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BACKGROUND: Hyperuricemia contributes to decrease in kidney function and induces additional renal damage in children with acute kidney injury (AKI). Rasburicase oxidizes uric acid (UA), decreasing its serum quantities in less than 24 h. METHODS: This is a retrospective study involving hospitalized patients under 18 years of age with underlying pathology diagnosed with AKI and severe hyperuricemia treated with rasburicase over a 4-year period. RESULTS: We describe 15 patients from 4 days of life to 18 years (median: 4.4 years). Seventy-three percent had known underlying pathologies. All presented worsening of basal renal function or AKI data. All received the usual medical treatment for AKI without response. Twenty percent received an extrarenal depuration technique. All had hyperuricemia with a mean (± SD) of 13.1 (± 2.19) mg/dl. After rasburicase administration UA levels fell to a mean (± SD) of 0.76 (± 0.62) mg/dl (p < 0.001) in less than 24 h. In parallel, a decrease in the mean plasma creatinine was observed (2.92 mg/dl to 1.93 mg/dl (p = 0.057)) together with a significant improvement of the mean glomerular filtration rate (16.3 ml/min/1.73 m2 to 78.6 ml/min/1.73 m2) (p = 0.001)). No side effects were recorded. Kidney function normalized in all cases or returned to baseline levels. CONCLUSIONS: Although the use of rasburicase is not routinely approved in pediatric patients with severe hyperuricemia and AKI, it has been used successfully without complications, and helped prevent progressive kidney damage. This study could serve as a basis for suggesting the off-label use of rasburicase for the management of complex pediatric patients in whom UA plays an important role in the development of AKI.
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Lesión Renal Aguda , Hiperuricemia , Humanos , Niño , Adolescente , Hiperuricemia/complicaciones , Hiperuricemia/tratamiento farmacológico , Estudios Retrospectivos , Urato Oxidasa/efectos adversos , Lesión Renal Aguda/etiología , Lesión Renal Aguda/complicaciones , Ácido Úrico , RiñónRESUMEN
Alzheimer's disease has a long asymptomatic phase that offers a substantial time window for intervention. Using this window of opportunity will require early diagnostic and prognostic biomarkers to detect Alzheimer's disease pathology at predementia stages, thus allowing identification of patients who will most probably progress to dementia of the Alzheimer's type and benefit from specific disease-modifying therapies. Consequently, we searched for CSF proteins associated with disease progression along with the clinical disease staging. We measured the levels of 184 proteins in CSF samples from 556 subjective cognitive decline and mild cognitive impairment patients from three independent memory clinic longitudinal studies (Spanish ACE, n = 410; German DCN, n = 93; German Mannheim, n = 53). We evaluated the association between protein levels and clinical stage, and the effect of protein levels on the progression from mild cognitive impairment to dementia of the Alzheimer's type. Mild cognitive impairment subjects with increased CSF level of matrix metalloproteinase 10 (MMP-10) showed a higher probability of progressing to dementia of the Alzheimer's type and a faster cognitive decline. CSF MMP-10 increased the prediction accuracy of CSF amyloid-ß 42 (Aß42), phospho-tau 181 (P-tau181) and total tau (T-tau) for conversion to dementia of the Alzheimer's type. Including MMP-10 to the [A/T/(N)] scheme improved considerably the prognostic value in mild cognitive impairment patients with abnormal Aß42, but normal P-tau181 and T-tau, and in mild cognitive impairment patients with abnormal Aß42, P-tau181 and T-tau. MMP-10 was correlated with age in subjects with normal Aß42, P-tau181 and T-tau levels. Our findings support the use of CSF MMP-10 as a prognostic marker for dementia of the Alzheimer's type and its inclusion in the [A/T/(N)] scheme to incorporate pathologic aspects beyond amyloid and tau. CSF level of MMP-10 may reflect ageing and neuroinflammation.
