Pronóstico del trasplante cardiaco en pacientes con miocardiopatía hipertrófica y restrictiva. Análisis de un registro nacional

Introduction and objectives: Posttransplant outcomes among recipients with a diagnosis of hypertrophic cardiomyopathy (HCM) or restrictive cardiomyopathy (RCM) remain controversial. Methods: Retrospective analysis of a nationwide registry of first-time recipients undergoing isolated heart transplant between 1984 and 2021. One-year and 5-year mortality in recipients with HCM and RCM were compared with those with dilated cardiomyopathy (DCM). Results: We included 3703 patients (3112 DCM; 331 HCM; 260 RCM) with a median follow-up of 5.0 [3.1-5.0] years. Compared with DCM, the adjusted 1-year mortality risk was: HCM: HR, 1.38; 95%CI, 1.07-1.78; P = .01, RCM: HR, 1.48; 95%CI, 1.14-1.93; P = .003. The adjusted 5-year mortality risk was: HCM: HR, 1.17; 95%CI, 0.93-1.47; P = .18; RCM: HR, 1.52; 95%CI, 1.22-1.89; P < .001. Over the last 20 years, the RCM group showed significant improvement in 1-year survival (adjusted R2 = 0.95) and 5-year survival (R2 = 0.88); the HCM group showed enhanced the 5-year survival (R2 = 0.59), but the 1-year survival remained stable (R2 = 0.16). Conclusions: Both RCM and HCM were linked to a less favorable early posttransplant prognosis compared with DCM. However, at the 5-year mark, this unfavorable difference was evident only for RCM. Notably, a substantial temporal enhancement in both early and late mortality was observed for RCM, while for HCM, this improvement was mainly evident in late mortality.Introducción y objetivos: Existe controversia acerca de los resultados del trasplante cardiaco en pacientes con miocardiopatía hipertrófica (MCH) o restrictiva (MCR). Métodos: Análisis retrospectivo de receptores adultos de un primer trasplante cardiaco entre 1984 y 2021 incluidos en un registro nacional. La mortalidad al primer y quinto año postrasplante en receptores con MCH y MCR se comparó con la de receptores con miocardiopatía dilatada (MCD). Resultados: Se incluyó a 3.703 pacientes (3.112 MCD; 331 MCH y 260 MCR) con seguimiento mediano de 5,0 años (3,1-5,0). En comparación con la MCD, el riesgo ajustado de mortalidad a 1 año fue: MCH: hazard ratio (HR)=1,38; intervalo de confianza del 95% (IC95%), 1,07-1,78; p=0,01, MCR: HR=1,48; IC95%, 1,14-1,93; p=0,003. El riesgo ajustado a 5 años fue: MCH: HR=1,17; IC95%, 0,93-1,47; p=0,18; MCR: HR=1,52; IC95%, 1,22-1,89; p<0,001. En los últimos 20 años, la MCR mejoró significativamente la supervivencia a 1 año (R2 ajustada=0,95) y a 5 años (R2=0,88); la MCH mejoró la supervivencia a 5 años (R2=0,59) y a 1 año permaneció estable (R2=0,16). Conclusiones: Se asoció la MCR y la MCH a peor pronóstico precoz postrasplante que la MCD. La diferencia desfavorable se mantuvo para la supervivencia a 5 años solo para la MCR. Se observa una tendencia temporal a mejor pronóstico precoz y tardío para la MCR, y solo para el tardío en la MCH.Sin financiación5.9 Q1 JCR 20221.1991 Q1 SJR 2023No data IDR 2022UE

Associations of Balance, Strength, and Gait Speed with Cognitive Function in Older Individuals over 60 Years: A Cross-Sectional Study

This research examined the association between the risk of falls and cognitive function in older individuals at risk of mild cognitive impairment. One hundred seventy-five older adults were included in 2021. Balance confidence was scored using the Activities-Specific Balance Confidence Scale (ABC), gait speed was assessed by the 4 m test, handgrip strength by a digital dynamometer, and balance by the Timed Up-and-Go Test (TUG). The Mini-Mental State Examination (MMSE), The Controlled Oral Word Association Test, and The Boston Naming Test short-version questionnaires assessed global cognitive function, verbal fluency, and language, respectively. A bivariate correlation analysis and multivariate linear regressions were applied, adjusting for confounders (BMI, sex, age, and educational level). Shorter time in the TUG and greater educational status were independently associated with improved scores on the MMSE. Lower age and greater educational status were independently associated with increased phonological fluency. Better ABC and performance on the TUG and higher educational attainment were independently associated with enhanced semantic fluency. Higher education level and gait speed were independently associated with increased language (all p < 0.05). Improved physical factors, such as gait speed, grip strength, balance, and balance confidence enhanced cognitive function, particularly global cognitive function, verbal fluency, and language, in individuals over 60, with education as a potential confounder.2014–2020 Operational Program FEDER in Andalusia (1260735)2.7 Q2 JCR 20220.492 Q2 SJR 2022No data IDR 2022UE

ChatGPT as an information tool in rhinology. Can we trust each other today?

