Clinical Profile and Determinants of Mortality in Patients with Interstitial Lung Disease Admitted for COVID-19.

BACKGROUND Concern has risen about the effects of COVID-19 in interstitial lung disease (ILD) patients. The aim of our study was to determine clinical characteristics and prognostic factors of ILD patients admitted for COVID-19. METHODS Ancillary analysis of an international, multicenter COVID-19 registry (HOPE: Health Outcome Predictive Evaluation) was performed. The subgroup of ILD patients was selected and compared with the rest of the cohort. RESULTS A total of 114 patients with ILDs were evaluated. Mean ± SD age was 72.4 ± 13.6 years, and 65.8% were men. ILD patients were older, had more comorbidities, received more home oxygen therapy and more frequently had respiratory failure upon admission than non-ILD patients (all p < 0.05). In laboratory findings, ILD patients more frequently had elevated LDH, C-reactive protein, and D-dimer levels (all p < 0.05). A multivariate analysis showed that chronic kidney disease and respiratory insufficiency on admission were predictors of ventilatory support, and that older age, kidney disease and elevated LDH were predictors of death. CONCLUSIONS Our data show that ILD patients admitted for COVID-19 are older, have more comorbidities, more frequently require ventilatory support and have higher mortality than those without ILDs. Older age, kidney disease and LDH were independent predictors of mortality in this population.S

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

MIBiG 3.0 : a community-driven effort to annotate experimentally validated biosynthetic gene clusters

With an ever-increasing amount of (meta)genomic data being deposited in sequence databases, (meta)genome mining for natural product biosynthetic pathways occupies a critical role in the discovery of novel pharmaceutical drugs, crop protection agents and biomaterials. The genes that encode these pathways are often organised into biosynthetic gene clusters (BGCs). In 2015, we defined the Minimum Information about a Biosynthetic Gene cluster (MIBiG): a standardised data format that describes the minimally required information to uniquely characterise a BGC. We simultaneously constructed an accompanying online database of BGCs, which has since been widely used by the community as a reference dataset for BGCs and was expanded to 2021 entries in 2019 (MIBiG 2.0). Here, we describe MIBiG 3.0, a database update comprising large-scale validation and re-annotation of existing entries and 661 new entries. Particular attention was paid to the annotation of compound structures and biological activities, as well as protein domain selectivities. Together, these new features keep the database up-to-date, and will provide new opportunities for the scientific community to use its freely available data, e.g. for the training of new machine learning models to predict sequence-structure-function relationships for diverse natural products. MIBiG 3.0 is accessible online at https://mibig.secondarymetabolites.org/

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Factores asociados al conocimiento de las señales de alarma en el embarazo en gestantes, Lima 2017

Objetivo: Determinar los factores asociados al nivel de conocimiento de las señales de alarma en el embarazo en gestantes atendidas en los consultorios externos pertenecientes al Departamento de Ginecología y Obstetricia en el Hospital Nacional Hipólito Unanue en 2017. Materiales y métodos: Estudio transversal, observacional, analítico; con muestro no probabilístico por conveniencia a 196 gestantes de consultorios externos del Departamento de Ginecología y Obstetricia en el Hospital Nacional Hipólito Unanue durante los meses de octubre, noviembre y diciembre 2017. Los datos fueron recolectados con una encuesta estructurada y las variables categóricas se analizaron con test de chi2 y se utilizó el modelo de regresión logística, calculándose OR ajustados con sus respectivos intervalos de confianza. Resultados: Edad promedio de 26 años ± 5.36 años. La soltería en las gestantes actúo como un factor protector del nivel de conocimiento alto de las señales de alarma del embarazo (OR: 0.362; IC95%: 0.362-0.947; p=0.033). Conclusiones: Existe una relación entre gestantes solteras con el nivel de conocimiento alto de las señales de alarma en el embarazo en la población del Hospital Nacional Hipólito Unanue en el 2017, si la gestante es soltera presenta 0.3 veces la posibilidad de tener un nivel alto de conocimiento de las señales de alarma en el embarazo; actúa como factor protector

Impact of renal function on admission in COVID-19 patients: an analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID 19) Registry.

Coronavirus disease 2019 (COVID-19) is a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite its international aggressive extension, with a significant morbidity and mortality, the impact of renal function on its prognosis is uncertain. Analysis from the international HOPE-Registry (NCT04334291). The objective was to evaluate the association between kidney failure severity on admission with the mortality of patients with SARS-CoV-2 infection. Patients were categorized in 3 groups according to the estimated glomerular filtration rate on admission (eGFR > 60 mL/min/1.73 m2, eGFR 30-60 mL/min/1.73 m2 and eGFR  60 mL/min/1.73 m2, eGFR 30-60 mL/min/1.73 m2 and eGFR  758 patients were included: mean age was 66 ± 18 years, and 58.6% of patient were male. Only 8.5% of patients had a history of chronic kidney disease (CKD); however, 30% of patients had kidney dysfunction upon admission (eGFR  60 vs eGFR 30-60 vs and eGFR  Renal failure on admission in patients with SARS-CoV-2 infection is frequent and is associated with a greater number of complications and in-hospital mortality. Our data comes from a multicenter registry and therefore does not allow to have a precise mortality risk assessment. More studies are needed to confirm these findings

Renin-angiotensin system inhibitors effect before and during hospitalization in COVID-19 outcomes: Final analysis of the international HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID-19) registry.

The use of Renin-Angiotensin system inhibitors (RASi) in patients with coronavirus disease 2019 (COVID-19) has been questioned because both share a target receptor site. HOPE-COVID-19 (NCT04334291) is an international investigator-initiated registry. Patients are eligible when discharged after an in-hospital stay with COVID-19, dead or alive. Here, we analyze the impact of previous and continued in-hospital treatment with RASi in all-cause mortality and the development of in-stay complications. We included 6503 patients, over 18 years, from Spain and Italy with data on their RASi status. Of those, 36.8% were receiving any RASi before admission. RASi patients were older, more frequently male, with more comorbidities and frailer. Their probability of death and ICU admission was higher. However, after adjustment, these differences disappeared. Regarding RASi in-hospital use, those who continued the treatment were younger, with balanced comorbidities but with less severe COVID19. Raw mortality and secondary events were less frequent in RASi. After adjustment, patients receiving RASi still presented significantly better outcomes, with less mortality, ICU admissions, respiratory insufficiency, need for mechanical ventilation or prone, sepsis, SIRS and renal failure (p RASi historic use, at admission, is not related to an adjusted worse prognosis in hospitalized COVID-19 patients, although it points out a high-risk population. In this setting, the in-hospital prescription of RASi is associated with improved survival and fewer short-term complications

Very high energy gamma-ray observation of the peculiar transient event Swift J1644+57 with the MAGIC telescopes and AGILE

Context. On March 28, 2011, the BAT instrument on board the Swift satellite detected a new transient event that in the very beginning was classified as a gamma ray burst (GRB). However, the unusual X-ray flaring activity observed from a few hours up to days after the onset of the event made a different nature seem to be more likely. The long-lasting activity in the X-ray band, followed by a delayed brightening of the source in infrared and radio activity, suggested that it is better interpreted as a tidal disruption event that triggered a dormant black hole in the nucleus of the host galaxy and generated an outflowing jet of relativistic matter. Aims. Detecting a very high energy emission component from such a peculiar object would be enable us to constrain the dynamic of the emission processes and the jet model by providing information on the Doppler factor of the relativistic ejecta. Methods. The MAGIC telescopes observed the peculiar source Swift J1644+57 during the flaring phase, searching for gamma-ray emission at very-high energy (VHE, E > 100 GeV), starting observations nearly 2.5 days after the trigger time. MAGIC collected a total of 28 h of data during 12 nights. The source was observed in wobble mode during dark time at a mean zenith angle of 35 degrees. Data were reduced using a new image-cleaning algorithm, the so-called sum-cleaning, which guarantees a better noise suppression and a lower energy threshold than the standard analysis procedure. Results. No clear evidence for emission above the energy threshold of 100 GeV was found. MAGIC observations permit one to constrain the emission from the source down to 100 GeV, which favors models that explain the observed lower energy variable emission. Data analysis of simultaneous observations from AGILE, Fermi and VERITAS also provide negative detection, which additionally constrain the self-Compton emission component

Middle Jurassic-Late Cretaceous Paleogeography of the Western Margin of the Neuquén Basin (34° 30′–36° S)

U–Pb dating of detrital and igneous zircons from the retroarc deposits of the Neuquén Basin has shed light over the Mesozoic evolution of the western border of South America, yet the coeval arc and forearc regions remain mostly indirectly characterized. Furthermore, recent paleogeographic reconstructions consider the arc and forearc regions as a tectonically stable and static region at least until Late Cretaceous. In this chapter, we aim to contribute to the Middle Jurassic-Late Cretaceous paleogeographic reconstructions of the western margin of South America from a western point of view integrating the coeval arc and forearc evolution, between 34° 30′ and 36° S. We focus here in the deposits exposed along the Chilean slope of the Principal Cordillera and use four new detrital zircon age data to determine their ages and main source areas. These ages are compared with 38 published U–Pb detrital zircon ages and integrated into a series of paleogeographic cross sections which illustrate the Mesozoic evolution along the Southern Central Andes encompassing the forearc, arc, and retroarc regions. Our data show that the arc and forearc regions were active at least since the Middle Jurassic. Evidence for this tectonic activity corresponds to the development of forearc basins in the Middle Jurassic and Early Cretaceous times. New ages along the Chilean slope of the Andes allow suggesting an early beginning for the compressive period during the latest Early Cretaceous. The formation of a geographic barrier, as a consequence of the compressive regime, would explain the differences in the sediments provenance between western and eastern deposits during the latest Late Cretaceous. Finally, the almost complete record of Mesozoic ages in the detrital and volcanic deposits of the western slope of the Southern Central Andes constitutes a counter-argument about the null or waning activity proposed for the Middle Jurassic or Late Cretaceous from U–Pb detrital zircon analysis of the eastern Mesozoic deposits. Conversely, our data indicate a continued activity of the arc-related volcanism and magmatism throughout all the Mesozoic time.Fil: Tapia Silva, Felipe Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Estudios Andinos "Don Pablo Groeber". Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Estudios Andinos "Don Pablo Groeber"; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Geología; ArgentinaFil: Muñoz, Marcia. Universidad Andrés Bello; ChileFil: Farías, Marcelo. Universidad de Chile. Facultad de Ciencias Físicas y Matemáticas. Departamento de Geología; ChileFil: Charrier, Reynaldo. Universidad Andrés Bello; ChileFil: Astaburuaga, Daniela. Universidad de Chile. Facultad de Ciencias Físicas y Matemáticas. Departamento de Geología; Chil

Transcatheter Mitral Repair for Functional Mitral Regurgitation According to Left Ventricular Function: A Real-Life Propensity-Score Matched Study

Background: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip&reg; between two groups according to LVEF. Methods: In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF &lt;30%. The primary endpoint was the combined one-year all-cause mortality and unplanned hospital readmissions due to HF. The secondary end-points were New York Heart Association (NYHA) functional class and mitral regurgitation (MR) severity. Propensity-score matching was used to create two groups with the same baseline characteristics, except for baseline LVEF. Results: Among 535 FMR eligible patients, 144 patients with LVEF &lt;30% (group 1) and 144 with LVEF &gt;30% (group 2) had similar propensity scores and were included in the analyses. The primary study endpoint was significantlly higher in group 1 (33.3% vs. 9.4%, p = 0.002). There was a maintained improvement in secondary endpoints without significant differences among groups. Conclusion: FMR patients with LVEF &lt;30% treated with MitraClip&reg; had higher mortality and readmissions than patients with LVEF &ge;30% treated with the same device. However, both groups improved the NYHA functional class and MR severity