Validity of a four-factor modelunderlying the physical fitness in adults with intellectual disabilities a confirmatory factor analysis

Purpose: To use confirmatory factor analysis to test whether a four factor might explain the clustering of the components of the physical fitness in adults with intellectual disabilities (FID). Relevance: Individuals with intellectual disabilities (ID) are significantly weaker than individuals without ID at all stages of life. These subjects might be particularly susceptible to loss of basic function because of poor physical fitness. Participants: We studied 267 adults with intellectual disability of the Spanish Special Olympics Games. Methods: The four-factor model included: the flexibility, the strength, the balance and the cardiorespiratory endurance with 9 variables of the fitness assessment. Analysis: The construct validity of the model was assessed through the factor loadings, interpreted as the correlation between the variables in the model and their underlying factor, which is the FID construct. Results: Factor loading were 0,55 for the passive knee extension, o,52 for Functional shoulder rotation, −0.71 for the timed-stand test, 0.58 for the grip test, 0.75 the single leg stance with eyes open, 0.69 single leg stance with eyes closed, 0.72 for the resting heart rate, 0.56 for the two-minute step test (2MST) 0,97 for 2 minutes after finish 2MST. The four-factor model also showed a good fit to the data, as indicated by a high comparative fit index (CFI=0,93) and a low standardized root mean square residual (SRMR=0,072) Conclusions: A four underlying factor has shown acceptable validity to represent FID Implications: The new model of FID can offer understanding better these construct in this special populationUniversidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Effect of obesity in Independence and balance in people with intelectual disability

Background People with obesity often have problems with postural control. Some studies show that people with intellectual disabilities (ID) have a higher likelihood of having falls than the general population, with a prevalence in adults of between 29% and 70% (Cox et al., 2010). Currently, there are no studies that show the effects of obesity on independence and balance in people with ID. The objective of our study is analyse, in people with ID, the degree of influence that obesity has on independence with regard to activities of daily living, static and semi-static balance. Therefore, we can compare two groups: obese people and non-obese people. Our hypothesis is that obesity will exercise a negative influence on static and semi-static balance as well as on independence and the development of the activities of daily living. Method In a cross-sectional study, we compared static and semi-static balance in two groups of people with ID: the obese and the non-obese. All those in the sample had a low ID (IQ: 70-50) to mild ID (IQ 50-35). To measure balance we used a single leg balance test (SLBT) with opened eyes and closed eyes, and a functional reach test (FRT). In order to measure levels of dependence we used a Barthel index. The outcome variables were: time in balance in SLBT open eyes/closed eyes), maximum range of FRT and Barthel index. Results and Discussion We found significant differences in all outcome variables between two groups. To our knowledge, this is the first study to analyze how obesity affects independence, static balance and semi-static balance in people with ID. However, other studies have analyzed the effects of obesity on the general population (Singh et al., 2009). In both studies (General population: Singh et al. 2009 and people with ID in this study) we observed that obesity can be a determinant of negatively static balance and semi-static balance. Conclussion The main conclusion of this study is that obesity has a negative effect on independence, static balance and semi-static balance in people with ID. These results would have been carried out when we carry out an intervention on people with ID to prevent falls. References - Cox CR, Clemson L, Stancliffe RJ, Durvasula S, Sherrington C. Incidence of and risk factors for falls among adults with an intellectual disability. J Intellect Disabil Res. 2010 Dec;54(12):1045-57. doi: 10.1111/j.1365-2788.2010.01333.x. - Enkelaar L, Smulders E, van Schrojenstein Lantman-de Valk H, Weerdesteyn V, Geurts AC. Clinical measures are feasible and sensitive to assess balance and gait capacities in older persons with mild to moderate Intellectual Disabilities. Res Dev Disabil. 2013 Jan;34(1):276-85. doi: 10.1016/j.ridd.2012.08.014. - Singh D, Park W, Levy MS, Jung ES. The effects of obesity and standing time on postural sway during prolonged quiet standing. Ergonomics. 2009 Aug;52(8):977-86.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Partial oxidation of hydrogen sulphide to sulphur over vanadium oxides bronzes

[EN] Me-containing V2O5 materials (Me =Ag, Cu, Ca and Na) were prepared hydrothermally (from aqueous gels containing V2O5/H2O2/MeClx mixtures, with Me/V ratios of 0.17). The samples were finally heattreated in air or in N2 atmosphere. The heat-treated samples have been characterized by several physicochemical techniques and tested in the partial oxidation of hydrogen sulfide. According to XRD, electron paramagnetic resonance and 51V NMR results, Ag0.35V2O5 and Na0.33V2O5 (or NaV6O15) bronzes with a minority presence of V2O5 were mainly obtained in the case of Ag- and Na-containing materials in samples both heat-treated in air or in N2 atmosphere. In the case of Cu- and Ca-containing samples, V2O5 was mainly observed in samples calcined in air. However, Cu0.26V2O5 and Ca0.17V2O5 bronzes, with the minority presence of V2O5, have been observed in Cu- and Ca-containing samples heat-treated in N2. On the other hand, the catalytic behavior strongly depends on the metal promoter. Thus catalysts presenting vanadium oxide bronzes, i.e. samples presenting Ag0.35V2O5, NaV6O15, Cu0.26V2O5 or Ca0.17V2O5 shows a catalytic activity during the partial oxidation of H2S to sulfur higher than that observed over pure V2O5 or over promoted catalysts presenting mainly V2O5 (i.e. Cu- or Ca-containing samples calcined in air). Moreover, some differences in the selectivity to sulfur were observed. A higher formation of SO2 at high reaction temperature has been favored over Ag0.35V2O5-containing catalyst. This different behavior between samples could be explained by the presence of metallic Ag on the surface of Ag0.35V2O5, which was detected by XRD. Also, higher formation of SO2 is favored in the case of catalyst heat-treated in N2, in which the presence of VO2, as minority, could have a role in combustion of sulfur. Accordingly, this work should be considered as a first approach to relate catalytic activity of the Me-containing vanadium oxide bronze (containing Ag, Cu, Ca and Na) for the selective oxidation of hydrogen sulfide.The authors would like to thank the DGICYT in Spain (Projects CTQ2012-37925-0O3-01 and CTQ2012-37925-0O3-03) for financial support.Soriano Rodríguez, MD.; Vidal Moya, JA.; Rodriguez Castellon, E.; Melo Faus, FV.; Blasco Lanzuela, T.; López Nieto, JM. (2015). Partial oxidation of hydrogen sulphide to sulphur over vanadium oxides bronzes. Catalysis Today. 259:237-244. https://doi.org/10.1016/j.cattod.2015.08.009S23724425

Revisión del sistema de vigilancia de lesiones y enfermedades durante juegos multideportivos

El objetivo de este estudio fuer presentar al Sistema de Vigilancia de Lesiones y Enfermedades (SVLE) del ComitéOlímpico Internacional (COI) diseñado para eventos multideportivos como un insumo para la planificación de los recursosnecesarios para competencias deportivas. Desarrollamos una revisión sistemática siguiendo la guía PRISMA considerandocomo criterio de inclusión los eventos multideportivos con implementación de la SVLE del COI. La búsqueda fue realizadaen los principales buscadores científicos (PubMed, Scopus, Scielo, ScientDirect, LILACS, y Latindex), en servidores públicosde pre-publicaciones (bioRxiv, SocArXiv, medRxiv y Preprints) y en metabuscadores (Google Scholar y Yahoo!). En laselección inicial se obtuvieron 367 estudios, incluyéndose 19 estudios para su análisis, donde solo 4 fueron deportes unitarioscomo fútbol, atletismo y balonmano. El SVLE del COI se ha usado inicialmente a gran escala en los Juegos Olímpicos deBeijing 2008 en 7 idiomas, al día de hoy más de 56,063 atletas en 19 eventos deportivos. En Sudamérica este sistema fueempleado en el I Juegos Deportivos Nacionales de Chile, los Juegos Olímpicos de Verano y los Juegos Olímpicos Rio 2016,y en los Juegos Panamericanos Lima 2019. Esta revisión muestra la experiencia documentada del SVLE del COI a lo largo demás de una década de uso de este instrumento, demostrando que el SVLE representa una herramienta útil, sencilla y ágil parael monitoreo de incidencias sanitarias

