La actividad física como promotora de salud en personas mayores.

Se considera que la actividad física tiene un papel fundamental en la salud de los individuos en todas las edades. Los efectos beneficiosos del ejercicio sobre la salud, tanto físicos como psicológicos de las personas constituyen un hecho cada vez más evidente y su estudio se ha abordado desde distintos campos profesionales, encontrándose entre ellos la Medicina, la Psicología y la Educación Física.La OMS destaca los efectos positivos del ejercicio físico sobre la salud y propone que forme parte de un planteamiento más amplio que podríamos definir como promoción de la salud. El objetivo de este estudio espromover la Salud a través del diseño, ejecución y evaluación de un taller de envejecimiento activo en ámbito abierto no institucionalizado en población mayor de 60 años, para ello planteamos conocer los autoesquemas en el origen de los conceptos, desarrollar y evaluar la influencia de las actividades llevadas a cabo en el taller sobre las esferas funcional, cognitiva, afectiva y de calidad de vida y por último mejorar el programa conociendo las opiniones, motivaciones y grado de satisfacción de los participantes. Se parte de un diseño de intervención pretestypostest de un solo grupo con muestreo por conveniencia, no probabilístico utilizando una metodología cualitativa-cuantitativa que nos permita verificar las relaciones de estudio planteadas. Como resultados la elaboración de planes de trabajo con los autoesquemas muestra una asociación positiva entre actividad física, salud, bienestar, sentimientos positivos e interacción social que repercute no solo en el aspecto físico motor sino cognitivo y emocional con aplicación a facilitar y orientar la adherencia al programa. La influencia del programa en la esfera funcional recoge una mejora en los test de Tinetti, Barthel, Lawton y Brody, SFT y Timed Get Up and Go Test. Sobre la esfera cognitiva mejoran el MMSE y sobre la esfera afectiva, la escala de Yesavage, ha obtenido resultados estadísticamente significativos con mejoría de los participantes reduciendo en casi un 70% los posibles estados anímicos depresivos. El APGAR familiar muestra cómo perciben las personas, el nivel de funcionamiento de la unidad familiar, con una buena adaptación La mejora en la calidad de vida es apreciada por el Euroqol 5D y el SF36 lo que sugiere un mayor bienestar, grado de resistencia y autonomía e independencia Por último, como motivación y mejora del programa hemos reflexionado y adquirido una visión global y profunda de las motivaciones de los participantes y hemos podido conocer y estudiar sus preferencias, valoraciones y aportaciones que siempre hemos implementado para mejorar cada día e intentar superarnos y conseguir que los principales motivos se cumplan generando un ambiente lúdico, recreativo y participativo, aprendiendo habilidades en condición física útiles a cualquier edadPhysical activity is considered to have a main role in the health of individuals of all ages. The beneficial effects of exercise in people’s physical and psychological health is more and more clear and its study has been approached in different professional fields, such as Medicine, Psychology and Physical Education. The OMS emphasize on the positive effects of physical activity when it comes to health and suggests for it to be part of a bigger approach that we could define as health promotion. The aim of this study is to promote health through design, implementation and evaluation of an active ageing workshop in a non-institutionalized open area in a population older than 60. For this to happen we plan to learn the auto schemes in the origin of the concepts, develop and evaluate the influence of the activities that have been done in the workshop on the functional, cognitive, affective and quality of life spheres, and finally improve the programme by acknowledging the opinions, motivations and degree of satisfaction of the participants. We start off from a quasi-experimental design pretest–postest of a unique group with a sampling by convenience, non-probabilistic using a qualitative - quantitative methodology that will allow us to verify the relations established that have been studied. The elaboration of work plans with the auto schemes show a result with a positive association between physical activity, health, welfare, positive feelings, and social interaction that has an impact not only on the motor physical aspect, but also in the cognitive and emotional aspects too, used to facilitate and orientate the adherence to the programme.The influence of the programme on the sphere includes an improvement on the Tinetti, Barthel, Lawton and Brody, SFT and Timed Get Up and Go tests. On the cognitive sphere the MMSE improves, and on the affective sphere, the Yesavage scale has obtained significant results, with an improvement of the participants reducing nearly a 70% the possible depressions. The family APGAR shows how people perceive the functional level of family unity, with a positive adaption. The lifestyle quality improvement is noticed by the Euroqol and the SF36; this suggests a better welfare, a bigger amount of resistance, autonomy and independence. Finally, as a motivation and improvement of the programme, we have thought thoroughly and acquired a global and deep vision of the motivations of the participants, and we have acknowledged and studied their preferences, valuations, and contributions that we have always implemented in order to improve every day and try to overcome any problems and accomplish the main aims generating a playful, creative and participative environment, learning skills in physical condition that will be useful to people of any age

