Gestión del tratamiento dietético cuali-cuantitativo en el sobrepeso y la obesidad: metodología y una nueva perspectiva de asesoramiento individualizado

%WL: porcentaje de pérdida de peso; %FL: porcentaje de pérdida de grasa. Objetivo: describir la metodología en la gestión del tratamiento dietético cuali-cuantitativo en el sobrepeso y la obesidad. Método: se llevaron a cabo 4.625 consultas con 616 pacientes mayores de 25 años con sobrepeso y obesidad, en el sur-este de España, durante los años 2006-12. Se utilizó una dieta equilibrada, hipocalórica, cuali-cuantitativa con alimentos de la zona. Se describió la metodología del tratamiento dietético en la pérdida y el mantenimiento. Se trató qué unidades de medida son adecuadas para la expresión del éxito en la pérdida; una nueva visión del asesoramiento individualizado y el tratamiento multidisciplinar. Resultados: el 80% de los pacientes obtienen un %FL ≥ 5% (22,6 ± 11,8 - 11,2 ± 7,4), y asistieron a la consulta más de mes y medio. Conclusión: se presenta un esquema de la metodología del tratamiento dietético; se han recomendado las unidades de medidas a utilizar en consulta y en la publicación de ensayos clínicos, creando un precedente con grado de evidencia de cómo determinar la pérdida exitosa; se recomienda medir los perímetros de cadera y cintura, e incorporar el estudio de la imagen corporal; se presenta una nueva visión del asesoramiento individualizado y una atención multidisciplinar avanzada, independiente de la edad, el estado de gestación y las minusvalías físicas. La postura del sanitario debe de ser considerada como el gestor encargado de determinar qué técnicas podrían ser más efectivas en dicha pérdida.

Spectral BRDF-based determination of proper measurement geometries to characterize color shift of special effect coatings

A reduced set of measurement geometries allows the spectral reflectance of special effect coatings to be predicted for any other geometry. A physical model based on flake-related parameters has been used to determine nonredundant measurement geometries for the complete description of the spectral bidirectional reflectance distribution function (BRDF). The analysis of experimental spectral BRDF was carried out by means of principal component analysis. From this analysis, a set of nine measurement geometries was proposed to characterize special effect coatings. It was shown that, for two different special effect coatings, these geometries provide a good prediction of their complete color shift.

Simultaneous synthesis of work exchange networks with heat integration

The optimal integration of work and its interaction with heat can represent large energy savings in industrial plants. This paper introduces a new optimization model for the simultaneous synthesis of work exchange networks (WENs), with heat integration for the optimal pressure recovery of process gaseous streams. The proposed approach for the WEN synthesis is analogous to the well-known problem of synthesis of heat exchanger networks (HENs). Thus, there is work exchange between high-pressure (HP) and low-pressure (LP) streams, achieved by pressure manipulation equipment running on common axes. The model allows the use of several units of single-shaft-turbine-compressor (SSTC), as well as stand-alone compressors, turbines and valves. Helper motors and generators are used to respond to any demand and excess of energy. Moreover, between the WEN stages the streams are sent to the HEN to promote thermal recovery, aiming to enhance the work integration. A multi-stage superstructure is proposed to represent the process. The WEN superstructure is optimized in a mixed-integer nonlinear programming (MINLP) formulation and solved with the GAMS software, with the goal of minimizing the total annualized cost. Three examples are conducted to verify the accuracy of the proposed method. In all case studies, the heat integration between WEN stages is essential to improve the pressure recovery, and to reduce the total costs involved in the process.

