Desarrollo e implantación de un protocolo de violencia laboral en una residencia geriátrica.

La violencia en el lugar de trabajo se ha convertido en los últimos años en un problema mundial emergente. Numerosos autores y organizaciones como la OMS o la OIT han tratado de definirla, aunque actualmente no existe una definición unánime. Se ha evidenciado un aumento de su incidencia y prevalencia. Por ello, es imprescindible un adecuado conocimiento de esta situación, para llevar a cabo una detección precoz. El propósito de nuestro estudio es elaborar, desarrollar y poner en marcha un protocolo de actuación en casos de violencia en una residencia de ancianos Metodología: Se trata de un estudio descriptivo, trasnversal . El estudio ha tenido lugar en Torrevieja (Alicante). La información, ha sido recopilada, principalmente gracias a las entrevistas llevadas a cabo con personal y trabajadores del centro. Resultados: En general, la percepción de los trabajadore s en cuanto a la violencia laboral es bastante positiva. El protocolo aplicado consta de 6 apartados en el que vienen perfectamente desarrollado el procedimiento de actuación en caso de situaciones de violencia. Discusión: Atendiendo a la evidencia científica citada, coincidimos en que la implantación e instauración de un protocolo específico en los centros de trabajo, supone mejorar las condiciones de salud , para ello es fundamental realizar un estudio previo de la situación. Conclusiones: Podemos afirmar que la aplicación de un protocolo para situaciones de violencia laboral, mejora la calidad y las condiciones de la empresa

Cardiac Rehabilitation Improves Endothelial Function in Coronary Artery Disease Patients

Exercise-based cardiac rehabilitation may be an effective nonpharmacological intervention for improving endothelial function in coronary artery disease patients. Therefore, this systematic review with meta-analysis aimed to (a) estimate the training-induced effect on endothelial and vascular smooth muscle function, assessed by flow-mediated dilation and nitroglycerin- mediated dilation, respectively, in coronary artery disease patients; and to (b) study the influence of potential trial-level variables (i. e. study and intervention characteristics) on the training-induced effect on endothelial and vascular smooth muscle function. Electronic searches were performed in Pubmed, Scopus, and Embase up to February 2021. Randomeffects models of standardised mean change were estimated. Heterogeneity analyses were performed by using the Chi2 test and I2 index. Our results showed that exercise-based cardiac rehabilitation significantly enhanced flow-mediated dilation (1.04 [95 % confidence interval = 0.76 to 1.31]) but did not significantly change nitroglycerin-mediated dilation (0.05 [95 % confidence interval = –0.03 to 0.13]). Heterogeneity testing reached statistical significance (p < .001) with high inconsistency for flow-mediated dilation (I2 = 92 %). Nevertheless, none of the analysed variables influenced the training-induced effect on flow-mediated dilation. Exercise-based cardiac rehabilitation seems to be an effective therapeutic strategy for improving endothelial-dependent dilation in coronary artery disease patients, which may aid in the prevention of cardiovascular events

Variability and effect sizes of intracranial current source density estimations during pain: Systematic review, experimental findings, and future perspectives

Pain arises from the integration of sensory and cognitive processes in the brain, resulting in specific patterns of neural oscillations that can be characterized by measuring electrical brain activity. Current source density (CSD) estimation from low-resolution brain electromagnetic tomography (LORETA) and its standardized (sLORETA) and exact (eLORETA) variants, is a common approach to identify the spatiotemporal dynamics of the brain sources in physiological and pathological pain-related conditions. However, there is no consensus on the magnitude and variability of clinically or experimentally relevant effects for CSD estimations. Here, we systematically examined reports of sample size calculations and effect size estimations in all studies that included the keywords pain, and LORETA, sLORETA, or eLORETA in Scopus and PubMed. We also assessed the reliability of LORETA CSD estimations during non-painful and painful conditions to estimate hypothetical sample sizes for future experiments using CSD estimations. We found that none of the studies included in the systematic review reported sample size calculations, and less than 20% reported measures of central tendency and dispersion, which are necessary to estimate effect sizes. Based on these data and our experimental results, we determined that sample sizes commonly used in pain studies using CSD estimations are suitable to detect medium and large effect sizes in crossover designs and only large effects in parallel designs. These results provide a comprehensive summary of the effect sizes observed using LORETA in pain research, and this information can be used by clinicians and researchers to improve settings and designs of future pain studies.Fil: Völker, Juan Manuel. Aalborg University; DinamarcaFil: Arguissain, Federico Gabriel. Aalborg University; DinamarcaFil: Kæseler Andersen, Ole. Aalborg University; DinamarcaFil: Biurrun Manresa, José Alberto. Aalborg University; Dinamarca. Universidad Nacional de Entre Ríos. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Investigación y Desarrollo en Bioingeniería y Bioinformática; Argentin

A novel ensemble method for electric vehicle power consumption forecasting: Application to the Spanish system

The use of electric vehicle across the world has become one of the most challenging issues for environmental policies. The galloping climate change and the expected running out of fossil fuels turns the use of such non-polluting cars into a priority for most developed countries. However, such a use has led to major concerns to power companies, since they must adapt their generation to a new scenario, in which electric vehicles will dramatically modify the curve of generation. In this paper, a novel approach based on ensemble learning is proposed. In particular, ARIMA, GARCH and PSF algorithms' performances are used to forecast the electric vehicle power consumption in Spain. It is worth noting that the studied time series of consumption is non-stationary and adds difficulties to the forecasting process. Thus, an ensemble is proposed by dynamically weighting all algorithms over time. The proposal presented has been implemented for a real case, in particular, at the Spanish Control Centre for the Electric Vehicle. The performance of the approach is assessed by means of WAPE, showing robust and promising results for this research field.Ministerio de Economía y Competitividad Proyectos ENE2016-77650-R, PCIN-2015-04 y TIN2017-88209-C2-R

Exercise‑based cardiac rehabilitation and parasympathetic function in patients with coronary artery disease: a systematic review and meta‑analysis

Purpose The effects of exercise-based cardiac rehabilitation (CR) on parasympathetic modulation are controversial. This systematic review and meta-analysis aims to (a) determine the effect of exercise-based CR on heart-rate-derived indices associated with cardiac parasympathetic modulation in resting and post-exercise conditions in coronary artery disease (CAD) patients and (b) identify the possible moderator variables of the effect of exercise-based CR on parasympathetic modulation. Methods We searched CENTRAL and Web of Science up to November 2018 for the following terms: adult CAD patients, controlled exercise-based CR interventions and parasympathetic modulation measured in resting (vagal-related heart rate variability [HRV] indices of the root mean square of the differences in successive in RR interval [RMSSD] and high frequency [HF]) and post-exercise (heart rate recovery [HRR]) pre- and post-intervention. We estimated a random-effects model of standardised mean difference (SMD) and mean difference (MD) for vagal-related HRV indices and HRR, respectively. We assessed the influence of categorical and continuous variables. Results The overall effect size showed significant differences in RMSSD (SMD+ = 0.30; 95% confidence interval [CI] = 0.12–0.49) and HRR (MD+ = 5.35; 95% CI = 4.08–6.61 bpm) in favour of the exercise-based CR group. The overall effect size showed no differences in HF between groups (SMD+ = 0.14; 95% CI, −0.12–0.40). Heterogeneity analyses reached statistical significance, with high heterogeneity for HF (p < 0.001; I2 = 70%) and HRR (p < 0.001; I2 = 85%). Analysis of the moderator variables showed that the effect on HRR is greater in young patients (p = 0.008) and patients treated with percutaneous intervention (p = 0.020). Conclusions Exercise-based CR improves the post-exercise parasympathetic function, with greater effects in younger CAD patients and in those who were revascularised with percutaneous intervention. The effects on resting parasympathetic function are more controversial due to methodological inconsistencies in measuring HRV, with the use of RMSSD recommended instead of HF because its results show higher consistency. Future studies involving women, focusing on methodological issues, and performing other training methods are needed to increase our knowledge about this topic

Effects of high-intensity interval training on vascular function in patients with cardiovascular disease: a systematic review and meta-analysis

Background: Exercise training improves endothelial function in patients with cardiovascular disease (CVD). However, the influence of training variables remains unclear. The aim of this study was to evaluate the effect of high-intensity interval training (HIIT), compared to moderate intensity training (MIT) and other exercise modalities (i.e., resistance and combined exercise), on endothelial function, assessed by arterial flow-mediated dilation (FMD) or endothelial progenitor cells (EPCs), in patients with CVD. Secondly, we investigated the influence of other training variables (i.e., HIIT protocol).Methods: The PICOS strategy was used to identify randomised and non-randomised studies comparing the effect of HIIT and other exercise modalities (e.g., MIT) on endothelial function in patients with CVD. Electronic searches were carried out in Pubmed, Embase, and Web of Science up to November 2022. The TESTEX scale was used to evaluate the methodological quality of the included studies. Random-effects models of between-group mean difference (MD) were estimated. A positive MD indicated an effect in favour of HIIT. Heterogeneity analyses were performed by the chi-square test and I2 index. Subgroup analyses evaluated the influence of potential moderator variables.Results: Fourteen studies (13; 92.9% randomised) were included. Most of the studies trained 3 days a week for 12 weeks and performed long HIIT. No statistically significant differences were found between HIIT and MIT for improving brachial FMD in patients with coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF) (8 studies; MD+ = 0.91% [95% confidence interval (CI) = −0.06, 1.88]). However, subgroup analyses showed that long HIIT (i.e., &gt; 1 min) is better than MIT for enhancing FMD (5 studies; MD+ = 1.46% [95% CI = 0.35, 2.57]), while no differences were found between short HIIT (i.e., ≤ 1 min) and MIT (3 studies; MD+ = −0.41% [95% CI = −1.64, 0.82]). Insufficient data prevented pooled analysis for EPCs, and individual studies failed to find statistically significant differences (p &gt; .050) between HIIT and other exercise modalities in increasing EPCs.Discussion: Poor methodological quality could limit the precision of the current results and increase the inconsistency. Long HIIT is superior to MIT for improving FMD in patients with CAD or HFrEF. Future studies comparing HIIT to other exercise modalities, as well as the effect on EPCs and in HF with preserved ejection fraction are required.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42022358156

Novel indole-based tambjamine-analogues induce apoptotic lung cancer cell death through p38 mitogen-activated protein kinase activation

Lung cancer has become the leading killer cancer worldwide, due to late diagnosis and lack of efficient anticancer drugs. We have recently described novel natural-derived tambjamine analogues that are potent anion transporters capable of disrupting cellular ion balance, inducing acidification of the cytosol and hyperpolarization of cellular plasma membranes. Although these tambjamine analogues were able to compromise cell survival, their molecular mechanism of action remains largely unknown. Herein we characterize the molecular cell responses induced by highly active indole-based tambjamine analogues treatment in lung cancer cells. Expression changes produced after compounds treatment comprised genes related to apoptosis, cell cycle, growth factors and its receptors, protein kinases and topoisomerases, among others. Dysregulation of BCL2 and BIRC5/survivin genes suggested the apoptotic pathway as the induced molecular cell death mechanism. In fact, activation of several proapoptotic markers (caspase-9, caspase-3, and PARP) and reversion of the cytotoxic effect upon treatment with an apoptosis inhibitor (Z-VAD-FMK) were observed. Moreover, members of the Bcl-2 protein family suffered changes after tambjamine analogues treatment, with a concomitant protein decrease towards the prosurvival members. Besides this, it was observed cellular accumulation of ROS upon compound treatment and an activation of the stress-kinase p38 MAPK route that, when inhibited, reverted the cytotoxic effect of the tambjamine analogues. Finally, a significant therapeutic effect of these compounds was observed in subcutaneous and orthotopic lung cancer mice models. Taken together, these results shed light on the mechanism of action of novel cytotoxic anionophores and demonstrate the therapeutic effects against lung cancer.Spanish Government and EU funds through the Fondo de Investigaciones Sanitarias (FIS, project PI13/ 00089) and from La Marat o de TV3 Foundation (project 20132730) to R. P erez-Tom as. R. Ramos was supported by the Sociedad Espa~nola de Neumología y Cirugía Tor acica (SEPAR, Project 017/2013), R. Quesada by the Consejería de Educación de la Junta de Castilla y León (project BU340U13) and by the La Marat o de TV3 Foundation (project 20132732) and A. Villanueva by the FIS (project PI13/01339)

Facilitated Anion Transport Induces Hyperpolarization of the Cell Membrane That Triggers Differentiation and Cell Death in Cancer Stem Cells

Facilitated anion transport potentially represents a powerful tool to modulate various cellular functions. However, research into the biological effects of small molecule anionophores is still at an early stage. Here we have used two potent anionophore molecules inspired in the structure of marine metabolites tambjamines to gain insight into the effect induced by these compounds at the cellular level. We show how active anionophores, capable of facilitating the transmembrane transport of chloride and bicarbonate in model phospholipid liposomes, induce acidification of the cytosol and hyperpolarization of plasma cell membranes. We demonstrate how this combined effect can be used against cancer stem cells (CSCs). Hyperpolarization of cell membrane induces cell differentiation and loss of stemness of CSCs leading to effective elimination of this cancer cell subpopulation.panishgovernment and the EU (FIS PI13/00089, FIS PI12/02838,FIS PI12/00956 and RD12/0036/0025), a grant from LaMaratóde TV3 Foundation (20132730), a grant from SEPAR(17/2014), Consejería de Educación de la Junta de Castilla yLeón (Project BU340U13), Ministerio de Economíaycompetitividad/Instituto de Salud Carlos III (SAF2014-55700-P), and ICREA Academia-201

PhDay Educación 2020. VI Jornadas de Investigación. Libro de Actas

Todas las contribuciones presentadas en este Libro de Actas forman parte de la evaluación de seguimiento de los doctorandos de segundo año a tiempo completo y tercer año a tiempo parcial del Programa de Doctorado en Educación de la Universidad Complutense de Madrid. Cada trabajo ha sido revisado formalmente por el comité organizador y valorado por los directores y tutores de tesis. Asimismo, cada doctorando ha recibido mejoras por otros estudiantes del programa que han podido incluir antes de la finalización del presente documento

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research