Use of ontological structures for integrated supply chain management

The integration of the different hierarchical decision making levels involved within a Chemical Supply Chain is essential for its adequate management in dynamic and competitive markets. Any approach encompassing design issues, planning, coordination and responses to customer demands, requires the consideration of huge amounts of data, which are a valuable source of information only if properly managed. But these data could also cause a lack of coordination if not stored and interpreted appropriately, so standardizing information structures and tools to improve the availability and communication of data information between different hierarchical decision levels is essential. Thus, this work addresses the problem of making the best use of the information systems associated to a Supply Chain, in order to improve the knowledge and the information comprehension capabilities in the area of Process Systems Engineering.Postprint (published version

Atrial fibrosis identification with unipolar electrogram eigenvalue distribution analysis in multi-electrode arrays

Atrial fbrosis plays a key role in the initiation and progression of atrial fbrillation (AF). Atrial fbrosis is typically identifed by a peak-to-peak amplitude of bipolar electrograms (b-EGMs) lower than 0.5 mV, which may be considered as ablation targets. Nevertheless, this approach disregards signal spatiotemporal information and b-EGM sensitivity to catheter orientation. To overcome these limitations, we propose the dominant-to-remaining eigenvalue dominance ratio (EIGDR) of unipolar electrograms (u-EGMs) within neighbor electrode cliques as a waveform dispersion measure, hypothesizing that it is correlated with the presence of fbrosis. A simulated 2D tissue with a fbrosis patch was used for validation. We computed EIGDR maps from both original and time-aligned u-EGMs, denoted as R and RA, respectively, also mapping the gain in eigenvalue concentration obtained by the alignment, ΔRA. The performance of each map in detecting fbrosis was evaluated in scenarios including noise and variable electrode-tissue distance. Best results were achieved by RA, reaching 94% detection accuracy, versus the 86% of b-EGMs voltage maps. The proposed strategy was also tested in real u-EGMs from fbrotic and non-fbrotic areas over 3D electroanatomical maps, supporting the ability of the EIGDRs as fbrosis markers, encouraging further studies to confrm their translation to clinical settings

Patrones y estrategias de regulación emocional empleadas en personas mayores de 60 años con deterioro cognitivo.

Introducción. Son escasos los estudios científicos sobre los patrones cognitivos y estrategias empleadas en personas mayores con deterioro cognitivo (DC). Objetivo. El objetivo fue comparar 2 grupos de personas mayores, con DC y sin DC, la refocalización de planes, catastrofización, autoculpa, refoca-lización positiva y reinterpretación positiva para observar diferencias y establecer patrones cognitivos adaptados al perfil para la mejora en la atención profesional. Método. Para ello en este estudio de corte transversal con diseño correlacional y muestreo no probabilístico por conveniencia se empleó el Cog-nitive Emotion Regulation Questionnaire (CERQ) y Geriatric Depression Scale (GDS) en 196 personas mayores de 60 años pertenecientes a centros de día y residencias (M= 75,95 DT= 10,08). Resultados. Se han obtenido resultados estadísticamente significativos en refocalización de planes (p <. 00); catas-trofización (p= .00); autoculpa (p <. 00); refocalización positiva (p <. 00) reinterpretación positiva (p <. 00). Conclusiones. Es uno de los escasos estudios de este campo que contribuye a enfatizar la necesidad de estudio de variables emocionales adaptativas o desadaptativas para la vida del adulto mayor con DC inexistentes en el ámbito científico, además, muestra diferentes patrones cognitivos y estrategias adaptativas empleadas en DC y sin DC. Su conocimiento ayudaría a personalizar intervenciones en función de los patrones cognitivos presentes en esta publicaciónScientific studies on cognitive patterns and strategies used in older people with cognitive impair-ment (CD) are scarce. Objective: The objective was to compare 2 groups of older people, with CD and without CD, the refocusing of plans, catastrophizing, self-blame, positive refocusing and positive rein-terpretation to observe differences and establish cognitive patterns adapted to the profile for the impro-vement in professional care. Method: For this, in this cross-sectional study with correlational design and probability sampling by not convenience, the Cognitive Emotion Regulation Questionnaire (CERQ) and Geriatric Depression Scale (GDS) were used in 196 people over 60 years old belonging to day centers and residences (M=75.95 SD= 10.08) Results: Statistically significant results have been obtained in re-focusing plans (p<.00); catastrophizing (p=.00); self-blame (p<.00); positive refocusing (p<.00); positive reinterpretation (p<.00). Conclusions: It is one of the few studies in this field that contributes to empha-size the need to study adaptative or maladaptative emotional variables for the life of the elderly with CD that do not exist in the scientific field, in addition, it shows different cognitive patterns and adaptative strategies used in CD and without DC. Their knowledge would help to personalize interventions based on the cognitive patterns present in this publicatio

