Characteristics and outcomes of a Hispanic lupus nephritis cohort from Mexico.

OBJECTIVES: To characterize the clinical presentation and outcomes of LN in a Hispanic cohort from Mexico. METHODS: We studied 440 subjects with systemic lupus erythematosus and biopsy-proven LN followed for >36 months. We obtained demographic, clinical, laboratory, histopathological and treatment variables. All outcomes were analysed by survival analysis and included response to therapy, renal relapses, progression of kidney disease (decline in eGFR ≥ 30%, doubling of serum creatinine, end-stage kidney disease) and patient survival. RESULTS: The median age of the study cohort was 29 years (IQR 23-37) and 96% were female. The median eGFR at inclusion was 81 mL/min/1.73m2 (IQR 48-118) and 24 h-uPCR was 3.4 g/g (IQR 1.9-5.6). Mixed class LN (III/IV+V) was the most frequently observed (69%). Over a median follow-up of 79 months, complete response rates were 22.3%, 40.5% and 51.6%, at 6, 12 and 24 months, respectively. Renal relapse rates were 32.3% and 50.6% at 3 and 5 years. By 3 and 5 years, 20.7% and 31.4% had decline in eGFR ≥30%, 14.4% and 22.5% doubled their serum creatinine, and 9.1% and 17.7% progressed to ESKD. The factors associated with loss of kidney function were age, eGFR at presentation, the histologic chronicity index in the kidney biopsy, and the type of response to therapy. Patient survival was 98.2% and 97.1% at 3 and 5 years. CONCLUSION: Although the response to treatment and patient survival in this Latin American cohort is comparable to that observed in other regions, there is still a high rate of renal relapses and progression to decline in kidney function.

Optical fiber pH sensor based on a multimode interference device with polymer overlay.

An optical fiber pH sensor based on a multimode interference structure is presented. The sensitive element is a piece of no-core fiber (NCF) coated with a mixture of polyallylamine hydrochloride and polyacrylic acid by a modified layer-by-layer (LbL) self-assembly method. It is experimentally shown that by reducing the diameter of the NCF by chemical etching, the sensitivity is increased from -0.31n m/p H to -2n m/p H. The sensor exhibits a high linear response of 0.997 over a pH range from 5 to 11.3 with a rapid response time lower than 1 s.

An Entropy-Based Condition Monitoring Strategy for the Detection and Classification of Wear Levels in Gearboxes.

Gears are reliable and robust elements that are found in any power transmission system. However, gears are prone to present incipient faults, such as wear, since they are constantly subjected to contact forces. Due to gears playing a key role in many industrial processes, it is important to develop condition monitoring strategies that ensure the proper functioning of the related power transmission system and the overall components. In this regard, the data on entropy provide relevant information that allow us to identify and quantify the effect of different wear levels in gears. Therefore, in this work, we proposed the use of seven entropy-related features to perform the identification of different wear severities in a gearbox. The novelty of this proposal lies in the use of the entropy features to carry out a high-performance characterization of the available vibration signals that are acquired from experimental tests. The novelty of this proposal lies in the fusion of three different techniques: entropy features, linear discriminant analysis, and artificial neural networks to obtain a machine learning approach for improving the detection of different wear severities in gears compared to other reported methodologies. This situation is achieved due to the high-performance characterization of the available vibration signals that are acquired from experimental tests. Additionally, the entropy features are subjected to a feature space transformation by means of linear discriminant analysis to obtain a 2D representation and, finally, the set of features extracted by linear discriminant analysis are used as inputs of a neural network-based classifier to determine the severity of wear that is present in the gears. The proposed methodology is validated and compared with a conventional statistical approach to show the improvement in the classification.

Histamine elimination by a coupling reaction of fungal amine oxidase and bacterial aldehyde oxidase†.

