Alpine ski technique observation instrument: reliability and validity / Instrumento de observación de la técnica en esquí alpino: fiabilidad y validez

The aim of the study was to design an accurate and useful observational instrument for evaluating basic turn techniques in alpine skiing, and to determine its validity and reliability. A multi-step approach was used to design and validate the instrument: a literature revision; an expert meeting; a pilot test; the assessment of intra- and inter-observer reliability; a convergent validity test; and the responsiveness calculation with a pre- post-test. Results showed adequate values of intra-rater (P=0.80-0.83) and inter-rater reliability (P=0.86-0.97). For the convergent validity, a moderate statistically significant correlation for the speed and trajectory control dimensions were achieved (rho=0.58-0.65, p<0.001), but not for the balance position dimension (rho=0.24, p=0.166). The responsiveness was also acceptable (p<0.05, r=0.46-0.60). In conclusion, the Alpine Ski Technique Observation Instrument is a useful, reliable, valid, and responsive observational tool. (AU)

El objetivo del estudio fue diseñar un instrumento de observación preciso y útil para evaluar la técnica de cambios de dirección básicos en el esquí alpino, y determinar su validez y fiabilidad. Para diseñar y validar el instrumento se siguieron los siguientes pasos: revisión de la literatura, valoración por comité de expertos, prueba piloto, evaluación de la fiabilidad intra e inter-evaluador, prueba de validez convergente, y cálculo de sensibilidad con una prueba pre y post-intervención. Los resultados mostraron valores adecuados de fiabilidad intra-evaluador (P=0,80-0,83) e inter-evaluador (P=0,86-0,97). Respecto a la validez convergente se obtuvo una correlación moderada para las dimensiones de control de la velocidad y de la trayectoria (rho=0,58-0,65, p<0,001), pero no para la dimensión de posición de equilibrio (rho=0,24, p=0,166). La sensibilidad fue aceptable (p<0,05, r=0,46-0,60). En conclusión, el Instrumento de Observación de la Técnica en Esquí Alpino es una herramienta útil, fiable, válida y sensible. (AU)

Fiabilidad y validez de la Escala de valoración del estilo de vida saludable adquirido (E-VEVSA) en adultos de Albacete y Murcia (España) / Reliability and validity of the Acquired healthy lifestyle assessment scale (E-VEVSA) in adults from Albacete and Murcia (Spain)

Fundamentos El estilo de vida es un constructo teórico que está formado por los hábitos de vida de un sujeto. El análisis y la cuantificación objetivable del estilo de vida, puede tener un gran impacto sobre la salud de las personas, así como en la evolución del estado de la misma con el transcurso de los años. El objetivo de la presente investigación ha sido la validación de la Escala de valoración del estilo de vida saludable adquirido (E-VEVSA) en adultos españoles. Métodos Sobre una muestra inicial para las pruebas exploratorias de 248 sujetos y final para las pruebas confirmatorias de 780 sujetos, de edades comprendidas entre los 22 y 72 años de edad, se realizaron pruebas psicométricas exploratorias y confirmatorias basadas en el estadístico alfa de Cronbach (fiabilidad) y análisis factorial exploratorio con rotación oblicua (oblimin) y confirmatorio con rotación varimax (validez de constructo), que dieron lugar a un instrumento definitivo formado por 52 ítems y estructurado en siete dimensiones: Responsabilidad individual en el cuidado de la salud (nueve ítems), hábitos de práctica físico-deportiva (seis ítems), hábitos de salud en las relaciones sociales (10 ítems), hábito de consumo de tabaco y alcohol (nueve ítems), hábito de alimentación saludable (siete ítems), hábito de salud psicológica (seis ítems) y hábito de descanso y sueño diario (cinco ítems). Resultados Todos los ítems explicaron una varianza total de 66,87% y un alfa de Cronbach de 0,894, estando por encima de 0,700 el alfa parcial de cada dimensión o factor. Conclusiones Los resultados arrojan pruebas psicométricas que confirman la validez de la escala E-VEVSA como un instrumento útil para medir el estilo de vida saludable adquirido en personas adultas (AU)

