Microwave heating processes involving carbon materials

[EN] Carbon materials are, in general, very good absorbents of microwaves, i.e., they are easily heated by microwave radiation. This characteristic allows them to be transformed by microwave heating, giving rise to new carbons with tailored properties, to be used as microwave receptors, in order to heat other materials indirectly, or to act as a catalyst and microwave receptor in different heterogeneous reactions. In recent years, the number of processes that combine the use of carbons and microwave heating instead of other methods based on conventional heating has increased. In this paper some of the microwave-assisted processes in which carbon materials are produced, transformed or used in thermal treatments (generally, as microwave absorbers and catalysts) are reviewed and the main achievements of this technique are compared with those obtained by means of conventional (non microwave-assisted) methods in similar conditions.B.F., Y.F and L.Z. are grateful to CSIC of Spain and the European Social Fund (ESF) for financial support under thesis grant I3P-BDP-2006. Financial support from the PCTI-Asturias (Project PEST08-03) is also acknowledgedPeer reviewe

Intergroup conflict and rational decision making

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict ¿associated with indicators of the activation of negative feelings (negative affect state and heart rate)¿ has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making

Oval Domes. The Case of the Basílica de la Virgen de los Desamparados of Valencia

[EN] The dome of the Basilica de la Virgen de los Desamparados of Valencia is an emblematic example of Valencian baroque architecture and painting. Its shape, oval or elliptical, has been the subject of controversy in various studies. The study of oval domes throughout history is a very interesting field of research because, among other things, the determination of the exact shape is important in order to conclude how it was built. We approach the problem from a new mathematical point of view, calculating the distances between the points that make up the real data cloud and the hypothetical form considered, oval or ellipse. The use of modern graphic surveying techniques, carried out with a 3D laser scanner, and computation with the powerful symbolic and numerical mathematical solver, Mathematica, has allowed us to accurately determine the shape of the dome and determine that its sections are not well-described by ellipses. A better fit is obtained assuming that sections are ovals. The programming and generalization of the mathematical method employed in this work will allow it to be applied to determine the exact geometry of other oval or ellipsoidal vaults.Calvo Roselló, V.; Capilla Tamborero, E.; Navarro Fajardo, JC. (2020). Oval Domes. The Case of the Basílica de la Virgen de los Desamparados of Valencia. Nexus Network Journal. 22(2):393-409. https://doi.org/10.1007/s00004-019-00465-0S393409222Arphe i Villafañe, Juan de. 1585. Tratado De varia conmmensuracion para la Escultura y Architectura. Sevilla: imprenta de Andrea Pescioni i Juan de León.Barrallo J. 2011. Ovals and Ellipses in Architecture. Proceedings of ISAMA 2011, Columbia College, Chicago, Illinois; p. 9–18.Bérchez Gómez, J. 1995. Basílica de Nuestra Señora de los Desamparados (Valencia). In: Monumentos de la Comunidad Valenciana. Catálogo de Monumentos declarados y conjuntos históricos incoados. Tomo X. Valencia. Arquitectura Religiosa. Valencia: Conselleria de Cultura, Educació i Ciència—Generalitat Valenciana, 