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Aims Cardiac resynchronization therapy defibrillators (CRT-D) are able to monitor various parameters that may be combined by an automatic algorithm to provide a heart failure risk status (HFRS). We sought to validate the HFRS for stratifying patient risk, evaluate its association with heart failure (HF) symptoms, and investigate its utility for triage of automatic alerts. Methods and results Data from 722 patients included in the MORE-CARE trial were analysed in a post hoc analysis. A high HFRS was associated with a significantly increased risk of admission over the next 30 days with a relative risk for cardiovascular hospitalization (CVH) of 4.5 (95% CI: 3.1-6.6, P < 0.001), of HF hospitalization of 6.3 (95% CI: 3.9-10.2, P < 0.001) and of non-HF related CVH of 3.5 (95% CI: 2.0-6.9, P < 0.001). The negative predictive value of low or medium HFRS for these admissions was >= 98%. A high HFRS was associated with an increased risk of HF symptoms. Of all the automatic remote monitoring alerts generated during the study, only 10% had a high HFRS. Conclusion The HFRS is able to risk-stratify CRT-D patients, which is potentially useful for managing automatic remote monitoring alerts, by focusing attention on the minority of high-risk patients.

SUMMARY Background: Vitamin A, mainly in their form of retinoic acid, it carries out a function of vital importance during the gestational development, in all the tissues and organs of the body. Objective: To evaluate the levels of retinoic acid in the serum of blood from umbilical cord and to relate them with the weight/gestational age ratio of the newborns and the maternal intake of vitamin A, jointly with socioeconomic and nutritional variables. Method: A descriptive study of traverse court, in the maternities of the Hospitals San Jose and Barros Luco-Trudeau of Santiago, Chile, studying a total of 62 cases. Results: In the population in study, a direct relationship was observed between the newborn ratio weight/gestational age and the maternal consumption of vitamin A, but no relationship was found among the same weight/gestational age ratio and the levels of this vitamin in the serum of blood of umbilical cord. On the other hand, it was found that the

A test with two groups (n for each group = 25) of Holstein cows was conducted to evaluate the effects of chromium picolinate (CrPic) on the incidence of placenta retention (PR). Organic chromium supplementation, equivalent to 3.5 mg Cr d−1 per cow, administered during the last 9 wk of pregnancy, decreased nearly four times the incidence of placental retention observed in unsupplemented cows (16% vs. 56%, P

Our capacity to recognize clinical situations--such as epileptic crises--depends on observation, clinical analysis, evolution, response to drugs and the establishment of a rational differential diagnosis of crises. Sometimes, with all these clinical factors and complementary tests, epileptic crises may be recognized and diagnosed. Thanks to current advances in neuroimaging and other complementary tests, we can recognize all the various ways in which cerebrovascular disease becomes manifest in relation to crises and epilepsies together with normal aging and dementias, and genetic factors which affect the occurrence of crises in senile patients and modulate aging of the brain. Considering the above data, it is possible to diagnose as symptomatic 80-90% of cases of epilepsy occurring in senile patients. There will be fewer cryptogenic and idiopathic cases of epilepsy in adults. The most outstanding epidemiological studies give high percentages of idiopathic cases in adults and the elderly. On critical analysis, no detailed examination is described for each patient to determine the aetiology, before labelling the case as idiopathic. In young adults, many so-called idiopathic cases of genetic origin, and occur during adolescence. These same types of epilepsy may been seen in young adults and in adolescents. Other genetic syndromes include familial temporal epilepsy, nocturnal familial frontal epilepsy, etc.

ILO pub. Working paper on trends in the utilization of manufacturing production capacity in Ecuador from 1975 to 1980 - examines business cycles, finding production increase does not keep up with its potential in certain economic sectors; attributes fluctuations to changes in purchasing power, export volume, import substitution according to industrial policy, credit policies, trade policy, etc. Bibliography, graphs, statistical tables.

A series of moment capacity tests have been carried out at model scale, to investigate the effects of different installation procedures on the response of suction caisson foundations in sand. Two caissons of different diameters and wall thicknesses, but similar skirt length to diameter ratio, have been tested in watersaturated dense sand. The caissons were installed either by pushing or by using suction. It was found that the moment resistance depends on the method of installation. © 2005 Taylor and Francis Group.

