Global Matrix 4.0 Physical Activity Report Card Grades for Children and Adolescents: Results and Analyses From 57 Countries.

BACKGROUND: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children's and adolescents' (5-17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. METHODS: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders' top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. RESULTS: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. CONCLUSIONS: The Global Matrix 4.0 represents the largest compilation of children's and adolescents' PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation.

Isolation and test of novel yeast strains with lignin usage capability and phenolic compound resistance.

Five yeast fungi strains (i.e., two Cryptococcus albidus, one Candida guillermondii, and two Candida tropicalis) were isolated from sugarcane and tested for their use of lignin as sole carbon source and their potential to grow in the presence of phenol and phenol derivatives (i.e., pentachlorophenol and p-nitrophenol). The full set of isolated yeasts showed ligninolytic activity, achieving at least 36% lignin degradation after 25 days. The C. albidus JS-B1 strain had the highest ligninolytic activity, achieving 27% lignin degradation within 4 days. This increased activity was associated with the production of ligninolytic laccase enzymes. All the tested yeast fungi strains showed growth in the presence of high concentrations of phenolic compounds (i.e., 900 mg/L phenol, 200 mg/L p-nitrophenol, 50 mg/L pentachlorophenol) and showed significant potential for lignin and lignin by-product degradation. Each of these five strains has the potential to be used in biological treatment processes for contaminated effluents from paper pulping and bleaching or phenol and phenol-derivative biodegradation processes for other industrial wastewater effluents.

Testing for Vitamin D in High-Risk COPD in Outpatient Clinics in Spain: A Cross-Sectional Analysis of the VITADEPOC Study.

Background: Vitamin D deficiency has been associated with an accelerated deterioration in lung function and increased exacerbations in chronic obstructive pulmonary disease (COPD). 25(OH) vitamin D levels have been indicated as a potentially useful marker for adverse results related to COPD. Methods: VITADEPOC is a cross-sectional clinical study recruiting consecutive patients with high-risk COPD. The objective of our study was to investigate vitamin D determination frequency in patients with high-risk COPD in clinical practice at outpatient clinics in Spain and to describe the factors associated with vitamin D testing. We also aimed to determine the frequency of vitamin D deficiency in these patients. Results: Only 51 (44%) patients underwent vitamin D determination and 33 (28.4%) had received vitamin D supplements in clinical practice. The patients who underwent testing for vitamin D in clinical practice were more often women (58.8% vs. 26.2%, p < 0.001) with comorbidities such as osteoporosis (19.6% vs. 6.2%, p < 0.001) or chronic renal failure (7.8% vs. 0%, p < 0.001) and with exacerbator phenotype (55% vs. 32.3%, p = 0.015). A total of 63 (54.3%) patients had serum vitamin D levels <20 ng/mL at the inclusion visit. Of these, 29 (46%) had serum vitamin D levels <12 ng/mL (severe deficiency). Having a history of inhaled corticosteroids (OR 3.210, p < 0.016), being treated with a cycle of systemic corticosteroids (OR 2.149, p < 0.002), and having a lower physical activity level (OR 3.840, p < 0.004) showed a statistically significant positive association with vitamin D deficiency. Conclusion: The testing of vitamin D levels in patients with high-risk COPD treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, a severe deficiency is detected in one in four patients. Efforts to optimize case detection in COPD are needed.

Association between Physical Literacy and Self-Perceived Fitness Level in Children and Adolescents.

BACKGROUND: Physical fitness is considered a predictor of mortality and comorbidities resulting from physical inactivity in children and adolescents. Physical literacy provides a robust and comprehensive assessment of physical fitness. Thus, it is considered a crucial element for understanding children and adolescents' health status and their physical activity-related behaviours. Moreover, the self-perceived fitness should also be considered. Therefore, this study aims to analyse the relationship between physical literacy and self-perceived physical fitness in children and adolescents aged 8-12 years. METHODS: A single-measure cross-sectional study was conducted with 135 children and adolescents. Anthropometric measurements and the Canadian Assessment of Physical Literacy Development (CAPL-2) were applied. Descriptive statistics and correlations were calculated. The Fitness Perception Scale for Adolescents (FP VAS A) scale was also administered to assess participants' self-perceived fitness. RESULTS: Moderate significant correlations were found between "physical competence", "motivation and confidence", and the total CAPL-2 score with FP VAS A. CONCLUSIONS: The influence of motivation on self-perceived fitness has been demonstrated. Moreover, cardiorespiratory fitness could be considered one of the most relevant and influential factors in the total CAPL-2 score. It means that higher levels of self-perceived fitness would be associated with greater levels of physical literacy.

