85,154 research outputs found

    Comparison of physical fitness between healthy and mild‐to‐moderate asthmatic children with exercise symptoms: A cross‐sectional study

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    .Objective Asthma is a chronic disease that may affect physical fitness, although its primary effects on exercise capacity, muscle strength, functionality and lifestyle, in children and adolescents, are still poorly understood. This study aimed to evaluate the differences in cardiorespiratory fitness, muscle strength, lifestyle, lung function, and functionality between asthmatics with exercise symptoms and healthy children. In addition, we have analyzed the association between clinical history and the presence of asthma. Study Design Cross-sectional study including 71 patients with a diagnosis of asthma and 71 healthy children and adolescents (7–17 years of age). Anthropometric data, clinical history, disease control, lifestyle (KIDMED and physical activity questionnaires), lung function (spirometry), exercise-induced bronchoconstriction test, aerobic fitness (cardiopulmonary exercise test), muscle strength and functionality (timed up and go; timed up and down stairs) were evaluated. Results Seventy-one patients with asthma (mean age 11.5 ± 2.7) and 71 healthy subjects (mean age 10.7 ± 2.5) were included. All asthmatic children had mild to moderate and stable asthma. EIB occurred in 56.3% of asthmatic children. Lung function was significantly (p < .05) lower in the asthmatic group when compared to healthy peers, as well as the cardiorespiratory fitness, muscle strength, lifestyle and functionality. Moreover, asthmatic children were more likely to have atopic dermatitis, allergic reactions, food allergies, and a family history of asthma when compared to healthy children. Conclusions Children with mild-to-moderate asthma presenting exercise symptoms show a reduction in cardiorespiratory fitness, muscle strength, lung function, functionality, and lifestyle when compared to healthy peers. The study provides data for pediatricians to support exercise practice aiming to improve prognosis and quality of life in asthmatic children.S

    Aspectos clínicos de la COVID-19

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    La transmisión del SARS-CoV-2 generalmente ocurre por gotitas respiratorias de diferente tamaño. Los síntomas de presentación suelen incluir fiebre, tos, astenia, mialgia o disnea. La mayoría de las personas infectadas son asintomáticas o tienen una enfermedad leve, pero una minoría desarrolla insuficiencia respiratoria progresiva que requiere hospitalización y soporte respiratorio. El tratamiento es fundamentalmente de soporte, sin embargo, en pacientes hospitalizados, algunos agentes antivirales directos (administrados durante los primeros días de la infección) y el tratamiento inmunomodulador con esteroides y bloqueadores de citocinas (en el periodo de hiperinflamación), pueden mejorar el pronóstico. No obstante, se necesitan nuevas moléculas antivirales frente a SARS-CoV-2, con buena tolerancia y que se puedan administrar por vía oral, para evitar la progresión de la enfermedad, prevenir el contagio en pacientes de riesgo y cortar la cadena de transmisión. La duración exacta de la inmunidad después de la infección natural o la vacunación aún espera un estudio de seguimiento a largo plazo. Después de una COVID aguda, un número significativo de pacientes desarrollan diversos síntomas persistentes que, en la mayoría de personas, mejoran espontáneamente a lo largo de las semanas o meses siguientes. La pandemia de COVID-19 ha provocado millones de infecciones en todo el mundo, con morbi-mortalidad significativa, y generado una tensión extrema en los sistemas sanitarios y económicos. La buena noticia es la aparición de vacunas muy eficaces que están ayudando a controlar la enfermedad en países desarrollados; de su implementación masiva durante los próximos meses, incluyendo a los países con menos recursos, va a depender el control adecuado de esta pandemia

    Application of lactic acid bacteria for the biopreservation of meat products: A systematic review

