Evaluación cualitativa del programa comunitario Irunsasoi para la promoción de la actividad física: la perspectiva de los médicos

Objectives: The sedentarism is an important conditioner of morbidity and mortality. The communitarian programs of promotion of physical activity that include a pursuit protocol can help and complement to the medical advice in the consultation. The objectives that we marked ourselves with this study have been to know the opinion the doctors on the prescription of physical activity and the implantation of the Irunsasoi program, collaboration between the doctors of Primary Attention and the technicians of physical activity of the council of Irún City to help the sedentary people. Methodology Design: Technique of focal groups. The discussions were recorded and later transcribed, previous authorization, for their analysis. Location: Primary attention. Irún Centro health Center. Subjects: The study population was the 15 doctors of AP. Two groups of 5 doctors, homogenous were made in age and sex, the recruitment was made, the invitation at random to participate was verbal by the investigator without no refusal took place. Measures: The discussion lines were grouped in: attitude before the advice and participation in the program, difficulties of collaboration and proposals of improvement. Results: Positive evaluation of the program to have enabled personnel, sufficient time and guarantees of pursuit. The collaboration difficulties are based on the forgetfulness not to have it built-in to our mechanics of work and to wort in other activities by lack of time. Conclusions: He is positive to work jointly with the technicians of physical activity. Aspects to improve: the formation in prescription of physical activity, the implication of nurses, the circuit of communication and the support in computerized historyObjetivos: El sedentarismo es un importante condicionante de morbilidad y mortalidad. Los programas comunitarios de promoción de actividad física que incluyan un protocolo de seguimiento pueden ayudar y complementar al consejo médico en la consulta. Los objetivos que nos marcamos con este estudio han sido conocer la opinión de los médicos sobre la prescripción de actividad física y sobre la implantación del programa Irunsasoi, de colaboración entre los médicos de Atención Primaria y los técnicos de actividad física del Ayuntamiento de Irún para ayudar a las personas sedentarias. Metodología: Diseño: Técnica de grupos focales. Las discusiones fueron grabadas y posteriormente transcritas, previa autorización, para su análisis. Emplazamiento: Atención primaria. Centro de salud Irún Centro. Sujetos: La población de estudio fueron los 15 médicos de AP. Se realizaron dos grupos de 5 médicos, homogéneos en edad y sexo, el reclutamiento se realizó al azar, la invitación a participar fue verbal por el investigador sin que se produjera ninguna negativa. Medidas: Los ejes de discusión se agruparon en: actitud ante el consejo y participación en el programa, dificultades de colaboración y propuestas de mejora. Resultados: Valoración positiva del programa por disponer de personal capacitado, tiempo suficiente y garantías de seguimiento. Las dificultades de colaboración se basan en el olvido por no tenerlo incorporado a nuestra mecánica de trabajo y priorización de otras actividades por falta de tiempo. Conclusiones: Es positivo trabajar conjuntamente con los técnicos de actividad física. Aspectos a mejorar: la formación en prescripción de actividad física, la implicación de enfermería, el circuito de comunicación y el soporte en la historia informatizad

A plasma fatty acid profile associated to type 2 diabetes development: from the CORDIOPREV study

Purpose: The prevalence of type 2 diabetes mellitus (T2DM) is increasing worldwide. For this reason, it is essential to identify biomarkers for the early detection of T2DM risk and/or for a better prognosis of T2DM. We aimed to identify a plasma fatty acid (FA) profile associated with T2DM development. Methods: We included 462 coronary heart disease patients from the CORDIOPREV study without T2DM at baseline. Of these, 107 patients developed T2DM according to the American Diabetes Association (ADA) diagnosis criteria after a median follow-up of 60 months. We performed a random classification of patients in a training set, used to build a FA Score, and a Validation set, in which we tested the FA Score. Results: FA selection with the highest prediction power was performed by random survival forest in the Training set, which yielded 4 out of the 24 FA: myristic, petroselinic, α-linolenic and arachidonic acids. We built a FA Score with the selected FA and observed that patients with a higher score presented a greater risk of T2DM development, with an HR of 3.15 (95% CI 2.04–3.37) in the Training set, and an HR of 2.14 (95% CI 1.50–2.84) in the Validation set, per standard deviation (SD) increase. Moreover, patients with a higher FA Score presented lower insulin sensitivity and higher hepatic insulin resistance (p < 0.05). Conclusión: Our results suggest that a detrimental FA plasma profile precedes the development of T2DM in patients with coronary heart disease, and that this FA profile can, therefore, be used as a predictive biomarker

Reappraising the production and transfer of hydrogen atoms from the middle to the upper atmosphere of Mars at times of elevated water vapor