Accelerated immunosenescence, oxidation and inflammation lead to a higher biological age in COPD patients.

Chronic obstructive pulmonary disease (COPD) is characterised by inflammatory and oxidative alterations in the lung and extrapulmonary compartments, through involvement of the immune system. Several leukocyte functions are health markers and good predictors of longevity, and high pro-inflammatory and oxidative states are related to more aged profiles. Here, we aimed to investigate the aging rate in terms of immunosenescence in COPD men with respect to healthy age-matched controls. Several neutrophil (adherence, chemotaxis, phagocytosis, superoxide anion stimulated production) and lymphocyte (adherence, chemotaxis, lymphoproliferation, natural killer activity) functions, cytokine concentrations released in response to lipopolysaccharide (tumor necrosis factor-alpha, interleukin (IL)-6, IL-8, IL-10) and redox parameters (intracellular glutathione content, basal superoxide anion level) were assessed in circulating leukocytes of men with moderate and severe stages of COPD, and compared to healthy age-matched volunteers. The biological age or aging rate in each participant was determined using the values of leukocyte functions. The results indicated impairment of immune functions in COPD patients, both in innate and adaptive immunity, and higher pro-inflammatory and oxidative states in peripheral leukocytes than controls. In general, these changes were more remarkable at the severe stage of airway obstruction. Importantly, COPD patients were found to be aging at a faster rate than age-matched healthy counterparts.

Mortality rate in rheumatoid arthritis-related interstitial lung disease: the role of radiographic patterns.

BACKGROUND: To assess mortality rate (MR) and standardized mortality rate (SMR) of rheumatoid arthritis-related interstitial lung disease (RA-ILD) patients and to evaluate the role of radiographic patterns in mortality. METHODS: A longitudinal multicentric study was conducted in RA-ILD patients from 2005 to 2015 and followed-up until October 2018 in Madrid. Patients were included in the Neumologia-Reumatología y Enfermedades Autoinmunes Registry, from diagnosis of ILD. The main outcome was all-cause mortality. The radiographic pattern at baseline [usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), or others] was the independent variable. Covariables included sociodemographic and clinical data. Survival techniques were used to estimate MR, expressed per 1000 persons-year with their 95% confidence intervals [CI]. Cox multiple regression model was run to examine the influence of radiographic patterns on survival. SMR [CI] was calculated comparing MR obtained with MR expected in the general population of Madrid by indirect age-gender standardization. RESULTS: 47 patients were included with a follow-up 242 patients-year. There were 16 (34%) deaths, and most frequent causes were acute ILD exacerbation and pneumonia. MR was 64.3 [39.4-104.9], and 50% of the patients died at 8.3 years from ILD diagnosis. After adjusting for confounders, (UIP compared to NSIP was associated with higher mortality risk. The overall SMR was 2.57 [1.4-4.17]. Women of 60-75 years of age were the group with the highest SMR. CONCLUSIONS: RA-ILD is associated with an excess of mortality compared to general population. Our results support that UIP increases the risk of mortality in RA-ILD, regardless other factors.

Noninvasive electrical stimulation of oropharyngeal muscles in obstructive sleep apnea.

Introduction: Continuous positive airway pressure (CPAP) therapy remains the standard treatment for obstructive sleep apnea. However, its proven effect is useless if the patient does not tolerate the treatment. The electrical stimulation approach has been investigated for several decades now and it seems that the implantable devices for invasive electrical stimulation of hypoglossal nerve are viewed as effective with some of them already approved for human use.Areas covered: in this review, we intent to summarize the existing records of noninvasive stimulation in sleep apnea to make the scientific community aware of the details before deciding on its future. We believe that this is a battle still to fight and more could be done bearing in mind the safety of this method.Expertopinion: noninvasive electrical stimulation has been left behind based on few, small and inconsistent studies using different stimulation parameters. These studies are difficult to compare and to draw conclusions.Electrical stimulation is a field for research in the treatment of obstructive sleep apnea, with many aspects still to be discovered, and which may become a therapeutic alternative to the use of CPAP in certain patients.

Influencia de la regucalcina en la pérdida de masa ósea / Influence of regucalcin on bone loss

Objetivo: El propósito de este trabajo ha sido revisar la literatura científica con relación al papel de la regucalcina en la pérdida de masa ósea. Método: Se realizó una búsqueda bibliográfica en la base de datos PubMed. Se encontraron 31 artículos. Tras analizar su contenido y aplicar los criterios de inclusión y exclusión, un total de 13 artículos fueron incluidos. Resultados: La disminución en el contenido de calcio femoral observado en ratones transgénicos con regucalcina se observó con el aumento de la edad, lo que sugiere que la pérdida ósea no se restaura con el modelado óseo. De la misma manera, se encontró que la adición de regucalcina con 1 a 100 nM estimulaba significativamente la actividad basal de NF-kB (P<0.01). Se apreció una disminución significativa en el contenido de ADN en los tejidos metafisarios femorales, con una mayor disminución en hembras que en machos, siendo estos valores: 3.3 mg/g pasaron a ser 2.6 mg/g en las hembras (P<0.01). La reabsorción ósea osteoclástica aumentó en ratones transgénicos con regucalcina machos y hembras con edad creciente. La regucalcina exógena revela efectos supresores sobre la osteoblastogénesis y la mineralización in vitro y que no tuvo efectos sobre la proliferación celular y la apoptosis en las células osteoblásticas en cultivos a corto plazo. Conclusión: La regucalcina desempeña un papel fundamental en el mantenimiento del homeostasis celular y la función de la respuesta celular en relación a la masa ósea.(AU)

Purpose: The aim of this work has been to review the scientific literature regarding the role of regucalcin in bone loss.Method: A bibliographic search was performed in the PubMed database. A total of 31 articles were used. After analyzing its content and applying the inclusion and exclusion criteria, a total of 13 articles were included.Results: The decrease in femoral calcium content observed in regucalcin transgenic mice decreased with increasing age, suggesting that bone loss is not restored with bone modeling. In the same way, it was found that the addition of regucalcin with 1 to 100 nM significantly stimulated the baseline activity of NF-kB (P <0.01). Likewise, there was a significant decrease in the DNA content in femoral metaphyseal tissues, with a greater decrease in females than in males, these values ​​being: 3,3 mg / g became 2,6 mg / g (P <0.01). Osteoclastic bone resorption increased in male and female transgenic regucalcin mice with increasing age. Also, exogenous regucalcin reveals suppressive effects on osteoblastogenesis and mineralization in vitro and that it had no effects on cell proliferation and apoptosis in osteoblast cells in short-term cultures.Conclusion: Regucalcin plays a fundamental role in the maintenance of cell homeostasis and the function of the cellular response in relation to bone mass.(AU)

Assessing the Usefulness of the Prevexair Smartphone Application in the Follow-Up High-Risk Patients with COPD.

INTRODUCTION: This manuscript analyzes the exacerbations recorded by the Prevexair application through the daily analysis of symptoms in high-risk patients with COPD and explores its usefulness in assessing clinical stability with respect to that reported in visits. PATIENTS AND METHODS: This study is a multi-centre cohort of COPD patients with the exacerbator phenotype who were monitored over 6 months. The Prevexair application was installed on the patients' smartphones. Patients used the app to record symptom changes, use of medication and use of healthcare resources. It is not established a recommended action plan when worsening of symptoms. At their clinical visit during the follow-up period, patients were asked about exacerbations suffered during these 6 months of monitoring. The investigators who conducted the visit were blinded about the Prevexair app records. RESULTS: The patients experienced a total of 185 exacerbations according to daily records in the app whereas only 64 exacerbations were recalled during medical visits. Perception became more accurate for severe exacerbations (kappa 0.6577), although we found no factors that predicted poor recall. The proportion of 72.5% patients were classified as unstable if the exacerbations captured by Prevexair were used to define stability, versus 47.8% if the exacerbations recall in visit was used. Two-thirds of the exacerbations recorded in the Prevexair application were not reported to doctors during their clinical visits. Almost half were treated with oral corticosteroids and/or antibiotics and more than one-quarter of the exacerbations treated did not seek medical attention. CONCLUSION: The findings of this cohort study confirm that patients do not always remember the exacerbations suffered during their medical visit. The prevexair application is useful in monitoring COPD patients at high risk, in order to a better assessment of exacerbations of COPD during medical visits. Further research must be carried out to evaluate this strategy in clinical practice.

Efecto del entrenamiento con traje de electroestimulación de cuerpo entero en las adaptaciones neuromusculares en individuos desentrenados - Ensayo clínico aleatorizado, protocolo de estudio / Effect of full body electrostimulation training (WB-EMS) on neuromuscular adaptations in untrained individuals - Randomized clinical trial, study protocol

INTRODUCCIÓN: La electroestimulación es un método de entrenamiento utilizados en el ámbito deportivo que ha demostrado ser efectivo para mejorar manifestaciones de fuerza como la potencia muscular. Actualmente, no se conoce literatura científica en la que se aplique un programa de entrenamiento con traje de electroestimulación. Por ello, este estudio pretende llevar a cabo un programa para ver qué efectos tiene sobre las adaptaciones neuromusculares en sujetos no entrenados. OBJETIVO: estudiar las alteraciones neuronales y musculares que ocurren en el entrenamiento activo de electroestimulación aplicada con traje de cuerpo entero en los músculos extensores de brazos y extensores de la pierna. MATERIAL Y MÉTODOS: Se realizará un estudio controlado aleatorizado entre grupos. El diseño experimental del estudio permitirá analizar las adaptaciones neuromusculares que ocurren con el entrenamiento de electroestimulación aplicada con traje de cuerpo entero y compararlas a las de un entrenamiento de fuerza tradicional. Las variables dependientes medidas serán: actividad electromiografía en test de fuerza isométrica máxima, valor de fuerza máxima, tasa de producción de fuerza, indicadores de adaptación neurales. El programa se llevará a cabo durante 24 sesiones, 2 veces por semana, durante 12 semanas. RESULTADOS ESPERADOS: Se espera conseguir una mayor activación neuromuscular con la combinación de electroestimulación aplicada con traje de cuerpo entero. Independientemente de los resultados obtenidos, sean estos positivos o negativos, el estudio final será publicado

INTRODUCTION: Electrostimulation is a method of training used in sports that has been shown to be effective in improving strength manifestations such muscle power. Currently, there is no known scientific literature in which a training program with electrostimulation suit is applied. Therefore, the aim of this study is to carry out a program to see the effects on neuromuscular adaptations in untrained subjects. OBJECTIVE: to study the neuronal and muscular adaptations that occur in the active electrostimulation training applied with a full body suit on the extensor muscles of the arms and extensors of the leg. MATERIAL AND METHODS: A randomized controlled study between groups. The experimental design of the study will allow us to analyze the neuromuscular adaptations that occur with the electrostimulation training applied with a full body suit and compare them to those of a traditional strength training. The dependent variables measured will be: electromyography activity in maximum isometric force test, maximum force value, force production rate, neural adaptation indicators. The program will be carried out during 24 sessions, twice a week, for 12 weeks. EXPECTED RESULTS: We expect to achieve greater neuromuscular activation with the combination of electrostimulation applied with full body suit. Regardless of the results obtained, the final study will be published

La figura docente del profesor contratado doctor vinculado: situación actual en España y la experiencia de Andalucía / The figure of the tenure-eligible lecturer: current situation Spain and experience in Andalusia

En este documento se refieren las bases legales nacionales y, más en concreto, las autonómicas andaluzas que dan respaldo a la figura del profesor contratado doctor vinculado y a la posibilidad de convocar las plazas correspondientes en las facultades de medicina de las universidades públicas españolas. Se exponen, asimismo, las características asistenciales y académicas que deben darse para llevar a cabo la convocatoria pública de dichas plazas. Se resume, a continuación, cuál es la situación actual existente en relación con dicha figura del profesorado en las facultades de medicina españolas. Se analizan también las ventajas y las posibles limitaciones que actualmente se derivan de contar con profesores contratados doctores vinculados y ello tanto para los médicos especialistas eventualmente interesados en optar a una de estas plazas como para el centro sanitario y la facultad de medicina correspondientes. Finalmente, se reseña la posible utilidad del documento elaborado por la Conferencia Nacional de Decanos de Facultades de Medicina de España (CNDFME) en la Asamblea General que se celebró en la Facultad de Medicina de Oviedo del 17 al 19 de mayo del 2018 y actualizado en marzo de 2020

