Blood biomarker changes following therapeutic hypothermia in ischemic stroke

Biomarkers; Hypothermia; IschemiaBiomarcadores; Hipotermia; IsquemiaBiomarcadors; Hipotèrmia; IsquèmiaIntroduction Therapeutic hypothermia is a promising candidate for stroke treatment although its efficacy has not yet been demonstrated in patients. Changes in blood molecules could act as surrogate markers to evaluate the efficacy and safety of therapeutic cooling. Methods Blood samples from 54 patients included in the EuroHYP-1 study (27 treated with hypothermia, and 27 controls) were obtained at baseline, 24 ± 2 h, and 72 ± 4 h. The levels of a panel of 27 biomarkers, including matrix metalloproteinases and cardiac and inflammatory markers, were measured. Results Metalloproteinase-3 (MMP-3), fatty-acid-binding protein (FABP), and interleukin-8 (IL-8) increased over time in relation to the hypothermia treatment. Statistically significant correlations between the minimum temperature achieved by each patient in the hypothermia group and the MMP-3 level measured at 72 h, FABP level measured at 24 h, and IL-8 levels measured at 24 and 72 h were found. No differential biomarker levels were observed in patients with poor or favorable outcomes according to modified Rankin Scale scores. Conclusion Although the exact roles of MMP3, FABP, and IL-8 in hypothermia-treated stroke patients are not known, further exploration is needed to confirm their roles in brain ischemia

Surface wind over Europe: Data and variability

This work improves the characterization and knowledge of the surface wind climatology over Europe with the development of an observational database with unprecedented quality control (QC), the European Surface Wind Observational database (EuSWiO). EuSWiO includes more than 3,829 stations with sub-daily resolution for wind speed and direction, with a number of sites spanning the period of 1880–2017, a few hundred time series starting in the 1930s and relatively good spatial coverage since the 1970s. The creation of EuSWiO entails the merging of eight different data sets and its submission to a common QC. About 5% of the total observations were flagged, correcting a great part of the extreme and unrealistic values, which have a discernible impact on the statistics of the database. The daily wind variability was characterized by means of a classification technique, identifying 11 independent subregions with distinct temporal wind variability over the 2000–2015 period. Significant decreases in the wind speed during this period are found in five regions, whereas two regions show increases. Most regions allow for extending the analysis to earlier decades. Caution in interpreting long-term trends is needed as wind speed data have not been homogenized. Nevertheless, decreases in the wind speed since the 1980s can be noticed in most of the regions. This work contributes to a deeper understanding of the temporal and spatial surface wind variability in Europe. It will allow from meteorological to climate and climate change studies, including potential applications to the analyses of extreme events, wind power assessments or the evaluation of reanalysis or model-data comparison exercises at continental scales

Ampliar el estudio de la oferta y demanda de servicios ecosistémicos e incorporarlo a la gestión sostenible en los paisajes agropecuarios de la altillanura plana del departamento del Meta

CORMACARENA y el Instituto Humboldt han trabajado de manera conjunta desde 2012, aunando esfuerzos para avanzar hacia la construcción y consolidación tanto de una estrategia, como de un equipo interinstitucional e interdisciplinario para la gestión de los Servicios Ecosistémicos en paisajes agropecuarios, en el marco del proyecto "Caracterización, valoración y análisis de las relaciones de oferta y demanda de servicios ecosistémicos como indicadores de sostenibilidad en paisajes agropecuarios de la Altillanura colombiana". De acuerdo a lo anterior, durante el año 2013 se suscribió el convenio interadministrativo No PE.GDE.1.4.8.1.13.015 del 2013, entre la Corporación y el Instituto de Investigación de Recursos Biológicos Alexander von Humboldt (INSTITUTO HUMBOLDT), cuyo objeto fue "Aunar esfuerzos entre las entidades cooperantes (lAVH y CORMACARENA) para avanzar en la gestión y desarrollo del proyecto: Caracterización y Valoración de los Servicios Ecosistémicos como Indicadores de Sostenibilidad en Paisajes Agropecuarios de la Altillanura ColombianaBogotáCiencias sociales y saberes de la Biodiversida

Report on WRF model sensitivity studies and specifications for the mesoscale wind atlas production runs:Deliverable D4.3

