Adhesión de osteoblastos sobre andamios de PLA-PLG- biocerámico-colágeno, fotosensibilizados con luz UV

ResumenEmpleando simultáneamente, las técnicas de Espectroscopia de Impedancia Electroquímica (EIE) y Microbalanza de Cristal de Cuarzo (MCC) en una celda de tres electrodos, bajo condiciones de bioseguridad y adicionando una concentración de 60000células/ml de osteoblastos, con 2ml de medio celular, fue evaluada la adhesión celular sobre películas delgadas de polímeros (PLA-PGA) con 10% de biocerámicos de hidroxiapatita y fosfato tricálcico (HAP, TCP-β). Estas películas fueron obtenidas por electrodeposición catódica sobre un sustrato de Ti6Al4V ELI y sobre cristales de cuarzo con Au- Ti. Estos materiales, luego fueron modificados superficialmente con colágeno disuelto, pipeteado homogéneamente sobre la superficie polimérica en concentraciones de 10μg/ml y 20μg/ml y luego, fueron irradiados con luz ultravioleta durante 10 minutos. Observaciones de Microscopía electrónica sellevaron a cabo para estudiar la morfología superficial, comprobando una mayor adhesión por el efectode la fotoxidación por irradiación UV. Palabras clave: ingeniería de tejidos, irradiación ultravioleta, adhesión celular, espectroscopia de impedancia electroquímica, microbalanza de cristal de cuarzo. Osteoblast adhesion on PLA-PLG bioceramic- collagen scaffolds, photosensitized UV light  Abstract Simultaneously using the techniques of Electrochemical Impedance Spectroscopy ( EIS ) and quartz crystal microbalance (MCC) in a three-electrode cell under conditions of biosafety and adding a concentration of 60000cells/ml of osteoblasts , with 2ml of medium cell was evaluated cell adhesion on thin films of polymers (PLA -PGA) bioceramic 10% tricalcium phosphate and hydroxyapatite (HAP , TCP - β ) . These films were obtained by cathodic electrodeposition on ELI Ti6Al4V substrate and quartz crystals with Au –Ti. These materials were then surface modified with dissolved collagen, pipetting homogeneously on the polymer surface at concentrations of 10μg/ml and 20μg/ml and then they were irradiated with UV light for 10minutes. Electron microscopy observations were carried out to study the surface morphology, ensuring greater adherence by the effect of photo-oxidation by UV irradiation. Keywords: tissue engineering, ultraviolet irradiation, cell adhesion, electrochemical impedance spectroscopy, quartz crystal microbalance.  Adesão de osteoblastos no andaime PLA-PLG- biocerâmica-colágeno, fotossensibilizada com luz UV   Resumo  Simultaneamente, utilizando as técnicas de espectroscopia de impedância electroquímica (EIA) e microbalança de cristal de quartzo (MCC), em uma célula de três eléctrodos em condições de segurança biológica e a adição de uma concentração de 60000células/ml de osteoblastos, com 2ml de meio de células foi avaliada a adesão celular em filmes finos de polímeros (PLA-PGA) biocerâmica 10% fosfato tricálcico e hidroxiapatita (HAP, TCP - β). Estes filmes foram obtidos por electrodeposição catódica em ELI Ti6Al4V substrato de quartzo e cristais com Au-Ti. Estes materiais foram então superfície modificada com dissolvido colagénio, pipetagem homogeneamente na superfície do polímero em concentrações de 10μg/ml e 20μg/ml e, em seguida, foram irradiadas com luz UV durante 10 minutos. Observações de microscopia eletrônica foram realizados para estudar a morfologia da superfície, garantindo maior aderência pelo efeito da foto-oxidação por irradiação UV.    Palabras-chave: engenharia de tecidos, a irradiação ultravioleta, adesão celular, espectroscopia de impedância eletroquímica, cristal de quartzo microbalance.      Cita: Estupiñan Duran HA, Peña Ballesteros DY, Martínez NM. Adhesión de osteoblastos sobre andamios de PLA-PLG-biocerámico- colágeno, fotosensibilizados con luz UV. rev.ion. 2014;27(2): 7-15

