COVID-19 pandemic on coronary artery and cerebrovascular diseases in Southern Spain: interrupted time series analysis

Objective: Healthcare systems have been put under intense pressure by the COVID-19 pandemic, although some studies have shown a decline in hospital admissions for cardiovascular and cerebrovascular diseases during the first and second wave of the pandemic. In addition, studies analyzing gender and procedural differences are scarce. The present study aimed to determine the impact of the pandemic on hospital admissions for acute myocardial infarction (AMI) and cerebrovascular disease (CVD) in Andalusia (Spain) and analyzed differences by gender and by percutaneous coronary interventions performed. Patients and methods: An interrupted time series analysis of AMI and CVD hospital admissions in Andalusia (Spain) was carried out to measure the impact of the COVID-19 outbreak. AMI and CVD cases admitted daily in public hospitals of Andalusia between January 2018 and December 2020 were included. Results: During the pandemic, significant reductions in AMI [-19%; 95% confidence interval (CI): (-29%, -9%), p<0.001] and CVD [-17%; 95% CI: (-26%, -9%); p<0.01] in daily hospital admissions were observed. Differences were also produced according to the diagnosis (ST-Elevation Myocardial Infarction, Non-ST-Elevation Myocardial Infarction, other AMI and stroke), with a greater reduction in females for AMI and in males for CVD. Although there were more percutaneous coronary interventions during the pandemic, no significant reductions were observed. Conclusions: A decline in AMI and CVD daily hospital admissions during the first and second wave of COVID-19 pandemic was noted. Gender differences were observed, but no clear impact was observed in percutaneous interventions

CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults

Background: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls. Methods: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021. Results: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis. Conclusions: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies

Sources of Relativistic Jets in the Galaxy

Black holes of stellar mass and neutron stars in binary systems are first detected as hard X-ray sources using high-energy space telescopes. Relativistic jets in some of these compact sources are found by means of multiwavelength observations with ground-based telescopes. The X-ray emission probes the inner accretion disk and immediate surroundings of the compact object, whereas the synchrotron emission from the jets is observed in the radio and infrared bands, and in the future could be detected at even shorter wavelengths. Black-hole X-ray binaries with relativistic jets mimic, on a much smaller scale, many of the phenomena seen in quasars and are thus called microquasars. Because of their proximity, their study opens the way for a better understanding of the relativistic jets seen elsewhere in the Universe. From the observation of two-sided moving jets it is inferred that the ejecta in microquasars move with relativistic speeds similar to those believed to be present in quasars. The simultaneous multiwavelength approach to microquasars reveals in short timescales the close connection between instabilities in the accretion disk seen in the X-rays, and the ejection of relativistic clouds of plasma observed as synchrotron emission at longer wavelengths. Besides contributing to a deeper comprehension of accretion disks and jets, microquasars may serve in the future to determine the distances of jet sources using constraints from special relativity, and the spin of black holes using general relativity.Comment: 39 pages, Tex, 8 figures, to appear in vol. 37 (1999) of Annual Reviews of Astronomy and Astrophysic

High-pressure technology for Sargassum spp biomass pretreatment and fractionation in the third generation of bioethanol production

Sargassum spp is an invasive macroalgae and an alternative feedstock for bioethanol production. Sargassum spp biomass was subjected to high-pressure technology for biomass fractionation under different operating conditions of temperature and residence time to obtain glucan enriched pretreated solids (32.22 g/100 g of raw material). Enzyme hydrolysis process at high pretreated solid loading (13%, w/v) and enzyme loading of 10 FPU/g of glucan was performed, obtaining 43.01 g/L of glucose corresponding to a conversion yield of 92.12%. Finally, a pre-simultaneous saccharification and fermentation strategy (PSSF) was performed to produce bioethanol. This operational strategy produced 45.66 g/L of glucose in the pre-saccharification stage, and 18.14 g/L of bioethanol was produced with a glucose to bioethanol conversion yield of 76.23%. The development of this process highlights the feasibility of bioethanol production from macroalgal biomass in the biorefinery concept