Fomento del aprendizaje permanente en estudiantes del grado de ingeniería Biomédica, primeros pasos: identificación de áreas a reforzar en gestión de información y aprendizaje autónomo

[EN] The ability to search and assess information and autonomous learning are key aspects related to the learning to learn (LtL) competence and are increasingly relevant for students and professionals. For the design of training activities it is extremely important to identify the specific aspects that require further training or reinforcement. In this work, surveys were designed and carried out for students in the 3rd and 4th year of biomedical engineering to collect information related to the abilities of the LtL competence in general, information management in particular, and the use and usefulness of materials available in the subjects from the electronics area. The results obtained show that information management is a highly relevant issue in which students consider not having sufficient training, they point to various specific aspects to work on in the training activities to be developed (eg how to assess the information and source of a resource, how to refine searches, presentation of specialized repositories ...). In addition, the assessment of the students' capacities and the needs for additional teaching materials in the subjects, before and after the implementation of training activities, will allow obtaining indicators to objectively assess their effects.[ES] La capacidad de búsqueda y valoración de la información y el aprendizaje autónomo, son aspectos clave relacionados con la competencia aprender a aprender (AaA) y cada vez son de mayor relevancia para estudiantes y profesionales. Para el diseño de actividades formativas es de suma importancia identificar los aspectos concretos que requieren de mayor formación o refuerzo. En este trabajo se diseñaron y realizaron encuestas para alumnos de 3º y 4º curso de ingeniería biomédica para recabar información relativa a capacidades de la competencia AaA en general, la gestión de la información en particular, y el uso y utilidad de materiales disponibles en las asignaturas del área electrónica. Los resultados obtenidos muestran que la gestión de la información es un tema de gran relevancia en el que los alumnos consideran no tener formación suficiente, apuntan a diversos aspectos específicos a trabajar en las actividades formativos a desarrollar (p.e. cómo valorar la información y fuente de un recurso, cómo refinar búsquedas, presentación repositorios especializados…). Además, la valoración de las capacidades del alumnado y de las necesidades de materiales didácticos adicionales en las asignaturas, antes y después de la implementación de actividades formativas, permitirá obtener indicadores para valorar de forma objetiva sus efectos.Se agradece a la UPV la financiación de los proyectos PIME/20-21/211 (“Fomento del aprendizaje permanente en estudiantes del grado de ingeniería biomédica”).Garcia Casado, FJ.; Martínez De Juan, JL.; Guijarro Estelles, ED.; Saiz Rodríguez, FJ.; Guillem Sánchez, MS.; Prats Boluda, G.; Ye Lin, Y. (2021). Fomento del aprendizaje permanente en estudiantes del grado de ingeniería Biomédica, primeros pasos: identificación de áreas a reforzar en gestión de información y aprendizaje autónomo. En IN-RED 2021: VII Congreso de Innovación Edicativa y Docencia en Red. Editorial Universitat Politècnica de València. 1217-1232. https://doi.org/10.4995/INRED2021.2021.134691217123

