The Effectiveness of a Program of Physical Activity and Diet to Modify Cardiovascular Risk Factors in Patients with Severe Mental Illness (CAPiCOR Study)

Background: Patients with severe mental disorders have a higher prevalence of cardiovascular risk factors. Obesity and sedentarism are cardiovascular risk factors and their control reduces morbidity and mortality. Thus, interventions directed toward decreasing weight and/ or increasing the level of physical activity are necessary.Objectives: The aim of this study would be to evaluate the effectiveness of an educational intervention focused on diet and physical activity in order to change the amount of physical activity, Body Mass Index and waist circumference in these patients.Design: Randomized clinical trial with a control group with one-year follow-up.Setting: Outpatient Mental Health Teams of Barcelona and a residence for patients with severe mental disorders.Participants: Patients between 18 and 65 years of age diagnosed with schizophrenia, a schizoaffective disorder or bipolar disorder in treatment with antipsychotic medication and a low level of physical activity (240 patients in each randomized group).Intervention group: Physical activity group educational program of 24 sessions over 12 weeks and diet (16 sessions in the fist 8 weeks) carried out by nurses and physical activity specialists.Control group: Usual practice with regular checks and the usual treatment of their disease.Main outcome measures: Level of physical activity (IPAQ questionnaire), weight, Body Mass Index and waist circumference.Other outcomes: Cardiovascular risk, quality of life (SF-36 questionnaire), tobacco consumption, dietary habit (PREDIMED questionnaire), blood pressure and laboratory parameters (cholesterol, triglycerides, glucose).Evaluations will be masked and will be made at 0, 3, 6 and 12 months.Data analysis: Intention to treat analysis. Analysis of variance for repeated measures to adjust for differences attributable to the effect of the intervention for potential confounders (drug treatment, care level of intervention and mental status of the patient).Ethical aspects: The project has been evaluated and approved by the ethics committee (CEIC) of the Primary Healthcare-University Research Institute IDIAP Jordi Gol, with registration number P11/64.Trial registration: Clinicaltrials.gov NCT01729650

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved

Software for Teaching Emotions to Students with Autism Spectrum Disorder

This paper reports the results of a research project in which educational software was used to teach social and emotional skills to primary and secondary school students with autism spectrum disorders (ASD). The participants with difficulties in recognizing emotional states were nine male and female students aged between 8 and 18, with a mental age range of between 5 and 7 years. A single group design with pre-test/post-test was used. The students were assessed before teaching in relation to their levels of social and emotional skills. This assessment was intended to set the starting level of the teaching process for each student. The educational intervention consisted of two 45-minute weekly sessions for 20 weeks over two academic years (2006/2008). Following the intervention, each student was again assessed. Results indicate that the pupils improved their performance in tasks that evaluate the ability to recognize and understand emotional expressions. These results confirmed that the use of educational software for teaching social and emotional skills helps students with ASD to improve their ability to perform tasks aimed at the understanding of emotional skills. In addition, the participants improved their social skills significantly, a fact that was noticed by both teachers and families

Hybrid SGP4 propagator based on machine-learning techniques applied to GALILEO-type orbits

ResumenSpace Situational Awareness current needs demand innovative solutions to the orbit propagation problem, so as to find new algorithms which are simultaneously accurate and fast. The hybrid methodology for orbit propagation constitutes a recent approach based on modeling the error of any orbit propagator with the aim of complementing its calculations and hence enhancing its precision. Diverse sources of inaccuracy can exist in propagators, such as incomplete perturbation models, forces not considered, low-order of the series expansions, etc. The creation of a time series with the differences between ephemerides computed with low-accuracy propagators and their corresponding real observations (or precisely computed ephemerides) allows applying time-series forecasting techniques so as to create a model that includes any dynamics not contained in the original propagator. Then, the adjusted model can be used in order to correct other future predictions. We present an application of the hybrid methodology, in which the time-series forecasting process is performed by means of machine-learning techniques, to the well-known SGP4 propagator. We have adjusted the resulting Hybrid SGP4 propagator, HSGP4, to the case of Galileo-type orbits. We will show how the use of HSGP4 can reduce the position error of SGP4, hence extending the validity of Two-Line Elements (TLE) from Galileo satellites.</p

The Triterpenes of Kageneckia oblonga

Three known triterpenes were isolated from leaf extracts of Kageneckia oblonga by conventional chromatographic methods: ursolic acid, benthamic acid and a third called Kc-III. The structure of Kc-III was determined by RMN spectroscopy, FT-IT and HR-MS. The compound was identified as fern-7-en-3β-ol (motiol), not previously reported in Kageneckia