array:23 [ "pii" => "S0300289624002199" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.06.003" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3596" "copyright" => "The Authors" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:646-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289624002163" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.05.034" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3592" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:649-51" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Sleep–Wake Cycle in a Female Crew During an Earth-Based Martian Analogue Mission" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "649" "paginaFinal" => "651" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1393 "Ancho" => 2467 "Tamanyo" => 343159 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Evolution in sleep time, wake time (WASO), rest time, REM time, light sleep time and deep sleep time parameters during the simulation (orange) and the baseline (blue) periods. Error bars express the standard deviation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Carla Conejo-González, Georgina Company-Se, Aida Muñoz-Ferrer, Ignacio Vicente, Anna Núñez, Jorge Abad" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Carla" "apellidos" => "Conejo-González" ] 1 => array:2 [ "nombre" => "Georgina" "apellidos" => "Company-Se" ] 2 => array:2 [ "nombre" => "Aida" "apellidos" => "Muñoz-Ferrer" ] 3 => array:2 [ "nombre" => "Ignacio" "apellidos" => "Vicente" ] 4 => array:2 [ "nombre" => "Anna" "apellidos" => "Núñez" ] 5 => array:2 [ "nombre" => "Jorge" "apellidos" => "Abad" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624002163?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624002163/v1_202410020659/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289624002187" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.06.001" "estado" => "S300" "fechaPublicacion" => "2024-10-01" "aid" => "3594" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:643-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:9 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "New Indicators of Exercise Capacity and Respiratory Function in COPD Patients: The Role of Gastrocnemius Muscle Oxygenation and Elastography Levels" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "643" "paginaFinal" => "645" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Buğra Kerget, İsmail Çınar, Büşra Nur Akdağ, Mustafa Yeşilyurt, Muhammed Furkan Barutçugil, Fatih Alper" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Buğra" "apellidos" => "Kerget" ] 1 => array:2 [ "nombre" => "İsmail" "apellidos" => "Çınar" ] 2 => array:2 [ "nombre" => "Büşra Nur" "apellidos" => "Akdağ" ] 3 => array:2 [ "nombre" => "Mustafa" "apellidos" => "Yeşilyurt" ] 4 => array:2 [ "nombre" => "Muhammed Furkan" "apellidos" => "Barutçugil" ] 5 => array:2 [ "nombre" => "Fatih" "apellidos" => "Alper" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624002187?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624002187/v1_202410020659/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Questionnaires May Help Pulmonologists for Referral of Patients With IPF to a Holistic Approach" "tieneTextoCompleto" => true "saludo" => "To the Director," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "646" "paginaFinal" => "648" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Paola Faverio, Isabella Sala, Niccolò Anzani, Umberto Zanini, Valentina Bonfanti, Maria Falzone, Alice Biffi, Sara Conti, Lorenzo Mantovani, Fabrizio Luppi" "autores" => array:10 [ 0 => array:4 [ "nombre" => "Paola" "apellidos" => "Faverio" "email" => array:1 [ 0 => "paola.faverio@unimib.it" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Isabella" "apellidos" => "Sala" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Niccolò" "apellidos" => "Anzani" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Umberto" "apellidos" => "Zanini" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Valentina" "apellidos" => "Bonfanti" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Maria" "apellidos" => "Falzone" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "Alice" "apellidos" => "Biffi" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 7 => array:3 [ "nombre" => "Sara" "apellidos" => "Conti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 8 => array:3 [ "nombre" => "Lorenzo" "apellidos" => "Mantovani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 9 => array:3 [ "nombre" => "Fabrizio" "apellidos" => "Luppi" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "School of Medicine and Surgery, University of Milan Bicocca, Monza, Italy" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Respiratory Unit, IRCCS San Gerardo dei Tintori, Monza, Italy" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Statistics and Quantitative Methods, University of Milan Bicocca, Milan, Italy" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A holistic approach, including psychological support, participation to rehabilitation programs and nutrition management, has been proposed for chronic pulmonary diseases including idiopathic pulmonary fibrosis (IPF).<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Prevalence of depression and anxiety ranges between 14 and 60% in patients with pulmonary fibrosis and both of them are associated with worse outcomes, although are often overlooked and undertreated.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">1,3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Rehabilitative interventions are recommended by international guidelines,<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a> but the few data available from national registries show that only less than 20% of the patients are referred to rehabilitation programs.