CUIDADOS DE ENFERMERÍA A LOS PACIENTES CON FIBROMIALGIA

Through our daily activities in the health center we have detected a growing demand from patients that go to family medical clinics for treatment, information, nursing and social work, that have been weakened by fibromyalgia (FM). FM patients are confronted with society’s and health professional’s ignorance of this syndrome. Faced with this problem, we the nurses at the Health Center, have decided to design an educational activity for healthcare professionals to update their knowledge about this syndrome of chronic pain and to promote among these patients further knowledge, skills and attitudes to understand and accept the disease, improve communication, as well as teaching healthy living and promoting associations. We must act on them individually with a personalized assessment and collectively, with relaxation workshops, physical activity, self-esteem, healthy posture and psychological intervention. The methodology we use is both theoretical expositions as well as interrogative method and group dynamics. We hope to present the different interventions for the management of FM, especially those with strong evidence of effectiveness. And from now on, to work with these patients, we will have a standardized care plan for patients with FM.A través de nuestra actividad diaria en el centro de salud hemos detectado una demanda creciente de pacientes que acuden a las consultas de medicina de familia, de enfermería, y de trabajo social, solicitando ayuda ante su situación de salud, mermada por la fibromialgia (FM). Los pacientes con FM se enfrentan al desconocimiento del síndrome por parte de la sociedad y de los profesionales sanitarios.Ante esta problemática, las enfermeras del Centro de Salud, nos hemos planteado el objetivo de diseñar una actividad educativa para que los profesionales sanitarios puedan actualizar sus conocimientos sobre este síndrome de dolor crónico y para promover entre estos pacientes la adquisición de conocimientos, habilidades y actitudes para poder comprender y aceptar la enfermedad, favorecer la comunicación, enseñar a vivir saludablemente, y fomentar el asociacionismo.Hemos de actuar sobre ellos de forma individual, con una valoración personalizada, y de manera colectiva, con la realización de talleres de relajación, actividad física, autoestima, higiene postural e intervención psicológica.Como metodología utilizaremos tanto las exposiciones teóricas como el método interrogativo y las dinámicas grupales.Esperamos dar a conocer las distintas intervenciones para el manejo de la FM, sobre todo, aquellas que tienen una evidencia fuerte de eficacia.Y a partir de ahora, para trabajar con estos pacientes, vamos a disponer de un Plan de Cuidados Estandarizados para pacientes con FM

Electronic Structure Calculations with LDA+DMFT

The LDA+DMFT method is a very powerful tool for gaining insight into the physics of strongly correlated materials. It combines traditional ab-initio density-functional techniques with the dynamical mean-field theory. The core aspects of the method are (i) building material-specific Hubbard-like many-body models and (ii) solving them in the dynamical mean-field approximation. Step (i) requires the construction of a localized one-electron basis, typically a set of Wannier functions. It also involves a number of approximations, such as the choice of the degrees of freedom for which many-body effects are explicitly taken into account, the scheme to account for screening effects, or the form of the double-counting correction. Step (ii) requires the dynamical mean-field solution of multi-orbital generalized Hubbard models. Here central is the quantum-impurity solver, which is also the computationally most demanding part of the full LDA+DMFT approach. In this chapter I will introduce the core aspects of the LDA+DMFT method and present a prototypical application.Comment: 21 pages, 7 figures. Chapter of "Many-Electron Approaches in Physics, Chemistry and Mathematics: A Multidisciplinary View", eds. V. Bach and L. Delle Site, Springer 201

Unmasking a new prognostic marker and therapeutic target from the GDNF-RET/PIT1/p14ARF/p53 pathway in acromegaly

Most of acromegaly is caused by a sporadic somatotropinoma and a couple of novel gene mutations responsible for somatotropinoma have recently been reported. To determine the cause of sporadic somatotropinoma in Japanese patients, we analyzed 61 consecutive Japanese patients with somatotropinoma without apparent family history. Comprehensive genetic analysis revealed that 31 patients harbored guanine nucleotide-binding protein, alpha stimulating (GNAS) mutations (50.8%) and three patients harbored aryl hydrocarbon receptor interacting protein (AIP) mutations (4.9%). No patients had G protein-coupled receptor 101 (GPR101) mutations. The patients in this cohort study were categorized into three groups of AIP, GNAS, and others and compared the clinical characteristics. The AIP group exhibited significantly younger age at diagnosis, larger tumor, and higher nadir GH during oral glucose tolerance test. In all patients with AIP mutation, macro- and invasive tumor was detected and repetitive surgery or postoperative medical therapy was needed. One case showed a refractory response to postoperative somatostatin analogue (SSA) but after the addition of cabergoline as combined therapy, serum IGF-I levels were controlled. The other case showed a modest response to SSA and the switching to cabergoline monotherapy was also effective. These data suggest that although resistance to SSA has been reported in patients with AIP mutations, the response to dopamine agonist (DA) may be retained. In conclusion, the cause of sporadic somatotropinoma in Japanese patients was comparable with the previous reports in Caucasians, patients with AIP mutations showed unique clinical characteristics, and DA may be a therapeutic option for patients with AIP mutations

Life-saving automated external defibrillation in a teenager: a case report

<p>Abstract</p> <p>Background</p> <p>Adolescent sudden death during sport participation is commonly due to cardiac causes. Survival is more likely when an automated external defibrillator (AED) is used soon after collapse.</p> <p>Case presentation</p> <p>We describe a case of sudden death in a 14 year old boy with two remarkable points, successful resuscitation at school using an AED and diagnosis of arrhythmogenic right ventricular cardiomyopathy (ARVC). Bystander cardiopulmonary resuscitation (CPR) was immediately started by a witness and 5 minutes after the event the child was placed on an AED monitor that determined he was in a non shockable rhythm, therefore CPR was continued. Two minutes later, the AED monitor detected a shockable rhythm and recommended a shock, which was then administered. One minute after the shock, a palpable pulse was detected and the child began to breathe by himself. Four days after cardiac arrest, the boy was conversing and self-caring. Cardiac magnetic resonance imaging was suggestive of ARVC.</p> <p>Conclusion</p> <p>Ventricular fibrillation secondary to ARVC may be a devastating event and places young patients and athletes at high risk of sudden death. Immediate CPR and AED have been demonstrated to be lifesaving in such events. Therefore, we suggest that schools should have teachers skilled in CPR and accessible AEDs.</p

Psychophysiological effects of massage-myofascial release after exercise: a randomized sham-control study

This is a copy of an article published in the Journal of Alternative and Complementary Medicine © 2008 Mary Ann Liebert, Inc.; Journal of Alternative and Complementary Medicine is available online at: http://online.liebertpub.com.Objective: The aim of this study was to evaluate the effect of massage on neuromuscular recruitment, mood state, and mechanical nociceptive threshold (MNT) after high-intensity exercise. Design: This was a prospective randomized clinical trial using between-groups design. Setting: The study was conducted at a university-based sports medicine clinic. Participants: Sixty-two (62) healthy active students age 18–26 participated. Interventions: Participants, randomized into two groups, performed three 30-second Wingate tests and immediately received whole-body massage-myofascial induction or placebo (sham ultrasound/magnetotherapy) treatment. The duration (40 minutes), position, and therapist were the same for both treatments. Main outcome measures: Dependent variables were surface electromyography (sEMG) of quadriceps, profile of mood states (POMS) and mechanical nociceptive threshold (MNT) of trapezius and masseter muscles. These data were assessed at baseline and after exercise and recovery periods. Results: Generalized estimating equations models were performed on dependent variables to assess differences between groups. Significant differences were found in effects of treatment on sEMG of Vastus Medialis (VM) (p 0.02) and vigor subscale (p 0.04). After the recovery period, there was a significant decrease in electromyographic (EMG) activity of VM (p 0.02) in the myofascial-release group versus a nonsignificant increase in the placebo group (p 0.32), and a decrease in vigor (p 0.01) in the massage group versus no change in the placebo group (p 0.86). Conclusions: Massage reduces EMG amplitude and vigor when applied as a passive recovery technique after a high-intensity exercise protocol. Massage may induce a transient loss of muscle strength or a change in the muscle fiber tension–length relationship, influenced by alterations of muscle function and a psychological state of relaxation.The trial was funded by a research project grant (11/UPB10/06) from the Spanish Higher Sports Council

Outlier detection algorithms over fuzzy data with weighted least squares

In the classical leave-one-out procedure for outlier detection in regression analysis, we exclude an observation and then construct a model on the remaining data. If the difference between predicted and observed value is high we declare this value an outlier. As a rule, those procedures utilize single comparison testing. The problem becomes much harder when the observations can be associated with a given degree of membership to an underlying population, and the outlier detection should be generalized to operate over fuzzy data. We present a new approach for outlier detection that operates over fuzzy data using two inter-related algorithms. Due to the way outliers enter the observation sample, they may be of various order of magnitude. To account for this, we divided the outlier detection procedure into cycles. Furthermore, each cycle consists of two phases. In Phase 1, we apply a leave-one-out procedure for each non-outlier in the dataset. In Phase 2, all previously declared outliers are subjected to Benjamini–Hochberg step-up multiple testing procedure controlling the false-discovery rate, and the non-confirmed outliers can return to the dataset. Finally, we construct a regression model over the resulting set of non-outliers. In that way, we ensure that a reliable and high-quality regression model is obtained in Phase 1 because the leave-one-out procedure comparatively easily purges the dubious observations due to the single comparison testing. In the same time, the confirmation of the outlier status in relation to the newly obtained high-quality regression model is much harder due to the multiple testing procedure applied hence only the true outliers remain outside the data sample. The two phases in each cycle are a good trade-off between the desire to construct a high-quality model (i.e., over informative data points) and the desire to use as much data points as possible (thus leaving as much observations as possible in the data sample). The number of cycles is user defined, but the procedures can finalize the analysis in case a cycle with no new outliers is detected. We offer one illustrative example and two other practical case studies (from real-life thrombosis studies) that demonstrate the application and strengths of our algorithms. In the concluding section, we discuss several limitations of our approach and also offer directions for future research