Water escape on Mars has recently undergone a paradigm shift with the discovery of unexpected seasonal variations in the population of hydrogen atoms in the exosphere where thermal escape occurs and results in water lost to space. This discovery led to the hypothesis that, contradicting the accepted pathway, atomic hydrogen in the exosphere was not only produced by molecular hydrogen but mostly by high altitude water vapor. Enhanced presence of water at high altitude during southern spring and summer, due to atmospheric warming and intensified transport, favors production of H through photon-induced ion chemistry of water molecules and thus appears to be the main cause of the observed seasonal variability in escaping hydrogen. This hypothesis is supported by the observation of large concentrations of water vapor between 50 km and 150 km during the southern summer solstice and global dust events. Using a simplified yet representative air parcel transport model, we show that in addition to the formation of atomic hydrogen from water photolysis above 80 km, a major fraction of the exospheric hydrogen is formed at altitudes as low as 60 km and is then directly advected to the upper atmosphere. Comparing the injection modes of a variety of events (global dust storm, perihelion periods, regional storm), we conclude that southern spring/summer controls H production and further ascent into the upper atmosphere on the long term with direct implication for water escape

An altered microbiota pattern precedes Type 2 diabetes mellitus development: From the CORDIOPREV study

Introduction. A distinctive gut microbiome have been linked to type 2 diabetes mellitus (T2DM). We aimed to evaluate whether gut microbiota composition, in addition to clinical biomarkers, could improve the prediction of new incident cases of diabetes in patients with coronary heart disease. Methods All the patients from the CORDIOPREV (Clinical Trials.gov.Identifier: NCT00924937) study without T2DM at baseline were included (n = 462). Overall, 107 patients developed it after a median of 60 months. The gut microbiota composition was determined by 16S rRNA gene sequencing and predictive models were created using hold-out method. Results. A gut microbiota profile associated with T2DM development was determined through a microbiome-based predictive model. The addition of microbiome data to clinical parameters (variables included in FINDRISC risk score and the diabetes risk score of the American Diabetes Association, HDL, triglycerides and HbA1c) improved the prediction increasing the area under the curve from 0.632 to 0.946. Furthermore, a microbiome-based risk score including the ten most discriminant genera, was associated with the probability of develop T2DM. Conclusión. These results suggest that a microbiota profile is associated to the T2DM development. An integrate predictive model of microbiome and clinical data that can improve the prediction of T2DM is also proposed, if is validated in independent populations to prevent this disease

Troposphere-to-mesosphere microphysics of carbon dioxide ice clouds in a Mars Global Climate Model

We have implemented full CO ice cloud microphysics into the LMD Mars Global Climate Model (MGCM) and we have conducted the first global simulations. The microphysical model implementation follows the modal scheme used for water ice cloud microphysics in the MGCM, but includes specific aspects that need to be accounted for when dealing with CO ice clouds. These include nucleation of CO on water ice crystals and CO condensation theory adapted for the Martian conditions. The model results are compared to available observations globally, and separately for polar regions and equatorial mesosphere. The observed seasonal and latitudinal variability of the CO ice clouds is in general reproduced. The polar regions are covered by CO ice clouds during the winter as observed. Instead of forming only in the lowest 10–15 km of the atmosphere, they extend up to several tens of kilometers above the surface in the model, dictated by the modeled temperature structure. We have also quantified the contribution of the cloud microphysics to the surface CO ice deposits. Snowfall from these clouds contributes up to 10% of the atmosphere–surface ice flux in the polar regions in our simulations, in the range that has been indirectly deduced from observations. In the mesosphere, notable amounts of CO ice clouds form only when water ice crystals are used as condensation nuclei in addition to dust particles, and their spatial distribution is in agreement with observations. The mesospheric temperature structure, dominated by tides, dictates the longitudinal and seasonal distribution of these clouds. The seasonal and local time variations of the clouds are not fully reproduced by the model. There is a long pause in CO ice cloud formation in the model around the aphelion season, but clouds have been observed during this period, although with a lower apparition frequency. Modeled mesospheric clouds form mainly during the night and in the morning, whereas during the daytime, when most of the cloud observations have been made, the model rarely predicts clouds. These discrepancies could be explained by the strong dependence of the cloud formation process on mesospheric temperatures that are themselves challenging to reproduce and sensitive to the MGCM processes and parameters. The rare possibilities for nighttime observations might also bias the observational climatologies towards daytime detections. Future developments of the model consist in the inclusion of a possible exogenous condensation nucleus source in the mesosphere and the radiative effect of CO ice clouds. © 2022 Elsevier Inc. All rights reserved.This paper presents the results of ten years of development that has been supported by funding from several sources. We thank the Agence National de la Recherche for funding (project MECCOM, ANR-18-CE31-0013). We are also grateful for the financial support by the LabEx (Laboratoire d’Excellence) ESEP, by the French space agency CNES and the European Space Agency ESA. We acknowledge the support of the French national planetology programme (PNP) as well. F.G.-G. is funded by the Spanish Ministerio de Ciencia, Innovación y Universidades, the Agencia Estatal de Investigación and EC FEDER funds under project RTI2018-100920-J-I00, and acknowledges financial support from the State Agency for Research of the Spanish MCIU through the Center of Excellence Severo Ochoa” award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709). This work was performed using HPC computing resources from GENCI-CINES (Grant 2021-A0100110391), and resources at the ESPRI mesocentre of the IPSL institute .Peer reviewe