Histamine (HIST) and other biogenic amines found in fish and fishery products accumulated by the action of bacterial amino acid decarboxylase cannot be decomposed and eliminated by heating or other chemical methods. A simple method for HIST elimination is proposed by a coupling reaction of the fungal amine oxidase (FAO) and bacterial aldehyde oxidase (ALOX) of acetic acid bacteria. As a model reaction, FAO oxidized benzylamine to benzaldehyde, which in turn was oxidized spontaneously to benzoic acid with ALOX. Likely, in HIST elimination, FAO coupled well with ALOX to produce imidazole 4-acetic acid from HIST with an apparent yield of 100%. Imidazole 4-acetaldehyde was not detected in the reaction mixture. In the absence of ALOX, the coupling reaction was incomplete given a number of unidentified substances in the reaction mixture. The proposed coupling enzymatic method may be highly effective to eliminate toxic amines from fish and fishery products.

Automatic Classification of Rotor Faults in Soft-Started Induction Motors, Based on Persistence Spectrum and Convolutional Neural Network Applied to Stray-Flux Signals.

Due to their robustness, versatility and performance, induction motors (IMs) have been widely used in many industrial applications. Despite their characteristics, these machines are not immune to failures. In this sense, breakage of the rotor bars (BRB) is a common fault, which is mainly related to the high currents flowing along those bars during start-up. In order to reduce the stresses that could lead to the appearance of these faults, the use of soft starters is becoming usual. However, these devices introduce additional components in the current and flux signals, affecting the evolution of the fault-related patterns and so making the fault diagnosis process more difficult. This paper proposes a new method to automatically classify the rotor health state in IMs driven by soft starters. The proposed method relies on obtaining the Persistence Spectrum (PS) of the start-up stray-flux signals. To obtain a proper dataset, Data Augmentation Techniques (DAT) are applied, adding Gaussian noise to the original signals. Then, these PS images are used to train a Convolutional Neural Network (CNN), in order to automatically classify the rotor health state, depending on the severity of the fault, namely: healthy motor, one broken bar and two broken bars. This method has been validated by means of a test bench consisting of a 1.1 kW IM driven by four different soft starters coupled to a DC motor. The results confirm the reliability of the proposed method, obtaining a classification rate of 100.00% when analyzing each model separately and 99.89% when all the models are analyzed at a time.

Acute Kidney Injury in Critical Care COVID-19 Patients on Invasive Mechanical Ventilation: The Potential Preventive Role of Dexamethasone.

Background: A high incidence of acute kidney injury (AKI) has been reported in coronavirus disease 2019 (COVID-19) patients in critical care units and those undergoing invasive mechanical ventilation (IMV). The introduction of dexamethasone (DXM) as treatment for severe COVID-19 has improved mortality, but its effects in other organs remain under study. Objective: The objective of this study was to evaluate the association between DXM and AKI in COVID-19. Methods: In this prospective observational cohort study, we evaluated the incidence of AKI in critically ill COVID-19 patients undergoing mechanical ventilation, and the association of DXM treatment with the incidence, severity, and outcomes of AKI. The association between DXM treatment and AKI was evaluated by multivariable logistic regression. The association of the combination of DXM treatment and AKI on mortality was evaluated by Cox-regression analysis. Results: We included 552 patients. AKI was diagnosed in 311 (56%), of which 196 (63%) corresponded to severe (stage 2 or 3) AKI, and 46 (14.8%) received kidney replacement therapy. Two hundred and sixty-seven (48%) patients were treated with DXM. This treatment was associated to lower incidence of AKI (Odds Radio 0.34, 95% Confidence intervals [CI] 0.22-0.52, p < 0.001) after adjusting for age, body mass index, laboratory parameters, SOFA score, and vasopressor use. DXM treatment significantly reduced mortality in patients with severe AKI (HR 0.63, 95%CI 0.41-0.96, p = 0.032). Conclusions: The incidence of AKI is high in COVID-19 patients under IMV. DXM treatment is associated with a lower incidence of AKI and a lower mortality in the group with severe AKI.

