Minimally invasive therapy in the treatment of plantar heel pain.

Objectives: To compare the effectiveness of dry needling (DN) versus percutaneous needle electrolysis (PNE) forimproving the level of pain, function and quality of life (QoL) of patients suffering from plantar heel pain (PHP) provoked by myofascial trigger points. Design: A prospective, parallel- group, randomised controlled trial with blinded outcome assessment. Setting: A single treatment facility in the State of Kuwait. Participants: 118 participants were screened for eligibility. Of these, 102 participants were enrolled (30 men (49.5±8.9 years) and 72 women (48.1±8.8 years)) and 68 of them completed the trial. Interventions: Two parallel groups, one study arm received DN and a stretching protocol whereas the other arm received percutaneous needling electrolysis with a stretching protocol. Primary and secondary outcome measures: The primary outcome measure was the Foot Pain domain ofthe Foot Health Status Questionnaire, with 13 questions related to foot health- related domains. Secondary outcome measures included the 0–10 numerical rating scale pain visual analogue scale (VAS) scores, performedbefore and after each treatment session. In addition, QoL was measured using the EuroQoL-5 dimensions. Allmeasurements were taken at baseline, at 4, 8, 12, 26 and 52 weeks. Results: Foot Pain domain improved at all time points for DN group (p(p<br /

Desarrollo de una escala pronóstica del riesgo de mortalidad en ancianos tras un ingreso hospitalario en la unidad de agudos en geriatría

La estimación de la mortalidad es esencial para la individualización de los cuidados del paciente mayor; sin embargo, dicha estimación habitualmente no es sencilla. El ingreso hospitalario supone con frecuencia para el anciano una transición relevante en su estado de salud; el ingreso brinda entonces una extraordinaria oportunidad al clínico para la estimación de la posible evolución posterior y la revisión de los objetivos de cuidados con paciente y familiares. Herramientas desarrolladas en el entorno hospitalario con este fin presentan algunas características que las convierten en poco idóneas para nuestros pacientes: todas han sido desarrolladas en entornos sociosanitarios con diferentes prestaciones a las nuestras, de forma que el perfil de paciente atendido en el hospital no es el mismo. Como ejemplo, la ausencia de programas semejantes al sistema Hospice norteamericano hace que en nuestro entorno ingresen en los hospitales ancianos cada vez más mayores y más deteriorados. Muchas de estas escalas pronósticas son complicadas, y algunas veces no tienen en cuenta factores muy relevantes en este grupo de pacientes cuya importancia ha sido puesta de manifiesto sobre todo a lo largo de los últimos años (p.e., la fragilidad). Existe por tanto la necesidad de un sistema que contemple las características específicas de la población de ancianos hospitalizados en nuestro país, y proporcione información pronóstica fiable, incorporando variables no solo demográficas y médicas, sino también funcionales y de fragilidad. Idealmente, debería tratarse de un sistema sencillo, reproducible y preciso, que permitiera su incorporación a la práctica diaria. Demostrada su utilidad en dicho entorno, probablemente pudiera emplearse también en áreas de gestión para la optimización de los modelos sanitarios de asistencia al anciano..

Production of aromatics from biomass by computer-aided selection of the zeolite catalyst

[EN] Taking into account that the transformation of biomass-derived 2,5-dimethylfuran (DMF) top-xylene involves Diels-Alder (DA) cycloaddition as the limiting step, the use of an ITQ-2 zeolite obtained by direct synthesis (DS-ITQ-2) as a catalyst for this reaction is proposed based on the fact that the organic molecule employed for its synthesis mimics the size and shape of the DA oxanorbornene cycloadduct intermediate. Periodic Density Functional Theory (DFT) calculations reveal a better stabilization of the oxanorbornene intermediate within the external hemicavities or "cups" of the DS-ITQ-2 zeolite (MWW-framework) than in other zeolites employed for this reaction, such as FAU and Beta. Interestingly, experimental results also show improved catalytic conversion values for the DS-ITQ-2 zeolite compared to FAU and Beta, in good agreement with the stabilization energies calculated by DFT. The "ab initio" catalyst design presented here to enhance the catalytic performance for the transformation of biomass-derived products is a valuable example that could be employed for the rationalization of other chemical processes catalyzed by zeolites.This work has been supported by the European Union through ERC-AdG-2014-671093 (SynCatMatch) and by Spanish Government through "Severo Ochoa" (SEV-2016-0683, MINECO), MAT2017-82288-C2-1-P (AEI/FEDER, UE) and RTI2018-101033-B-I00 (MCIU/AEI/FEDER, UE). E. M. G. acknowledges "La Caixa - Severo Ochoa" International PhD Fellowships (call 2015). Elisa Garcia is acknowledged for her technical assistance in this work. The Electron Microscopy Service of the UPV is also acknowledged for their help in sample characterization. We appreciate the support of ExxonMobil Research and Engineering for their help with our efforts in fundamental catalytic research.Margarit Benavent, VJ.; Gallego, EM.; Paris, C.; Boronat Zaragoza, M.; Moliner Marin, M.; Corma Canós, A. (2020). Production of aromatics from biomass by computer-aided selection of the zeolite catalyst. Green Chemistry. 22(15):5123-5131. https://doi.org/10.1039/d0gc01031fS512351312215Owusu, P. A., & Asumadu-Sarkodie, S. (2016). A review of renewable energy sources, sustainability issues and climate change mitigation. Cogent Engineering, 3(1), 1167990. doi:10.1080/23311916.2016.1167990Corma, A., Iborra, S., & Velty, A. (2007). Chemical Routes for the Transformation of Biomass into Chemicals. Chemical Reviews, 107(6), 2411-2502. doi:10.1021/cr050989dSettle, A. E., Berstis, L., Rorrer, N. A., Roman-Leshkóv, Y., Beckham, G. T., Richards, R. M., & Vardon, D. R. (2017). Heterogeneous Diels–Alder catalysis for biomass-derived aromatic compounds. Green Chemistry, 19(15), 3468-3492. doi:10.1039/c7gc00992eWilliams, C. L., Chang, C.-C., Do, P., Nikbin, N., Caratzoulas, S., Vlachos, D. G., … Dauenhauer, P. J. (2012). Cycloaddition of Biomass-Derived Furans for Catalytic Production of Renewable p-Xylene. ACS Catalysis, 2(6), 935-939. doi:10.1021/cs300011aPacheco, J. J., & Davis, M. E. (2014). Synthesis of terephthalic acid via Diels-Alder reactions with ethylene and oxidized variants of 5-hydroxymethylfurfural. Proceedings of the National Academy of Sciences, 111(23), 8363-8367. doi:10.1073/pnas.1408345111Tomás, R. A. F., Bordado, J. C. M., & Gomes, J. F. P. (2013). p-Xylene Oxidation to Terephthalic Acid: A Literature Review Oriented toward Process Optimization and Development. Chemical Reviews, 113(10), 7421-7469. doi:10.1021/cr300298jLin, Y.-C., & Huber, G. W. (2009). The critical role of heterogeneous catalysis in lignocellulosic biomass conversion. Energy Environ. Sci., 2(1), 68-80. doi:10.1039/b814955kDo, P. T. M., McAtee, J. R., Watson, D. A., & Lobo, R. F. (2012). Elucidation of Diels–Alder Reaction Network of 2,5-Dimethylfuran and Ethylene on HY Zeolite Catalyst. ACS Catalysis, 3(1), 41-46. doi:10.1021/cs300673bBinder, J. B., & Raines, R. T. (2009). Simple Chemical Transformation of Lignocellulosic Biomass into Furans for Fuels and Chemicals. Journal of the American Chemical Society, 131(5), 1979-1985. doi:10.1021/ja808537jFitzPatrick, M., Champagne, P., Cunningham, M. F., & Whitney, R. A. (2010). A biorefinery processing perspective: Treatment of lignocellulosic materials for the production of value-added products. Bioresource Technology, 101(23), 8915-8922. doi:10.1016/j.biortech.2010.06.125Rohling, R. Y., Tranca, I. C., Hensen, E. J. M., & Pidko, E. A. (2018). Electronic Structure Analysis of the Diels–Alder Cycloaddition Catalyzed by Alkali-Exchanged Faujasites. The Journal of Physical Chemistry C, 122(26), 14733-14743. doi:10.1021/acs.jpcc.8b04409Rohling, R. Y., Uslamin, E., Zijlstra, B., Tranca, I. C., Filot, I. A. W., Hensen, E. J. M., & Pidko, E. A. (2017). An Active Alkali-Exchanged Faujasite Catalyst for p-Xylene Production via the One-Pot Diels–Alder Cycloaddition/Dehydration Reaction of 2,5-Dimethylfuran with Ethylene. ACS Catalysis, 8(2), 760-769. doi:10.1021/acscatal.7b03343Kim, T.