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In this paper, a procedure for experimental optimization under safety constraints, to be denoted as constraint-aware Bayesian Optimization, is presented. The basic ingredients are a performance objective function and a constraint function; both of them will be modeled as Gaussian processes. We incorporate a prior model (transfer learning) used for the mean of the Gaussian processes, a semi-parametric Kernel, and acquisition function optimization under chance-constrained requirements. In this way, experimental fine-tuning of a performance objective under experiment-model mismatch can be safely carried out. The methodology is illustrated in a case study on a line-follower application in a CoppeliaSim environment.

Carpophores of Ganoderma lingzhi (GZ) from industrial crops in China were analysed and compared with carpophores of three Iberian strains of cultivated Ganoderma lucidum (GL) (Aveiro, Madrid, Palencia) previously genetically characterized. The genetic determination of all the fungi in the study coincided with the identification provided by the companies and entities that supplied the samples. Cultivation time ranged between 107 and 141 days. The analysis of total phenol content showed to be 56.8% higher for GL from Palencia than for GZ. Intraspecific variation was a maximum of 56% from GL. The content of antioxidants, both intraspecific and interspecific, was found to be strain-dependent with a maximum variation of 78.5%. The nutritional analysis shows that there are differences in dietary fiber, protein, ash and sodium content between GL and GZ. In fatty acids analysis, only trans fatty acids showed significant differences, being higher in GL. Protein profile and digestibility of GZ and GL-Madrid mushroom proteins were evaluated by digestion with simulated gastric fluid and were different. The two species were perfectly differentiated according to their protein profile. These results should be considered for nutritional and industrial applications.

In this paper, a procedure for experimental optimization under safety constraints, to be denoted as constraint-aware Bayesian Optimization, is presented. The basic ingredients are a performance objective function and a constraint function; both of them will be modeled as Gaussian processes. We incorporate a prior model (transfer learning) used for the mean of the Gaussian processes, a semi-parametric Kernel, and acquisition function optimization under chance-constrained requirements. In this way, experimental fine-tuning of a performance objective under experiment-model mismatch can be safely carried out. The methodology is illustrated in a case study on a line-follower application in a CoppeliaSim environment. [ABSTRACT FROM AUTHOR]

Background: To evaluate the impact of COVID‐19 lockdown on glycaemic control and diabetes follow‐up in a Spanish metropolitan area with a total general population of 340,000. Methods: A retrospective real‐world study comparing HbA1c testing, an indicator of diabetes control, and mean HbA1c during different COVID‐19 restriction periods in 2020 (full lockdown, post‐lockdown, partial lockdown) with the same periods in 2019. HbA1c testing was analysed per study period and according to gender, age and clinical setting. Associations between HbA1c testing and different covariables were investigated using logistic regression analysis. Changes in HbA1c were evaluated by repeated measures multivariate analysis of variance (ANOVA). Results: During full lockdown, 6847 individuals, of which 56.7% were over 65 and 6.5% below 40, were tested for HbA1c compared to 14,180 in 2019 (OR 0.47, 95% CI:0.46–0.49). Reduction in HbA1c testing was greater among older individuals (OR 0.44, 95% CI:0.42–0.45). No differences were observed for post‐lockdown (OR 1.01, 95% CI:0.99–1.04). During partial lockdown, 10,816 individuals had at least one HbA1c measured compared to 12,749 in 2019 (OR 0.84, 95% CI:0.82‐0.87). Mean HbA1c during full lockdown was 7.26% (±1.06) compared to 7.50% (±1.14) in 2019 (p <.0001). For gender and across all age groups, HbA1c levels were lower during full lockdown. HbA1c changes were not significantly different during post‐lockdown and partial lockdown. Conclusions: COVID‐19 restriction measures affected HbA1c testing. During complete lockdown, HbA1c testing decreased by half across all gender and age groups. No deleterious effect on glycaemic control was observed during lockdown and post‐lockdown among those tested. [ABSTRACT FROM AUTHOR]

