1,571 research outputs found
Drenaje Urbano Sostenible
Sustainable Urban Drainage Systems (SUDS) aim the stormwater
management by getting the infiltration property of the sealed soils back, as well as
its retention capacity and peak flow attenuation. They are essential in urban area
over sandy subsoil whose absorption capacity has been voided and need to be regained.
It is depicted the situation of coastal residential areas with low slopes and
sandy soils, which require pumping to convey the water, and, thus, the energy
consumption increases to unsustainable values. Measures favouring infiltration are
needed wherever runoff is generated. Catching the stormwater by inlet grates1 results
ineffective because they become obstructed and cause damage to the sewer
pipes, thus surface drainage and filtration systems appears as a solution backed by
its implementation in countries such as USA, Great Britain and Australia for decades.
The participation of stakeholders, manager and citizen, must be considered
when implementing this techniques. Cooperation with the stakeholders in the design
process is essential to disseminate the knowledge and encourage its acceptance.
The ongoing research aims to demonstrate the benefit of efficient and
sustainable runoff management as well as the social and economic benefits involved,
contextualizing measures in the South of SpainLos Sistemas de Drenaje Urbano Sostenible (SUDS) tienen como fin
gestionar las aguas de lluvia devolviendo a los suelos impermeabilizados urbanos
su capacidad de filtración, de retención y de laminación de las escorrentías que en
ellos se generan. Se hacen indispensables en zonas urbanas donde el subsuelo está
constituido por arenas, cuya capacidad de absorción ha sido anulada y se requiere
recuperar. Se recoge la situación de las urbanizaciones costeras con bajas pendientes
y suelos arenosos, que requieren bombeos que elevan el consumo de energía a
valores insostenibles, aconsejándose el empleo de técnicas que favorezcan la filtración
al terreno de las aguas de lluvia en lugar de dejarlas escurrir. En estas zonas
el uso de imbornales resulta ineficaz por aterramiento y daño a la red de conducciones,
por ello, las técnicas de drenaje superficial y filtración constituyen una
solución, avalada por su empleo en países como EEUU, Gran Bretaña y Australia
desde hace décadas. La implantación de estas nuevas técnicas incluye la participación
de técnicos y gestores así como de la ciudadanía afectada o interesada. La inclusión
de estos actores en el proceso de diseño resulta indispensable para difundir
el conocimiento de las medidas y favorecer su aceptación. Con la investigación en
curso se espera poder demostrar el beneficio de la gestión eficaz y sostenible de
las escorrentías así como el social y económico, contextualizando las medidas en
el Sur de España
Intelligent Dolls and robots for the treatment of elderly people with dementia
Doll and robot are effective and beneficial non-pharmacological therapies applied in different clinical settings. Doll therapy (DT), principally based in Bowlby's attachment theory, uses an empathy or lifelike baby doll to conduct caring behaviors of it. Robot therapies (RT) use care robots with a friendly attitude and appearance that create emotions and movements that lead to different verbal, motor and emotional reactions. Both DT and RT are person-centred therapies that aim to improve wellbeing of people that suffer from different neurological, psychological and mental health disorders, such as Alzheimer's Disease, autism spectrum disorder, stress or depression, by providing a realistic experience. In this paper, the characteristics of both therapies, their benefits and the possibilities of innovation in the therapeutic field are presented
RING1B contributes to Ewing sarcoma development by repressing the Na(V)1.6 sodium channel and the NF-kappa B pathway, independently of the fusion oncoprotein
Ewing sarcoma (ES) is an aggressive tumor defined by EWSR1 gene fusions that behave as an oncogene. Here we demonstrate that RING1B is highly expressed in primary ES tumors, and its expression is independent of the fusion oncogene. RING1B-depleted ES cells display an expression profile enriched in genes functionally involved in hematological development but RING1B depletion does not induce cellular differentiation. In ES cells, RING1B directly binds the SCN8A sodium channel promoter and its depletion results in enhanced Nav1.6 expression and function. The signaling pathway most significantly modulated by RING1B is NF-κB. RING1B depletion results in enhanced p105/p50 expression, which sensitizes ES cells to apoptosis by FGFR/SHP2/STAT3 blockade. Reduced NaV1.6 function protects ES cells from apoptotic cell death by maintaining low NF-κB levels. Our findings identify RING1B as a trait of the cell-of-origin and provide a potential targetable vulnerability.Ministerio de Economía y Competitividad SAF2012-31089 and SAF2015-69762-RMEC FEDER RD12/0036/0017, PT13/0010/0056, RTC-2014- 2102-1, ISCIII Sara Borrell CD06/00001, PI12/03102, PI14/01466European FP7 Projects EuroSARC FP7- HEALTH-2011-two-stage, Project 278742 EUROSARCEuroewing FP7-HEALTH.2013.2.4.1-1, Project 60285
Metabolomics-guided insights on bariatric surgery versus behavioral interventions for weight loss.