Visual Manifestations of Primary Metaphors Through Mise-en-scène Techniques

Grady distinguishes two main types of metaphor in order to provide a solution in the controversies stemming from the conceptual theory of metaphor: correlation-based metaphors and resemblance metaphors. In “correlation-based metaphors”, the source domain is sensory-motor, while the target domain is not. On the contrary, “resemblance metaphors” are originated by a physical or conceptual perception which is common in both domains, by the association of concepts with common features. Primary metaphors are the minimal units of correlation-based metaphors; they are inherent in human nature and the result of the nature of our brain, our body and the world that we inhabit. We acquire them automatically and we cannot avoid them. Furthermore, as corporal experiences are universal, so are primary metaphors. In this paper, I will argue that primary metaphors manifest themselves visually through scene-setting techniques such as composition, framing, camera movement or lighting. Film-makers can use the different aspects of mise-en-scène metaphorically in order to express abstract notions like evil, importance, control, relationship or confusion. Such visual manifestations, as also occurs with their verbal equivalents, frequently go unnoticed or have been used so often that they have become clichés. But the important thing to bear in mind is that their origin lies in a primary metaphor and due to this origin these kinds of film-making strategies have been so expressively successful.

Repeatability and reproducibility of corneal thickness using SOCT Copernicus HR

Purpose: The aim of this study is to determine the reliability of corneal thickness measurements derived from SOCT Copernicus HR (Fourier domain OCT). Methods: Thirty healthy eyes of 30 subjects were evaluated. One eye of each patient was chosen randomly. Images were obtained of the central (up to 2.0 mm from the corneal apex) and paracentral (2.0 to 4.0 mm) cornea. We assessed corneal thickness (central and paracentral) and epithelium thickness. The intra-observer repeatability data were analysed using the intra-class correlation coefficient (ICC) for a range of 95 per cent within-subject standard deviation (SW) and the within-subject coefficient of variation (CW). The level of agreement by Bland–Altman analysis was also represented for the study of the reproducibility between observers and agreement between methods of measurement (automatic versus manual). Results: The mean value of the central corneal thickness (CCT) was 542.4 ± 30.1 μm (SD). There was a high intra-observer agreement, finding the best result in the central sector with an intra-class correlation coefficient of 0.99, 95 per cent CI (0.989 to 0.997) and the worst, in the minimum corneal thickness, with an intra-class correlation coefficient of 0.672, 95 per cent CI (0.417 to 0.829). Reproducibility between observers was very high. The best result was found in the central sector thickness obtained both manually and automatically with an intra-class correlation coefficient of 0.990 in both cases and the worst result in the maximum corneal thickness with an intra-class correlation coefficient of 0.827. The agreement between measurement methods was also very high with intra-class correlation coefficient greater than 0.91. On the other hand the repeatability and reproducibility for epithelial measurements was poor. Conclusion: Pachymetric mapping with SOCT Copernicus HR was found to be highly repeatable and reproducible. We found that the device lacks an appropriate ergonomic design as proper focusing of the laser beam onto the cornea for anterior segment scanning required that patients were positioned slightly farther away from the machine head-rest than in the setup for retinal imaging.

Assessment of the Association of Health with the Liberalisation of Trade in Services under the World Trade Organisation

Background: The liberalisation of trade in services which began in 1995 under the General Agreement on Trade in Services (GATS) of the World Trade Organisation (WTO) has generated arguments for and against its potential health effects. Our goal was to explore the relationship between the liberalisation of services under the GATS and three health indicators – life expectancy (LE), under-5 mortality (U5M) and maternal mortality (MM) - since the WTO was established. Methods and Findings: This was a cross-sectional ecological study that explored the association in 2010 and 1995 between liberalisation and health (LE, U5M and MM), and between liberalisation and progress in health in the period 1995–2010, considering variables related to economic and social policies such as per capita income (GDP pc), public expenditure on health (PEH), and income inequality (Gini index). The units of observation and analysis were WTO member countries with data available for 2010 (n = 116), 1995 (n = 114) and 1995–2010 (n = 114). We conducted bivariate and multivariate linear regression analyses adjusted for GDP pc, Gini and PEH. Increased global liberalisation in services under the WTO was associated with better health in 2010 (U5M: 20.358 p,0.001; MM: 20.338 p = 0.001; LE: 0.247 p = 0.008) and in 1995, after adjusting for economic and social policy variables. For the period 1995–2010, progress in health was associated with income equality, PEH and per capita income. No association was found with global liberalisation in services. Conclusions: The favourable association in 2010 between health and liberalisation in services under the WTO seems to reflect a pre-WTO association observed in the 1995 data. However, this liberalisation did not appear as a factor associated with progress in health during 1995–2010. Income equality, health expenditure and per capita income were more powerful determinants of the health of populations.

