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The aim of this study is to explore the existence of different segments of future university students on the basis of their university selection criteria and to analyse the extent to which the segments identified differ as regards the students' perceptions of the reliability of university communication tools. This has been done using 605 usable questionnaires, while the segmentation method employed was a latent class cluster analysis. Future students were divided into five clusters based on their university selection criteria: (1) high academic performance; (2) high academic performance but economy and word of mouth (WOM); (3) unconcerned; (4) independence from parents; and (5) overinformed. The differences in the perceptions of the reliability of universities' communication tools among the clusters identified were studied using the bias-adjusted three-step approach. Students in the cluster labelled 'high academic performance but economy and WOM' tended to rate the university's communication tools as more reliable, while those included in the cluster labelled 'independence from parents' found them to be less reliable. This paper contributes to the marketing theory for higher education by modelling the heterogeneity in the students' choices. This makes it possible to cover one of the main gaps in the literature on higher education.

With the understanding that videogames have become a powerful resource not only for entertainment but also as an educational resource for foreign language teaching today, the objective of this study was to examine the use of the videogame "Broken Sword" for the teaching of French as a foreign language in a higher education setting. To assess the suitability of the video game as a foreign language teaching tool, a quantitative methodology based on a 22-item ad hoc questionnaire was used, through which we collected the assessment of the students. Despite the expectations and the high degree of participation and cooperation of the students surveyed, the results revealed an attitude of indifference regarding the videogame's contributions to language learning. We considered the results to be very positive, as for many of the students this exercise was not only a test with a language that they did not master yet, but also had technical difficulties that they had to overcome. The challenge of this experience invites us to continue working with new videogames titles and to improve our future methodological interventions.

Purpose: Dietary supplement use by athletes has been the topic of previous research; however, the lack of homogeneity among published studies makes it difficult to analyze the differences, if any, in the patterns of use between male and female athletes. The aim of this study was to determine gender differences in the patterns of dietary supplement use by elite athletes. Methods: A total of 504 elite athletes (329 males and 175 females) participating in individual and team sports completed a validated questionnaire on dietary supplement use during the preceding season. The dietary supplements were categorized according to the latest IOC consensus statement. Results: A higher proportion of male versus female athletes (65.3 versus 56.5%, p < 0.05) consumed dietary supplements. Both male and female athletes reported a similar mean consumption of dietary supplements (3.2 ± 2.1 versus 3.4 ± 2.3 supplements/season, respectively; p = 0.45). Protein supplements were the most commonly consumed supplements in male athletes (49.8%) and their prevalence was higher than in female athletes (29.3%, p < 0.01). In females, multivitamins (39.4%) and branched-chain amino acids (39.4%) were the most commonly consumed supplements and iron supplementation was more prevalent than in males (22.2% versus 10.2%, p = 0.01). A higher proportion of male athletes relied on themselves to plan dietary supplements use (48.0%), while female appeared to rely more on doctors (34.0%, p < 0.01). Conclusion: In summary, male athletes had a slightly higher prevalence in the use of supplements than their female counterparts, specifically regarding protein supplements, and were more involved in the self-prescription of supplements.

A research project involving 16 children with Down syndrome aged 4–14 approaching mathematics at home was developed during the COVID‐19‐lockdown in Spain. In the research project a series of 14 short mathematical challenges were designed and delivered in a WhatsApp group used as a communication and documentation tool with the participating families. Videos recorded by them were subsequently analyzed with the purpose of describing and analyzing: (a) the experience children live in contact with informal situations underlying the concepts of number and shape and (b) the engagement of families. The choice of these informal situations is based upon recent research that shows the need to consider the wide range of occasional experiences with mathematical ideas children have in their family prior to schooling. In order to design productive mathematical activities we drew on our past research for the choosing of crucial mathematical issues (whole numbers, plane geometry, and solids). We discuss the evolution in parents from practical help to deep engagement, and the fact that notwithstanding diversity in family contexts, engagement and an especially joyful approach to mathematics emerged. The use of videos opens up a path to the possibility to online learning for children with Down syndrome. [ABSTRACT FROM AUTHOR]

The objective of this research is to analyze the knowledge structure of the academic literature indexed in the Core Collection of the Web of Science on automation in the wine industry, from the first registered article in 1996 to 2022, in order to identify the latest trends in the study of this subject. A bibliometric and systematic analysis of the literature was carried out. First, for the quantitative analysis of the scientific production, the bibliometric study was conducted, using the WoS database for data collection and the VosViewer and Bibliometrix applications to create the network maps. Second, once the literature had been examined quantitatively, content analysis was undertaken using the PRISMA methodology. The results show, among other aspects, the uneven distribution of the examined scientific production from 1996 to 2022, that computer vision, data aggregation, life cycle assessment, precision viticulture, extreme learning machine and collaborative platforms are the major current keywords and the predominance of Spain and Italy in terms of scientific production in the field. There are various justifications which support the originality of this study. First, it contributes to the understanding of academic literature and the identification of the most recent trends in the study of automation in the wine industry. Second, to the best of our knowledge, no prior bibliometric studies have considered this topic. Third, this research evaluates the literature from the first record to the year 2022, thereby providing a comprehensive analysis of the scientific production. [ABSTRACT FROM AUTHOR]

In this paper we try to assess whether there are differences in a group when their members try to remember the content of a text, and if this fact affects the learning levels through an experimental methodology with a design of two groups only with posttest to assess the readers' free recall after reading a text. We found firstly interindividual and intergroup differences in recall of textual material. And secondly text comprehension and therefore the memory of the reading depend largely on reader's inferences. In this paper we propose a specific intervention in order to prepare students for a better understanding of the text read, using a simple methodology to apply with materials easy to prepare.

Background Socioeconomic status (SES) factors often result in profound health inequalities among populations, and their impact may differ between sexes. The aim of this study was to estimate and compare the effect of socioeconomic status indicators on incident cardiovascular disease (CVD)-related events among males and females with type 2 diabetes (T2D). Methods A population-based cohort from a southern European region including 24,650 patients with T2D was followed for five years. The sex-specific associations between SES indicators and the first occurring CVD event were modeled using multivariate Fine-Gray competing risk models. Coronary Heart Disease (CHD) and stroke were considered secondary outcomes. Results Patients without a formal education had a significantly higher risk of CVD than those with a high school or university education, with adjusted hazard ratios (HRs) equal to 1.24 (95%CI: 1.09–1.41) for males and 1.50 (95%CI: 1.09–2.06) for females. Patients with <18 000€ income had also higher CVD risk than those with ≥18 000€, with HRs equal to 1.44 (95%CI: 1.29–1.59) for males and 1.42 (95%CI: 1.26–1.60) for females. Being immigrant showed a HR equal to 0.81 (95%CI: 0.66–0.99) for males and 1.13 (95%CI: 0.68–1.87) for females. Similar results were observed for stroke, but differed for CHD when income is used, which had higher effect in females. Conclusion Socioeconomic inequalities in CVD outcomes are present among T2D patients, and their magnitude for educational attainment is sex-dependent, being higher in females, suggesting the need to consider them when designing tailored primary prevention and management strategies. [ABSTRACT FROM AUTHOR]

