Prevention and Treatment of Sarcopenic Obesity in Women

Sarcopenic obesity (SO) is referred to as the combination of obesity with low skeletal muscle mass and function. However, its definition and diagnosis is debated. SO represents a sizable risk factor for the development of disability, possibly with a worse prognosis in women. The present narrative review summarizes the current evidence on pharmacological, nutrition and exercise strategies on the prevention and/or treatment of SO in middle-aged and older-aged women. A literature search was carried out in Medline and Google Scholar between 29th January and 14th March 2019. Only controlled intervention studies on mid-age and older women whose focus was on the prevention and/or treatment of sarcopenia associated with obesity were included. Resistance training (RT) appears effective in the prevention of all components of SO in women, resulting in significant improvements in muscular mass, strength, and functional capacity plus loss of fat mass, especially when coupled with hypocaloric diets containing at least 0.8 g/kg body weight protein. Correction of vitamin D deficit has a favorable effect on muscle mass. Treatment of SO already established is yet unsatisfactory, although intense and prolonged RT, diets with higher (1.2 g/kg body weight) protein content, and soy isoflavones all look promising. However, further confirmatory research and trials combining different approaches are required

Las relaciones entre profesionales en los códigos de deontología de diversas profesiones de la salud

Una buena atención y cuidado de las personas en el ámbito sanitario requiere de la coordinación entre los profesionales responsables de dicha atención, tanto a nivel interdisciplinar como entre niveles asistenciales. Las consideraciones éticas que subyacen, siendo fundamentales, han sido poco estudiadas de manera específica, a pesar de que todos los Códigos de Deontología de las profesiones relacionadas con la salud recogen recomendaciones y sugerencias relativas a las relaciones entre profesionales. En este artículo se desarrolla una revisión reflexiva sobre estas recomendaciones, a partir de los Códigos de las profesiones relacionadas con nuestro ámbito asistencial, y su importancia en el mismo. A good care of people in the health field requires coordination among the professionals responsible for such care, both interdisciplinary and between levels of care. The ethical considerations that underlie, being fundamental, have been little studied in a specific way, although all the Codes of Deontology of the professions related to the health collect recommendations and suggestions regarding the relations between professionals. This article makes a reflective review on these recommendations and their importance in our care environment

A Machine Learning Approach to Predict Healthcare Cost of Breast Cancer Patients

This paper presents a novel machine learning approach to per- form an early prediction of the healthcare cost of breast cancer patients. The learning phase of our prediction method considers the following two steps: i) in the first step, the patients are clustered taking into account the sequences of ac- tions undergoing similar clinical activities and ensuring similar healthcare costs, and ii) a Markov chain is then learned for each group to describe the action- sequences of the patients in the cluster. A two step procedure is undertaken in the prediction phase: i) first, the healthcare cost of a new patient’s treatment is estimated based on the average healthcare cost of its k−nearest neighbors in each group, and ii) finally, an aggregate measure of the healthcare cost estimated by each group is used as the final predicted cost. Experiments undertaken reveal a mean absolute percentage error as small as 6%, even when half of the clinical records of a patient is available, substantiating the early prediction capability of the proposed method. Comparative analysis substantiates the superiority of the proposed algorithm over the state-of-the-art techniques.IT1244-19 PID2019-104966GB-I00 TIN2016-78365-

A KK-monopole giant graviton in AdS_5 x Y_5

We construct a new giant graviton solution in AdS_5 x Y_5, with Y_5 a quasi-regular Sasaki-Einstein manifold, consisting on a Kaluza-Klein monopole wrapped around the Y_5 and with its Taub-NUT direction in AdS_5. We find that this configuration has minimal energy when put in the centre of AdS_5, where it behaves as a massless particle. When we take Y_5 to be S^5, we provide a microscopical description in terms of multiple gravitational waves expanding into the fuzzy S^5 defined as an S^1 bundle over the fuzzy CP^2. Finally we provide a possible field theory dual interpretation of the construction.Comment: 11 pages, published versio

Représentations du plurilinguisme chez de futurs enseignants de langue en formation initiale

What kind of representations of plurilingualism do students who are training to become teachers have? Do they take into account learners’ multilingual repertoires (L1 and others)? What role do these questions play in the building of their professional identity? These questions are addressed in this article by examining the results of a questionnaire study of 87 students training to become teachers. This research is part of a larger regional project which examines obstacles and opportunities in developing plurilingualism in an educational context

On the Formation Height of the SDO/HMI Fe 6173 Doppler Signal

The Helioseismic and Magnetic Imager (HMI) onboard the Solar Dynamics Observatory (SDO) is designed to study oscillations and the mag- netic field in the solar photosphere. It observes the full solar disk in the Fe I absorption line at 6173\AA . We use the output of a high-resolution 3D, time- dependent, radiation-hydrodynamic simulation based on the CO5BOLD code to calculate profiles F({\lambda},x,y,t) for the Fe I 6173{\AA} line. The emerging profiles F({\lambda},x,y,t) are multiplied by a representative set of HMI filter transmission profiles R_i({\lambda},1 \leq i \leq 6) and filtergrams I_i(x,y,t;1 \leq i \leq 6) are constructed for six wavelengths. Doppler velocities V_HMI(x,y,t) are determined from these filtergrams using a simplified version of the HMI pipeline. The Doppler velocities are correlated with the original velocities in the simulated atmosphere. The cross- correlation peaks near 100 km, suggesting that the HMI Doppler velocity signal is formed rather low in the solar atmosphere. The same analysis is performed for the SOHO/MDI Ni I line at 6768\AA . The MDI Doppler signal is formed slightly higher at around 125 km. Taking into account the limited spatial resolution of the instruments, the apparent formation height of both the HMI and MDI Doppler signal increases by 40 to 50 km. We also study how uncertainties in the HMI filter-transmission profiles affect the calculated velocities.Comment: 15 pages, 11 Figure

Therapeutic Exercise and Pain Neurophysiology Education in Female Patients with Fibromyalgia Syndrome: A Feasibility Study

Background: We compared the effects of therapeutic exercise (TE) combined with pain neurophysiology education (PNE) to those of TE in isolation on pain intensity, general fibromyalgia impact, mechanical pain sensitivity, pain catastrophizing, psychological distress and quality of life in women with fibromyalgia syndrome (FMS). Methods: A feasibility study with a 3 month follow-up was designed. Thirty-two patients with FMS were randomly assigned to PNE + TE group (n = 16) or to TE group (n = 16). Both groups received 30 sessions of TE (3 per week), and the PNE + TE group received eight face-to-face educational sessions. The measuring instruments used were the visual analogue scale, a standard pressure algometer, the Revised Fibromyalgia Impact Questionnaire, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale and the Health Assessment Questionnaire. Results: The PNE + TE group showed a statistically significant decrease on pain intensity compared to TE group at short term (p = 0.015). No between-groups differences were found for mechanical pain sensitivity, general fibromyalgia impact, pain catastrophizing, psychological distress or quality of life (p > 0.05). Conclusions: The combination of PNE and TE was more effective than TE for reducing pain intensity in the short-term. No differences were found for psychological distress, pain catastrophizing and quality of life after the intervention or at 3 months of follow-up

Macrophages exert homeostatic actions in pregnancy to protect against preterm birth and fetal inflammatory injury

Macrophages are commonly thought to contribute to the pathophysiology of preterm labor by amplifying inflammation — but a protective role has not previously been considered to our knowledge. We hypothesized that given their antiinflammatory capability in early pregnancy, macrophages exert essential roles in maintenance of late gestation and that insufficient macrophages may predispose individuals to spontaneous preterm labor and adverse neonatal outcomes. Here, we showed that women with spontaneous preterm birth had reduced CD209⁺CD206⁺ expression in alternatively activated CD45⁺CD14⁺ICAM3⁻ macrophages and increased TNF expression in proinflammatory CD45⁺CD14⁺CD80⁺HLA-DR⁺ macrophages in the uterine decidua at the materno-fetal interface. In Cd11b(DTR/DTR) mice, depletion of maternal CD11b⁺ myeloid cells caused preterm birth, neonatal death, and postnatal growth impairment, accompanied by uterine cytokine and leukocyte changes indicative of a proinflammatory response, while adoptive transfer of WT macrophages prevented preterm birth and partially rescued neonatal loss. In a model of intra-amniotic inflammation–induced preterm birth, macrophages polarized in vitro to an M2 phenotype showed superior capacity over nonpolarized macrophages to reduce uterine and fetal inflammation, prevent preterm birth, and improve neonatal survival. We conclude that macrophages exert a critical homeostatic regulatory role in late gestation and are implicated as a determinant of susceptibility to spontaneous preterm birth and fetal inflammatory injury.Nardhy Gomez-Lopez, Valeria Garcia-Flores, Peck Yin Chin, Holly M. Groome, Melanie T. Bijland, Kerrilyn R. Diener, Roberto Romero, and Sarah A. Robertso

Amebas de vida libre en aguas residuales y fangos: Su papel como reservorio natural de bacterias potencialmente patógenas

Las amebas de vida libre (AVL) son protozoos ubicuos, presentes en suelos y en ecosistemas acuáticos naturales y artificiales. Participan en los procesos de depuración desarrollados en las Estaciones Depuradoras de Aguas Residuales (EDAR), convirtiéndolas en un nicho ecológico idóneo para la proliferación de AVL, que las colonizan e instauran en ellas su hábitat, ya que se alimentan de bacterias presentes en el medio. Los procesos de depuración biológica no están diseñados con el fin de eliminar la contaminación microbiológica, aunque ayudan a reducir algunas poblaciones bacterianas. Hasta la fecha, sólo algunas especies y géneros de AVL han sido descritos como patógenos, pero todas ellas suponen un riesgo como reservorio de bacterias patógenas. Su forma quística, les confiere resistencia frente a las condiciones adversas y desinfectantes comunes, permitiéndoles superar los procesos de depuración y potabilización y colonizar sistemas artificiales de agua. En este trabajo, se estudió la presencia de AVL en aguas y fangos de 5 EDAR que vierten sus aguas a la cuenca del Ebro, analizando un total de 20 puntos de muestreo. Para ello, se llevó a cabo el aislamiento AVL y la posterior identificación de género y especie, así como de las bacterias endosimbiontes, mediante la reacción en cadena de la polimerasa (PCR). De las 41 amebas aisladas en el 85 % de las muestras, 21 fueron identificadas genéticamente. Trece de ellas, pertenecieron al género Acanthamoeba spp., 6 a Naegleria spp. y 2 se identificaron como Vermamoeba vermiformis. El 53,66 % de las AVL albergaba en su interior Mycobacterium spp., el 29,27 % Legionella pneumophila y el 14,63 % Pseudomonas spp. Free-living amoebae (FLA) are ubiquitous protozoa, present in soils and in natural and artificial aquatic ecosystems. They take part in the purification processes that take place in Wastewater Treatment Plants (WWTPs), thereby turning these plants into ecological niches suitable for proliferation of FLAs, which they colonize and in which they establish their habitat, since they feed on bacteria present in the environment. Biological purification processes are not designed to remove microbiological contamination, although they help to reduce some microbial populations. At present only some genera and species of FLAs have been described as pathogenic, but all of them pose a risk as reservoirs of pathogenic bacteria. Their cystic stage gives them resistance to adverse conditions and common disinfectants, allowing them to withstand water purification processes and colonize artificial water systems. The presence of FLAs in waters and sludges from 5 WWTPs that discharge their waters into the Ebro river basin has been studied in this work. To this end, a total of 20 sample points were analysed by isolating the FLAs and subsequently identifying their genus and species. The same was done for endosymbiotic bacteria, by Polymerase Chain Reaction (PCR). Out of 41 FLAs that were isolated in 85 % of the samples, 21 were genetically identified. Thirteen belonged to the genus Acanthamoeba spp., 6 to Naegleria spp. and 2 were identified as Vermamoeba vermiformis. 53.66 % of FLAs hosted Mycobacterium spp., 29.27 % Legionella pneumophila, and 14.63 % Pseudomonas spp