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Enfermedad de Alzheimer , Disfunción Cognitiva , Metaloproteinasa 10 de la Matriz , Enfermedad de Alzheimer/patología , Péptidos beta-Amiloides , Biomarcadores , Disfunción Cognitiva/diagnóstico , Progresión de la Enfermedad , Humanos , Estudios Longitudinales , Metaloproteinasa 10 de la Matriz/líquido cefalorraquídeo , Fragmentos de Péptidos , Proteínas tauRESUMEN
BACKGROUND: Digital biomarkers (DB), as captured using sensors embedded in modern smart devices, are a promising technology for home-based sign and symptom monitoring in Parkinson disease (PD). OBJECTIVE: Despite extensive application in recent studies, test-retest reliability and longitudinal stability of DB have not been well addressed in this context. We utilized the large-scale m-Power data set to establish the test-retest reliability and longitudinal stability of gait, balance, voice, and tapping tasks in an unsupervised and self-administered daily life setting in patients with PD and healthy controls (HC). METHODS: Intraclass correlation coefficients were computed to estimate the test-retest reliability of features that also differentiate between patients with PD and healthy volunteers. In addition, we tested for longitudinal stability of DB measures in PD and HC, as well as for their sensitivity to PD medication effects. RESULTS: Among the features differing between PD and HC, only a few tapping and voice features had good to excellent test-retest reliabilities and medium to large effect sizes. All other features performed poorly in this respect. Only a few features were sensitive to medication effects. The longitudinal analyses revealed significant alterations over time across a variety of features and in particular for the tapping task. CONCLUSIONS: These results indicate the need for further development of more standardized, sensitive, and reliable DB for application in self-administered remote studies in patients with PD. Motivational, learning, and other confounders may cause variations in performance that need to be considered in DB longitudinal applications.
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Enfermedad de Parkinson , Biomarcadores , Estudios de Cohortes , Marcha , Humanos , Enfermedad de Parkinson/diagnóstico , Reproducibilidad de los ResultadosRESUMEN
Chilean papaya is grown in Central Chile and is considered to be an important source of fiber, sugars, and antioxidants. The effect of different vacuum drying temperatures (40, 50, 60, 70, and 80 °C) on the composition of papaya pulp was evaluated. The inhibitory effect of papaya extracts on α-glucosidase activity, as a regulator of blood sugar, was also evaluated. Drying reduced water activity of the pulp to less than 0.6, thereby, assuring the product stability, while maintaining simple sugars, vitamin C, and total flavonoids. Total phenolic content and antioxidant capacity by DPPH assay increased with respect to the fresh pulp by 1.5 and 2.6 times, respectively. The inhibitory effect of papaya extracts on α-glucosidase was evaluated by determining the IC50 for each sample and the acarbose equivalents. The results indicate the suitability of the dried extract of Chilean papaya as a regulator of glucose metabolism in Type II diabetes patients.
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The archaeological record shows that typically human cultural traits emerged at different times, in different parts of the world, and among different hominin taxa. This pattern suggests that their emergence is the outcome of complex and nonlinear evolutionary trajectories, influenced by environmental, demographic, and social factors, that need to be understood and traced at regional scales. The application of predictive algorithms using archaeological and paleoenvironmental data allows one to estimate the ecological niches occupied by past human populations and identify niche changes through time, thus providing the possibility of investigating relationships between cultural innovations and possible niche shifts. By using such methods to examine two key southern Africa archaeological cultures, the Still Bay [76-71 thousand years before present (ka)] and the Howiesons Poort (HP; 66-59 ka), we identify a niche shift characterized by a significant expansion in the breadth of the HP ecological niche. This expansion is coincident with aridification occurring across Marine Isotope Stage 4 (ca. 72-60 ka) and especially pronounced at 60 ka. We argue that this niche shift was made possible by the development of a flexible technological system, reliant on composite tools and cultural transmission strategies based more on "product copying" rather than "process copying." These results counter the one niche/one human taxon equation. They indicate that what makes our cultures, and probably the cultures of other members of our lineage, unique is their flexibility and ability to produce innovations that allow a population to shift its ecological niche.