Background Lifestyle is a theoretical construct that is formed by the life habits of a subject. The analysis and objective quantification of lifestyle can have a great impact on people's health, as well as on the evolution of its status over the years. The objective of this research has been the validation of the Acquired Healthy Lifestyle Assessment Scale (E-VEVSA) in Spanish adults. Method On an initial sample for the exploratory tests of 248 subjects and a final sample for the confirmatory tests of 780 subjects, aged between 22 and 72 years of age. Exploratory and confirmatory psychometric tests were carried out based on the Cronbach's alpha statistic (reliability) and exploratory factorial analysis with oblique rotation (oblimin) and confirmatory with varimax rotation (construct validity), which resulted in an instrument made up of 52 items and structured in 7 dimensions: individual responsibility in health care (9 items), habits of physical-sports practice (6 items), health habits in social relationships (10 items), habit of tobacco and alcohol consumption (9 items), habit of healthy eating (7 items), psychological health habits (6 items) and daily rest and sleep habits (5 items). Results All the items explained a total variance of 66.87% and a Cronbach's alpha of .894, with the partial alpha of each dimension or factor being above .700. Conclusions The results show psychometric tests that confirm the validity of the E-VEVSA scale as a useful instrument to measure the healthy lifestyle acquired among adults (AU)

[Reliability and validity of the Acquired healthy lifestyle assessment scale (E-VEVSA) in adults from Albacete and Murcia (Spain)]. / Fiabilidad y validez de la Escala de valoración del estilo de vida saludable adquirido (E-VEVSA) en adultos de Albacete y Murcia (España).

BACKGROUND: Lifestyle is a theoretical construct that is formed by the life habits of a subject. The analysis and objective quantification of lifestyle can have a great impact on people's health, as well as on the evolution of its status over the years. The objective of this research has been the validation of the Acquired Healthy Lifestyle Assessment Scale (E-VEVSA) in Spanish adults. METHOD: On an initial sample for the exploratory tests of 248 subjects and a final sample for the confirmatory tests of 780 subjects, aged between 22 and 72 years of age. Exploratory and confirmatory psychometric tests were carried out based on the Cronbach's alpha statistic (reliability) and exploratory factorial analysis with oblique rotation (oblimin) and confirmatory with varimax rotation (construct validity), which resulted in an instrument made up of 52 items and structured in 7 dimensions: individual responsibility in health care (9 items), habits of physical-sports practice (6 items), health habits in social relationships (10 items), habit of tobacco and alcohol consumption (9 items), habit of healthy eating (7 items), psychological health habits (6 items) and daily rest and sleep habits (5 items). RESULTS: All the items explained a total variance of 66.87% and a Cronbach's alpha of .894, with the partial alpha of each dimension or factor being above .700. CONCLUSIONS: The results show psychometric tests that confirm the validity of the E-VEVSA scale as a useful instrument to measure the healthy lifestyle acquired among adults.

Physical activity and its association with Mediterranean diet patterns among Spanish university students / Actividad física y su asociación con los patrones de dieta mediterránea en universitarios españoles

Objective: the aim of the present study was to assess the level of physical activity and its association with Mediterranean dietary patterns in university students of health sciences at Universidad de Castilla-La Mancha (Spain). Method: a cross-sectional study was performed through an online survey. The final sample consisted of 555 university students (78.2 % females). Adherence to Mediterranean diet was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). To measure physical activity, the Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used. Results: according to physical activity, 2.5 % of the participants were considered active and 35.1 % did both strength and flexibility activities. A greater association was seen between intake of fruits (OR = 1.95; 95 % CI, 1.25-3.04), pulses (OR = 1.51; 95 % CI, 1.00-3.20), and nuts (OR = 1.99; 95 % CI, 1.33-2.99) in those considered sufficiently active. Similarly, we found a significant relationship between the intake of fruits (OR = 2.28; 95 % CI, 1.49-3.47), pulses (OR = 1.41; 95 % CI, 1.00-2.08), nuts (OR = 1.96; 95 % CI, 1.34-2.86), and fish/seafood (OR = 1.67; 95 % CI, 1.15-2.43) in those who engaged in both strength and flexibility activities. Conclusion: this study suggests that consumption of certain Mediterranean foods was associated with higher levels of physical activity in a sample of Spanish university students (AU)