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">5–7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Signs of nutritional and physical performance impairment, including unintentional weight loss and low hand grip strength, have been observed early in the disease course with a further worsening already after 6-month of follow-up.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">8,9</span></a> Furthermore, malnutrition has been associated with worse clinical outcomes.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Despite the increasing evidence, recent IPF guidelines do not provide specific recommendations for referral to the above mentioned specialists.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Real-life data on the inclusion of patients in rehabilitation programs and referral to psychological and nutritional counseling are lacking. Furthermore, there are no data regarding the implementation in clinical practice of specific questionnaires to help pulmonologists to identify IPF patients who may benefit from a holistic approach.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The aim of this study is to evaluate the proportion of patients with IPF who are referred to these specific interventions and the role of questionnaires in supporting the decision-making process.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Sixty-nine consecutive patients (median [IQR] age: 76 [71–79] years; 20 [29.0%] females) followed-up at the IPF clinic of the IRCCS “San Gerardo dei Tintori” Monza, Italy between October 2022 and March 2023 were enrolled in the study. The patients underwent a pneumological visit during which the following data were collected: respiratory symptoms, physical exam, pulmonary function tests, 6-minute walking test (6MWT) and body mass index (BMI). The majority of patients were in Gender, Age and Physiology (GAP) stage I and II (28 [40.6%] and 33 [47.8%], respectively), while only 8 (11.6%) patients were in GAP stage III. The study received Ethics Committee approval.</p><p id="par0045" class="elsevierStylePara elsevierViewall">At every visit, two IPF expert pulmonologists (AB and FL) answered the following 3 questions based on their clinical judgment: (1) “<span class="elsevierStyleItalic">Does this patient require psychological support?</span>”; (2) “<span class="elsevierStyleItalic">Does this patient require nutritional intervention?</span>” and (3) “<span class="elsevierStyleItalic">Should this patient be referred for pulmonary rehabilitation (PR)?</span>”. The only two possible answers to the prior questions were “yes” or “no” and the two pulmonologists were asked to reach a consensus between them, without other supporting tools.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Before the visit, the patients were asked to fill out 3 self-administered questionnaires: (1) International Physical Activity Questionnaire (IPAQ); (2) Mini Nutritional Assessment (MNA), and (3) Hospital Anxiety and Depression Scale (HADS).<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">11–13</span></a> These questionnaires were collected by nursing personnel, while the two IPF experts remained blinded.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The results of the questionnaires were interpreted as summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Categorical variables were reported with absolute and relative frequencies, continuous variables with median and interquartile range (IQR). For each assessment (i.e., nutritional, physical and psychological status), Cohen's Kappa Statistic was used to assess the agreement between the pulmonologists’ clinical judgment and the results of the self-administrated questionnaires.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> Corresponding 95% confidence interval (95% CI) were also reported.</p><p id="par0065" class="elsevierStylePara elsevierViewall">In regards to the psychological support, 54 (78.3%) cases did not require any intervention in the opinion of the IPF experts, while 15 (21.7%) patients required a specialistic support.</p><p id="par0070" class="elsevierStylePara elsevierViewall">According to the HADS results, 57 (82.6%) patients had moderate or severe anxiety and depression scores, while 4 (5.8%) patients had mild or absent anxiety and depression and 8 (11.6%) patients did not complete the questionnaire.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The Cohen's Kappa evaluating the agreement between pulmonologists’ clinical evaluation and the results of the HADS was −0.05 (95% CI: −0.14; 0.05), indicating a very low agreement. Only in 14 out of 61 patients (23.0%) there was agreement between the two methodologies, <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">In regards to the nutritional management, 51 (73.9%) cases did not require any intervention in the opinion of the IPF experts, while 18 (26.1%) patients required a specialistic support.</p><p id="par0085" class="elsevierStylePara elsevierViewall">According to the MNA screening score, 3 (4.3%) patients were malnourished and 22 (31.9%) at risk of malnutrition, while 39 (56.5%) patients had a normal nutritional status and 5 (7.2%) did not complete the questionnaire.</p><p id="par0090" class="elsevierStylePara elsevierViewall">The Cohen's Kappa for agreement between the pulmonologists’ clinical judgment and the results of the MNA screening score was 0.51 (95% CI: 0.30; 0.73), indicating a moderate agreement. In 50 out of 64 patients (78.1%) there was agreement between the two methodologies, <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><p id="par0095" class="elsevierStylePara elsevierViewall">In regards to PR referral, 62 (89.9%) cases did not require any intervention in the opinion of the IPF experts, while 7 (10.1%) patients required specialized support. The severity of the disease (evaluated through GAP stage) did not influence the clinical judgment in regards to this domain.