Patterns of sedentary behavior in overweight and moderately obese users of the Catalan primary-health care system

Background and objectives Prolonged sitting time (ST) has negative consequences on health. Changing this behavior is paramount in overweight/obese individuals because they are more sedentary than those with normal weight. The aim of the study was to establish the pattern of sedentary behavior and its relationship to health, socio-demographics, occupation, and education level in Catalan overweight/obese individuals. Methods A descriptive study was performed at 25 healthcare centers in Catalonia (Spain) with 464 overweight/moderately obese patients, aged25 to 65 years. Exclusion criteria were chronic diseases which contraindicated physical activity and language barriers. Face-to-face interviews were conducted to collect data on age, gender, educational level, social class, and marital status. Main outcome was ‘sitting time’ (collected by the Marshall questionnaire); chronic diseases and anthropometric measurements were registered. Results 464 patients, 58.4% women, mean age 51.9 years (SD 10.1), 76.1% married, 60% manual workers, and 48.7% had finished secondary education. Daily sitting time was 6.2 hours on working days (374 minutes/day, SD: 190), and about 6 hours on non-working ones (357 minutes/day, SD: 170). 50% of participants were sedentary 6 hours. The most frequent sedentary activities were: working/academic activities around 2 hours (128 minutes, SD: 183), followed by watching television, computer use, and commuting. Men sat longer than women (64 minutes more on working days and 54 minutes on non-working days), and individuals with office jobs (91 minutes), those with higher levels of education (42 minutes), and younger subjects (25 to 35 years) spent more time sitting. Conclusions In our study performed in overweight/moderately obese patients the mean sitting time was around 6 hours which was mainly spent doing work/academic activities and watching television. Men, office workers, individuals with higher education, and younger subjects had longer sitting time. Our results may help design interventions targeted at these sedentary patients to decrease sitting time.

Effect of nanosilica-based activators on the performance of an alkali-activated fly ash

This paper assesses the effect of the use of an alternative activator based on nanosilica/MOH (M = K+ or Na+) blended solutions on the performance of alkali-activated fly ash binders. Binders produced with commercial silicate activators display a greater degree of reaction, associated with increased contents of geopolymer gel; however, mortars produced with the alternative nanosilica-based activators exhibited lower water demand and reduced permeability, independent of the alkali cation used. Na-based activators promote higher compressive strength compared with K-based activators, along with a refined pore structure, although K-activated samples exhibit reduced water demand. Zeolite type products are the major crystalline phases formed within these binders. A wider range of zeolites is formed when using commercial silicate solutions compared with the alternative activators. These results suggest that there are variations in the availability of Si in the system, and consequently in the alkalinity, depending on the silicate source in the activator, which is important in determining the nanostructure of the geopolymer gel.This study was sponsored by the Ministerio de Ciencia e Innovacion of Spain (Project GEORES MAT2010-19934 and research scholarship BES-2008-002440), European regional development fund (FEDER), and the Universitat Politecnica de Valencia (Spain). The participation of SAB and JLP was funded by the Australian Research Council (ARC), including partial funding through the Particulate Fluids Processing Centre, a Special Research Centre of the ARC. A special acknowledgement is also due to the Centre of Electron Microscopy of the Universitat Politecnica de Valencia and Pedro Garces from the Universidad de Alicante for support in some experiments.Rodriguez Martinez, ED.; Bernal, SA.; Provis, JL.; Paya Bernabeu, JJ.; Monzó Balbuena, JM.; Borrachero Rosado, MV. (2013). Effect of nanosilica-based activators on the performance of an alkali-activated fly ash. Cement and Concrete Composites. 35(1):1-11. doi:10.1016/j.cemconcomp.2012.08.025S11135

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Jean-Jacques Rousseau i la socialització incompleta : individu i societat com a construccions socials. 'Jean-Jacques Rousseau y la socialización incompleta : individuo y sociedad como construcciones sociales'