Background: In today's business environment, where sustainability has emerged as a strategic axis of business practices, the study of the link between human resources management and environmental management becomes increasingly necessary. In this sense, the present research focuses on analyzing the impact of Green Human Resource Management (GHRM) on the Sustainable Performance (SP) of Spanish wineries, as well as the mediating effect of Employee Wellbeing (EW) and Work Engagement (WE) on this linkage. In addition, age, size and membership in a Protected Designation of Origin (PDO) are introduced as control variables to increase the precision of the cause-effect relationships examined. Methods: The study proposes a conceptual model based on previous studies, which is tested using structural equations (PLS-SEM) with data collected from 196 Spanish wineries between September 2022 and January 2023. Results: The findings of the research reveal the existence of a positive and significant relationship between the GHRM development and the SP of Spanish wineries, as well as the partial mediation of EW and WE in this association. Conclusions: The uniqueness and significance of this study can be attributed to several crucial factors. First, it enhances the understanding and knowledge regarding the advantages associated with GHRM development. Second, no prior research has conducted a comprehensive study on GHRM as a catalyst for SP within the context of Spanish wineries. Third, to the best of the authors' knowledge, no previous study has analyzed the mediating role of EW and WE as mediators in the relationship between GHRM and SP of wineries. [ABSTRACT FROM AUTHOR]

A hydrochemical and mineral study of groundwaters and damaged rocks from the Tíscar and Larva fault zones (Betic Cordillera, Iberian Peninsula) was carried out in order to (a) describe the physical and chemical properties of the groundwaters; (b) recognize significant locations with deep-origin fluids related to active tectonics; (c) and to describe the water–rock interaction and the neoformation of clay mineral processes and their importance in the seismicity of the faults. A sampling campaign was completed between November 2012 and November 2013, during which data were obtained from 23 different groundwater sites in the fault areas. Two main groups of waters were distinguished: (a) Ca2+-Mg2+-HCO3− facies characterized by poor conductivity and salinity; and (b) saline waters (up to 30 meq/L) rich in Ca2+-Mg2+-SO4-Cl− and with an elevated conductivity (frequently > 1000 μS/cm). In addition, a minor group of saline and warm waters (T > 16.5 °C) was found to be Na+-rich and show moderately high B values (>0.33 ppm), and which mig ht be hosted in aquifers deeper than the two main groups. This group of deep-origin waters is oversaturated in clay minerals and is in equilibrium for Ca-Mg carbonate minerals. X-ray diffraction and scanning and transmission electron microscopy data corroborate the crystallization forecast of authigenic smectite, which appears as thin films coating carbonate fragments. The origin of smectite is related to the fragile strain and thermal–fluid–mineral interactions in fault rocks. Smectite could lubricate carbonate rocks, which favor creep deformation versus seismic slip. This work provides locations where groundwater physico-chemical properties and composition suggest tectonic fault activity. [ABSTRACT FROM AUTHOR]

Introduction: The risk of SARS-CoV-2 infection or severe coronavirus disease 2019 (COVID-19) has been shown to increase in patients with multiple sclerosis (MS). Vaccination is recommended in this patient population, and the effect of disease-modifying treatments (DMTs) on response to vaccination should be considered. Methods: This prospective, observational, cross-sectional study investigated humoral response after COVID-19 vaccination as well as possible predictors for response in patients with MS and other neuroinflammatory diseases who received DMTs in routine clinical practice in Spain. Responses were compared versus those seen in healthy controls. Results: After vaccination against COVID-19, most patients with MS developed an immune response comparable to that of healthy individuals. However, approximately half of patients receiving a sphingosine-1-phosphate modulator (SP1-M, fingolimod or siponimod) or a B-cell-depleting agent (aCD20, ocrelizumab or rituximab) did not develop protective antibodies, although patients receiving other DMTs had humoral immune responses comparable to healthy controls. Lymphocyte count was not associated with reduced humoral response in patients receiving an SP1-M or aCD20, whereas, in patients receiving an aCD20 or SP1-M, older age was associated with lower anti-SARS-CoV-2 spike protein immunoglobulin G antibody levels. Conclusions: Treatment with aCD20 or SP1-M therapies appears to be associated with a lower humoral response to vaccines against SARS-CoV-2. Vaccination prior to initiation of these DMTs should be recommended whenever possible. [ABSTRACT FROM AUTHOR]

Since the prevalence of hypophosphatasia (HPP), a rare genetic disease, seems to be underestimated in clinical practice, in this study, a new diagnostic algorithm to identify missed cases of HPP was developed and implemented. Analytical determinations recorded in the Clinical Analysis Unit of the Hospital Universitario Clínico San Cecilio in the period June 2018 – December 2020 were reviewed. A new clinical algorithm to detect HPP-misdiagnosed cases was used including the following steps: confirmation of persistent hypophosphatasemia, exclusion of secondary causes of hypophosphatasemia, determination of serum pyridoxal-5′-phosphate (PLP) and genetic study of ALPL gene. Twenty-four subjects were selected to participate in the study and genetic testing was carried out in 20 of them following clinical algorithm criteria. Eighty percent of patients was misdiagnosed with HPP following the current standard clinical practice. Extrapolating these results to the current Spanish population means that there could be up to 27,177 cases of undiagnosed HPP in Spain. In addition, we found a substantial proportion of HPP patients affected by other comorbidities, such as autoimmune diseases (∼40 %). This new algorithm was effective in detecting previously undiagnosed cases of HPP, which appears to be twice as prevalent as previously estimated for the European population. In the near future, our algorithm could be globally applied routinely in clinical practice to minimize the underdiagnosis of HPP. Additionally, some relevant findings, such as the high prevalence of autoimmune diseases in HPP-affected patients, should be investigated to better characterize this disorder. [ABSTRACT FROM AUTHOR]

In 2020, the COVID-19 pandemic followed a two-wave pattern in most countries. Hospital admission for COVID-19 in one wave or another could have affected mortality, especially among the older persons. The objective of this study was to evaluate whether the admission of older patients during the different waves, before SARS-CoV-2 vaccination was available, was associated with a different mortality. We compared the mortality rates of patients hospitalized during 2020 before (first wave) and after (second wave) July 7, 2020, included in the SEMI-COVID-19 Registry, a large, multicenter, retrospective cohort of patients admitted to 126 Spanish hospitals for COVID-19. A multivariate logistic regression analysis was performed to control for changes in either the patient or disease profile. As of December 26, 2022, 22,494 patients had been included (17,784 from the first wave and 4710 from the second one). Overall mortality was 20.4% in the first wave and 17.2% in the second wave (risk difference (RD) − 3.2%; 95% confidence interval (95% CI) − 4.4 to − 2.0). Only patients aged 70 and older (10,973 patients: 8571 in the first wave and 2386 in the second wave) had a significant reduction in mortality (RD − 7.6%; 95% CI − 9.7 to − 5.5) (unadjusted relative risk reduction: 21.6%). After adjusting for age, comorbidities, variables related to the severity of the disease, and treatment received, admission during the second wave remained a protective factor. In Spain, patients aged 70 years and older admitted during the second wave of the COVID-19 pandemic had a significantly lower risk of mortality, except in severely dependent persons in need of corticosteroid treatment. This effect is independent of patient characteristics, disease severity, or treatment received. This suggests a protective effect of a better standard of care, greater clinical expertise, or a lesser degree of healthcare system overload. [ABSTRACT FROM AUTHOR]