A randomized clinical trial to evaluate the efficacy and safety of rivaroxaban in patients with bioprosthetic mitral valve and atrial fibrillation or flutter: Rationale and design of the RIVER trial.

The efficacy and safety of rivaroxaban in patients with bioprosthetic mitral valves and atrial fibrillation or flutter remain uncertain. DESIGN: RIVER was an academic-led, multicenter, open-label, randomized, non-inferiority trial with blinded outcome adjudication that enrolled 1005 patients from 49 sites in Brazil. Patients with a bioprosthetic mitral valve and atrial fibrillation or flutter were randomly assigned (1:1) to rivaroxaban 20 mg once daily (15 mg in those with creatinine clearance <50 mL/min) or dose-adjusted warfarin (target international normalized ratio 2.0-30.); the follow-up period was 12 months. The primary outcome was a composite of all-cause mortality, stroke, transient ischemic attack, major bleeding, valve thrombosis, systemic embolism, or hospitalization for heart failure. Secondary outcomes included individual components of the primary composite outcome, bleeding events, and venous thromboembolism. SUMMARY: RIVER represents the largest trial specifically designed to assess the efficacy and safety of a direct oral anticoagulant in patients with bioprosthetic mitral valves and atrial fibrillation or flutter. The results of this trial can inform clinical practice and international guidelines.

Community- and Hospital-Acquired Acute Kidney Injury in COVID-19: Different Phenotypes and Dismal Prognosis.

INTRODUCTION: Acute kidney injury (AKI) is common in coronavirus disease 2019 (COVID-19). It is unknown if hospital-acquired AKI (HA-AKI) and community-acquired AKI (CA-AKI) convey a distinct prognosis. METHODS: The study aim was to evaluate the incidence and risk factors associated with both CA-AKI and HA-AKI. Consecutive patients hospitalized at a reference center for COVID-19 were included in this prospective cohort study. RESULTS: We registered 349 (30%) AKI episodes in 1,170 hospitalized patients, 224 (19%) corresponded to CA-AKI, and 125 (11%) to HA-AKI. Compared to patients with HA-AKI, subjects with CA-AKI were older (61 years [IQR 49-70] vs. 50 years [IQR 43-61]), had more comorbidities (hypertension [44 vs. 26%], CKD [10 vs. 3%]), higher Charlson Comorbidity Index (2 points [IQR 1-4] vs. 1 point [IQR 0-2]), and presented to the emergency department with more severe disease. Mortality rates were not different between CA-AKI and HA-AKI (119 [53%] vs. 63 [50%], p = 0.66). In multivariate analysis, CA-AKI was strongly associated to a history of CKD (OR 4.17, 95% CI 1.53-11.3), hypertension (OR 1.55, 95% CI 1.01-2.36), Charlson Comorbidity Index (OR 1.16, 95% CI 1.02-1.32), and SOFA score (OR 2.19, 95% CI 1.87-2.57). HA-AKI was associated with the requirement for mechanical ventilation (OR 68.2, 95% CI 37.1-126), elevated troponin I (OR 1.95, 95% CI 1.01-3.83), and glucose levels at admission (OR 1.05, 95% CI 1.02-1.08). DISCUSSION/CONCLUSIONS: CA-AKI and HA-AKI portend an adverse prognosis in CO-VID-19. Nevertheless, CA-AKI was associated with a higher comorbidity burden (including CKD and hypertension), while HA-AKI occurred in younger patients by the time severe multiorgan disease developed.

Power Quality Disturbance Tracking Based on a Proprietary FPGA Sensor with GPS Synchronization.

The study of power quality (PQ) has gained relevance over the years due to the increase in non-linear loads connected to the grid. Therefore, it is important to study the propagation of power quality disturbances (PQDs) to determine the propagation points in the grid, and their source of generation. Some papers in the state of the art perform the analysis of punctual measurements of a limited number of PQDs, some of them using high-cost commercial equipment. The proposed method is based upon a developed proprietary system, composed of a data logger FPGA with GPS, that allows the performance of synchronized measurements merged with the full parameterized PQD model, allowing the detection and tracking of disturbances propagating through the grid using wavelet transform (WT), fast Fourier transform (FFT), Hilbert-Huang transform (HHT), genetic algorithms (GAs), and particle swarm optimization (PSO). Measurements have been performed in an industrial installation, detecting the propagation of three PQDs: impulsive transients propagated at two locations in the grid, voltage fluctuation, and harmonic content propagated to all the locations. The results obtained show that the low-cost system and the developed methodology allow the detection of several PQDs, and track their propagation within a grid with 100% accuracy.

5-Keto-D-fructose production from sugar alcohol by isolated wild strain Gluconobacter frateurii CHM 43.

GLUCONOBACTER FRATEURII: CHM 43 have D-mannitol dehydrogenase (quinoprotein glycerol dehydrogenase) and flavoprotein D-fructose dehydrogenase in the membranes. When the two enzymes are functional, D-mannitol is converted to 5-keto-D-fructose with 65% yield when cultivated on D-mannitol. 5-Keto-D-fructose production with almost 100% yield was realized with the resting cells. The method proposed here should give a smart strategy for 5-keto-D-fructose production.

Taro koji of Amorphophallus konjac enabling hydrolysis of konjac polysaccharides to various biotechnological interest.

Due to the indigestibility, utilization of konjac taro, Amorphophallus konjac has been limited only to the Japanese traditional konjac food. Koji preparation with konjac taro was examined to utilize konjac taro as a source of utilizable carbohydrates. Aspergillus luchuensis AKU 3302 was selected as a favorable strain for koji preparation, while Aspergillus oryzae used extensively in sake brewing industry was not so effective. Asp. luchuensis grew well over steamed konjac taro by extending hyphae with least conidia formation. Koji preparation was completed after 3-day incubation at 30°C. D-Mannose and D-glucose were the major monosaccharides found in a hydrolyzate giving the total sugar yield of 50 g from 100 g of dried konjac taro. An apparent extent of konjac taro hydrolysis at 55°C for 24 h seemed to be completed. Since konjac taro is hydrolyzed into monosaccharides, utilization of konjac taro carbohydrates may become possible to various products of biotechnological interest.

Physiological stressor impact on peripheral facial temperature, Il-6 and mean arterial pressure, in young people.

Nowadays, stress is part of everyday life, whose long-term effects can trigger health risks. Among the main alterations that occur in the human body we can find the variation of inflammatory activity, blood pressure, and facial peripheral temperature. The objective of this work is to show the facial thermal behavior for men and women, as well as the differences in vascular and inflammatory responses induced by the effect of acute social stress. The Trier Social Stress Test was applied to 15 women and 15 men, free of disease, with an average age of 23.8 years and a standard deviation of 5.52. After capturing the baseline state, and at the end of the test, the inflammatory activity was measured through salivary interleukin-6; the mean blood pressure, and the capture of facial thermographic images. For the thermal images, six regions of interest (biothermomarkers) were analyzed: forehead, right cheek, left cheek, chin, nose, and corrugator muscle. The results obtained after analyzing the information were: an increase in inflammatory activity, an increase in mean blood pressure, and significant temperature changes in different areas of interest of the face, depending on gender. For men, it only appeared in the region of the nose and women's forehead, cheeks, and nose. Furthermore, the correlation between the three variables (il-6, blood pressure, and temperature) was performed and no significant values were found. Regarding the relationship between genders, only significant values were found for il-6.

ß-Hairpins as peptidomimetics of human phosphoprotein-binding domains.

