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We report two new cyanido-bridged Fe(II)-Ag(I) coordination polymers using different acetylpyridine isomers, {Fe(4acpy)2[Ag(CN)2]2} 1 and {Fe(3acpy)[Ag(CN)2]2} 2 (4acpy = 4-acetylpyridine; 3acpy = 3-acetylpyridine) displaying thermally and photoinduced spin crossover (SCO). In both cases, the acetylpyridine ligand directs the coordination polymer structure and the SCO of the materials. Using 4-acetylpyridine, a two-dimensional (2D) structure is observed in 1 made of layers stacked on each other by silver-ketone interactions leading to a complete SCO and reversible thermally and photoswitching of the magnetic and optical properties. Changing the acetyl group to a 3-position, a completely different structure is obtained for 2. The unexpected coordination of the carbonyl group to the Fe(II) centers induces a three-dimensional (3D) structure, leading to statistical disorder around the Fe(II) with three different coordination spheres, [N6], [N4O2], and [N5O]. This disorder gives rise to an incomplete thermally induced SCO with a poor photoswitchability. These results demonstrate that the choice of the acetyl position on the pyridine dictates the structural characteristics of the compounds with a direct impact on the SCO behavior. Remarkably, this work opens interesting perspectives for the future design of Fe-Ag cyanido coordination polymers with judiciously substituted pyridine ligands to tune the thermally and photoinduced SCO properties.
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Anthraquinone-based hollow COFs were synthesized via a template-assisted method involving polystyrene nanospheres as the hard template, which enabled doubling the specific capacitance and energy density compared to non-templated COFs. Our approach can be extended to other COFs, offering a promising strategy for enhancing the performance of COF-based electrodes in energy storage applications.
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Core-shell micro/nanomotors have garnered significant interest in biomedicine owing to their versatile task-performing capabilities. However, their effectiveness for photothermal therapy (PTT) still faces challenges because of their poor tumor accumulation, lower light-to-heat conversion, and due to the limited penetration of near-infrared (NIR) light. In this study, we present a novel core-shell micromotor that combines magnetic and photothermal properties. It is synthesized via the template-assisted electrodeposition of iron (Fe) and reduced graphene oxide (rGO) on a microtubular pore-shaped membrane. The resulting Fe-rGO micromotor consists of a core of oval-shaped zero-valent iron nanoparticles with large magnetization. At the same time, the outer layer has a uniform reduced graphene oxide (rGO) topography. Combined, these Fe-rGO core-shell micromotors respond to magnetic forces and near-infrared (NIR) light (1064 nm), achieving a remarkable photothermal conversion efficiency of 78% at a concentration of 434 µg mL-1. They can also carry doxorubicin (DOX) and rapidly release it upon NIR irradiation. Additionally, preliminary results regarding the biocompatibility of these micromotors through in vitro tests on a 3D breast cancer model demonstrate low cytotoxicity and strong accumulation. These promising results suggest that such Fe-rGO core-shell micromotors could hold great potential for combined photothermal therapy.
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In light of the post-genomic era, epigenetics brings about an opportunity to better understand how the molecular machinery works and is led by a complex dynamic set of mechanisms, often intricate and complementary in many aspects. In particular, epigenetics links developmental biology and genetics, as well as many other areas of knowledge. The present work highlights substantial scopes and relevant discoveries related to the development of the term from its first notions. To our understanding, the concept of epigenetics needs to be revisited, as it is one of the most relevant and multifaceted terms in human knowledge. To redirect future novel experimental or theoretical efforts, it is crucial to compile all significant issues that could impact human and ecological benefit in the most precise and accurate manner. In this paper, the reader can find one of the widest compilations of the landmarks and epistemic considerations of the knowledge of epigenetics across the history of biology from the earliest epigenetic formulation to genetic determinism until the present. In the present work, we link the current body of knowledge and earlier pre-genomic concepts in order to propose a new definition of epigenetics that is faithful to its regulatory nature.