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BACKGROUND: Consumption of bell peppers is recommended because of their bioactive compound content and their positive effects on health. Growth-promoting rhizobacteria are popular because of their ability to promote plant growth by improving the fixation of nutrients or by inducing a systemic response. Green bell pepper (Capsicum annum) roots were inoculated with an autochthonous strain of Bacillus amyloliquefaciens, at different stages of development: T1, inoculation in the seedbed before transplant; T2, inoculation at and after transplant; T3, inoculation in the seedbed, at and after transplant. Bell pepper plants without inoculation were considered as control. Physicochemical composition and antioxidant activity of the fruits were measured to select the best treatment. RESULTS: T1 increased crude proteins, fat, Ca, Fe, vitamin C, total phenolic content, antioxidant capacity by DPPH and by ORAC. On the other hand, T1 decreased reducing sugars, K and Cu content. No significant differences for total carbohydrates, ash and photosynthetic pigments were found. CONCLUSION: Inoculated green bell peppers have enhanced its functional value and could be considered as an important source of bioactive compounds with elevated antioxidant activity. © 2019 Society of Chemical Industry.
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Inoculantes Agrícolas/fisiología , Antioxidantes/química , Bacillus amyloliquefaciens/fisiología , Capsicum/química , Extractos Vegetales/química , Raíces de Plantas/microbiología , Capsicum/crecimiento & desarrollo , Capsicum/microbiología , Frutas/química , Frutas/crecimiento & desarrollo , Raíces de Plantas/crecimiento & desarrolloRESUMEN
OBJECTIVE: To trace the evolution of type 1 diabetes (T1D) in Navarre in children under 15, between 1977 and 2016, and their characteristics at onset regarding age and sex. SUBJECTS AND METHODS: We performed a descriptive analysis, using prospective-retrospective information. The study included all cases of T1D diagnosed in Navarre in children aged 0 to 14 years old from 1 January 1977 until 31 December 2016. The capture-recapture method was used, retrieving information from three independent sources: the five hospitals in Navarre as a primary source, and the Navarre Association of Diabetics (ANADI) and the primary healthcare system as the secondary source. Estimates and confidence intervals were calculated assuming a subjacent Poisson distribution. Chi square test was used to compare incidence between groups. The analysis of changes in incidence since 1977, adjusted for age group, sex and year of diagnosis, were evaluated with a multivariate Poisson regression model and joinpoint regression. RESULTS: A total of 577 cases were registered resulting in a crude incidence rate of 14.99/100 000 inhabitants-year (95% confidence interval [CI]: 13.79-16.26). From 1977, the incidence has increased in cycles, reaching an incidence rate of 22.98 (95% CI: 18.52-28.21) in 2016. The relative annual increase is 3% (95% CI: 2.3-3.8). The highest incidence is in the 10 to 14 age group (P < 0.001). No differences in sex were found. The mean age at onset in children under 15 years has not changed significantly (P = 0.572). CONCLUSIONS: The incidence of T1D in Navarre has increased 4-fold in the last four decades but is stable since 2001.
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Diabetes Mellitus Tipo 1/epidemiología , Adolescente , Edad de Inicio , Niño , Preescolar , Femenino , Humanos , Incidencia , Masculino , Periodicidad , Distribución de Poisson , Estudios Prospectivos , Estudios Retrospectivos , España/epidemiologíaRESUMEN
BACKGROUND: The aim of this study was to determine if the achievement of control targets in patients with type 2 diabetes was associated with personal socioeconomic factors and if these associations were sex-dependent. METHODS: This cross-sectional, population-based study was conducted in Spain. Glycated haemoglobin (HbA1c) level and other clinical parameters were obtained from electronic primary care records (n = 32,638 cases). Socioeconomic status was determined using education level and yearly income. Among patients, having their HbA1c level checked during the previous year was considered as an indirect measure of the process of care, whereas tobacco use and clinical parameters such as HbA1c, low-density lipoprotein cholesterol (LDL-c) and blood pressure (BP) were considered intermediate control outcomes. General linear mixed effect models were used to assess associations. RESULTS: The achievement of metabolic and cardiovascular control targets in patients with type 2 diabetes was associated with educational level and income, and socioeconomic gradients differed by sex. The probability of having had an HbA1c test performed in the previous year was higher in patients with lower education levels. Patients in the lowest income and education level categories were less likely to have reached the recommended HbA1c level. Males in the lowest education level categories were less likely to be non-smokers or to have achieved the blood pressure targets. In contrast, patients within the low income categories had a higher probability of reaching the recommended LDL-c level. CONCLUSIONS: Our results suggest the presence of socioeconomic inequalities in the achievement of cardiovascular and metabolic control that differed in direction and magnitude depending on the measured outcome and sex of the patient. These findings may help health professionals focus on high-risk individuals to decrease health inequalities.