Objetivo: el objetivo del presente estudio fue evaluar el nivel de actividad física y su asociación con la dieta mediterránea en estudiantes universitarios de ciencias de la salud de la Universidad de Castilla-La Mancha (España). Método:: se realizó un estudio transversal a través de una encuesta online. La muestra final estuvo formada por 555 estudiantes universitarios (78,2 % mujeres). La adherencia a la dieta mediterránea se evaluó mediante el evaluador de adherencia a la dieta mediterránea de 14 ítems (MEDAS). Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA). Resultados: de acuerdo con la actividad física, el 2,5 % de los participantes se consideraron activos y el 35,1 % realizaban actividades tanto de fuerza como de flexibilidad. Se observó una mayor asociación entre la ingesta de frutas (OR = 1,95; IC 95 %, 1,25-3,04), legumbres (OR = 1,51; IC 95 %, 1,00-3,20) y frutos secos (OR = 1,99; IC 95 %, 1,33-2,99) en aquellos considerados suficientemente activos. Asimismo, encontramos una relación significativa entre la ingesta de frutas (OR = 2,28; IC 95 %, 1,49-3,47), legumbres (OR = 1,41; IC 95 %, 1,00-2,08), frutos secos (OR = 1,96; IC 95 %, 1,34-2,86) y pescado/marisco (OR = 1,67; IC 95 %, 1,15-2,43), en aquellos que participaron en actividades de fuerza y flexibilidad. Conclusión: este estudio sugiere que el consumo de determinados alimentos mediterráneos se asocia con mayores niveles de actividad física en la muestra de universitarios españoles analizada (AU)

Laparoscopic and robotic pyeloplasty as minimally invasive alternatives to the open approach for the treatment of uretero-pelvic junction obstruction in infants: a multi-institutional comparison of outcomes and learning curves.

BACKGROUND: Since the development of minimally invasive surgery (MIS), laparoscopic and robotic approaches have been widely adopted. However, little has been published detailing the learning curve of MIS, especially in infants. OBJECTIVE: To quantify the learning curve of laparoscopic (LP) and robot-assisted laparoscopic pyeloplasty (RAL-P) for treatment of uretero-pelvic junction obstruction (UPJO) in infants evidenced by number of cases, operative time, success and complications. PATIENTS AND METHODS: Between 2009 and 2017, we retrospectively reviewed pyeloplasty cases for treatment of UPJO in infants at three academic institutions. The primary outcome was success. Secondary outcomes were UPJO recurrence, complications, and operative time as a surrogate of skill acquisition. Continuous variables were analyzed by t test, Welch-test, and one-way ANOVA. Non-continuous variables were analyzed by Chi-squared test or Fisher's exact test. Learning curves (LC) were studied by r-to-z transformation and CUSUM. RESULTS: Thirty-nine OP, 26 LP, and 39 RAL-P had mean operative times (OT) of 106, 121, and 151 min, respectively. LCs showed plateau in OT after 18 and 13 cases for LP and RAL-P, respectively. RAL-P showed a second phase of further improvements after 37 cases. At 16 months follow-up, there were similar rates of success and complications between the three groups. CONCLUSIONS: Despite different duration of learning phases, proficiency was achieved in both LP and RAL-P as evidenced by stabilization of operative time and similar success rates and complications to OP. Before and after achievement of proficiency, LP and RAL-P can be safely learned and implemented for treatment of UPJO in infants.

Update on smoking. Alternatives for the management of patients with cardiovascular risk / Puesta al día del tabaquismo. Alternativas para el manejo del paciente con riesgo cardiovascular

Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stress and endothelial dysfunction as can be shown in different biomarkers modifications. Despite the aids currently available for smoking cessation, many smokers are unwilling or unable to achieve this. So alternative tools with potential harm reduction, such as non-combustion tobacco products, could be an option due to the better results they had shown on cardiovascular risk factors. This has led these devices to be taken into account as a risk-modifying tobacco product according to the FDA. (AU)

