La aportación de José Miguel Sacristán (1887-1957) al desarrollo de la psiquiatría científica en España

Tesis doctoral inédita de la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Psiquiatría. Fecha de lectura: 16 de Junio 199

Affective feelings and perceived exertion during a 10-km time trial and head-to-head running race

Purpose: Our aim was to verify the affective feelings (AF) and rating of perceived exertion (RPE) responses during a 10-km competitive head-to-head (HTH) and compare it to a time-trial (TT) running race. Methods: Fourteen male runners completed 2 x 10-km runs (TT and HTH) on different days. Speed, RPE and AF were measured every 400-m. For pacing analysis races were 14 divided into four stages: I) first 400 m (F400); II) 401m to 5000m (M1); III) 5001m and 9600m (M2) and; IV) the last 400m (final sprint [FS]). Results: Improvement of performance was observed (39:32 ± 02:41 min:s vs 40:28 ± 02:55 min:s; p = 0.03; ES = - 0.32) in HTH compared to TT. There were not differences in either pacing strategy or RPE between conditions. AF were higher during the HTH,being different in M2 when compared to TT (2.09 ± 1.81 vs 0.22 ± 2.25; p = 0.02; ES = 0.84). Conclusion: AF are directly influenced by the presence of opponents during a HTH race and a more positive AF could be involved in the dissociation between RPE and running speed and consequently, the overall race performance

Exercise training and DNA methylation profile in post-bariatric women: Results from an exploratory study

[Abstract]: Exercise training and bariatric surgery have been shown to independently modulate DNA methylation profile in clusters of genes related to metabolic and inflammatory pathways. This study aimed to investigate the effects of a 6-month exercise training program on DNA methylation profile in women who underwent bariatric surgery. In this exploratory, quasi-experimental study, we analyzed DNA methylation levels by array technology in eleven women who underwent Roux-en-Y Gastric Bypass and a 6-month, three-times-a-week, supervised exercise training program. Epigenome Wide Association Analysis showed 722 CpG sites with different methylation level equal to or greater than 5% (P < 0.01) after exercise training. Some of these CpGs sites were related to pathophysiological mechanisms of inflammation, specially Th17 cell differentiation (FDR value < 0.05 and P < 0.001). Our data showed epigenetic modification in specific CpG sites related to Th17 cell differentiation pathway in post-bariatric women following a 6-months exercise training program.This study was supported by São Paulo Research Foundation (FAPESP) (grants #2015/18669–0, #2016/05638–1, #2017/13552–2) and Coordenação de Aperfeiçoamento de Pesquisa de Pessoal de Nível Superior - CAPES (grant #88887.473556/2020–00)

Hazard score, rating of perceived exertion and pacing strategy during a 10 km running