Objective: It has been proposed that a mild form of acquired resistance to thyroid hormone may occur in the general population. Its clinical significance remains largely unknown. The objective of the study was to explore whether a newly described thyroid hormone resistance index is associated with the risk of mortality in a sample of community-dwelling euthyroid subjects representative of the adult population of Spain. Design: Longitudinal observational study including 3750 individuals, free of thyroid disease, TPO antibodies-negative (<50 IU/mL) and with TSH levels within the euthyroid range (≥0.5 and ≤5.0 mUI/mL) participating in the nationwide study Di@bet.es (2008-2010). Methods: We used the Thyroid Feedback Quantile-based Index (TFQI) as a marker of resistance to thyroid hormone. The study population was grouped into categories according to their TFQI values at baseline. Fatal events were ascertained from the national death registry (end of follow-up December 2016). Results: A total of 231 deaths were recorded during an average follow-up of 7.3 years. Compared with the category with the highest sensitivity to free thyroxine (TFQI ≤ p5) (reference), the relative risk of mortality in the categories with TFQI > p5 and ≤p25; >p25 and ≤p50; >p50 and ≤p75; >p75 and ≤p95 and >p95 were 1.01, (0.47-2.19), 1.42 (0.682.97), 1.54 (0.74-3.22), 1.47 (0.70-3.11) and 2.61 (1.16-5.89), respectively (P for trend 0.003). The association remained significant after multivariate adjustment of the data (P for trend 0.017). Conclusions: A thyroid hormone resistance index focused on deviations of the average pituitary response to thyroid hormones may be associated with all-cause mortality independently of other conventional risk factors and comorbidities. [ABSTRACT FROM AUTHOR]

This work develops a method to perform surface treatment tasks using a bimanual robotic system, i.e. two robot arms cooperatively performing the task. In particular, one robot arm holds the workpiece while the other robot arm has the treatment tool attached to its end-effector. Moreover, the human user teleoperates all the six coordinates of the former robot arm and two coordinates of the latter robot arm, i.e. the teleoperator can move the treatment tool on the plane given by the workpiece surface. Furthermore, a force sensor attached to the treatment tool is used to automatically attain the desired pressure between the tool and the workpiece and to automatically keep the tool orientation orthogonal to the workpiece surface. In addition, to assist the human user during the teleoperation, several constraints are defined for both robot arms in order to avoid exceeding the allowed workspace, e.g. to avoid collisions with other objects in the environment. The theory used in this work to develop the bimanual robot control relies on sliding mode control and task prioritisation. Finally, the feasibility and effectiveness of the method are shown through experimental results using two robot arms. [ABSTRACT FROM AUTHOR]

Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a population-based, cross-sectional, randomly sampled study conducted in 2009–2010 in Spain. International Physical Activity Questionnaire (SF-IPAQ) was used to assess PA. 4991 individuals (median age 50 years, 57% women) were studied. Prevalence of sedentariness was 32.3% for men and 39% for women (p < 0.0001). Sex differences were particularly notable (age*sex interaction, p = 0.0024) at early and older ages. Sedentary individuals had higher BMI (28 vs. 27 kg/m2) and obesity prevalence (37 vs. 26%). Low PA was present in 44, 43, and 38% of individuals with known diabetes (KDM), prediabetes/unknown-diabetes (PREDM/UKDM), and normal glucose regulation (p = 0.0014), respectively. No difference between KDM and PREDM/UKDM (p = 0.72) was found. Variables independently associated (p < 0.05) with sedentariness were age, sex, BMI, central obesity, Mediterranean diet adherence, smoking habit, HDL-cholesterol, triglycerides and dyslipidemia. Low PA is on the rise in Spain, especially among women. Sedentariness is associated with several cardiovascular risk factors and may be responsible for the increasing prevalence of obesity and diabetes in this country. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to examine possible associations between ambient temperature and obesity in the Spanish population using an ecological focus. Methods The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. Sample: 5,061 subjects in 100 clusters. Variables: Clinical, demographic and lifestyle survey, physical examination, and blood sampling. The mean annual temperature (°C) for each study site was collected from the Spanish National Meteorology Agency (1971-2000). Results The prevalence rates of obesity in the different geographical areas divided according to mean annual temperature quartiles were 26.9% in quartile 1 (10.4-14.5°C), 30.5% in quartile 2 (14.5-15.5°C), 32% in quartile 3 (15.5-17.8°C), and 33.6% in quartile 4 (17.8-21.3°C) ( P = 0.003). Logistic regression analyses including multiple socio-demographic (age, gender, educational level, marital status) and lifestyle (physical activity, Mediterranean diet score, smoking) variables showed that, as compared with quartile 1, the odd ratios for obesity were 1.20 (1.01-1.42), 1.35 (1.12-1.61), and 1.38 (1.14-1.67) in quartiles 2, 3, and 4, respectively ( P = 0.001 for difference, P < 0.001 for trend). Conclusions Our study reports an association between ambient temperature and obesity in the Spanish population controlled for known confounders. [ABSTRACT FROM AUTHOR]