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Epigénesis Genética , Epigenómica , Humanos , Epigenómica/métodos , Animales , Metilación de ADNRESUMEN
Spatial navigation allows us to move around our environment, walking being the most advanced form of human locomotion. Over the years, a range of tools has been developed to study spatial navigation in children. Aim. To describe the role of locomotion during the assessment of spatial navigation in children, providing an overview of the instruments available for assessing spatial navigation in typically developing children and those with neurodevelopmental disorders. Methods and Procedures. A systematic search was performed in six electronic databases between December 2022 and February 2023, then updated in July 2023. Cross-sectional and observational studies were included. Outcomes and results. Of the 3,385 studies screened, 47 were selected for this review. Five studies described the influence of locomotion on spatial navigation, and seven studies included locomotion as an explanatory variable in this area. Most studies focused on children from five to twelve years old, whereas only nine were centred on infants and preschoolers. Just eight assessed spatial abilities in individuals with neurodevelopmental disorders. Conclusions and implications. Children with or at risk of neurodevelopmental impairments show poorer spatial navigation skills. Having the choice to actively explore the space is more important than the way they locomote. It is necessary to have tools to assess spatial navigation during locomotion early in infancy.
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The aim of this work was to assess the chemical composition and physico-chemical, techno-functional, and in vitro antioxidant properties of flours obtained from the peel and flesh of pitahaya (Hylocereus ocamponis) to determine their potential for use as ingredients for food enrichment. The chemical composition, including total betalains, mineral content, and polyphenolic profile, was determined. The techno-functional properties (water holding, oil holding, and swelling capacities) were also evaluated. For the antioxidant capacity, four different methodologies, namely ferrous ion-chelating ability assay, ferric-reducing antioxidant power assay; 1,1-Diphenyl-2-picrylhydrazyl radical scavenging ability assay, and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical assay, were used. Pitahaya-peel flour had higher values for protein (6.72 g/100 g), ash (11.63 g/100 g), and dietary fiber 56.56 g/100 g) than pitahaya-flesh flour, with values of 6.06, 3.63, and 8.22 g/100 g for protein, ash, and dietary fiber, respectively. In the same way, pitahaya peel showed a higher content of minerals, betalains, and polyphenolic compounds than pitahaya-flesh flour, with potassium (4.43 g/100 g), catechin (25.85 mg/g), quercetin-3-rhamnoside (11.66 mg/g) and myricetrin (12.10 mg/g) as principal compounds found in the peel. Again, pitahaya-peel flour showed better techno-functional and antioxidant properties than pitahaya-flesh flour. The results obtained suggest that the flours obtained from the peel and pulp of pitahaya (H. ocamponis) constitute a potential material to be utilized as an ingredient in the food industry due to the high content of bioactive compounds such as betalains, phenolic acids, and flavonoids, with notable antioxidant capacity.
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Antioxidantes , Cactaceae , Harina , Frutas , Polifenoles , Cactaceae/química , Antioxidantes/química , Antioxidantes/análisis , Frutas/química , Harina/análisis , Polifenoles/análisis , Polifenoles/química , Betalaínas/química , Betalaínas/análisis , Extractos Vegetales/químicaRESUMEN
An early diagnosis of cancer is fundamental not only in regard to reducing its mortality rate but also in terms of counteracting the progression of the tumor in the initial stages. Breast cancer (BC) is the most common tumor pathology in women and the second deathliest cancer worldwide, although its survival rate is increasing thanks to improvements in screening programs. However, the most common techniques to detect a breast tumor tend to be time-consuming, unspecific or invasive. Herein, the use of untargeted hydrophilic interaction liquid chromatography-mass spectrometry analysis appears as an analytical technique with potential use for the early detection of biomarkers in liquid biopsies from BC patients. In this research, plasma samples from 134 BC patients were compared with 136 from healthy controls (HC), and multivariate statistical analyses showed a clear separation between four BC phenotypes (LA, LB, HER2, and TN) and the HC group. As a result, we identified two candidate biomarkers that discriminated between the groups under study with a VIP > 1 and an AUC of 0.958. Thus, targeting the specific aberrant metabolic pathways in future studies may allow for better molecular stratification or early detection of the disease.