Simple Summary: Supratidal rockpools stand out as some of the most extreme environments on the planet. These pools are exposed to the wave's action, fluctuations in sea level, dramatic shifts in water temperature, high salinity levels, desiccation, and intense sunshine. As a result, only a handful of species can survive there, with aquatic beetles of the genus Ochthebius being the insects that dominate this kind of habitat on the Mediterranean coast. In this work, we genetically analysed four species (O. lejolisii, O. subinteger, O. celatus, and O. quadricollis) found along the Mediterranean coasts of Spain and Malta to develop microsatellite markers, which are repetitive DNA motifs, for the first time for this genus. Additionally, we obtained the complete mitochondrial genome of three species (O. lejolisii, O. subinteger, and O. quadricollis). These newly developed microsatellite markers and mitochondrial genomes for Ochthebius will be valuable in future studies for evolutionary and ecological research on the diversity of this genus: identification, genetic structure, population connectivity, etc. Here we focus on designing, for the first time, microsatellite markers for evolutionary and ecological research on aquatic beetles from the genus Ochthebius (Coleoptera, Hydraenidae). Some of these non-model species, with high cryptic diversity, exclusively inhabit supratidal rockpools, extreme and highly dynamic habitats with important anthropogenic threats. We analysed 15 individuals of four species (O. lejolisii, O. subinteger, O. celatus, and O. quadricollis) across 10 localities from the Mediterranean coasts of Spain and Malta. Using next-generation sequencing technology, two libraries were constructed to interpret the species of the two subgenera present consistently (Ochthebius s. str., O. quadricollis; and Cobalius, the rest of the species). Finally, 20 markers (10 for each subgenus) were obtained and successfully tested by cross-validation in the four species under study. As a by-catch, we could retrieve the complete mitochondrial genomes of O. lejolisii, O. quadricollis, and O. subinteger. Interestingly, the mitochondrial genome of O. quadricollis exhibited high genetic variability compared to already published data. The novel SSR panels and mitochondrial genomes for Ochthebius will be valuable in future research on species identification, diversity, genetic structure, and population connectivity in highly dynamic and threatened habitats such as supratidal coastal rockpools. [ABSTRACT FROM AUTHOR]

Oleotourism (olive oil tourism) is a new form of gastronomic tourism that satisfies increasingly challenging tourist demand, especially in the wake of the pandemic and for tourists who seek not only quality food products but also a safe environment to enjoy their chosen activity. Córdoba is a province in southern Spain where olives play a very important role, accounting for 50% of its cultivated area, and whose agricultural activity can be complemented with tourism due to its 189 oil mills that can welcome visitors for oil tasting. However, this type of tourism is not seeing an expected boom. This research analyzes, through a varimax analysis, the factors that attract and drive oleotourists as well as the components of such tourism. As a result, four principal components related to tourists and tourism offers were obtained, finding a high degree of satisfaction of oleotourist with the routes explored as well as a lack of knowledge of this type of tourism in international markets. [ABSTRACT FROM AUTHOR]

Simple Summary: Apples are one of the most important fruits worldwide. In addition to their interesting nutritional value, they are a source of bioactive compounds with health-promoting effects. The composition may differ in different genotypes so it is important to investigate whether local varieties may differ in terms of total phenolic content, antioxidant, and bioactive properties. In this study Spanish local varieties showed better behavior in terms of phenolic content, antioxidant activity and bioactivity than other commercial samples, acting as functional foods with antiradical, antidiabetic and anti-obesity potential. Apples (Malus domestica Borkh.) have a great agricultural and economic impact worldwide; they also present an interesting nutritional value, and their consumption has been associated with beneficial health effects. In this study, 15 apple varieties (three commercial, 12 autochthonous genotypes) were collected from mountainous areas in Spain and were evaluated for their phenolic content, antioxidant, anti-obesity and antidiabetic activities. Quercetin was tested as the reference substance in bioassays due to its role as one of the most common flavonoids in apples and other vegetables. Total Phenolic Content (TPC) of apple pulp extracts was quantified using the Folin-Ciocalteu method. The antioxidant activity was determined by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) scavenging and xanthine/xanthine oxidase (X/XO) scavenging assays. Antidiabetic and anti-obesity potential were evaluated by inhibition of alpha-glucosidase (α-GLU), advance glycation end products (AGEs) formation and pancreatic lipase. The results showed in general higher phenol content in autochthonous varieties than in commercial apple pulp extracts. Phenolic-rich extracts showed better antioxidant profiles and significantly inhibited AGEs production and the α-glucosidase enzyme in a dose-dependent manner. None of them showed pancreatic lipase inhibitory effects but in general, the genotype known as "Amarilla de Octubre" was the best in terms of TPC and bioactive properties. [ABSTRACT FROM AUTHOR]

Background: Autosomal dominant spinocerebellar ataxia 36 (SCA36) is caused by hexanucleotide repeat expansion in the NOP56 gene. Objectives: To assess frequency, clinical and genetic features of SCA36 in Eastern Spain. Methods: NOP56 expansion was tested in a cohort of undiagnosed cerebellar ataxia families (n = 84). Clinical characterization and haplotype studies were performed. Results: SCA36 was identified in 37 individuals from 16 unrelated families. It represented 5.4% of hereditary ataxia patients. The majority were originally from the same region and displayed a shared haplotype. Mean age at onset was 52.5 years. Non‐ataxic features included: hypoacusis (67.9%), pyramidal signs (46.4%), lingual fasciculations/atrophy (25%), dystonia (17.8%), and parkinsonism with evidence of dopaminergic denervation (10.7%). Conclusions: SCA36 is a frequent cause of hereditary ataxia in Eastern Spain, and is associated with a strong founder effect. SCA36 analysis should be considered prior to other studies, especially in AD presentations. Parkinsonism reported here broadens SCA36 clinical spectrum. [ABSTRACT FROM AUTHOR]