Recuperar la figura de Rousseau para la tradición sociológica analizando su obra desde una perspectiva global. Mostrar la interrelación de los aspectos sociales, políticos y pedagógicos de la obra de Rousseau.. El objeto de estudio es el pensamiento sociológico de Rousseau a través de sus escritos. Se analizan las siguientes obras: 'Confessions', 'Considerations sur le governement de Pologne', 'Contrat social', 'Rousseau juge de Jean Jacques, dialogues', 'Discours sur le sciences et les arts', 'Emile', 'Essai sur l'origine des langues', 'Discours sur l'economie politique', 'Manuscrit de Geneve', 'Narcise ou l'amant de lui-meme', 'Julie ou la nouvelle Eloise', 'Project de constitution pour la Corse et fragments' y 'Correspondences generales de J.J. Rousseau'. . La investigación se divide en 7 capítulos en cada uno de los cuales se analiza un aspecto determinado del pensamiento de Rousseau a partir de los textos indicados. E primer capítulo se centra en el origen de la sociedad y la política. El segundo capítulo estudia la sociedad como artificio. El tercer capítulo se centra en el cuerpo político y el vínculo social. El cuarto capítulo trata sobre la libertad individual y la voluntat general. El quinto capítulo estudia al hombre natural en relación al hombre civil, el sexto capítulo focaliza sobre las relaciones entre educación y naturaleza y el séptimo y último capítulo lo hace sobre la própia socialización: el ideal y lo imposible.. Bibliografía. . Análisis de textos.. Se constata un cierto dualismo en la obra de Rousseau, entendiéndose dicho dualismo como la capacidad de decantarse por dos opciones contrapuestas en función de las circunstancias particulares. Rousseau parece defender un cierto modelo de organicismo social basado en la necesidad de la existencia del estado y el educador para la existencia social del hombre..CataluñaES

Pozzolanic activity of tiles, bricks and ceramic sanitary-ware in eco-friendly Portland blended cements

Reusing ceramic waste as a pozzolanic admixture may offer environmental benefits as it allows the reduction in the consumption of natural resources and energy, and the reduction of CO2 emissions associated with Portland cement (PC) production, while valorising waste materials with a long biodegradation period. This paper assessed the pozzolanic activity of three different ceramic waste types: red clay bricks (RCB), ceramic tiles (TCW) and ceramic sanitary-ware (CSW). After adapting their particle size by crushing and milling, each was used to replace 0 to 50 wt% PC (CEM I 42.5 R type). The milled powders were characterised by laser diffraction, field emission scanning electron microscopy (FESEM), X-ray fluorescence (XRF) and X-ray diffraction (XRD), and consistency and setting time tests were used to investigate the fresh behaviour of the ceramic waste/PC blended pastes. A basic sustainability analysis was performed, and the pozzolanic activity of RCB, TCW and CSW was assessed by compressive strength tests (performed in mortars cured at room temperature from 3 to 365 days) and microstructural analyses (thermogravimetry, XRD and FESEM performed in the pastes cured at 20 °C for 28 and 90 days). The pozzolanic reaction of these waste materials improved with curing time, and all the mortars prepared with up to 25 wt% RCB, TCW or CSW met the mechanical requirements set out for coal fly ashes, whatever the ceramic waste type used. Among them, these results open up the possibility of partially replacing PC with the closest available ceramic waste, which would reduce the CO2 emissions and economic cost deriving from transporting waste. © 2020 Elsevier Lt

Diagnóstico etiológico de la disfunción ventricular izquierda con tomografía computarizada: comparación con coronariografía y cardiorresonancia

