Significant progress is described in the development of cellular solids, specifically functional and multifunctional foams, prepared by bioinspired approaches and consisting of green components. This ...article covers recent examples mainly developed at the Materials Science Institute of Madrid, ICMM‐CSIC, on bionanocomposites and bioinspired materials conformed as foams. These novel hierarchical porous systems bring out a broad range of advanced applications from biomedical purposes to energy generation and storage.
Recent progress in the development of advanced bionanocomposite and bioinspired foams with controlled porosity and low relative density is paving the way towards applications in a wide range of fields, from energy storage and insulating materials with reduced flammability for application in building and transport productivity sectors to novel scaffolds for tissue engineering and other biomedical purposes.
To analyze the performance of the 1980 ACR and new 2013 ACR/EULAR criteria for systemic sclerosis (SSc) in cutaneous SSc (lcSSc) patients, especially those affected by lcSSc and pulmonary arterial ...hypertension (PAH).
All patients with a clinical lcSSc diagnosis from a prospective observational SSc cohort were included. Sociodemographic and disease-related variables were collected, and PAH confirmed by right heart catheterization (RHC). Performance of the 2013 and 1980 SSc criteria was analyzed in terms of clinical diagnosis. Descriptive and between-group analyses were performed as to the fulfillment of criterion sets, including comparison of survival.
Overall, 321 patients were included, 63% of whom fulfilled the 1980 ACR and 93% the 2013 ACR/EULAR criteria. Agreement between both criteria sets proved poor (κ = 0.23). LcSSC patients fulfilling both criterion sets were significantly younger at diagnosis, whilst presenting organ involvement, calcinosis, fingertip digital ulcers, and pitting scars more frequently than those who met the 2013 criteria only. Patients who fulfilled the 2013 but not the 1980 criteria presented a higher degree of ACA positivity and PAH. Nearly 12% of patients developed PAH. Patients who did not meet the 1980 criteria were affected by a milder disease from but demonstrated higher pulmonary vascular resistance and lower cardiac index than those fulfilling both criterion sets. Whereas patients with PAH met the 2013 criteria, only 47% fulfilled the 1980 criteria. Regardless of criterion set fulfillment, high mortality was observed in PAH patients, with no significant between-patient difference based on criterion set.
The new 2013 ARC/EULAR criteria prove more accurate than the former 1980 ACR criteria in identifying and differentiating patients with lcSSc, especially those with associated PAH. Since PAH exhibits a better prognosis if treated early, all SSc patients should undergo PAH screening.
Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older ...free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (βadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (βadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.
Purpose
To assess the association between three different a priori dietary patterns adherence (17-item energy reduced-Mediterranean Diet (MedDiet), Trichopoulou-MedDiet and Dietary Approach to Stop ...Hypertension (DASH)), as well as the Protein Diet Score and kidney function decline after one year of follow-up in elderly individuals with overweight/obesity and metabolic syndrome (MetS).
Methods
We prospectively analyzed 5675 participants (55–75 years) from the PREDIMED-Plus study. At baseline and at one year, we evaluated the creatinine-based estimated glomerular filtration rate (eGFR) and food-frequency questionnaires-derived dietary scores. Associations between four categories (decrease/maintenance and tertiles of increase) of each dietary pattern and changes in eGFR (ml/min/1.73m
2
) or ≥ 10% eGFR decline were assessed by fitting multivariable linear or logistic regression models, as appropriate.
Results
Participants in the highest tertile of increase in 17-item erMedDiet Score showed higher upward changes in eGFR (
β
: 1.87 ml/min/1.73m
2
; 95% CI: 1.00–2.73) and had lower odds of ≥ 10% eGFR decline (OR: 0.62; 95% CI: 0.47–0.82) compared to individuals in the decrease/maintenance category, while Trichopoulou-MedDiet and DASH Scores were not associated with any renal outcomes. Those in the highest tertile of increase in Protein Diet Score had greater downward changes in eGFR (
β
: − 0.87 ml/min/1.73m
2
; 95% CI: − 1.73 to − 0.01) and 32% higher odds of eGFR decline (OR: 1.32; 95% CI: 1.00–1.75).
Conclusions
Among elderly individuals with overweight/obesity and MetS, only higher upward change in the 17-item erMedDiet score adherence was associated with better kidney function after one year. However, increasing Protein Diet Score appeared to have an adverse impact on kidney health. Trial Registration Number: ISRCTN89898870 (Data of registration: 2014).