Despite evidence to support their utility, lifestyle-based strategies for weight loss and treatment of obesity (i.e., based on diet and physical activity) have met so far with little success in the long term in terms of permanent weight loss (1). Bariatric surgery is the only current treatment for obesity leading to sustained weight loss (2) and to improvements in glucose regulation, up to a complet
Vascular and cognitive effects of cocoa-rich chocolate in postmenopausal women: a study protocol for a randomised clinical trial
Introduction The intake of polyphenols has certain health
benefits. This study will aim to assess the effect of adding
a daily amount of chocolate high in cocoa content and
polyphenols to the normal diet on blood pressure, vascular
function, cognitive performance, quality of life and body
composition in postmenopausal women.
Methods and analysis Here we plan a randomised
clinical trial with two parallel groups involving a
total of 140 women between 50 and 64 years in the
postmenopausal period, defined by amenorrhoea of at
least 12 consecutive months. The main variable will be
the change in blood pressure. Secondary variables will
be changes in vascular function, quality of life, cognitive
performance and body composition. The intervention
group will be given chocolate containing 99% cocoa, with
instructions to add 10 g daily to their normal diet for 6
months. The daily nutritional contribution of this amount
of chocolate is 59 kcal and 65.4 mg of polyphenols. There
will be no intervention in the control group. All variables
will be measured at the baseline visit and 3 and 6 months
after randomisation, except cognitive performance and
quality of life, which will only be assessed at baseline and
at 6 months. Recruitment is scheduled to begin on 1 June
2018, and the study will continue until 31 May 2019.
Ethics and dissemination This study was approved
by the Clinical Research Ethics Committee of the Health
Area of Salamanca, Spain (‘CREC of Health Area of
Salamanca’), in February 2018. A SPIRIT checklist is
available for this protocol. The clinical trial has been
registered at ClinicalTrials. gov provided by the US National
Library of Medicine, number NCT03492983. The results
will be disseminated through open access peer-reviewed
journals, conference presentations, broadcast media and a
presentation to stakeholders.Gerencia Regional de Castilla y León (GRS 1583/B/1
Beneficial Effect of Short-Term Supplementation of High Dose of Vitamin D3 in Hospitalized Patients With COVID-19: A Multicenter, Single-Blinded, Prospective Randomized Pilot Clinical Trial.
There is now sufficient evidence to support that vitamin D deficiency may predispose to SARS-CoV-2 infection and increase COVID-19 severity and mortality. It has been suggested that vitamin D3 supplementation may be used prophylactically as an affordable and safe strategy that could be added to the existing COVID-19 standard treatment. This multicenter, single-blinded, prospective randomized pilot clinical trial aimed to evaluate the safety, tolerability, and effectiveness of 10,000 IU/day in comparison with 2000 IU/day of cholecalciferol supplementation for 14 days to reduce the duration and severity of COVID-19 in 85 hospitalized individuals. The median age of the participants was 65 years (Interquartile range (IQR): 53-74), most of them (71%) were men and the mean baseline of 25-hydroxyvitamin D (25(OH)D) in serum was 15 ng/ml (standard deviation (SD):6). After 14 days of supplementation, serum 25(OH)D levels were significantly increased in the group who received 10,000IU/day (p < 0.0001) (n = 44) in comparison with the 2,000IU/day group (n = 41), especially in overweight and obese participants, and the higher dose was well tolerated. A fraction of the individuals in our cohort (10/85) developed acute respiratory distress syndrome (ARDS). The median length of hospital stay in these patients with ARDS was significantly different in the participants assigned to the 10,000IU/day group (n = 4; 7 days; IQR: 4-13) and the 2,000IU/day group (n = 6; 27 days; IQR: 12-45) (p = 0.04). Moreover, the inspired oxygen fraction was reduced 7.6-fold in the high dose group (p = 0.049). In terms of blood parameters, we did not identify overall significant improvements, although the platelet count showed a modest but significant difference in those patients who were supplemented with the higher dose (p = 0.0492). In conclusion, the administration of 10,000IU/day of vitamin D3 for 14 days in association with the standard clinical care during hospitalization for COVID-19 was safe, tolerable, and beneficial, thereby helping to improve the prognosis during the recovery process.This work was supported by Fundación Universidad Alfonso X el Sabio (FUAX, Madrid, Spain; ID Project: 1.012.010; ID Project EQA: 925.280); the Coordinated Research Activities at the National Center of Microbiology (Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr. Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain). The work of Montserrat Torres was financed by the Coordinated Research Activities at the CNM (Instituto de Salud Carlos III) (COV20_00679). The work of Lorena Vigón was supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Sara Rodríguez-Mora was financed by NIH grant R01AI143567.S
Behavioural intervention to reduce disruptive behaviours in adult day care centres users: A randomizsed clinical trial (PROCENDIAS study)
[ENG]Aim: This study assesses the effect of an intervention to reduce the disruptive behaviours
(DB) presented by care recipient users of adult day care centres (ADCC),
thereby reducing caregiver overload. While ADCC offer beneficial respite for family
caregivers, the DB that many care recipients show promote resistance to attending
these centres, which can be a great burden on their family caregivers.