Phosphoprotein-binding domains interact with cognate phosphorylated targets ruling several biological processes. The impairment of such interactions is often associated with disease development, namely cancer. The breast cancer susceptibility gene 1 (BRCA1) C-terminal (BRCT) domain is involved in the control of complex signaling networks of the DNA damage response. The capture and identification of BRCT-binding proteins and peptides may be used for the development of new diagnostic tools for diseases with abnormal phosphorylation profiles. Here we show that designed cyclic ß-hairpin structures can be used as peptidomimetics of the BRCT domain, with high selectivity in binding to a target phosphorylated peptide. The amino acid residues and spatial constraints involved in the interaction between a phosphorylated peptide (GK14-P) and the BRCT domain were identified and crafted onto a 14-mer ß-hairpin template in silico. Several cyclic peptides models were designed and their binding towards the target peptide and other phosphorylated peptides evaluated through virtual screening. Selected cyclic peptides were then synthesized, purified and characterized. The high affinity and selectivity of the lead cyclic peptide towards the target phosphopeptide was confirmed, and the possibility to capture it using affinity chromatography demonstrated. This work paves the way for the development of cyclic ß-hairpin peptidomimetics as a novel class of affinity reagents for the highly selective identification and capture of target molecules.

Asymmetrical voltage response in resonant neurons shaped by nonlinearities.

The conventional impedance profile of a neuron can identify the presence of resonance and other properties of the neuronal response to oscillatory inputs, such as nonlinear response amplifications, but it cannot distinguish other nonlinear properties such as asymmetries in the shape of the voltage response envelope. Experimental observations have shown that the response of neurons to oscillatory inputs preferentially enhances either the upper or lower part of the voltage envelope in different frequency bands. These asymmetric voltage responses arise in a neuron model when it is submitted to high enough amplitude oscillatory currents of variable frequencies. We show how the nonlinearities associated to different ionic currents or present in the model as captured by its voltage equation lead to asymmetrical response and how high amplitude oscillatory currents emphasize this response. We propose a geometrical explanation for the phenomenon where asymmetries result not only from nonlinearities in their activation curves but also from nonlinearites captured by the nullclines in the phase-plane diagram and from the system's time-scale separation. In addition, we identify an unexpected frequency-dependent pattern which develops in the gating variables of these currents and is a product of strong nonlinearities in the system as we show by controlling such behavior by manipulating the activation curve parameters. The results reported in this paper shed light on the ionic mechanisms by which brain embedded neurons process oscillatory information.

Post-translational modifications of the intrinsically disordered terminal domains of histone H1: effects on secondary structure and chromatin dynamics.

H1 linker histones are involved both in the maintenance of chromatin higher-order structure and in gene regulation. H1 binds to linker DNA regions on the surface of the nucleosome. In higher eukaryotes, H1 contains three distinct domains: a short N-terminal domain (NTD), a central globular domain, and a long C-terminal domain (CTD). Terminal domains determine subtype specificity and to a large extent the linker DNA binding and chromatin condensing properties of histone H1. This review is focused on the recent numerous studies that have provided insights in the role of H1 terminal domains in chromatin dynamics. The N- and C-terminal domains behave as intrinsically disordered proteins with coupled binding and folding. We examine the potential kinetic advantages of intrinsic disorder in the recognition of the specific H1 binding sites in chromatin. As typical intrinsically disordered regions, H1 terminal domains are post-translationally modified. Post-translational modifications in the NTD determine the interaction of histone H1 with other proteins involved in heterochromatin formation and transcriptional regulation, while phosphorylation by cyclin-dependent kinases modulates the secondary structure of the CTD and chromatin condensation. We review the arguments in favor of the involvement of H1 hyperphosphorylation in metaphase chromatin condensation and of partial phosphorylation in interphase chromatin relaxation. In addition, the interplay of histone H1 and other chromatin architectural proteins, such as proteins of the high-mobility group, protamines, and MeCP2, is associated with changes in chromatin structure.