El tabaquismo es la principal causa de morbimortalidad a nivel mundial y tiene una implicación clara como factor de riesgo cardiovascular. El tabaco posee distintos efectos a nivel cardiovascular, como son una disminución del óxido nítrico, aumento de la respuesta inflamatoria, aumento de la adhesión de moléculas proaterogénicas, modificaciones lipídicas, generación de estrés oxidativo y disfunción endotelial que puede verse reflejada en distintos biomarcadores. A pesar de las ayudas que se poseen actualmente para la cesación tabáquica, parte de la población consumidora no quiere o no lo puede conseguir y es por ello que herramientas alternativas como los productos de reducción del daño y el tabaco por calentamiento podrían ser una opción gracias a los mejores resultados que muestran sobre los factores de riesgo cardiovascular comparado con el cigarrillo convencional. Algo que ha llevado a estos dispositivos para ser considerados como producto de tabaco modificador del riesgo, según la FDA. (AU)

68Ga-PSMA-11 PET/CT in patients with occult biochemical recurrence of prostate carcinoma and negative 18F-Choline PET/CT. Preliminary assessment of its clinical use.

OBJECTIVE: To assess the clinical usefulness of 68Ga-PSMA PET/CT studies in patients with occult biochemical recurrence of prostate carcinoma, with negative or inconclusive radiologic and 18 F-Choline PET/CT imaging studies. MATERIAL AND METHODS: Retrospective descriptive study. The first 14 patients with a history of prostate carcinoma, treated with curative intent and presenting suspicion of biochemical recurrence with low PSA values (<3 ng/mL) were selected. Imaging studies, prostate ultrasound, pelvic CT and/or MRI were negative, and all of them had a negative or inconclusive 18F-Choline PET/CT. All patients were referred to 68 Ga-PSMA-11 PET/CT. PROTOCOL: Dose 2.2 M Bq/kg. 20 mg furosemide at start. PET/CT images from skull base to proximal third of thighs at 60 min, and late images at 3 h if needed. RESULTS: The 68 Ga-PSMA-11 PET/CT was able to localize the occult biochemical recurrence in 9 of the 14 patients (64.2%), and it affected the therapeutic attitude in all of them. Four patients (28.5%) obtained a negative or inconclusive 68 Ga-PSMA-11 PET/CT and continued under vigilant approach with PSA controls and imaging studies according to the clinical guidelines. These patients had the lowest PSA values (less than 1 ng/mL). One of the 68 Ga-PSMA-11 PET/CT studies was inconclusive, reporting the presence of a doubtful right iliac adenopathy. CONCLUSION: 68 Ga-PSMA-11 PET/CT allows an early diagnosis, with low PSA values, of occult biochemical recurrence of prostate carcinoma, even in patients with negative 18 F-Choline PET/CT.

Ga-PSMA-11 PET/TC en la recidiva bioquímica oculta del carcinoma de próstata, con 18F-Colina PET/TC negativa. Valoración preliminar de su uso clínico / Ga-PSMA-11 PET/CT in patients with occult biochemical recurrence of prostate carcinoma and negative 18F-Choline PET/CT. Preliminary assessment of its clinical use

Objetivo: Valorar la utilidad de los estudios 68Ga-PSMA PET/TC en la práctica clínica de los pacientes con recidiva bioquímica oculta de carcinoma de próstata, con estudios de imagen radiológicos y 18F-Colina PET/TC negativos o no concluyentes.Material y métodosobservacional retrospectivo y de exactitud diagnóstica. Se seleccionaron los primeros 14 pacientes con antecedentes de carcinoma de próstata, tratados con intención curativa y que presentaban sospecha de recidiva bioquímica con valores bajos de antígeno prostático específico (PSA) (< 3 ng/mL). Los estudios de imagen, ecografía prostática, tomografía computarizada (TC) y/o resonancia magnética (RM) pélvica eran negativos, y todos ellos tenían un 18F-Colina PET/TC negativo o no concluyente. Se derivó a todos los pacientes para realizarse un 68Ga-PSMA-11 PET/TC. Protocolo: Dosis 2,2 MBq/kg, 20 mg de furosemida en el minuto 0. Imágenes PET/TC desde calota craneal hasta el tercio proximal de muslos a los 60 min, e imágenes tardías a las tres horas, si precisara.ResultadosEn nueve de los 14 pacientes (64,2%) el 68Ga-PSMA-11 PET/TC consiguió localizar la recidiva bioquímica oculta, y en todos ellos hubo cambios en la actitud terapéutica. En cuatro de los 14 pacientes (28,5%) el 68Ga-PSMA-11 PET/TC resultó negativo o no concluyente, se prosiguió con la actitud vigilante con controles de PSA y estudios de imagen, según los protocolos habituales. Estos pacientes presentaban los valores más bajos de PSA (inferiores a 1 ng/mL). Uno de los estudios 68Ga-PSMA-11 PET/TC fue no concluyente, informándose la presencia de una dudosa adenopatía iliaca derecha. (AU)