This report describes the sensitivity studies performed with the mesoscale model WRF in preparation of the mesoscale wind atlas production runs. The objective of this work was to find a model setup that is not just a best practice setup but well-founded and based on scientific evaluation. We started with performing some initial sensitivity experiments changing the PBL scheme and the initialisation of the model. The work was distributed among several partners, each conducting the same set of experiments but on a different domain. The objective of this first phase was to ensure that everybody speaks the same language in terms of applying WRF in the context of NEWA. The results were analysed and compared in terms of the mean wind climate. To draw conclusions regarding the quality of the experiments, the results of one domain were compared to tall mast observations. Overall the model showed a good performance with slightly better results for one of the two tested PBL schemes (MYNN) and weekly initialisation of simulations (compared to daily). In the next phase, further sensitivity tests were conducted for one of the previously defined domains, varying a multitude of parameters as e.g. model version, vertical resolution, forcing data and land surface parameterisation. These studies showed that virtually each parameter change is affecting the results in some way, while significant effects on the wind climate are mostly obtained by changes in physical parameterisation e.g. PBL scheme, representation of the land surface and surface roughness. However, also non-physical parameters as the simulation length and the domain size affects the results considerably. The results suggest to use rather small domains and not too long simulations (in the order of 1–2 weeks). One of the objectives of NEWA is to create a probabilistic wind atlas, i.e. to provide uncertainty information to the mesoscale wind atlas (see Deliverables D3.1 and D4.4). This will be achieved by generating an ensemble of WRF simulations with different model configurations. While the final ensemble to be run over the complete NEWA domain will only include a few members, a much larger ensemble was run for a smaller sub-domain to find the ensemble members that generate the largest spread and will be used in the final NEWA ensemble. A second objective of this initial large ensemble was to find an optimal setup for the mesoscale production run. Based on the experience gained in the previous sensitivity experiments, a 47-member ensemble was assembled and run. The individual members were compared against each other, as well as against tall mast observations. Different metrics were explored to assess the performance of the members, i.e. not only the usual statistical measures as RMSE, BIAS and correlation but also metrics that compare the wind speed distributions. In the final part of this report we present the ultimate WRF setup for the NEWA production run that was run between August 2018 and March 2019 on the MareNostrum supercomputer in Barcelona

Half a century of newborn screening in Spain: Evolution of ethical, legal and social issues (ELSIs). Part III, social issues

[ES] Las bases para la toma de decisiones acerca del desarrollo de los programas de cribado de Salud Pública no son exclusivamente médicas, sino también sociales. En esta parte III del artículo se contemplan los actores que intervienen en la gobernanza de los programas, cómo son las autoridades sanitarias, las sociedades científicas y profesionales, así como las familias y su movimiento asociativo. En primer lugar, se analiza el papel de las instituciones/autoridades sanitarias en el desarrollo de los programas y en la evolución del modelo para la toma de decisiones, hasta el actual basado en la evidencia, así como en la elaboración de una opinión experta, imparcial y transparente en política sanitaria y su coordinación en el marco del Sistema Nacional de Salud (SNS). Y, de acuerdo con dicha evidencia y con el consenso, las instituciones/autoridades sanitarias han tratado de conseguir un abordaje más homogéneo y conforme a criterios de calidad del programa de cribado neonatal en todo el territorio. A continuación, se aborda el papel de las sociedades científicas y profesionales, especialmente de la Sociedad Española de Química Clínica (actualmente Sociedad Española de Medicina de Laboratorio (SEQCML), a través de la Comisión de Errores Congénitos del Metabolismo, y de la Asociación Española de Cribado Neonatal (AECNE), que desde 1985 y durante 33 años recogieron los datos de actividad de los centros de cribado y establecieron un foro de debate, intercambio de conocimientos y colaboración entre ellos y con las autoridades sanitarias. De ellas, destaca el importante papel de la Asociación Española de Errores Congénitos del Metabolismo (AECOM) desde 1999 en el diagnóstico, seguimiento y tratamiento de los pacientes. Finalmente, se contempla el papel de las familias y los aspectos psicosociales del programa, así como la evolución del movimiento asociativo, con especial mención a la fundación en 1990 de la Federación Española de PKU y otros trastornos (FAEPKU) (que pasó después a llamarse la Federación Española de Enfermedades Metabólicas Hereditarias) y en 1999 de la Federación Española de Enfermedades Raras (FEDER). Estas asociaciones han contribuido notablemente al empoderamiento de los pacientes, a apoyar la investigación y la formación y a establecer una red de colaboración y soporte para los pacientes y sus familias. Y aunque están en contacto y colaboran con las autoridades sanitarias, hasta el momento no han participado en la elaboración de decisiones y en la gobernanza de los programas. El espíritu de superación y mejora ha marcado la evolución de los programas durante este medio siglo al incluir el desarrollo de sus aspectos éticos, legales y sociales. Se avecinan desafíos tecnológicos importantes y habrá que saber utilizarlos con eficiencia, proporcionalidad y justicia en el mejor interés del niño y, por extensión, de la familia y de la sociedad. [EN] Decision making for the development of newborn screening programs is based on not only medical but also social concerns and involves different stakeholders. Part III of the article focuses on their role in the governance of the programs. First of all, we consider the proactive role that health authorities has played in the evolution to an evidentiary model of policy development currently based on evidence, just as in the preparation of an expert, impartial and transparent opinion on health policy and its coordination with the national health system. And, in accordance with this evidence and with the consensus, health autorities following quality criteria have made an attempt to achieve a more homogeneous approach of the neonatal screening program throughout the territory. Secondly, we address the role of several scientific and professional societies in newborn screening. Among them, it deserves to be mentioned the Spanish Society for Clinical Chemistry, currently Spanish Society of Laboratory Medicine (SEQCML), and its Commission of inborn errors of metabolism and the Spanish Society for Newborn Screening (AECNE), which since 1985 and for thirty three years collected the activity of newborn screening centers and established a forum for debate, sharing of knowledge and cooperation among screening centers and with health authorities. Since 1999, the Spanish Society for Inborn Errors of Metabolism (AECOM) exercises an important activity in the field of diagnosis treatment and follow up of patients. Finally, we consider the role of families and the psychosocial aspects of the programme, and the associative activity of patient organizations. In 1990 the Spanish federation of PKU and other disorders (FAEPKU) was found, renamed currently as The Spanish Federation of Inherited Metabolic Diseases; together with the Spanish Federation for Rare Diseases (FEDER), found in 1999, they both have clearly contributed to the patient’s empowerment, supporting research and education and establishing a network of cooperation and support for patients and their families. Patient organizations collaborate with health authorities but they have not participated in policy decision making yet. During this half century, the evolution of newborn screening programs have been characterized for a spirit of improvement, by including the development of ethical, legal and social issues. Important technological challenges lie ahead and it will be necessary to know how to use them efficiently, proportionally and fairly in the best interest of newborns and by extension of their family and society.S

