En el presente artículo hemos recopilado información acerca de los desórdenes de tipo músculo esqueléticos y
cómo afectan los mismos en la salud del trabajador. Se realiza un estudio de caso en una ...empresa de productos químicos y se aplica la técnica REBA para detectar desórdenes en la postura para un puesto de trabajo. Los resultados muestran la necesidad de mejorar el ambiente laboral y puesto de trabajo, al igual que la recomendación de evaluaciones médicas del trabajador, con el fin de recomendar acciones preventivas.
In recent years, Christian Pentecostalism has been one of the most successful religious movements in the province of Barcelona, while the high level of immigration from Latin America has clearly been ...an influential factor in its development. Yet, despite the fact that Pentecostalism has played a prominent role in religious diversification in Catalonia, it has been the subject of very few studies. This paper seeks to address this gap in research and shed light on an area of fundamental importance to the movement: its ritual dimension. Drawing on ethnographic information from the Iglesia Evangélica el Vallès (Canovelles), we describe and analyze the principal channels of communication with the sacred established by the Latin American Pentecostals. In our conclusions, we show that the communicative practices developed during worship are oriented toward manifesting the presence of the Holy Spirit, leading to the emergence of ritual condensation around this symbolic force. For this purpose, practices such as “praise”, the “laying on of hands” and “speaking in tongues” establish sequential and progressive communication with the Holy Spirit throughout the process of worship, culminating in mimetic communication.
Summary
The study included 1848 diffuse large B‐cell lymphoma (DLBCL)patients treated with chemotherapy/rituximab. The aims were to validate the National Comprehensive Cancer Network International ...Prognostic Index (NCCN‐IPI) and explore the effect of adding high Beta‐2 microglobulin (β2M), primary extranodal presentation and intense treatment to the NCCN‐IPI variables in order to develop an improved index. Comparing survival curves, NCCN‐IPI discriminated better than IPI, separating four risk groups with 5‐year overall survival rates of 93%, 83%, 67% and 49%, but failing to identify a true high‐risk population. For the second aim the series was split into training and validation cohorts: in the former the multivariate model identified age, lactate dehydrogenase, Eastern Cooperative Oncology Group performance status, Stage III‐IV, and β2M as independently significant, whereas the NCCN‐IPI‐selected extranodal sites, primary extranodal presentation and intense treatments were not. These results were confirmed in the validation cohort. The Grupo Español de Linfomas/Trasplante de Médula ósea (GELTAMO)‐IPI developed here, with 7 points, significantly separated four risk groups (0, 1–3, 4 or ≥5 points) with 11%, 58%, 17% and 14% of patients, and 5‐year overall survival rates of 93%, 79%, 66% and 39%, respectively. In the comparison GELTAMO IPI discriminated better than the NCCN‐IPI. In conclusion, GELTAMO‐IPI is more accurate than the NCCN‐IPI and has statistical and practical advantages in that the better discrimination identifies an authentic high‐risk group and is not influenced by primary extranodal presentation or treatments of different intensity.
The main aims of this study were to determine the accuracy of the portable metabolic cart K5 by comparison with a stationary metabolic cart (Vyntus CPX), to check on the validity of Vyntus CPX using ...a butane combustion test, and to assess the reliability of K5 during prolonged walks in the field. For validation, measurements were consecutively performed tests with both devices at rest and during submaximal exercise (bicycling) at low (60 W) and moderate intensities (130-160 W) in 16 volunteers. For the reliability study, 14 subjects were measured two times during prolonged walks (13 km, at 5 km/h), with the K5 set in mixing chamber (Mix) mode. Vyntus measured the stoichiometric RQ of butane combustion with high accuracy (error <1.6%) and precision (CV <0.5%), at VO
values between 0.788 and 6.395 L/min. At rest and 60 W, there was good agreement between Vyntus and K5 (breath-by-breath, B×B) in VO
, VCO
, RER, and energy expenditure, while in Mix mode the K5 overestimated VO
by 13.4 and 5.8%, respectively. Compared to Vyntus, at moderate intensity the K5 in B×B mode underestimated VO
, VCO
and energy expenditure by 6.6, 6.9, and 6.6%, respectively. However, at this intensity there was an excellent agreement between methods in RER and fat oxidation. In Mix mode, K5 overestimated VO
by 5.8 and 4.8%, at 60 W and the higher intensity, respectively. The K5 had excellent reliability during the field tests. Total energy expenditure per Km was determined with a CV for repeated measurements of 4.5% (CI: 3.2-6.9%) and a concordance correlation coefficient of 0.91, similar to the variability in VO
. This high reproducibility was explained by the low variation of F
O
measurements, which had a CV of 0.9% (CI: 0.7-1.5%) combined with a slightly greater variability of F
CO
, V
, VCO
, and RER. In conclusion, the K5 is an excellent portable metabolic cart which is almost as accurate as a state-of-art stationary metabolic cart, capable of measuring precisely energy expenditure in the field, showing a reliable performance during more than 2 h of continuous work. At high intensities, the mixing-chamber mode is more accurate than the B×B mode.
El concepto de Acceso Abierto (Open Access, OA) no sólo tiene que ver con la accesibilidad al documento científico, sino también con los permisos de reutilización más o menos restrictivos en función ...de los derechos reservados para su distribución. A partir de esta idea, surgieron numerosas iniciativas, con o sin ánimo de lucro, con el fin de facilitar el acceso universal a través de internet a las publicaciones científicas.
