI 0.02 to 0.70), p = 0.038. In visuospatial/executive capacity and in language, improvements were also observed in the IG, 1.36 (95% CI 0.77 to 1.95), p = 0.001, and 0.54 points (95% CI 0.12 to 0.96), p = 0.014, respectively. Immediate and delayed recall, assessed with the Rey Auditory Verbal Learning Test, improved in the IG. In addition, the IG showed a better quality of life and greater autonomy in instrumental activities of daily living after 6 months. No significant changes were observed in the rest of the variables analyzed. Therefore, the consumption of 50 g of raisins produces a slight improvement in cognitive performance, quality of life, and functional activities in the elderly.

Multimodal Physical Exercise and Functional Rehabilitation Program in Oncological Patients with Cancer-Related Fatigue-A Randomized Clinical Trial.

The increase in life expectancy and survival time implies an increase in the possible side-effects of pharmacological treatments in patients. Cancer-related fatigue is one of these side-effects. The main objective of this study was to evaluate the effects of a multimodal program of physical exercise and functional rehabilitation on asthenia, pain, functional capacity, and quality of life in cancer patients with cancer-related fatigue. METHODS: This was a randomized, parallel-controlled clinical trial, with two arms (experimental and control group), and it was conducted over the course of a year in the Oncology Hospitalization Unit at the University Hospital of Salamanca, Spain. Participants (n = 48) were assessed at three points during the study. The first assessment was prior to hospital discharge, the second assessment was after 15 days, and the final assessment was at one month post-hospital follow-up. The intervention lasted one month. The main variables studied were the dependency levels (Barthel), cancer-related fatigue (FACT-An), health-related quality of life (EuroQoL-5D), functional capacity (SPPB), and kinesiophobia (TSK-F). RESULTS: Sample size (n = 44). Mean age 63.46 ± 12.36 years. Significant differences between control and experimental group participants in Barthel, FACT-An, TSK-F, and SPPB scores at follow-up and final assessment. CONCLUSIONS: There are beneficial effects of a multimodal physical exercise and functional rehabilitation program in improving the autonomy of cancer-related fatigue patients.

Analysis of the determinants of sleep quality in a Spanish population: a study protocol for a cross-sectional study.

INTRODUCTION: Sleep problems are a growing public health concern being related, among others, to an increased risk of cardiovascular diseases or worse cognitive functioning. In addition, they can affect aspects related to personal motivation and quality of life. However, very few studies have analysed the possible determinants of sleep quality in the adult population as a whole, establishing patterns based on these determinants.The objectives are to evaluate the determinants of sleep quality in a representative sample of the general adult population between 25 and 65 years old, and to establish patterns of sleep quality based on lifestyles, psychological factors, morbidities, sociodemographic variables, biological markers and other possible determinants. METHODS AND ANALYSIS: Descriptive observational cross-sectional study. The study population will include a representative sample of 500 people between 25 and 65 years old from the cities of Salamanca and Ávila (Spain) selected by random sampling stratified by age groups and sex. A 90-minute visit will be performed, during which sleep quality will be assessed. The variables collected will be: morbidity, lifestyles (physical activity, diet, toxic habits), psychological factors (depression, stress, occupational stress and anxiety), socioeconomic and work-related variables, habitability conditions of the habitual residence and rest area, screen time, relaxation techniques and melatonin as a biological marker related to sleep quality. DISCUSSION: With the results of this work, improved interventions for behaviour modification could be designed, as well as intervention and education programmes or other research aimed at improving sleep quality. ETHICS AND DISSEMINATION: This study has a favourable opinion from the Ethics Committee for Drug Research of the Health Areas of Salamanca and Ávila (CEim Code: PI 2021 07 815). The results of this study will be published in international impact journals of different specialties. TRIAL REGISTRATION NUMBER: NCT05324267.

[Measurement of quality of life of workers who have passed cancer treatment]. / Calidad de vida tras superar un tratamiento oncológico.

The developing certain cancerous disease, affecting more and more people at younger ages, in many cases coincide with their working age. Through research and development of new therapies, there has been an increase in the number of people who manage to beat the disease and achieve a return above their working lives, giving thanks to this effort, a great help and motivation. A number of questionnaires consolidated and experienced to assess the quality of life of the population, but few studies have been reported on what type of survey would be most appropriate for use in the workplace to older workers who manage to overcome the cancer and rebuild their lives. This article aims to clarify which are the most widely used health questionnaires and proposing what would be most suitable to apply to these cases prevention services.

Vascular target organ damage in patients with Philadelphia negative myeloproliferative syndrome: A propensity score analysis.