The aim of the study was to verify the modifications on pacing strategy induced by the hazard score of premature fatigue and rated perceived exertion (RPE) in amateur runners during a simulated 10-km running. Fifty five amateur runners with the 10-km run time of 41:39 ± 3:52 min:s participated in the study. The pacing strategy and the RPE were analyzed each kilometer. The hazard score of premature fatigue was expressed as the product of RPE by the remaining distance of the running. An ANOVA one-way for repeated measures was applied to determine possible statistical differences in speed, RPE and hazard score at each kilometer or the running speed differences at each kilometer and the average running speed. Pearson's product moment correlations were calculated between RPE and hazard of premature fatigue and running speed. The speed in the first kilometer was 8.1% higher than the average speed (p ≤ 0.001). There was a progressive decrease in speed during the running with an increment near the last kilometer. The RPE increased linearly until the end of the running and the hazard score of premature fatigue significantly decreased after the third kilometer. During the running there was a strong negative correlation between speed and RPE (r = -0.80; p = 0.006). It was also observed a moderate negative correlation between speed and hazard score of premature fatigue (r = -0.57; p = 0.04). Thus, our results suggested the important role of RPE on speed adjustment during a 10-km running and the increase of running speed near the end of the race seems to be associated to the lower score of hazard of premature fatigue.O objetivo do estudo foi verificar as modificações na estratégia de prova frente às alterações do risco de fadiga prematura e da percepção subjetiva de esforço (PSE) em corredores durante uma corrida de 10 km. Participaram do estudo 55 corredores com tempo nos 10 km de 41:39 ± 3:52 min:s. A estratégia de prova e a PSE foram avaliadas a cada quilômetro. O risco de fadiga prematura foi determinado pelo produto entre a PSE e a distância restante de prova e a estratégia de prova foi determinada pela curva da velocidade e distância. A ANOVA de um caminho para medidas repetidas foi utilizada para determinar as diferenças na velocidade, PSE e risco de fadiga a cada quilômetro e entre a velocidade a cada quilômetro e a velocidade média da prova. O coeficiente de correlação de Pearson foi calculado entre a PSE e o risco de fadiga prematura com a velocidade. A velocidade do primeiro quilômetro foi 8,1% maior do que a média (p ≤ 0,001). A velocidade diminuiu gradualmente ao longo da prova, ocorrendo um novo aumento no décimo quilômetro. A PSE aumentou linearmente ao longo da prova e o risco de fadiga diminuiu significantemente após o terceiro quilômetro. Houve forte correlação negativa entre a PSE e a velocidade desenvolvida durante a prova (r = -0,80; p = 0,006). Foi observada uma correlação moderada negativa entre o risco de fadiga prematura e a velocidade (r = -0,57; p = 0,04). Com isso, os achados do presente estudo sugerem que a PSE parece ter importante papel sobre os ajustes da velocidade ao longo da prova, sendo que o aumento da velocidade observado no último quilômetro pode estar associado ao baixo risco de fadiga prematura

Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID‐19: a prospective observational study.

Background: Strength and muscle mass are predictors of relevant clinical outcomes in critically ill patients, but in hospitalized patients with COVID-19, it remains to be determined. In this prospective observational study, we investigated whether muscle strength or muscle mass are predictive of hospital length of stay (LOS) in patients with moderate to severe COVID-19 patients. Methods: We evaluated prospectively 196 patients at hospital admission for muscle mass and strength. Ten patients did not test positive for SARS-CoV-2 during hospitalization and were excluded from the analyses. Results: The sample comprised patients of both sexes (50% male) with a mean age (SD) of 59 (±15) years, body mass index of 29.5 (±6.9) kg/m2. The prevalence of current smoking patients was 24.7%, and more prevalent coexisting conditions were hypertension (67.7%), obesity (40.9%), and type 2 diabetes (36.0%). Mean (SD) LOS was 8.6 days (7.7); 17.0% of the patients required intensive care; 3.8% used invasive mechanical ventilation; and 6.6% died during the hospitalization period. The crude hazard ratio (HR) for LOS was greatest for handgrip strength comparing the strongest versus other patients (1.47 [95% CI: 1.07–2.03; P = 0.019]). Evidence of an association between increased handgrip strength and shorter hospital stay was also identified when handgrip strength was standardized according to the sex-specific mean and standard deviation (1.23 [95% CI: 1.06–1.43; P = 0.007]). Mean LOS was shorter for the strongest patients (7.5 ± 6.1 days) versus others (9.2 ± 8.4 days). Evidence of associations were also present for vastus lateralis cross-sectional area. The crude HR identified shorter hospital stay for patients with greater sex-specific standardized values (1.20 [95% CI: 1.03–1.39; P = 0.016]). Evidence was also obtained associating longer hospital stays for patients with the lowest values for vastus lateralis cross-sectional area (0.63 [95% CI: 0.46–0.88; P = 0.006). Mean LOS for the patients with the lowest muscle cross-sectional area was longer (10.8 ± 8.8 days) versus others (7.7 ± 7.2 days). The magnitude of associations for handgrip strength and vastus lateralis cross-sectional area remained consistent and statistically significant after adjusting for other covariates. Conclusions: Muscle strength and mass assessed upon hospital admission are predictors of LOS in patients with moderate to severe COVID-19, which stresses the value of muscle health in prognosis of this disease