La coartación aórtica constituye entre el 4% y 6% de los defectos cardíacos congénitos y ocupa el séptimo lugar en la lista de todas las cardiopatías congénitas. Se caracteriza por un estrechamiento ...discreto, generalmente en la porción descendente del arco aórtico y distal a la arteria subclavia izquierda. Las pacientes embarazadas con coartación aórtica presentan mayor riesgo de complicaciones: ruptura o disección de la aorta, aneurismas en el polígono de Willis y endocarditis. Es importante definir el tratamiento oportuno y preventivo durante el embarazo, así como la vía del parto. Se presenta el caso clínico de una paciente con antecedente de coartación aórtica no corregida y diagnóstico de preeclampsia, resaltando el proceso de atención, enfoque diagnóstico y manejo integral durante la hospitalización. Se expone además una revisión de la literatura y un análisis crítico del caso. Se concluye que la coartación aórtica sin tratamiento genera múltiples complicaciones; se destaca la importancia de la consulta preconcepcional para evaluar los riesgos del embarazo y llevar un adecuado control multidisciplinario por medicina materno fetal, cardiología y hemodinamia. Palabras clave: coartación aórtica, embarazo, perinatología, cardiología, complicaciones cardiovasculares del embarazo Aortic coarctation accounts for 4% to 6% of congenital heart defects, ranking seventh in the list of all congenital heart diseases. It is characterized by a discrete narrowing, usually in the descending portion of the aortic arch and distal to the left subclavian artery. Pregnant patients with aortic coarctation present a higher risk of complications: rupture or dissection of the aorta, aneurysms in the polygon of Willis and endocarditis. Therefore, defining correct and preventive treatment during pregnancy as well as the way of delivery is important. We present the clinical case of a patient with a history of uncorrected aortic coarctation and diagnosis of preeclampsia, highlighting the process of care, diagnostic approach and integrated handling during hospitalization. A literature review and critical analysis of the case are also presented. It can be concluded that uncorrected aortic coarctation generates multiple complications; the importance of preconception consultation is highlighted and, in the absence of contraindications, carry out adequate multidisciplinary control by maternal-fetal medicine, cardiology and haemodynamics. Key Words: aortic coarctation, pregnancy, perinatology, cardiology, pregnancy complications, cardiovascular A coarctação da aorta representa entre 4% e 6% das cardiopatias congênitas e ocupa o sétimo lugar na lista de todas as cardiopatias congênitas. Caracteriza-se por estreitamento discreto, geralmente na porção descendente do arco aórtico e distal à artéria subclávia esquerda. Pacientes grávidas com coarctação da aorta apresentam risco aumentado de complicações: ruptura ou dissecção da aorta, aneurismas no círculo de Willis e endocardite. É importante definir o tratamento oportuno e preventivo durante a gravidez, bem como a via de parto. Apresenta-se o caso clínico de uma paciente com história de coarctação de aorta não corrigida e diagnóstico de pré-eclâmpsia, destacando o processo de cuidado, abordagem diagnóstica e atenção integral durante a internação. Uma revisão da literatura e uma análise crítica do caso também são apresentados. Conclui-se que a coarctação da aorta sem tratamento gera múltiplas complicações por tanto é ressaltada a importância da consulta preconcepcional para avaliar os riscos da gravidez e realizar controle multidisciplinar pela medicina materno-fetal, cardiologia e hemodinâmica. Palavras-chave: coarctação da aorta, gravidez, perinatologia, cardiologia, complicações cardiovasculares da gravidez.
Economically viable alternatives for utilizing municipal solid waste are still a major challenge for society, especially in less developed countries. A potential pathway is using the organic fraction ...of municipal solid waste (OFMSW) to produce energy, biofuels, organic fertilizers, and value-added chemical compounds. We evaluated an integrated biorefinery structure for the treatment of used cooking oil, pruning biomass, and organic and food residues to produce biodiesel, biogas, organic compost, 1,3-propanediol, and electrical energy at the campus of the Federal University of Pernambuco, which was considered a case study to represent a small city of Northeastern Brazil. A pilot transesterification plant, a biodigestion unit, and a compost unit were installed to process 3.3 tons daily of OFMSW produced. Additionally, research was carried out to produce 1,3-propanediol on a laboratory scale from residual glycerol. The quality of the biodiesel generated from the used cooking oil met national technical standards and the conversion of residual oil into biodiesel reached 93%. The average biogas production was 0.584 ± 0.176 Nm
3
kgVS
−1
, with an average methane production of 50% generating up to 44 MWh of electricity per year. The organic compost produced met the quality requirements of organic fertilizers, such as maturation and nutrient contents. Glycerol treatment increased the yield of 1,3-propanediol production. Our findings demonstrate that the integrated biorefinery will lead to a reduction of US$ 80,000 in the costs of OFMSW management. More importantly, this approach generates incentives for circular economy initiatives in small municipalities in Brazil and other less developed countries.
Graphical abstract
Following publication, it was brought to the authors’ attention by Dr. Julia Toscano-Garibay that she did not participate as a reviewer of the final version of this manuscript prior to its submission ...and publication in Clinical Rheumatology.
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