La formación especializada en España es responsabilidad de las instituciones sanitarias, que cuentan con una estructura docente para regularla, supervisarla y evaluarla. Dentro de esta estructura, el ...tutor es el responsable directo de garantizar la correcta formación del residente. Sin embargo, a pesar de esta gran responsabilidad legal y ética, en ocasiones este desafío se acepta sin tener experiencia y sin tener la formación necesaria para llevar a cabo las tareas que requiere la mentoría. Este artículo presenta lo que el tutor debe saber, saber hacer y saber ser. Para entender que la tutoría es más que una gestión, destacamos su vertiente educativa para formar profesionales de excelencia en los aspectos científico-técnico y humano.
Specialized training in Spain is the responsibility of health institutions, which have a teaching structure to regulate, supervise and evaluate. Within this structure, the tutor is directly responsible for guaranteeing the correct training of the resident. However, despite this great legal and ethical responsibility, sometimes this challenge is accepted without having experience and without having the necessary training to carry out the tasks that require mentoring. In this article, it is presented what the tutor should know, know how to do and know how to be. in order to understand that tutoring is more than management, highlighting its educational aspect to train professionals of excellence in the scientific-technical and human aspects.
Resumen: La formación especializada en España es responsabilidad de las instituciones sanitarias, que cuentan con una estructura docente para regularla, supervisarla y evaluarla. Dentro de esta ...estructura, el tutor es el responsable directo de garantizar la correcta formación del residente. Sin embargo, a pesar de esta gran responsabilidad legal y ética, en ocasiones este desafío se acepta sin tener experiencia y sin tener la formación necesaria para llevar a cabo las tareas que requiere la mentoría. Este artículo presenta lo que el tutor debe saber, saber hacer y saber ser. Para entender que la tutoría es más que una gestión, destacamos su vertiente educativa para formar profesionales de excelencia en los aspectos científico-técnico y humano. Abstract: Specialized training in Spain is the responsibility of health institutions, which have a teaching structure to regulate, supervise and evaluate. Within this structure, the tutor is directly responsible for guaranteeing the correct training of the resident. However, despite this great legal and ethical responsibility, sometimes this challenge is accepted without having experience and without having the necessary training to carry out the tasks that require mentoring. In this article, it is presented what the tutor should know, know how to do and know how to be. in order to understand that tutoring is more than management, highlighting its educational aspect to train professionals of excellence in the scientific-technical and human aspects.
The aim was to analyze the characteristics and predictors of unfavorable outcomes in solid organ transplant recipients (SOTRs) with COVID-19. We conducted a prospective observational cohort study of ...210 consecutive SOTRs hospitalized with COVID-19 in 12 Spanish centers from 21 February to 6 May 2020. Data pertaining to demographics, chronic underlying diseases, transplantation features, clinical, therapeutics, and complications were collected. The primary endpoint was a composite of intensive care unit (ICU) admission and/or death. Logistic regression analyses were performed to identify the factors associated with these unfavorable outcomes. Males accounted for 148 (70.5%) patients, the median age was 63 years, and 189 (90.0%) patients had pneumonia. Common symptoms were fever, cough, gastrointestinal disturbances, and dyspnea. The most used antiviral or host-targeted therapies included hydroxychloroquine 193/200 (96.5%), lopinavir/ritonavir 91/200 (45.5%), and tocilizumab 49/200 (24.5%). Thirty-seven (17.6%) patients required ICU admission, 12 (5.7%) suffered graft dysfunction, and 45 (21.4%) died. A shorter interval between transplantation and COVID-19 diagnosis had a negative impact on clinical prognosis. Four baseline features were identified as independent predictors of intensive care need or death: advanced age, high respiratory rate, lymphopenia, and elevated level of lactate dehydrogenase. In summary, this study presents comprehensive information on characteristics and complications of COVID-19 in hospitalized SOTRs and provides indicators available upon hospital admission for the identification of SOTRs at risk of critical disease or death, underlining the need for stringent preventative measures in the early post-transplant period.
This paper reports the use of solarization and biosolarization to decontaminate a soil polluted with six insecticides (buprofezin, pirimicarb, pirimiphos methyl, pyridaben, pyriproxyfen and ...tebufenpyrad). In the experiment, 17-L pots filled with clay-loam soil were placed in a greenhouse during the summer season and then contaminated with the insecticides of interest. Treatments consisted of different solarization and biosolarization treatments, including a control without disinfection. For both solarization and biosolarization treatments, low-density polyethylene film was used as cover; the biosolarization treatment involving application of a mixture of sheep and chicken manures at a rate of 400
g
pot
−1. Five pots per treatment were sampled periodically up to 90
d after the beginning of each treatment. The results showed that both solarization and biosolarization enhanced the degradation rates of most of the insecticides tested compared with the control, probably as a result of the increased soil temperature. Pirimicarb, pirimiphos methyl, tebufenpyrad, pyriproxyfen and pyridaben were degraded to a greater extent in the biosolarization than in the solarization treatment. The results confirm that both solarization and biosolarization can be considered as a remediation tool for soils polluted by these insecticides.
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