Sostenibilidad de la vida y participación popular como ejes vertebradores de los nuevos horizontes emancipatorios: hacia la cuidacracia participativa

El objetivo de este trabajo es presentar una propuesta o invitación a mirar, interpretar y posicionarse en los debates en torno a la construcción de los nuevos horizontes emancipatorios. Tratamos de contribuir desde una mirada feminista y anticapitalista al fortalecimiento de las disímiles realidades que comienzan a transitar hacia modelos políticos y económicos participativos, horizontales y democráticos y que sitúan la sostenibilidad de la vida en el centro del discurso y de la(s) práctica(s) emancipatoria(s). Entendemos, por lo tanto, que los nuevos horizontes emancipatorios se han de sostener, principalmente, sobre dos ejes vertebradores: cuidado/sostenibilidad de la vida y participación popular. Así mismo, estos dos ejes confluyen en una cuestión central para cualquier proceso emancipatorio: la gestión y organización colectiva, participativa y descentralizada de los trabajos y actividades que garantizan la reproducción de la población: los cuidados. Sin embargo, durante todo el trabajo de investigación se argumentará que la cuestión no reside únicamente en socializar el cuidado, sino en priorizarlo y situarlo como eje vertebrador de la nueva economía. El documento estará dotado de cuatro capítulos principales. En primer lugar, se analizarán brevemente los cinco elementos constitutivos del Sistema de Dominación Múltiple y se expondrán las seis ideas-fuerza que otorgan cierta identidad común a los nuevos horizontes emancipatorios. El segundo capítulo centra su mirada en el trabajo doméstico y de cuidados y en el papel fundamental que éste juega en la sostenibilidad de la vida. El tercer capítulo propone una perspectiva holística e integral de la participación y la democracia. Finalmente, en el cuarto capítulo, estableceremos un nexo entre los dos ejes vertebradores (cuidado y participación). La aportación más relevante de este Trabajo Fin de Máster la hallamos en la propuesta conceptual que realiza, un concepto (Cuidacracia Participativa) encaminado a enriquecer el debate en torno a los nuevos horizontes emancipatorios

Surgical treatment for recurrent cholangiocarcinoma: a single-center series

Purpose: The present study aims to assess the results obtained after surgical treatment of cholangiocarcinoma (CC) recurrences. Methods: We carried out a single-center retrospective study, including all patients with recurrence of CC. The primary outcome was patient survival after surgical treatment compared with chemotherapy or best supportive care. A multivariate analysis of variables affecting mortality after CC recurrence was performed. Results: Eighteen patients were indicated surgery to treat CC recurrence. Severe postoperative complication rate was 27.8% with a 30-day mortality rate of 16.7%. Median survival after surgery was 15 months (range 0-50) with 1- and 3-year patient survival rates of 55.6% and 16.6%, respectively. Patient survival after surgery or CHT alone, was significantly better than receiving supportive care (p< 0.001). We found no significant difference in survival when comparing CHT alone and surgical treatment (p=0.113). Time to recurrence of <1 year, adjuvant CHT after resection of the primary tumor and undergoing surgery or CHT alone versus best supportive care were independent factors affecting mortality after CC recurrence in the multivariate analysis. Conclusion: Surgery or CHT alone improved patient survival after CC recurrence compared to best supportive care. Surgical treatment did not improve patient survival compared to CHT alone

Highly thermally stable heterogeneous catalysts: study of 0D and 3D porphyrinic MOFs

Heterogeneous catalysts are a great bet for green chemistry in many industrial processes and, in the past decade, promising results have been achieved in order to improve the catalytic activity of Metal Organic Frameworks (MOFs). Accordingly, porphyrins make possible to design new coordination polymers with better properties, taking into account the important functions they develop in nature. In this sense, porphyrin-based MOFs are becoming very relevant in heterogeneous catalysis. Thus, the aim of this work was obtaining metalloporphyrinic MOFs exhibiting catalytic activity. Studying the effect of dimensionality on the MOF properties (including thermal stability and catalytic activity), in this work we study two catalysts with different dimensionalities, 3D [Ni5(H2TCPP)2O(H2O)4]•nS (1) and 0D [Cu(H4TCPP)]•6DMF (2) (where H6TCPP is meso-tetra(4-carboxyphenyl)porphyrin, DMF is N,N-dimethylformamide and S is the solvent). The structural features of both compounds, combined with their high thermal stability and accessible networks, are responsible for the excellent behaviour as heterogeneous catalysts. It is worth mentioning that significant reduction in reaction time compared to other reported catalysts has been observed. The recyclability of one of the herein studied porphyrin-based MOFs is outstanding. Further structural and thermal characterization has been carried out by means of single crystal X-ray diffraction, IR spectroscopy, thermogravimetry (TG), powder X-ray diffraction (XRD) and transmission electron microscopy (TEM).Ministerio de Economia, Industria y Competitividad (MAT2016-76739-R) Gobierno Vasco’’ (Basque University System Research Groups, IT-630-13

