Ionoluminescent response of several phosphor screens to keV ions of different masses

We have characterized the ionoluminescent response of several phosphor powder materials when irradiated with ions of different masses H+ ,He+ ,Ar+ accelerated to keV energies. In particular, we have determined the absolute luminosity in terms of the number of photons per incident ion emitted by luminescent screens of Y2O2S:Tb P45, Y3Al5O12 :Ce P46, Y2SiO5 :Ce P47, Y2O3 :Eu P56, and SrGa2S4 :Eu TG-green. Their ionoluminescence has been studied as a function of ion beam energy and current and ion fluency. The energy trend and mass dependence of selected experimental results are compared relative to stopping and range of ions in matter SRIM code predictions.Ministerio de Educación y Ciencia FTN2003-090

Prevalence of disability in a composite ≥75 year-old population in Spain: A screening survey based on the International Classification of Functioning

<p>Abstract</p> <p>Background</p> <p>The prevalence and predictors of functional status and disability of elderly people have been studied in several European countries including Spain. However, there has been no population-based study incorporating the International Classification of Functioning, Disability and Health (ICF) framework as the basis for assessing disability. The present study reports prevalence rates for mild, moderate, and severe/extreme disability by the domains of activities and participation of the ICF.</p> <p>Methods</p> <p>Nine populations surveyed in previous prevalence studies contributed probabilistic and geographically defined samples in June 2005. The study sample was composed of 503 subjects aged ≥75 years. We implemented a two-phase screening design using the MMSE and the World Health Organization-Disability Assessment Schedule 2^ndedition (WHO-DAS II, 12 items) as cognitive and disability screening tools, respectively. Participants scoring within the positive range of the disability screening were administered the full WHO-DAS II (36 items; score range: 0-100) assessing the following areas: Understanding and communication, Getting along with people, Life activities, Getting around, Participation in society, and Self-care. Each disability area assessed by WHO-DAS II (36 items) was reported according to the ICF severity ranges (No problem, 0-4; Mild disability, 5-24; Moderate disability, 25-49; Severe/Extreme disability, 50-100).</p> <p>Results</p> <p>The age-adjusted disability prevalence figures were: 39.17 ± 2.18%, 15.31 ± 1.61%, and 10.14 ± 1.35% for mild, moderate, and severe/extreme disability, respectively. Severe and extreme disability prevalence in mobility and life activities was three times higher than the average, and highest among women. Sex variations were minimal, although life activities for women of 85 years and over had more severe/extreme disability as compared to men (OR = 5.15 95% CI 3.19-8.32).</p> <p>Conclusions</p> <p>Disability is highly prevalent among the Spanish elderly. Sex- and age-specific variations of disability are associated with particular disability domains.</p

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Disability, support and long-term social care of an elderly Spanish population, 2008-2009: an epidemiologic analysis

BACKGROUND: Though poorly known, relationships between disability, need of help (dependency) and use of social services are crucial aspects of public health. The objective of this study was to describe the links between disability, officially assessed dependency, and social service use by an industrial population, and identify areas of inequity. METHODS: We took advantage of a door-to-door survey conducted in the Cinco Villas district, Spain, in 2008–2009, which provided data on disability, morbidity, and service use among 1216 residents aged ≥50 years, and officially assessed dependency under the 2006 Dependency Act (OAD). Using logistic regression, we combined data collected at homes/residences on 625 disability screened-positive participants, and administrative information on degree of OAD and benefits at date of visit. RESULTS: Based on 163 disabled persons, the prevalence of residential/community-care users was 13.4% overall, with 6.0% being market-provided, 2.5% supported by the 2006 Act, and 4.9% supported by other public funds. Of 111 OAD applicants, 30 had been assigned an OAD degree; in 29 cases this was the highest OAD degree, with 12 receiving direct support for residential care and 17 receiving home care. Compared to unassessed dependency, the highest OAD degree was linked to residential care (OR and 95% CI) 12.13 (3.86–38.16), declared non-professional care 10.99 (1.28–94.53), and publicly-funded, non-professional care 26.30 (3.36–205.88). In contrast, 43 persons, 58% of the severely/extremely disabled, community-dwelling sample population, 81% of whom were homebound, including 10 persons with OAD but no implemented service plan, made no use of any service, and of these, 40% lacked a non-professional carer. CONCLUSIONS: Formal service use in the Cinco Villas district attained ratios observed for established welfare systems but the publicly-funded proportion was lower. The 2006 Act had a modest, albeit significant, impact on support for non-professional carers and residential care, coexisting with a high prevalence of non-use of social services by severely disabled persons

