Physical therapy in Down syndrome: systematic review and meta-analysis.

BACKGROUND: Down syndrome is the most common chromosomal abnormality, with a worldwide incidence of around 0.1% in live births. It is related to several conditions in which the physical therapy could take action-preventing co-morbidities. This study aims to evaluate the effectiveness of physical therapy in Down syndrome, to know and compare the effectiveness of different physical therapy interventions in this population. METHODS: A systematic review and a meta-analysis of randomised controlled trials were conducted. The search was performed during June 2018 in the following databases: PubMed, Web of Science, Physiotherapy Evidence Database and Scopus. The studies were selected using predefined inclusion and exclusion criteria. The Physiotherapy Evidence Database scale evaluated the quality of the methods used in the studies. Subsequently, the data were extracted, and statistical analysis was performed when possible. RESULTS: A total of 27 articles were included, of which nine contributed information to the meta-analysis. Statistical analysis showed favourable results for the strength of upper and lower limbs [standardised mean difference (SMD) = 1.46; 95% confidence interval (CI): (0.77-2.15); and SMD = 2.04; 95% CI: (1.07-3.01)] and mediolateral oscillations of balance [SMD = -3.30; 95% CI: (-5.34 to -1.26)]. CONCLUSIONS: The results show the potential benefit of certain types of physical therapy interventions, specifically in strength and balance, in people with Down syndrome. There are still many aspects to clarify and new lines of research.

Thermally Driven Electronic Topological Transition in FeTi.

Ab initio molecular dynamics, supported by inelastic neutron scattering and nuclear resonant inelastic x-ray scattering, showed an anomalous thermal softening of the M_{5}^{-} phonon mode in B2-ordered FeTi that could not be explained by phonon-phonon interactions or electron-phonon interactions calculated at low temperatures. A computational investigation showed that the Fermi surface undergoes a novel thermally driven electronic topological transition, in which new features of the Fermi surface arise at elevated temperatures. The thermally induced electronic topological transition causes an increased electronic screening for the atom displacements in the M_{5}^{-} phonon mode and an adiabatic electron-phonon interaction with an unusual temperature dependence.

Iodine status and thyroid function among Spanish schoolchildren aged 6-7 years: the Tirokid study.

I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6-7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 µg/l, and 17·9 % of children showed UI<100 µg/l. The median UI was higher in males (180·8 v. 153·6 µg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.

Myotonic dystrophy type 1: 13 years of experience at a tertiary hospital. Clinical and epidemiological study and genotype-phenotype correlation.

INTRODUCTION: The incidence of myotonic dystrophy type 1 (DM1), a disease with great phenotypic variety, in our region is unknown. This study aims to estimate the incidence of DM1 at our hospital (a reference centre in Aragon, Spain) and to identify the characteristics of our population (genotype-phenotype correlation). METHODS: Retrospective, descriptive study of 459 patients classified according to the number of CTG repeats, as follows: normal (5-35), premutation (36-50), protomutation (51-80), small expansions (81-150), intermediate expansions (151-1000), and large expansions (> 1000). Furthermore, according to clinical phenotype, patients were categorised as unaffected (5-50 CTG repeats), mild form or asymptomatic (51-150), classical form (151-1000), and severe form (> 1000). RESULTS: The incidence of DM1 was 20.61 cases per million person-years (95% CI, 19.59-21.63). An inverse correlation was observed between the number of CTG repeats and the age at genetic diagnosis (ρ = -0.547; 95% CI, -0.610 to -0.375; P < .001). CTG5 was the most frequent polymorphic allele in healthy individuals. Of all patients with DM1, 28.3% presented the mild or asymptomatic form, 59.1% the classical form, and 12.6% the severe form. Inheritance was maternal in 35.1% of cases, paternal in 59.4%, and uncertain in 5.5%. In mild forms, frontal balding in men was the most prevalent phenotypic trait, as well as myotonia and cataracts, while in the classical form, ptosis, facial weakness, voice and pronunciation alterations, myotonia, and fatigue/sleepiness were most frequent. CONCLUSIONS: The incidence of DM1 in Aragon is significant. Multidisciplinary study of the phenotype of patients with DM1 is key to early diagnosis and personalised management.