</p><p id="par0100" class="elsevierStylePara elsevierViewall">In contrast, according to the IPAQ results, 10 (14.5%) patients had a sufficiently active lifestyle and 20 (29.0%) had a very active lifestyle, while 17 (24.6%) patients had an inactive lifestyle and 22 (31.9%) did not complete the questionnaire.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The Cohen's Kappa for agreement between pulmonologists’ clinical evaluation and the results of the IPAQ was −0.01 (95% CI: −0.18; 0.16), indicating a very low agreement. Only in 29 out of 47 patients (61.7%) there was agreement between the two methodologies, <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The results of the MNA and IPAQ did not correlate with the BMI and the meters walked 6MWT, respectively, as shown in <a class="elsevierStyleCrossRef" href="#sec0025">Supplementary Tables 1 and Table 2</a>. On one hand, 11 out of 22 patients that were at risk of malnutrition according to MNA were overweight (5 cases), obese (5 cases) and severely obese (1 case). On the other hand, 6 out of 16 patients with an inactive lifestyle according to IPAQ walked equal or more than 350<span class="elsevierStyleHsp" style=""></span>m at 6MWT.</p><p id="par0115" class="elsevierStylePara elsevierViewall">To our knowledge, this is the first study evaluating the role of specific questionnaires in supporting the pulmonologists in the referral of patients with IPF to other specialist services. Our results showed a very low agreement between the clinical judgment and the results of HADS and IPAQ questionnaires in identifying patients that may benefit from psychological and PR support, respectively. In particular, the questionnaires identified a higher number of patients that may benefit from specialist intervention compared to the evaluation of the IPF experts: 45, 11 and 16 patients identified with HADS, MNA and IPAQ, respectively, would not have been identified at clinical judgment only.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Nevertheless, a moderate agreement was observed between clinical judgment and MNA screening score in identifying patients to refer to the nutritionist service.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Furthermore, prior studies conducted in patients both with and without respiratory diseases highlighted the prognostic role of IPAQ, a higher score being associated with better outcomes, such as lower mortality rates and improved pulmonary function tests.<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">15,16</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">Real life studies performed in different European countries already showed that, despite IPF guidelines recommendations, only a minority of patients are referred to PR programs (<20%), which is in line with our data; in fact only 10% of patients would have been referred to PR programs in the opinion of the IPF experts.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> Using the IPAQ, the proportion of patients who would have required PR increased to 24.6%. Similar results are observed for anxiety and depression, where the number of patients identified with clinical judgment was low (22.0%), while the questionnaires identified a much higher amount of cases (82.6%).</p><p id="par0135" class="elsevierStylePara elsevierViewall">These data support the inclusion of further specialists in the multidisciplinary discussion with the aim to better characterize these specific domains in IPF management.</p><p id="par0140" class="elsevierStylePara elsevierViewall">We also acknowledge some limitations. First of all, the study was conducted in a single center which may limit the generalizability of the results. Secondly, being the questionnaires self-administered, a proportion of patients, particularly for the IPAQ, did not complete the questionnaire leading to missing data. IPAQ is not a multiple choice questionnaire but includes some open questions, and not all patients, particularly elderly, feel comfortable answering this type of questionnaire. This will be the starting point in future studies to use simpler questionnaires, when self-administered, in this group of patients.</p><p id="par0145" class="elsevierStylePara elsevierViewall">In conclusion, the support of specific questionnaires to investigate the nutritional, psychological and physical activity domains may help the pulmonologist, without these expertises, to early identify comorbidities and to refer patients with IPF to psychological support, nutritional evaluation and rehabilitation programs. Questionnaires can give more precise indications than simpler tools already integrated into clinical practice, such as BMI and 6MWT, but they should be easily interpretable by patients. Future studies should evaluate questionnaires designed specifically for patients with IPF on larger cohorts with inclusion of follow-up.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0150" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contributions</span><p id="par0155" class="elsevierStylePara elsevierViewall">LM and FL are the guarantors of this research. PF, AB and SC were responsible for study concept and design. PF, AB, NA, UZ, VB, MF and FL contributed to patient recruitment and follow-up. PF, AB, NA, UZ, VB, MF and FL contributed to data acquisition. PF, IS, and SC performed data analysis. PF, IS, SC and FB contributed to the drafting of this manuscript. All authors read and approved the final manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare not to have any conflicts of interest that may be considered to influence directly or indirectly the content of the manuscript.