Background and Aim: Prevalence rates of "metabolically healthy obese" (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. The aims of the present study were, first, to determine the prevalence rates of MHO and MNHNO subjects using the same criteria as those of the National Health and Nutrition Examination Survey (NHANES) (1999-2004) study, and second to compare the prevalence and correlates of obese subjects who are resistant to the development of adiposity-associated cardiometabolic abnormalities (CA) and normal-weight individuals who display cardiometabolic risk factor clustering between the Spanish and the US populations.Methods and Results: Di@bet.es study is a national, cross-sectional population-based survey of 5728 adults conducted in 2009-2010. Clinical, metabolic, sociodemographic, and anthropometric data and information about lifestyle habits, such as physical activity, smoking habit, alcohol intake and food consumption, were collected. Subjects were classified according to their body mass index (BMI) (normal-weight, <25 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, >30 kg/m(2)). CA included elevated blood pressure; elevated levels of triglycerides, fasting glucose, and high-sensitivity C-reactive protein (hs-CRP); and elevated homeostasis model assessment of insulin resistance (HOMA-IR) value and low high-density lipoprotein cholesterol (HDL-c) level. Two phenotypes were defined: metabolically healthy phenotype (0-1 CA) and metabolically abnormal phenotype (≥2 CA). The prevalence of metabolically abnormal normal-weight phenotype was slightly lower in the Spanish population (6.5% vs. 8.1%). The prevalence of metabolically healthy overweight and MHO subjects was 20.9% and 7.0%, respectively, while in NHANES study it was 17.9% and 9.7%, respectively. Cigarette smoking was associated with CA in each phenotype, while moderate physical activity and moderate alcohol intake were associated with being metabolically healthy. Olive oil intake was negatively associated with the prevalence of CA.Conclusions: Smoking, physical activity level, and alcohol intake contribute to the explanation of the prevalence of CA in the Spanish population, as in the US population. However in Spain, olive oil intake contributes significantly to the explanation of the variance in the prevalence of CA. [ABSTRACT FROM AUTHOR]