Constraints of Weight Loss as a Marker of Bariatric Surgery Success: An Exploratory Study

PurposeThe aim of this exploratory study was to investigate whether the degree of weight loss properly reflects improvements in cardiometabolic health among patients who underwent Roux-en-Y gastric bypass.MethodsIn this ancillary analysis from a clinical trial, patients were clustered into tertiles according to the magnitude of the percentage weight loss (1st tertile: “higher weight loss”: −37.1 ± 5.8%; 2nd tertile: “moderate weight loss”: −29.7 ± 1.4%; 3rd tertile: “lower weight loss”: −24.2 ± 2.3%). Delta changes (9 months after surgery-baseline) in clustered cardiometabolic risk (i.e., blood pressure index, fasting glucose, high-density lipoprotein [HDL] and triglycerides [TG]), glycated hemoglobin (HbA1c), homeostasis model assessment (HOMA-IR), and C-reactive protein (CRP) were calculated.ResultsA total of 42 patients who had complete bodyweight data (age = 40 ± 8 year; BMI = 47.8 ± 7.1 kg/m2) were included. Surgery led to substantial weight loss (−37.9 ± 11.3 kg, P &lt; 0,001), and clinically significant improvements in blood pressure index (−17.7 ± 8.2 mmHg, P &lt; 0.001), fasting glucose (−36.6 ± 52.5 mg/dL, P &lt; 0.001), HDL (9.4 ± 7.1 mg/dL, P &lt; 0.001), TG (−35.8 ± 44.1 mg/dL P &lt; 0,001), HbA1c (−1.2 ± 1.6%, P &lt; 0.001), HOMA-IR (−4.7 ± 3.9 mg/dL, P &lt; 0.001) and CRP (−8.5 ± 6.7 μg/mL P &lt; 0.001). Comparisons across tertiles revealed no differences for cardiometabolic risk score, fasting glucose, HbAc1, HOMA-IR, blood pressure index, CRP, HDL, and TG (P &gt; 0.05 for all). Individual variable analysis confirmed cardiometabolic improvements across the spectrum on weight-loss. There were no associations between weight loss and any dependent variable.ConclusionWeight loss following bariatric surgery does not correlate with improvements in cardiovascular risk factors. These findings suggest that weight loss alone may be insufficient to assess the cardiometabolic success of bariatric surgery, and the search for alternate proxies that better predict surgery success are needed

Carotid intima-media thickness and flow-mediated dilation do not predict acute in-hospital outcomes in patients hospitalized with COVID-19

Studies have suggested a potential role of endothelial dysfunction and atherosclerosis in the pathophysiology of COVID-19. Herein, we tested whether brachial flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT) measured upon hospital admission are associated with acute in-hospital outcomes in patients hospitalized with COVID-19. A total of 211 patients hospitalized with COVID-19 were submitted to assessments of FMD and mean and maximum cIMT (cIMTmean and cIMTmax) within the first 72 h of hospital admission. Study primary outcome was a composite of intensive care unit admission, mechanical ventilation, or death during the hospitalization. These outcomes were also considered independently. Thrombotic events were included as a secondary outcome. Odds ratios (ORs) and confidence intervals (CIs) were calculated using unadjusted and adjusted multivariable logistic regression models. Eighty-eight (42%) participants demonstrated at least one of the composite outcomes. cIMTmean and cIMTmax were predictors of mortality and thrombotic events in the univariate analysis (cIMTmean and mortality: unadjusted OR 12.71 [95% CI 1.71–94.48]; P = 0.014; cIMTmean and thrombotic events: unadjusted OR 11.94 [95% CI 1.64–86.79]; P = 0.015; cIMTmax and mortality: unadjusted OR 8.47 [95% CI 1.41–51.05]; P = 0.021; cIMTmax and thrombotic events: unadjusted OR 12.19 [95% CI 2.03–73.09]; P = 0.007). However, these associations were no longer present after adjustment for potential confounders (P > 0.05). In addition, FMD% was not associated with any outcome. In conclusion, cIMT and FMD are not independent predictors of clinical outcomes in patients hospitalized with COVID-19. These results suggest that subclinical atherosclerosis and endothelial dysfunction may not be the main drivers of COVID-19 complications in patients hospitalized with COVID-19

