Predictors of engagement with remote sensing technologies for symptom measurement in Major Depressive Disorder.

BACKGROUND: Remote sensing for the measurement and management of long-term conditions such as Major Depressive Disorder (MDD) is becoming more prevalent. User-engagement is essential to yield any benefits. We tested three hypotheses examining associations between clinical characteristics, perceptions of remote sensing, and objective user engagement metrics. METHODS: The Remote Assessment of Disease and Relapse - Major Depressive Disorder (RADAR-MDD) study is a multicentre longitudinal observational cohort study in people with recurrent MDD. Participants wore a FitBit and completed app-based assessments every two weeks for a median of 18 months. Multivariable random effects regression models pooling data across timepoints were used to examine associations between variables. RESULTS: A total of 547 participants (87.8% of the total sample) were included in the current analysis. Higher levels of anxiety were associated with lower levels of perceived technology ease of use; increased functional disability was associated with small differences in perceptions of technology usefulness and usability. Participants who reported higher system ease of use, usefulness, and acceptability subsequently completed more app-based questionnaires and tended to wear their FitBit activity tracker for longer. All effect sizes were small and unlikely to be of practical significance. LIMITATIONS: Symptoms of depression, anxiety, functional disability, and perceptions of system usability are measured at the same time. These therefore represent cross-sectional associations rather than predictions of future perceptions. CONCLUSIONS: These findings suggest that perceived usability and actual use of remote measurement technologies in people with MDD are robust across differences in severity of depression, anxiety, and functional impairment.

Effect of the hematopoietic growth factors erythropoietin and kit ligand on bovine oocyte in vitro maturation and developmental competence.

The overall aim of this work was to study the influence of the hematopoietic growth factors erythropoietin (EPO) and kit ligand (KITL) during bovine oocyte in vitro maturation (IVM). The effect of adding different concentrations of EPO or KITL to maturation medium was evaluated analyzing oocyte nuclear maturation, cumulus cells apoptosis, embryo cleavage, reactive oxygen species (ROS) production in matured oocytes and cleaved embryos and the developmental competence to the blastocyst stage. No significant differences were observed in the percentage of oocytes that completed nuclear maturation among treatments, but the percentages of cleaved embryos and blastocysts obtained increased. With the addition of both hematopoietic growth factors the percentage of cumulus cells undergoing apoptosis decreased, the number of blastomeres per cleaved embryo was larger and ROS production per cleaved embryo increased. In conclusion, although the addition of EPO and KITL hematopoietic growth factors during bovine oocyte IVM had no impact on nuclear maturation, it had a positive effect on oocyte cytoplasmic maturation and developmental competence.

Non-plastic reorganization of frequency coding in the inferior colliculus of the rat following noise-induced hearing loss.

It is well established that restricted mechanical lesions of the cochlea result in reorganization of the tonotopic map in the auditory thalamus and cortex, but it is unclear whether acoustic trauma produces similar effects at earlier stages of the auditory pathways. To test whether the tonotopic map is reorganized after acoustic trauma at the midbrain level, i.e. the inferior colliculus (IC), we exposed rats to an acoustic trauma and let them survive for at least 5 weeks to ensure that we produced a permanent threshold shift. Experiments were carried out in urethane-anesthetized animals 35-296 days after the traumatic exposure. The acoustic lesions were assessed by measuring the compound action potential. We mapped the frequency organization of the IC using multiunit recordings. In addition, we recorded frequency response areas (FRAs) when a single unit was isolated (N=142). The results show that acoustic trauma produces a persistent reorganization of the tonotopic map and that the normal stepwise representation of sound frequency in the IC is profoundly disrupted. Although the reorganization in the IC is similar to that previously described in the cortex and thalamus in that the affected area appears to be invaded by the adjacent normal frequencies, changes in thresholds and FRAs in these regions are different from those in the forebrain. We conclude that most of the changes can be explained by the residual-response hypothesis [Irvine DR, Rajan R, Smith S (2003) Effects of restricted cochlear lesions in adult cats on the frequency organization of the inferior colliculus. J Comp Neurol 467:354-374]. Plastic reorganization of frequency response areas and tonotopic organization does not seem to occur at the midbrain level following acoustic trauma in adult animals in a manner similar to that previously shown in the auditory cortex. Maintaining the stability of the neuronal circuitry for frequency coding in the IC may be important for the treatment of noise-induced hearing loss.