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Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus Tipo 2/sangre , Disparidades en el Estado de Salud , Enfermedades Metabólicas/prevención & control , Anciano , LDL-Colesterol/sangre , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , España/epidemiologíaRESUMEN
PURPOSE: To investigate the preference of HER2+ breast cancer patients and nursing professionals for subcutaneous (SC) versus intravenous (IV) trastuzumab and to evaluate the financial impact derived from the use of the SC formulation. METHODS: A cross-sectional questionnaire-based study was carried out to investigate preferences of all patients who started treatment with SC trastuzumab while they had received the IV formulation before. The preference of nursing staff in charge of preparation and administration was also analysed. The financial impact was evaluated considering the number of preparations of SC trastuzumab and the cost of IV and SC trastuzumab, the consumables used for preparation and administration and nursing staff time for preparation. RESULTS: 76 female patients were included, 84% completed the questionnaire. Of the patients, 94% declared to be satisfied with the SC route and 88% would prefer SC administration if they had to choose between IV and SC. Time saving was the main reason to justify satisfaction and preference (48 and 45% respectively). The most common adverse event related to SC trastuzumab was post-injection pain in the injection site, experienced by 77% of the patients. SC trastuzumab was preferred by 100% of the nursing staff. Total annual savings using SC formulation instead of the IV were 35.332. CONCLUSIONS: SC trastuzumab is preferred by patients and the nursing staff versus the IV administration. The use of SC trastuzumab reduced the cost derived from trastuzumab administration.
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Antineoplásicos/administración & dosificación , Neoplasias de la Mama/tratamiento farmacológico , Receptor ErbB-2/metabolismo , Trastuzumab/administración & dosificación , Administración Intravenosa/métodos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/metabolismo , Estudios Transversales , Femenino , Humanos , Infusiones Intravenosas/métodos , Inyecciones Subcutáneas/efectos adversos , Persona de Mediana EdadRESUMEN
Chitosan must be dissolved in acid solution to activate its antimicrobial properties. The objectives of present study were to determine whether acetic and lactic acids used to dissolve chitosan would influence its effectiveness to control the native microflora of Butterhead lettuce at harvest and during postharvest storage (7-8 °C, 5 days). Chitosan was applied as a SINGLE DOSE (14, 10, 7, 3 or 0 days previous to harvest) or in SUCCESSIVE DOSES (at 14 + 10 + 7+3 + 0 days prior to harvest). Although chitosan in acetic acid showed antimicrobial activity, treated plants showed dried brown stains which significantly reduced sensorial quality. Chitosan in lactic acid applied in a SINGLE DOSE at harvest or in SUCCESSIVE DOSES reduced microbial counts of all populations at harvest without affecting sensorial quality. After postharvest storage, lettuce treated with SUCCESSIVE APPLICATIONS of chitosan in lactic acid presented significant reductions in the microbial populations compared with untreated sample (-2.02 log in yeast and molds, -1.83 log in total coliforms, -1.4 log CFU g-1 in mesophilic bacteria and -1.1 log in psychrophilic bacteria). In conclusion, replacement of acetic by lactic acid did not affect the antimicrobial activity of chitosan, reducing microbial counts at harvest and after postharvest storage without affecting sensorial quality.
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Although grassland and savanna occupy only a quarter of the world's vegetation, burning in these ecosystems accounts for roughly half the global carbon emissions from fire. However, the processes that govern changes in grassland burning are poorly understood, particularly on time scales beyond satellite records. We analyzed microcharcoal, sediments, and geochemistry in a high-resolution marine sediment core off Namibia to identify the processes that have controlled biomass burning in southern African grassland ecosystems under large, multimillennial-scale climate changes. Six fire cycles occurred during the past 170,000 y in southern Africa that correspond both in timing and magnitude to the precessional forcing of north-south shifts in the Intertropical Convergence Zone. Contrary to the conventional expectation that fire increases with higher temperatures and increased drought, we found that wetter and cooler climates cause increased burning in the study region, owing to a shift in rainfall amount and seasonality (and thus vegetation flammability). We also show that charcoal morphology (i.e., the particle's length-to-width ratio) can be used to reconstruct changes in fire activity as well as biome shifts over time. Our results provide essential context for understanding current and future grassland-fire dynamics and their associated carbon emissions.
