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Few tests were delivered using mobile phones a few years ago, but the flexibility and capability of these devices make them valuable tools even for high stakes testing. This paper addresses research done through the PAULEX (2007-2010) and OPENPAU (2012-2014) research projects at the Universidad Politécnica de Valencia and Universidad de Alcalá (Spain) to provide a powerful but low cost delivery system for the foreign language paper of the Spanish College Entrance Examination (henceforth PAU). The first project, PAULEX, intended to create a robust mobile platform for language testing while the second, OPENPAU, examined the specific applications of ubiquitous devices to create more dynamic forms of assessment. This paper focuses on the projects' design, testing theory, and technical evolution including visual ergonomics. The current results demonstrate the technical and didactic feasibility of mobile-based formal assessment that aligns student needs with the kind of inferences that the mobile based language test should provide academic authorities.

Background: Alterations in resting metabolic rate (RMR), the largest component of daily total energy expenditure, with aging have been shown in various studies. However, little is known about the associations between RMR and health outcomes in later life. Aims: To analyze whether RMR is associated with incident disability and mobility decline in a 10-year longitudinal study, as well as the moderating role of frailty in these associations. Methods: Data from 298 older adults aged 70 and over from the Frailty and Dependence in Albacete (FRADEA) study in Spain were used, including a baseline measurement in 2007–2009 and a follow-up measurement 10 years later. RMR was measured by indirect calorimetry. Outcomes were incident disability in basic activities of daily living (BADL, Barthel Index), incident disability in instrumental ADL (IADL, Lawton index), and mobility decline (Functional Ambulation Categories scores). Fried's frailty phenotype was used as an indicator of frailty. Logistic regression analyses were conducted. Results: Fully adjusted and stratified analyses revealed that only in the pre-frail/frail group, a higher RMR was associated with a lower risk of incident BADL disability (OR = 0.47, 95% CI = 0.23–0.96, p = 0.037), incident IADL disability (OR = 0.39, 95% CI = 0.18–0.84, p = 0.017), and mobility decline (OR = 0.30, 95% CI = 0.14–0.64, p = 0.002). Conclusions: To our knowledge, this is the first study looking at the associations between RMR and functional health using a longitudinal research design. The results suggest that RMR could be used as an early identifier of a specific resilient group within the pre-frail and frail older population, with a lower risk of further health decline. [ABSTRACT FROM AUTHOR]

In the last quarter of 2021, there was a very significant eruption of the Cumbre Vieja volcano on the island of La Palma, belonging to the Canary Islands, Spain. It generated a large amount of pyroclastic volcanic materials, which must be studied for their possible applicability. This work studies the properties and applicability of the lava and volcanic ash generated in this process. The need for reconstruction of the areas of the island that suffered from this environmental catastrophe is considered in this study from the point of view of the valuation of the waste generated. For this purpose, the possibility of using the fine fraction of ashes and lava as a supplementary cement material (SCM) in the manufacture of cement is investigated. The volcanic material showed a chemical composition and atomic structure suitable for replacing clinker in the manufacture of Portland cement. In this study, the cementing and pozzolanic reaction characteristics of unprocessed volcanic materials and those processed by crushing procedures are analysed. To evaluate the cementitious potential by analysing the mechanical behaviour, a comparison with other types of mineral additions (fly ash, silica fume, and limestone filler) commonly used in cement manufacture or previously studied was carried out. The results of this study show that volcanic materials are feasible to be used in the manufacture of cement, with up to a 22% increase in pozzolanicity from 28 to 90 days, showing the high potential as a long-term supplementary cementitious material in cement manufacturing, though it is necessary to carry out crushing processes that improve their pozzolanic behaviour. [ABSTRACT FROM AUTHOR]

A proteomic approach was used to search for larval proteins specific to the mussel Mytilus galloprovincialis from Galicia in northwest Spain. The study included both a comparative analysis, through two-dimensional electrophoresis, of protein expression maps of the larvae of the mussel and of 5 abundant and commercially important bivalve species from the region ( Ostrea edulis, Cerastoderma edule, Pecten maximus, Tapes decussatus, and Venarupis pullastra) and subsequent mass spectrometric analysis of some of the protein spots. A total of 18 spots were selected and isolated from gels of M. galloprovincialis larvae. From their relative position on the electrophoresis gels, 6 of these were clearly exclusive to the mussel species. However, it was not clear whether the other spots were shared by other species. To overcome this ambiguity, first an analysis using matrix assisted laser desorption ionization with time-of-flight (MALDI-TOF) was conducted on the 6 spots of Mytilus that could possibly be shared with only one species. The peptide mass fingerprinting was completely different for the proteins compared. This result confirmed that the 6 proteins were exclusively mussel proteins, but demonstrated the utility of this approach when working with species that are poorly represented at the protein level in databases. [ABSTRACT FROM AUTHOR]