A discussion is presented on the national legal foundations, and more specifically, those of Andalusia, that support the figure of the tenure-eligible lecturer and the possibility of filling the corresponding positions in the faculties of medicine in Spanish public universities are discussed. The clinical and academic characteristics that they must have in order to fill those public positions are also presented. The current situation as regards such a figure as a lecturer in Spanish faculties of medicine is then summarised. An analysis is made of the advantages and the possible limitations arising from having a tenure-eligible lecturer, and how this affects both the medical specialists possibly interested in opting for one of these positions, as well as for the corresponding health centres and faculties of medicine. Finally, mention is made of the possible use of the document prepared by the National Conference of Medical Faculty Deans (CNDFME) in the General Assembly held in the Oviedo Faculty of Medicine from 17 to 19 May 2018, and updated in March 2020

Short-term branched-chain amino acid supplementation does not enhance vertical jump in professional volleyball players. A double-blind, controlled, randomized study / La suplementación con BCAA no mejora el salto vertical en los jugadores de voleibol profesionales. Estudio doble ciego, controlado y aleatorizado

To the best of the author's knowledge, no previous studies have described the effect of branched-chain amino acids (BCAA) on vertical performance during a week in professional volleyball players. This study assessed BCAA supplementation for a week, aiming to improve vertical jump performance in male professional volleyball players. Twelve male volleyballers were randomly assigned to a BCAA group (n = 6) or a control group (n = 6). The BCAA group ingested 21 g over a week, 7 g per day on Monday, Wednesday, and Friday, before a volleyball training session, while the control group drank a placebo drink. Participants performed 8 maximal countermovement jumps (CMJ); the 3 CMJs on Monday and Wednesday were evaluated after warm-up, after plyometric training, and at the end of the training session; and the 2 CMJs on Friday were evaluated after warm-up, and at the end of the training session. Compared with baseline, no significant differences in CMJ over the week were observed in BCAA or control group, neither between groups. The results indicated that 21 g of BCAA supplementation over a week did not improve vertical jump performance in professional volleyball players

Hasta donde los autores saben, no se han descrito estudios previos sobre el efecto de los aminoácidos ramificados (BCAA) en el rendimiento vertical durante una semana en jugadores de voleibol profesionales. Este artículo estudió la suplementación de BCAA durante una semana con el objeto de mejorar el rendimiento del salto vertical en jugadores de voleibol profesionales masculinos. Doce jugadores de voleibol masculinos se asignaron aleatoriamente a un grupo con BCAA (n = 6) o a un grupo de control (n = 6). El grupo con BCAA ingirió 21 g en una semana, 7 g por día los lunes, miércoles y viernes antes de la sesión de entrenamiento de voleibol, mientras que el grupo de control bebió una bebida placebo. Los participantes realizaron 8 saltos máximos de contramovimiento (CMJ); los 3 CMJ de lunes y miércoles se evaluaron después del calentamiento y del entrenamiento pliométrico, y al final de la sesión de entrenamiento; los 2 CMJ del viernes se evaluaron después del calentamiento y al final de la sesión de entrenamiento. En comparación con el valor inicial, no se observaron diferencias significativas en los CMJ a lo largo de la semana, ni en el grupo BCAA ni en el grupo control, tampoco hubo diferencias entre grupos. Los resultados indicaron que 21 g de BCAA administrados durante una semana no mejoraron el rendimiento del salto vertical en jugadores de voleibol profesionales

Short-term branched-chain amino acid supplementation does not enhance vertical jump in professional volleyball players. A double-blind, controlled, randomized study.