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Ecosistema , Incendios , Fósiles , Suelo , NamibiaRESUMEN
PETG (poly(ethylene glycol-co-cyclohexane-1,4-dimethanol terephthalate)) is an amorphous copolymer, biocompatible, recyclable, and versatile. Nowadays, it is being actively researched for biomedical applications. However, proposals of PETG as a platform for the loading of bioactive compounds from natural extract are scarce, as well as the effect of the supercritical impregnation on this polymer. In this work, the supercritical impregnation of PETG filaments with Olea europaea leaf extract was investigated, evaluating the effect of pressure (100-400 bar), temperature (35-55 °C), and depressurization rate (5-50 bar min-1) on the expansion degree, antioxidant activity, and mechanical properties of the resulting filaments. PETG expansion degree ranged from ~3 to 120%, with antioxidant loading ranging from 2.28 to 17.96 g per 100 g of polymer, corresponding to oxidation inhibition values of 7.65 and 66.55%, respectively. The temperature and the binary interaction between pressure and depressurization rate most affected these properties. The mechanical properties of PETG filaments depended greatly on process variables. Tensile strength values were similar or lower than the untreated filaments. Young's modulus and elongation at break values decreased below ~1000 MPa and ~10%, respectively, after the scCO2 treatment and impregnation. The extent of this decrease depended on the supercritical operational parameters. Therefore, filaments with higher antioxidant activity and different expansion degrees and mechanical properties were obtained by adjusting the supercritical processing conditions.
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AIMS/HYPOTHESIS: The role of metalloproteinase-10 (MMP-10) in type 1 diabetes is not known. We hypothesise that it plays a role in the onset and progression of diabetic nephropathy and retinopathy. METHODS: Serum MMP-10 levels from 269 patients with type 1 diabetes were measured, and their association with microvascular complications was analysed. We also studied whether knocking out the Mmp10 gene influenced the extent of renal injury and retinal damage in a streptozotocin-induced diabetic mouse model. RESULTS: The risk of nephropathy and proliferative retinopathy associated with the highest vs the lowest MMP-10 tertile was increased three to four times independently of the classical risk factors. Accordingly, renal function and morphology were better preserved in diabetic Mmp10 −/− mice than in their Mmp10 +/+ counterparts. There were more kidney-infiltrating macrophages in diabetic Mmp10+/+ mice, suggesting that MMP-10 contributes to the inflammatory response leading to microvascular complications. The loss of neuronal cells in the retinas of diabetic Mmp10 +/+ mice was higher than in Mmp10 −/− mice. Retinal inflammation was decreased in Mmp10 −/− mice, as indicated by their reduced retinal caspase-1 levels. CONCLUSIONS/INTERPRETATION: MMP-10 is involved in the development of microvascular complications in type 1 diabetes and emerges as a potential therapeutic target for slowing down the evolution of diabetic nephropathy and retinopathy.
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Diabetes Mellitus Experimental/enzimología , Diabetes Mellitus Tipo 1/enzimología , Nefropatías Diabéticas/enzimología , Retinopatía Diabética/enzimología , Hiperglucemia/enzimología , Metaloproteinasa 10 de la Matriz/metabolismo , Adulto , Animales , Progresión de la Enfermedad , Femenino , Humanos , Riñón/enzimología , Pruebas de Función Renal , Masculino , Metaloproteinasa 10 de la Matriz/genética , Metaloproteinasa 9 de la Matriz/metabolismo , Ratones , Ratones Transgénicos , Retina/enzimología , EstreptozocinaRESUMEN
The end of the Middle Pleistocene Transition (MPT, ~ 800-670 thousand years before present, ka) was characterised by the emergence of large glacial ice-sheets associated with anomalously warm North Atlantic sea surface temperatures enhancing moisture production. Still, the direction and intensity of moisture transport across Eurasia towards potential ice-sheets is poorly constrained. To reconstruct late MPT moisture production and dispersal, we combine records of upper ocean temperature and pollen-based Mediterranean forest cover, a tracer of westerlies and precipitation, from a subtropical drill-core collected off South-West Iberia, with records of East Asia summer monsoon (EASM) strength and West Pacific surface temperatures, and model simulations. Here we show that south-western European winter precipitation and EASM strength reached high levels during the Marine Isotope Stage 18 glacial. This anomalous situation was caused by nearly-continuous moisture supply from both oceans and its transport to higher latitudes through the westerlies, likely fuelling the accelerated expansion of northern hemisphere ice-sheets during the late MPT.