Understanding the impact of the COVID-19-related lockdown in university workers. Identifying groups through cluster analysis.

Objective: To analyse the COVID-19-related lockdown impact on University workers, to identify groups based on this information, and to study the factors associated with each group. Study design: Cross-sectional study. Methods: A survey was conducted 3.5 weeks after COVID-19-related lockdown in University workers in Spain. Sociodemographic variables, housing, work, health conditions, levels of anxiety, stress and depression (DASS-21), and social support (MSPSS) were collected. A cluster analysis was performed to identify groups depending on the impact of the lockdown. Differences between groups were tested using Chi-square and Mann-Whitney-U tests, and associated factors with binary logistic regression. Results: We identified two groups of workers. "G1: Consequences in the daily life routine" was mainly composed of men, Research and Teaching Personnel (RTP) with more stable professional categories, higher income level, and bigger houses than people in G2. Participants in "G2: Concerns for the current and future well-being" presented worse intensity of pain than before the lockdown, more anxiety, depression, stress and less social support than people in G1. ASP (Administration and Services Personnel) had more risk of belonging to G2 than RTP (OR = 5.863). A higher number of people living at home decreased the risk of being in G2 (OR = 0.439). People with lower pain intensity had less risk of being in G2 (OR = 0.014), and this risk decreased as friends support increased (OR = 0.833). Conclusions: In G1, the consequences were immediately reflected in the stress resulting from changes in their daily work routine. In G2, the concerns were related to their professional future, with worse mental health, greater intensity of pain and less social support.

Structural relationship between negative thermal expansion and quartic anharmonicity of cubic ScF3.

Cubic scandium trifluoride (ScF3) has a large negative thermal expansion over a wide range of temperatures. Inelastic neutron scattering experiments were performed to study the temperature dependence of the lattice dynamics of ScF3 from 7 to 750 K. The measured phonon densities of states show a large anharmonic contribution with a thermal stiffening of modes around 25 meV. Phonon calculations with first-principles methods identified the individual modes in the densities of states, and frozen phonon calculations showed that some of the modes with motions of F atoms transverse to their bond direction behave as quantum quartic oscillators. The quartic potential originates from harmonic interatomic forces in the DO9 structure of ScF3, and accounts for phonon stiffening with the temperature and a significant part of the negative thermal expansion.

Positive vibrational entropy of chemical ordering in FeV.

Inelastic neutron scattering and nuclear resonant inelastic x-ray scattering were used to measure phonon spectra of FeV as a B2 ordered compound and as a bcc solid solution. The two data sets were combined to give an accurate phonon density of states, and the phonon partial densities of states for V and Fe atoms. Contrary to the behavior of ordering alloys studied to date, the phonons in the B2 ordered phase are softer than in the solid solution. Ordering increases the vibrational entropy by +0.22±0.03 kB/atom, which stabilizes the ordered phase to higher temperatures. First-principles calculations show that the number of electronic states at the Fermi level increases upon ordering, enhancing the screening between ions, and reducing the interatomic force constants. The effect of screening is larger at the V atomic sites than at the Fe atomic sites.

Improving anaphylaxis management in a pediatric emergency department.

BACKGROUND: The management of anaphylaxis in pediatric emergency units (PEU) is sometimes deficient in terms of diagnosis, treatment, and subsequent follow-up. The aims of this study were to assess the efficiency of an updated protocol to improve medical performance, and to describe the incidence of anaphylaxis and the safety of epinephrine use in a PEU in a tertiary hospital. METHODS: We performed a before-after comparative study with independent samples through review of the clinical histories of children aged <14 years old diagnosed with anaphylaxis in the PEU according to the criteria of the European Academy of Allergy and Clinical Immunology (EAACI). Two allergists and a pediatrician reviewed the discharge summaries codified according to the International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) as urticaria, acute urticaria, angioedema, angioneurotic edema, unspecified allergy, and anaphylactic shock. Patients were divided into two groups according to the date of implantation of the protocol (2008): group A (2006-2007; the period before the introduction of the protocol) and group B (2008-2009; after the introduction of the protocol). We evaluated the incidence of anaphylaxis, epinephrine administration, prescription of self-injecting epinephrine (SIE), other drugs administered, the percentage of admissions and length of stay in the pediatric emergency observation area (PEOA), referrals to the allergy department, and the safety of epinephrine use. RESULTS: During the 4 years of the study, 133,591 children were attended in the PEU, 1673 discharge summaries were reviewed, and 64 cases of anaphylaxis were identified. The incidence of anaphylaxis was 4.8 per 10,000 cases/year. After the introduction of the protocol, significant increases were observed in epinephrine administration (27% in group A and 57.6% in group B) (p = 0.012), in prescription of SIE (6.7% in group A and 54.5% in group B) (p = 0.005) and in the number of admissions to the PEOA (p = 0.003) and their duration (p = 0.005). Reductions were observed in the use of corticosteroid monotherapy (29% in group A, 3% in group B) (p = 0.005), and in patients discharged without follow-up instructions (69% in group A, 22% in group B) (p = 0.001). Thirty-three epinephrine doses were administered. Precordial palpitations were observed in one patient. CONCLUSION: The application of the anaphylaxis protocol substantially improved the physicians' skills to manage this emergency in the PEU. Epinephrine administration showed no significant adverse effects.