• Physicians rated the anatomists as teachers first (50.4%), next as physicians (41%), then as scientists (32.5%) and lastly as biologists (1.9%). • The opinion on the dissection usefulness for the undergraduates and the anatomist's professional identity differed among physicians' genders. • There was a disparity between the opinions of physicians and anatomists as to whether the dissection shall influence the behavior of students towards the patient. • A progressive reduction in dissecting human bodies has been detected during undergraduate medical training over the years. • The practice of dissecting in the medical degree needs to be reinforced. It serves to acquire anatomical knowledge but also skills and demeanors. Studies abound regarding the views of faculty anatomists and medical students on the importance of anatomy and the dissection of human bodies, but very little is known about the views of practicing physicians. A survey was distributed among physicians and surgeons practicing in Spain in order to find out their views on the practice and consequences of human dissection by undergraduate students of medicine. The most relevant definition to qualify faculty anatomists of medical schools was also requested. Responses were repeatedly clustered into characteristic subgroups for analysis. In total, 536 physicians and surgeons belonging to 36 different specialties in seven Spanish hospitals responded to the survey. The results highlighted two main facts. Firstly, faculty anatomists were perceived as teachers, above any other professional identity (namely: physician, biologist or scientist); nonetheless, the ascription of identities varied between specialties (p = 0.009); and it also depended on whether the respondents had dissected in their undergraduate degree (p = 0.03) and on the respondent's gender (p = 0.03). Secondly, physicians and surgeons confirmed that dissecting human cadavers serves the undergraduate student not only for acquiring anatomical knowledge, but also essential skills and attitudes, including professionalism. The results strongly suggest that dissection practice should be reinforced and enriched in undergraduate medical school. As this is important in itself, the results of the study could also help with the development of strategies to alleviate the current shortage of adequately trained anatomists for medical degrees. [ABSTRACT FROM AUTHOR]

• A real case of study of biomass to apply a gasification process. • Almond shells showed the optimal technological properties. • Greenhouses vegetables residues have not aceptable properties. • Multivariable analysis allows to select olive tree prunings as the optimal ones from economic, technical and logistic point of view. The great potential for bioenergy in Spain is undeniable given our country´s enormous biomass supply. This fact contrasts with the limited evolution in the biomass sector for thermal and electricity generation over recent years. In this paper, we consider the utilization of fluidized bed gasification (FBG) as a biomass utilization technology incorporated into a thermal electric system to improve power plant production both thermally and electrically. Firstly, we studied the biomass resources available within a 100 km radius of the plant's location in Almería province (Spain). This biomass included almond shells, olive tree prunings, holm oak prunings and vegetable residues from greenhouse tomato and pepper plants. Technical criteria were applied to determine the most appropriate biomass to use in the gasification process; this included the physical-chemical characterization, the cost and the logistic-agronomic profile. The physical-chemical characterization included humidity, ash, calorific value, an elemental analysis, sulfur and chlorine, etc. On the basis of this characterization, almond shells were found to be the optimal biomass (M ar = 12.9%, A r = 1.1%, V d = 82.2%, Q p,net,d =18,470 kJ/kg and Cl = 60 mg/kg), and depending on certain parameters, could be classified as A1 or A2. Both the olive tree prunings (M ar = 6.2%, A r = 5.5%, Vd = 83.4%, Q p,net,d =18,193 kJ/kg and Cl =15 mg/kg) and the holm oak prunings (M ar = 9.2%, A r = 4.1%, V d = 80.3%, Q p,net,d =16,335 kJ/kg and Cl =12 mg/kg) were also considered to be good biomass resources, and were given an A2 or B1 classification. However, greenhouse vegetable residues (tomato and pepper) did not have suitable technical parameters (M ar = 82.6-29.6%, A r = 35.5-6.4%, V d = 75.1-59.1%, Q p,net,d = 17277-11529 kJ/kg and Cl = 1196-751 mg/kg) for use in the gasification process. Concerning the economic criteria, the best cost per kilogram (0.01€/kg) was found for the greenhouse vegetable residues, followed by the olive tree prunings (0.04€/kg); the highest cost corresponded to almond shells (0.07€/kg). With regard to the logistic-agronomic criteria, the theoretical hours of production in the power station are determined by the total availability of the resource in the particular location. The results indicate that the amount of almond shells available in the area was not sufficient (3854 h) to ensure the operation of the power station at full load (8760 h) but it would be possible in conjunction with other biomass types. The final decision regarding the optimal biomass to use was made on the basis of a multivariable analysis using the Visual Preference Ranking Organization Methods for Enrichment Evaluations (PROMETHEE) tool. From this analysis, olive tree prunings were selected as the optimum biomass to use because of their extensive local availability (58,080 t/year), in addition to them having suitable physical-chemical characteristics (M ar = 6.2%, A r = 5.5%, V d = 83.4%, Q p,net,d =18,193 kJ/kg and Cl =15 mg/kg)) and a reasonable cost (0.07€/kg). [ABSTRACT FROM AUTHOR]