Objective: To assess the clinical usefulness of 68Ga-PSMA PET/CT studies in patients with occult biochemical recurrence of prostate carcinoma, with negative or inconclusive radiologic and 18F-Choline PET/CT imaging studies.Material and methodsRetrospective observational and diagnostic accuracy. The first 14 patients with a history of prostate carcinoma, treated with curative intent and presenting suspicion of biochemical recurrence with low PSA values (< 3 ng/ml) were selected. Imaging studies, prostate ultrasound, pelvic CT and/or MRI were negative, and all of them had a negative or inconclusive 18F-Choline PET/CT.All patients were referred to 68Ga-PSMA-11 PET/CT. Protocol: Dose 2.2 MBq/kg. 20 mg furosemide at start. PET/CT images from skull base to proximal third of thighs at 60 min, and late images at 3 hours if needed.ResultsThe 68Ga-PSMA-11 PET/CT was able to localize the occult biochemical recurrence in 9 of the 14 patients (64.2%), and it affected the therapeutic attitude in all of them.Four patients (28.5%) obtained a negative or inconclusive 68Ga-PSMA-11 PET/CT and continued under vigilant approach with PSA controls and imaging studies according to the clinical guidelines. These patients had the lowest PSA values (less than 1 ng/ml).One of the 68Ga-PSMA-11 PET/CT studies was inconclusive, reporting the presence of a doubtful right iliac adenopathy. (AU)

Update on smoking. Alternatives for the management of patients with cardiovascular risk.

Smoking is the leading cause of morbidity and mortality worldwide and is clearly involved as a cardiovascular risk factor. Smoking has different effects on the cardiovascular system, such as a decrease in nitric oxide, increased inflammatory response, increased adhesion of pro-atherogenic molecules, lipid disturbances, generation of oxidative stress and endothelial dysfunction as can be shown in different biomarkers modifications. Despite the aids currently available for smoking cessation, many smokers are unwilling or unable to achieve this. So alternative tools with potential harm reduction, such as non-combustion tobacco products, could be an option due to the better results they had shown on cardiovascular risk factors. This has led these devices to be taken into account as a risk-modifying tobacco product according to the FDA.

Effect of boar seminal dose type (cervical compared with post-cervical insemination) on cooling curve, sperm quality and storage time.

Seminal doses used for cervical and post-cervical artificial insemination (CAI and PCAI, respectively) vary in volume, the number of spermatozoa and packaging. The aim was to evaluate the outcomes when there was use of routine processing procedures for CAI- and PCAI-doses. Two different types of seminal doses were processed: 1) CAI: 2.7 × 109 sperm/80 ml; 2) PCAI: 1.5 × 109 sperm/45 ml. In Experiment 1, the cooling curve of seminal doses during processing occurred in two phases: 1st) At room temperature (23.4 ±â€¯0.5 °C) from 0 (just after packaging) to 120 min; 2nd) At refrigeration (15.7 ±â€¯0.8 °C) from 121-240 min. For the PCAI-doses, the time required to reach room temperature was 47 min compared to 107 min for CAI-doses (decreasing velocity of 0.093 °C/min and 0.048 °C/min, respectively). During refrigeration, for the PCAI-doses the time required to reach the desired preservation temperature was 20 min less than for CAI-doses (PCAI: 90 min, 0.074 °C/min; CAI: 110 min, 0.066 °C/min). In Experiment 2, sperm motility, kinetic parameters and acrosome damage for both types of doses were evaluated at 0, 24, 48 and 72 h of refrigeration. Also, morphology, pH, and osmolality were assessed at 0 and 72 h. Values for all these did not differ between CAI- and PCAI-doses. In conclusion, PCAI-doses took less time than CAI-doses to reach the desired temperature, but sperm quality was similar for CAI- and PCAI-doses during storage. Nevertheless, the different cooling curves should be taken into consideration for further investigation.