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    .The increasing concern of consumers about food quality and safety and their rejection of chemical additives has promoted the breakthrough of the biopreservation field and the development of studies on the use of beneficial bacteria and their metabolites as potential natural antimicrobials for shelf life extension and enhanced food safety. Control of foodborne pathogens in meat and meat products represents a serious challenge for the food industry which can be addressed through the intelligent use of bio-compounds or biopreservatives. This article aims to systematically review the available knowledge about biological strategies based on the use of lactic acid bacteria to control the proliferation of undesirable microorganisms in different meat products. The outcome of the literature search evidenced the potential of several strains of lactic acid bacteria and their purified or semi-purified antimicrobial metabolites as biopreservatives in meat products for achieving longer shelf life or inhibiting spoilage and pathogenic bacteria, especially when combined with other technologies to achieve a synergistic effect.S

    Balancing the urban stomach: public health, food selling and consumption in London, c. 1558-1640

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    Until recently, public health histories have been predominantly shaped by medical and scientific perspectives, to the neglect of their wider social, economic and political contexts. These medically-minded studies have tended to present broad, sweeping narratives of health policy's explicit successes or failures, often focusing on extraordinary periods of epidemic disease viewed from a national context. This approach is problematic, particularly in studies of public health practice prior to 1800. Before the rise of modern scientific medicine, public health policies were more often influenced by shared social, cultural, economic and religious values which favoured maintaining hierarchy, stability and concern for 'the common good'. These values have frequently been overlooked by modern researchers. This has yielded pessimistic assessments of contemporary sanitation, implying that local authorities did not care about or prioritise the health of populations. Overly medicalised perspectives have further restricted historians' investigation and use of source material, their interpretation of multifaceted and sometimes contested cultural practices such as fasting, and their examination of habitual - and not just extraordinary - health actions. These perspectives have encouraged a focus on reactive - rather than preventative - measures. This thesis contributes to a growing body of research that expands our restrictive understandings of pre-modern public health. It focuses on how public health practices were regulated, monitored and expanded in later Tudor and early Stuart London, with a particular focus on consumption and food-selling. Acknowledging the fundamental public health value of maintaining urban foodways, it investigates how contemporaries sought to manage consumption, food production waste, and vending practices in the early modern City's wards and parishes. It delineates the practical and political distinctions between food and medicine, broadly investigates the activities, reputations of and correlations between London's guild and itinerant food vendors and licensed and irregular medical practitioners, traces the directions in which different kinds of public health policy filtered up or down, and explores how policies were enacted at a national and local level. Finally, it compares and contrasts habitual and extraordinary public health regulations, with a particular focus on how perceptions of and actual food shortages, paired with the omnipresent threat of disease, impacted broader aspects of civic life

    South Yorkshire low carbon energy supply chains: insulation sector summary

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    P469 Infliximab for induction of medically-induced remission in Crohn’s disease: a Cochrane systematic review

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    Background Infliximab is a monoclonal antibody that binds and neutralizes tumour necrosis factor-alpha, which is present in high levels in the blood serum, mucosa and stool of patients with Crohn’s disease (CD). We sought to determine the effectiveness and safety of infliximab in inducing remission in patients with CD. Methods On 31 August 2021, we searched CENTRAL, CINAHL, ClinicalTrials.gov, Embase, MEDLINE, and WHO ICTRP with no language, date, publication status, or document type limitations. We included randomized controlled trials (RCTs) in which infliximab was compared to placebo or another active comparator in adult (18 and over) patients with active CD. The review authors independently conducted data extraction and ‘Risk of bias’ assessment of the included studies. We expressed dichotomous and continuous outcomes as risk ratios and mean differences with 95% confidence intervals. We assessed the certainty of the evidence using GRADE methodology. The primary outcome was the proportion of patients who achieved clinical remission. Results We included 9 RCTs (1130 participants). Three studies compared multiple arms with different infliximab doses (between 5mg and 20mg/kg) to placebo. Two studies each with three arms compared azathioprine and placebo, infliximab and placebo, or infliximab and azathioprine combined. One study compared infliximab with biosimilar CT-P13. One study compared infliximab and azathioprine with steroids and azathioprine and only infliximab if no response. The final study compared a single dose (5mg/kg) of infliximab to placebo. In all trials that didn’t require a purine analogue to be given to both study groups, they allowed such concomitant use in both groups. There is evidence that infliximab combined with azathioprine is superior to azathioprine combined with placebo in inducing clinical remission for CD (RR 1.97, 95% CI 1.60–2.42, moderate certainty evidence downgraded due to risk of bias, NNT = 3). Sensitivity analysis considering a fixed effects model and then removing a study where most received azathioprine in both groups instead of all, had no impact on the result, which remained significant. There is evidence that there may be no difference in withdrawals from adverse events between infliximab combined with azathioprine and azathioprine combined with placebo when inducing clinical remission for CD (RR 0.74, 95% CI 0.29–1.86, low certainty evidence downgraded due to serious imprecision). The evidence is uncertain for all other comparisons and outcomes due to imprecision from small sample sizes. Conclusion There is evidence that infliximab with azathioprine is probably better than azathioprine, however the remaining data is based on limited total patient numbers and offers limited scope for meta-analysis

    Structural and Attitudinal Barriers to Bicycle Ownership and Cycle-Based Transport in Gauteng, South Africa

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    Policies that aim to facilitate and promote non-motorised transport (NMT), and in particular cycling, have been developed by many high-income countries facing increasingly congested roads and saturated public transport systems. Such policies are also emerging in many low- and middle-income settings where high rates of urbanisation have led to similar problems with motorised transport. The aim of the present study was to better understand the potential structural and attitudinal barriers to cycle-based transport in one such context: South Africa’s Gauteng Province, the industrial powerhouse of sub-Saharan Africa that has recently made a firm commitment to NMT. The study focussed on demographic and socioeconomic variation in bicycle and car ownership, and related this to: (1) the reported use of motorised and non-motorised transport (both private and public); and (2) perceived ‘problems’ with cycling. The analyses drew on interviews with key respondents from n = 27,490 households conducted in 2013 as part of the third Quality of Life survey undertaken by the Gauteng City Regional Observatory. The survey contained items on three outcomes of interest: household vehicle ownership (bicycles and cars); modes of transport used for the “trips” most often made; and respondents’ “single biggest problem with… cycling”. Respondent- and household-level demographic and socioeconomic determinants of these outcomes were examined using descriptive and multivariable statistical analyses, the latter after adjustment for measured potential confounders identified using a theoretical causal path diagram (in the form of a directed acyclic graph). Of the n = 26,469 households providing complete data on all of the variables examined in the present study, only n = 8722 (32.9%) owned a car and fewer still (n = 2244; 8.4%) owned a bicycle. The ownership of these assets was commonest amongst wealthier, economically active households; and those that owned a car had over five times the odds of also owning a bicycle, even after adjustment for potential confounding (OR 5.17; 95% CI 4.58, 5.85). Moreover, of household respondents who reported making ‘trips’ during the preceding month (n = 18,209), over two-thirds of those whose households owned a car (70.1%) reported private car-based transport for such trips, while only 3.2% of those owning a bicycle reported cycling. Amongst the specific responses given to the item requesting the “single biggest problem with… cycling” by far the commonest was “Don’t know how to cycle” (32.2%), less than half as many citing “Vehicle accident risk” (15.9%), and fewer still: “Destination is too far” (13.9%); “Crime” (10.3%); “Too much effort” (9.2%); or “Lack of good paths” (4.6%). While the first of these reasons was commonest amongst poorer households, concerns about risk and effort were both most common amongst better educated, economically active and wealthier/better serviced households. In contrast, concerns over (cycle) paths were only common amongst those owning bicycles. The low prevalence of household bicycle ownership, and the disproportionate number of households owning bicycles that also owned cars, might explain the very small proportion of the ‘the trips most often made’ that involved cycle-based transport (0.3%), and the preferential use of cars amongst households owning both bicycles and cars. Low levels of bicycle ownership might also explain why so many respondents cited “Don’t know how” as the “single biggest problem with… cycling”; although risk and effort were also substantial concerns (presumably for many who did, and some who did not, know how to cycle); the lack of suitable cycle lanes being only primarily a concern for those who actually owned bicycles. Structural and attitudinal barriers to cycle-based transport limit the use of cycle-based transport in Gauteng, not only amongst the vast majority of household respondents who lack the means to cycle (and the means to learn how), but also amongst those dissuaded from learning to cycle, purchasing a bicycle and/or using a bicycle they own by: the risks and effort involved; the lack of suitable cycle paths; and/or because they also own a car and prefer to drive than cycle

    Cyber-threat landscape of border control infrastructures

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    Various events in recent decades, such as the 9/11 tragedy and the European migration crisis, have highlighted the critical nature of robust borders and the impact of associated attacks on their integrity. However, it is unclear as to the extent to which cyber-attacks can threaten border operations. Interestingly, no extensive research has been conducted into this topic, possibly due to the complexity and diversity of border controls. This paper specifies the cyber-threat landscape of border control infrastructures to assist professionals in assessing the relevant cybersecurity risks. Border control infrastructures are complex environments and relevant risks might not be easily identified. To investigate the cyber-threat landscape of these infrastructures, a mixed research method, combining qualitative and quantitative results, and using border-related expert interviews and risk analysis investigation was chosen. Key contributions of this work include the classification of a widespread set of border assets, the description of the profiles of threat actors and their potential synergies, the specification of a threat taxonomy applicable to all border types, and the identification of potential areas of vulnerability. Moreover, through the risk analysis investigations, exemplary input is developed to guide professionals while applying a risk assessment methodology in the context of border control infrastructures. The paper concludes with future directions addressed to policy makers and border professionals

    Uso de las histonas circulantes y sus modificaciones post-traduccionales como biomarcadores en sepsis y shock séptico

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    La sepsis es una afección potencialmente mortal causada por una respuesta anormal del huésped a una infección, produciendo respuestas fisiológicas alteradas que dañan los propios tejidos del paciente y pueden provocar disfunción orgánica e incluso la muerte. Asimismo, algunos pacientes sépticos progresan a shock séptico, caracterizado por alteraciones circulatorias, celulares y metabólicas sustanciales que aumentan el riesgo de mortalidad. A pesar de que la sepsis se caracteriza por un mal funcionamiento del sistema inmunológico, lo que a su vez conduce a una respuesta inmune alterada e inmunosupresión, la alta complejidad de la fisiopatología de la sepsis requiere una mayor investigación para comprender las respuestas inmunes que ocurren durante la sepsis. Asimismo, las histonas extracelulares circulantes han ganado relevancia como mediadores citotóxicos en la sepsis, ya que actúan como patrones moleculares asociados a daño, que inducen estrés oxidativo y activan el inflamasoma NLRP3. Estos mecanismos median la activación de la piroptosis, un mecanismo de muerte celular programada que produce inflamación mediante la expresión de IL-18, IL-1β and IL-1α. Sin embargo, a pesar de la evidencia de activación del inflamasoma en las células inmunes durante la sepsis, se desconoce si las histonas extracelulares son capaces de activar los inflamasomas endoteliales y sus consecuencias. En este trabajo destacamos el papel previamente desconocido de las histonas extracelulares, mediando la activación del inflamasoma NLRP3 y la piroptosis en las células endoteliales, contribuyendo a la disfunción endotelial y la desregulación de la respuesta inmune mediada por el endotelio. Asimismo, también demostramos cómo la acetilación de histonas disminuye la activación de la piroptosis. Además, demostramos que la piroptosis se produce en pacientes con shock séptico y los niveles de histonas circulantes se correlacionan con la expresión de citoquinas proinflamatorias y citoquinas piroptóticas, la liberación de factores de adhesión endotelial y la gravedad de la enfermedad. Proponemos la piroptosis mediada por histonas como un nuevo objetivo para desarrollar intervenciones clínicas. De manera similar, hemos analizado las respuestas inmunorelacionadas que ocurren durante las primeras etapas de la sepsis con el objetivo de proporcionar nuevos datos comparando las cantidades de citoquinas, inmunomoduladores y otros mediadores endoteliales en pacientes críticamente enfermos no sépticos, sépticos y de shock séptico. Nuestro enfoque ayudará a caracterizar rápidamente las respuestas inmunes alteradas en pacientes sépticos y de shock séptico ingresados en la Unidad de Cuidados Intensivos. Finalmente analizamos el papel de la metilación del ADN en el control del sistema inmune séptico. Nuestros resultados demostraron el papel central de la metilación del ADN modulando la respuesta molecular en los pacientes de shock séptico y contribuyendo a la inmunosupresión, a través de la alteración de los patrones de metilación de los promotores de IL-10 y TREM-2.Sepsis is a life-threatening condition caused by an abnormal host response to an infection that produce altered physiological responses which damages own tissues of the patient and can result in organ dysfunction and in some cases death. Likewise, a subset of septic patients progresses to septic shock, characterized by substantial circulatory, cellular and metabolic abnormalities, which substantially increase the risk of mortality. Sepsis is characterized by a malfunction of the immune system and it can lead to an altered immune response and immunosuppression. Moreover, the high complexity of the pathophysiology of sepsis requires of further investigation to characterize the immune responses in sepsis and septic shock. Likewise, circulating extracellular histones have gained relevance as cytotoxic mediators in sepsis pathophysiology, since they act as damage-associated molecular patterns, which induce oxidative stress and activate NLRP3 inflammasome. Subsequently, inflammasome mediates pyroptosis activation, a programmed cell death mechanism that produces inflammation through the release of IL-18, IL-1β and IL-1α. However, despite inflammasome activation may occur in immune cells during sepsis, it is unknown if this process also takes place in endothelial cells and particularly whether extracellular histones are capable of activating endothelial inflammasomes and their consequences. In this work we highlight a previously unknown role for extracellular histones, that mediates the activation of NLRP3 inflammasome and pyroptosis in endothelial cells by contributing to endothelial dysfunction and the dysregulation of the immune response mediated by endothelium. Likewise, we demonstrated how histone acetylation decreases pyroptosis activation. Furthermore, we show how pyroptosis occurs in septic shock patients and how circulating histone levels correlate with the expression of pro-inflammatory and pyroptotic cytokines, the release of endothelial adhesion factors and septic shock severity. We propose histone-mediated pyroptosis as a new target to develop clinical interventions. Similarly, we have analyzed the immune-related responses occurring during the early stages of sepsis with the aim of providing new data by comparing the amounts of cytokines, immune modulators and other endothelial mediators in critically-ill non-septic patients, septic and septic shock patients. Our approach will help to rapidly characterize the altered immune responses in septic and septic shock patients admitted in the Intensive Care Unit. Finally, we also analyzed the role of DNA methylation in the control of septic immune system. Our results demonstrated the central role of DNA methylation modulating the molecular response in septic shock patients and contributing to immunosuppression, through the alteration of DNA methylation patterns of IL-10 and TREM2 promoters