The laboratory investigation of monotonic loading response of skirted shallow foundations on sand was discussed. The objectives of the study were to provide input for the plasticity models and to help in solving the civil engineering problem in the development of design calculations for wind turbines in the offshore environments. The vertical loading values calculated by the method were used for developing installation calculation procedures. The results of the method were also useful in determining the ultimate moment capacity of the shallow foundation when the vertical load was very low.

Background Physical activity is a major, modifiable, risk factor for cardiovascular disease (CVD) that contributes to the prevention and management of CVD. The aim of this study was to assess the short- and medium-term effectiveness of 9 months of a supervised physical activity program, including sociocultural activities, on CVD risk in adults. Methods Multicentered, randomized, controlled community intervention involving 364 patients in four primary care centers. The participants were randomly assigned to a Control Group (CG = 104) or Intervention Group (IG = 260); mean age 65.19 years; 76.8% women. The intervention consisted of 120 min/week walking (396 METs/min/week) and sociocultural gathering once a month. Clinical history, physical activity, dietary intake, CVD risk factors (smoking, systolic and diastolic blood pressure, weight, waist circumference, BMI, total cholesterol, LDL- and HDL-cholesterol, triglycerides, glycosylated hemoglobin and glucose) and global CVD risk were assessed at baseline and at the end of the intervention and multivariate models were applied to the data. Incidence of adverse cardiovascular events and continued adherence to the physical activity were assessed 2 years after intervention. Results At the end of the intervention period, in the IG relative to the CG group, there was a significant increase in physical activity (774.81 METs/min/week), a significant change during the intervention period in systolic blood pressure ( '6.63 mmHg), total cholesterol ( '10.12 mg/dL) and LDL-cholesterol ( '9.05 mg/dL) even after adjustment for potential confounders. At 2 years after the intervention, in the IG, compared with the CG, tthe incidence of adverse cardiovascular events was significantly lower (2.5% vs. 10.5%) and the adherence to regular physi

Intervention program; Physical activity; Cardiovascular disease risk prevention; Primary care program Activitat física; Prevenció de riscos de malalties cardiovasculars; Programa d'atenció primària Actividad física; Prevención de riesgos de enfermedades cardiovasculares; Programa de atención primaria BACKGROUND: Physical activity is a major, modifiable, risk factor for cardiovascular disease (CVD) that contributes to the prevention and management of CVD. The aim of this study was to assess the short- and medium-term effectiveness of 9 months of a supervised physical activity program, including sociocultural activities, on CVD risk in adults. METHODS: Multicentered, randomized, controlled community intervention involving 364 patients in four primary care centers. The participants were randomly assigned to a Control Group (CG = 104) or Intervention Group (IG = 260); mean age 65.19 years; 76.8% women. The intervention consisted of 120 min/week walking (396 METs/min/week) and sociocultural gathering once a month. Clinical history, physical activity, dietary intake, CVD risk factors (smoking, systolic and diastolic blood pressure, weight, waist circumference, BMI, total cholesterol, LDL- and HDL-cholesterol, triglycerides, glycosylated hemoglobin and glucose) and global CVD risk were assessed at baseline and at the end of the intervention and multivariate models were applied to the data. Incidence of adverse cardiovascular events and continued adherence to the physical activity were assessed 2 years after intervention. RESULTS: At the end of the intervention period, in the IG relative to the CG group, there was a significant increase in physical activity (774.81 METs/min/week), a significant change during the intervention period in systolic blood pressure (-6.63 mmHg), total cholesterol (-10.12 mg/dL) and LDL-cholesterol (-9.05 mg/dL) even after adjustment for potential confounders. At 2 years after the intervention, in the IG, compared with the CG, tthe incidence of adverse cardiovascular events was significantly lower (2.5% vs. 10.5%) and the adherence to regular physical activity was higher (72.8% vs 27.2%) in IG compared to CG. CONCLUSIONS: This community-based physical activity program improved cardiovascular health in the short- as well as medium-term, and promoted regular physical activity in the medium-term in older Spanish adults. TRIALS REGISTRATION: Clinicaltrials.gov ID NCT02767739 . Trial registered on May 5th, 2016. Retrospectively registered.