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Biomarcadores de Tumor , Neoplasias de la Mama , Interacciones Hidrofóbicas e Hidrofílicas , Metabolómica , Humanos , Neoplasias de la Mama/sangre , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Femenino , Biomarcadores de Tumor/sangre , Biopsia Líquida/métodos , Metabolómica/métodos , Persona de Mediana Edad , Cromatografía Liquida/métodos , Anciano , Adulto , Espectrometría de Masas/métodos , Cromatografía Líquida con Espectrometría de MasasRESUMEN
We conducted a two-year retrospective evaluation of infants aged under two years with a confirmed, clinical, or suspected diagnosis of scabies in a healthcare center in Alicante (Spain) to determine possible factors associated with diagnostic delay and poor treatment response. We collected epidemiological, clinical, diagnostic, and treatment variables. After describing our findings as mean values and percentages, we compared categorical variables using the Student's t-test and the Mann-Whitney U test, and we compared continuous variables with the Chi2 test and Pearson's correlation coefficient. We included 51 infants (19 boys and 32 girls) with a mean age of 15 months. The main source of contagion was the family; half of the infants lived with four or more people. According to the International Consensus Criteria for the Diagnosis of Scabies, confirmed scabies was diagnosed in 45% of cases and clinical scabies in 47%, and 45% of cases had a diagnostic delay. Lesions mainly affected the hands, feet, and trunk, with papules in 92% of cases and burrows in 55%. The predominant symptoms were pruritus (94%) and irritability (69%). Regarding treatment, 98% of the infants received topical permethrin and 35% received oral ivermectin. Treatment failed in 76% of infants. Living in large family units was associated with a higher risk of contagion and therapeutic failure. Diagnostic delay was associated with previous misdiagnosis.
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The artificial brain is conceived as advanced intelligence technology, capable to emulate in-memory processes occurring in the human brain by integrating synaptic devices. Within this context, improving the functionality of synaptic transistors to increase information processing density in neuromorphic chips is a major challenge in this field. In this article, Li-ion migration promoting long afterglow organic light-emitting transistors, which display exceptional postsynaptic brightness of 7000 cd m-2 under low operational voltages of 10 V is presented. The postsynaptic current of 0.1 mA operating as a built-in threshold switch is implemented as a firing point in these devices. The setting-condition-triggered long afterglow is employed to drive the photoisomerization process of photochromic molecules that mimic neurotransmitter transfer in the human brain for realizing a key memory rule, that is, the transition from long-term memory to permanent memory. The combination of setting-condition-triggered long afterglow with photodiode amplifiers is also processed to emulate the human responding action after the setting-training process. Overall, the successful integration in neuromorphic computing comprising stimulus judgment, photon emission, transition, and encoding, to emulate the complicated decision tree of the human brain is demonstrated.