Assessment of University External Internships. Towards a Mixed Model for Measuring the Acquisition of Skills and the Satisfaction of Parties Involved

The continuous improvement of management and assessment processes for curricular external internships has led a group of university teachers specialised in this area to develop a mixed model of measurement that combines the verification of skill acquisition by those students choosing external internships with the satisfaction of the parties involved in that process. They included academics, educational tutors of companies and organisations and administration and services personnel in the latter category. The experience, developed within University of Alicante, has been carried out in the degrees of Business Administration and Management, Business Studies, Economics, Advertising and Public Relations, Sociology and Social Work, all part of the Faculty of Economics and Business. By designing and managing closed standardised interviews and other research tools, validated outside the centre, a system of continuous improvement and quality assurance has been created, clearly contributing to the gradual increase in the number of students with internships in this Faculty, as well as to the improvement in satisfaction, efficiency and efficacy indicators at a global level. As this experience of educational innovation has shown, the acquisition of curricular knowledge, skills, abilities and competences by the students is directly correlated with the satisfaction of those parties involved in a process that takes the student beyond the physical borders of a university campus. Ensuring the latter is a task made easier by the implementation of a mixed assessment method, combining continuous and final assessment, and characterised by its rigorousness and simple management. This report presents that model, subject in turn to a persistent and continuous control, a model all parties involved in the external internships are taking part of. Its short-term results imply an increase, estimated at 15% for the last course, in the number of students choosing curricular internships and, for the medium and long-term, a major interweaving between the academic world and its social and productive environment, both in the business and institutional areas. The potentiality of this assessment model does not lie only in the quality of its measurement tools, but also in the effects from its use in the various groups and in the actions that are carried out as a result of its implementation and which, without any doubt and as it is shown below, are the real guarantee of a continuous improvement.

Global color estimation of special-effect coatings from measurements by commercially available portable multiangle spectrophotometers

Colors of special-effect coatings have strong dependence on illumination/viewing geometry and an appealing appearance. An open question is to ask about the minimum number of measurement geometries required to completely characterize their observed color shift. A recently published principal components analysis (PCA)-based procedure to estimate the color of special-effect coatings at any geometry from measurements at a reduced set of geometries was tested in this work by using the measurement geometries of commercial portable multiangle spectrophotometers X-Rite MA98, Datacolor FX10, and BYK-mac as reduced sets. The performance of the proposed PCA procedure for the color-shift estimation for these commercial geometries has been examined for 15 special-effect coatings. Our results suggest that for rendering the color appearance of 3D objects covered with special-effect coatings, the color accuracy obtained with this procedure may be sufficient. This is the case especially if geometries of X-Rite MA98 or Datacolor FX10 are used.

Semiotic Vision of Ideologies

A semiotic theory of systems derived from language would have the purpose of classifying all the systems of linguistic expression: philosophy, ideology, myth, poetry, art, as much as the dream, lapsus, and free association in a pluridimensional matrix that will interact with many diversified fields. In each one of these discourses it is necessary to consider a plurality of questions, the essence of which will only be comprehensible by the totality; it will be necessary to ask, in the first place, what will be the purpose of this language, what function does it fulfill and for which reason has it been constructed. The concept of World vision (WV) is introduced and its relation with Generalized Collective Conscience (GCC) and Particularized Collective Conscience. Culture implies a particular WV. Culture creates GCC. The semantic field is a structure that formalizes the units of a certain culture constituting a portion of the vision of the Reality that owns this culture. An ecological case is explained.