Towards an operational system for oil-spill forecast over Spanish waters: initial developments and implementation test.

The ESEOO Project, launched after the Prestige crisis, has boosted operational oceanography capacities in Spain, creating new operational oceanographic services and increasing synergies between these new operational tools and already existing systems. In consequence, the present preparedness to face an oil-spill crisis is enhanced, significantly improving the operational response regarding ocean, meteorological and oil-spill monitoring and forecasting. A key aspect of this progress has been the agreement between the scientific community and the Spanish Search and Rescue Institution (SASEMAR), significantly favoured within the ESEOO framework. Important achievements of this collaboration are: (1) the design of protocols that at the crisis time provide operational state-of-the-art information, derived from both forecasting and observing systems; (2) the establishment, in case of oil-spill crisis, of a new specialized unit, named USyP, to monitor and forecast the marine oceanographic situation, providing the required met-ocean and oil-spill information for the crisis managers. The oil-spill crisis scenario simulated during the international search and rescue Exercise "Gijón-2006", organized by SASEMAR, represented an excellent opportunity to test the capabilities and the effectiveness of this USyP unit, as well as the protocols established to analyze and transfer information. The results presented in this work illustrate the effectiveness of the operational approach, and constitute an encouraging and improved base to face oil-spill crisis.

A new diagnostic tool for neurocysticercosis is a member of a cestode specific hydrophobic ligand binding protein family.

A protein of unknown function has been identified as a key serological tool for diagnosis of human tapeworm neurocysticercosis, a major worldwide neurological disease. Our own sequence analysis predicts that this protein is a member of a newly identified cestode specific oligomeric hydrophobic ligand binding protein family. In this report, using a rat cestode model, we confirm that homologues of this protein can bind fatty acids and their derivatives, and thus suggest a biological function for this key diagnostic tool.

Biochemical characterisation of a hydrophobic ligand binding protein from the tapeworm Hymenolepis diminuta.

The cestode Hymenolepis diminuta contains an abundant, cytoplasmic, hydrophobic ligand, binding protein (H-HLBP). Studies with polarity sensitive probes suggest a single hydrophobic binding site, the results also indicate that the single tryptophan in the molecule (Trp41) is involved in ligand binding. Of the possible physiological ligands tested, only haematin and retinoids (retinol and retinoic acid) show appreciable binding in addition to fatty acids. H-HLBP also binds a range of anthelmintics, again with K(D) values in the nM range. The interaction of anthelmintics with hydrophobic binding proteins may be important in determining drug specificity and site of action and could have a role in the development of drug resistance.

[Usefulness of abdominal echography in the diagnosis of active Crohn's disease]. / Utilidad de la ecografía abdominal en el diagnóstico de la enfermedad de Crohn en actividad.

OBJECTIVE: The aim of this study was to evaluate the relevance of the ultrasonography in assessing activity in a series of patients with Crohn's disease. PATIENTS AND METHODS: A series of 24 patients with active (Crohn's disease activity index > 150) ileal or ileocolonic Crohn disease underwent abdominal ultrasonography. RESULTS: There was a significant correlation between bowel wall thickening and the Crohn's disease activity index: the higher the bowel wall thickening was the higher were the values of Crohn's disease activity index. Two or more ultrasound studies were performed in 10 patients with bowel wall > 4 mm during treatment, and a progressive normalization of bowel wall size was observed with new thickening when recurrence occurred. CONCLUSIONS: A bowel wall thickening (> or = 4 mm) was found in patients with active Crohn's disease. A patient with bowel wall thickness > 6 mm should make us suspect the presence of stenosis. Abdominal ultrasonography is an accurate method in the first assessment of Crohn's disease because its high correlation with the Crohn's disease activity index.

[Comparison of ropivacaine and bupivacaine for epidural analgesia during labor]. / Estudio comparativo entre ropivacaína y bupivacaína en analgesia epidural del parto.