Sorption and desorption of Cd, Cu and Pb using biomass from an eutrophized habitat in monometallic and bimetallic systems.

This work examines the sorption capacity of a natural biomass collected from an irrigation pond. The biomass mainly consisted of a mixture of chlorophyte algae with caducipholic plants. Biosorption experiments were performed in monometallic and bimetallic solutions containing different metals commonly found in industrial effluents (Cd, Cu and Pb). The biosorption process was slightly slower in the binary system comparing with monometallic system which was related to competition phenomena between metal cations in solution. The biosorbent behaviour was quantified by the sorption isotherms fitting the experimental data to mathematical models. In monometallic systems, the Langmuir model showed a better fit with the following sorption order: Cu ~ Pb > Cd; and biomass-metal affinity order: Pb > Cd ~ Cu. In bimetallic systems, the binary-type Langmuir model was used and the sorption order obtained was: Pb ~ Cu > Cd. In addition, the effectiveness of the biomass was investigated in several sorption-desorption cycles using HCl and NaHCO(3). The recovery of metal was higher with HCl than with NaHCO(3), though the sorption uptake of the biomass was sensitively affected by the former desorption agent in subsequent sorption cycles.

Mechanism of adsorption of ferric iron by extracellular polymeric substances (EPS) from a bacterium Acidiphilium sp.

The aim of this study was to assess the sorption of Fe(III) by extracellular polymeric substances (EPS) of the Acidiphilium 3.2Sup(5) bacterium, which has promising properties for use in microbial fuel cells (MFC). The EPS of A. 3.2Sup(5) was extracted using EDTA. The sorption isotherms were determined using aliquots of purified EPS. The exosubstances loaded with metal were characterized by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), X-ray diffraction spectroscopy (XRD) and Fourier transform infrared spectroscopy (FTIR). The sorption uptake approaches to 536.1 +/- 26.6 mg Fe(III) (g EPS)(-1) at an initial ferric concentration of 2.0 g l(-1). The sorption of Fe(III) by EPS can be fitted to the Freundlich model. The sorption process produces hydrated iron (III) oxalate [Fe(OH)(C2O4) x 2H2O] by a reversible reaction (log K = 1.06 +/- 0.16), indicating that a shift in the sorption of the cation can be easily achieved. Know the magnitude and form of iron sorption by EPS in MFC can foresee the potential impact on the metabolism of iron-reducing and iron-oxidazing bacteria and, therefore, on the feasibility of the system.

Myotonic dystrophy type1: 13years of experience at a tertiary hospital. Clinical and epidemiological study and genotype-phenotype correlation. / Distrofia miotónica tipo1: 13años de experiencia en un hospital terciario. Estudio clínico y epidemiológico. Correlación genotipo-fenotipo.