REQUITE: A prospective multicentre cohort study of patients undergoing radiotherapy for breast, lung or prostate cancer

Purpose: REQUITE aimed to establish a resource for multi-national validation of models and biomarkers that predict risk of late toxicity following radiotherapy. The purpose of this article is to provide summary descriptive data. Methods: An international, prospective cohort study recruited cancer patients in 26 hospitals in eight countries between April 2014 and March 2017. Target recruitment was 5300 patients. Eligible patients had breast, prostate or lung cancer and planned potentially curable radiotherapy. Radiotherapy was prescribed according to local regimens, but centres used standardised data collection forms. Pre-treatment blood samples were collected. Patients were followed for a minimum of 12 (lung) or 24 (breast/prostate) months and summary descriptive statistics were generated. Results: The study recruited 2069 breast (99% of target), 1808 prostate (86%) and 561 lung (51%) cancer patients. The centralised, accessible database includes: physician-(47,025 forms) and patient-(54,901) reported outcomes; 11,563 breast photos; 17,107 DICOMs and 12,684 DVHs. Imputed genotype data are available for 4223 patients with European ancestry (1948 breast, 1728 prostate, 547 lung). Radiation-induced lymphocyte apoptosis (RILA) assay data are available for 1319 patients. DNA (n = 4409) and PAXgene tubes (n = 3039) are stored in the centralised biobank. Example prevalences of 2-year (1-year for lung) grade >= 2 CTCAE toxicities are 13% atrophy (breast), 3% rectal bleeding (prostate) and 27% dyspnoea (lung). Conclusion: The comprehensive centralised database and linked biobank is a valuable resource for the radiotherapy community for validating predictive models and biomarkers. Patient summary: Up to half of cancer patients undergo radiation therapy and irradiation of surrounding healthy tissue is unavoidable. Damage to healthy tissue can affect short-and long-term quality-of-life. Not all patients are equally sensitive to radiation "damage" but it is not possible at the moment to identify those who are. REQUITE was established with the aim of trying to understand more about how we could predict radiation sensitivity. The purpose of this paper is to provide an overview and summary of the data and material available. In the REQUITE study 4400 breast, prostate and lung cancer patients filled out questionnaires and donated blood. A large amount of data was collected in the same way. With all these data and samples a database and biobank were created that showed it is possible to collect this kind of information in a standardised way across countries. In the future, our database and linked biobank will be a resource for research and validation of clinical predictors and models of radiation sensitivity. REQUITE will also enable a better understanding of how many people suffer with radiotherapy toxicity

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Spontaneous Breathing in Early Acute Respiratory Distress Syndrome: Insights From the Large Observational Study to UNderstand the Global Impact of Severe Acute Respiratory FailurE Study

OBJECTIVES: To describe the characteristics and outcomes of patients with acute respiratory distress syndrome with or without spontaneous breathing and to investigate whether the effects of spontaneous breathing on outcome depend on acute respiratory distress syndrome severity. DESIGN: Planned secondary analysis of a prospective, observational, multicentre cohort study. SETTING: International sample of 459 ICUs from 50 countries. PATIENTS: Patients with acute respiratory distress syndrome and at least 2 days of invasive mechanical ventilation and available data for the mode of mechanical ventilation and respiratory rate for the 2 first days. INTERVENTIONS: Analysis of patients with and without spontaneous breathing, defined by the mode of mechanical ventilation and by actual respiratory rate compared with set respiratory rate during the first 48 hours of mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Spontaneous breathing was present in 67% of patients with mild acute respiratory distress syndrome, 58% of patients with moderate acute respiratory distress syndrome, and 46% of patients with severe acute respiratory distress syndrome. Patients with spontaneous breathing were older and had lower acute respiratory distress syndrome severity, Sequential Organ Failure Assessment scores, ICU and hospital mortality, and were less likely to be diagnosed with acute respiratory distress syndrome by clinicians. In adjusted analysis, spontaneous breathing during the first 2 days was not associated with an effect on ICU or hospital mortality (33% vs 37%; odds ratio, 1.18 [0.92-1.51]; p = 0.19 and 37% vs 41%; odds ratio, 1.18 [0.93-1.50]; p = 0.196, respectively ). Spontaneous breathing was associated with increased ventilator-free days (13 [0-22] vs 8 [0-20]; p = 0.014) and shorter duration of ICU stay (11 [6-20] vs 12 [7-22]; p = 0.04). CONCLUSIONS: Spontaneous breathing is common in patients with acute respiratory distress syndrome during the first 48 hours of mechanical ventilation. Spontaneous breathing is not associated with worse outcomes and may hasten liberation from the ventilator and from ICU. Although these results support the use of spontaneous breathing in patients with acute respiratory distress syndrome independent of acute respiratory distress syndrome severity, the use of controlled ventilation indicates a bias toward use in patients with higher disease severity. In addition, because the lack of reliable data on inspiratory effort in our study, prospective studies incorporating the magnitude of inspiratory effort and adjusting for all potential severity confounders are required

Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis of the LUNG SAFE database

Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF fully explained by cardiac failure were excluded. Important clinical characteristics were included in a stepwise selection approach (forward and backward selection combined with a significance level of 0.05) to identify a set of independent variables associated with having ARDS at any time, developing ARDS (defined as ARDS occurring after day 2 from meeting AHRF criteria) and with hospital mortality. Furthermore, propensity score analysis was undertaken to account for the differences in baseline characteristics between patients with and without diabetes mellitus, and the association between diabetes mellitus and outcomes of interest was assessed on matched samples. Results: Of the 4107 patients with AHRF included in this study, 3022 (73.6%) patients fulfilled ARDS criteria at admission or developed ARDS during their ICU stay. Diabetes mellitus was a pre-existing co-morbidity in 913 patients (22.2% of patients with AHRF). In multivariable analysis, there was no association between diabetes mellitus and having ARDS (OR 0.93 (0.78-1.11); p = 0.39), developing ARDS late (OR 0.79 (0.54-1.15); p = 0.22), or hospital mortality in patients with ARDS (1.15 (0.93-1.42); p = 0.19). In a matched sample of patients, there was no association between diabetes mellitus and outcomes of interest. Conclusions: In a large, global observational study of patients with AHRF, no association was found between diabetes mellitus and having ARDS, developing ARDS, or outcomes from ARDS. Trial registration: NCT02010073. Registered on 12 December 2013

Epidemiology and patterns of tracheostomy practice in patients with acute respiratory distress syndrome in ICUs across 50 countries

Background: To better understand the epidemiology and patterns of tracheostomy practice for patients with acute respiratory distress syndrome (ARDS), we investigated the current usage of tracheostomy in patients with ARDS recruited into the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG-SAFE) study. Methods: This is a secondary analysis of LUNG-SAFE, an international, multicenter, prospective cohort study of patients receiving invasive or noninvasive ventilation in 50 countries spanning 5 continents. The study was carried out over 4 weeks consecutively in the winter of 2014, and 459 ICUs participated. We evaluated the clinical characteristics, management and outcomes of patients that received tracheostomy, in the cohort of patients that developed ARDS on day 1-2 of acute hypoxemic respiratory failure, and in a subsequent propensity-matched cohort. Results: Of the 2377 patients with ARDS that fulfilled the inclusion criteria, 309 (13.0%) underwent tracheostomy during their ICU stay. Patients from high-income European countries (n = 198/1263) more frequently underwent tracheostomy compared to patients from non-European high-income countries (n = 63/649) or patients from middle-income countries (n = 48/465). Only 86/309 (27.8%) underwent tracheostomy on or before day 7, while the median timing of tracheostomy was 14 (Q1-Q3, 7-21) days after onset of ARDS. In the subsample matched by propensity score, ICU and hospital stay were longer in patients with tracheostomy. While patients with tracheostomy had the highest survival probability, there was no difference in 60-day or 90-day mortality in either the patient subgroup that survived for at least 5 days in ICU, or in the propensity-matched subsample. Conclusions: Most patients that receive tracheostomy do so after the first week of critical illness. Tracheostomy may prolong patient survival but does not reduce 60-day or 90-day mortality. Trial registration: ClinicalTrials.gov, NCT02010073. Registered on 12 December 2013

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis