Circulating MicroRNAs and Novel Proteins as Potential Biomarkers of Neurological Complications after Heart Bypass Surgery

Postoperative recovery can be impaired by many conditions, some of which are difficult to diagnose clinically. These include type 2 neurological complications such as hypoactive subtype of postoperative delirium (PD) and early postoperative cognitive dysfunction (ePOCD). Hope for their timely detection may lie with novel biomarkers. Plasma concentrations of microRNA-1-3p, microRNA-21-5p, glial fibrillary acidic protein (GFAP), neuroserpin (NSP), phosphorylated axonal neurofilament subunit H (pNfH) and visinin-like protein 1 (VILIP-1) were investigated in 30 patients undergoing elective off-pump coronary artery bypass grafting. Blood samples were collected at the start and end of a surgery as well as 24 h postoperatively. Associations between the studied biomarkers’ perioperative expression and type 2 neurological complications were analyzed. PD was associated with postoperative expression of GFAP; ePOCD was associated with postoperative expression of microRNA-21-5p and GFAP as well as intraoperative expression of NSP. The predictive accuracy of these molecules was found acceptable, with all their areas under the curve (AUC) values above 0.7. Multivariable regression indicated that microRNA-21-5p, GFAP and NSP were the only significant predictors of ePOCD. Evaluation of a multi-marker model including these three molecules revealed its outstanding predictive accuracy for ePOCD (AUC = 0.95). The use of microRNA-21-5p, GFAP and NSP for monitoring postoperative recovery warrants further research considering their potential to predict PD and ePOCD

Defining a competency framework for health and social professionals to promote healthy ageing throughout the lifespan: an international Delphi study

Abstract Purpose: The promotion of healthy ageing has become a priority in most parts of the world, and it should be promoted at all ages. However, baseline training of health and social professionals is currently not adequately tailored to face these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals’ competencies to promote healthy ageing throughout the lifespan within the SIENHA project. Materials and Methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and built following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy ageing with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. Results: The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. Conclusions: The SIENHA competence framework for healthy ageing may help students, and educators, to enrich their learning, and the academic content of their subjects or/and programmes and incentivize innovation.info:eu-repo/semantics/acceptedVersio