Integrative development of a short screening questionnaire of highly processed food consumption (sQ-HPF)

Background: Recent lifestyle changes include increased consumption of highly processed foods (HPF), which has been associated with an increased risk of non-communicable diseases (NCDs). However, nutritional information relies on the estimation of HPF consumption from food-frequency questionnaires (FFQ) that are not explicitly developed for this purpose. We aimed to develop a short screening questionnaire of HPF consumption (sQ-HPF) that integrates criteria from the existing food classification systems. Methods: Data from 4400 participants (48.1% female and 51.9% male, 64.9 +/- 4.9 years) of the Spanish PREDIMED-Plus (PREvention with MEDiterranean DIet) trial were used for this analysis. Items from the FFQ were classified according to four main food processing-based classification systems (NOVA, IARC, IFIC and UNC). Participants were classified into tertiles of HPF consumption according to each system. Using binomial logistic regression, food groups associated with agreement in the highest tertile for at least two classification systems were chosen as items for the questionnaire. ROC analysis was used to determine cut-off points for the frequency of consumption of each item, from which a score was calculated. Internal consistency of the questionnaire was assessed through exploratory factor analysis (EFA) and Cronbach's analysis, and agreement with the four classifications was assessed with weighted kappa coefficients. Results: Regression analysis identified 14 food groups (items) associated with high HPF consumption for at least two classification systems. EFA showed that items were representative contributors of a single underlying factor, the HPF dietary pattern (factor loadings around 0.2). We constructed a questionnaire asking about the frequency of consumption of those items. The threshold frequency of consumption was selected using ROC analysis. Comparison of the four classification systems and the sQ-HPF showed a fair to high agreement. Significant changes in lifestyle characteristics were detected across tertiles of the sQ-HPF score. Longitudinal changes in HPF consumption were also detected by the sQ-HPF, concordantly with existing classification systems. Conclusions: We developed a practical tool to measure HPF consumption, the sQ-HPF. This may be a valuable instrument to study its relationship with NCDs

Non-invasive localization of atrial ectopic beats by using simulated body surface P-wave integral maps

Non-invasive localization of continuous atrial ectopic beats remains a cornerstone for the treatment of atrial arrhythmias. The lack of accurate tools to guide electrophysiologists leads to an increase in the recurrence rate of ablation procedures. Existing approaches are based on the analysis of the P-waves main characteristics and the forward body surface potential maps (BSPMs) or on the inverse estimation of the electric activity of the heart from those BSPMs. These methods have not provided an efficient and systematic tool to localize ectopic triggers. In this work, we propose the use of machine learning techniques to spatially cluster and classify ectopic atrial foci into clearly differentiated atrial regions by using the body surface P-wave integral map (BSPiM) as a biomarker. Our simulated results show that ectopic foci with similar BSPiM naturally cluster into differentiated non-intersected atrial regions and that new patterns could be correctly classified with an accuracy of 97% when considering 2 clusters and 96% for 4 clusters. Our results also suggest that an increase in the number of clusters is feasible at the cost of decreasing accuracy.This work was partially supported by The "Programa Prometeu" from Conselleria d'Educacio Formacio I Ocupacio, Generalitat Valenciana (www.edu.gva.es/fio/index_es.asp) Award Number: PROMETEU/2016/088 to JS; The "Plan Estatal de Investigacion Cientifica y Tecnica y de Innovacion 2013-2016" from the Ministerio de Economia, Industria y Competitividad of Spain, Agencia Estatal de Investigacion (www.mineco.gob.es) and the European Commission (European Regional Development Funds - ERDF -FEDER) (ec.europa.eu/regional_policy/es/funding/erdf/) Award Number: DPI2016-75799-R to JS and The "Programa Estatal de Investigacion, Desarrollo e Innovacion Orientado a los Retos de la Sociedad" from the Ministerio de Economia y Competitividad of Spain, Agencia Estatal de Investigacion (www.mineco.gob.es) and the European Commission (European Regional Development Funds - ERDF -FEDER) (ec.europa.eu/regional_policy/es/funding/erdf/) Award Number: TIN2014-59932-JIN to AFA and RS. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ferrer Albero, A.; Godoy, EJ.; Lozano, M.; Martínez Mateu, L.; Alonso Atienza, F.; Saiz Rodríguez, FJ.; Sebastián Aguilar, R. (2017). Non-invasive localization of atrial ectopic beats by using simulated body surface P-wave integral maps. PLoS ONE. 12(7):1-23. https://doi.org/10.1371/journal.pone.0181263S12312