INTRODUCTION: To the best of the authors' knowledge, no previous studies have described the effect of branched-chain amino acids (BCAA) on vertical performance during a week in professional volleyball players. This study assessed BCAA supplementation for a week, aiming to improve vertical jump performance in male professional volleyball players. Twelve male volleyballers were randomly assigned to a BCAA group (n = 6) or a control group (n = 6). The BCAA group ingested 21 g over a week, 7 g per day on Monday, Wednesday, and Friday, before a volleyball training session, while the control group drank a placebo drink. Participants performed 8 maximal countermovement jumps (CMJ); the 3 CMJs on Monday and Wednesday were evaluated after warm-up, after plyometric training, and at the end of the training session; and the 2 CMJs on Friday were evaluated after warm-up, and at the end of the training session. Compared with baseline, no significant differences in CMJ over the week were observed in BCAA or control group, neither between groups. The results indicated that 21 g of BCAA supplementation over a week did not improve vertical jump performance in professional volleyball players.

INTRODUCCIÓN: Hasta donde los autores saben, no se han descrito estudios previos sobre el efecto de los aminoácidos ramificados (BCAA) en el rendimiento vertical durante una semana en jugadores de voleibol profesionales. Este artículo estudió la suplementación de BCAA durante una semana con el objeto de mejorar el rendimiento del salto vertical en jugadores de voleibol profesionales masculinos. Doce jugadores de voleibol masculinos se asignaron aleatoriamente a un grupo con BCAA (n = 6) o a un grupo de control (n = 6). El grupo con BCAA ingirió 21 g en una semana, 7 g por día los lunes, miércoles y viernes antes de la sesión de entrenamiento de voleibol, mientras que el grupo de control bebió una bebida placebo. Los participantes realizaron 8 saltos máximos de contramovimiento (CMJ); los 3 CMJ de lunes y miércoles se evaluaron después del calentamiento y del entrenamiento pliométrico, y al final de la sesión de entrenamiento; los 2 CMJ del viernes se evaluaron después del calentamiento y al final de la sesión de entrenamiento. En comparación con el valor inicial, no se observaron diferencias significativas en los CMJ a lo largo de la semana, ni en el grupo BCAA ni en el grupo control, tampoco hubo diferencias entre grupos. Los resultados indicaron que 21 g de BCAA administrados durante una semana no mejoraron el rendimiento del salto vertical en jugadores de voleibol profesionales.

Seis semanas de ejercicio físico mejoran la capacidad funcional y la composición corporal en pacientes con Alzheimer / Six weeks of physical exercise improve functional capacity and body composition in Alzheimer's patients

OBJETIVO: El propósito de este estudio fue conocer si seis semanas de ejercicio físico podrían mejorar la condición física y la composición corporal en personas diagnosticadas de Alzheimer. MÉTODO: Se llevó a cabo un programa de entrenamiento donde 13 individuos (78,5±6,4 años) diagnosticados de Alzheimer, realizaron dos sesiones semanales de entrenamiento, en una de ellas se hizo ejercicio aeróbico en cicloergómetro y en la otra, trabajo de equilibrio, fuerza y coordinación. RESULTADOS: Encontramos cambios significativos en la composición corporal (disminución de masa grasa, y aumento de masa muscular), y en la capacidad funcional, reflejados por la mejora en el test de "sentarse y levantarse de una silla", el test de "levantarse, caminar y volverse a sentar", en la escala de Berg y en las mediciones de la velocidad de la marcha. Las mediciones de dinamometría manual se mantuvieron constantes o mejoraron levemente sin significación suficiente. CONCLUSIÓN: La combinación de entrenamiento aeróbico con ejercicios de fuerza, equilibrio y coordinación, dos veces por semana, durante seis semanas en personas con Alzheimer, podría mejorar la capacidad funcional y la composición corporal. Sin embargo, no parece claro que este protocolo de entrenamiento permita mejorar la fuerza de prensión manual

OBJECTIVE: The purpose of this study was to know if six weeks of physical exercise allowed to improve physical condition and body composition in people diagnosed with Alzheimer's. METHOD: A training program was carried out where 13 individuals (78.5 ± 6.4 years) diagnosed with Alzheimer's disease, performed two weekly training sessions, in one of them aerobic exercise was performed in a cycle ergometer and in the other, they performed balance, strength and coordination exercises. RESULTS: We found significant changes in body composition (decrease in fat mass, and increase in muscle mass), and in functional capacity, reflected by the improvement in the "sitting and getting up from a chair" test, the "getting up," walk and sit down again ", on the Berg scale and on gait speed measurements. The manual dynamometry measurements remained constant or improved slightly without sufficient significance. CONCLUSION: The combination of aerobic training with strength, balance and coordination exercises, twice a week, for six weeks in people with Alzheimer's, could improve functional capacity and body composition. However, it is not clear that this training protocol allows to improve manual grip strength

Efficacy of rituximab in slowing down progression of rheumatoid arthritis-related interstitial lung disease: data from the NEREA Registry.