PURPOSE: To assess whether subjects with Philadelphia negative myeloproliferative neoplasms (Ph-MPNs) show differences in the presence of vascular, cardiac or renal target organ damage (TOD) and other vascular function parameters as compared to individuals without this condition. METHODS: An observational study was conducted. Fifty-seven subjects diagnosed with Ph-MPNs used as cases and 114 subjects without Ph-MPNs as controls. We matched the subjects with and without Ph-MPNs using the propensity scores in a 1:2 ratio using the variables gender, type 2 diabetes mellitus, high blood pressure, hyperlipidaemia and smoking. Vascular, cardiac and renal TOD were established according to the criteria of the European Society of Hypertension and Cardiology guidelines. Arterial stiffness was also assessed using the cardio-ankle vascular index (CAVI). RESULTS: Mean age was 63.50±11.70 and 62.90±8.32 years in subjects with and without Ph-MPNs, 32 females (56%) in the first group and 62 (54%) in the second. Subjects with Ph-MPNs have a higher percentage of carotid injury than subjects without Ph-MPNs (35.1% vs. 21.1%) and higher albumin/creatinine ratio. In the logistic regression analysis, subjects with Ph-MPNs had an OR=2.382 (IC95% 1.066-5.323) for carotid injury versus those without haematological disease. CONCLUSIONS: Subjects with Ph-MPNs have twice the risk of by carotid injury than those without haematological disease.

Relationship of healthy vascular aging with lifestyle and metabolic syndrome in the general Spanish population. The EVA study.

INTRODUCTION AND OBJECTIVES: Our objective was to study the relationship of healthy vascular aging (HVA) with lifestyle and the components of metabolic syndrome. We also analyzed the differences between chronological age and heart age (HA) and vascular age (VA) in the Spanish adult population without cardiovascular disease. METHODS: This descriptive cross-sectional study selected 501 individuals without cardiovascular disease (mean age, 55.9 years; 50.3% women) via random sampling stratified by age and sex. HA was estimated with the Framingham equation, whereas VA was estimated with the VaSera VS-1500 device. HVA was defined as a <5-year difference between the chronological age and the HA or VA and the absence of a vascular lesion, hypertension, and diabetes mellitus. RESULTS: Compared with the chronological age, the mean HA and VA were 2.98±10.13 and 3.08±10.15 years lower, respectively. Smoking (OR, 0.23), blood pressure ≥ 130/85mmHg (OR, 0.11), altered baseline blood glucose (OR, 0.45), abdominal obesity (OR, 0.58), triglycerides ≥ 150mg/dL (OR, 0.17), and metabolic syndrome (OR, 0.13) decreased the probability of HVA estimated by HA; an active lifestyle (OR, 1.84) and elevated high-density lipoprotein-cholesterol (OR, 3.26) increased the probability of HVA estimated by HA. Smoking (OR, 0.45), blood pressure ≥ 130/85mmHg (OR, 0.26), altered baseline blood glucose (OR, 0.42), and metabolic syndrome (OR, 0.40) decreased the probability of HVA estimated by VA; abdominal obesity (OR, 1.81) had the opposite effect. CONCLUSIONS: HA and VA were 3 years lower than the chronological age. HA was associated with tobacco consumption, physical activity, and the components of metabolic syndrome. Meanwhile, VA was associated with tobacco consumption, blood pressure, waist circumference, and altered baseline glycemia. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Identifier: NCT02623894.

Combination of Polymeric Superplasticizers, Water Repellents and Pozzolanic Agents to Improve Air Lime-Based Grouts for Historic Masonry Repair.

This paper presents the experimental procedure to develop air lime-based injection grouts, including polymeric superplasticizers, a water repellent agent and pozzolanic agents as additives. Our research focuses on the development of grouts to improve various characteristics simultaneously by combining different additions and admixtures. Aiming to improve the injectability of the grouts, in this study, different polymeric superplasticizers were added, namely polycarboxylated-ether derivative (PCE), polynaphthalene sulfonate (PNS) and condensate of melamine-formaldehyde sulfonate (SMFC). As a water-repellent agent, sodium oleate was used to reduce the water absorption. The enhancement of the strength and setting time was intended by using microsilica and metakaolin as pozzolanic mineral additions. Compatibility between the different admixtures and action mechanism of the different polymers were studied by means of zeta potential and adsorption isotherms measurements. Diverse grout mixtures were produced and investigated by assessing their injectability, fluidity, stability, compressive strength, hydrophobicity and durability. This research led to several suitable mixtures produced by using more than one component, to enhance efficiency and to provide better performance of grouts. According to the results, the grout composed of air lime, metakaolin, sodium oleate and PCE was found to be the most effective composition, improving the mechanical strength, injectability and hydrophobicity.