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Artificial Intelligence Involvement</span><p id="par0165" class="elsevierStylePara elsevierViewall">Artificial intelligence was not used for the conduct and the writing of this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of Interest" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Artificial Intelligence Involvement" ] 4 => array:2 [ "identificador" => "xack778790" "titulo" => "Acknowledgements" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0180" class="elsevierStylePara elsevierViewall">The followings are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix B" "titulo" => "Supplementary Data" "identificador" => "sec0030" ] ] ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">IPAQ<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>International Physical Activity Questionnaire; MNA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>mini nutritional assessment; HADS<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>hospital anxiety and depression scale.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Score \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Interpretation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Recommendation \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">IPAQ</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><700<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inactive lifestyle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The patient may benefit from PR \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>≥700<span class="elsevierStyleHsp" style=""></span>m \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Active lifestyle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The patient may not require PR \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">MNA</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>0–7 points \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Malnourished \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The patient may benefit of a nutritional intervention</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>8–11 points \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At risk of malnutrition \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>12–14 points \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Normal nutritional status \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The patient may not require a nutritional intervention \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="3" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">HADS</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>≥11 points \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Moderate or severe symptoms of depression and/or anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The patient may benefit from a psychological support \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>≤10 points \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Absent or mild symptoms of depression and/or anxiety \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The patient may not require a psychological support \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3676076.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Interpretation of the Questionnaires.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">IPAQ<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>International Physical Activity Questionnaire; MNA<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>mini nutritional assessment; HADS<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>hospital anxiety and depression scale.</p>" "tablatextoimagen" => array:3 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HADS – anxiety and depression domain</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical judgment \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mild/no symptoms \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Moderate/severe symptoms \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No referral, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45 (73.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (77.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes referral, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (3.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (19.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (23.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (6.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (93.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3676078.png" ] ] 1 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">MNA screening score – nutritional domain</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Normal nutritional status \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Risk of or overt malnourishment \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No referral, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (56.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (17.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (73.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes referral, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (4.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (21.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (26.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (60.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (39.