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1.
Materials (Basel) ; 17(17)2024 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-39274771

RESUMO

The partial replacement effect of Portland cement by geothermal nano-SiO2 waste (GNSW) for sustainable Portland-cement-based concrete was investigated to improve the properties of concrete exposed at high critical temperatures. Portland cement was partially replaced by 20 and 30 wt.% of GNSW. The partial replacement effect on Portland-cement-based concrete subjected to 350, 550, and 750 °C was evaluated by measuring the weight changes, ultrasonic pulse velocity, thermogravimetric and differential thermal analysis, X-ray diffraction, surface inspection, and scanning electron microscopy under residual conditions. The ultrasonic pulse velocity results showed that the GNSW specimens maintained suitable stability after being heated to 350 °C. The SEM analysis revealed a denser microstructure for the 20 wt.% of partial replacement of Portland cement by GNSW specimen compared to the reference concrete when exposed to temperatures up to 400 °C, maintaining stability in its microstructure. The weight losses were higher for the specimens with partial replacements of GNSW than the reference concrete at 550 °C, which can be attributed to the pozzolanic activity presented by the GNSW, which increases the amounts of CSH gel, leading to a much denser cementitious matrix, causing a higher weight loss compared to the reference concrete. GNSW is a viable supplementary cementitious material, enhancing thermal properties up to 400 °C due to its high pozzolanic activity and filler effect while offering environmental benefits by reducing industrial waste.

2.
PLoS Pathog ; 20(9): e1012534, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39259722

RESUMO

Legionella longbeachae and Legionella pneumophila are the most common causative agents of Legionnaires' disease. While the clinical manifestations caused by both species are similar, species-specific differences exist in environmental niches, disease epidemiology, and genomic content. One such difference is the presence of a genomic locus predicted to encode a capsule. Here, we show that L. longbeachae indeed expresses a capsule in post-exponential growth phase as evidenced by electron microscopy analyses, and that capsule expression is abrogated when deleting a capsule transporter gene. Capsule purification and its analysis via HLPC revealed the presence of a highly anionic polysaccharide that is absent in the capsule mutant. The capsule is important for replication and virulence in vivo in a mouse model of infection and in the natural host Acanthamoeba castellanii. It has anti-phagocytic function when encountering innate immune cells such as human macrophages and it is involved in the low cytokine responses in mice and in human monocyte derived macrophages, thus dampening the innate immune response. Thus, the here characterized L. longbeachae capsule is a novel virulence factor, unique among the known Legionella species, which may aid L. longbeachae to survive in its specific niches and which partly confers L. longbeachae its unique infection characteristics.


Assuntos
Cápsulas Bacterianas , Evasão da Resposta Imune , Legionella longbeachae , Animais , Camundongos , Cápsulas Bacterianas/imunologia , Cápsulas Bacterianas/metabolismo , Legionella longbeachae/imunologia , Humanos , Doença dos Legionários/imunologia , Doença dos Legionários/microbiologia , Macrófagos/microbiologia , Macrófagos/imunologia , Fatores de Virulência/metabolismo , Acanthamoeba castellanii/microbiologia , Virulência
3.
J Phycol ; 2024 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-39292829

RESUMO

Cryptophytes are abundant and ubiquitous microalgae that constitute a major plastid source for kleptoplastidic ciliates and dinoflagellates. Despite their ecological significance, the understanding of their light preferences and photophysiology remains limited. Here, we provide a comprehensive study of the response of the haploid strain Teleaulax amphioxeia (Cr10EHU) to varying light irradiance. This strain is capable of growing under a wide range of irradiance levels, notably by finely tuning the different pigments bound to the membrane light-harvesting proteins. Analysis of the luminal phycoerythrin content revealed remarkable flexibility, with phycoerythrin emerging as a pivotal protein facilitating acclimation to varying light levels. Detailed ultrastructure examinations unveiled that this adaptability was supported by the synthesis of large thylakoidal vesicles, likely enhancing the capture of green photons efficiently under low light, a phenomenon previously undocumented. Teleaulax amphioxeia Cr10EHU effectively regulated light utilization by using a cryptophyte state transition-like process, with a larger amplitude observed under high growth irradiance. Furthermore, our results revealed the establishment of growth irradiance-dependent non-photochemical quenching of fluorescence, likely inducing the dissipation of excess light. This study underscores the particularities and the significant photoadaptability of the plastid of the haploid form of T. amphioxeia. It constitutes a comprehensive photophysiological characterization of the Cr10EHU strain that paves the way for future studies of the kleptoplastidy process.