OBJECTIVES: To compare the analgesic efficacy and level of motor block using two local anesthetics, ropivacaine and bupivacaine, during labor. MATERIAL AND METHODS: Sixty nulliparous women were enrolled during labor after full-term pregnancies. They were randomly assigned to receive epidural analgesia with ropivacaine (group R) or bupivacaine (group B). Group R patients received 10 ml of 0.18% ropivacaine with 5 microgram/ml of fentanyl followed by continuous epidural infusion of 0.1% ropivacaine with 2 microgram/ml of fentanyl at a rate of 10 ml/h. Group B patients received 10 ml of 0.15% bupivacaine with 5 microgram/ml of fentanyl followed by continuous epidural perfusion of 0.0625% bupivacaine with 2 microgram/ml of fentanyl at the same rate. Pain intensity was assessed on a visual analog scale, motor blockade on a Bromage scale, and level of sensory block at different moments. We also recorded total doses of local anesthetic employed during continuous epidural infusion, manner of final delivery, Apgar score, degree of maternal satisfaction and side effects. RESULTS: The demographic and delivery characteristics were similar in both groups. We found no statistically significant differences between the two groups for level of motor blockade, which was nil for 29 patients (96.66%) in group R and 28 patients (93.33%) in group B. No differences in degree of pain or level of sensory block (T8-T10 in both groups) were observed. The total doses of local anesthetic used were similar at 23.7 +/- 11.6 mg in group R and 16.5 +/- 7.3 mg in group B (non-significant difference). Nor did we find differences in manner of delivery, neonatal Apgar scores, degree of maternal satisfaction or side effects. CONCLUSION: Ropivacaine and bupivacaine are equally effective for epidural analgesia during labor at the doses used and they do not cause a relevant level of motor blockade.

[Advanced stage laryngeal chondrosarcoma]. / Condrosarcoma laríngeo de alto grado de agresividad.

Chondrosarcoma is a tumor very seldom encountered in the larynx. In this location chondrosarcomas have typical features: slow growing, metastasis rares and scarce tendency to recur. But recurrences occurs at long-term and often can be controlled. We report a case diagnosed and treated in our Hospital which, on the contrary, recurrences presented in a short-term after first surgical removal. Clinical management and treatment of these neoplasms are reviewed.

Expectation maximization (EM) algorithms using polar symmetries for computed tomography (CT) image reconstruction.

We suggest a symmetric-polar pixellation scheme which makes possible a reduction of the computational cost for expectation maximization (EM) iterative algorithms. The proposed symmetric-polar pixellation allows us to deal with 3D images as a whole problem without dividing the 3D problem into 2D slices approach. Performance evaluation of each approach in terms of stability and image quality is presented. Exhaustive comparisons between all approaches were conducted in a 2D based image reconstruction model. From these 2D approaches, that showing the best performances were finally implemented and evaluated in a 3D based image reconstruction model. Comparison to 3D images reconstructed with FBP is also presented. Although the algorithm is presented in the context of computed tomography (CT) image reconstruction, it can be applied to any other tomographic technique as well, due to the fact that the only requirement is a scanning geometry involving measurements of an object under different projection angles. Real data have been acquired with a small animal (CT) scanner to verify the proposed mathematical description of the CT system.

ALBIRA: a small animal PET∕SPECT∕CT imaging system.

PURPOSE: The authors have developed a trimodal PET∕SPECT∕CT scanner for small animal imaging. The gamma ray subsystems are based on monolithic crystals coupled to multianode photomultiplier tubes (MA-PMTs), while computed tomography (CT) comprises a commercially available microfocus x-ray tube and a CsI scintillator 2D pixelated flat panel x-ray detector. In this study the authors will report on the design and performance evaluation of the multimodal system. METHODS: X-ray transmission measurements are performed based on cone-beam geometry. Individual projections were acquired by rotating the x-ray tube and the 2D flat panel detector, thus making possible a transaxial field of view (FOV) of roughly 80 mm in diameter and an axial FOV of 65 mm for the CT system. The single photon emission computed tomography (SPECT) component has a dual head detector geometry mounted on a rotating gantry. The distance between the SPECT module detectors can be varied in order to optimize specific user requirements, including variable FOV. The positron emission tomography (PET) system is made up of eight compact modules forming an octagon with an axial FOV of 40 mm and a transaxial FOV of 80 mm in diameter. The main CT image quality parameters (spatial resolution and uniformity) have been determined. In the case of the SPECT, the tomographic spatial resolution and system sensitivity have been evaluated with a (99m)Tc solution using single-pinhole and multi-pinhole collimators. PET and SPECT images were reconstructed using three-dimensional (3D) maximum likelihood and ordered subset expectation maximization (MLEM and OSEM) algorithms developed by the authors, whereas the CT images were obtained using a 3D based FBP algorithm. RESULTS: CT spatial resolution was 85 µm while a uniformity of 2.7% was obtained for a water filled phantom at 45 kV. The SPECT spatial resolution was better than 0.8 mm measured with a Derenzo-like phantom for a FOV of 20 mm using a 1-mm pinhole aperture collimator. The full width at half-maximum PET radial spatial resolution at the center of the field of view was 1.55 mm. The SPECT system sensitivity for a FOV of 20 mm and 15% energy window was 700 cps∕MBq (7.8 × 10(-2)%) using a multi-pinhole equipped with five apertures 1 mm in diameter, whereas the PET absolute sensitivity was 2% for a 350-650 keV energy window and a 5 ns timing window. Several animal images are also presented. CONCLUSIONS: The new small animal PET∕SPECT∕CT proposed here exhibits high performance, producing high-quality images suitable for studies with small animals. Monolithic design for PET and SPECT scintillator crystals reduces cost and complexity without significant performance degradation.