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3676077.png" ] ] 2 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IPAQ – rehabilitation domain</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Active lifestyle \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Inactive lifestyle \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No referral, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (59.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 (34.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 (93.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Yes referral, <span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (4.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 (2.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (6.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (63.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (36.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3676079.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Agreement Between Clinical Judgment and Questionnaires.</p>" ] ] 2 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.doc" "ficheroTamanyo" => 50688 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0085" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Holistic management of patients with progressive pulmonary fibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Oliveira" 1 => "G. Fabbri" 2 => "T. Gille" 3 => "E. Bargagli" 4 => "B. Duchemann" 5 => "R. Evans" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/20734735.0101-2023" "Revista" => array:5 [ "tituloSerie" => "Breathe (Sheff)" "fecha" => "2023" "volumen" => "19" "paginaInicial" => "230101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/37719243" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0090" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic pulmonary fibrosis beyond the lung: understanding disease mechanisms to improve diagnosis and management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "F. Luppi" 1 => "M. Kalluri" 2 => "P. Faverio" 3 => "M. Kreuter" 4 => "G. Ferrara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Respir Res" "fecha" => "2021" "volumen" => "22" "paginaInicial" => "109" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0095" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anxiety and depression in IPF and response to pulmonary rehabilitation (PR)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.D. Edwards" 1 => "O. Polgar" 2 => "S. Patel" 3 => "R.E. Barker" 4 => "J. Walsh" 5 => "J. Harvey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Eur Respir J" "fecha" => "2022" "volumen" => "60" "paginaInicial" => "518" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0100" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS/ERS/JRS/ALAT clinical practice guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Raghu" 1 => "M. Remy-Jardin" 2 => "L. Richeldi" 3 => "C.C. Thomson" 4 => "K.M. Antoniou" 5 => "B.D. Bissell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.202202-0399ST" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2022" "volumen" => "205" "paginaInicial" => "E18" "paginaFinal" => "E47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35486072" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0105" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of patients with idiopathic pulmonary fibrosis in clinical practice: the INSIGHTS-IPF registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Behr" 1 => "M. Kreuter" 2 => "M.M. Hoeper" 3 => "H. Wirtz" 4 => "J. Klotsche" 5 => "D. Kosche" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.00217614" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "186" "paginaFinal" => "196" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25837040" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0110" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Demographic and clinical profile of idiopathic pulmonary fibrosis patients in Spain: the SEPAR National Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Fernández-Fabrellas" 1 => "M. Molina-Molina" 2 => "J.B. Soriano" 3 => "J.A.R. Portal" 4 => "J. Ancochea" 5 => "C. Valenzuela" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12931-019-1084-0" "Revista" => array:5 [ "tituloSerie" => "Respir Res" "fecha" => "2019" "volumen" => "20" "paginaInicial" => "127" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31208406" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0115" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Implementation of guideline recommendations and outcomes in patients with idiopathic pulmonary fibrosis: data from the IPF-PRO registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. De Andrade" 1 => "T. Kulkarni" 2 => "M.L. Neely" 3 => "A.S. Hellkamp" 4 => "A.H. Case" 5 => "K. Guntupalli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2021.106637" "Revista" => array:5 [ "tituloSerie" => "Respir Med" "fecha" => "2021" "volumen" => "189" "paginaInicial" => "106637" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34656903" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0120" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutritional assessment in idiopathic pulmonary fibrosis: a prospective multicentre study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Faverio" 1 => "A. Fumagalli" 2 => "S. Conti" 3 => "F. Madotto" 4 => "F. Bini" 5 => "S. Harari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/23120541.00443-2021" "Revista" => array:5 [ "tituloSerie" => "ERJ Open Res" "fecha" => "2022" "volumen" => "8" "paginaInicial" => "00443-2021" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35265706" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0125" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short-term evolution of nutritional status in patients with idiopathic pulmonary fibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Faverio" 1 => "A. Fumagalli" 2 => "S. Conti" 3 => "F. Madotto" 4 => "F. Bini" 5 => "S. Harari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1513/AnnalsATS.202211-935RL" "Revista" => array:6 [ "tituloSerie" => "Ann Am Thorac Soc" "fecha" => "2023" "volumen" => "20" "paginaInicial" => "1066" "paginaFinal" => "1070" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36857649" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0130" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body mass index and weight loss as risk factors for poor outcomes in patients with idiopathic pulmonary fibrosis: a systematic review and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. He" 1 => "J. Ji" 2 => "C. Liu" 3 => "Z. Luo" 4 => "J. Tang" 5 => "H. Yan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/07853890.2024.2311845" "Revista" => array:6 [ "tituloSerie" => "Ann Med" "fecha" => "2024" "volumen" => "56" "paginaInicial" => "2311845" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/38301276" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673620323357" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0135" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Quality of life, symptoms and pulmonary function in asthma: long-term treatment with nedocromil sodium examined in a controlled multicentre trial. Nedocromil Sodium Quality of Life Study Group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.W. Jones" 1 => "R.J.C. De Amaral-Marques" 2 => "M.F. Bone" 3 => "L.P. Boulet" 4 => "V. Brusasco" 5 => "C.M. Burke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.94.07010055" "Revista" => array:7 [ "tituloSerie" => "Eur Respir J" "fecha" => "1994" "volumen" => "7" "paginaInicial" => "55" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8143833" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673615008363" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0140" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Overview of the MNA – its history and challenges" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Vellas" 1 => "H. Villars" 2 => "G. Abellan" 3 => "M.E. Soto" 4 => "Y. Rolland" 5 => "Y. Guigoz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Nutr Health Aging" "fecha" => "2006" "volumen" => "10" "paginaInicial" => "456" "paginaFinal" => "463" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17183418" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002937822003155" "estado" => "S300" "issn" => "00029378" ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0145" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Validation of the long international physical activity questionnaire: Influence of age and language region" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Wanner" 1 => "N. Probst-Hensch" 2 => "S. Kriemler" 3 => "F. Meier" 4 => "C. Autenrieth" 5 => "B.W. Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pmedr.2016.03.003" "Revista" => array:6 [ "tituloSerie" => "Prev Med Rep" "fecha" => "2016" "volumen" => "3" "paginaInicial" => "250" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27419023" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0150" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A coefficient of agreement for nominal scales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Cohen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Educ Psychol Meas" "fecha" => "1960" "volumen" => "20" "paginaInicial" => "37" "paginaFinal" => "46" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0155" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association between physical activity in daily life and pulmonary function in adult smokers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.L. Barboza" 1 => "A.C.B. Barbosa" 2 => "G.D. Spina" 3 => "E.F. Sperandio" 4 => "R.L. Arantes" 5 => "A.R. de T. Gagliardi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/S1806-37562015000000102" "Revista" => array:5 [ "tituloSerie" => "J Bras Pneumol" "fecha" => "2016" "volumen" => "42" "paginaInicial" => "130" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27167434" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0160" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mortality and cause of death in physical activity and insufficient physical activity participants: A longitudinal follow-up study using a national health screening cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Min" 1 => "D.M. Yoo" 2 => "J.H. Wee" 3 => "H.J. Lee" 4 => "S.H. Byun" 5 => "H.G. Choi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "BMC Public Health" "fecha" => "2020" "volumen" => "20" "paginaInicial" => "1" "paginaFinal" => "10" "itemHostRev" => array:3 [ "pii" => "S0140673619319634" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack778790" "titulo" => "Acknowledgements" "texto" => "<p id="par0170" class="elsevierStylePara elsevierViewall">We acknowledge that this research was partially supported by the Grant: Italian MUR Dipartimenti di Eccellenza 2023–2027 (l. 232/2016, art. 1, commi 314–337)</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000010/v1_202410020659/S0300289624002199/v1_202410020659/en/main.assets" "Apartado" => array:4 [ "identificador" => "93560" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Scientific Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000010/v1_202410020659/S0300289624002199/v1_202410020659/en/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624002199?idApp=UINPBA00003Z" ]
Archivos de Bronconeumología follows the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals
