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Long-term noninvasive ventilation in obesity hypoventilation syndrome without severe OSA. The Pickwick Randomized Controlled Trial
(Elseiver, 2020) Masa Jiménez, Juan Fernando; Benítez, Iván; Sánchez Quiroga, María A.; Gomez de Terreros, Francisco J.; Corral, Jaime; Romero, Auxiliadora; Caballero Eraso, Candela; Alonso Álvarez, María L.; Ordax Carbajo, Estrella; Gómez García, Teresa; González, Mónica; López Martín, Soledad; Marín, José M.; Martí, Sergi; Díaz Cambriles, Trinidad; Chiner, Eusebi; Egea, Carlos; Barca Durán, Francisco Javier; Vázquez Polo, Francisco J.; Negrín, Miguel A.; Martel Escobar, María; Barbé, Ferrán; Mokhlesi, Babak; Hospital San Pedro de Alcántara. Cáceres; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES). Madrid; Universidad de Extremadura. Instituto Universitario de Investigación Biosanitaria de Extremadura (INUBE); Hospital Virgen del Puerto (Plasencia, Cáceres)
; Hospital Universitario Virgen del Rocío. Sevilla; Hospital Universitario de Burgos; Hospital General Universitario Gregorio Marañón. Madrid; Hospital Marqués de Valdecilla. Santander
; Hospital Miguel Servet. Zaragoza
; Universidad de Extremadura. Departamento de Enfermería; Universidad de Las Palmas de Gran Canaria
; University of Chicago. USA
; Hospital Universitari Vall d’Hebron. Barcelona
BACKGROUND: Noninvasive ventilation (NIV) is an effective form of treatment in obesity
hypoventilation syndrome (OHS) with severe OSA. However, there is paucity of evidence in patients with OHS without severe OSA phenotype.
RESEARCH QUESTION: Is NIV effective in OHS without severe OSA phenotype?
STUDY DESIGN AND METHODS: In this multicenter, open-label parallel group clinical trial performed at 16 sites in Spain, we randomly assigned 98 stable ambulatory patients with untreated OHS and apnea-hypopnea index < 30 events/h (ie, no severe OSA) to NIV or lifestyle modification (control group) using simple randomization through an electronic database. The primary end point was hospitalization days per year. Secondary end points included other hospital resource utilization, incident cardiovascular events, mortality, respiratory
functional tests, BP, quality of life, sleepiness, and other clinical symptoms. Both investigators and patients were aware of the treatment allocation; however, treating physicians from the routine care team were not aware of patients’ enrollment in the clinical trial.
The study was stopped early in its eighth year because of difficulty identifying patients with OHS without severe OSA. The analysis was performed according to intention-to-treat and per-protocol principles and by adherence subgroups.
RESULTS: Forty-nine patients in the NIV group and 49 in the control group were randomized, and 48 patients in each group were analyzed. During a median follow-up of 4.98 years (interquartile range, 2.98-6.62), the mean hospitalization days per year SD was 2.60 5.31
in the control group and 2.71 4.52 in the NIV group (adjusted rate ratio, 1.07; 95% CI, 0.44-2.59; P ¼ .882). NIV therapy, in contrast with the control group, produced significant longitudinal improvement in PaCO2, pH, bicarbonate, quality of life (Medical Outcome Survey Short Form 36 physical component), and daytime sleepiness. Moreover, per-protocol
Food practices and representations in gamer culture. Theories and ethnographies of an emerging field
(Universidad de Extremadura, Servicio de Publicaciones, 2025) Naharro Gil, Eduardo; Mariano Juárez, Lorenzo; Universidad de Extremadura. Departamento de Psicología y Antropología
The relationships between food and video games have been approached mostly from biomedical perspectives, producing a stereotypical image that associates sedentary lifestyles, junk food, and gamer culture. Emerging research in the social sciences provides a more complex and diverse picture of dietary practices and connections in this cultural context. This article presents a narrative review with the aim of delimiting the field of study of food practices in gamer culture, offering an overview of published approaches as well as new lines of inquiry. Various elements discussed in existing work are addressed, such as the functions of food in video game mechanics and the limitations of current studies, the emergence of cooking games as a genre and the debates surrounding domestic labor, the issue of culinary heritage, the Eurocentric bias of many cooking games, and the responses currently being developed within the industry. Furthermore, attention must be paid to the interpretation of fan practices, ranging from community rituals to intermedial productions such as cook-books and online discussions, which reconfigure the meanings of food beyond the screen. This article argues that the relationships between food and video games constitute a cultural space where social, identity-based, symbolic, and affective dynamics intersect, underscoring the need to further investigate their history and to complicate hegemonic and stereotypical discourses that represent only a small fragment of a much denser and more complex narrative.