HYPEST study: profile of hypertensive patients in Estonia

<p>Abstract</p> <p>Background</p> <p>More than one third of adult population in Estonia has problems with elevated blood pressure (BP). The <it>Hypertension in Estonia </it>(HYPEST) study represents the country's first hypertension-targeted sample collection aiming to examine the epidemiological and genetic determinants for hypertension (HTN) and related cardiovascular diseases (CVD) in Estonian population. The HYPEST subjects (n = 1,966) were recruited across Estonia between 2004-2007 including clinically diagnosed HTN cases and population-based controls. The present report is focused on the clinical and epidemiological profile of HYPEST cases, and gender-specific effects on the pathophysiology of hypertension.</p> <p>Methods</p> <p>Current analysis was performed on 1,007 clinically diagnosed HTN patients (617 women and 390 men) aged 18-85 years. The hypertensives were recruited to the study by BP specialists at the North Estonia Medical Center, Centre of Cardiology, Tallinn or at the Cardiology Clinic, Tartu University Hospital, Estonia. Longitudinal BP data was extracted retrospectively from clinical records. Current and retrospective data of patient's medical history, medication intake and lifestyle habits were derived from self-administrated questionnaire and each variable was examined separately for men and women. Eleven biochemical parameters were measured from fasting serum samples of 756 patients.</p> <p>Results</p> <p>The distribution of recruited men and women was 39% and 61% respectively. Majority of Estonian HTN patients (85%) were overweight (BMI ≥ 25 kg/m²) and a total of 79% of patients had additional complications with cardiovascular system. In men, the hypertension started almost 5 years earlier than in women (40.5 ± 14.5 vs 46.1 ± 12.7 years), which led to earlier age of first myocardial infarction (MI) and overall higher incidence rate of MI among male patients (men 21.2%, women 8.9%, <it>P </it>< 0.0001). Heart arrhythmia, thyroid diseases, renal tubulo-intestinal diseases and hyperlipidemia were more prevalent in hypertensive women compared to men (<it>P </it>< 0.0001). An earlier age of HTN onset was significantly associated with smoking (<it>P </it>= 0.00007), obesity (BMI ≥ 30 kg/m²; <it>P </it>= 0.0003), increased stress (<it>P </it>= 0.0003) and alcohol consumption (<it>P </it>= 0.004).</p> <p>Conclusion</p> <p>Understanding the clinical profile of HTN patients contributes to CVD management. Estonian hypertension patients exhibited different disease and risk profiles of male and female patients. This well-characterized sample set provides a good resource for studying hypertension and other cardiovascular phenotypes.</p

Hydroxychloroquine is associated with a lower risk of polyautoimmunity: data from the RELESSER Registry

OBJECTIVES: This article estimates the frequency of polyautoimmunity and associated factors in a large retrospective cohort of patients with SLE. METHODS: RELESSER (Spanish Society of Rheumatology Lupus Registry) is a nationwide multicentre, hospital-based registry of SLE patients. This is a cross-sectional study. The main variable was polyautoimmunity, which was defined as the co-occurrence of SLE and another autoimmune disease, such as autoimmune thyroiditis, RA, scleroderma, inflammatory myopathy and MCTD. We also recorded the presence of multiple autoimmune syndrome, secondary SS, secondary APS and a family history of autoimmune disease. Multiple logistic regression analysis was performed to investigate possible risk factors for polyautoimmunity. RESULTS: Of the 3679 patients who fulfilled the criteria for SLE, 502 (13.6%) had polyautoimmunity. The most frequent types were autoimmune thyroiditis (7.9%), other systemic autoimmune diseases (6.2%), secondary SS (14.1%) and secondary APS (13.7%). Multiple autoimmune syndrome accounted for 10.2% of all cases of polyautoimmunity. A family history was recorded in 11.8%. According to the multivariate analysis, the factors associated with polyautoimmunity were female sex [odds ratio (95% CI), 1.72 (1.07, 2.72)], RP [1.63 (1.29, 2.05)], interstitial lung disease [3.35 (1.84, 6.01)], Jaccoud arthropathy [1.92 (1.40, 2.63)], anti-Ro/SSA and/or anti-La/SSB autoantibodies [2.03 (1.55, 2.67)], anti-RNP antibodies [1.48 (1.16, 1.90)], MTX [1.67 (1.26, 2.18)] and antimalarial drugs [0.50 (0.38, 0.67)]. CONCLUSION: Patients with SLE frequently present polyautoimmunity. We observed clinical and analytical characteristics associated with polyautoimmunity. Our finding that antimalarial drugs protected against polyautoimmunity should be verified in future studies