Effects of Cocoa-Rich Chocolate on Blood Pressure, Cardiovascular Risk Factors, and Arterial Stiffness in Postmenopausal Women: A Randomized Clinical Trial.

This study aimed to evaluate the effects of the intake of 10 g of cocoa-rich chocolate on blood pressure, other cardiovascular risk factors, and vascular structure and function in postmenopausal women. A total of 140 postmenopausal women participated in this randomized and controlled parallel clinical trial. For six months, the intervention group (IG; n = 73) consumed daily 10 g of chocolate (99% cocoa) added to their usual food intake, whereas the control group (CG; n = 67) did not receive any intervention. Blood pressure, pulse pressure (PP), cardio-ankle vascular index (CAVI), ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), augmentation index, and laboratory variables were measured at baseline and six months. ANCOVA analyses adjusted for baseline values revealed no significant differences for systolic blood pressure (-1.45 mm Hg; 95% confidence interval (CI): -4.79, 1.88; p = 0.391) or baPWV (0.18 m/s; 95% CI: -0.14, 0.50; p = 0.263) between groups. A decrease in PP was observed in the IG compared to the CG (-2.05 mm Hg; 95% CI: -4.08, -0.02; p = 0.048). The rest of the vascular structure and function parameters and other measured variables remained unchanged. The daily intake of 10 g of cocoa-rich chocolate seems to provide little improvement to cardiovascular health, but neither does it cause any adverse effects on the parameters evaluated in postmenopausal women in the long term.

Using a smartphone app in changing cardiovascular risk factors: A randomized controlled trial (EVIDENT II study).

BACKGROUND AND OBJECTIVE: The last few years have seen the appearance many mobile applications aimed at improving health, but studies analyzing their effectiveness on cardiovascular risk factors (CVRFs) are few and far between. Our aim was to assess the effect on CVRFs such as hypertension, dyslipidemia, diabetes and global CVR, of adding the use of a smartphone app to an intervention consisting of standard counseling on physical activity and the Mediterranean diet. METHOD: This is a multicenter, randomized and controlled clinical trial. From January 2014 and September 2016, a total of 833 subjects selected by random sampling from six health centers participated. Of these, 415 were assigned to the counseling + app group (IG) and 418 to the counseling only group (CG). The IG additionally received training in the use of a mobile application. The main outcome was the change in CVRFs and estimated CVR at 3 and 12 months in the IG compared to the CG. RESULTS: No significant changes were observed at 3 or 12 months in terms of CVR. Nevertheless, an effect between groups was observed in favor of the CG at 12 months in some CVRFS: SBP, DBP, total cholesterol and triglycerides: 2.02 mmHg (95%CI: 0.43-3.61), 1.21 mmHg (95%CI: 0.20-2.24), 5.24 mg/dl (95%CI: 1.22-9.26) and 7.24 mg/dl (95%CI: 0.53-14.32). CONCLUSION: Adding an intervention with the use of an app for three months to standard counseling on diet and physical activity, does not provide additional benefits for improving CVRFs or the estimated CVR in the long term. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT02016014.

Relationship between the presence of insomnia and walking physical activity and diet quality: A cross-sectional study in a sample of Spanish adults.

INTRODUCTION AND OBJECTIVES: Certain lifestyle habits may influence aspects of sleep quality, such as insomnia. The main objective of the present study was to analyze the relationship of the presence of insomnia, with walking physical activity and diet quality in an adult population. PATIENTS AND METHODS: A cross-sectional descriptive study was performed (subanalysis of the TRIPLE A study) between January of 2014 to June of 2015. A total of 454 subjects were selected by consecutive sampling. Insomnia was evaluated with the Atenas scale, diet quality using the diet quality index (DQI) questionnaire, and physical activity using pedometers for seven days, evaluating the total number of steps, aerobic steps, and energy expended. RESULTS: Of all patients, 26.8% presented with insomnia (33.8% in women and 17.5% in men). In a adjusted model, the mean differences of total steps/day, aerobic steps/day, and kilocalories/day spent in performing physical activity, between no insomnia group and insomnia group were: 1022.5 (95% CI: 177.9-1867.0), 743.9 (95% CI: 68.3-1419.4) and 39.8 (95% CI: 5.7-73.9), respectively. We did not find an association between the diet quality index (DQI) and insomnia. CONCLUSIONS: The findings suggest that completing daily a greater total number of steps, aerobic steps, and energy expended by walking, could be correlated with less insomnia, independent of age, sex, and other confounding variables. However, no relationship was observed between diet quality and insomnia.