Carbon dioxide (CO2) emissions and adherence to Mediterranean diet in an adult population: the Mediterranean diet index as a pollution level index

Background Research related to sustainable diets is is highly relevant to provide better understanding of the impact of dietary intake on the health and the environment. Aim To assess the association between the adherence to an energy-restricted Mediterranean diet and the amount of CO2 emitted in an older adult population. Design and population Using a cross-sectional design, the association between the adherence to an energy-reduced Mediterranean Diet (erMedDiet) score and dietary CO2 emissions in 6646 participants was assessed. Methods Food intake and adherence to the erMedDiet was assessed using validated food frequency questionnaire and 17-item Mediterranean questionnaire. Sociodemographic characteristics were documented. Environmental impact was calculated through greenhouse gas emissions estimations, specifically CO2 emissions of each participant diet per day, using a European database. Participants were distributed in quartiles according to their estimated CO2 emissions expressed in kg/day: Q1 (= 2.80 kg CO2). Results More men than women induced higher dietary levels of CO2 emissions. Participants reporting higher consumption of vegetables, fruits, legumes, nuts, whole cereals, preferring white meat, and having less consumption of red meat were mostly emitting less kg of CO2 through diet. Participants with higher adherence to the Mediterranean Diet showed lower odds for dietary CO2 emissions: Q2 (OR 0.87; 95%CI: 0.76-1.00), Q3 (OR 0.69; 95%CI: 0.69-0.79) and Q4 (OR 0.48; 95%CI: 0.42-0.55) vs Q1 (reference). Conclusions The Mediterranean diet can be environmentally protective since the higher the adherence to the Mediterranean diet, the lower total dietary CO2 emissions. Mediterranean Diet index may be used as a pollution level index

Mediterranean, DASH, and MIND Dietary Patterns and Cognitive Function: The 2-Year Longitudinal Changes in an Older Spanish Cohort

Background and Aims: Plant-forward dietary patterns have been associated with cardiometabolic health benefits, which, in turn, have been related to cognitive performance with inconsistent findings. The objective of this study was to examine the relationship between baseline adherence to three a priori dietary patterns (Mediterranean, DASH, and MIND diets) with 2-year changes in cognitive performance in older adults with overweight or obesity and high cardiovascular disease risk. Methods: A prospective cohort analysis was conducted within the PREDIMED-Plus trial, involving 6,647 men and women aged 55-75 years with overweight or obesity and metabolic syndrome. Using a validated, semiquantitative 143-item food frequency questionnaire completed at baseline, the dietary pattern adherence scores were calculated. An extensive neuropsychological test battery was administered at baseline and 2-year follow-up. Multivariable-adjusted linear regression models were used to assess associations between 2-year changes in cognitive function z-scores across tertiles of baseline adherence to the a priori dietary patterns. Results: Adherence to the Mediterranean diet at baseline was associated with 2-year changes in the general cognitive screening Mini-Mental State Examination (MMSE, β: 0.070; 95% CI: 0.014, 0.175, P-trend = 0.011), and two executive function-related assessments: the Trail Making Tests Part A (TMT-A, β: −0.054; 95% CI: −0.110, − 0.002, P-trend = 0.047) and Part B (TMT-B, β: −0.079; 95% CI: −0.134, −0.024, P-trend = 0.004). Adherence to the MIND diet was associated with the backward recall Digit Span Test assessment of working memory (DST-B, β: 0.058; 95% CI: 0.002, 0.114, P-trend = 0.045). However, higher adherence to the DASH dietary pattern was not associated with better cognitive function over a period of 2 years. Conclusion: In older Spanish individuals with overweight or obesity and at high cardiovascular disease risk, higher baseline adherence to the Mediterranean dietary pattern may be associated with better cognitive performance than lower adherence over a period of 2 years

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio