Tracking the National Early Warning Score 2 from prehospital care to the emergency department: A prospective, ambulance-based, observational study

Article Subjects > Biomedicine Europe University of Atlantic > Research > Scientific Production Cerrado Inglés metadata Martín-Rodríguez, Francisco and Sanz-García, Ancor and Ortega, Guillermo J. and Delgado Benito, Juan F. and Aparicio Obregón, Silvia and Martínez Fernández, Francisco T. and González Crespo, Pilar and Otero de la Torre, Santiago and Castro Villamor, Miguel A. and López-Izquierdo, Raúl mail UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, silvia.aparicio@uneatlantico.es, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED, UNSPECIFIED (2021) Tracking the National Early Warning Score 2 from prehospital care to the emergency department: A prospective, ambulance-based, observational study. Prehospital Emergency Care. pp. 1-13. ISSN 1090-3127 (Unpublished)

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Abstract

Aim of the study: To assess the prognostic ability of the National Early Warning Score 2 (NEWS2) at three time points of care -at the emergency scene (NEWS2-1), just before starting the transfer by ambulance to the hospital (NEWS2- 2), and at the hospital triage box (NEWS2-3)- to estimate in-hospital mortality after two days since the index event. Methods: Prospective, multicenter, ambulance-based, cohort ongoing study in adults (>18 years) consecutively attended by advanced life support (ALS) and evacuated with high-priority to the emergency departments (ED) between October 2018 and May 2021. Vital sign measures were used to calculate the NEWS2 score at each time point, then this score was entered in a logistic regression model as the single predictor. Two outcomes were considered: first, all-cause mortality of the patients within 2 days of presentation to EMS, and second, unplanned ICU admission. The calibration and scores comparison was performed by representing the predicted vs the observed risk curves according to NEWS score value. Results: 4943 patients were enrolled. Median age was 69 years (interquartile range 53- 81). The NEWS2-3 presented the better performance for all-cause two-day in-hospital mortality with an AUC of 0.941 (95% CI: 0.917-0.964), showing statistical differences with both the NEWS2-1 (0.872 (95% CI: 0.833-0.911); p < 0.003) and with the NEWS2- 2 (0.895 (95% CI: 0.866-0.925; p < 0.05). The calibration and scores comparison results showed that the NEWS2-3 was the best predictive score followed by the NEWS2-2 and the NEWS2-1, respectively. Conclusions: The NEWS2 has an excellent predictive performance. The score showed a very consistent response over time with the difference between “at the emergency scene” and “pre-evacuation” presenting the sharpest change with decreased threshold values, thus displaying a drop in the risk of acute clinical impairment.

Item Type: Article
Uncontrolled Keywords: Clinical skills; Early warning score; In-hospital mortality; Physiological monitoring; Prehospital care; Vital sings
Subjects: Subjects > Biomedicine
Divisions: Europe University of Atlantic > Research > Scientific Production
Date Deposited: 03 Mar 2022 13:02
Last Modified: 03 Mar 2022 13:02
URI: https://repositorio.uneatlantico.es/id/eprint/487

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Detection of Upper Limb Asymmetries in Athletes According to the Stage of the Season—A Longitudinal Study

Abstract: Sports injuries can affect the performance of athletes. For this reason, functional tests are used for injury assessment and prevention, analyzing physical or physiological imbalances and detecting asymmetries. The main aim of this study was to detect the asymmetries in the upper limbs (right and left arms) in athletes, using the OctoBalance Test (OB), depending on the stage of the season. Two hundred and fifty-two participants (age: 23.33 ± 8.96 years old; height: 178.63 ± 11.12 cm; body mass: 80.28 ± 17.61 kg; body mass index: 24.88 ± 4.58; sports experience: 12.52 ± 6.28 years), practicing different sports (rugby, athletics, football, swimming, handball, triathlon, basketball, hockey, badminton and volleyball), assessed with the OB in medial, superolateral, and inferolateral directions in both arms, in four moments of the season (May 2017, September 2017, February 2018 and May 2018). ANOVA test was used with repeated measures with a p ≤ 0.05, for the analysis of the different studied variances. Significant differences were found (p = 0.021) in the medial direction of the left arm, between the first (May 2017) and fourth stages (May 2018), with values of 71.02 ± 7.15 cm and 65.03 ± 7.66 cm. From the detection of asymmetries, using the OB to measure, in the medial, superolateral and inferolateral directions, mobility and balance can be assessed. In addition, it is possible to observe functional imbalances, as a risk factor for injury, in each of the stages into which the season is divided, which will help in the prevention of injuries and in the individualization of training.

Producción Científica

Álvaro Velarde-Sotres mail alvaro.velarde@uneatlantico.es, Antonio Bores-Cerezal mail antonio.bores@uneatlantico.es, Marcos Mecías-Calvo mail marcos.mecias@uneatlantico.es, Martín Barcala Furelos mail martin.barcala@uneatlantico.es, Silvia Aparicio Obregón mail silvia.aparicio@uneatlantico.es, Julio Calleja-González mail ,

Velarde-Sotres

Blockchain Interoperability: Towards a Sustainable Payment System

The highly fragmented blockchain and cryptocurrency ecosystem necessitates interoperability mechanisms as a requirement for blockchain-technology acceptance. The immediate implication of interchain interoperability is automatic swapping between cryptocurrencies. We performed a systematic review of the existing literature on Blockchain interoperability and atomic cross-chain transactions. We investigated different blockchain interoperability approaches, including industrial solutions, categorized them and identified the key mechanisms used, and list several example projects for each category. We focused on the atomic transactions between blockchain, a process also known as atomic swap. Furthermore, we studied recent implementations along with architectural approaches for atomic swap and deduced research issues and challenges in cross-chain interoperability and atomic swap. Atomic swap can instantly transfer tokens and significantly reduce the associated costs without using any centralized authority, and thus facilitates the development of a sustainable payment system for wider financial inclusion.

Producción Científica

Debasis Mohanty mail , Divya Anand mail , Hani Moaiteq Aljahdali mail , Santos Gracia Villar mail santos.gracia@uneatlantico.es,

Mohanty

The Regular Consumption of Nuts Is Associated with a Lower Prevalence of Abdominal Obesity and Metabolic Syndrome in Older People from the North of Spain

Background: The aim of this study was to relate the adherence to nut consumption (30 g) three or more days per week to the prevalence of abdominal obesity and metabolic syndrome (MetS) in an elderly population from the north of Spain. Methods: The study consists of an observational, descriptive, cross-sectional, and correlational study conducted in 556 non-institutionalised individuals between 65 and 79 years of age. To define the consumption recommendation of nuts the indication of the questionnaire MEDAS-14 was followed. The diagnosis of MetS was conducted using the International Diabetes Federation (IDF) criteria. Results: In 264 subjects aged 71.9 (SD: ±4.2) years old, 39% of whom were men, the adherence to nut consumption recommendations was 40.2%. Of these individuals, 79.5% had abdominal obesity. The prevalence of MetS was 40.2%, being 47.6% in men and 35.4% in women (p < 0.05). A nut consumption lower than recommended was associated with a 19% higher prevalence of abdominal obesity (Prevalence Ratio: 1.19; 95% CI: 1.03−1.37; p < 0.05) and a 61% higher prevalence of MetS (Prevalence Ratio: 1.61; 95% CI: 1.16−2.25; p = 0.005) compared to a consumption of ≥3 servings per week. Conclusion: An inverse relationship was established between nut consumption and the prevalence of abdominal obesity and metabolic syndrome.

Producción Científica

Gloria Cubas-Basterrechea mail , Iñaki Elío Pascual mail inaki.elio@uneatlantico.es, Sandra Sumalla Cano mail sandra.sumalla@uneatlantico.es, Silvia Aparicio Obregón mail silvia.aparicio@uneatlantico.es, Carolina Teresa González-Antón mail , Pedro Muñoz-Cacho mail ,

Cubas-Basterrechea

Effects of ergo-nutritional strategies on recovery in combat sports disciplines

In order to improve the recovery process in combat sports disciplines, ergo-nutritional strategies could be an effective option in training and competition. Some of these ergo-nutritional aids could improve performance but literature references are scarce, with controversial results regarding actual recovery effects. This systematic review aimed to examine which ergo-nutritional methods are most effective for assisting in the recovery process in combat sports, and to determine the appropriate training stimuli. This systematic review was carried out following the Preferred Reporting Items for Systematic Review (PRISMA) guidelines. A computerized search was performed in PubMed, Web of Science, the Cochrane Collaboration Database, Evidence Database, Evidence Based Medicine Search review, National Guidelines, EM-BASE, Scopus and Google Scholar system (from 1995 to April 30, 2021). The PICOS model was used to define inclusion and exclusion criteria. Out of 123 studies initially found, 18 met the eligibility criteria and were included in the review. Data from 367 athletes from different disciplines were examined. The evidence was grouped in 4 areas: oxidative stress, muscle and energy recovery, muscle repair, and metabolic acidosis. Evidence showed that vitamins, minerals, and some natural ergo-nutritional products are effective as antioxidants. Carbohydrates and protein determine the recovery effect. Sodium bicarbonate has a role as primary acidosis metabolic delayer. Accordingly, ergo-nutritional aids can help in the recovery process. Considering the effects outlined in the literature, more studies are needed to provide firm evidence.

Producción Científica

Isaac López Laval mail , Diego Marqués Giménez mail , Álvaro Velarde-Sotres mail alvaro.velarde@uneatlantico.es, Sebastian Sitko mail , Julio Calleja Gonzalez mail ,

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Non-homogeneous dispersion of graphene in polyacrylonitrile substrates induces a migrastatic response and epithelial-like differentiation in MCF7 breast cancer cells

Background Recent advances from studies of graphene and graphene-based derivatives have highlighted the great potential of these nanomaterials as migrastatic agents with the ability to modulate tumor microenvironments. Nevertheless, the administration of graphene nanomaterials in suspensions in vivo is controversial. As an alternative approach, herein, we report the immobilization of high concentrations of graphene nanoplatelets in polyacrylonitrile film substrates (named PAN/G10) and evaluate their potential use as migrastatic agents on cancer cells. Results Breast cancer MCF7 cells cultured on PAN/G10 substrates presented features resembling mesenchymal-to-epithelial transition, e.g., (i) inhibition of migratory activity; (ii) activation of the expression of E-cadherin, cytokeratin 18, ZO-1 and EpCAM, four key molecular markers of epithelial differentiation; (iii) formation of adherens junctions with clustering and adhesion of cancer cells in aggregates or islets, and (iv) reorganization of the actin cytoskeleton resulting in a polygonal cell shape. Remarkably, assessment with Raman spectroscopy revealed that the above-mentioned events were produced when MCF7 cells were preferentially located on top of graphene-rich regions of the PAN/G10 substrates. Conclusions The present data demonstrate the capacity of these composite substrates to induce an epithelial-like differentiation in MCF7 breast cancer cells, resulting in a migrastatic effect without any chemical agent-mediated signaling. Future works will aim to thoroughly evaluate the mechanisms of how PAN/G10 substrates trigger these responses in cancer cells and their potential use as antimetastatics for the treatment of solid cancers.

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Nazely Diban mail , Marián Mantecón-Oria mail , María T. Berciano mail , Alba Puente-Bedia mail , María J. Rivero mail , Ane Urtiaga mail , Miguel Lafarga mail , Olga Tapia Martínez mail olga.tapia@uneatlantico.es,

Diban