Adhesión de osteoblastos sobre andamios de PLA-PLG- biocerámico-colágeno, fotosensibilizados con luz UV

ResumenEmpleando simultáneamente, las técnicas de Espectroscopia de Impedancia Electroquímica (EIE) y Microbalanza de Cristal de Cuarzo (MCC) en una celda de tres electrodos, bajo condiciones de bioseguridad y adicionando una concentración de 60000células/ml de osteoblastos, con 2ml de medio celular, fue evaluada la adhesión celular sobre películas delgadas de polímeros (PLA-PGA) con 10% de biocerámicos de hidroxiapatita y fosfato tricálcico (HAP, TCP-β). Estas películas fueron obtenidas por electrodeposición catódica sobre un sustrato de Ti6Al4V ELI y sobre cristales de cuarzo con Au- Ti. Estos materiales, luego fueron modificados superficialmente con colágeno disuelto, pipeteado homogéneamente sobre la superficie polimérica en concentraciones de 10μg/ml y 20μg/ml y luego, fueron irradiados con luz ultravioleta durante 10 minutos. Observaciones de Microscopía electrónica sellevaron a cabo para estudiar la morfología superficial, comprobando una mayor adhesión por el efectode la fotoxidación por irradiación UV. Palabras clave: ingeniería de tejidos, irradiación ultravioleta, adhesión celular, espectroscopia de impedancia electroquímica, microbalanza de cristal de cuarzo. Osteoblast adhesion on PLA-PLG bioceramic- collagen scaffolds, photosensitized UV light  Abstract Simultaneously using the techniques of Electrochemical Impedance Spectroscopy ( EIS ) and quartz crystal microbalance (MCC) in a three-electrode cell under conditions of biosafety and adding a concentration of 60000cells/ml of osteoblasts , with 2ml of medium cell was evaluated cell adhesion on thin films of polymers (PLA -PGA) bioceramic 10% tricalcium phosphate and hydroxyapatite (HAP , TCP - β ) . These films were obtained by cathodic electrodeposition on ELI Ti6Al4V substrate and quartz crystals with Au –Ti. These materials were then surface modified with dissolved collagen, pipetting homogeneously on the polymer surface at concentrations of 10μg/ml and 20μg/ml and then they were irradiated with UV light for 10minutes. Electron microscopy observations were carried out to study the surface morphology, ensuring greater adherence by the effect of photo-oxidation by UV irradiation. Keywords: tissue engineering, ultraviolet irradiation, cell adhesion, electrochemical impedance spectroscopy, quartz crystal microbalance.  Adesão de osteoblastos no andaime PLA-PLG- biocerâmica-colágeno, fotossensibilizada com luz UV   Resumo  Simultaneamente, utilizando as técnicas de espectroscopia de impedância electroquímica (EIA) e microbalança de cristal de quartzo (MCC), em uma célula de três eléctrodos em condições de segurança biológica e a adição de uma concentração de 60000células/ml de osteoblastos, com 2ml de meio de células foi avaliada a adesão celular em filmes finos de polímeros (PLA-PGA) biocerâmica 10% fosfato tricálcico e hidroxiapatita (HAP, TCP - β). Estes filmes foram obtidos por electrodeposição catódica em ELI Ti6Al4V substrato de quartzo e cristais com Au-Ti. Estes materiais foram então superfície modificada com dissolvido colagénio, pipetagem homogeneamente na superfície do polímero em concentrações de 10μg/ml e 20μg/ml e, em seguida, foram irradiadas com luz UV durante 10 minutos. Observações de microscopia eletrônica foram realizados para estudar a morfologia da superfície, garantindo maior aderência pelo efeito da foto-oxidação por irradiação UV.    Palabras-chave: engenharia de tecidos, a irradiação ultravioleta, adesão celular, espectroscopia de impedância eletroquímica, cristal de quartzo microbalance.      Cita: Estupiñan Duran HA, Peña Ballesteros DY, Martínez NM. Adhesión de osteoblastos sobre andamios de PLA-PLG-biocerámico- colágeno, fotosensibilizados con luz UV. rev.ion. 2014;27(2): 7-15

Evidence for surface uplift of the Atlas Mountains and the surrounding peripheral plateaux: Combining apatite fission-track results and geomorphic indicators in the Western Moroccan Meseta (coastal Variscan Paleozoic basement)

This work represents an initial attempt to link the evolution of the topography in relation to the general tectonic framework of western Morocco. For this purpose, in a section of the Western Moroccan Meseta different tools are combined in order to attain the general objective. Apatite fission-track (AFT) data of granitic rocks of the Rabat–Khenifra area give ages around 200 Ma with track length distributions which are compatible with the thermal models already established for the area. An inverse correlation between AFT ages and elevation is observed which is compatible with previous models indicating northward tilting of the whole Western Moroccan Meseta which is younger than 20–25 Ma. In order to test this possibility a detailed analysis of the topography at different scales in the Western Moroccan Meseta has been performed. Results indicate that two open folds with different amplitudes are recognized and that the one with wider wavelength could correspond to a lithospheric fold as previously stated by other authors on the basis of independent geological arguments. The northward tilting proposed based on the AFT data agrees with the results obtained in the analysis of the topography which reinforces the presence of a very open fold with a wavelength of 200–300 km in the north-western limb of the Western Moroccan Meseta

Federated causal inference based on real-world observational data sources:Application to a SARS-CoV-2 vaccine effectiveness assessment

Introduction Causal inference helps researchers and policy-makers to evaluate public health interventions. When comparing interventions or public health programs by leveraging observational sensitive individual-level data from populations crossing jurisdictional borders, a federated approach (as opposed to a pooling data approach) can be used. Approaching causal inference by re-using routinely collected observational data across different regions in a federated manner, is challenging and guidance is currently lacking. With the aim of filling this gap and allowing a rapid response in the case of a next pandemic, a methodological framework to develop studies attempting causal inference using federated cross-national sensitive observational data, is described and showcased within the European BeYond-COVID&nbsp;project. Methods A framework for approaching federated causal inference by re-using routinely collected observational data across different regions, based on principles of legal, organizational, semantic and technical interoperability, is proposed. The framework includes step-by-step guidance, from defining a research question, to establishing a causal model, identifying and specifying data requirements in a common data model, generating synthetic data, and developing an interoperable and reproducible analytical pipeline for distributed deployment. The conceptual and instrumental phase of the framework was demonstrated and an analytical pipeline implementing federated causal inference was prototyped using open-source software in preparation for the assessment of real-world effectiveness of SARS-CoV-2 primary vaccination in preventing infection in populations spanning different countries, integrating a data quality assessment, imputation of missing values, matching of exposed to unexposed individuals based on confounders identified in the causal model and a survival analysis within the matched&nbsp;population. Results The conceptual and instrumental phase of the proposed methodological framework was successfully demonstrated within the BY-COVID project. Different Findable, Accessible, Interoperable and Reusable (FAIR) research objects were produced, such as a study protocol, a data management plan, a common data model, a synthetic dataset and an interoperable analytical&nbsp;pipeline. Conclusions The framework provides a systematic approach to address federated cross-national policy-relevant causal research questions based on sensitive population, health and care data in a privacy-preserving and interoperable way. The methodology and derived research objects can be re-used and contribute to pandemic&nbsp;preparedness.</p

Differences in health outcomes for high-need high-cost patients across high-income countries.

ObjectiveThis study explores variations in outcomes of care for two types of patient personas-an older frail person recovering from a hip fracture and a multimorbid older patient with congestive heart failure (CHF) and diabetes.Data sourcesWe used individual-level patient data from 11 health systems.Study designWe compared inpatient mortality, mortality, and readmission rates at 30, 90, and 365 days. For the hip fracture persona, we also calculated time to surgery. Outcomes were standardized by age and sex.Data collection/extraction methodsData was compiled by the International Collaborative on Costs, Outcomes and Needs in Care across 11 countries for the years 2016-2017 (or nearest): Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.Principal findingsThe hip sample across ranged from 1859 patients in Aragon, Spain, to 42,849 in France. Mean age ranged from 81.2 in Switzerland to 84.7 in Australia, and the majority of hip patients across countries were female. The congestive heart failure (CHF) sample ranged from 742 patients in England to 21,803 in the United States. Mean age ranged from 77.2 in the United States to 80.3 in Sweden, and the majority of CHF patients were males. Average in-hospital mortality across countries was 4.1%. for the hip persona and 6.3% for the CHF persona. At the year mark, the mean mortality across all countries was 25.3% for the hip persona and 32.7% for CHF persona. Across both patient types, England reported the highest mortality at 1 year followed by the United States. Readmission rates for all periods were higher for the CHF persona than the hip persona. At 30 days, the average readmission rate for the hip persona was 13.8% and 27.6% for the CHF persona.ConclusionAcross 11 countries, there are meaningful differences in health system outcomes for two types of patients

Derivation and external validation of the SIMPLICITY score as a simple immune-based risk score to predict infection in kidney transplant recipients

Existing approaches for infection risk stratification in kidney transplant recipients are suboptimal. Here, we aimed to develop and validate a weighted score integrating non-pathogen-specific immune parameters and clinical variables to predict the occurrence of post-transplant infectious complications. To this end, we retrospectively analyzed a single-center derivation cohort of 410 patients undergoing kidney transplantation in 2008-2013 in Madrid. Peripheral blood lymphocyte subpopulations, serum immunoglobulin and complement levels were measured at one-month post-transplant. The primary and secondary outcomes were overall and bacterial infection through month six. A point score was derived from a logistic regression model and prospectively applied on a validation cohort of 522 patients undergoing kidney transplantation at 16 centers throughout Spain in 2014-2015. The SIMPLICITY score consisted of the following variables measured at month one after transplantation: C3 level, CD4+ T-cell count, CD8+ T-cell count, IgG level, glomerular filtration rate, recipient age, and infection within the first month. The discrimination capacity in the derivation and validation cohorts was good for overall (areas under the receiver operating curve of 0.774 and 0.730) and bacterial infection (0.767 and 0.734, respectively). The cumulative incidence of overall infection significantly increased across risk categories in the derivation (low-risk 13.7%; intermediate-risk, 35.9%; high-risk 77.6%) and validation datasets (10.2%, 28.9% and 50.4%, respectively). Thus, the SIMPLICITY score, based on easily available immune parameters, allows for stratification of kidney transplant recipients at month one according to their expected risk of subsequent infection

Differences in health care spending and utilization among older frail adults in high-income countries: ICCONIC hip fracture persona.

ObjectiveThis study explores differences in spending and utilization of health care services for an older person with frailty before and after a hip fracture.Data sourcesWe used individual-level patient data from five care settings.Study designWe compared utilization and spending of an older person aged older than 65 years for 365 days before and after a hip fracture across 11 countries and five domains of care as follows: acute hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, and outpatient drugs. Utilization and spending were age and sex standardized..Data collection/extraction methodsThe data were compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries as follows: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.Principal findingsThe sample ranged from 1859 patients in Spain to 42,849 in France. Mean age ranged from 81.2 in Switzerland to 84.7 in Australia. The majority of patients across countries were female. Relative to other countries, the United States had the lowest inpatient length of stay (11.3), but the highest number of days were spent in post-acute care rehab (100.7) and, on average, had more visits to specialist providers (6.8 per year) than primary care providers (4.0 per year). Across almost all sectors, the United States spent more per person than other countries per unit ($13,622 per hospitalization,$233 per primary care visit, $386 per MD specialist visit). Patients also had high expenditures in the year prior to the hip fracture, mostly concentrated in the inpatient setting.ConclusionAcross 11 high-income countries, there is substantial variation in health care spending and utilization for an older person with frailty, both before and after a hip fracture. The United States is the most expensive country due to high prices and above average utilization of post-acute rehab care

International comparison of health spending and utilization among people with complex multimorbidity.

OBJECTIVE: The objective of this study was to explore cross-country differences in spending and utilization across different domains of care for a multimorbid persona with heart failure and diabetes. DATA SOURCES: We used individual-level administrative claims or registry data from inpatient and outpatient health care sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States (US). DATA COLLECTION/EXTRACTION METHODS: Data collected by ICCONIC partners. STUDY DESIGN: We retrospectively analyzed age-sex standardized utilization and spending of an older person (65-90 years) hospitalized with a heart failure exacerbation and a secondary diagnosis of diabetes across five domains of care: hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, and outpatient drugs. PRINCIPAL FINDINGS: Sample sizes ranged from n = 1270 in Spain to n = 21,803 in the United States. Mean age (standard deviation [SD]) ranged from 76.2 (5.6) in the Netherlands to 80.3 (6.8) in Sweden. We observed substantial variation in spending and utilization across care settings. On average, England spent $10,956 per person in hospital care while the United States spent$30,877. The United States had a shorter length of stay over the year (18.9 days) compared to France (32.9) and Germany (33.4). The United States spent more days in facility-based rehabilitative care than other countries. Australia spent $421 per person in primary care, while Spain (Aragon) spent$1557. The United States and Canada had proportionately more visits to specialist providers than primary care providers. Across almost all sectors, the United States spent more than other countries, suggesting higher prices per unit. CONCLUSION: Across 11 countries, there is substantial variation in health care spending and utilization for a complex multimorbid persona with heart failure and diabetes. Drivers of spending vary across countries, with the United States being the most expensive country due to high prices and higher use of facility-based rehabilitative care

A methodology for identifying high-need, high-cost patient personas for international comparisons.

ObjectiveTo establish a methodological approach to compare two high-need, high-cost (HNHC) patient personas internationally.Data sourcesLinked individual-level administrative data from the inpatient and outpatient sectors compiled by the International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) across 11 countries: Australia, Canada, England, France, Germany, the Netherlands, New Zealand, Spain, Sweden, Switzerland, and the United States.Study designWe outline a methodological approach to identify HNHC patient types for international comparisons that reflect complex, priority populations defined by the National Academy of Medicine. We define two patient profiles using accessible patient-level datasets linked across different domains of care-hospital care, primary care, outpatient specialty care, post-acute rehabilitative care, long-term care, home-health care, and outpatient drugs. The personas include a frail older adult with a hip fracture with subsequent hip replacement and an older person with complex multimorbidity, including heart failure and diabetes. We demonstrate their comparability by examining the characteristics and clinical diagnoses captured across countries.Data collection/extraction methodsData collected by ICCONIC partners.Principal findingsAcross 11 countries, the identification of HNHC patient personas was feasible to examine variations in healthcare utilization, spending, and patient outcomes. The ability of countries to examine linked, individual-level data varied, with the Netherlands, Canada, and Germany able to comprehensively examine care across all seven domains, whereas other countries such as England, Switzerland, and New Zealand were more limited. All countries were able to identify a hip fracture persona and a heart failure persona. Patient characteristics were reassuringly similar across countries.ConclusionAlthough there are cross-country differences in the availability and structure of data sources, countries had the ability to effectively identify comparable HNHC personas for international study. This work serves as the methodological paper for six accompanying papers examining differences in spending, utilization, and outcomes for these personas across countries