Peripheral arterial disease in patients with chronic obstructive pulmonary disease.

AIM: Cardiovascular disease (CV) is the second leading cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD). Peripheral arterial disease (PAD) is associated with cardiovascular disease, and its risk factors are common to other atherosclerotic diseases. The objective is to determine the prevalence of PAD in a population of patients with COPD using the ankle / brachial index (ABI) and to investigate the relationship between PAD and lung disease severity. METHODS: In a prospective cross-sectional study, 246 patients with COPD were recruited. Patients were enrolled consecutively according to their admission to Povisa hospital from September 1, 2008, until March 1, 2010, and were assessed by clinical history, spirometry and ABI. The COPD severity was graded by GOLD criteria in spirometry. RESULTS: Overall, 84 patients (36.8%) had abnormal ABI results and 59 (70.2%) were asymptomatic for PAD. COPD patients with PAD had a higher prevalence of moderate to severe COPD (61.9% vs. 41.7%, P=0.004), lower mean forced expiratory volume in 1 second (FEV1) values (46.7% ± 15 vs. 52.3±14%, P=0.001) and a higher prevalence of hypertension (69% vs. 54.3%, P=0.03) and previous cardiovascular disease (34.5% vs. 21.3%, P=0.03). CONCLUSION: There was a high prevalence of asymptomatic PAD in the COPD patients we examined. Abnormal ABI results were associated with a higher prevalence of cardiovascular risk factors and more severe lung disease. The diagnosis of peripheral arterial disease in COPD is important because this is an entity that limits the patient's physical activity and impairs their quality of life in addition to turn it into a high cardiovascular risk patient that requiring additional therapeutic measures.

[Relationship between arginase activity and the storage time of packed red blood cells]. / Relación entre la actividad arginasa y el tiempo de conservación de los concentrados de hematíes.

OBJECTIVES: Given the increasing evidence regarding a relationship between packed red blood cells storage time and post-transfusion complications, we decided to determine the relationship between the arginase enzyme levels, biochemical parameters and haemolysis, with the storage time of transfused packed red blood cells. MATERIAL AND METHODS: We designed a prospective study that included 24 units of packed cells that had been consecutively transfused to patients of our hospital. After recording the storage time of each bag, 15 ml of blood was removed to determine arginase activity, biochemical parameters and haemolysis. A univariate analysis was performed on all the recorded parameters, and included those that were significant in the multiple regression model (P<.05). RESULTS: The mean storage time was 18.6±6.1 days (range: 6-31 days), with a haematocrit of 59.8%±0.05%, a haemoglobin of 20.3±1.8 g/dl, a pH of 6.5±0.1, and an arginase activity of 140.1±124.0 mU/ml. A linear relationship was observed in the univariate analysis between the storage time and the pH (P=.001), the actual HCO(3) (P=.001), the haemolysis index (P=.035) and the SpO(2) (P=.01). Once adjusted for the confounding variables of the univariate model, a linear relationship was observed between the arginase activity and the storage time (P=.031). CONCLUSIONS: Our study shows a directly proportional linear relationship between the storage time of packed red blood cells and their arginase activity. We suggest that these findings could be associated with the high incidence of complications after transfusion that may be directly proportional to their storage time.