Muticenter spanish study for perioperative stroke risk prediction after isolated coronary artery bypass surgery: The PACK2 score

[ES] Objetivos: Desarrollar un modelo predictivo multivariante del accidente cerebrovascular (ACV) intrahospitalario tras cirugía de bypass coronario. Métodos: Veintiséis mil trescientos cuarenta y siete pacientes incluidos en el estudio procedentes de 21 bases de datos de hospitales españoles. El análisis de regresión logística fue utilizado para predecir el riesgo de ACV perioperatorio (ictus o accidente isquémico transitorio). El modelo predictivo fue desarrollado a partir de un subgrupo de datos «de prueba» y validado en otro subgrupo independiente, ambos seleccionados aleatoriamente del total de la muestra. La capacidad predictiva del modelo se relacionó con el área bajo la curva ROC (ABC). Las variables consideradas fueron: preoperatorias (edad, sexo, diabetes mellitus, hipertensión arterial, ACV previo, insuficiencia cardiaca y/o fracción de eyección del ventrículo izquierdo < 40%, prioridad de la intervención no electiva, arteriopatía extracardiaca, insuficiencia renal crónica y/o creatininemia &#8805; 2 mg/dl y fibrilación auricular) e intraoperatorias (cirugía coronaria con/sin circulación extracorpórea). Resultados: Incidencia global de ACV perioperatorio 1,38%. La prioridad no electiva de la cirugía (priority; OR = 2,32), arteriopatía extracardiaca (arteriopathy; OR = 1,37), insuficiencia cardiaca (cardiac; OR = 3.64) e insuficiencia renal crónica (kidney; OR = 6,78) fueron identificados como factores de riesgo independientes de ACV perioperatorio en los modelos uni y multivariante en el subgrupo de prueba; p < 0,0001; ABC = 0,77, IC del 95%, 0,73-0,82. El modelo PACK2 de ACV perioperatorio tras cirugía de bypass coronario se estableció con 1 punto para cada ítem, excepto para la insuficiencia renal crónica que se le otorgaron 2 puntos (rango 0-5 puntos); ABC = 0,76, IC del 95%, 0,72-0,80. En pacientes con puntuación PACK2 &#8805; 2 puntos, la cirugía coronaria sin circulación extracorpórea redujo la incidencia de ACV en un 2,3% cuando se comparó con el grupo con cirugía realizada con circulación extracorpórea. Conclusiones: La escala de riesgo PACK2 muestra una buena capacidad predictiva en los datos analizados y podría ser útil en la toma de decisiones y selección de pacientes de la práctica clínica.[EN] Objectives: To develop a multivariate predictive risk score of perioperative in-hospital stroke after coronary artery bypass grafting (CABG) surgery. Methods: A total of 26,347 patients were enrolled from 21 Spanish hospital databases. Logistic regression analysis was used to predict the risk of perioperative stroke (stroke or transient ischaemic attack). The predictive scale was developed from a training set of data and validated by an independent test set, both selected randomly from the global sample. The assessment of the accuracy of prediction was related to the area under the ROC curve (AUC). The variables considered were: preoperative (age, gender, diabetes mellitus, arterial hypertension, previous stroke, cardiac failure and/or left ventricular ejection fraction < 40%, non-elective priority of surgery, extracardiac arteriopathy, chronic kidney failure and/or serum creatinine ≥2 mg/dl, and atrial fibrillation) and intra-operative (on/off-pump). Results: The overall perioperative stroke incidence was 1.38%. Non-elective priority of surgery (priority; OR = 2.32), vascular disease (arteriopathy; OR = 1.37), heart failure (cardiac; OR = 3.64), and chronic kidney failure (kidney; OR = 6.78) were found to be independent risk factors for perioperative stroke in uni- and multivariate models in the training set of data; P < .0001; AUC = 0.77, 95% CI 0.73–0.82. The PACK2 stroke CABG score was established with 1 point for each item, except for chronic kidney failure with 2 points (range 0–5 points); AUC = 0.76, 95% CI 0.72–0.80. In patients with PACK2 score ≥2 points, off-pump reduced perioperative stoke incidence by 2.3% when compared with on-pump CABG. Conclusions: PACK2 risk scale shows good predictive accuracy in the data analysed and could be useful in clinical practice for decision making and patient selection.Martín, E.; Hornero, F.; Rodríguez, R.; Castellà, M.; Porras, C.; Romero, B.; Maroto, L.... (2014). Estudio multicéntrico español para la predicción del riesgo perioperatorio de accidente cerebrovascular tras cirugía de bypass coronario aislada: el modelo PACK2. Cirugia Cardiovascular. 21(3):175-180. doi:10.1016/j.circv.2014.02.009S17518021

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

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

Prevalence of and factors associated with homebound status among adults in urban and rural Spanish populations

BACKGROUND: There is a marked growth in the number of homebound older adults, due mainly to increased life expectancy. Although this group has special characteristics and needs, it has not been properly studied. This study thus aimed to measure the prevalence of homebound status in a community-dwelling population, and its association with both socio-demographic, medical and functional characteristics and the use of health care and social services. METHODS: We used instruments coming under the WHO International Classification of Functioning (ICF) framework to carry out a cross-sectional study on populations aged 50 years and over in the province of Zaragoza (Spain), covering a total of 1622 participants. Persons who reported severe or extreme difficulty in getting out of the house in the last 30 days were deemed to be homebound. We studied associations between homebound status and several relevant variables in a group of 790 subjects who tested positive to the WHODAS-12 disability screening tool. RESULTS: Prevalence of homebound status was 9.8 % (95 % CI: 8.4 to 11.3 %). Homebound participants tended to be older, female and display a lower educational level, a higher number of diseases, poorer cognition and a higher degree of disability. In fully adjusted models including disability as measured with the ICF-Checklist, the associated variables (odds ratios and [95 % confidence intervals]) were: female gender (3.75 [2.10–6.68]); urban population (2.36 [1.30–4.29]); WHODAS-12 disability (6.27 [2.56–15.40]); depressive symptoms (2.95 [1.86–4.68]); moderate pain (2.37 [1.30–4.31] and severe pain (3.03 [1.31–7.01]), as compared to the group with no/mild pain; hospital admissions in the previous 3 months (2.98 [1.25–7.11]); and diabetes (1.87 [1.03–3.41]). Adjustment for ICF-Checklist disability had a notable impact on most associations. CONCLUSIONS: The study shows that homebound status is a common problem in our setting, and that being disabled is its main determinant. Socio-demographic characteristics, barriers and chronic diseases can also be assumed to be playing a role in the onset of this condition, indicating the need for further research, including longitudinal studies on its incidence and associated factors

The database of the PREDICTS (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems) project

The PREDICTS project-Projecting Responses of Ecological Diversity In Changing Terrestrial Systems (www.predicts.org.uk)-has collated from published studies a large, reasonably representative database of comparable samples of biodiversity from multiple sites that differ in the nature or intensity of human impacts relating to land use. We have used this evidence base to develop global and regional statistical models of how local biodiversity responds to these measures. We describe and make freely available this 2016 release of the database, containing more than 3.2 million records sampled at over 26,000 locations and representing over 47,000 species. We outline how the database can help in answering a range of questions in ecology and conservation biology. To our knowledge, this is the largest and most geographically and taxonomically representative database of spatial comparisons of biodiversity that has been collated to date; it will be useful to researchers and international efforts wishing to model and understand the global status of biodiversity