OBJECTIVES: To asses the clinical course in RA-related interstitial lung disease (RA-ILD) patients with and without rituximab (RTX). The influence of other variables was also evaluated. METHODS: A longitudinal multicentre study was conducted in RA diagnosed with ILD from 2007 until 2018 in Madrid. Patients were included in a registry [pNEumology RhEumatology Autoinmune diseases (NEREA)] from the time of ILD diagnosis. The main endpoint was functional respiratory impairment (FI), when there was a decline ≥5% in the predicted forced vital capacity compared with the previous one. Pulmonary function was measured at baseline and in follow-up visits every 6-12 months. The independent variable was therapy with RTX. Covariables included sociodemographic, clinical, radiological and other therapies. Survival techniques were used to estimate the incidence rate (IR) and 95% CI of functional impairment, expressed per 100 patient-semesters. Cox multivariate regression models were run to examine the influence of RTX and other covariates on FI. Results were expressed as the hazard ratio (HR) and CI. RESULTS: A total of 68 patients were included. FI occurred in 42 patients [IR 23.5 (95% CI 19, 29.1)] and 50% of them had FI within 1.75 years of an ILD diagnosis. A multivariate analysis showed that RTX exposure resulted in a lower risk of FI compared with non-exposure [HR 0.51 (95% CI 0.31, 0.85)]. Interstitial pneumonia, glucocorticoids, disease activity and duration also influenced FI. CONCLUSION: RA-ILD patients deteriorate over time, with the median time free of impairment being <2 years. Patients exposed to RTX had a higher probability of remaining free of FI compared with other therapies. Other factors have also been identified.

Advanced Exergy Analysis in the Dynamic Framework for Assessing Building Thermal Systems.

This work applies the Dynamic Advanced Exergy Analysis (DAEA) to a heating and domestic hot water (DHW) facility supplied by a Stirling engine and a condensing boiler. For the first time, an advanced exergy analysis using dynamic conditions is applied to a building energy system. DAEA provides insights on the components' exergy destruction (ED) by distinguishing the inefficiencies that can be prevented by improving the quality (avoidable ED) and the ones constrained because of technical limitations (unavoidable ED). ED is related to the inherent inefficiencies of the considered element (endogenous ED) and those coming from the interconnections (exogenous ED). That information cannot be obtained by any other approach. A dynamic calculation within the experimental facility has been performed after a component characterization driven by a new grey-box modelling technique, through TRNSYS and MATLAB. Novel solutions and terms of ED are assessed for the rational implementation of the DAEA in building energy installations. The influence of each component and their interconnections are valuated in terms of exergy destruction for further diagnosis and optimization purposes.

El hospital universitario: criterios para su acreditación / The university hospital: Criteria for its accreditation

No disponible

La enseñanza de la práctica clínica en la Facultad de Medicina de la Universidad Complutense de Madrid / Teaching of clinical practice in the Faculty of Medicine of the Complutense University of Madrid

Se describe la metodología de instrucción y evaluación en práctica clínica y el grado de implicación del profesorado en esta tarea en la Unidad Docente del Hospital 12 de Octubre (Facultad de Medicina, Universidad Complutense de Madrid). A pesar de algunas disfunciones curriculares, nuestros estudiantes alcanzan un buen nivel de competencia clínica al final del grado. Algunos profesores tienen un conocimiento limitado de los roles docentes que pueden asumir, por lo que deberían recibir formación específica. Idealmente, la enseñanza clínica ha de implicar a todos los profesionales que cuidan del paciente en el contexto extra- e intrahospitalario

We describe the methodology for instruction and assessment of clinical practice and analyze the profile and teaching roles of faculty at the Teaching Unit of the Hospital 12 de Octubre (Faculty of Medicine, Complutense University of Madrid). Despite some structural limitations in curriculum development our students reach a good final level of clinical competence. The need for trainers to understand the different roles they can assume, improving faculty development and involving all the professionals taking care of the patient in the teaching process are emphasized