Post-cervical artificial insemination in porcine: The technique that came to stay.

The porcine industry is of great importance worldwide, and so any technological innovation in one or more of the associated production areas is of interest for meat production. Among such innovations in the reproduction area, post-cervical or intrauterine artificial insemination (PCAI) has emerged as a new approach in artificial insemination (AI). PCAI is gradually replacing traditional cervical insemination (CAI), particularly in countries with intensive pig production industries. This type of insemination, which deposits the semen in the body of the uterus (as opposed to traditional cervical deposition), is increasingly used in the field due to its simplicity and the numerous advantages that it provides at production level (e.g. reduced number of sperm, less time required to perform insemination and faster genetic improvement) and, consequently, from an economic point of view. In addition, since its inception, PCAI has been combined with other reproductive biotechnologies, such as the use of frozen-thawed sperm, fixed-time AI or sperm-mediated gene transfer. However, despite its wide acceptance and application, new approaches for increasing the efficiency of PCAI are constantly being sought, such as the adjustment and standardization in sperm numbers, the conservation of the PCAI semen dose, its association with other biotechnologies (sex-sorted sperm) or its efficacy in young (nulliparous and primiparous) females.

Morphological changes in the porcine cervix: A comparison between nulliparous and multiparous sows with regard to post-cervical artificial insemination.

In recent decades, new artificial insemination (AI) methods, such as post-cervical AI (PCAI), have been developed in pig. PCAI involves crossing the cervix to deposit the sperm in the uterine body. Although PCAI application in sows is frequent, its application in nulliparous (gilts) females it is still limited due to the difficulty of passing through the cranial part of the cervical lumen. We hypothesized that ageing and parity would modify the cervical canal, facilitating the introduction of AI devices through the cervix. The aim was to compare the morphology of the uterus at different levels between multiparous and nulliparous females. Morphological analysis of the uterus pointed to a longer cervix (25.9 ±â€¯4.6 vs. 21.6 ±â€¯3.3 cm, p < 0.001) and greater length of the part of the reproductive tract involved in PCAI (from rima vulvae to the last cervical cushion) (56.2 ±â€¯6.0 vs. 50.3 ±â€¯5.2 cm, p < 0.001) in multiparous sows compared with nulliparous animals. As regards the structure of the vaginal and uterine parts of the cervix (the part in contact with the vagina and uterine body, respectively), the cross-sectional area, perimeter and total thickness were greater in the uterine part of multiparous than of nulliparous animals (area: 4.07 ±â€¯1.46 vs. 2.46 ±â€¯0.56 cm2, p < 0.01; perimeter: 8.50 ±â€¯1.44 cm vs. 6.28 ±â€¯0.92 cm, p < 0.001; thickness: 10.79 ±â€¯0.96 vs. 8.35 ±â€¯0.62 mm, p < 0.05), but not in the vaginal part. The tissue content analysed in histological cross-sections also showed differences between female groups, a greater content of connective tissue (58.86 ±â€¯10.78 vs. 67.60 ±â€¯13.38%, p < 0.001) and a lower amount of muscle fibres (39.79 ±â€¯10.24 vs. 30.66 ±â€¯13.69%, p < 0.001) being observed in multiparous sows. Finally, silicone casts of the cervical lumen revealed differences between the two groups in the size and shape of the ridges in the lumen trajectory. Parity, which is also influenced by ageing, determines important changes in the size, structure and tissue content of the cervix wall, as well as in the morphology of the cervical canal, which may be responsible for the different levels of performance of PCAI in the female populations. Therefore, the future design of AI strategies and catheters should take into consideration the morphological variations of the cervix lumen, which will depend on age and parity of the females.

[Influence of a programme of therapeutic exercise on different clinical indicators related to dyslipidaemia in adult subjects aged between 26 to 73 years with a cardiovascular risk factor]. / Influencia de un programa de ejercicio físico terapéutico en diferentes indicadores clínicos relacionados con la dislipidemia en sujetos adultos de 26 a 73 años con algún factor de riesgo cardiovascular.

INTRODUCTION: A sedentary lifestyle is indicated in the international literature as one of the main causes for the onset of some cardiovascular risk factors. OBJECTIVE: To assess the effect of a therapeutic physical exercise programme on different clinical indicators related to dyslipidaemia (total cholesterol, HDL and LDL) in sedentary subjects with a cardiovascular risk factor. METHOD: Intervention study with before-and-after evaluation of a sample of 340 patients (132 males and 208 females) referred from the 2 primary care centres of the municipality of Molina de Segura (Murcia), and who participated in a 30-week programme of physical exercise combining muscle-conditioning work circuits with other cardio-respiratory resistance workouts. Regarding the clinical indicators, the health professionals collected in the medical history the health indicators corresponding to the biological evolution of the process for which the subjects studied had started the physical exercise programme. RESULTS: The statistical analyses showed a significant improvement (p<.005) in the LDL indicator and a non-significant improvement in total and HDL cholesterol indicators after a 3-month exercise programme of 3 weekly sessions. CONCLUSIONS: The prescription of physical exercise in dyslipidaemic subjects from primary care centre should be evaluated as a resource for improving the clinical indicators specific to their pathology.

Multi-Sensor Data Fusion for Real-Time Surface Quality Control in Automated Machining Systems.

Multi-sensor data fusion systems entail the optimization of a wide range of parameters related to the selection of sensors, signal feature extraction methods, and predictive modeling techniques. The monitoring of automated machining systems enables the intelligent supervision of the production process by detecting malfunctions, and providing real-time information for continuous process optimization, and production line decision-making. Monitoring technologies are essential for the reduction of production times and costs, and an improvement in product quality, discarding the need for post-process quality controls. In this paper, a multi-sensor data fusion system for the real-time surface quality control based on cutting force, vibration, and acoustic emission signals was assessed. A total of four signal processing methods were analyzed: time direct analysis (TDA), power spectral density (PSD), singular spectrum analysis (SSA), and wavelet packet transform (WPT). Owing to the nonlinear and stochastic nature of the process, two predictive modeling techniques, multiple regression and artificial neural networks, were evaluated to correlate signal parametric characterization with surface quality. The results showed a high correlation of surface finish with cutting force and vibration signals. The signal processing methods based on signal decomposition in a combined time and frequency domain (SSA and WPT) exhibited better signal feature extraction, detecting excitation frequency ranges correlated to surface finish. The artificial neural network model obtained the highest predictive power, with better behavior for the whole data range. The proposed on-line multi-sensor data fusion provided significant improvements for in-process quality control, with excellent predictive power, reliability, and response times.

Evidence-based treatment of multicystic dysplastic kidney: a systematic review.

OBJECTIVES: There is a lack of a standardised protocol for the investigation and non-operative management of paediatric multicystic dysplastic kidney (MCDK). Institutional protocols for non-operative management remain essentially ad hoc. The primary outcome of this systematic review is to establish the incidence of hypertension associated with an MCDK. The secondary outcome is to determine the malignancy risk associated with an MCDK. The tertiary outcome is to assess the rate of MCDK involution. Subsequent to these, an evidence-based algorithm for follow-up is described. METHODOLOGY: A systematic review of all relevant studies published between 1968 and April 2017 was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were identified by specific inclusion and exclusion criteria, all of which included data relevant to the primary, secondary and tertiary outcomes. Hypertension was defined as systolic blood pressure greater than the 95th centile for gender, age and height centile. Subset analysis was performed for hypertension associated with an MCDK. RESULTS: The primary outcome measure revealed a 3.2% (27/838) risk of developing hypertension associated with an MCDK. The secondary outcome measure noted a 0.07% malignancy risk (2/2820). The tertiary outcome measure established that 53.3% (1502/2820) had evidence of involution of the dysplastic kidney. A total of 44 cohort studies (2820 patients) were analysed. CONCLUSION: Given the low risk of hypertension and malignancy, which is similar to the general population, the current conservative non-operative pathway is an appropriate management strategy. An algorithm to help support clinicians with ongoing management is proposed.