Background: MicroRNAs (miRNAs) are noncoding RNAs involved in post-transcriptional genetic regulation with a proposed role in intercellular communication. miRNAs are considered promising biomarkers in ischemic heart disease. Invasive physiological evaluation allows a precise assessment of each affected coronary compartment. Although some studies have associated the expression of circulating miRNAs with invasive physiological indexes, their global relationship with coronary compartments has not been assessed. Here, we will evaluate circulating miRNAs profiles according to the coronary pattern of the vascular compartment affectation. Study and design: This is an investigator-initiated, multicentre, descriptive study to be conducted at three centres in Spain (NCT05374694). The study will include one hundred consecutive patients older than 18 years with chest pain of presumed coronary cause undergoing invasive physiological evaluation, including fractional flow reserve (FFR) and index of microvascular resistance (IMR). Patients will be initially classified into four groups, according to FFR and IMR: macrovascular and microvascular affectation (FFR≤0.80 / IMR≥25), isolated macrovascular affectation (FFR≤0.80 / IMR<25), isolated microvascular affectation (FFR>0.80 / IMR ≥25) and normal coronary indexes (FFR>0.80 / IMR<25). Patients with isolated microvascular affectation or normal indexes will also undergo the acetylcholine test and may be reclassified as a fifth group in the presence of spasm. A panel of miRNAs previously associated with molecular mechanisms linked to chronic coronary syndrome will be analysed using RT-qPCR. Conclusions: The results of this study will identify miRNA profiles associated with patterns of coronary affectation and will contribute to a better understanding of the mechanistic pathways of coronary pathology. [ABSTRACT FROM AUTHOR]

A determined expansion in the productive capacity of Spanish agriculture was a fundamental and contentious objective during the crisis of the country's ancien régime and the formation of the liberal state, in the years of transition from the eighteenth to the nineteenth centuries. In this study we examine a fundamental reorientation that occurred in an ambitious project for the expansion of irrigation in the region of Valencia. In this region, characterised by a well-rooted commercial agriculture, the original scheme, initiated by an enlightened aristocrat well connected with the royal court, would be profoundly altered in the transition from one political regime to another. The irrigated area increased much more than had been anticipated, and very diverse sections of the social hierarchy eventually benefited from this agricultural expansion. In contrast, the control exercised over the irrigation canal by the aristocrat himself would be increasingly questioned in the context of the nineteenth century. [ABSTRACT FROM AUTHOR]

Most studies on the geomorphological evolution of the Holocene from the Ebro depression (NE Spain) are focused on the period up to the Roman Epoch (218 BC–476 AD) while some references to medieval (476 AD–15th century) deposits are also occasionally dated. This paper focuses on the establishment of aggradation units on the valley bottoms and slopes of the Ebro depression after 1400 BP, their origin, comparison with other areas, and relationship with global paleoenvironmental changes. These units were produced after the incision phase that marked the end of the large Holocene accumulation (unit H1) around 1400 BP (at the end of the Late Roman Epoch). Morphosedimentary records enable us to establish three aggradation units during the last 1400 years: unit H2 (ca. 1400–650 cal BP); unit H3 – with two H3A subunits (ca. 650–500 cal BP) and H3B (ca. 500–320 cal BP); and the H4 unit (after 320 cal BP). These units are organized following five types of aggradation/incision arrangements with differing complexities. There are also connections among these units and two slope stages in the region. Finally, the genetic relationships between these units and global paleoenvironmental changes are shown (LALIA, MCA, and LIA) and related to anthropic activity. This contribution is the first detailed and systematic approach to the study of morphosedimentary units and sedimentary arrangements during the Recent Holocene in the Mediterranean area. [ABSTRACT FROM AUTHOR]

Due to the edaphoclimatic conditions in southeast Spain, which are expected to worsen due to climate change, more efficient ways of using water must be found to maintain sustainable agriculture. Due to the current high price of irrigation control systems in southern Europe, 60–80% of soilless crops are still irrigated, based on the experience of the grower or advisor. The hypothesis of this work is that the development of a low-cost, high-performance control system will allow small farmers to improve the efficiency of water use by obtaining better control of soilless crops. The objective of the present study was to design and develop a cost-effective control system for the optimization of soilless crop irrigation after evaluating the three most commonly used irrigation control systems to determine the most efficient. Based on the agronomic results comparing these methods, a prototype of a commercial smart gravimetric tray was developed. The device records the irrigation and drainage volumes and drainage pH and EC. It also offers the possibility of determining the temperature, EC, and humidity of the substrate. This new design is scalable thanks to the use of an implemented data acquisition system called SDB and the development of software in the Codesys programming environment based on function blocks and variable structures. The reduced wiring achieved by the Modbus-RTU communication protocols means the system is cost-effective even with multiple control zones. It is also compatible with any type of fertigation controller through external activation. Its design and features solve the problems in similar systems available on the market at an affordable cost. The idea is to allow farmers to increase their productivity without having to make a large outlay. The impact of this work will make it possible for small-scale farmers to have access to affordable, state-of-the-art technology for soilless irrigation management leading to a considerable improvement in productivity. [ABSTRACT FROM AUTHOR]

The construction and demolition sectors are among the world's most critical activities, generating large amounts of waste. Thus, these sectors' waste accumulation problem is related to the environmental protection system and proper waste management. On the other hand, it is well known that proper waste disposal can increase its value. In this way, the economic potential of the trash can be raised again. Therefore, this article will examine the economic potential of construction and demolition (C & D) waste. Different waste management processes will be analyzed to better understand the topic from a financial perspective in this area underway in Spain. Therefore, data from other regions of Spain were collected. This data led to results where the most expensive rooms were Pais Vasco and the Balearic Islands, where disposal of C & D waste had the highest prices, exceeding EUR 30 per ton. Conversely, the lowest prices are found in regions such as Navarre and Andalusia, where prices per ton are EUR 8 and EUR 6, respectively. The values show a direct relationship between the treatment price and the amount of C & D waste disposed of. Therefore, this article will look at different factors influencing sustainable waste management. Such activities have a positive impact, as waste needs to be recycled and reevaluated by waste management operators. The cost of construction waste is an integral part of the budget because it represents the monetary value of the cost of collecting and recycling construction waste. Construction waste is an essential resource for economic and social development, as it contributes to job creation, education and culture, and the protection and preservation of the environment. [ABSTRACT FROM AUTHOR]

Salt efflorescences from metal sulphides and their waste are important drivers of pollution both in and around mining areas. However, little is known about these supergene minerals, particularly in the mining areas of the Mediterranean. This study aims to characterise saline efflorescences and their leachates from a Mediterranean mining area located in Southeast Spain. The physicochemical characteristics were determined using stereomicroscopy and compositional analysis, with the following techniques: XRD, WDXRF and TG-MS. Additionally, to assess the risk and potential mobility of their analytes, the samples were subjected to the leaching test DIN 38414-S4. The results showed that the salt efflorescences presented a wide range of crystalline habits and colours. Sulphates were by far the largest mineral group, followed by silicates, oxides and sulphides. Their geochemistry was dominated by elements such as S or Fe, although other potentially toxic elements such as Cd, As, Zn, Pb, Ni and Cu were also present. Due to their high metal(loid) concentrations, the salt crusts studied may act as sources of environmental contaminants, demonstrating that their leachates pose a considerable risk to soil and drinking water quality. An analysis of the correlations and provenances of the components of the salt efflorescences revealed the possible presence of some rare supergene minerals of great interest, such as cuprocopiapite and Pb-As-jarosite. [ABSTRACT FROM AUTHOR]