Efficacy of a Multicomponent Occupational Therapy Intervention on Balance, Functional Mobility, and Proprioception in Institutionalized Older Adults: A Randomized Controlled Pilot Trial
(MDPI, 2025) Caña Pino, Alejandro; Marín Rubio, Alba; Universidad de Extremadura. Departamento de Terapéutica Médico-Quirúrgica; Universidad de Extremadura. Grupo de investigación Fisioterapia e Hipoterapia
Background: With the progressive aging of the in institutionalized settings population, functional decline—manifested as reduced proprioception, joint stiffness, and muscle loss—poses a growing threat to the autonomy and quality of life of older adults. Occupational therapy plays a central role in addressing these challenges through targeted, evidence-based interventions. Objectives: This clinical trial evaluates the effectiveness of a multicomponent occupational therapy intervention that integrates balance and postural stability exercises, proprioceptive stimulation, and lower-limb strengthening with conventional gerontogymnastics. The program was designed to improve gait performance, reduce fall risk, and promote independence in institutionalized older adults. Methods: A total of 35 community-dwelling older adults were randomly assigned to three groups: gerontogymnastics intervention (n = 13), multicomponent intervention (n = 13), and control (n = 9). Participants underwent a 6-week intervention comprising two 45 min sessions per week. Pre- and post-intervention assessments focused on postural stability and balance-related functional outcomes. Results: The multicomponent group exhibited trends toward improvement in balance, proprioception, and functional mobility, although these did not reach statistical significance. Clinically meaningful improvements were defined using minimally clinically important differences (MCIDs) for functional measures such as Timed UP and Go (TUG) (>1.3 s) and Performance-Oriented Mobility Assessment (POMA) (≥3 points). The multicomponent group showed a 22.1% improvement in proprioceptive accuracy and a 13.9% improvement in mobility (TUG). Additionally, this trend may indicate a potential protective effect against age-related functional decline. Conclusions: These findings suggest that a multicomponent occupational therapy intervention may help maintain mobility and reduce functional decline in institutionalized older adults. Statistically significant gains were observed in lower-limb strength, while other improvements—such as proprioception and balance—did not reach significance but approached clinical relevance. These preliminary results support further investigation into balance-specific training within occupational therapy to promote independence and reduce fall risk. Interpretation should remain cautious due to the small sample size (n = 35) and short intervention duration, which limit statistical power and generalizability.
Time-dependent homogeneous states of binary granular suspensions
(2021) Gómez González, Rubén; Garzó Puertos, Vicente; Universidad de Extremadura. Departamento de Didáctica de las Ciencias Experimentales y Matemáticas; Universidad de Extremadura. Departamento de Física; Universidad de Extremadura. Instituto de Computación Científica Avanzada de la Universidad de Extremadura (ICCAEx)
The time evolution of a homogeneous bidisperse granular suspension is studied in the context of the Enskog kinetic equation. The influence of the surrounding viscous gas on the solid particles is modeled via a deterministic viscous drag force plus a stochastic Langevin-like term. It is found first that, regardless of the initial conditions, the system reaches (after a transient period lasting a few collisions per particle) a universal unsteady hydrodynamic regime where the distribution function of each species not only depends on the dimensionless velocity (as in the homogeneous cooling state) but also on the instantaneous temperature scaled with respect to the background temperature. To confirm this result, theoretical predictions for the time-dependent partial temperatures are compared against direct simulation Monte Carlo (DSMC) results; the comparison shows an excellent agreement confirming the applicability of hydrodynamics in granular suspensions. Also, in the transient regime, the so-called Mpemba-like effect (namely, when an initially hotter sample cools sooner than the colder one) is analyzed for inelastic collisions. The theoretical analysis of the Mpemba effect is performed for initial states close to and far away from the asymptotic steady state. In both cases, a good agreement is found again between theory and DSMC results. As a complement of the previous studies, we determine in this paper the dependence of the steady values of the dynamic properties of the suspension on
the parameter space of the system. More specifically, we focus on our attention in the temperature ratio T1/T2 and the fourth degree cumulants c1 and c2 (measuring the departure of the velocity distributions f1 and f2 from their Maxwellian forms). While our approximate theoretical expression for T1/T2 agree very well with computer simulations, some discrepancies are found for the cumulants. Finally, a linear stability analysis of the steady state solution is also carried out showing that the steady state is always linearly stable.
Gorriones trágicos y águilas homéricas
(Fabrizio Serra Editore, 2019) Librán Moreno, Míriam; Universidad de Extremadura. Departamento de Ciencias de la Antigüedad
The apparition of ‘sparrows’ in the middle of the portent of the eagles and the hare in Aeschylus’ Agamemnon (109-157) has not been satisfactorily explained. This paper proposes that there are similarities between the eagle portent in Agamemnon and the eagle omen that encouraged Priam’s trip to the Achaean camp in Hom. Il. 24.308-321, to which should be added the dark hunting eagles starring in similes in Il. 17.673-678 and Il. 21.252-253. Thematic, literary, and wording parallels between all texts are examined. On Ag. 145 the conjecture μόρφνων is proposed instead of the mss. reading στρουθῶν on the grounds that Hom. Il. 24.308-321 may have provided one of the literary models for Agamemnon’s eagle portent. La comparsa dei ‘passeri’ nel prodigio delle aquile e della lepre nell’Agamennone di Eschilo (109-157) manca ancora di una spiegazione soddisfacente. In questo lavoro si evidenziano alcune somiglianze tra il prodigio dell’aquila nell’Agamennone e il presagio dell’aquila che incoraggia Priamo nel suo viaggio verso il campo acheo in Hom. Il. 24.308-321; a questo passo si possono accostare le aquile nere in caccia che compaiono nelle similitudini di Il. 17.673-678 e Il. 21.252-253. Il lavoro prende in esame anche vari paralleli tematici, letterali e lessicali tra i vari testi. Viene proposta inoltre la congettura μόρφνων ad Ag. 145 contro il tràdito στρουθῶν, sulla base del possibile parallelo omerico di Il. 24.308-321.