We aimed to analyse the impact of COVID-19 during 2020 and 2021 on the prescription of enteral nutritional support and its expenditure in the Community of Madrid, Spain, compared to pre-pandemic data from 2016 in the general population vs. elderly. We analysed official electronic prescriptions of all public hospitals of the Community of Madrid. The population over 75 years of age have the higher prescription of nutritional supplements (p < 0.001 vs. other age groups), with no differences between the 45−64 age group compared to the 65−74 age group (χ2 = 3.259, p = 0.196). The first wave of COVID-19 or the first time there was a real awareness of the virus in Spain is similar in a way to the first peak of prescription of enteral nutrition in March 2020. The second peak of prescription was observed in the over 75 age group in July 2020, being more pronounced in December 2020 and March−April of the following year (F = 7.863, p = 0.041). The last peaks correspond to summer 2021 and autumn of the same year (p = 0.031—year 2021 vs. 2020, p = 0.011—year 2021 vs. 2019), where a relationship between increased prescription of enteral nutrition and COVID-19 cases is observed. High-protein and high-calorie dietary therapies were the most prescribed in patients with or without diabetes. All of this entailed higher cost for the Community of Madrid. In conclusion, COVID-19 significantly affected the prescription of nutritional support, especially in the population over 75 years of age.

Background: Kingella kingae is an emergent pathogen causing septic arthritis (SA) in children.The objective of this study was to analyze the etiology of SA in children before and after the implementation of universal 16S rRNA gene polymerase chain reaction and sequencing (16SPCR) in synovial fluid., Methods: Children ≤14 years with acute SA from a Madrid cohort (2002-2013) were reviewed. Differences in etiology were analyzed before (period 1) and after (period 2) the implementation of bacterial 16SPCR in 2009. A comparison in epidemiology, clinical syndromes, therapy and outcome between infections caused by K. kingae and other bacteria was performed., Results: Bacteria were detected from 40/81 (49.4%) children, with a higher proportion of diagnosis after 16SPCR establishment (period 2, 63% vs. period 1, 31.4%; P = 0.005). The main etiologies were Staphylococcus aureus (37.5%) and K. kingae (35%), although K. kingae was the most common microorganism in P2 (48.3%). Children with K. kingae SA were less likely to be younger than 3 months (0 vs. 42.3%; P < 0.001), had less anemia (21.4 vs. 50%; P = 0.010), lower C-reactive protein (3.8 vs. 8.9 mg/dL; P = 0.039), less associated osteomyelitis (0 vs. 26.9%; P = 0.033), shorter intravenous therapy (6 vs. 15 days; P < 0.001), and had a nonsignificant lower rate of sequelae (0 vs. 30%; P = 0.15) than children with SA caused by other bacteria. However, they tended to have higher rate of fever (86 vs. 57%; P = 0.083)., Conclusions: K. kingae was frequently recovered in children with SA after the implementation of bacterial 16SPCR, producing a milder clinical syndrome and better outcome. Therefore, the use of molecular techniques may be important for the management of these children.

The International Prognostic Score (IPS) is the most widely used system to date for identifying risk groups for the outcome of patients with advanced Hodgkin lymphoma, although important limitations have been recognized. We analyzed the value of the IPS in a series of 311 patients with advanced classical Hodgkin lymphoma (cHL) (Ann Arbor stage III, IV or stage II with B symptoms and/or bulky masses) treated with first-line chemotherapy including adriamycin (adriamycin, bleomycin, vinblastine, dacarbazine [ABVD] or equivalent variants). In univariate and multivariate analyses, stage IV disease and age ≥ 45 years were the only factors with independent predictive significance for overall survival (OS) (p = 0.002 and p < 0.001, respectively). Stage IV was still significant for freedom from progression (FFP) (p = 0.001) and age ≥ 45 years was borderline significant (p = 0.058). IPS separates prognostic groups, as in the original publication, but this is mainly due to the high statistical significance of stage IV and age ≥ 45 years. Moreover, the combination of these two factors enables a simpler system to be constructed that separates groups with different FFP and OS. In conclusion, in our series, stage IV and age ≥ 45 years are the key prognostic factors for the outcome of advanced cHL.

Aim: A multi-centred, open-labelled, phase 11 study containing 46 patients was conducted to evaluate the clinical benefit of gemcitabine (1,400 mg/m(2)) combined with 5-FU (3 g/m(2)) in a 48 h continuous infusion (CI)., Methods: Both drugs were administered on days 1, 8 and 15 of every 4 week cycle in chemotherapy-naïve patients with locally advanced unresectable metastatic pancreatic carcinoma. The minimum follow-up was 6 months., Results: Clinical benefit response was the primary endpoint and this was achieved by 24.4% of the patients. Quality of life (QoL) improved in 16.6% of patients. Objective response was observed in 7% of the patients. The median progression-free survival (PFS) was 14.4 weeks and the median overall survival (OS) time was 22.7 weeks. One-year survival was 25%. The most frequent grade 3-4 toxicities were neutropenia (45%), mucositis (7.5%) and hyperbilirubinaemia (10.5%)., Conclusions: This schedule was not superior in terms of clinical benefit, response rate, PFS and OS than standard gemcitabine treatment