ECOSTRESS: NASA's next generation mission to measure evapotranspiration from the International Space Station

The ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station ECOSTRESS) was launched to the International Space Station on June 29, 2018. The primary science focus of ECOSTRESS is centered on evapotranspiration (ET), which is produced as level‐3 (L3) latent heat flux (LE) data products. These data are generated from the level‐2 land surface temperature and emissivity product (L2_LSTE), in conjunction with ancillary surface and atmospheric data. Here, we provide the first validation (Stage 1, preliminary) of the global ECOSTRESS clear‐sky ET product (L3_ET_PT‐JPL, version 6.0) against LE measurements at 82 eddy covariance sites around the world. Overall, the ECOSTRESS ET product performs well against the site measurements (clear‐sky instantaneous/time of overpass: r2 = 0.88; overall bias = 8%; normalized RMSE = 6%). ET uncertainty was generally consistent across climate zones, biome types, and times of day (ECOSTRESS samples the diurnal cycle), though temperate sites are over‐represented. The 70 m high spatial resolution of ECOSTRESS improved correlations by 85%, and RMSE by 62%, relative to 1 km pixels. This paper serves as a reference for the ECOSTRESS L3 ET accuracy and Stage 1 validation status for subsequent science that follows using these data

Altimetry for the future: Building on 25 years of progress

In 2018 we celebrated 25 years of development of radar altimetry, and the progress achieved by this methodology in the fields of global and coastal oceanography, hydrology, geodesy and cryospheric sciences. Many symbolic major events have celebrated these developments, e.g., in Venice, Italy, the 15th (2006) and 20th (2012) years of progress and more recently, in 2018, in Ponta Delgada, Portugal, 25 Years of Progress in Radar Altimetry. On this latter occasion it was decided to collect contributions of scientists, engineers and managers involved in the worldwide altimetry community to depict the state of altimetry and propose recommendations for the altimetry of the future. This paper summarizes contributions and recommendations that were collected and provides guidance for future mission design, research activities, and sustainable operational radar altimetry data exploitation. Recommendations provided are fundamental for optimizing further scientific and operational advances of oceanographic observations by altimetry, including requirements for spatial and temporal resolution of altimetric measurements, their accuracy and continuity. There are also new challenges and new openings mentioned in the paper that are particularly crucial for observations at higher latitudes, for coastal oceanography, for cryospheric studies and for hydrology. The paper starts with a general introduction followed by a section on Earth System Science including Ocean Dynamics, Sea Level, the Coastal Ocean, Hydrology, the Cryosphere and Polar Oceans and the ‘‘Green” Ocean, extending the frontier from biogeochemistry to marine ecology. Applications are described in a subsequent section, which covers Operational Oceanography, Weather, Hurricane Wave and Wind Forecasting, Climate projection. Instruments’ development and satellite missions’ evolutions are described in a fourth section. A fifth section covers the key observations that altimeters provide and their potential complements, from other Earth observation measurements to in situ data. Section 6 identifies the data and methods and provides some accuracy and resolution requirements for the wet tropospheric correction, the orbit and other geodetic requirements, the Mean Sea Surface, Geoid and Mean Dynamic Topography, Calibration and Validation, data accuracy, data access and handling (including the DUACS system). Section 7 brings a transversal view on scales, integration, artificial intelligence, and capacity building (education and training). Section 8 reviews the programmatic issues followed by a conclusion