MINLP Optimization Algorithm for the Synthesis of Heat and Work Exchange Networks

This paper introduces a new optimization model for the simultaneous synthesis of heat and work exchange networks. The work integration is performed in the work exchange network (WEN), while the heat integration is carried out in the heat exchanger network (HEN). In the WEN synthesis, streams at high-pressure (HP) and low-pressure (LP) are subjected to pressure manipulation stages, via turbines and compressors running on common shafts and stand-alone equipment. The model allows the use of several units of single-shaft-turbine-compressor (SSTC), as well as helper motors and generators to respond to any shortage and/or excess of energy, respectively, in the SSTC axes. The heat integration of the streams occurs in the HEN between each WEN stage. Thus, as the inlet and outlet streams temperatures in the HEN are dependent of the WEN design, they must be considered as optimization variables. The proposed multi-stage superstructure is formulated in mixed-integer nonlinear programming (MINLP), in order to minimize the total annualized cost composed by capital and operational expenses. A case study is conducted to verify the accuracy of the proposed approach. The results indicate that the heat integration between the WEN stages is essential to enhance the work integration, and to reduce the total cost of process due the need of a smaller amount of hot and cold utilities.

Indicators of success in the dietary management of overweight and obesity: weight, body fat loss and quality

Concepts: %WL: Percentage of weight loss; %FL: Percentage of fat loss. Objective: evaluate which unit of measurement for weight loss could determine the success or failure of dietary treatment for overweight and obesity. Method: 4,625 consultations carried out on 616 patients in the southeast of Spain from 2006 to 2012. All of the patients were over 25 years of age and suffered from overweight or obesity. The consultations were carried out every fortnight, using the Mediterranean or low-calorie diet. The patients were divided into four groups according to their %WL and %FL. Results: most of the sample consisted of: women; participants between 25-45 years of age; attended consultations for over a month and a half; obese. 80% of the patients obtained a %FL ≥ 5% (15.5 ± 12.8). The groups with a higher %FL obtained significant differences in weight loss (22.6 vs 11.2%, p = 0.000). The multinomial analysis shows significant differences between the groups with the highest %FL and the lowest %WL and %FL: sex (p = 0.006 vs p = 0.005), BMI (p = 0.010 vs p = 0.003) and attendance (p = 0.000 vs p = 0.000). Conclusion: the patients who lost < 5% of fat had higher initial parameters (percentage of weight and fat); most of the sample lost ≥ 5% of fat. This means that the method of personalised dietary treatment results in a high fat loss; fat is an indicator of the quality loss obtained. Recommendations: use the measurement of fat as a complementary unit of measurement to weight loss; establish a limit of 5% to evaluate such loss; and increase this type of research in any method of weight loss.

On the Radial Onset of Clumping in the Wind of the B0I Massive Star QV Nor

We present an analysis of a 78 ks Chandra high-energy transmission gratings observation of the B0I star QV Nor, the massive donor of the wind-accreting pulsar 4U1538−52. The neutron star (NS) orbits its companion in a very close orbit (r < 1.4R*, in units of the stellar radii), thereby allowing probing of the innermost wind regions. The flux of the Fe Kα line during eclipse reduces to only ∼30% of the flux measured out of eclipse. This indicates that the majority of Fe fluorescence must be produced in regions close to the NS, at distances smaller than 1R* from its surface. The fact that the flux of the continuum decreases to only ∼3% during eclipse allows for a high contrast of the Fe Kα line fluorescence during eclipse. The line is not resolved and centered at 1.9368 0.0018 l = 0.0032 - + Å. From the inferred plasma speed limit of v < c l < 800 l D km s−1 and range of ionization parameters of log 1, 2 x = [- ], together with the stellar density profile, we constrain the location of the cold, dense material in the stellar wind of QV Nor using simple geometrical considerations. We then use the Fe Kα line fluorescence as a tracer of wind clumps and determine that these clumps in the stellar wind of QV Nor (B0I) must already be present at radii r < 1.25R*, close to the photosphere of the star.

The Early Miocene “Bisciaro volcaniclastic event” (northern Apennines, Italy): a key study for the geodynamic evolution of the central-western Mediterranean

The Early Miocene Bisciaro Fm., a marly limestone succession cropping out widely in the Umbria–Romagna–Marche Apennines, is characterized by a high amount of volcaniclastic content, characterizing this unit as a peculiar event of the Adria Plate margin. Because of this volcaniclastic event, also recognizable in different sectors of the central-western Mediterranean chains, this formation is proposed as a “marker” for the geodynamic evolution of the area. In the Bisciaro Fm., the volcaniclastic supply starts with the “Raffaello” bed (Earliest Aquitanian) that marks the base of the formation and ends in the lower portion of the Schlier Fm. (Late Burdigalian–Langhian p.p.). Forty-one studied successions allowed the recognition of three main petrofacies: (1) Pyroclastic Deposits (volcanic materials more than 90 %) including the sub-petrofacies 1A, Vitroclastic/crystallo-vitroclastic tuffs; 1B, Bentonitic deposits; and 1C, Ocraceous and blackish layers; (2) Resedimented Syn-Eruptive Volcanogenic Deposits (volcanic material 30–90 %) including the sub-petrofacies 2A, High-density volcanogenic turbidites; 2B, Low-density volcanogenic turbidites; 2C, Crystal-rich volcanogenic deposits; and 2D, Glauconitic-rich volcaniclastites; (3) Mixing of Volcaniclastic Sediments with Marine Deposits (volcanic material 5–30 %, mixed with marine sediments: marls, calcareous marls, and marly limestones). Coeval volcaniclastic deposits recognizable in different tectonic units of the Apennines, Maghrebian, and Betic Chains show petrofacies and chemical–geochemical features related to a similar calc-alkaline magmatism. The characterization of this event led to the hypothesis of a co-genetic relationship between volcanic activity centres (primary volcanic systems) and depositional basins (depositional processes) in the Early Miocene palaeogeographic and palaeotectonic evolution of the central-western Mediterranean region. The results support the proposal of a geodynamic model of this area that considers previously proposed interpretations.

Compositional signatures of the Cenozoic sedimentary succesions of the Malaguide Complex (Betic Cordillera, Spain)

The studied Cenozoic sedimentary successions consist of deposits from continental/shallow-water to deep-marine environments of the Malaguide Complex (Betic Cordillera) outcropping in the Sierra Espuña area (SE Spain). The aim of this study is to characterize the composition, source area(s) provenance and weathering processes of these sedimentary successions from the pre-orogenic (Paleocene-Early Oligocene) to the syn-orogenic (Late Oligocene-Early Miocene) stage using petrological and geochemical methodologies. The studied sandstones are mainly quartzolithic with abundant metamorphic and sedimentary lithic fragments. In particular, the composition of samples from the pre-orogenic cycle is mainly carbonate with important siliciclastic components that occur within the medium to fine grained arenites. The composition of samples from the syn-orogenic cycle is characterized by a sharp change from carbonate to siliciclastic terms. Thus, the composition of the overall sandstone samples is very heterogeneous and suggests a source area mainly characterized by the Malaguide basement and lower units of the Internal Betic Zone, that partially compose the Mesomediterranean Microplate. The geochemical proxies suggest a provenance mainly from felsic source area with a minor supply from mafic rocks in some samples of the syn-orogenic stage. Furthermore, palaeoweathering indices indicate low to moderate weathering conditions for the sources. The Cenozoic sedimentary successions of the Malaguide Complex played an important role in the geodynamic evolution of the Betic Cordillera that represents the key tectonic element of the western domains of the Mesomediterranean Microplate.