-W., Kim, S.-Y., Kim, J.-C., Kim, Y., Ryoo, R., & Kim, C.-U. (2016). Selective p-xylene production from biomass-derived dimethylfuran and ethylene over zeolite beta nanosponge catalysts. Applied Catalysis B: Environmental, 185, 100-109. doi:10.1016/j.apcatb.2015.11.046Chang, C.-C., Je Cho, H., Yu, J., Gorte, R. J., Gulbinski, J., Dauenhauer, P., & Fan, W. (2016). Lewis acid zeolites for tandem Diels–Alder cycloaddition and dehydration of biomass-derived dimethylfuran and ethylene to renewable p-xylene. Green Chemistry, 18(5), 1368-1376. doi:10.1039/c5gc02164bCho, H. J., Ren, L., Vattipalli, V., Yeh, Y.-H., Gould, N., Xu, B., … Fan, W. (2017). Renewablep-Xylene from 2,5-Dimethylfuran and Ethylene Using Phosphorus-Containing Zeolite Catalysts. ChemCatChem, 9(3), 398-402. doi:10.1002/cctc.201601294Zhao, R., Zhao, Z., Li, S., Parvulescu, A.-N., Müller, U., & Zhang, W. (2018). Excellent Performances of Dealuminated H-Beta Zeolites from Organotemplate-Free Synthesis in Conversion of Biomass-derived 2,5-Dimethylfuran to Renewable p -Xylene. ChemSusChem, 11(21), 3803-3811. doi:10.1002/cssc.201801504Chang, C.-C., Green, S. K., Williams, C. L., Dauenhauer, P. J., & Fan, W. (2014). Ultra-selective cycloaddition of dimethylfuran for renewable p-xylene with H-BEA. Green Chem., 16(2), 585-588. doi:10.1039/c3gc40740cLi, Y.-P., Head-Gordon, M., & Bell, A. T. (2014). Computational Study of p-Xylene Synthesis from Ethylene and 2,5-Dimethylfuran Catalyzed by H-BEA. The Journal of Physical Chemistry C, 118(38), 22090-22095. doi:10.1021/jp506664cNikbin, N., Feng, S., Caratzoulas, S., & Vlachos, D. G. (2014). p-Xylene Formation by Dehydrative Aromatization of a Diels–Alder Product in Lewis and Brønsted Acidic Zeolites. The Journal of Physical Chemistry C, 118(42), 24415-24424. doi:10.1021/jp506027fRohling, R. Y., Hensen, E. J. M., & Pidko, E. A. (2017). Multi-site Cooperativity in Alkali-Metal-Exchanged Faujasites for the Production of Biomass-Derived Aromatics. ChemPhysChem, 19(4), 446-458. doi:10.1002/cphc.201701058DEROUANE, E. (1988). Surface curvature effects in physisorption and catalysis by microporous solids and molecular sieves. Journal of Catalysis, 110(1), 58-73. doi:10.1016/0021-9517(88)90297-7Corma, A. (2004). Attempts to Fill the Gap Between Enzymatic, Homogeneous, and Heterogeneous Catalysis. Catalysis Reviews, 46(3-4), 369-417. doi:10.1081/cr-200036732Gounder, R., & Iglesia, E. (2013). The catalytic diversity of zeolites: confinement and solvation effects within voids of molecular dimensions. 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E., Navarro, M. T., Martínez, C., & Corma, A. (2015). Direct Dual-Template Synthesis of MWW Zeolite Monolayers. Angewandte Chemie International Edition, 54(46), 13724-13728. doi:10.1002/anie.201506822Leonowicz, M. E., Lawton, J. A., Lawton, S. L., & Rubin, M. K. (1994). MCM-22: A Molecular Sieve with Two Independent Multidimensional Channel Systems. Science, 264(5167), 1910-1913. doi:10.1126/science.264.5167.1910Corma, A., Corell, C., & Pérez-Pariente, J. (1995). Synthesis and characterization of the MCM-22 zeolite. Zeolites, 15(1), 2-8. doi:10.1016/0144-2449(94)00013-iMin, H.-K., & Hong, S. B. (2011). Mechanistic Investigations of Ethylbenzene Disproportionation over Medium-Pore Zeolites with Different Framework Topologies. The Journal of Physical Chemistry C, 115(32), 16124-16133. doi:10.1021/jp204945cLAFORGE, S. (2004). Xylene transformation over H-MCM-22 zeolites3. Role of the three pore systems in o-, m- and p-xylene transformations. 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Tratamientos mínimamente invasivos en fisioterapia para el tratamiento de la tendinopatía rotuliana.