Membrane-bound glycerol dehydrogenase catalyzes oxidation of D-pentonates to 4-keto-D-pentonates, D-fructose to 5-keto-D-fructose, and D-psicose to 5-keto-D-psicose.

A novel oxidation of D-pentonates to 4-keto-D-pentonates was analyzed with Gluconobacter thailandicus NBRC 3258. D-Pentonate 4-dehydrogenase activity in the membrane fraction was readily inactivated by EDTA and it was reactivated by the addition of PQQ and Ca2+. D-Pentonate 4-dehydrogenase was purified to two different subunits, 80 and 14 kDa. The absorption spectrum of the purified enzyme showed no typical absorbance over the visible regions. The enzyme oxidized D-pentonates to 4-keto-D-pentonates at the optimum pH of 4.0. In addition, the enzyme oxidized D-fructose to 5-keto-D-fructose, D-psicose to 5-keto-D-psicose, including the other polyols such as, glycerol, D-ribitol, D-arabitol, and D-sorbitol. Thus, D-pentonate 4-dehydrogenase was found to be identical with glycerol dehydrogenase (GLDH), a major polyol dehydrogenase in Gluconobacter species. The reaction versatility of quinoprotein GLDH was notified in this study.

18F-FDG-PET/CT Angiography for the Diagnosis of Infective Endocarditis.

PURPOSE OF REVIEW: This article reviews the current imaging role of 18F-fluordeoxyglucose positron emission computed tomography (18F-FDG-PET/CT) combined with cardiac CT angiography (CTA) in infective endocarditis and discusses the strengths and limitations of this technique. RECENT FINDINGS: The diagnosis of infective endocarditis affecting prosthetic valves and intracardiac devices is challenging because echocardiography and, therefore, the modified Duke criteria have well-recognized limitations in this clinical scenario. The high sensitivity of 18F-FDG-PET/CT for the detection of infection associated with the accurate definition of structural damage by gated cardiac CTA in a combined technique (PET/CTA) has provided a significant increase in diagnostic sensitivity for the detection of IE. PET/CTA has proven to be a useful diagnostic tool in patients with suspected infective endocarditis. The additional information provided by this technique improves diagnostic performance in prosthetic valve endocarditis when it is used in combination with the Duke criteria. The findings obtained in PET/CTA studies have been included as a major criterion in the recently updated diagnostic algorithm in infective endocarditis guidelines.

Comparison of Olympic and Hexagonal Barbells With Midthigh Pull, Deadlift, and Countermovement Jump.

Malyszek, KK, Harmon, RA, Dunnick, DD, Costa, PB, Coburn, JW, and Brown, LE. Comparison of olympic and hexagonal barbells with midthigh pull, deadlift, and countermovement jump. J Strength Cond Res 31(1): 140-145, 2017-Those training for strength and power commonly use different bars and different lifts. The hexagonal barbell (HBar) and Olympic barbell (OBar) are frequently used training implements, and the midthigh pull (MTP) and deadlift (DL) are 2 popular exercises. Therefore, the purpose of this study was to compare force between an HBar and OBar for a MTP, DL, and countermovement jump (CMJ). Twenty resistance-trained men (age = 24.05 ± 2.09 years, ht = 178.07 ± 7.05 cm, mass = 91.42 ± 14.44 kg) volunteered to participate and performed MTP and DL using both bars and a CMJ. Joint angles were recorded for all pulls and the bottom position of the CMJ. Peak ground reaction force (PGRF) was greater in the MTP (3,186.88 ± 543.53 N) than DL (2,501.15 ± 404.04 N) but not different between bars. Midthigh pull joint angles were more extended than DL, and the strongest correlations between isometric and dynamic performance were seen between DL PGRF and CMJ impulse (OBar r = 0.85; HBar r = 0.84). These findings are likely because of the different anatomical characteristics between the MTP and DL and the similarity in joint angles between the DL and CMJ. Therefore, the DL may be an optimal choice for athletes in jump-dependent sports, regardless of bar.