204–217.Borngässer, B. 1997a. Arquitectura barroca en España y Portugal. In Toman R. (ed.) El barroco. Arquitectura-escultura-pintura. Köln: Könemann, 78–119.Borngässer, B. 1997b. Arquitectura barroca en Francia. In Toman R. (ed.) El barroco. Arquitectura-escultura-pintura. Köln: Könemann, 122–151.Bosch Reig, I., Roig Picazo, P. 1999. El proyecto de restauración arquitectónica de las cúpulas, tambor y linterna de la Basílica de la Virgen de los Desamparados de Valencia. In: Restauración de Pintura Mural aplicada a la Basílica de la Virgen de los Desamparados de Valencia, Roig Picazo, P. y Bosch Reig, I. Valencia: Servicio de Publicaciones de la U.P.V., 21–74.Calvo López, J., Alonso Rodríguez, M.A., Rabasa Díaz, E.; López Mozo, A. 2005. Cantería Renacentista en la Catedral de Murcia. Murcia: Colegio Oficial de Arquitectos.Capilla Tamborero E., Calvo Roselló, V. 2014. Chapter 8: La cúpula interior de la Basílica de la Virgen de los Desamparados de Valencia. Análisis geométrico y matemático. In: J. C. Navarro (ed.) Bóvedas Valencianas. Arquitecturas ideales, reales y virtuales en época medieval y moderna. Valencia: ed. UPV (Scientia), 196–237. ISBN: 978-84-9048-188-2.Connors, J. 1999. Un teorema sacro: San Carlo alle Quattro Fontane. In Il giovane Borromini. Dagli esordi a San Carlo alle Quattro Fontane. Milano: Skira, 459–512.Dotto, E. 2001. Note sulle costruzioni degli ovali a quattro centri. Vecchie e nuove costruzioni dell’ovale. Disegnare Idee Immagini; XII 23: 7–14.Duvernoy, Sylvie. 2015. Baroque Oval Churches: Innovative Geometrical Patterns in Early Modern Sacred Architecture. Nexus Network Journal 17 (2): 425–456.Fernández Gómez M. 1996. La planta oval. Traza y símbolo. Loggia. Arquitectura & Restauración 3: 16–21.García Jara F. 2008. Las cúpulas de la arquitectura religiosa de la provincia de Alicante: del Renacimiento al siglo XIX. Ph.D. Thesis.García Jara F. 2010. La estereotomía de las cúpulas sobre base oval. In: X Congreso Internacional de Expresión Gráfica aplicada a la Edificación, APEGA 2010, Alicante: 767–780.Gentil Baldrich, J. M. 1994. Planta oval y traza elíptica en la arquitectura: Consideraciones geométricas y un ejemplo español. Valladolid.Gentil Baldrich J.M. 1996. La traza oval y la Sala Capitular de la catedral de Sevilla. Una aproximación geométrica. In: J. A. Ruiz de la Rosa et al. Quatro edificios sevillanos. Sevilla: Colegio Oficial de Arquitectos de Andalucía, Demarcación Occidental, 73–147.Gómez-Collado, M.C.; Calvo Roselló, V; Capilla Tamborero, E. 2018. Mathematical modeling of oval arches. A study of the George V and Neuilly Bridges. Journal of Cultural Heritage Vol. 32: 144–155; https://doi.org/10.1016/j.culher.2018.01.012Hatch, John G. 2015. The Science Behind Francesco Borromini’s Divine Geometry. In: Architecture and Mathematics from Antiquity to the Future, eds. Kim Williams and Michael J. Oswald, vol. II, ch. 61, 217–228. Basel: Birkhäuser.Hill, Michael. 2013. Practical and Symbolic Geometry in Borromini’s San Carlo alle Quattro Fontane. Journal of the Society of Architectural Historians 72 (4): 555–583.Huerta Fernández, S. 2002. Informe sobre la estabilidad de la cúpula interior de la Basílica de la Virgen de los Desamparados de Valencia. Valencia. Conselleria Cultura, Educació y Ciència de la Generalitat Valenciana, 20 páginas.Huerta Fernández, S. 2007. Oval domes, geometry and mechanics. Nexus Network Journal 9(2), 211–248.Huerta Fernández, S. 2012a. Análisis estructural de cúpulas tabicadas: la cúpula interior de la Basílica de la Virgen de los Desamparados en Valencia. Construyendo Bóvedas