Half a century of newborn screening in Spain: Evolution of ethical, legal and social issues (ELSIs). Part II, legal system

[ES] El cribado neonatal es una actuación sanitaria regulada específicamente en nuestra legislación. El ordenamiento jurídico establece que el cribado sanitario es una actuación de salud pública, enfocada a la prevención de la salud de la sociedad en general y, a la vez, una prestación sanitaria, es decir, un derecho de los individuos, cuyo interés constituye el eje de la regulación. En su diseño e implantación están involucradas las autoridades sanitarias estatales y autonómicas. La eficacia, eficiencia y calidad son los criterios para valorar su idoneidad, y la adopción de medidas que garanticen los derechos de los participantes, la trasparencia y la voluntariedad, son imprescindibles para su aprobación. Estas exigencias generales se refuerzan cuando el cribado se dirige a la población pediátrica y cuando se trata de cribados genéticos, caso en que está prevista la revisión por parte de un comité de ética como requisito previo a su autorización. [EN] Neonatal screening is a health action specifically regulated in our legislation. The legal system establishes that health screening is a public health action, focused on the prevention of health of the community in general and, at the same time, a health service, that is, a right of individuals, whose interest is the focus of the regulation. In its design and implementation are involved the State and Regional Health Authorities. The effectiveness, efficiency and quality, are the criteria for assessing its suitability, and the adoption of measures to ensure the rights of participants, transparency and voluntariness, are essential for approval. These general requirements are reinforced when the screening is aimed at the paediatric population and when it comes to genetic screening, in which case a review by an ethics committee is foreseen as a prerequisite for authorization.Grupo de Investigación Cátedra de Derecho y Genoma Humano. Financiado por el Departamento de Educación del Gobierno Vasco (Grupos de Investigación del Sistema Universitario Vasco. Referencia número IT1066-16).N

Randomized Clinical Trials of obesity treatments in Mexican population. Systematic Review and Meta-Analysis

Background: Mexicans and Mexican Americans share similar culture, genetic background, and predisposition for obesity and diabetes. Randomized clinical trials (RCT) assessing obesity treatments (ObT) are reliable to assess efficacy. To date, there is no systematic review to investigate ObT tested by RCT in Mexican adults. Methods: We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve ObT RCT from 1990 to 2019. The ObT included alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions. The analyzed RCT were at least three months of duration, and reported: BMI, weight, waist circumference, triglycerides, glucose and blood pressure. Results: We found 634 entries; after removal of duplicates and exclusions based on eligibility criteria, we analyzed 43 and 2 multinational-collaborative studies. Most of the national studies had small sample sizes, and did not have replications from other studies. The nutrition/behavioral interventions were difficult to blind, and most studies had medium to high risk of bias. Random effects meta-analysis of nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like plain water instead of sweet beverages decreased triglycerides and systolic blood pressure. Participants with obesity and hypertension had beneficial effects with antioxidants, and the treatment with insulin increased weight in those with T2D. Conclusions: The RCT’s in Mexico reported effects on metabolic components despite small sample sizes and lack of replication. In the future we should analyze ObT in population living on the U.S.-Mexico border; therefore, bi-national collaboration is desirable to disentangle cultural effects on ObT response