4.
J Am Coll Cardiol ; 84(13): 1208-1223, 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39293884

RESUMO

The American Heart Association considers sleep health an essential component of cardiovascular health, and sleep is generally a time of cardiovascular quiescence, such that any deviation from normal sleep may be associated with adverse cardiovascular consequences. Many studies have shown that both impaired quantity and quality of sleep, particularly with obstructive sleep apnea (OSA) and comorbid sleep disorders, are associated with incident cardiometabolic consequences. OSA is associated with repetitive episodes of altered blood gases, arousals, large negative swings in intrathoracic pressures, and increased sympathetic activity. Recent studies show that OSA is also associated with altered gut microbiota, which could contribute to increased risk of cardiovascular disease. OSA has been associated with hypertension, atrial fibrillation, heart failure, coronary artery disease, stroke, and excess cardiovascular mortality. Association of OSA with chronic obstructive lung disease (overlap syndrome) and morbid obesity (obesity hypoventilation syndrome) increases the odds of mortality.


Assuntos
Doenças Cardiovasculares , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Doenças Cardiovasculares/etiologia
5.
J Am Coll Cardiol ; 84(13): 1224-1240, 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39293885

RESUMO

Many studies have shown an association of obstructive sleep apnea (OSA) with incident cardiovascular diseases, particularly when comorbid with insomnia, excessive sleepiness, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease. Randomized controlled trials (RCTs) have demonstrated that treatment of OSA with positive airway pressure devices (CPAP) improves systemic hypertension, particularly in those with resistant hypertension who are adherent to CPAP. However, large RCTs have not shown long-term benefits of CPAP on hard cardiovascular outcomes, but post hoc analyses of these RCTs have demonstrated improved hard outcomes in those who use CPAP adequately. In theory, low CPAP adherence and patient selection may have contributed to neutral results in intention-to-treat analyses. Only by further research into clinical, translational, and basic underlying mechanisms is major progress likely to continue. This review highlights the various treatment approaches for sleep disorders, particularly OSA comorbid with various other disorders, the potential reasons for null results of RCTs treating OSA with CPAP, and suggested approaches for future trials.


Assuntos
Doenças Cardiovasculares , Pressão Positiva Contínua nas Vias Aéreas , Apneia Obstrutiva do Sono , Humanos , Apneia Obstrutiva do Sono/terapia , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/complicações , Doenças Cardiovasculares/terapia , Doenças Cardiovasculares/epidemiologia , Pressão Positiva Contínua nas Vias Aéreas/métodos
6.
BMC Geriatr ; 24(1): 682, 2024 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-39143509

RESUMO

BACKGROUND: From March 7 to April 7, 2020, the Community of Madrid (CoM), Spain, issued interventions in response to the COVID-19 epidemic, including hospital referral triage protocols for long-term care facility (LTCF) residents (March 18-25). Those with moderate to severe physical disability and cognitive impairment were excluded from hospital referral. This research assesses changes in the association between daily hospital referrals and the deaths of LTCF residents attributable to the triage protocols. METHODS: Daily hospital referrals and all-cause mortality from January to June 2020 among LTCF residents and the CoM population aged 65 + were obtained. Significant changes in LTCF resident daily hospital referrals time series, and in-LTCF and in-hospital daily deaths, were examined with tests for breaks and regimes in time series. Multivariate time series analyses were conducted to test changes in the associations between LTCF resident hospital referrals with daily deaths in-hospital and in-LTCF, and in the CoM population aged 65 + when the triage protocols were implemented. RESULTS: Among LTCF residents, hospital referrals declined sharply from March 6 to March 23, 2020. Increases in LTCF residents' daily deaths occurred from March 7 to April 1, followed by a decrease reaching pre-epidemic levels after April 28. The daily ratio of in-hospital deaths to in-LTCF deaths reached its lowest values from March 9 to April 19, 2020. The four versions of the triage protocol, published from March 18 to March 25 had no impact on further changes in the association of hospital referrals with daily deaths of LTCF residents in-hospital or in-LTCF. CONCLUSIONS: While LTCF residents' deaths increased, hospital referrals of LTCF residents decreased with the introduction of the CoM governmental interventions on March 7. They were implemented before the enactment of the triage protocols, protecting hospitals from collapse while overlooking the need for standards of care within LTCFs. The CoM triage protocols sanctioned the existing restrictions on hospital referrals of LTCF residents.


Assuntos
COVID-19 , Assistência de Longa Duração , Encaminhamento e Consulta , Humanos , COVID-19/mortalidade , COVID-19/epidemiologia , Espanha/epidemiologia , Idoso , Encaminhamento e Consulta/tendências , Masculino , Feminino , Assistência de Longa Duração/tendências , Assistência de Longa Duração/métodos , Idoso de 80 Anos ou mais , Triagem/métodos , Mortalidade Hospitalar/tendências , Casas de Saúde/tendências , SARS-CoV-2 , Análise Multivariada
7.
Neurology ; 103(4): e209692, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39088773

RESUMO

BACKGROUND AND OBJECTIVES: To analyze the ability of prehospital lactate levels to predict 2-day in-hospital mortality in patients with traumatic brain injury (TBI), severe TBI (Glasgow Coma Scale (GCS) ≤ 8 points), and mild or moderate TBI (GCS ≥ 9 points). Second, 90-day mortality was also explored. METHODS: This was a prospective, multicenter, emergency medical services (EMSs) delivery, ambulance-based, derivation-validation cohort study developed in 5 tertiary hospitals (Spain), from November 1, 2019, to July 31, 2022. Patients were recruited from among all phone requests for emergency assistance among adults who were later evacuated to referral hospitals with acute TBI. The exclusion criteria were minors, pregnancy, trauma patients without TBI, delayed presentations, patients were discharged in situ, participants with cardiac arrest, and unavailability to obtain a blood sample. The primary outcome was all-cause 2-day in-hospital mortality and 90-day mortality in patients with moderate or mild TBI compared with patients with severe TBI. Clinical and analytical parameters (lactate and glucose) were collected. The discriminative power (area under the receiver operating characteristic curve [AUC]) and calibration curve were calculated for 2 geographically separated cohorts. RESULTS: A total of 509 patients were ultimately included. The median age was 58 years (interquartile range: 43-75), and 167 patients were female (32.8%). The primary outcome occurred in 9 (2.2%) of 415 patients with moderate or mild TBI and in 42 (44.7%) of 94 patients with severe TBI. The predictive capacity of the lactate concentration was globally validated in our cohort, for which the AUC was 0.874 (95% CI 0.805-0.942) for the validation cohort. The ability of the GCS score to predict lactate concentration was greater in patients with a GCS score ≥9 points, with an AUC of 0.925 (95% CI 0.808-1.000) and a negative predictive value of 99.09 (95% CI 98.55-99.64) in the validation cohort. CONCLUSION: Our results show the benefit of using lactate in all patients with TBI, particularly in those with a GCS ≥9 points. Routine incorporation of lactate in the screening of patients with TBI could presumably reduce mortality and deterioration rates because of quicker and better identification of patients at risk.