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Low-temperature vacuum drying (LTVD) has shown great potential for drying vegetables. It could avoid excessive degradations of active compounds with potential therapeutic agents. In this study, the effect on several relevant bioactive compounds, anti-inflammatory activity, and anti-proliferative activity of broccoli (Brassica oleracea var. italica) were evaluated. Effects of other drying methods, including vacuum drying (VD), convective drying (CD), infrared drying (IRD), and freeze drying (FD), were also comparatively evaluated. The results of all dried samples showed high polyunsaturated fatty acid contents (of up to 71.3%) and essential amino acid contents (of up to 8.63%). The LTVD method stands out above the other drying methods, since it obtained the highest content of total phenols, chlorogenic acid, and ferulic acid. Both the LTVD and CD samples demonstrated high anti-inflammatory and anti-proliferative activities. These CD and LTVD samples were also the most active against the breast carcinoma MDA-MB-23 cell line. Due to the good retention of bioactive compounds via LTVD, the obtained dried broccoli here can be used in a near time as an ingredient for the development of novel natural products with anti-inflammatory and anti-proliferative effects.
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PURPOSE: The CArdiovascular Risk in patients with DIAbetes in Navarra (CARDIANA cohort) cohort was established to assess the effects of sociodemographic and clinical variables on the risk of cardiovascular events in patients with type 1 (T1D) or type 2 (T2D) diabetes, with a special focus on socioeconomic factors, and to validate and develop cardiovascular risk models for these patients. PARTICIPANTS: The CARDIANA cohort included all patients with T1D and T2D diabetes registered in the Public Health Service of Navarra with prevalent disease on 1 January 2012. It consisted of 1067 patients with T1D (ages 2-88 years) and 33842 patients with T2D (ages 20-105 years), whose data were retrospectively extracted from the Health and Administrative System Databases. FINDINGS TO DATE: The follow-up period for wave 1 was from 1 January 2012 to 31 December 2016. During these 5 years, 9 patients (0.8%; 95% CI (0.4% to 1.6%)) in the T1D cohort developed a cardiovascular disease event, whereas for the T2D cohort, 2602 (7.7%; 95% CI (7.4% to 8.0%)) had an event. For the T2D cohort, physical activity was associated with a reduced risk of cardiovascular events, with adjusted estimated ORs equal to 0.84 (95% CI 0.66 to 1.07) for the partially active group and 0.71 (95% CI 0.56 to 0.91) for the active group, compared with patients in the non-active group. FUTURE PLANS: The CARDIANA cohort is currently being used to assess the effect of sociodemographic risk factors on CV risk at 5 years and to externally validate cardiovascular predictive models. A second wave is being conducted in late 2022 and early 2023, to extend the follow-up other 5 years, from 1 January 2016 to 31 December 2021. Periodic data extractions are planned every 5 years.
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Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Humanos , Preescolar , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Diabetes Mellitus Tipo 1/complicaciones , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Factores de Riesgo , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/complicaciones , Estudios Retrospectivos , Factores de Riesgo de Enfermedad CardiacaRESUMEN
BACKGROUND: Fatigue is a common and burdensome symptom in Rheumatoid Arthritis (RA), yet is poorly understood. Currently, clinicians rely solely on fatigue questionnaires, which are inherently subjective measures. For the effective development of future therapies and stratification, it is of vital importance to identify biomarkers of fatigue. In this study, we identify brain differences between RA patients who improved and did not improve their levels of fatigue based on Chalder Fatigue Scale variation (ΔCFS≥ 2), and we compared the performance of different classifiers to distinguish between these samples at baseline. METHODS: Fifty-four fatigued RA patients underwent a magnetic resonance (MR) scan at baseline and 6 months later. At 6 months we identified those whose fatigue levels improved and those for whom it did not. More than 900 brain features across three data sets were assessed as potential predictors of fatigue improvement. These data sets included clinical, structural MRI (sMRI) and diffusion tensor imaging (DTI) data. A genetic algorithm was used for feature selection. Three classifiers were employed in the discrimination of improvers and non-improvers of fatigue: a Least Square Linear Discriminant (LSLD), a linear Support Vector Machine (SVM) and a SVM with Radial Basis Function kernel. RESULTS: The highest accuracy (67.9%) was achieved with the sMRI set, followed by the DTI set (63.8%), whereas classification performance using clinical features was at the chance level. The mean curvature of the left superior temporal sulcus was most strongly selected during the feature selection step, followed by the surface are of the right frontal pole and the surface area of the left banks of the superior temporal sulcus. CONCLUSIONS: The results presented evidence a superiority of brain metrics over clinical metrics in predicting fatigue changes. Further exploration of these methods may support clinicians to triage patients towards the most appropriate fatigue alleviating therapies.