Purpose: ChatGPT (Chat-Generative Pre-trained Transformer) has proven to be a powerful information tool on various topics, including healthcare. This system is based on information obtained on the Internet, but this information is not always reliable. Currently, few studies analyze the validity of these responses in rhinology. Our work aims to assess the quality and reliability of the information provided by AI regarding the main rhinological pathologies. Methods: We asked to the default ChatGPT version (GPT-3.5) 65 questions about the most prevalent pathologies in rhinology. The focus was learning about the causes, risk factors, treatments, prognosis, and outcomes. We use the Discern questionnaire and a hexagonal radar schema to evaluate the quality of the information. We use Fleiss's kappa statistical analysis to determine the consistency of agreement between diferent observers. Results The overall evaluation of the Discern questionnaire resulted in a score of 4.05 (±0.6). The results in the Reliability section are worse, with an average score of 3.18. (±1.77). This score is afected by the responses to questions about the source of the information provided. The average score for the Quality section was 3.59 (±1.18). Fleiss's Kappa shows substantial agreement, with a K of 0.69 (p<0.001). Conclusión: The ChatGPT answers are accurate and reliable. It generates a simple and understandable description of the pathology for the patient's beneft. Our team considers that ChatGPT could be a useful tool to provide information under prior supervision by a health professional.Sin financiación2.6 Q2 JCR 20220.857 Q1 SJR 2022No data IDR 2022UE

Predictive Model of Anxiety and Depression Perception in Multiple Sclerosis Patients: Possible Implications for Clinical Treatment

Abstract: Multiple Sclerosis (MS) is a neurodegenerative disease characterized by motor and nonmotor symptoms, including emotional distress, anxiety, and depression. These emotional symptoms currently have a pharmacological treatment with limited effectiveness; therefore, it is necessary to delve into their relationship with other psychological, functional, or prefrontal alterations. Additionally, exploring non-pharmacological therapeutic alternatives that have shown benefits in addressing emotional distress in MS patients is essential. Aim: To establish a predictive model for the presence of anxiety and depression in MS patients, based on variables such as psychological well-being, functional activity, and prefrontal symptoms. Additionally, this study aimed to propose non pharmacological therapeutic alternatives based on this model. Materials and Methods: A descriptive, observational, and cross-sectional study was conducted with a sample of 64 diagnosed MS patients who underwent functional and cognitive assessments using the following questionnaires and scales: Functional Activities Questionnaire (FAQ), Acceptance and Action Questionnaire (AAQ-II), Experiences Questionnaire (EQ), Self-Compassion Scale Short Form (SCS-SF), Beck Depression Inventory II (BDI-II), State-Trait Anxiety Inventory (STAI), and Prefrontal Symptoms Inventory (PSI). Results: The model showed an excellent fit to the data and indicated that psychological well-being was the most significant predictor of the criteria (β = −0.83), followed by functional activity (β = −0.18) and prefrontal symptoms (β = 0.15). The latter two are negatively related to psychological well-being (β = −0.16 and β = −0.75, respectively). Conclusions: Low psychological well-being is the variable that most significantly predicts the presence of anxiety and depression in MS patients, followed by functional activity and prefrontal alterations. Interventions based on mindfulness and acceptance are recommended, along with nutritional interventions such as antioxidant-enriched ketogenic diets and moderate group physical exercise.Catholic University Foundation San Vicente Mártir, for the research project The Impact of Triglycerides on Multiple Sclerosis (Promotion code 2018-203-001)4.6 Q2 JCR 20220.627 Q3 SJR 2023No data IDR 2023UE

"Democratic" and systematic violation of the fundamental right to active vote in case of request for registration in the registry of a municipality different from the current

El objetivo de este artículo es analizar empíricamente la situación y tratamiento del derecho fundamental del sufragio activo y, por ende, a la participación en la vida política del país por cualquier ciudadano en los casos de cambio de empadronamiento, procedimiento administrativo gestionado por los Ayuntamientos bajo las instrucciones del INE que supone la baja inmediata y automática de los datos censales existentes, teniendo en cuenta que la inscripción en el padrón es declarativa y no constitutiva del derecho de sufragio, erigiéndose como un instrumento indispensable para el ejercicio del derecho fundamental al voto. Se analizan los requisitos constitucionales y jurisprudenciales para el desarrollo y limitación del contenido de este derecho fundamental, así como para su efectivo ejercicio en condiciones de igualdad, transparencia y equidad.The objective of this article is to empirically analyze the situation and treatment of the fundamental right to active suffrage and, therefore, to participation in the political life of the country by any citizen in cases of change of registration, an administrative procedure that involves the immediate and automatic removal of existing census data, taking into account that registration in the register is declarative and does not constitute the right to vote, constituting an essential instrument for the exercise of the fundamental right to vote. The constitutional and jurisprudential requirements for the development and limitation of the content of this fundamental right are analyzed, as well as for its effective exercise in conditions of equality, transparency and equity.Sin financiación0.1 Q* JCR 2022No data SJR 20230,20 C2 IDR 2022UE