Assuntos
Ambulâncias , Lesões Encefálicas Traumáticas , Mortalidade Hospitalar , Ácido Láctico , Humanos , Lesões Encefálicas Traumáticas/mortalidade , Lesões Encefálicas Traumáticas/sangue , Lesões Encefálicas Traumáticas/diagnóstico , Feminino , Masculino , Pessoa de Meia-Idade , Ácido Láctico/sangue , Idoso , Estudos Prospectivos , Adulto , Serviços Médicos de Emergência , Escala de Coma de Glasgow , Valor Preditivo dos Testes , Estudos de Coortes , Espanha/epidemiologia
8.
Intern Emerg Med ; 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39090370

RESUMO

How prehospital medication predicts patient outcomes is unclear. The aim of this work was to unveil the association between medication burden administration in prehospital care and short, mid, and long-term mortality (2, 30, and 365 day) in unselected acute diseases and to assess the potential of the number of medications administered for short, mid, and long-term mortality prediction. A prospective, multicenter, ambulance-based, cohort study was carried out in adults with unselected acute diseases managed by emergency medical services (EMS). The study was carried out in Spain with 44 ambulances and four hospitals. The principal outcome was cumulative mortality at 2, 30, and 365 days. Epidemiological variables, vital signs, and prehospital medications were collected. Patients were classified into four categories: no medication dispensed in prehospital care, one to two medications, three to four medications, and five or more medications. A total of 6401 patients were selected. The 2-day mortality associated with each group was 0.5%, 1.8%, 6.5%, and 18.8%. The 30-day mortality associated with each group was 3.8%, 6.2%, 13.5%, and 31.9%. The 365-day mortality associated with each group was 11%, 15.3%, 25.2%, and 45.7%. The predictive validity of the number of drugs administered, measured by the area under the curve, was 0.808, 0.720, and 0.660 for 2-, 30-, and 365-day mortality, respectively. Our results showed that prehospital drugs could provide relevant information regarding the mortality prediction of patients. The incorporation of this score could improve the management of high-risk patients by the EMS.

9.
OTA Int ; 7(5 Suppl): e330, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39114372

RESUMO

Trauma is one of the main causes of death in younger people and ongoing disability worldwide. In Europe, while there is generally good organization of trauma reception and acute treatment, rehabilitation from major musculoskeletal injuries is less well defined and provided. This article documents the diverse approaches to rehabilitation after major injury in 6 European nations. The recognition of need is universal, but achieving a robust rehabilitation strategy is more elusive across the varying health care systems. Switzerland has the most robust service in the insured population. In the other countries, particularly where there is a reliance on public institutes, this provision is at best patchy. In the Netherlands, innovative patient-empowering strategies have gained traction with notable success, and in the United Kingdom, a recent randomized trial also showed this approach to be reproducible and robust. Overall, there is a clear need for learning across the national systems and implementation of a minimum set of standards.

10.
Appl Spectrosc ; : 37028241267938, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39094005

RESUMO

This study investigates the combined effects of nanoscale surface roughness and electron-phonon interaction on the vibrational modes of cadmium telluride (CdTe) using resonant Raman spectroscopy. Raman spectra simulations aided in identifying the active phonon modes and their dependence on roughness. Our results reveal that increasing surface roughness leads to an asymmetric line shape in the first-order longitudinal optical (1LO) phonon mode, attributed to an increase in the electron-phonon interaction. This asymmetry broadens the entire Raman spectrum. Conversely, the overtone (second-order longitudinal optical [2LO]) mode exhibits a symmetrical line shape that intensifies with roughness. Additionally, we identify and discuss the contributions of surface optical phonon mode and multiphonon modes to the Raman spectra, highlighting their dependence on roughness. This work offers a deeper understanding of how surface roughness and electron-phonon scattering influence the line shape of CdTe resonant Raman spectra, providing valuable insights into its vibrational properties.