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Litio , Transistores Electrónicos , Litio/química , Humanos , Memoria , Luz , Compuestos Orgánicos/química , Encéfalo/fisiologíaRESUMEN
Background: Crises and health policies to tackle them can increase health inequalities. We explored the scope and usefulness of helplines set up during the COVID-19 crisis and characterised the vulnerability of their users. This study explored the geographic and socioeconomic effects of the telephone helplines set up by the Balearic Islands Government and aimed to characterise the vulnerability of their users. Methods: Telephonic survey combined with a geographical analysis of a sample of calls made between 15th of March and 30th of June of 2020 to five helplines: COVID-19 general information; psychological, social (minimum vital income), labour (temporary employment regulation), and housing (rental assistance) helps. The questionnaire included sociodemographic and housing characteristics, type of problem, and if it was solved or not. We used multinomial regression to explore factors associated with having solved the problem. We calculated the standardised rate of calls by municipality using Chi-squared and z-test to test differences. Results: 1,321 interviews from 2,678 selected (231 excluded, 608 untraceable, and 518 refusals). 63.8% of women, 48.7% were born in another country. They had no internet at home in 3.1%, only on the phone in 17.3%. The 23.5% had no income at home. The Problem was solved in 25.4%, and partly in 30.9%. Factors associated with not solving the problem were not having income at home (p = 0.021), labour (p = 0.008), economic (p = 0.000) or housing (p = 0.000) problems. People from 55 of 67 municipalities did at least one call. The highest rates of calls were from coastal tourist municipalities. Conclusion: Helplines reached most of the territory of the Balearic Islands and were used mainly in tourist municipalities. It probably has not been helpful for families with more significant deprivation. Digital inequalities have emerged.
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COVID-19 , Cambio Social , Humanos , Femenino , España/epidemiología , COVID-19/epidemiología , Vivienda , Encuestas y CuestionariosRESUMEN
Zinc hybrid supercapacitors (Zn-HSCs) hold immense potential toward the next-generation energy storage systems, effectively spanning the divide between conventional lithium-ion batteries (LIBs) and supercapacitors. Unfortunately, the energy density of most of Zn-HSCs has not yet rivalled the levels observed in LIBs. The electrochemical performance of aqueous Zn-HSCs can be enhanced through the chemical functionalization of graphene-based cathode materials with thiol moieties as they will be highly suitable for favoring Zn2+ adsorption/desorption. Here, a single-step reaction is employed to synthesize thiol-functionalized reduced graphene oxide (rGOSH), incorporating both oxygen functional groups (OFGs) and thiol functionalities, as demonstrated by X-ray photoelectron spectroscopy (XPS) studies. Electrochemical analysis reveals that rGOSH cathodes exhibit a specific capacitance (540 F g-1) and specific capacity (139 mAh g-1) at 0.1 A g-1 as well as long-term stability, with over 92% capacitance retention after 10 000 cycles, outperforming chemically reduced graphene oxide (CrGO). Notably, rGOSH electrodes displayed an exceptional maximum energy density of 187.6 Wh kg-1 and power density of 48.6 kW kg-1. Overall, this study offers an unprecedented powerful strategy for the design and optimization of cathode materials, paving the way for efficient and sustainable energy storage solutions to meet the increasing demands of modern energy applications.
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BACKGROUND: Rheumatic and musculoskeletal diseases (RMDs) are chronic diseases that may alternate between asymptomatic periods and flares. These conditions require complex treatments and close monitoring by rheumatologists to mitigate their effects and improve the patient's quality of life. Often, delays in outpatient consultations or the patient's difficulties in keeping appointments make such close follow-up challenging. For this reason, it is very important to have open communication between patients and health professionals. In this context, implementing telemonitoring in the field of rheumatology has great potential, as it can facilitate the close monitoring of patients with RMDs. The use of these tools helps patients self-manage certain aspects of their disease. This could result in fewer visits to emergency departments and consultations, as well as enable better therapeutic compliance and identification of issues that would otherwise go unnoticed. OBJECTIVE: The main objective of this study is to evaluate the implementation of a hybrid care model called the mixed attention model (MAM) in clinical practice and determine whether its implementation improves clinical outcomes compared to conventional follow-up. METHODS: This is a multicenter prospective observational study involving 360 patients with rheumatoid arthritis (RA) and spondylarthritis (SpA) from 5 Spanish hospitals. The patients will be followed up by the MAM protocol, which is a care model that incorporates a digital tool consisting of a mobile app that patients can use at home and professionals can review asynchronously to detect incidents and follow patients' clinical evolution between face-to-face visits. Another group of patients, whose follow-up will be conducted in accordance with a traditional face-to-face care model, will be assessed as the control group. Sociodemographic characteristics, treatments, laboratory parameters, assessment of tender and swollen joints, visual analog scale for pain, and electronic patient-reported outcome (ePRO) reports will be collected for all participants. In the MAM group, these items will be self-assessed via both the mobile app and during face-to-face visits with the rheumatologist, who will do the same for patients included in the traditional care model. The patients will be able to report any incidence related to their disease or treatment through the mobile app. RESULTS: Participant recruitment began in March 2024 and will continue until December 2024. The follow-up period will be extended by 12 months for all patients. Data collection and analysis are scheduled for completion in December 2025. CONCLUSIONS: This paper aims to provide a detailed description of the development and implementation of a digital solution, specifically an MAM. The goal is to achieve significant economic and psychosocial impact within our health care system by enhancing control over RMDs. TRIAL REGISTRATION: ClinicalTrials.gov NCT06273306; https://clinicaltrials.gov/ct2/show/NCT06273306. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/55829.