INTRODUCTION: The incidence of myotonic dystrophy type1 (DM1), a disease with great phenotypic variety, in our region is unknown. This study aims to estimate the incidence of DM1 at our hospital (a reference centre in Aragon, Spain) and to identify the characteristics of our population (genotype-phenotype correlation). METHODS: Retrospective, descriptive study of 459 patients classified according to the number of CTG repeats, as follows: normal (5-35), premutation (36-50), protomutation (51-80), small expansions (81-150), intermediate expansions (151-1000), and large expansions (>1000). Furthermore, according to clinical phenotype, patients were categorised as unaffected (5-50 CTG repeats), mild form or asymptomatic (51-150), classical form (151-1000), and severe form (>1000). RESULTS: The incidence of DM1 was 20.61 cases per million person-years (95%CI: 19.59-21.63). An inverse correlation was observed between the number of CTG repeats and the age at genetic diagnosis (ρ=-0.547; 95%CI: -0.610 to -0.375; P<.001). CTG5 was the most frequent polymorphic allele in healthy individuals. Of all patients with DM1, 28.3% presented the mild or asymptomatic form, 59.1% the classical form, and 12.6% the severe form. Inheritance was maternal in 35.1% of cases, paternal in 59.4%, and uncertain in 5.5%. In mild forms, frontal balding in men was the most prevalent phenotypic trait, as well as myotonia and cataracts, while in the classical form, ptosis, facial weakness, voice and pronunciation alterations, myotonia, and fatigue/sleepiness were most frequent. CONCLUSIONS: The incidence of DM1 in Aragon is significant. Multidisciplinary study of the phenotype of patients with DM1 is key to early diagnosis and personalised management.

Phosphorus digestibility and bioavailability in soybean meal, spray-dried plasma protein, and meat and bone meal determined using different methods.

Three experiments were conducted to determine phosphorus (P) digestibility and bioavailability using different methods. The objective of the first experiment was to determine ileal P digestibility of soybean meal (SBM), meat and bone meal (MBM), and spray-dried plasma protein (SDPP) using a precision-fed broiler chick assay. This assay involved feeding 8 g of SBM, MBM, or SDPP to broiler chicks at 21 D of age. At 6 h after feeding, ileal digesta were collected. Ileal P digestibility of SBM, MBM, and SDPP was 64, 42, and 94%, respectively. In the second experiment, ileal P digestibility and excreta P retention of SBM, SDPP, and MBM were determined using an ad libitum fed chick assay. On day 17 of age, chicks were placed on 1 of 12 dietary treatments that consisted of diets containing increasing levels of SBM, SDPP, or MBM. On day 21, ileal digesta and excreta were collected. True ileal P digestibility and true excreta P retention estimated using regression of ileal P or excreta P output on dietary P content yielded true ileal P digestibility values for SBM, SDPP, and MBM (2 diet methods for MBM) to be 83, 98, 61, and 23%, respectively. True excreta P retention values for SBM, SDPP, and MBM (2 methods) were determined to be 51, 99, 32, and 53%, respectively. The third experiment determined bioavailability of P in SBM, SDPP, and MBM relative to KH2PO4 using a chick bone ash bioassay. Dietary treatments included a P-deficient cornstarch-dextrose-SBM diet supplemented with 2 increasing levels of P from KH2PO4, SBM, SDPP, or MBM. Bioavailability of P based on tibia ash estimated using the multiple regression slope ratio method was 36, 125, and 76% for SBM, SDPP, and MBM, respectively, relative to KH2PO4. The results of this study indicated the digestibility/relative bioavailability of the P in SDPP was very high for all 3 methods, but values for SBM and MBM varied greatly among different methods.

[Use of single-electrode EEG in the evaluation of attention-deficit/hyperactivity disorder]. / Empleo del electroencefalograma de un solo electrodo en la evaluación del trastorno por déficit de atención/hiperactividad.

INTRODUCTION: Attention deficit/hyperactivity disorder (ADHD) maintains a diagnosis based on behavioral data despite its involvement in neuropsychophysiological models. The monopolar electroencephalography (EEG) record focused on differentiating children with ADHD versus controls based on a higher theta/beta ratio has been proposed as an alternative to objectify the diagnosis and guide neurofeedback-based intervention, but its results have been controversial. AIM: To analyze the viability of a single electrode to detect differences in the main cerebral rhythms and especially in theta/beta ratio, in children diagnosed with ADHD, analyzing the differences by subtype, age, sex and type of experimental task. PATIENTS AND METHODS: 92 children (range: 7-13 years) diagnosed with ADHD were evaluated in a monopolar EEG record on four experimental tasks (rest, reading, active listening and copying a figure). Seven measures on slow and fast EEG rhythms were obtained, plus theta/beta ratio. RESULTS: There were no differences by ADHD subtypes. The task of greatest cognitive demand obtained the highest wave amplitudes. Smaller participants and boys presented higher amplitudes in slow waves and in theta/beta ratio in all the experimental tasks, showing a greater tendency to attentional regulation problems. CONCLUSION: Monopolar record and theta/beta ratio are a viable alternative in the clinical setting to complement the evaluation of ADHD.