Las tendinopatías son un tipo de trastorno musculoesquelético muy común en la población, producidas habitualmente por un sobreuso o sobrecarga del tendón afectado. Una de las más habituales es la tendinopatía rotuliana, en la cual se ve afectado el tendón rotuliano encontrando dolor y pérdida de la funcionalidad, asociado a una degeneración y desorganización del colágeno presente en el tendón en diversas ocaciones. La encontramos especialmente en los sujetos que realizan deportes con saltos, y por ello ha recibido también el nombre de “rodilla del saltador”. El tratamiento habitual para conseguir una mejora de esta sintomatología es la aplicación de carga por medio del ejercicio terapéutico, el cual, provoca un estímulo al tendón para que sea capaz de adaptarse a las nuevas condiciones. Sin embargo, en fisioterapia están empezando a usarse nuevas técnicas de regeneración mínimamente invasivas (punción seca, electrolisis, etc.) que buscan la regeneración de ese tejido lesionado, sin todavía una evidencia científica concluyente. Además, no existen estudios que hayan comparado la efectividad de las técnicas anteriormente mencionadas cuando son aplicadas para el tratamiento de lesiones tendinosas, lo que constituye la principal novedad de esta tesis.Por ello, el principal objetivo de la presente Tesis Doctoral es analizar el papel de dos técnicas mínimamente invasivas en la mejora de las tendinopatías rotulianas, así como profundizar en los cambios que se producen en el tendón tanto estructural como funcionalmente. Esta Tesis incluye varios estudios. Por un lado, realizamos un ensayo en jugadores de baloncesto sanos para detectar los cambios que se producen en las propiedades físicas del tendón tras un protocolo de ejercicio excéntrico. Tras el análisis de los resultados junto con la consecuente capacidad de conseguir cambios en el tendón por medio del ejercicio terapéutico realizamos una revisión bibliográfica y metaanálisis de técnicas mínimamente invasivas que se utilizan en el tratamiento de las lesiones del tendón, más específicamente de la tendinopatía rotuliana. Por último, realizamos un estudio donde comparamos 3 intervenciones diferentes para el tratamiento de la patología. En dos de los grupos aplicamos diferentes técnicas mínimamente invasivas, las cuales carecían de ensayos clínicos aleatorizados hasta la fecha, junto con un programa de ejercicio terapéutico, y un tercer grupo que únicamente recibió el ejercicio terapéutico. En él, analizamos funcionalidad, dolor, calidad de vida y cambios estructurales del tendón en sujetos diagnosticados con tendinopatía rotuliana. Los principales resultados son los siguientes: - Los protocolos de ejercicio excéntrico parecen ser una técnica efectiva para conseguir cambios en la rigidez del tendón rotuliano sano, según el estudio realizado en jugadores de baloncesto. - Los estudios incluidos en la revisión que investigaron la efectividad de técnicas mínimamente invasivas demostraron que las técnicas mínimamente invasivas son efectivas a corto y largo plazo para el tratamiento de tendinopatía rotuliana cuando se realizaron junto con ejercicio físico. - No existe evidencia científica de calidad que respalde el uso de punción seca ni de electrolisis en el tratamiento de la tendinopatía rotuliana. - La punción seca, la electrolisis percutánea intratisular o la punción placebo combinado con un protocolo de ejercicio excéntrico han demostrado ser eficaces para mejorar la funcionalidad y el dolor en pacientes con tendinopatía rotuliana a corto y medio plazo.- La electrolisis percutánea intratisular fue capaz de conseguir una mayor mejoría en la calidad de vida a largo plazo de los pacientes con tendinopatía rotuliana analizados en este estudio. - Las mejoras clínicas de estos pacientes con tendinopatía rotuliana no se asociaron con cambios estructurales en dicho tendón.<br /