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Telemedicina , Humanos , Telemedicina/métodos , Estudios Prospectivos , Artritis Reumatoide/inmunología , Artritis Reumatoide/terapia , España , Masculino , FemeninoRESUMEN
We report on the synthesis of "clickable" graphene nanoribbons (GNRs) and their application as a versatile interface for electrochemical biosensors. GNRs are successfully deposited on gold-coated working electrodes and serve as a platform for the covalent anchoring of a bioreceptor (i.e., a DNA aptamer), enabling selective and sensitive detection of Interleukin 6 (IL6). Moreover, when applied as the intermediate linker on reduced graphene oxide (rGO)-based field-effect transistors (FETs), the GNRs provide improved robustness compared to conventional aromatic bi-functional linker molecules. GNRs enable an orthogonal and covalent attachment of a recognition unit with a considerably higher probe density than previously established methods. Interestingly, we demonstrate that GNRs introduce photoluminescence (PL) when applied to rGO-based FETs, paving the way toward the simultaneous optical and electronic probing of the attached biointerface.
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Técnicas Biosensibles , Grafito , Nanotubos de Carbono , Nanotubos de Carbono/química , Grafito/química , Técnicas Biosensibles/métodosRESUMEN
Zinc-ion batteries (ZIBs) are promising energy storage systems due to high energy density, low-cost, and abundant availability of zinc as a raw material. However, the greatest challenge in ZIBs research is lack of suitable cathode materials that can reversibly intercalate Zn2+ ions. 2D layered materials, especially MoS2-based, attract tremendous interest due to large surface area and ability to intercalate/deintercalate ions. Unfortunately, pristine MoS2 obtained by traditional protocols such as chemical exfoliation or hydrothermal/solvothermal methods exhibits limited electronic conductivity and poor chemical stability upon charge/discharge cycling. Here, a novel molecular strategy to boost the electrochemical performance of MoS2 cathode materials for aqueous ZIBs is reported. The use of dithiolated conjugated molecular pillars, that is, 4,4'-biphenyldithiols, enables to heal defects and crosslink the MoS2 nanosheets, yielding covalently bridged networks (MoS2-SH2) with improved ionic and electronic conductivity and electrochemical performance. In particular, MoS2-SH2 electrodes display high specific capacity of 271.3 mAh g-1 at 0.1 A g-1, high energy density of 279 Wh kg-1, and high power density of 12.3 kW kg-1. With its outstanding rate capability (capacity of 148.1 mAh g-1 at 10 A g-1) and stability (capacity of 179 mAh g-1 after 1000 cycles), MoS2-SH2 electrodes outperform other MoS2-based electrodes in ZIBs.