[EN] Introduction and objectives To evaluate the capability of multidetector computed tomography to diagnose the coronary etiology of left ventricular dysfunction compared with using invasive coronary angiography and magnetic resonance. Methods Forty consecutive patients with left ventricular dysfunction of uncertain etiology underwent invasive coronary angiography and contrast magnetic resonance. All patients were evaluated with multidetector computed tomography including coronary calcium presence and score, noninvasive coronary angiography, and myocardial tissue assessment. Results The sensitivity and specificity of the presence of coronary calcium to identify left ventricular dysfunction was 100% and 31%, respectively. If an Agatston calcium score of >100 is taken, specificity increases to 58% with sensitivity still 100%. Sensitivity and specificity for coronary angiography by multidetector computed tomography was 100% and 96%, respectively; for identifying necrosis in contrast acquisition it was 57% and 100%, respectively; and in late acquisition, 84% and 96%, respectively. To identify coronary ventricular dysfunction with necrosis, the sensitivity and specificity was 92% and 100%, respectively. Conclusions Of all the diagnostic tools available in multidetector computed tomography, coronary angiography is the most accurate in determining the coronary origin of left ventricular dysfunction. A combination of coronary angiography and myocardial tissue study after contrast allows a single test to obtain similar information compared with the combination of invasive coronary angiography and contrast magnetic resonance.[ES] Introducción y objetivos Evaluar la capacidad de la tomografía computarizada con multidetectores en el diagnóstico de la disfunción ventricular izquierda de origen coronario y valorar su exactitud diagnóstica comparándola con la combinación de coronariografía invasiva y resonancia magnética. Métodos Se estudió a 40 pacientes consecutivos con disfunción ventricular izquierda de origen no filiado mediante coronariografía invasiva y resonancia con contraste. A todos ellos se les realizó además un estudio de tomografía computarizada con multidetectores incluyendo presencia de calcio coronario y su cuantificación, coronariografía y valoración tisular del miocardio. Resultados La sensibilidad y la especificidad de la presencia de calcio coronario para identificar la disfunción ventricular izquierda de origen coronario fueron del 100 y el 31% respectivamente. Si se considera un score de calcio por Agatston >100, la especificidad sube al 58% manteniendo la sensibilidad del 100%. Los valores de sensibilidad y especificidad de la coronariografía por tomografía computarizada con multidetectores fueron del 100 y el 96% respectivamente; para la identificación de áreas de necrosis en la adquisición precoz, del 57 y el 100% y en la adquisición tardía, del 84 y el 96%. Para identificar a los pacientes coronarios con necrosis, la sensibilidad y la especificidad fueron del 92 y el 100% respectivamente. Conclusiones De todas las herramientas diagnósticas disponibles en tomografía computarizada con multidetectores, la coronariografía es la que muestra mayor exactitud diagnóstica para determinar el origen coronario de la disfunción ventricular. La combinación del estudio coronariográfico y el estudio tisular del miocardio tras el contraste permite obtener en un solo examen información similar a la de la combinación de cateterismo y resonancia con contraste.This work was supported in part by a grant from the Fundacion Espanola del Corazon and Fuente Liviana 2009 of Sociedad Espanola de Cardiologia. F. Ridocci received assistance from the Instituto de Salud Carlos III Research Activity Intensification Programme 2010.Estornell-Erill, J.; Igual-Muñoz, B.; Monmeneu-Menadas, JV.; Soriano-Navarro, C.; Valle-Muñoz, A.; Vilar Herrero, JV.; Perez-Bosca, L.... (2012). Etiological diagnosis of left ventricular dysfunction: computed tomography compared with coronary angiography and cardiac magnetic resonance. Revista Española de Cardiología. 65(6):517-524. https://doi.org/10.1016/j.rec.2011.07.011S51752465

Corticosteroid treatment and mortality in mechanically ventilated COVID-19-associated acute respiratory distress syndrome (ARDS) patients : a multicentre cohort study

Some unanswered questions persist regarding the effectiveness of corticosteroids for severe coronavirus disease 2019 (COVID-19) patients. We aimed to assess the clinical effect of corticosteroids on intensive care unit (ICU) mortality among mechanically ventilated COVID-19-associated acute respiratory distress syndrome (ARDS) patients. This was a retrospective study of prospectively collected data conducted in 70 ICUs (68 Spanish, one Andorran, one Irish), including mechanically ventilated COVID-19-associated ARDS patients admitted between February 6 and September 20, 2020. Individuals who received corticosteroids for refractory shock were excluded. Patients exposed to corticosteroids at admission were matched with patients without corticosteroids through propensity score matching. Primary outcome was all-cause ICU mortality. Secondary outcomes were to compare in-hospital mortality, ventilator-free days at 28 days, respiratory superinfection and length of stay between patients with corticosteroids and those without corticosteroids. We performed survival analysis accounting for competing risks and subgroup sensitivity analysis. We included 1835 mechanically ventilated COVID-19-associated ARDS, of whom 1117 (60.9%) received corticosteroids. After propensity score matching, ICU mortality did not differ between patients treated with corticosteroids and untreated patients (33.8% vs. 30.9%; p = 0.28). In survival analysis, corticosteroid treatment at ICU admission was associated with short-term survival benefit (HR 0.53; 95% CI 0.39-0.72), although beyond the 17th day of admission, this effect switched and there was an increased ICU mortality (long-term HR 1.68; 95% CI 1.16-2.45). The sensitivity analysis reinforced the results. Subgroups of age < 60 years, severe ARDS and corticosteroids plus tocilizumab could have greatest benefit from corticosteroids as short-term decreased ICU mortality without long-term negative effects were observed. Larger length of stay was observed with corticosteroids among non-survivors both in the ICU and in hospital. There were no significant differences for the remaining secondary outcomes. Our results suggest that corticosteroid treatment for mechanically ventilated COVID-19-associated ARDS had a biphasic time-dependent effect on ICU mortality. Specific subgroups showed clear effect on improving survival with corticosteroid use. Therefore, further research is required to identify treatment-responsive subgroups among the mechanically ventilated COVID-19-associated ARDS patients. The online version contains supplementary material available at 10.1186/s13613-021-00951-0