Tabicadas. In: Actas del Simposio Internacional sobre bóvedas tabicadas. Valencia, 26 y 27 de mayo de 2011. Valencia: Editorial Universitat Politècnica de València, 318–335.Huerta Fernández, S. 2012b. Structural Analysis of Thin Tile Vaults and Domes: The Inner Oval Dome of the Basílica de la Virgen de los Desamparados in Valencia. In: Carvais et al (ed.) Nuts and Bolts of construction history. Culture, technology and society. Vol. 1. Paris: Picard, 375–383.Jung, W. 1997.) Arquitectura y ciudad en Italia. In Toman R. (ed.) El barroco. Arquitectura-escultura-pintura. Köln: Könemann, 12–75.Kluckert, E. 1997. Arquitectura barroca en Alemania, Suiza, Austria y Europa oriental. In Toman R. (ed.) El barroco. Arquitectura-escultura-pintura. Köln: Könemann, 184–273.López Manzanares, G. 2005. La contribución de R. G. Boscovich al desarrollo de la teoría de cúpulas: el informe sobre la Biblioteca Cesarea de Viena. In: Huerta, S. (ed.) Actas del Cuarto Congreso Nacional de Historia de la Construcción. Cádiz, 27–29 January 2005. Madrid: Instituto Juan de Herrera, 655–665.López Mozo A. 2011. Ovals for Any Given Proportion in Architecture: A Layout Possibly Known in the Sixteenth Century. Nexus Network Journal Vol. 13: 569–597.Mazzotti, A. 2014a. A Euclidean Approach to Eggs and Polycentric Curves. Nexus Network Journal, 16, 345–387. DOI https://doi.org/10.1007/s00004-014-0189-5Mazzotti, A. 2014b. What Borromini Might Have Known About Ovals. Ruler and Compass Constructions. Nexus Network Journal. https://doi.org/10.1007/s00004-014-0190-z .Mazzotti, A. 2017. All sides to an oval. Properties, Parameters, and Borromini’s Mysterious Construction. Springer. DOI https://doi.org/10.1007/978-3-319-39375-9Montoliu Soler, V. 2012. La Real Capilla de la Virgen de los Desamparados de Valencia: sus orígenes histórico-artísticos. Valencia: Real Academia de Cultura Valenciana.Navascués Palacio, P. 1974. El libro de arquitectura de Hernán Ruiz el Joven. Estudio y edición crítica por Pedro Navascues Palacio. Madrid: Escuela Técnica Superior de Arquitectura.Petrovic, Maja et al. 2019. A Focal Curve Approximation of a Borromini Oval Contour. Nexus Network Journal 21:19–31 https://doi.org/10.1007/s00004-018-00421-4Rabasa, E. 2009. Soluciones innecesariamente complicadas de la estereotomía clásica. In: AA.VV. El arte de la piedra, teoría y prática de la cantería. Madrid: CEU Ediciones, 50–69.Ragazzo, F. 1995, Geometria delle figure ovoidali, In Disegnare: 11, 17-24.Rosin P. 2001. On Serlio’s construction of ovals. The Mathematical Intelligencer 23(1): 58–69.Serlio S. 1552. Tercero y cuarto libro de Architectura de Sebastiano Serlio Boloñes. Translated by Francisco de Villalpando Architecto. Toledo: Casa de Iván de Ayala, 1552. (Edición facs. Barcelona: Serie Arte y Arquitectura, Editorial Alta Fulla, 1990.) (Edición digitalizada en Huerta, S. 2004. Selección de Tratados españoles de Arquitectura y Construcción de los siglos XVI al XX).Simona, M. 2005. Ovals in Borromini’s Geometry. In: Emmer, M., (ed.) Mathematics and Culture II. Visual Perfection: Mathematics and Creativity. Springer. 45–52. springeronline.comSoler Verdú, R. 1995. La cúpula en la arquitectura moderna valenciana. Siglos XVI a XVIII. Metodologías de estudios previos, para las arquitecturas de sistemas abovedados. Ph.D. Thesis. Universitat Politècnica de València.VV.AA. 2001. Real Basílica de la Virgen de los Desamparados de Valencia. Restauración de los fondos pictóricos y escultóricos. 1998–2001. I. Bosch (ed.) Valencia: Fundación para la Restauración de la Basílica de la Mare de Déu dels Desamparats