Design: Randomized controlled clinical trial.
Methods: The study was carried out with 130 family caregivers of people attending
seven ADCC in the municipality of Salamanca (Spain), randomly distributed into intervention
and control groups. The intervention was applied across eight sessions, one
per week, in groups of 8–10 people where caregivers were trained in the Antecedent-
Behavior-Consequence (ABC) model of functional behaviour analysis. The primary
outcome was the reduction of DB measured with the Revised Memory and Behavior
Problems Checklist (RMBPC).
Results: An average reduction in the RMBPC of 4.34 points was obtained in the intervention
group after applying the intervention (p < 0.01 (U de Mann–Whitney); Cohen
d = 1.00); furthermore, differences were found in the Center for Epidemiologic
Studies Depression Scale (CES-D) (U = −2.67; p = 0.008; Cohen d = 0.50) and in the
Short Zarit Burden Interview (Short ZBI) (t = −4.10; p < 0.01; Cohen d = 0.98).
Conclusion: The results obtained suggest that the implementation of this intervention
could reduce both the frequency of DB occurrence and the reaction of the caregiver
to their appearance. Improvement was also noted in the results regarding overload
and emotional state of the family caregiver.
Impact: To our knowledge, this is the first randomized clinical trial to show that an
intervention based on the ABC model could reduce the frequency and reaction of DB
of care recipients in ADCC increasing their quality of life, and improving the mental
health and overload of their family caregivers
Combined use of smartphone and smartband technology in the improvement of lifestyles in the adult population over 65 years: study protocol for a randomized clinical trial (EVIDENT-Age study)
Background
The increasing use of smartphones by older adults also increases their potential for improving different aspects of health in this population. Some studies have shown promising results in the improvement of cognitive performance through lifestyle modification. All this may have a broad impact on the quality of life and carrying out daily living activities. The objective of this study is to evaluate the effectiveness of combining the use of smartphone and smartband technology for 3 months with brief counseling on life habits, as opposed to providing counseling only, in increasing physical activity and improving adherence to the Mediterranean diet. Secondary objectives are to assess the effect of the intervention on body composition, quality of life, independence in daily living activities and cognitive performance.
Methods
This study is a two-arm cluster-randomized trial that will be carried out in urban health centers in Spain. We will recruit 160 people aged between 65 and 80 without cardiovascular disease or cognitive impairment (score in the Mini-mental State Examination ≥24). On a visit to their center, intervention group participants will be instructed to use a smartphone application for a period of 3 months. This application integrates information on physical activity received from a fitness bracelet and self-reported information on the patient’s daily nutritional composition. The primary outcome will be the change in the number of steps measured by accelerometer. Secondary variables will be adherence to the Mediterranean diet, sitting time, body composition, quality of life, independence in daily living activities and cognitive performance. All variables will be measured at baseline and on the assessment visit after 3 months. A telephone follow-up will be carried out at 6 months to collect self-reported data regarding physical activity and adherence to the Mediterranean diet.