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Cardiovascular toxicity causes adverse drug reactions and may lead to drug removal from the pharmaceutical market. Cancer therapies can induce life-threatening cardiovascular side effects such as arrhythmias, muscle cell death, or vascular dysfunction. New technologies have enabled cardiotoxic compounds to be identified earlier in drug development. Human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CMs) and vascular endothelial cells (ECs) can screen for drug-induced alterations in cardiovascular cell function and survival. However, most existing hiPSC models for cardiovascular drug toxicity utilize two-dimensional, immature cells grown in static culture. Improved in vitro models to mechanistically interrogate cardiotoxicity would utilize more adult-like, mature hiPSC-derived cells in an integrated system whereby toxic drugs and protective agents can flow between hiPSC-ECs that represent systemic vasculature and hiPSC-CMs that represent heart muscle (myocardium). Such models would be useful for testing the multi-lineage cardiotoxicities of chemotherapeutic drugs such as VEGFR2/PDGFR-inhibiting tyrosine kinase inhibitors (VPTKIs). Here, we develop a multi-lineage, fully-integrated, cardiovascular organ-chip that can enhance hiPSC-EC and hiPSC-CM functional and genetic maturity, model endothelial barrier permeability, and demonstrate long-term functional stability. This microfluidic organ-chip harbors hiPSC-CMs and hiPSC-ECs on separate channels that can be subjected to active fluid flow and rhythmic biomechanical stretch. We demonstrate the utility of this cardiovascular organ-chip as a predictive platform for evaluating multi-lineage VPTKI toxicity. This study may lead to the development of new modalities for the evaluation and prevention of cancer therapy-induced cardiotoxicity.
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Células Madre Pluripotentes Inducidas , Neoplasias , Humanos , Cardiotoxicidad/etiología , Cardiotoxicidad/metabolismo , Células Endoteliales , Miocitos Cardíacos , Neoplasias/metabolismoRESUMEN
Introduction: Mycobacterium tuberculosis, the etiologic agent of tuberculosis (TB), has killed nearly one billion people during the last two centuries. Nowadays, TB remains a major global health problem ranked among the top 10 causes of death worldwide. One of the main challenges in developing new strategies to fight TB is focused on reducing the duration and complexity of drug regimens. Cannabidiol (CBD) is the main nonpsychoactive ingredient extracted from the Cannabis sativa L. plant, which has been shown to be biologically active against bacteria. The purpose of this work was to investigate the antimicrobial effect of CBD on M. tuberculosis intracellular infection. Materials and Methods: To assess the minimum inhibitory concentration (MIC) of CBD on mycobacterial strains, the MTT assay was performed on Mycobacterium smegmatis, and the Colony-Forming Unit (CFU) assay was conducted on MtbH37Rv. Additionally, the cytotoxic effect of CBD on THP-1 cells was assessed by MTT assay. Moreover, macrophages derived from the THP-1 cell were infected with MtbH37Rv (multiplicity of infection 1:10) to evaluate the intracellular activity of CBD by determining the CFU/mL. Results: Antimicrobial activity against M. smegmatis (MIC=100 µM) and MtbH37Rv (MIC=25 µM) cultures was exhibited by CBD. Furthermore, the effect of CBD was also evaluated on MtbH37Rv infected macrophage cells. Interestingly, a reduction in viable intracellular MtbH37Rv bacteria was observed after 24 h of treatment. Moreover, CBD exhibited a safe profile toward human THP-1 cells, since it showed no toxicity (CC50=1075 µM) at a concentration of antibacterial effect (selectivity index 43). Conclusion: These results extend the knowledge regarding the antimicrobial activity of CBD and demonstrate its ability to kill the human intracellular pathogen M. tuberculosis.