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Artritis Reumatoide , Imagen de Difusión Tensora , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/patología , Encéfalo/diagnóstico por imagen , Encéfalo/patología , Imagen de Difusión Tensora/métodos , Fatiga/etiología , Fatiga/patología , Humanos , Aprendizaje AutomáticoRESUMEN
AIM: To determine the association and the prognostic value of soluble ST2 (sST2) levels in the development of diabetic retinopathy (DR), diabetic macular oedema (DMO) or diabetic nephropathy (DN), in a cohort of patients with type 1 diabetes (T1D). METHODS: A total of 269 individuals with T1D (154 males and 115 females) were recruited. The overall mean age was 43.2±14.9 years, and the diabetes duration was 17.1±12.1 years. Levels of sST2 in serum were evaluated, and the presence as well as the degree of DR, DMO and DN was recorded. Additionally, other clinical and analytical parameters including demographic variables were recovered from patients' electronic health record. Ten years later, the presence and stage of DR, DMO and DN were again recorded under the same criteria. The association between previously mentioned parameters with DR and DN was analysed by univariate and multivariate logistic regression. The variables in the final multivariate models were adjusted from complete models via backward elimination and maintained only when significant. RESULTS: An increase of 10ng/ml in the levels of sST2 was associated with a 1.50 (1.02-2.19) and 1.48 (1.05-2.08) prevalence odds ratio (OR) in DMO and DR, respectively. There was no association between sST2 levels and DN. Meanwhile, sST2 levels did not display a prognostic effect in any of the microangiopathic diabetic complications studied. CONCLUSIONS: Levels of sST2 are associated with the presence of DR and DMO, they do not seem to be predictive for the development or deterioration of DR, DMO or DN.
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Diabetes Mellitus Tipo 1 , Nefropatías Diabéticas , Retinopatía Diabética , Edema Macular , Adulto , Diabetes Mellitus Tipo 1/complicaciones , Nefropatías Diabéticas/complicaciones , Retinopatía Diabética/epidemiología , Retinopatía Diabética/etiología , Femenino , Humanos , Proteína 1 Similar al Receptor de Interleucina-1 , Masculino , Persona de Mediana EdadRESUMEN
The leaves of Olea europaea as agricultural waste represent a convenient source of antioxidants. In combination with supercritical CO2 (scCO2), assisted impregnation is an interesting strategy for the preparation of biomedical devices with specific bioactivity. For this purpose, 3D-printable filaments of thermoplastic polyurethane (TPU) and polylactic acid (PLA) were employed for the supercritical impregnation of ethanolic olive leaves extract (OLE) for biomedical application. The extraction of OLE was performed using pressurized liquids. The effect of pressure (100-400 bar), temperature (35-55 °C), and the polymer type on the OLE impregnation and the swelling degree were studied including a morphological analysis and the measurement of the final antioxidant activity. All the studied variables as well as their interactions showed significant effects on the OLE loading. Higher temperatures favored the OLE loading while the pressure presented opposite effects at values higher than 250 bar. Thus, the highest OLE loadings were achieved at 250 bar and 55 °C for both polymers. However, TPU showed c.a. 4 times higher OLE loading and antioxidant activity in comparison with PLA at the optimal conditions. To the best of our knowledge, this is the first report using TPU for the supercritical impregnation of a natural extract with bioactivity.