The present study was undertaken to examine the prevalence of urinary ACR (albumin/creatinine ratio) >30 mg/g and the associated clinical and environmental factors in a representative sample of the population of Spain. Di@bet.es study is a national, cross-sectional population-based survey conducted in 2009-2010. Clinical, metabolic, socio-demographic, anthropometric data and information about lifestyle habit were collected. Those subjects without KDM (known diabetes mellitus) were given an OGTT (oral glucose tolerance test). Albumin and creatinine were measured in a urinary sample and ACR was calculated. The population prevalence of ACR >30 mg/g was 7.65% (adjusted for sex and age). The prevalence of ACR >30 mg/g increased with age (P<0.001). Subjects with carbohydrate metabolism disorders had a greater prevalence of ACR >30 mg/g but after being adjusted for age, sex and hypertension, was significant only in those subjects with UKDM (unknown diabetes mellitus) {OR (odd ratio), 2.07 [95% CI (confidence interval), 1.38-3.09]; P<0.001] and KDM [OR, 3.55 (95% CI, 2.63-4.80); P<0.001]. Prevalence of ACR >30 mg/g was associated with hypertension [OR, 1.48 (95% CI, 1.12-1.95); P=0.001], HOMA-IR (homoeostasis model assessment of insulin resistance) [OR, 1.47 (95% CI, 1.13-1.92); P ≤0.01], metabolic syndrome [OR, 2.17 (95% CI, 1.72-2.72); P<0.001], smoking [OR, 1.40 (95% CI, 1.06-1.83); P≤0.05], physical activity [OR, 0.68 (95% CI, 0.54-0.88); P≤0.01] and consumption of fish [OR, 0.38 (95% CI, 0.18-0.78); P≤0.01]. This is the first study that reports the prevalence of ACR >30 mg/g in the Spanish population. The association between clinical variables and other potentially modifiable environmental variables contribute jointly, and sometimes interactively, to the explanation of prevalence of ACR >30 mg/g. Many of these risk factors are susceptible to intervention. [ABSTRACT FROM AUTHOR]

Carpophores of Ganoderma lingzhi (GZ) from industrial crops in China were analysed and compared with carpophores of three Iberian strains of cultivated Ganoderma lucidum (GL) (Aveiro, Madrid, Palencia) previously genetically characterized. The genetic determination of all the fungi in the study coincided with the identification provided by the companies and entities that supplied the samples. Cultivation time ranged between 107 and 141 days. The analysis of total phenol content showed to be 56.8% higher for GL from Palencia than for GZ. Intraspecific variation was a maximum of 56% from GL. The content of antioxidants, both intraspecific and interspecific, was found to be strain-dependent with a maximum variation of 78.5%. The nutritional analysis shows that there are differences in dietary fiber, protein, ash and sodium content between GL and GZ. In fatty acids analysis, only trans fatty acids showed significant differences, being higher in GL. Protein profile and digestibility of GZ and GL-Madrid mushroom proteins were evaluated by digestion with simulated gastric fluid and were different. The two species were perfectly differentiated according to their protein profile. These results should be considered for nutritional and industrial applications. [ABSTRACT FROM AUTHOR]

Directive (EU) 2015/653 on driving licenses has involved the modification of different codes that must appear on driver's licenses. The definition of specific codes (20.07 and 40.01) compels measurement of the braking and steering forces. Performing practical tests to assess the driving fitness of special drivers will help to determine the maximum force that a driver can apply on primary controls when driving. From that point, definition of car control adaptations required to supply their functional deficiencies can be stated. This article describes a data acquisition system designed and developed for obtaining data from experimental tests based on the execution of habitual driving manoeuvres (braking, lane change and roundabouts). The data gathered will allow for definition of the thresholds of biomechanical values (forces on the steering wheel and brake pedal) and ergonomic values (driver's upper extremity mobility ranges) necessary for driving motor vehicles. The results have shown that application in real driving tests of the data acquisition system designed provides valid and suitable results for the case studied. Therefore, it will contribute to substantially improving the assessment procedure for drivers in general and for disabled people in particular when obtaining or renewing their driving licenses. [ABSTRACT FROM AUTHOR]