Activity of imipenem/relebactam against Enterobacterales and Pseudomonas aeruginosa in Spain. SMART 2016-2020

Objectives. To determine susceptibility to the novel β-lactam/β-lactamase inhibitor combination imipenem/relebactam in clinical isolates recovered from intra-abdominal (IAI), urinary (UTI), respiratory (RTI) and bloodstream (BSI) infections in the SMART (Study for Monitoring Antimicrobial Resistance Trends) study in SPAIN during 2016 – 2020. Methods. Broth microdilution MICs for imipenem/relebactam and comparators were determined by a central laboratory against isolates of Enterobacterales and Pseudomonas aeruginosa. MICs were interpreted using EUCAST-2021 breakpoints. Results. In total, 5,210 Enterobacterales and 1,418 P. aeruginosa clinical isolates were analyzed. Imipenem/relebactam inhibited 98.8% of Enterobacterales. Distinguishing by source of infection susceptibility was 99.1% in BSI, 99.2% in IAI, 97.9% in RTI, and 99.2% in UTI. Of intensive care unit isolates (ICU) 97.4% were susceptible and of non-ICU isolates 99.2% were susceptible. In Enterobacterales, activity against Class A, Class B and Class D carbapenemases was 96.2%, 15.4% and 73.2%, respectively. In P. aeruginosa, imipenem/relebactam was active in 92.2% of isolates. By source of infection it was 94.8% in BSI, 92.9% in IAI, 91.7% in RTI, and 93.1% in UTI. An 88.7% of ICU isolates and 93.6% of non-ICU isolates were susceptible to imipenem/relebactam. Imipenem/relebactam remained active against P. aeruginosa ceftazidime-resistant (76.3%), cefepime-resistant (73.6%), imipenem-resistant (71.5%) and piperacillin-resistant (78.7%) isolates. Of all multidrug-resistant or difficult-to-treat resistance P. aeruginosa isolates, 75.1% and 46.2%, respectively, were susceptible to imipenem/relebactam. Conclusions. Imipenem/relebactam showed high rates of susceptibility in Enterobacterales and P. aeruginosa isolates from different sources of infection as well as depending on patients’ location (ICU or non-ICU scenarios)

New approaches for Basophil Activation Tests employing Dendrimeric Antigen-Silica Nanoparticle composites.

Publicación en Open Acces. https://www.mdpi.com/1999-4923/16/8/1039In vitro detection of specific IgE bound to high-affinity receptor on basophils’ surface is 25 a widely used strategy for the evaluation of IgE-mediated immediate hypersensitivity reactions to 26 drugs. Due to the drug small size, IgE recognition requires conjugation to a carrier molecule present 27 in blood. Thus, the conjugate formed is large enough to allow the cross-linking of two IgE bound to 28 the basophil’s surface and their degranulation. However, no information about size and composi-29 tions of these conjugates is available. The use of well-defined hapten-carrier conjugates would be a 30 valuable tool for the investigation of the mechanism through which the activation occurs and could 31 offer clinical potential for diagnosis of drug-allergy. Silica Nanoparticles decorated with PAMAM-32 dendrimer-amoxicilloyl conjugates (NpDeAXO) of different size and amoxicilloyl densities have 33 been prepared and chemically characterized. Their functional effect on basophils was measured 34 using an in-house basophil activation test (BAT) by determining CD63+ or CD203chigh activation 35 markers. It was observed that NpDeAXO nanocomposites are not only able to specifically activate 36 basophils, but also do so with a lower concentration of amoxicilloyl compared to free amoxicillin. 37 These results indicate that NpDeAXO possess high basophil activation potency, pointing to a trans-38 lational potential of this strategy in the context of in vitro allergy determination.This work was supported by the Spanish Ministerio de Ciencia e Innovación (Proyectos 639 de I+D+I «Programación Conjunta Internacional», EuroNanoMed 2019 (PCI2019-111825-2), Minis-640 terio de Ciencia e Innovación (PID2022-136705NB-I00, CNS2022-136144), Instituto de Salud Carlos 641 III (ISCIII) (through projects co-funded by the European Union: AC19/00082, PI21/00329, 642 PI20/01734, PI23/00620, RETICS ARADYAL RD16/0006/0001 and RD16/0006/0012, RICORS Red de 643 Enfermedades Inflamatorias RD21/0002/0008); Junta de Andalucía (ProyExcel00971 and PE-0172-644 2018, all co-funded by the European Union). C.M. holds “Nicolas Monardes” research contract by 645 Andalusian Regional Ministry Health (Grant No. RC-0004-2021). This project has received funding 646 from the European Union’s Horizon 2020 research and innovation programme under the Marie 647 Sklodowska-Curie grant agreement No 101027955”. S.C.S. holds a grant from the Ministry of Eco-648 nomic Transformation, Industry, Knowledge, and Universities of the Andalusian Regional Govern-649 ment under the predoctoral contract with reference PREDOC_01545