TITLE: Empleo del electroencefalograma de un solo electrodo en la evaluación del trastorno por déficit de atención/hiperactividad.Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) mantiene un diagnóstico basado en datos conductuales a pesar de su implicación en modelos neuropsicofisiológicos. El registro del electroencefalograma (EEG) monopolar centrado en diferenciar a los niños con TDAH frente a los controles en función de una mayor ratio theta/beta se ha propuesto desde hace tiempo como una alternativa para objetivar el diagnóstico y guiar la intervención basada en neurofeedback, pero sus resultados han resultado controvertidos. Objetivo. Analizar la viabilidad de un único electrodo para detectar diferencias en los principales ritmos cerebrales, y especialmente en la ratio theta/beta, en niños con diagnóstico de TDAH, analizando las diferencias por subtipo, edad, sexo y tarea. Pacientes y métodos. Se evaluó a 92 niños (rango: 7-13 años) con diagnóstico de TDAH en un registro de EEG monopolar sobre cuatro tareas (reposo, lectura, escucha activa y copiar una figura). Se obtuvieron siete medidas basadas en ritmos EEG lentos y rápidos, más la ratio theta/beta. Resultados. No hubo diferencias por subtipos de TDAH. La tarea de mayor demanda cognitiva obtuvo en general las amplitudes de onda más elevadas. Los participantes más pequeños y los varones presentaron en general una ratio theta/beta y amplitudes en las ondas lentas más elevadas en todas las tareas investigadas, y mostraron una mayor tendencia a problemas de regulación atencional. Conclusión. El registro monopolar y la ratio theta/beta son una alternativa viable en el ámbito clínico, al menos para complementar la evaluación del TDAH.

Effects of a high-fat-diet supplemented with probiotics and ω3-fatty acids on appetite regulatory neuropeptides and neurotransmitters in a pig model.

The pig is a valuable animal model to study obesity in humans due to the physiological similarity between humans and pigs in terms of digestive and associated metabolic processes. The dietary use of vegetal protein, probiotics and omega-3 fatty acids is recommended to control weight gain and to fight obesity-associated metabolic disorders. Likewise, there are recent reports on their beneficial effects on brain functions. The hypothalamus is the central part of the brain that regulates food intake by means of the production of food intake-regulatory hypothalamic neuropeptides, as neuropeptide Y (NPY), orexin A and pro-opiomelanocortin (POMC), and neurotransmitters, such as dopamine and serotonin. Other mesolimbic areas, such as the hippocampus, are also involved in the control of food intake. In this study, the effect of a high fat diet (HFD) alone or supplemented with these additives on brain neuropeptides and neurotransmitters was assessed in forty-three young pigs fed for 10 weeks with a control diet (T1), a high fat diet (HFD, T2), and HFD with vegetal protein supplemented with Bifidobacterium breve CECT8242 alone (T3) or in combination with omega-3 fatty acids (T4). A HFD provoked changes in regulatory neuropeptides and 3,4-dihydroxyphenylacetic acid (DOPAC) in the hypothalamus and alterations mostly in the dopaminergic system in the ventral hippocampus. Supplementation of the HFD with B. breve CECT8242, especially in combination with omega-3 fatty acids, was able to partially reverse the effects of HFD. Correlations between productive and neurochemical parameters supported these findings. These results confirm that pigs are an appropriate animal model alternative to rodents for the study of the effects of HFD on weight gain and obesity. Furthermore, they indicate the potential benefits of probiotics and omega-3 fatty acids on brain function.

Optimization of the continuous biosorption of copper with sugar-beet pectin gels.

Sugar-beet pectin xerogels obtained from residues of the sugar industry are an adequate material for metal recovery from effluents in continuous systems. The xerogels were used as a biosorbent for copper removal in a fixed-bed column. The performance of the system was evaluated in different experimental conditions: flow rate, bed height, inlet metal concentration and feeding system (drop and reverse). The effect on the biosorption parameters (saturation time, amount of adsorbed and treated metal, column performance and metal uptake) and the shape of the breakthrough curves was determined. The saturation time increased with increasing bed height but decreased with increasing feed flow rate and inlet metal concentration. Preferential flow channels greatly influenced the metal uptake and column performance. Copper was completely desorbed with 0.1M HNO(3). Additionally, the column data fitted both the linear and nonlinear expressions of the Thomas model.

Extraction of extracellular polymeric substances from the acidophilic bacterium Acidiphilium 3.2Sup(5).

Extraction of extracellular polymeric substances (EPS) from Acidiphilium 3.2Sup(5) was investigated using five methods: EDTA, NaOH, ion exchange resin, heating and centrifugation. The bacterium studied presents promising application in microbial fuel cells (MFCs). The degree of cellular lysis provoked by each method was determined by UV-visible spectroscopy of cultures before and after EPS extraction. In addition, two electron microscopy techniques (TEM and SEM) were employed to determine the degree of attachment and the growth of the biofilm overtime on two solid supports: carbon fibre cloth and graphite rods. The main constituents of the EPS extracted by all methods were proteins and carbohydrates, as confirmed by FT-IR analysis, showing the major presence of carboxylic, hydroxylic and amino groups. The greater extractions of EPS were obtained using EDTA. This method also produced a less degree of cellular lysis. Furthermore, both the amount and the chemical composition of EPS strongly depended on the extraction method used.

[Effects of virtual reality on balance and gait in stroke: a systematic review and meta-analysis]. / Efectos de la realidad virtual sobre el equilibrio y la marcha en el ictus: revision sistematica y metaanalisis.

INTRODUCTION: Stroke is the leading cause of disability in adulthood. Recently the improvement of virtual reality technologies has been used in the rehabilitation of stroke patients. AIM: To review published research literature on the effects of the virtual reality interventions vs conventional therapy on balance and gait in stroke. PATIENTS AND METHODS: A systematic and a meta-analysis of randomized controlled trials was performed during March 2018 in the databases: PubMed, PEDro, Web of Science, Scopus, Cochrane Library and Medline at EBSCO. The selection criteria were: randomized controlled trials published in English or Spanish during the past ten years. The PEDro scale evaluated the quality of the methods used in the studies. A total of 14 clinical trials were included in the systemic review, of which 10 contributed information to the meta-analysis. RESULTS: Favourable results were found on balance (Berg Balance Scale: standardized mean difference, SMD = -1.89; 95% CI: -2.72 to -1.07; Timed Up and Go, SMD: 1.42; 95% CI: 1.03-1.81), and gait (GaitRite platform: cadence, SMD: -1.51, 95% CI: -2.05 to -0.97; step length, SMD: -1.63, 95% CI: -2.18 to -1.08; stride length, SMD: -1.63, 95% CI: -2.18 to -1.08; velocity, SMD: -1.58, 95% CI: -2.97 to -0.18). CONCLUSION: The results show the potential benefit of virtual reality interventions to recover balance and gait after stroke.