Cardiopulmonary resuscitation; Out-of-hospital cardiac arrest; Technology Reanimación cardiopulmonar; Paro cardíaco extrahospitalario; Tecnología Reanimació cardiopulmonar; Aturada cardíaca extrahospitalària; Tecnologia Background: Cardiorespiratory arrest (CRA) is a health emergency with high mortality. Mortality depends on time of initiation and quality of cardiopulmonary resuscitation (CPR) manoeuvres and the use of the automated external defibrillator (AED). Methods: The aim of the study is to determine the effectiveness of an automatically activated network of volunteers using smartwatch and smartphone applications on the reduction of time of initiation of cardiopulmonary resuscitation manoeuvres. The protocol will be developed in four phases: 1) validation of an application (App) for smartwatch that automatically generates a health alert in case of out-of-hospital cardiorespiratory arrest (OHCA); 2) training course for laypersons on CPR manoeuvres and AED use; 3) creation of a network of volunteers trained in CPR and AED use that covers our city; and 4) simulation in which the network of volunteers is automatically activated via smartphone to attend simulated OHCAs. A total of 134 health alerts will be generated; on 67 occasions the alert will be directed to the emergency health services and to the network of trained volunteers (Intervention Group) and on 67 occasions the alert will be solely directed to the emergency health services (Control Group). The arrival time of the first rescuer, category of first rescuer (emergency services versus network of volunteers), initiation time of manoeuvres and competence will be recorded. Discussion: CPR training for laypersons is advised, especially for relatives and people close to patients with heart disease, to reduce time of initiation of CPR and to improve OHCA survival rates. This study aims to verify that the initiation time of CPR manoeuvres and AED use is shorter in the intervention than in the control group.

Out-of-hospital cardiac arrest (OHCA) mortality remains high. The best survival rates are achieved when trained people provide OHCA victims with cardiopulmonary resuscitation (CPR), however, it is estimated that only 25% of victims receive CPR. This community health study aims to evaluate the effectiveness of a training programme in basic CPR and in the use of an automatic external defibrillator (AED) on knowledge and skills for lay people, and its social impact. The training courses were based on Catalan Council of Resuscitation guidelines. Data were collected on sociodemographic characteristics, evaluation of knowledge and practical skills at baseline and at the end of the training courses, and also on the social impact of the programme. A total of 36 training courses with 482 participants were carried out, and most participants achieved a qualification of suitable. The mean score in knowledge was 3.1 &plusmn, 1.1 at baseline and 3.8 &plusmn, 1.2 (p = 0.001) at the end of the programme. Participants rated the training courses as very satisfactory, considered the training useful, and felt more qualified to respond to an emergency. This study shows that a high percentage of participants acquired skills in basic CPR and use of an AED, which confirms the usefulness and effectiveness of training courses and its important social impact.

Species co-occur with different sets of other species across their geographical distribution,which can be either closely or distantly related. Such co-occurrence patterns and their phylogenetic structure within individual species ranges represent what we call the species phylogenetic fields (PFs). These PFs allow investigation of the role of historical processes—speciation, extinction and dispersal—in shaping species co-occurrence patterns, in both extinct and extant species. Here, we investigate PFs of large mammalian species during the last 3 Myr, and how these correlate with trends in diversification rates. Using the fossil record, we evaluate species’ distributional and co-occurrence patterns along with their phylogenetic structure. We apply a novel Bayesian framework on fossil occurrences to estimate diversification rates through time. Our findings highlight the effect of evolutionary processes and past climatic changes on species’ distributions and co-occurrences. From the Late Pliocene to the Recent, mammal species seem to have responded in an individualistic manner to climate changes and diversification dynamics, co-occurring with different sets of species from different lineages across their geographical ranges. These findings stress the difficulty of forecasting potential effects of future climate changes on biodiversity. © 2016 The Author(s) Published by the Royal Society. All rights reserved.