Discussion
Preventive healthy aging programs should include health education with training in nutrition and lifestyles, while stressing the importance of and enhancing physical activity; the inclusion of new technologies can facilitate these goals. The EVIDENT-AGE study will incorporate a simple, accessible intervention with potential implementation in the care of older adults.This study was supported in part by grants funded by the Instituto de Salud
Carlos III, Institute of Biomedical Research of Salamanca (IBSAL)-IBY17/00003,
and the Spanish Research Network for Preventive Activities and Health
Promotion in Primary Care (REDIAPP)-RD16/0007
Detection of mild cognitive impairment in people older than 65 years of age and its relationship to cardiovascular risk factors (DECRIVAM)
[ENG]Background: Studies centered on the detection of cognitive impairment and its relationship to cardiovascular risk factors in elderly people have gained special relevance in recent years. Knowledge of the cardiovascular risk factors that may be associated to cognitive impairment could be very useful for introducing treatments in early stagesthereby possibly contributing to improve patient quality of life. The present study explores cognitive performance in people over 65 years of age in Salamanca (Spain), with special emphasis on the identification of early symptoms of cognitive impairment, with the purpose of detecting mild cognitive impairment and of studying the relationships between this clinical situation and cardiovascular risk factors. Methods/Design: A longitudinal study is contemplated. The reference population will consist of 420 people over 65 years of age enrolled through randomized sampling stratified by healthcare area, and who previously participated in another study. Measurement: a) Sociodemographic variables; b) Cardiovascular risk factors; c) Comorbidity; d) Functional level for daily life activities; and e) Study of higher cognitive functions based on a neuropsychological battery especially adapted to the evaluation of elderly people. Discussion: We hope that this study will afford objective information on the representative prevalence of cognitive impairment in the population over 65 years of age in Salamanca. We also hope to obtain data on the relationship between cognitive impairment and cardiovascular risk factors in this specific population group. Based on the results obtained, we also will be able to establish the usefulness of some of the screening tests applied during the study, such as the Mini-Mental State Examination and the 7 Minute Screen test. Trial registration: ClinicalTrials.gov: NCT0132719
Sustained Cytotoxic Response of Peripheral Blood Mononuclear Cells from Unvaccinated Individuals Admitted to the ICU Due to Critical COVID-19 Is Essential to Avoid a Fatal Outcome
The main objective of this study was to determine the influence of the cytotoxic activity of peripheral blood mononuclear cells (PBMCs) on the outcome of unvaccinated individuals with critical COVID-19 admitted to the ICU. Blood samples from 23 individuals were collected upon admission and then every 2 weeks for 13 weeks until death (Exitus group) (n = 13) or discharge (Survival group) (n = 10). We did not find significant differences between groups in sociodemographic, clinical, or biochemical data that may influence the fatal outcome. However, direct cellular cytotoxicity of PBMCs from individuals of the Exitus group against pseudotyped SARS-CoV-2-infected Vero E6 cells was significantly reduced upon admission (−2.69-fold; p = 0.0234) and after 4 weeks at the ICU (−5.58-fold; p = 0.0290), in comparison with individuals who survived, and it did not improve during hospitalization. In vitro treatment with IL-15 of these cells did not restore an effective cytotoxicity at any time point until the fatal outcome, and an increased expression of immune exhaustion markers was observed in NKT, CD4+, and CD8+ T cells. However, IL-15 treatment of PBMCs from individuals of the Survival group significantly increased cytotoxicity at Week 4 (6.18-fold; p = 0.0303). Consequently, immunomodulatory treatments that may overcome immune exhaustion and induce sustained, efficient cytotoxic activity could be essential for survival during hospitalization due to critical COVID-19.This work was supported by the Coordinated Research Activities at the National Center of Microbiology (CNM, Instituto de Salud Carlos III) (COV20_00679) to promote an integrated response against SARS-CoV-2 in Spain (Spanish Ministry of Science and Innovation) that is coordinated by Dr Inmaculada Casas (WHO National Influenza Center of the CNM); a generous donation provided by Chiesi España, S.A.U. (Barcelona, Spain); the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Guiomar Casado is financed by CIBERINFEC, co-financed by the European Regional Development Fund (FEDER) “A way to make Europe”. The work of Montserrat Torres is supported by Instituto de Salud Carlos III (COV20_00679). The work of Fernando Ramos Martín is financed by the Spanish Ministry of Science and Innovation (PID2019-110275RB-I00). The work of Mario Manzanares is supported by a pre-doctoral grant from Instituto de Salud Carlos III (ISCIII-PFIS FI20CIII/00021). The work of Lorena Vigón is supported by a pre-doctoral grant from Instituto de Salud Carlos III (FIS PI16CIII/00034-ISCIII-FEDER). The work of Sara Rodríguez-Mora is financed by NIH grant R01AI143567.N
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