11.
Artigo em Inglês | MEDLINE | ID: mdl-39200588

RESUMO

The world is aging and experiencing loneliness. Functional impairment in instrumental activities of daily living (IADL) in older people (OP) with mild neurocognitive disorder (MNCD) predicts loneliness. After the pandemic, there was an increase in perceived loneliness. We explored the association between loneliness, depression, deficits in IADL, and cognitive symptoms among OP. From February to December 2023, using a cross-sectional design, we interviewed probable cases with mild cognitive impairment and caregivers in two public facilities. We administered the UCLA Loneliness Scale v3, Lawton IADL Scale, Mini-Mental State Examination (MMSE), and Yesavage's Geriatric Depression Scale. Samples were matched: 85 per group, 82.4% were women, married (52.95%), and mean age of 69.17 (±6.93) years. In our study, 30% displayed moderate to high levels of perceived loneliness. Multivariate analysis showed loneliness was associated with depression, low levels of IADL, and older age, but not with cognitive symptoms, which explained 22% of the total variance (F 165) = 16.99, (p < 0.001). Targeting symptoms and behaviors that could be modified (i.e., depression and functionality) can improve feelings of perceived loneliness and have an impact on morbidity and mortality with which it is associated.


Assuntos
Atividades Cotidianas , Disfunção Cognitiva , Depressão , Solidão , Humanos , Solidão/psicologia , Feminino , Idoso , Masculino , México/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Estudos Transversais , Pessoa de Meia-Idade , Disfunção Cognitiva/psicologia , Disfunção Cognitiva/epidemiologia , Idoso de 80 Anos ou mais , Cognição
12.
Int J Biol Macromol ; 278(Pt 1): 133946, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39029825

RESUMO

The incorporation of active compounds into polymeric matrices using traditional methods has several drawbacks mainly due to the high volatility and thermal sensitivity of these substances. A solution to this problem could be the incorporation of bioactive compounds forming inclusion complexes as a strategy to improve the chemical stability, bioactivity and achieve controlled release. In this work, ß-cyclodextrin/carvacrol inclusion complex was prepared by spray drying to be incorporated into poly(lactic acid) (PLA) and Mater-Bi® films by supercritical CO2 impregnation. The impregnation process was carried out at pressures of 10, 15 and 20 MPa and at 40 °C. Both polymers showed the highest amount of incorporated inclusion complex at 15 MPa, where the percentage of impregnation varied from 0.6 % to 7.1 % in Mater-Bi® and PLA, respectively. Release tests for PLA films impregnated with inclusion complex showed a slow release of the active compound, which did not reach equilibrium after 350 h under the experimental conditions. This prolonged release was not observed in Mater-Bi® due to the lower incorporation of the inclusion complex. The release rate was described herein by a comprehensive phenomenological model considering the decomplexation kinetics combined with the equilibrium and mass transfer expressions.


Assuntos
Cimenos , Poliésteres , beta-Ciclodextrinas , Poliésteres/química , beta-Ciclodextrinas/química , Cimenos/química , Cinética , Liberação Controlada de Fármacos
13.
Mol Ther Methods Clin Dev ; 32(2): 101271, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38946936

RESUMO

Hematopoietic stem cell gene therapy (HSCGT) is a promising therapeutic strategy for the treatment of neurodegenerative, metabolic disorders. The approach involves the ex vivo introduction of a missing gene into patients' own stem cells via lentiviral-mediated transduction (TD). Once transplanted back into a fully conditioned patient, these genetically modified HSCs can repopulate the blood system and produce the functional protein, previously absent or non-functional in the patient, which can then cross-correct other affected cells in somatic organs and the central nervous system. We previously developed an HSCGT approach for the treatment of Mucopolysaccharidosis type II (MPSII) (Hunter syndrome), a debilitating pediatric lysosomal disorder caused by mutations in the iduronate-2-sulphatase (IDS) gene, leading to the accumulation of heparan and dermatan sulfate, which causes severe neurodegeneration, skeletal abnormalities, and cardiorespiratory disease. In HSCGT proof-of-concept studies using lentiviral IDS fused to a brain-targeting peptide ApoEII (IDS.ApoEII), we were able to normalize brain pathology and behavior of MPSII mice. Here we present an optimized and validated good manufacturing practice hematopoietic stem cell TD protocol for MPSII in preparation for first-in-man studies. Inclusion of TEs LentiBOOST and protamine sulfate significantly improved TD efficiency by at least 3-fold without causing adverse toxicity, thereby reducing vector quantity required.

14.
BMJ Open Ophthalmol ; 9(1)2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39043575

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of faricimab compared with other anti-vascular endothelial growth factor (anti-VEGF) agents in treating neovascular age-related macular degeneration (nAMD) patients. METHODS AND ANALYSIS: A systematic review (SR) was conducted up to January 2023. Network meta-analyses (NMA) were performed, including sensitivity and subgroup analyses for naïve population. Outcomes included changes in visual acuity (Early Treatment of Diabetic Retinopathy Study [ETDRS] letters), anatomical changes, frequency of injections and adverse events. The Cochrane Collaboration guidelines and the Confidence in Network Meta-Analysis framework were used for the SR and the certainty of evidence, respectively. RESULTS: From 4128 identified records through electronic databases and complementary searches, 63 randomised controlled trials (RCTs) met the eligibility criteria, with 42 included in the NMA. Faricimab showed a significant reduction in the number of annual injections compared with most fixed and flexible anti-VEGF treatment regimens, while showing no statistically significant differences in visual acuity through ETDRS letter gain, demonstrating a comparable efficacy. Retinal thickness results showed comparable efficacy to other anti-VEGF agents, and inferior only to brolucizumab. Results also showed that more patients treated with faricimab were free from post-treatment retinal fluid compared with aflibercept every 8 weeks, and both ranibizumab and bevacizumab, in the fixed and pro re nata (PRN) assessed schedules. Faricimab showed a comparable safety profile regarding the risk of ocular adverse events and serious ocular adverse events (SOAE), except for the comparison with brolucizumab quarterly, in which faricimab showed a significant reduction for SOAE risk. CONCLUSION: Faricimab showed a comparable clinical benefit in efficacy and safety outcomes, with a reduction in annual injections compared with fixed and flexible anti-VEGF drug regimens, representing a valuable treatment option for nAMD patients. PROSPERO REGISTRATION NUMBER: CRD42023394226.


Assuntos
Inibidores da Angiogênese , Injeções Intravítreas , Metanálise em Rede , Fator A de Crescimento do Endotélio Vascular , Acuidade Visual , Degeneração Macular Exsudativa , Humanos , Inibidores da Angiogênese/uso terapêutico , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/administração & dosagem , Acuidade Visual/efeitos dos fármacos , Degeneração Macular Exsudativa/tratamento farmacológico , Degeneração Macular Exsudativa/fisiopatologia , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Resultado do Tratamento , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem
15.
NPJ Digit Med ; 7(1): 197, 2024 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-39048671

RESUMO

Emergency medical services (EMSs) face critical situations that require patient risk classification based on analytical and vital signs. We aimed to establish clustering-derived phenotypes based on prehospital analytical and vital signs that allow risk stratification. This was a prospective, multicenter, EMS-delivered, ambulance-based cohort study considering six advanced life support units, 38 basic life support units, and four tertiary hospitals in Spain. Adults with unselected acute diseases managed by the EMS and evacuated with discharge priority to emergency departments were considered between January 1, 2020, and June 30, 2023. Prehospital point-of-care testing and on-scene vital signs were used for the unsupervised machine learning method (clustering) to determine the phenotypes. Then phenotypes were compared with the primary outcome (cumulative mortality (all-cause) at 2, 7, and 30 days). A total of 7909 patients were included. The median (IQR) age was 64 (51-80) years, 41% were women, and 26% were living in rural areas. Three clusters were identified: alpha 16.2% (1281 patients), beta 28.8% (2279), and gamma 55% (4349). The mortality rates for alpha, beta and gamma at 2 days were 18.6%, 4.1%, and 0.8%, respectively; at 7 days, were 24.7%, 6.2%, and 1.7%; and at 30 days, were 33%, 10.2%, and 3.2%, respectively. Based on standard vital signs and blood test biomarkers in the prehospital scenario, three clusters were identified: alpha (high-risk), beta and gamma (medium- and low-risk, respectively). This permits the EMS system to quickly identify patients who are potentially compromised and to proactively implement the necessary interventions.

16.
Eur J Investig Health Psychol Educ ; 14(7): 1927-1939, 2024 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-39056643

RESUMO

Investigating the contribution of mindfulness training to psychological well-being and quality of life in the university setting is of interest. The objective of the study is to present a comparative analysis of the scores in the variables of self-efficacy, resilience, coping strategies, and communication skills before and after the application of an intervention program based on mindfulness. An ex post facto cross-sectional design and a convenience sample of participants were adopted. The participants were students belonging to Education Sciences who benefited from the activities of the program. Instruments were administered to assess mindfulness, self-efficacy, resilience, coping strategies, and communication skills. The correlations of the mindfulness variable with the other psychoeducational variables evaluated were also analyzed. The results indicate an increase in the scores in the selected variables of mindfulness, resilience, communication skills, and some of the coping strategies considered productive or functional such as problem solving, self-criticism, emotional expression, desiderative thinking, social support, and cognitive restructuring. Statistically significant correlations were also observed between the variable mindfulness and those of perceived self-efficacy, resilience, coping strategies, and communication skills. The development of mindfulness training programs in the university setting is necessary to contribute to the improvement of more adaptive coping skills and the promotion of resilience.

17.
J Pers Med ; 14(7)2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39064016

RESUMO

BACKGROUND: This study evaluates the diagnostic performance of high-sensitivity troponin using point-of-care testing (POCT) devices compared with main laboratory measurements for ruling out non-ST-elevation myocardial infarction (NSTEMI) in emergency department (ED) patients presenting with non-traumatic chest pain. METHODS: This multicenter, observational, prospective, non-interventional study was conducted in two Spanish hospitals from 1 June to 31 December 2023 and included adult patients presenting with non-traumatic chest pain admitted to the ED. High-sensitivity troponin levels were measured using both the Siemens Atellica® VTLi POCT device and main laboratory testing, with data collected on analytical results and measurement times. RESULTS: Of the 201 patients who met the inclusion criteria, a significant correlation was observed between the POCT and laboratory assays. The area under the curve (AUC) of the ROC curve was consistently greater than 0.9, indicating a high diagnostic accuracy for ruling out NSTEMI. In addition, measurement times were significantly reduced using POCT compared to the core laboratory. CONCLUSION: These results suggest that high-sensitivity troponin POCT devices offer comparable diagnostic performance to traditional laboratory methods for the diagnosis of NSTEMI in the emergency department, potentially speeding up clinical decisions and optimizing resource utilization.

18.
Microorganisms ; 12(7)2024 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-39065248

RESUMO

The changes in the cell physiology (growth rate, cell size, and cell DNA content), photosynthetic efficiency, toxicity, and sexuality under variable light and nutrient (phosphates) conditions were evaluated in cultures of the dinoflagellate Alexandrium minutum obtained from a red tide in the Ría de Vigo (NW Spain). The cells were grown at low (40 and 150 µE m-2 s-1), moderate (400 µE m-2 s-1), and high (800 µE m-2 s-1) light intensities in a medium with phosphate (P+) and without (P-). Cultures were acclimated to the irradiance conditions for one week, and the experiment was run for ~1 month. The cell size and DNA content were monitored via flow cytometry. Two different clonal strains were employed as a monoculture (in a P- or P+ medium) or, to foster sexuality and resting cyst formation, as a mixed culture (only in a P- medium). A. minutum growth was favored by increasing light intensities until 400 µE m-2 s-1. The DNA content analyses indicated the accumulation of S-phase cells at the highest light intensities (400 and 800 µE m-2 s-1) and therefore the negative effects on cell cycle progression. Only when the cells were grown in a P- medium did higher light intensities trigger dose-dependent, significantly higher toxicities in all the A. minutum cultures. This result suggests that the toxicity level is responsive to the combined effects of (high) light and (low) P stress. The cell size was not significantly affected by the light intensity or P conditions. The optimal light intensity for resting cyst formation was 150 µE m-2 s-1, with higher irradiances reducing the total encystment yield. Encystment was not observed at the lowest light intensity tested, indicative of the key role of low-level irradiance in gamete and/or zygote formation, in contrast to the stressor effect of excessive irradiance on planozygote formation and/or encystment.

19.
iScience ; 27(6): 110135, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38966569

RESUMO

ADAM29 (a disintegrin and metalloprotease domain 29) is a member of the membrane-anchored ADAM family of proteins, which is highly expressed in testis and may mediate different physiological and pathological processes. Although the functions of many ADAM family members have been well characterized, the biological relevance of ADAM29 has remained largely unknown. Here, we report the generation of an Adam29-deficient mouse model to delve deeper into the in vivo functions of this ADAM family member. We show that ADAM29 depletion does not affect mice viability, development, or fertility, but somehow impinges on metabolism and energy expenditure. We also report herein that ADAM29 deficiency leads to an accelerated wound healing process, without affecting cell reprogramming in mouse-derived fibroblasts. Collectively, our findings provide new insights into ADAM29 biological functions, highlighting the importance of non-catalytic ADAM proteases.

20.
J Fish Biol ; 2024 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-38978288

RESUMO

The genus Urotrygon comprises small- to medium-sized endemic round rays on the American continent and has undergone several synonymization processes. Here, we used an integrative taxonomic approach, including meristic, morphometric, and mtDNA analyses, to resolve the particularly intricate relationship among Urotrygon munda Gill, 1863, Urotrygon chilensis (Günther, 1872), and Urotrygon asterias (Jordan & Gilbert, 1883). The latter species is currently a synonym of U. munda but is also considered the U. chilensis "northern morphotype." These taxonomic entities have historically been confounded, mainly due to their phenotypical resemblance along their geographic distribution in the eastern Pacific. We assessed 78 specimens (43 "northern" and 30 "southern morphotypes" of U. chilensis, as well as 5 U. munda) using 19 external variables for taxonomic and morphometric analysis. Distinct meristic patterns, including pectoral and pelvic ceratotrichia, vertebrae number, and thorn distribution along the dorsal midline, were observed in the series-type specimens of the three taxonomic entities. Our multivariate morphometric analyses consistently differentiated the three groups as distinct taxonomic entities, with an overall classification accuracy of 66.7%. The meristic results also provided reliable information distinguishing the three entities. Based on the nicotinamide adenine dinucleotide (NADH2) and cytochrome oxidase subunit I (COI) genes, our phylogenetic analysis were consistent with the morphometric and meristic data, supporting these three entities as distinct species having their own evolutionary lineages. Our comprehensive approach confidently demonstrated that the northern U. chilensis morphotype matched and corresponded to the description of the Starry round ray, U. asterias, confirming its taxonomic resurrection as a valid species distinct from U. chilensis and U. munda. The geographic distribution of U. asterias spans from the tropical west coast of Mexico (including the Gulf of California) to Costa Rica, revealing that microevolutionary processes have well-defined population clades within this range. Furthermore, U. chilensis is unequivocally established as the sole Urotrygon species occurring south of the Guayaquil marine ecoregion. In addition, the public COI and NADH2 sequences available for Urotrygon hosted in the ad hoc online databases were found to be misidentified, emphasizing the need for rigorous taxonomic scrutiny in this group. Finally, our research underscores the significance of an integrative approach that combines morphometric, meristic, and molecular techniques with historical data to disentangle the complexities of closely related taxa.

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