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Cannabidiol , Mycobacterium tuberculosis , Tuberculosis , Humanos , Cannabidiol/farmacología , Tuberculosis/terapia , Antibacterianos/farmacología , MacrófagosRESUMEN
Precise monitoring of the humidity level is important for the living comfort and for many applications in various industrial sectors. Humidity sensors have thus become one among the most extensively studied and used chemical sensors by targeting a maximal device performance through the optimization of the components and working mechanism. Among different moisture-sensitive systems, supramolecular nanostructures are ideal active materials for the next generation of highly efficient humidity sensors. Their noncovalent nature guarantees fast response, high reversibility, and fast recovery time in the sensing event. Herein, the most enlightening recent strategies on the use of supramolecular nanostructures for humidity sensing are showcased. The key performance indicators in humidity sensing, including operation range, sensitivity, selectivity, response, and recovery speed are discussed as milestones for true practical applications. Some of the most remarkable examples of supramolecular-based humidity sensors are presented, by describing the finest sensing materials, the operating principles, and sensing mechanisms, the latter being based on the structural or charge-transport changes triggered by the interaction of the supramolecular nanostructures with the ambient humidity. Finally, the future directions, challenges, and opportunities for the development of humidity sensors with performance beyond the state of the art are discussed.
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The coupling of different 2D materials (2DMs) to form van der Waals heterostructures (vdWHs) is a powerful strategy for adjusting the electronic properties of 2D semiconductors, for applications in opto-electronics and quantum computing. 2D molybdenum disulfide (MoS2 ) represents an archetypical semiconducting, monolayer thick versatile platform for the generation of hybrid vdWH with tunable charge transport characteristics through its interfacing with molecules and assemblies thereof. However, the physisorption of (macro)molecules on 2D MoS2 yields hybrids possessing a limited thermal stability, thereby jeopardizing their technological applications. Herein, the rational design and optimized synthesis of 2D covalent organic frameworks (2D-COFs) for the generation of MoS2 /2D-COF vdWHs exhibiting strong interlayer coupling effects are reported. The high crystallinity of the 2D-COF films makes it possible to engineer an ultrastable periodic doping effect on MoS2 , boosting devices' field-effect mobility at room temperature. Such a performance increase can be attributed to the synergistic effect of the efficient interfacial electron transfer process and the pronounced suppression of MoS2 's lattice vibration. This proof-of-concept work validates an unprecedented approach for the efficient modulation of the electronic properties of 2D transition metal dichalcogenides toward high-performance (opto)electronics for CMOS digital circuits.
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BACKGROUND: Epidemiological data on patients with COVID-19 referred to specialized weaning centers (SWCs) are sparse, particularly in low- and middle-income countries. Our aim was to describe clinical features, epidemiology, and outcomes of subjects admitted to SWCs in Argentina. METHODS: We conducted a prospective, multi-center, observational study between July 2020-December 2021 in 12 SWCs. We collected demographic characteristics, laboratory results, pulmonary function, and dependence on mechanical ventilation at admission, decannulation, weaning from mechanical ventilation, and status at discharge. A multiple logistic model was built to predict home discharge. RESULTS: We enrolled 568 tracheostomized adult subjects after the acute COVID-19 phase who were transferred to SWCs. Age was 62 [52-71], males 70%, Charlson comorbidity index was 2 [0-3], and length of stay in ICU was 42 [32-56] d. Of the 315 ventilator-dependent subjects, 72.4% were weaned, 427 (75.2%) were decannulated, and 366 subjects (64.5%) were discharged home. The mortality rate was 6.0%. In multivariate analysis, age (odds ratio 0.30 [95% CI 0.16-0.56], P < .001), Charlson comorbidity index (odds ratio 0.43 [95% CI 0.22-0.84], P < .01), mechanical ventilation duration in ICU (odds ratio 0.80 [95% CI 0.72-0.89], P < .001), renal failure (odds ratio 0.40 [95% CI 0.22-0.73], P = .003), and expiratory muscle weakness (odds ratio 0.35 [95% CI 0.19-0.62], P < .001) were independently associated with home discharge. CONCLUSIONS: Most subjects with COVID-19 transferred to SWCs were weaned, achieved decannulation, and were discharged to home. Age, high-comorbidity burden, prolonged mechanical ventilation in ICU, renal failure at admission, and expiratory muscle weakness were inversely associated with home discharge.