To date it is not clear what the role of dairy products is in metabolic diseases like diabetes, obesity, and hypertension. Therefore, the aim of this study is to test the association between dairy product consumption and those pathologies. A cross-sectional study was conducted with 5081 adults included in the di@bet.es study, from 100 health centers around Spain. Food frequency questionnaires were carried out concerning consumption habits, which included dairy product consumption. Logistic regression models were used for the association analyses between the variables controlling confounding variables. Women had a higher consumption of milk, cheese, or yogurt than men (p < 0.0001), but men consumed more sugar dairy products (p < 0.001). People who live in the North of Spain consume more dairy products than those who live in the East. Dairy product consumption was inversely associated with the presence of hypertension regardless of age, sex, geographical region, and body mass index (BMI) (Odds Ratio (OR) 0.743; p = 0.022). The presence of obesity was inversely associated with dairy consumption regardless of age, sex, and geographical region (OR 0.61; p < 0.001). Milk consumption was not associated with diabetes. Our results show that consuming dairy products is associated with a better metabolic profile in the Spanish population. [ABSTRACT FROM AUTHOR]

Objective: It has been proposed that a mild form of acquired resistance to thyroid hormone may occur in the general population. Its clinical significance remains largely unknown. The objective of the study was to explore whether a newly described thyroid hormone resistance index is associated with the risk of mortality in a sample of community-dwelling euthyroid subjects representative of the adult population of Spain., Design: Longitudinal observational study including 3750 individuals, free of thyroid disease, TPO antibodies-negative (<50 IU/mL) and with TSH levels within the euthyroid range (≥0.5 and ≤5.0 mUI/mL) participating in the nationwide study Di@bet.es (2008-2010)., Methods: We used the Thyroid Feedback Quantile-based Index (TFQI) as a marker of resistance to thyroid hormone. The study population was grouped into categories according to their TFQI values at baseline. Fatal events were ascertained from the national death registry (end of follow-up December 2016)., Results: A total of 231 deaths were recorded during an average follow-up of 7.3 years. Compared with the category with the highest sensitivity to free thyroxine (TFQI ≤ p5) (reference), the relative risk of mortality in the categories with TFQI > p5 and ≤p25; >p25 and ≤p50; >p50 and ≤p75; >p75 and ≤p95 and >p95 were 1.01, (0.47-2.19), 1.42 (0.68-2.97), 1.54 (0.74-3.22), 1.47 (0.70-3.11) and 2.61 (1.16-5.89), respectively (P for trend 0.003). The association remained significant after multivariate adjustment of the data (P for trend 0.017)., Conclusions: A thyroid hormone resistance index focused on deviations of the average pituitary response to thyroid hormones may be associated with all-cause mortality independently of other conventional risk factors and comorbidities.

Introduction: Metabolic syndrome (MetS) is an important predictor of cardiovascular mortality. Identification of occurrence and regression trends of MetS could permit elaboration of preventive strategies with new targets. The objective of this study was to analyze the occurrence and regression rates of MetS and its associated factors in the representative cohort of Spain of the di@bet.es study., Research Design and Methods: The di@bet.es study is a prospective cohort where 5072 people representative of the Spanish population over 18 years of age were randomly selected between 2009 and 2010. Follow-up was a median of 7.5 (IQR 7.2-7.9) years, with 2408 (47%) participating subjects. A total of 1881 (78%) subjects had all the pertinent data available and were included in this study., Results: Of the 1146 subjects without baseline criteria for MetS, 294 (25.7%) developed MetS during follow-up, while of the 735 patients with prior MetS, 148 (20.1%) presented regression. Adjusted MetS incidence per 1000 person-years was 38 (95% CI 32 to 44), while regression incidence was 36 (95% CI 31 to 41). Regression rate was independently higher than incidence rate in the following: women, subjects aged 18-45, university-degree holders, patients without central obesity, without hypertension, as well as those with body mass index of <25 kg/m 2 . Lower progression and higher regression rates were observed with an adapted 14-point Mediterranean Diet adherence screener questionnaire score of >11 in both groups and with >500 and>2000 MET-min/week of physical activity, respectively., Conclusions: This study provides MetS incidence and regression rates, and identifies the target population for intervention strategies in Spain and possibly in other countries., Competing Interests: Competing interests: EMo has been on advisory boards, has received consulting fees, speaker honoraria or research support from Astra Zeneca, Menarini Laboratories, Merck Sharp & Dohme, Novartis, NovoNordisk and Sanofi., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)