    Metodología de intervención para trabajar ODS. Educación a través de las artes

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    La Agenda 2030 presenta 17 Objetivos de Desarrollo Sostenible (ODS), con sus metas e indicadores universales que los países miembros de la ONU emplean para enmarcar sus políticas. Entre las metas del ODS 4 “educación de calidad” encontramos: “asegurar que todos los alumnos adquieran los conocimientos teóricos y prácticos necesarios para promover el desarrollo sostenible, entre otras cosas mediante la educación para el desarrollo sostenible y los estilos de vida sostenibles, los derechos humanos, la igualdad de género, la promoción de una cultura de paz y no violencia, la ciudadanía mundial y la valoración de la diversidad cultural y la contribución de la cultura al desarrollo sostenible”. La educación, se considera el motor de la Agenda 2030 porque, además de representar el centro del ODS 4, desempeña también un papel notable en la implementación de los demás, mejorando su alcance y efectividad. Así pues, entre las disciplinas que sustentan este trabajo se escogió la Educación para el Desarrollo Sostenible y la Ciudadanía Global como marco de acción y punto de partida en la formación de los ciudadanos de un futuro viable, equitativo y habitable. Se continuó investigando las oportunidades del desarrollo de la Competencia Intercultural en las relaciones humanas, aquello que diferencia a unas personas de otras puede aportar al conjunto de la sociedad y cómo la educación permitiría su aprovechamiento. Con todo ello, se planteó el marco didáctico de interacción en el cual se implementó la interculturalidad en el ejercicio educativo. Se estudió así el poder de las artes como medio de motivación e inspiración a la hora de transmitir de la manera más eficaz posible los valores considerados más arriba. El objetivo del presente estudio se centra en demostrar el potencial de las artes para fomentar las competencias comunicativas, sociales, interculturales, emocionales, de ciudadanía y sostenibilidad. Para ello, se ha realizado una investigación aplicada que deriva en una propuesta concreta de intervención con un programa educativo destinado a la enseñanza de lenguas, tanto primera como extranjera, en distintos niveles de la educación formal en Mali y en España, aplicando un método holístico basado en el paradigma interpretativo. A través de la pintura, la literatura y el cine, se plantean una serie de actividades ideadas para crear un entorno educativo integrador, favorecer el empoderamiento del alumnado y promover el pensamiento crítico, la empatía, la resiliencia, la comunicación, la cooperación y la educación intercultural, como competencias esenciales para la consecución de los 17 ODS, la construcción de un mundo transcultural sostenible y el desarrollo de una ciudadanía global preparada para los retos del siglo XXI. En la metodología de este proceso educativo innovador, multidisciplinar, flexible y adaptable, se ha empleado un análisis del proceso de investigación para monitorizarlo adecuadamente (DAFO). Cada una de las propuestas presenta una recogida de datos cualitativos (observación, rúbricas) y cuantitativos (encuestas, entrevistas) y se ofrece un análisis de contraste de los resultados finales. Con todo, se espera facilitar la exigente tarea que supone hacer consciente a la sociedad de base (desde la misma infancia; desde los niveles más bajos de la misma y en todos los niveles de la educación formal) de en qué consisten los ODS y su relevancia para hacer de todas las personas corresponsables directas en su consecución para garantizar un futuro sostenible para toda la ciudadanía global.The 2030 Agenda presents 17 Sustainable Development Goals (SDGs), with their universal targets and indicators that UN member countries use to frame their policies. Among the targets of SDG 4 “quality education,” we find the one that seeks: “to ensure that all students acquire the theoretical and practical knowledge necessary to promote sustainable development, among other things through education for sustainable development and sustainable lifestyles, human rights, gender equality, the promotion of a culture of peace and non-violence, world citizenship and the appreciation of cultural diversity and the contribution of culture to sustainable development”. Education is considered the engine of the 2030 Agenda because, in addition to representing the centre of SDG 4, it also plays a notable role in the implementation of the others, improving their scope and effectiveness. Among the disciplines that support this research, Education for Sustainable Development and Global Citizenship sets the framework for action and represents a starting point in the formation of citizens for a viable, equitable and habitable future. Global citizenship implies human relations and those and intrinsically shaped by culture. Intercultural Education and, more specifically, the development of Intercultural Competence needed to be considered. What differentiates some people from others can contribute to society as a whole and education is the means to explore and understand. For the design of a didactic framework of interaction, the power of the arts was studied as a means of motivation and inspiration when transmitting the values considered above in the most effective way possible. The objective of this study focuses on proving the potential of the arts to promote communicative, social, intercultural, emotional, citizenship and sustainability skills. For this, the theoretical research derived in a concrete intervention proposal with an educational program in language teaching, both first and foreign languages, at different levels of formal education in Mali and Spain, applying a holistic method based on the interpretive paradigm. Through painting, literature and cinema, a series of activities were designed to create an inclusive educational environment, favour the empowerment of students and promote critical thinking, empathy, resilience, communication, cooperation and intercultural education, as essential skills for the achievement of the 17 SDGs, the construction of a sustainable transcultural world and the development of global citizenship prepared for the challenges of the 21st century. In the methodology of this innovative, multidisciplinary, flexible and adaptable educational process, an analysis of the research process has been used to adequately monitor it (SWOT). Each of the proposals presents a collection of qualitative data (observation, rubrics) and quantitative data (surveys, interviews) and contrast analysis of the final results is offered. All in all, it is expected to facilitate the demanding task of making basic society aware (from childhood itself, from its lowest levels and at all levels of formal education) of what the SDGs consist of and their relevance to make all people directly co-responsible in its achievement to guarantee a sustainable future for all global citizens
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