Psychosocial and sexual health factors of Spanish women who participate in ecofeminist spirituality

This article explores the spiritual movements emerging from ecofeminism as possible environments where psychosocial and sexual factors are promoted for the Spanish women who participate in them. The study is based on a qualitative exploratory research using the semi-structured interview method. Twelve women between the ages of 33 and 52 were interviewed, all of whom ascribe to this diverse model of spirituality. Data were analyzed using grounded theory. Results reveal that in these ecofeminist spiritual environments, some mental health factors are promoted. Considering these results, some ecofeminist spiritual movements may be acting as community health agents for Spanish wome

Forest Cover Changes in Tropical South and Central America from 1990 to 2005 and Related Carbon Emissions and Removals.

This paper outlines the methods and results for monitoring forest change and resulting carbon emissions for the 1990-2000 and 200-2005 periods carried out over tropical Central and South America. To produce our forest change estimates we used a systematic sample of medium resolution satellite data processed to forest change maps covering 1230 sites of 20 km by 20 km, each located at the degree confluence. Biomass data were spatially associated to each individual sample site so that annual carbon emissions could be estimated. For our study area we estimate that forest cover in the study area had fallen from 763 Mha (s.e. 10 Mha) in 1990 to 715 Mha (s.e. 10 Mha) in 2005. During the same period other wooded land (i.e., non-forest woody vegetation) had fallen from 191 Mha (s.e. 5.5 Mha) to 184 Mha (s.e. 5.5 Mha). This equates to an annual gross loss of 3.74 Mha·y&#8722;1 of forests (0.50% annually) between 1990 and 2000, rising to 4.40 Mha·y&#8722;1 in the early 2000s (0.61% annually), with Brazil accounting for 69% of the total losses. The annual carbon emissions from the combined loss of forests and other wooded land were calculated to be 482 MtC·y&#8722;1 (s.e. 29 MtC·y&#8722;1) for the 1990s, and 583 MtC·y&#8722;1 (s.e. 48 MtC·y&#8722;1) for the 2000 to 2005 period. Our maximum estimate of sinks from forest regrowth in tropical South America is 92 MtC·y&#8722;1. These estimates of gross emissions correspond well with the national estimates reported by Brazil, however, they are less than half of those reported in a recent study based on the FAO country statistics, highlighting the need for continued research in this area

The prohibitin-binding compound fluorizoline induces apoptosis in chronic lymphocytic leukemia cells through the upregulation of NOXA and synergizes with ibrutinib, 5-aminoimidazole-4-carboxamide riboside or venetoclax

Fluorizoline is a new synthetic molecule that induces apoptosis by selectively targeting prohibitins. In the study herein, the pro-apoptotic effect of fluorizoline was assessed in 34 primary samples from patients with chronic lymphocytic leukemia. Fluorizoline induced apoptosis in chronic lymphocytic leukemia cells at concentrations in the low micromolar range. All primary samples were sensitive to fluorizoline irrespective of patients' clinical or genetic features, whereas normal T lymphocytes were less sensitive. Fluorizoline increased the protein levels of the pro-apoptotic B-cell lymphoma 2 family member NOXA in chronic lymphocytic leukemia cells. Furthermore, fluorizoline synergized with ibrutinib, 5-aminoimidazole-4-carboxamide riboside or venetoclax to induce apoptosis. These results suggest that targeting prohibitins could be a new therapeutic strategy for chronic lymphocytic leukemia

Seroprevalence of SARS-CoV-2 in a Cohort of Patients with Multiple Sclerosis under Disease-Modifying Therapies

Background: Disease-modifying therapies (DMTs) used to treat multiple sclerosis (MS) alter the immune system and therefore increase the risk of infection. There is growing concern about the impact of COVID-19 on patients with MS (pwMS), especially those treated with DMTs. Methods: This is a single-center prospective observational study based on data from the Esclerosis Múltiple y COVID-19 (EMCOVID-19) study. Demographic characteristics, MS history, laboratory data and SARS-CoV-2 serology, and symptoms of COVID-19 in pwMS treated with any DTM were extracted. The relationship among demographics, MS status, DMT, and COVID-19 was evaluated. Results: A total of 259 pwMS were included. The administration of interferon was significantly associated with the presence of SARS-CoV-2 antibodies (26.4% vs. 10.7%, p = 0.006). Although patients taking interferon were significantly older (49.1 vs. 43.5, p = 0.003), the association of interferon with the presence of SARS-CoV-2 antibodies was still significant in the multivariate analysis (OR 2.99 (1.38; 6.36), p = 0.006). Conclusions: According to our data, pwMS present a higher risk of COVID-19 infection compared with results obtained from the general population. There is no evidence of a worse COVID-19 outcome in pwMS. DMTs did not significantly change the frequency of COVID-19, except for interferon; however, these findings must be interpreted with caution given the small sample of pwMS taking each DMT