Coordination and crystallisation molecules: Their interactions affecting the dimensionality of metalloporphyrinic SCFs

Synthetic metalloporphyrin complexes are often used as analogues of natural systems, and they can be used for the preparation of new Solid Coordination Frameworks (SCFs). In this work, a series of six metalloporphyrinic compounds constructed from different meso substituted metalloporphyrins (phenyl, carboxyphenyl and sulfonatophenyl) have been structurally characterized by means of single crystal X-ray diffraction, IR spectroscopy and elemental analysis. The compounds were classified considering the dimensionality of the crystal array, referred just to coordination bonds, into 0D, 1D and 2D compounds. This way, the structural features and relationships of those crystal structures were analyzed, in order to extract conclusions not only about the dimensionality of the networks but also about possible applications of the as-obtained compounds, focusing the interest on the interactions of coordination and crystallization molecules. These interactions provide the coordination bonds and the cohesion forces which produce SCFs with different dimensionalities.Ministerio de Economia y Competitividad (MAT2013-42092-R), Gobierno Vasco (Basque University System Research Groups, IT-630-13) and UPV/EHU (UFI 11/15

Assessing the impact of physical exercise on cognitive function in older medical patients during acute hospitalization: secondary analysis of a randomized trial

Background: Acute illness requiring hospitalization frequently is a sentinel event leading to long-term disability in older people. Prolonged bed rest increases the risk of developing cognitive impairment and dementia in acutely hospitalized older adults. Exercise protocols applied during acute hospitalization can prevent functional decline in older patients, but exercise benefits on specific cognitive domains have not been previously investigated. We aimed to assess the effects of a multicomponent exercise intervention for cognitive function in older adults during acute hospitalization. Methods and findings: We performed a secondary analysis of a single-blind randomized clinical trial (RCT) conducted from February 1, 2015, to August 30, 2017 in an Acute Care of the Elderly (ACE) unit in a tertiary public hospital in Navarre (Spain). 370 hospitalized patients (aged ≥75 years) were randomly allocated to an exercise intervention (n = 185) or a control (n = 185) group (usual care). The intervention consisted of a multicomponent exercise training program performed during 5–7 consecutive days (2 sessions/day). The usual care group received habitual hospital care, which included physical rehabilitation when needed. The main outcomes were change in executive function from baseline to discharge, assessed with the dual-task (i.e., verbal and arithmetic) Gait Velocity Test (GVT) and the Trail Making Test Part A (TMT-A). Changes in the Mini Mental State Examination (MMSE) test and verbal fluency ability were also measured after the intervention period. The physical exercise program provided significant benefits over usual care. At discharge, the exercise group showed a mean increase of 0.1 m/s (95% confidence interval [CI], 0.07, 0.13; p < 0.001) in the verbal GVT and 0.1 m/s (95% CI, 0.08, 0.13; p < 0.001) in the arithmetic GVT over usual care group. There was an apparent improvement in the intervention group also in the TMT-A score (−31.1 seconds; 95% CI, −49.5, −12.7 versus −3.13 seconds; 95% CI, −16.3, 10.2 in the control group; p < 0.001) and the MMSE score (2.10 points; 95% CI, 1.75, 2.46 versus 0.27 points; 95% CI, −0.08, 0.63; p < 0.001). Significant benefits were also observed in the exercise group for the verbal fluency test (mean 2.16 words; 95% CI, 1.56, 2.74; p < 0.001) over the usual care group. The main limitations of the study were patients’ difficulty in completing all the tasks at both hospital admission and discharge (e.g., 25% of older patients were unable to complete the arithmetic GVT, and 47% could not complete the TMT-A), and only old patients with relatively good functional capacity at preadmission (i.e., Barthel Index score ≥60 points) were included in the study. Conclusions: An individualized, multicomponent exercise training program may be an effective therapy for improving cognitive function (i.e., executive function and verbal fluency domains) in very old patients during acute hospitalization. These findings support the need for a shift from the traditional (bedrest-based) hospitalization to one that recognizes the important role of maintaining functional capacity and cognitive function in older adults, key components of intrinsic capacity.This study was funded by a Gobierno de Navarra project Resolución grant 2186/2014 and acknowledged with the 'Beca Ortiz de Landazuri' as the best research clinical project in 2014, as well as by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER)

Specific multimorbidity patterns modify the impact of an exercise intervention in older hospitalized adults

Background: Different multimorbidity patterns present with different prognoses, but it is unknown to what extent they may influence the effectiveness of an individualized multicomponent exercise program offered to hospitalized older adults. Methods: This study is a secondary analysis of a randomized controlled trial conducted in the Department of Geriatric Medicine of a tertiary hospital. In addition to the standard care, an exercise-training multicomponent program was delivered to the intervention group during the acute hospitalization period. Multimorbidity patterns were determined through fuzzy c-means cluster analysis, over 38 chronic diseases. Functional, cognitive and affective outcomes were considered. Results: Three hundred and six patients were included in the analyses (154 control; 152 intervention), with a mean age of 87.2 years, and 58.5% being female. Four patterns of multimorbidity were identified: heart valves and prostate diseases (26.8%); metabolic diseases and colitis (20.6%); psychiatric, cardiovascular and autoimmune diseases (16%); and an unspecific pattern (36.6%). The Short Physical Performance Battery (SPPB) test improved across all patterns, but the intervention was most effective for patients in the metabolic/colitis pattern (2.48-point difference between intervention/control groups, 95% CI 1.60-3.35). Regarding the Barthel Index and the Mini Mental State Examination (MMSE), the differences were significant for all multimorbidity patterns, except for the psychiatric/cardio/autoimmune pattern. Differences concerning quality of life were especially high for the psychiatric/cardio/autoimmune pattern (16.9-point difference between intervention/control groups, 95% CI 4.04, 29.7). Conclusions: Patients in all the analyzed multimorbidity patterns improved with this tailored program, but the improvement was highest for those in the metabolic pattern. Understanding how different chronic disease combinations are associated with specific functional and cognitive responses to a multicomponent exercise intervention may allow further tailoring such interventions to older patients’ clinical profile.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article. This work was supported by the Gobierno de Navarra project grant 2186/2014 and acknowledged with the “Beca Ortiz de Landázuri” as the best research clinical project in 2014, as well as by a research grant PI17/01814 of the Ministerio de Economía, Industria y Competitividad (ISCIII, FEDER). Additional contributions: NM-V received funding from “la Caixa” Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006

Cationic Mn2+/H+ exchange leading a slow solid-state transformation of a 2D porphyrinic network at ambient conditions

Metalloporphyrins exhibit outstanding chemical, physical and biological properties in dissolution, however, it is a challenge to synthesize them as stable solid frameworks. Long-time stability is crucial for future applications of these materials, and we have detected a slow, solid-state transformation of a 2D MnII-porphyrin at RT. The remarkable point is that this transformation showed up as a result of Electronic Paramagnetic Resonance measurements. Otherwise, the evolution of the system could have remained undetected. Thus, 2D [Mn3(TCPP)(H2O)4]•nD (1) (where TCPP is meso-tetra(4-carboxyphenyl)porphyrin and D is the sovent) has been synthesized hydrothermally, and characterised by means of X-ray diffraction (XRD), Thermogravimetry and X-ray thermodiffractometry (XRTD). This compound slowly transforms into [Mn(H4TCPP)(H2O)2]•nD (2) according to the equilibrium [Mn3(TCPP)]+4H+ ↔ [Mn(H4TCPP)]+2Mn2+. The evolution of the system has been studied through analysis of the distortion (both of the coordination sphere and the tetrapyrrolic macrocycle) and Density Functional Theory (DFT) quantum mechanical calculations.Ministerio de Economia y Competitividad (MAT2013-42092-R), Gobierno Vasco (Basque University System Research Groups, IT-630-13) and UPV/EHU (UFI11/15