Copyright of En la España Medieval is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sociedad e Infancias is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Body condition for reproduction in capital breeders such as the red deer (Cervus elaphus) is mostly determined by their stored energy reserves. Thus, environmental conditions and resource availability may affect reproductive performance and breeding success. In warm Mediterranean regions, current climate change is driving to a hotter and drier scenario that is expected to affect the biology and dynamics of many populations. We examined the impact of these local climate variations on red deer body condition and the relationship with female reproductive phenology and breeding success. We used satellite information of landscape vegetation along with a 22-year data series of direct field behavioural observations during the rutting season in Doñana National Park (SW Spain). We analyzed faecal nitrogen content (FN) from faeces collected during the rut. We found that poor vegetation availability in drier years was related to worse body condition of deer (measured by FN) and a delay in the rutting season, which associated with lower reproductive rates (measured by the proportion of females with calves observed the next year). We also evidenced an interesting interaction between environmental conditions in consecutive years on the timing of breeding season, with timing of breeding being more delayed when previous year resource availability was high and many females bred, and the consecutive one was poor, so females hardly recovered condition and the rut occurred later. These findings highlight the carry-over effect of reproduction in capital breeders and the potential impact of climate-change conditions on red deer breeding. [ABSTRACT FROM AUTHOR]

This research evaluates the prevalence of inadequate folate status in early pregnancy, the pattern of prenatal folic acid (FA) supplementation and associated factors in Spanish pregnant women from the ECLIPSES study, which included 791 participants prior gestational week 12. A cross-sectional evaluation of erythrocyte folate levels was performed at recruitment and used to calculate the prevalence of folate deficiency (erythrocyte folate < 340 nmol/l) and insufficiency (erythrocyte folate < 906 nmol/l). Sociodemographic and lifestyle data as well as information on prenatal FA supplementation were recorded. Descriptive and multivariate statistical analyses were performed. The prevalence of folate deficiency and insufficiency were 9·6 % and 86·5 %, respectively. Most of women used prenatal FA supplements, but only 6·3 % did so as recommended. Supplementation with FA during the periconceptional period abolished folate deficiency and reduced folate insufficiency. Prenatal FA supplementation with ≥1000 µg/d in periconceptional time and pregnancy planning increased erythrocyte folate levels. The main risk factor for folate insufficiency in early pregnancy was getting prenatal FA supplementation out of the periconceptional time (OR 3·32, 95 % CI 1·02, 15·36), while for folate deficiency they were young age (OR 2·02, 95 % CI 1·05, 3·99), and smoking (OR 2·39, 95 % CI 1·30, 4·37). In addition, social and ethnic differences according to folate status were also identified. As conclusion, periconceptional FA use is crucial for achieving optimal folate levels in early pregnancy. Pregnancy planning should focus on young women, smokers, those with low consumption of folate-rich foods, low socio-economic status or from ethnic minorities. [ABSTRACT FROM AUTHOR]

Water crises due to climate change, high population growth and increasing demands from industry and agriculture claim for increasing efficiency and universalizing water resources management strategies and techniques. Water monitoring helps providing necessary evidences for making sound decisions about managing water resources both now and in the future. In this work, a low cost and "do it yourself" communication device is proposed to record water production and energy consumption of electric pumpings from deep boreholes/wells, and to predict the impact of the ongoing and previous pumpings in the evolution of the water level in the aquifer. The proposal incorporates an edge-computing approach for the simulation of the aquifer response in real-time. Computation of results of interest is performed at the sensor, minimizing communication requirements and ensuring almost immediate results. An approximated solution to physically based modeling of aquifer response is computed thanks to the a priori expression of the water level time evolution in a reduced basis. The accuracy is enough to detect deviations from expected behaviour. The energy consumption of the device is very much reduced with respect to that of a full modelling, which can be computed off-line for calibrating reduced model parameters and perform detailed analyses. The device is tested in a real scenario, in a mountain subbasin of the Ebro river in Spain, obtaining a good trade-off between performance, price, and energy consumption. [ABSTRACT FROM AUTHOR]

On January 2021, the heaviest snowfall in five decades hit central Spain, especially affecting Madrid. The city's Barajas International Airport closed, along with a number of roads, and all trains to and from Madrid were cancelled. This storm was named Filomena by the Spanish Meteorological Agency (AEMET), and produced continuous snowfall in Spain on 7–10 January. The observed snow depth was around 50 cm in 24 h in Madrid, and even higher in other areas of Spain. However, the measured accumulation of national precipitation gauges was not consistent with the observed accumulated snow on the ground and with the modeled weather forecast. The undercatch of solid precipitation was the primary reason for this inconsistency. This undercatch was quantified using transfer functions developed from the World Meteorological Organization (WMO) Solid Precipitation Intercomparison Experiment (SPICE). Results show that an underestimation of 20%–30% of solid precipitation in large areas of Spain was observed, with some areas experiencing even larger differences. Without adjustments, it was impossible to accurately validate the model forecast. The adjusted precipitation was also more realistically distributed, and it was more consistent with all the damage that occurred. The same methods can be applied to other snowfall events occurring anywhere in the world, and also using different precipitation gauges and/or models. This an example of the type of extreme events that modelers, forecasters, and climatologists should be aware of to avoid misinterpreting differences between modeled precipitation, observed precipitation, and nowcasting. [ABSTRACT FROM AUTHOR]

This study reveals mineral and deformation processes associated with faulting of lacustrine unconsolidated sediments in the Guadix-Baza Basin (Betic Cordillera, S Spain) affected by the Baza Fault. Brittle carbonate and silt sediments develop deformation bands frequently sealed by dolomite crystallization, whereas ductile clay-rich sediments form clay smearing bands where late crystallization of gypsum can be observed. Granular flow and local cataclasis were the main deformation mechanisms in the brittle deformation bands. Flow alignment, grain-boundary sliding, and extrusion were predominant in the clay smearing bands. These water and clay-rich bands reduced shear strength of the faulting process due to their lubricating effect. Beidellitic smectite defines shear foliation of the smeared bands, but Mg-Fe, a K-rich smectite (Fe + Mg > 1 and K content up to 0.8 a.p.f.u), crystallizes in the micropores surrounding brittle clasts produced by deformation pressure shadows. These data suggest that the interaction of micromechanical events, which increased sediment porosity by the generation of pressure shadows, and the flow and concentration of saline fluids in these pores promoted structural diagenesis processes that favoured the beginning of local illitization. [ABSTRACT FROM AUTHOR]

The polyphasic evolution of the testimonial buttes in the central area of the Ebro basin (Los Monegros) is analysed. This is a semiarid area that favours high erosion rates. An evolutionary model of the Jubierre hills is presented that shows the environmental cycles represented by aggradational and degradative processes on the slopes that resulted in the present arrangement of talus flatiron rings. In the four studied cases, talus relicts are composed of detritic material from a disappeared caprock pediment. Four slope stages (S4 to S1) that formed under stable climate conditions are identified. Older stages (S4 and S3) are estimated by comparison with other talus flatirons in the region. The S2 stage contains Bronze Age archaeological remains and the radiocarbon age obtained was 1608–1446 years cal BC (2σ), while S1 is younger. A palaeoenvironmental interpretation was made for these aggradational stages (S4 to S1). The active erosion of these hills led to a relief inversion, and talus flatirons remain as the only features revealing the presence of the relict hills and past human occupations. [ABSTRACT FROM AUTHOR]

Aim: To establish groups of people with chronic non‐cancer pain according to the impairment caused by pain and to identify factors associated with the group with a higher level of impairment. Background: Knowing the profiles of people who suffer from chronic non‐cancer pain could make it possible to direct their treatment and to detect associated risks. Design: A cross‐sectional study. Methods: A sample of 395 people with chronic non‐cancer pain was collected in Pain Units and Primary Healthcare Centres in southern Spain (January to March 2020). A cluster analysis was performed to divide the population into groups and a binary logistic regression model was established to determine factors associated with the group with a higher level of impairment. Results: Two groups were identified: lower level of impairment due to pain, characterized by being 45–65 years old, not medicated with opioids or anxiolytics, employed and with a mild level of impact on daily life; and higher level of impairment characterized by being older than 65 years old, medicated with opioids and anxiolytics, retired or on medical leave and with a severe impact on daily life. In addition, among women, being widowed, single or a smoker are risk factors for belonging to the group with a higher level of impairment; being smokers or consuming alcohol three or less times a week would be risk factors in men. Conclusions: Age, chronic non‐cancer pain impact on daily life, work situation and the consumption of opioid drugs and/or anxiolytics are factors that appear to influence the level of impairment due to chronic pain. Impact These findings could help detect impairment due to pain in its early stages, determining the specific needs of each person. [ABSTRACT FROM AUTHOR]

In recent years, gastronomy has become a fundamental motivation to travel. Learning how to prepare gastronomic dishes and about the raw materials that compose them has attracted increasing numbers of tourists. In Andalusia (region of southern Spain), there are many quality products endorsed by Protected Designations of Origin, around which gastronomic routes have been created, some visited often (e.g., wine) and others remaining unknown (e.g., ham and oil). This study analyses the profile of gastronomic tourists in Andalusia to understand their motivations and estimates the demand for gastronomic tourism using seasonal autoregressive integrated moving average (SARIMA) models. The results obtained indicate that the gastronomic tourist in Andalusia is very satisfied with the places he/she visits and the gastronomy he/she savours. However, the demand for this tourist sector is very low and heterogeneous; while wine tourism is well established, tourism focusing on certain products, such as olive oil or ham, is practically non-existent. To obtain a homogeneous demand, synergies or pairings should be created between food products, e.g., wine-ham, oil-ham, etc., to attract a greater number of tourists and distinguish Andalusia as a gastronomic holiday destination. [ABSTRACT FROM AUTHOR]

The geochemistry of the Ría de Huelva estuary (Spain) has been widely studied owing to its unique conditions due to mixing of acid mine drainage (AMD), river water and seawater, which have been aggravated by the existence of an adjacent phosphate fertilizer plant and its associated phosphogypsum stack. To better understand the complex geochemistry of the overall estuarine system, we make use of (1) measured concentrations of relevant trace elements (rare earth elements (REEs) and metal(loid)s) in the sediments and waters of the estuary and (2) geochemical modeling which combines mixing and adsorption processes. Our study sheds light on the elemental distribution in the sediments and water in the water-mixing area. As seawater neutralizes the acidity of the river water (pH increases to 6.2) colloids of Fe- and Al-oxyhydroxysulphates (schwertmannite and basaluminite, respectively) precipitate as concentrations of aqueous Fe and Al increase. These phases have a high adsorption capacity and play a critical role in the geochemistry of the aquatic system by retaining Cu, Pb, Cr, As, P, REEs and smaller amounts of Zn, Co, Ni and Mn. The geochemical model reproduces the behaviour of the aqueous REEs, requiring high S/L ratios at pH ≥ 3.5 and participation of sediments and colloids in the reactions to match the field data. The evaluation of the effect of the adjacent phosphogypsum stack on the estuarine geochemistry shows that the stack has a notorious impact on the geochemistry of the surrounding estuarine environment owing to the release of high quantities of phosphate. [ABSTRACT FROM AUTHOR]

Aim: This study aims to describe the hiring of nurses in Catalonia and the rest of Spain over 10 years. Background: Precarious employment (PE) has negative consequences for nurses' quality of life and work performance. Methods: Quantitative study using a retrospective, longitudinal, descriptive design. We analysed publicly available employment data from Catalonia and the rest of Spain. Results: Nurses are among the health professionals with the lowest proportion of open‐term (permanent) contracts, 25% during the first 4 years of employment. During the study period, each nurse hired had an average of 3.44 contracts per year. The proportion of nurses with a fixed‐term (non‐permanent) contract shrank from 25.3% in 2006 to 20.5% in 2012 and grew rapidly to 38.7% in 2018. We estimate that 14,800 nurses signed fixed‐term contracts in 2018 without ever having registered as unemployed in nursing. Conclusion: High rates of fixed‐term hiring and the high number of contracts per nurse are evidence of a high level of PE for nurses in Catalonia. Implications for Nursing Management: When policymakers and workforce planners design recruitment and retention programmes for nurses, they should consider improving working conditions by extending more open‐term contracts to combat PE and, indirectly, the shortage of nurses. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected trauma practices all over the world. Despite the increasing number of studies focused on the epidemiology of vertebral fractures (VFs) in COVID-19 patients, the impact of the pandemic on the incidence of trauma pathologies at the emergency department (ED) remains unclear. In Spain, very few studies have explored how the pandemic has affected the care of patients with osteoporotic vertebral fracture (OVF) in the ED and on their follow-up. The aim of this work is to evaluate the impact on the demand for care and diagnosis of VF during the COVID-19 pandemic, as well as the repercussions on patient follow-up. A longitudinal retrospective observational study was designed comparing two cohorts (pre-COVID and COVID) of patients for whom an emergency computed tomography scan was requested due to suspected vertebral fracture. Information was gathered on patient demographics, number and type of OVFs, time of day at which the diagnosis was made, follow-up, and treatment received. Comparative analyses were performed between both patient groups, with stratification by time intervals according to the pandemic waves in the COVID cohort. A total of 581 eligible patients were included in the study. The analyzed cohorts included 288 patients (145 and 143 in the pre-COVID and COVID cohorts, respectively), with a mean age of 73.4 ± 13.8 years and 205 (71.4%) women. No significant differences were observed on most measured variables. In the COVID cohort, the group of patients who received follow up care had a significantly lower mean age than the group that did not receive follow up care (70.2 ± 12.7 vs 76.2 ± 14.1 years, respectively, p = 0.008). In conclusion, the COVID-19 pandemic has had little impact on the diagnosis and management of patients with OVF in our hospital. This could be explained by the specific characteristics of OVFs and the type of patients it affects. Our study has some limitations, mainly derived from its retrospective and single-center nature with a short follow-up interval. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infections in children are frequently asymptomatic or mild and can go unnoticed. This study aimed to describe the seroprevalence and clinical course of SARS-CoV-2 in a cohort of children with rheumatic diseases in a real-life setting and assess possible risk factors. A cross-sectional study was performed in a paediatric rheumatology unit (September 2020 to February 2021). At inclusion, a specific questionnaire was completed and SARS-CoV-2 serology was performed. Demographics, treatment and disease activity of patients with and without laboratory-confirmed SARS-CoV-2 infection were compared. A total of 105 children were included. SARS-CoV-2 infection was demonstrated in 27 patients (25.7%). The mean age was 11.8 years, and most patients were females (72.4%). The most frequent underlying condition was juvenile idiopathic arthritis (70.3%; 19/27). Patients received immunosuppressive treatment in 78% of cases (21/27). Overall, 44.4% (12/27) of infected patients were asymptomatic. A total of 66.7% (18/27) of patients did not require medical assistance. Three patients required hospital admission because of COVID-19. Children with confirmed SARS-CoV-2 infection were less frequently in remission (52% vs 72%; p 0.014). Moderate disease activity and treatment with oral corticosteroids were associated with higher risk for SARS-CoV-2 (OR 5.05; CI 95%: 1.56–16.3 and OR 4.2; CI 95%: 1.26–13.9, respectively). In a cohort of Spanish paediatric patients with rheumatic diseases, clinical course of COVID-19 was mild, with more than one third of asymptomatic cases. Higher disease activity and oral corticosteroids appear to be risk factors for SARS-CoV-2 infection. Key Points • We aimed to investigate the seroprevalence of SARS-CoV-2 infection in a cohort of Spanish paediatric patients with RD, testing both symptomatic and asymptomatic patients. We also compared treatment and disease activity of patients with and without laboratory-confirmed SARS-CoV-2 infection. • In our cohort of 105 paediatric patients with rheumatic diseases, the clinical course of COVID-19 was mild and 44% of cases were asymptomatic. Three cases required hospital admission with no complications. Seroprevalence was 20%. • No association was found between disease activity or treatment with corticosteroids and symptomatic or asymptomatic infection. Higher disease activity and treatment with oral corticosteroids appeared to be risk factors for laboratory-confirmed SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

The crises and the quick technological progress are changing the job market at high speeds. The mobility (search of employment in other countries), the reductions of staff to be competitive or the adaptation at new technologies are always making businesses improve. One of these changes is the necessary increase of small business owners. Morales, Giménez and Morales (2018) say that they are who create their own business; for Alda-Varas, Villardón-Gallego and Elexpuru-Albizuri (2012) entrepreneurship is vital to create new ideas and improve the economy of the society. This explains the importance of introducing actions to develop the entrepreneur. However, nobody starts a job if they don't feel prepared to do it; and in the case of the entrepreneur this is called "entrepreneurial self-efficacy". Morales et al. (2018) define entrepreneurial self-efficacy as the abilities and the aptitude, both cognitive and behavioral, and the beliefs, influenced by many factors (the experience and the emotions), which will determinate the success or not in the creation of a new business. Reynolds, Hay and Camp (1999) explain the meaning of entrepreneurship as the efforts to create businesses or new societies, like self-employment, the foundation of business organisms, or the extension of business already created, directed by one person, a team or an establishment. Enterprising is not a static quality, but a process (Alda-Varas et al., 2012) in constant change. The small business owner passes through a series of periods in which he or she develops his qualities. Summarized, this process has four periods (Alda-Varas et al., 2012) start, institutionalization, decentralization and conglomerate or social cohesion, each involving different functions and tasks. There is a series of characteristics (competences) associated with the self-employment which can forge success in the future: being a persistent person, having passion, determination, farsightedness, flexibility and good communication skills. Besides the abilities and the attitudes quoted that can be denominated "interior factors", there is another set of factors that influence in the success of the small business owner: these are the economic, cultural and social circumstances. It is worth asking at this stage if the current education system helps mould and create this entrepreneurial attitude, this perception of self-employment that motivates the students to consider creating their own business when they finish their studies. Since the education system presents two ways for the students to eventually join the work force (university and professional training), this begs the question if both of these ways are equally effective in developing entrepreneurial skills in the students. This article pretends to describe the perception of the entrepreneurial self-efficacy for the students of the university degree (U.D.) and the superior grade (S.G.) of professional training of the Autonomous City of Melilla, with the purpose to compare all the data with the rest of the autonomous communities of Spain and test two hypotheses: First hypothesis: students who have finalized S.G. will have a better perception of the entrepreneurial self-efficacy than students who have finished U.D. mainly due to the characteristics of the curriculum design. Second hypothesis: students in the 2nd course of S.G. (who have already taken the subject of Training and Vocational Guidance) will present a greater perception of entrepreneurial self-efficacy than those in the 1st course. A total of 177 subjects participated, belonging to both S.G. and U.D., both sexes, and ages between 18 and 50 years old, who answered the scale Entrepreneurial Self-Efficacy (ESE; De Noble, Jung y Ehrlich, 1999), in the adapted version by Moriano et al. (2012). Results show that there is a statistically significant difference between the entrepreneurial self-efficacy perceived in the sample studied and other peninsular students. On the other hand, no difference was found between U.D. and S.G. students. [ABSTRACT FROM AUTHOR]

The different technical and legal tools intended for heritage protection have augmented the possibilities to acknowledge important monumental complexes. However, a contrast lies in the artistic contexts in which, due to the consolidation of their programmatic typology, such monuments require habitation, unlike more conventional monuments. This article collects the results of an accurate investigation conducted by the authors, whose main objective was to obtain a tool that allows consistent measurement of different indicators in which both the protection of the elements, and the capacity for habitation, are safeguarded. To this aim, we contextualized the research at the Monastery of Santa Clara de la Columna in Belalcázar (Córdoba), a monastery with the highest heritage protection in Spain, and which, in turn, accommodates a religious community. The results have allowed us, for the first time in Andalucia, to define objective habitability parameters, within protected heritage contexts. [ABSTRACT FROM AUTHOR]

Introduction: Baricitinib is an oral Janus kinase (JAK)1/JAK2 inhibitor approved to treat rheumatoid arthritis (RA). This study aimed to investigate patients' characteristics, prescription patterns, effectiveness, and treatment persistence in patients receiving baricitinib in real-world practice in Spain. Methods: This retrospective longitudinal cohort study conducted in five rheumatology units included adults with RA initiating baricitinib (Sep-2017–May-19) with at least a 6-month-follow-up. Demographic/clinical characteristics, prescription patterns, and changes in disease activity and pain level were collected until treatment discontinuation/end of follow-up. Treatment persistence was estimated by Kaplan–Meier methods. Results: Data from 182 patients were included (mean (SD)): 83.5% women, 62.2 (12.3) years, body mass index 26.8 (5.1), disease duration 13.2 (10.8) years and Charlson Comorbidity Index score 2.4 (2.0). All patients had received at least one conventional synthetic disease-modifying anti-rheumatic drugs (csDMARD) before starting baricitinib and 78.0% at least one biologic disease-modifying anti-rheumatic drugs (bDMARD). Furthermore, 90.1% started with baricitinib 4 mg/day; 43.4% in monotherapy. One hundred and twelve (61.5%) of patients continued baricitinib at data collection time; mean persistence was 14.1 (0.5) months. Overall treatment persistence was 79.7/64.8/59.1% at 6/12/18 months. Seventy (38.5%) patients discontinued baricitinib during follow-up due to loss of efficacy (68.6%) or adverse events (18.6%). In those patients with available scores at the different observed cut-off points, remission or low disease activity was reported in 71.6 and 76.3% of patients at 6/12 months at any index: Disease Activity Score 28 joints using erythrocyte sedimentation rate (DAS28-ESR) (73.1 and 73.5%), Simplified Disease Activity Index (SDAI) (62.4 and 75.0%), and Clinical Disease Activity Index (CDAI) (66.7 and 78.1%). Good or moderate European League Against Rheumatism (EULAR)-response was noted in 80.0 and 78.2% of patients, respectively. Improvement from baseline in pain (Visual Analog Scale) was 2.5 cm and 3.0 cm at 6/12 months, respectively. Conclusions: This Spanish cohort of patients treated with baricitinib had a long-standing and refractory disease. Nevertheless, high persistence and improvements in disease activity and pain were found at 6 and 12 months after treatment initiation, independently of the composite disease activity measure used, reinforcing the effectiveness of baricitinib in routine clinical practice. [ABSTRACT FROM AUTHOR]

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Importance: It is estimated that only 27% of patients with acute ischemic stroke and large vessel occlusion who undergo successful reperfusion after mechanical thrombectomy are disability free at 90 days. An incomplete microcirculatory reperfusion might contribute to these suboptimal clinical benefits.Objective: To investigate whether treatment with adjunct intra-arterial alteplase after thrombectomy improves outcomes following reperfusion.Design, Setting, and Participants: Phase 2b randomized, double-blind, placebo-controlled trial performed from December 2018 through May 2021 in 7 stroke centers in Catalonia, Spain. The study included 121 patients with large vessel occlusion acute ischemic stroke treated with thrombectomy within 24 hours after stroke onset and with an expanded Treatment in Cerebral Ischemia angiographic score of 2b50 to 3.Interventions: Participants were randomized to receive intra-arterial alteplase (0.225 mg/kg; maximum dose, 22.5 mg) infused over 15 to 30 minutes (n = 61) or placebo (n = 52).Main Outcomes and Measures: The primary outcome was the difference in proportion of patients achieving a score of 0 or 1 on the 90-day modified Rankin Scale (range, 0 [no symptoms] to 6 [death]) in all patients treated as randomized. Safety outcomes included rate of symptomatic intracranial hemorrhage and death.Results: The study was terminated early for inability to maintain placebo availability and enrollment rate because of the COVID-19 pandemic. Of 1825 patients with acute ischemic stroke treated with thrombectomy at the 7 study sites, 748 (41%) patients fulfilled the angiographic criteria, 121 (7%) patients were randomized (mean age, 70.6 [SD, 13.7] years; 57 women [47%]), and 113 (6%) were treated as randomized. The proportion of participants with a modified Rankin Scale score of 0 or 1 at 90 days was 59.0% (36/61) with alteplase and 40.4% (21/52) with placebo (adjusted risk difference, 18.4%; 95% CI, 0.3%-36.4%; P = .047). The proportion of patients with symptomatic intracranial hemorrhage within 24 hours was 0% with alteplase and 3.8% with placebo (risk difference, -3.8%; 95% CI, -13.2% to 2.5%). Ninety-day mortality was 8% with alteplase and 15% with placebo (risk difference, -7.2%; 95% CI, -19.2% to 4.8%).Conclusions and Relevance: Among patients with large vessel occlusion acute ischemic stroke and successful reperfusion following thrombectomy, the use of adjunct intra-arterial alteplase compared with placebo resulted in a greater likelihood of excellent neurological outcome at 90 days. However, because of study limitations, these findings should be interpreted as preliminary and require replication.Trial Registration: ClinicalTrials.gov Identifier: NCT03876119; EudraCT Number: 2018-002195-40. [ABSTRACT FROM AUTHOR]

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We tested whether the concurrence of food intake and elevated concentrations of endogenous melatonin, as occurs with late eating, results in impaired glucose control, in particular in carriers of the type 2 diabetes-associated G allele in the melatonin receptor-1B gene (MTNR1B).Research Design and Methods: In a Spanish natural late-eating population, a randomized, crossover study was performed. Each participant (n = 845) underwent two evening 2-h 75-g oral glucose tolerance tests following an 8-h fast: an early condition scheduled 4 h prior to habitual bedtime ("early dinner timing") and a late condition scheduled 1 h prior to habitual bedtime ("late dinner timing"), simulating an early and a late dinner timing, respectively. Differences in postprandial glucose and insulin responses between early and late dinner timing were determined using incremental area under the curve (AUC) calculated by the trapezoidal method.Results: Melatonin serum levels were 3.5-fold higher in the late versus early condition, with late dinner timing resulting in 6.7% lower insulin AUC and 8.3% higher glucose AUC. The effect of late eating impairing glucose tolerance was stronger in the MTNR1B G-allele carriers than in noncarriers. Genotype differences in glucose tolerance were attributed to reductions in β-cell function (P for interaction, Pint glucose area under the curve = 0.009, Pint corrected insulin response = 0.022, and Pint disposition index = 0.018).Conclusions: Concurrently high endogenous melatonin and carbohydrate intake, as typical for late eating, impairs glucose tolerance, especially in MTNR1B G-risk allele carriers, attributable to insulin secretion defects. [ABSTRACT FROM AUTHOR]

Purpose: To adapt the work endurance recovery (WER) method based on rnndori maximal time to exhaustion (RMTE) for combat situations in judo. Methods: Eleven international-standard judo athletes (7 men and 4 women; mean age 20.73 ± 2.49 y, height 1.72 ±0.11 m, body mass 67.36 ± 10.67 kg) were recruited to take part in the study. All participants performed a maximal incremental test (MIT), a Wingate test (WIN), a Special Judo Fitness Test (SJFT), and 2 RMTE tests. They then took part in a session at an international training camp in Barcelona, Spain, in which 4 methods of load quantification were implemented: the WER method, the Stagno method, the Lucia method, and the session rating of perceived exertion (RPEsession). Results: RMTE demonstrated a very high test-retest reliability (intraclass correlation coefficient =.91), and correlations of the performance tests ranged from moderate to high: RMTE and MIT (r= .66), RMTE and WIN variables (r = .38-.53), RMTE and SJFT variables (r = .74-77). The correlation between the WER method, which considers time to exhaustion, and the other systems for quantifying training load was high: WER and RPEsession (r = .87), WER and Stagno (r = .77), WER and Lucia (r = .73). A comparative repeated-measures analysis of variance of the normalized values of the quantification did not yield statistically significant differences. Conclusions: The WER method using RMTE is highly adaptable to quantify rondori judo sessions and enables one to plan a priori individualized training loads. [ABSTRACT FROM AUTHOR]