International consensus guidelines for phosphoglucomutase 1 deficiency (PGM1-CDG): Diagnosis, follow-up, and management

P. W. is supported by the Clinical Research Fund, University Hospitals Leuven, Leuven, Belgium. This work is partially funded by the grant titled Frontiers in Congenital Disorders of Glycosylation (1U54NS115198-01) from the National Institute of Neurological Diseases and Stroke (NINDS), the National Center for Advancing Translational Sciences (NCATS), and the Rare Disorders Consortium Research Network (RDCRN) (E. M., K. R., C. F., H. F., C. L., and A. E.)Phosphoglucomutase 1 (PGM1) deficiency is a rare genetic disorder that affects glycogen metabolism, glycolysis, and protein glycosylation. Previously known as GSD XIV, it was recently reclassified as a congenital disorder of glycosylation, PGM1-CDG. PGM1-CDG usually manifests as a multisystem disease. Most patients present as infants with cleft palate, liver function abnormalities and hypoglycemia, but some patients present in adulthood with isolated muscle involvement. Some patients develop life-threatening cardiomyopathy. Unlike most other CDG, PGM1-CDG has an effective treatment option, d-galactose, which has been shown to improve many of the patients' symptoms. Therefore, early diagnosis and initiation of treatment for PGM1-CDG patients are crucial decisions. In this article, our group of international experts suggests diagnostic, follow-up, and management guidelines for PGM1-CDG. These guidelines are based on the best available evidence-based data and experts' opinions aiming to provide a practical resource for health care providers to facilitate successful diagnosis and optimal management of PGM1-CDG patients.preprintpublishe

The Mars Climate Database, version 6.1

The Mars Climate Database (MCD) is a database of meteorological fields derived from General Circulation Model (GCM) numerical simulations of the Martian atmosphere and validated using available observational data. The MCD includes complementary post-processing schemes such as high spatial resolution interpolation of environmental data and means of reconstructing the variability thereof. The GCM that is used to create the MCD data is developed at Laboratoire de Météorologie Dynamique du CNRS (Paris, France) [1] in collaboration with LATMOS (Paris, France), the Open University (UK), the Oxford University (UK) and the Instituto de Astrofisica de Andalucia (Spain) with support from the European Space Agency (ESA) and the Centre National d'Etudes Spatiales (CNES). The latest version of the MCD, version 5.3 [2], was released in July 2017, and at the time of writing of this abstract we are working on MCDv6.1, which we will release in May 2022. This new version will benefit from all the recent developments and improvements [1,3-5] in the GCM’s physics package. The MCD is freely distributed and intended to be useful and used in the framework of engineering applications as well as in the context of scientific studies which require accurate knowledge of the state of the Martian atmosphere. Over the years, various versions of the MCD have been released and handed to more than 400 teams around the world. Current applications include entry descent and landing (EDL) studies for future missions, investigations of some specific Martian issues (via coupling of the MCD with homemade codes), analysis of observations (Earth-based as well as with various instruments onboard Mars Express, Mars Reconnaissance Orbiter, Maven, Trace Gas Orbiter, Hope),... The MCD is freely available upon request via an online form on the dedicated website: http://wwwmars.lmd.jussieu.fr which moreover includes a convenient web interface for quick looks

Challenges in Mars climate modelling with the LMD Mars Global Climate Model, now called the Mars “Planetary Climate Model” (PCM)

The Mars atmosphere Global Climate Model (GCM) developed at the Laboratoire de Météorologie Dynamique [1] in collaboration with several teams around the world (LATMOS, the Instituto de Astrofisica de Andalucia, UAE University, University of Oxford, The Open University), and with the support of ESA and CNES is currently used for many kinds of applications. It simulates Mars from the subsurface to the top of the thermosphere and includes the cycles of dust, water and CO2 that control the current Martian climate as well as a photo-chemical/ionospheric module. The aim of this modeling is high: ultimately to build a numerical simulator based only on universal equations, yet able to consistently reproduce available observations. The goal is to create a realistic virtual planet on which all observed phenomena and climate-induced geological landforms arise naturally. Like for the other similar models in the community, this specific goal is a scientific endeavour by itself. Such a GCM can also provide useful environmental predictions that can be used to process observations or prepare space missions. For this purpose our teams have produced the Mars Climate Database (See Millour et al., this issue) which provides climatologies derived from GCM simulations completed by dedicated tools. The GCM is also used to perform meteorological data assimilation to create an optimal description of the Martian environment obtained by combining observation and model simulations (See e.g. Young et al., Read et al., Holmes et al., this issue)