Basophil activation test is a complementary tool in the diagnosis of immediate reactions to platinum salts and taxanes

Background Delabelling pathways offer confirmatory diagnosis and can prevent unnecessary second-line therapies or drug desensitization procedures after chemotherapeutic hypersensitivity reactions (CHT-HSRs). However, these pathways rely on risky in vivo tests. Data on whether in vitro tests could be helpful are scarce. We assessed the role of basophil activation test (BAT) in the diagnosis of HSRs to platin salts (PSs) and taxanes (TXs) in a well-defined population featuring varied endophenotypes and severities of HSRs. Methods We conducted a 3-year-long multicentric, prospective study with 121 suspected-immediate CHT-HSR patients. The allergy workup included clinical history (initial reaction based on Type I, cytokine release syndrome, and mixed phenotype's symptoms and if unable to fit in any of these, as “indeterminate”), skin testing (ST), and drug provocation testing (DPT), provided risk assessment was favorable. Final diagnosis classified patients as “hypersensitive,” “non-hypersensitive,” or “inconclusive.” We performed BAT using CD63 and CD203c as activation markers in patients and controls. Patients underwent DPT regardless of BAT results to prevent bias. Results ST positivity significantly correlated with skin involvement, Type I phenotype, cancer recurrence, and lifetime exposures before reactions. DPTs were negative in all indeterminate phenotype patients (p = .02) and those considered low-risk, whereas they were negative in 62% moderate-risk patients. 55% were confirmed as hypersensitive (mainly Type I reactions, p < .0001), 24% as non-hypersensitive (mainly TXs and indeterminate phenotypes), and 21% as inconclusive. BAT showed 79% sensitivity in Type I IgE-mediated reactions to PSs with a high correlation to ST.Funding for open access charge: Universidad de Málaga / CBUA. This work was supported by the Instituto de Salud Carlos III (ISCIII) of the Ministry of Economy and Competitiveness (MINECO), grants co-founded by Fondo Europeo de Desarrollo Regional—FEDER for the Thematic Networks and Co-operative Research Centres: PI22/01119; PI18/00095; RETICS ARADYAL RD16/0006/0001, RICORS REI (RD21/0002/0008); Biobank network RD09/0076/00112; Biobank platform PT13/0010/0006; Andalusian Regional Ministry of Economy and Knowledge (grants PI-0076-2019). G.B. is a clinical investigator (B-0007-2022), research contract by Andalusian Regional Ministry Health. A.A. thanks Senior Postdoctoral Contract (RH-0099-2020) from Andalusian Regional Ministry of Health (co-funded by European Social Fund [ESF]: “Andalucía se mueve con Europa”) and “Nicolas Monardes” research contract by Andalusian Regional Ministry Health (C1-0007-2023). CLM holds a P-FIS contract (FI23/00027) by ISCIII. SCS holds a predoctoral contract by Andalusian Regional Goverment (PREDOC_01545). CM holds a “Nicolas Monardes” research contract by Andalusian Regional Ministry Health (RC-0004-2021)

Calcium phosphate product is associated with subclinical carotid atherosclerosis in type 2 diabetes

Aims. To assess whether circulating 25-hydroxyvitamin D3 (25OHD) and mineral metabolism-related factors (serum phosphate, calcium, and parathormone) are associated with subclinical carotid atherosclerosis (SCA), defined as the presence of carotid atherosclerotic plaques (main study outcome), in patients with type 2 diabetes mellitus (T2DM) without kidney disease or previous cardiovascular disease. Methods. We undertook a post hoc analysis of a cross-sectional study in adults with T2DM in whom we evaluated SCA. A total of 303 subjects with T2DM were included. Clinical variables and carotid ultrasound imaging were obtained. Results. We found no association of 25OHD with the presence of SCA. However, calcium phosphate (CaP; mg2/dL2) product was positively associated with the presence of carotid plaques (ORadj = 1.078; 95% CI: 1.017–1.142). An inverse association was observed between higher levels of 25OHD (≥30 ng/mL versus <20 ng/mL concentrations) and common carotid intima-media thickness (cIMT; mm) (βadj ± SE = −0.055 ± 0.024). We conclude that the CaP product is independently associated with the presence of established subclinical carotid atherosclerosis in patients with T2DM.This study was supported by Grants PS09/01035 and PI15/ 00625 from Instituto de Salud Carlos III, Ministry of Economy and Competitiveness, Spain. CIBERDEM is an initiative from Instituto de Salud Carlos III (Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional). Minerva Granado-Casas holds a predoctoral fellowship from Ministerio de Educación, Cultura y Deporte, FPU15/03005