Del consenso al empoderamiento ciudadano

Sin financiaciónSPI 2022UE

Instrumental assessment of sleep bruxism: A systematic review and meta-analysis

This systematic review and meta -analysis (MA) aimed to evaluate the diagnostic validity of portable electromyography (EMG) diagnostic devices compared to the reference standard method polysomnography (PSG) in assessing sleep bruxism. This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta -Analysis (PRISMA) statement and was registered with PROSPERO prior to the accomplishment of the main search. Ten clinical studies on humans, assessing the diagnostic accuracy of portable instrumental approaches with respect to PSG, were included in the review. Methodological shortcomings were identified by QUADAS-2 quality assessment. The certainty of the evidence analysis was established by different levels of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. A meta -analysis of diagnostic test accuracy was performed with multiple thresholds per study applying a two-stage random effects model, using the thresholds offered by the studies and based on the number of EMG bruxism events per hour presented by the participants. Five studies were included. The MA indicated that portable EMG diagnostic devices showed a very good diagnostic capacity, although a high variability is evident in the studies with some outliers. Very low quality of evidence due to high risk of bias and high heterogeneity among included studies suggests that portable devices have shown high sensitivity and specificity when diagnosing sleep bruxism (SB) compared to polysomnography. The tests performed in the MA found an estimated optimal cut -off point of 7 events/hour of SB with acceptably high sensitivity and specificity for the EMG portable devices.Sin financiación10.5 Q1 JCR 20223.561 Q1 SJR 2023No data IDR 2022UE

New Approach on I.40 Migration Projects Using Agile Concurrent Methodology

The industry worldwide is undergoing continual changes owing to the emergence of new technologies and the globalization. Industry 4.0 is transforming the way things are done at the industrial level, and combined with the advancements in communication networks and the internet, it enables complete digitization of manufacturing processes. Nevertheless, the lack of appropriate management procedures and methodologies is hindering the implementation of digitization solutions, making it difficult to simplify requirements analysis and the incorporation of improvements using I4.0. Based on a literature review, the most crucial characteristics of migration projects have been identified, which are based on the I4.0 enablers. Currently, any technological system migration requires the use of an appropriate management methodology, which either replaces or complements the conventional. In this research proposes a new agile concurrent methodological procedure that relies on concurrent engineering and adapted Scrum to execute technology migration projects based on I4.0 enablers. It will be easy to applied in three level of management, and giving a faster and more efficient technology migration. Other benefits are a short periodic feedback for error correction, cross-functional teams, and simple implementation.Sin financiaciónSPI 2022UE

Legal status of non-catholic religious entities and model of state collaboration in Croatia

Este trabajo explora el régimen estatal croata relativo al estatuto jurídico de las entidades religiosas no católicas y el marco de colaboración con las mismas. En primer lugar, se analizan los principios constitucionales y el correspondiente desarrollo legislativo, de los que se desprende, en modo propositivo, una categorización de tales entidades. Seguidamente, se analiza el modo de colaboración estatal con cada tipo de entidad en función de su estatuto legal, estudiando cada categoría según el orden de prelación determinado por el nivel de importancia otorgado legal y administrativamente: las que han firmado acuerdos sobre materias de interés común con el gobierno croata; las registradas como entidades religiosas y las registradas como asociaciones. En el estudio de cada categoría y de sus correspondientes prerrogativas, han podido reseñarse aspectos singulares, en algún caso reconocidos -o rechazados- judicialmente como discriminatorios. Esta aproximación pretende ilustrar cómo han sido aplicados, durante veinte años de vigencia en Croacia, los principios de igualdad entre entidades religiosas y de neutralidad inclusiva del Estado en la colaboración con las mismas.Sin financiaciónNo data JCR 2022No data SJR 20220,31 C1 IDR 2022UE

Comparison of green solvents for the revalorization of orange by-products: carotenoid extraction and in vitro antioxidant activity

Orange peels contain a considerable number of bioactive compounds such as carotenoids, that can be used as ingredients in high-value products. The aim of this study was to compare orange peel extracts obtained with different green solvents (vegetable oils, fatty acids, and deep eutectic solvents (DES)). In addition, the chemical characterization of a new hydrophobic DES formed by octanoic acid and l-proline (C8:Pro) was performed. The extracts were compared in terms of carotenoid extraction, antioxidant activity by three methods, color, and environmental impact. The results confirmed that the mixture of C8:Pro is a DES and showed the highest carotenoid extraction (46.01 µg/g) compared to hexane (39.28 µg/g). The antioxidant activity was also the highest in C8:Pro (2438.8 µM TE/mL). Finally, two assessment models were used to evaluate the greenness and sustainability of the proposed extractions. These results demonstrated the potential use of orange peels in the circular economy and industry.Ministry of Science and Innovation (Spain) -State Research Agency (PID- 2019-111331RB-I00)Ministry of Science and Innovation (Spain) -State Research Agency (AEI/10.13039/501100011033)Ministry of Education of the Republic of Peru (PRONABEC)8.8 Q1 JCR 20221.624 Q1 SJR 2022No data IDR 2022UE