TITLE: Efectos de la realidad virtual sobre el equilibrio y la marcha en el ictus: revision sistematica y metaanalisis.Introduccion. El ictus es la mayor causa de discapacidad en los adultos. En los ultimos años, la mejora en las tecnologias de realidad virtual ha propiciado su uso para la rehabilitacion de pacientes de ictus. Objetivo. Analizar las evidencias cientificas existentes sobre la efectividad del uso de realidad virtual frente a la terapia convencional en la mejora de la marcha y el equilibrio de pacientes que han sufrido un ictus. Pacientes y metodos. Se ha realizado una revision sistematica y un metaanalisis durante marzo de 2018 en las siguientes bases de datos: PubMed, PEDro, Web of Science, Scopus, Cochrane Library y Medline via EBSCO. Los principales criterios de seleccion fueron ensayos clinicos controlados aleatorizados, publicados en ingles o español, durante los ultimos diez años (2008-2018). La calidad metodologica de los estudios se evaluo mediante la escala PEDro. Se incluyo un total de 14 ensayos clinicos aleatorizados con intervenciones de realidad virtual en la revision sistematica, 10 de ellos en el metaanalisis. Resultados. Se han obtenido resultados favorables de las intervenciones de realidad virtual sobre el equilibrio (Berg Balance Scale: diferencia de medias estandarizada, DME: ­1,89; intervalo de confianza al 95%, IC 95%: ­2,72 a ­1,07; Timed Up and Go: DME: 1,42; IC 95%: 1,03 a 1,81) y la marcha (GaitRite: cadencia, DME: ­1,51, IC 95%: ­2,05 a ­0,97; longitud del paso, DME: ­1,63, IC 95%: ­2,18 a ­1,08; longitud de la zancada, DME: ­1,63, IC 95%: ­2,18 a ­1,08; velocidad, DME: ­1,58, IC 95%: ­2,97 a ­0,18). Conclusion. Los resultados obtenidos muestran el beneficio potencial de la realidad virtual sobre la recuperacion de la marcha y equilibrio en sujetos que han sufrido ictus.

Biosorption of heavy metals by Fucus spiralis.

The sorption uptake of cadmium, nickel, zinc, copper and lead by marine brown alga Fucus spiralis was investigated in bimetallic, trimetallic and multimetallic solutions. The experimental data fitted very well to Langmuir model. In bimetallic systems, the affinity of biomass for lead and copper increased and the sorption uptake of these metals was not affected by increasing concentrations of cadmium, nickel or zinc. However, in solutions with both metals there was a significant mutual decrease of their sorption levels at high concentrations of the other metal. The sorption uptake of cadmium, nickel and copper was investigated in trimetallic aqueous systems. Based on the kinetic parameter b, the affinity of F. spiralis for copper was considerably higher than for cadmium or nickel: bCd=6.39, bNi=1.82 and bCu=17.89. In all tests, the maximum sorption uptake remained practically constant around 1 mmol/g, indicating that the number of active sites on the biomass was limited. Tests with four and five metals showed that copper was preferentially adsorbed. The differences between the experimental sorption data and those given by the chemical speciation program PHREEQCI were negligible. In general, the software used provided satisfactory estimated data for each metal and hence can be a useful tool to predict or simulate the real process.

Study of cadmium, zinc and lead biosorption by orange wastes using the subsequent addition method.

The biosorption of several metals (Cd2+, Zn2+ and Pb2+) by orange wastes has been investigated in binary systems. Multicomponent sorption isotherms were obtained using an original procedure, similar to that proposed by Pagnanelli et al. [Pagnanelli, F., Petrangeli, M.P., Toro, L., Trifoni, M., Veglio, F., 2001a. Biosorption of metal ions on Arthrobacter sp.: biomass characterization and biosorption modelling. Environ. Sci. Technol. 34, 2773-2778] for monoelement systems, known as subsequent addition method (SAM). Experimental sorption data were analysed using an extended multicomponent Langmuir equation. The maximum sorption uptake was approximately 0.25mmol/g for the three binary systems studied. The reliability of the proposed procedure for obtaining the equilibrium data in binary systems was verified by means of a statistical F-test.

Characterization of the biosorption of cadmium, lead and copper with the brown alga Fucus vesiculosus.

The recovery of cadmium, lead and copper with the brown alga Fucus vesiculosus was characterized and quantified. The biosorption data fitted the pseudo-second order and Langmuir isotherm models, but did not adjust to the intraparticle diffusion model. The metal uptakes deduced from the pseudo-second order kinetic model and the Langmuir isotherm model followed a similar sequence: Cu>Cd approximately Pb. The Langmuir maximum metal uptakes were: 0.9626 mmol/g, Pb 1.02 mmol/g, and Cu 1.66 mmol/g. According to the equilibrium constants of this isotherm model, the affinity of metals for the biomass followed this order: Pb>Cu>Cd. Biosorption was accomplished by ion exchange between metals in solution and algal protons, calcium and other light metals, and by complexation of the adsorbed metals with algal carboxyl groups. FTIR spectra showed a shift in the bands of carboxyl, hydroxyl and sulfonate groups.