Accelerometer Cut-Points for Physical Activity Assessment in Adults with Mild to Moderate Huntington’s Disease: A Cross-Sectional Multicentre Study

Accelerometers can estimate the intensity, frequency, and duration of physical activity in healthy adults. Although thresholds to distinguish varying levels of activity intensity using the Actigraph wGT3X-B have been established for the general population, their accuracy for Huntington’s disease (HD) is unknown. We aimed to define and cross-validate accelerometer cut-points for different walking speeds in adults with mild to moderate HD. A cross-sectional, multicentre, case-control, observational study was conducted with a convenience sample of 13 symptomatic ambulatory HD participants. The accelerometer was placed around the right hip, and a heart monitor was fitted around the chest to monitor heart rate variability. Participants walked on a treadmill at three speeds with light, moderate and vigorous intensities. Correlation and receiver operation curve analyses were performed between the accelerometer magnitude vector with relative oxygen and heart rate. Optimal cut-points for walking speeds of 3.2 km/h were ≤2852; 5.2 km/h: >2852 to ≤4117, and in increments until their maximum velocity: >4117. Our results support the application of the disease-specific cut-points for quantifying physical activity in patients with mild to moderate HD and promoting healthy lifestyle interventions.The project leading to these results has received funding from “La Caixa” Foundation (ID100010434), under agreement FUI1-PI008

Antiphospholipid syndrome (APS) in patients with systemic lupus erythematosus (SLE) implies a more severe disease with more damage accrual and higher mortality

Introduction: Antiphospholipid antibodies (aPL) have been associated with organ damage and certain features in systemic lupus erythematosus(SLE) patients. Our aim was to investigate the differences between SLE patients according to the presence of aPL and/or clinical antiphospholipid syndrome (APS). Materials and methods: Patients from the RELESSER-T registry were included. RELESSER-T is a Spanish multicenter, hospital-based, retrospective, SLE registry. Results: We included 2398 SLE patients, 1372 of whom were positive for aPL. Overall 1026 patients were classified as SLE, 555 as SLE-APS and817 as SLE-aPL. Regarding cardiovascular risk factors, SLE-APS patients had higher rates of hypertension, dyslipidemia and diabetes than those with SLE-aPL and SLE (p < 0.001). SLE-APS patients showed higher rates of neuropsychiatric, cardiac, pulmonary, renal and ophthalmological manifestations than the other groups (p < 0.001). SLE-APS patients presented greater damage accrual with higher SLICC values (1.9 ± 2.2 in SLE-APS, 0.9 ± 1.4 in SLE-aPL and 1.1 ± 1.6 in SLE, p < 0.001) and more severe disease as defined by the Katz index (3 ± 1.8 in SLE-APS, 2.7 ± 1.7 in SLE-aPL and 2.6 ± 1.6 in SLE, p < 0.001). SLE-APS patients showed higher mortality rates (p < 0.001). Conclusions: SLE-APS patients exhibited more severe clinical profiles with higher frequencies of major organ involvement, greater damage accrual and higher mortality than SLE-aPL and SLE patients.Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: FIS Grant PI11/02857 (Instituto Carlos III, Fondos FEDER) has supported this work. The RELESSER Registry was funded by grants from GSK, Roche, UCB, Lilly and Novartis. The board of Doctor Negrın University Hospital of Gran Canaria approved the protocol. RD 1720. Acknowledgements: Spanish Society of Rheumatology for their contribution in manuscript language editing