Heart failure and treatment with Sodium-glucose Co-transporter Inhibitor (SGLT2): dapagliflozin and its effects on the cardiac system

This article thoroughly examines the effectiveness of treatment with dapagliflozin, a sodium-glucose co-transporter inhibitor, in the context of heart failure. The primary focus of this analysis lies in evaluating patients' clinical condition, the diagnostic procedures employed, and the various medications used as part of the treatment regimen. The objective of this investigation is based on a meticulous analysis of relevant scientific articles. Classified as documentary research within the field of Applied Linguistics, this study draws upon research covering classification, pathophysiology, clinical presentation, diagnosis, pharmacological treatment, and the role of SGLT2 inhibitors in heart failure as its primary theoretical framework. The findings indicate dapagliflozin's efficacy in reducing the heart's ejection fraction, regardless of the presence of diabetes. However, it emphasizes the importance of a comprehensive medical assessment before initiating the use of this medication, highlighting the need for caution and appropriate professional supervision

ANÁLISIS DE LAS VENTAJAS Y DESVENTAJAS DE DOS PAQUETES DE CÓMPUTO, EMPLEANDO COMO CASO DE ESTUDIO UN PROCESO DE FABRICACIÓN DE TABICÓN (ANALYSIS OF THE ADVANTAGES AND DISADVANTAGES OF TWO COMPUTER PACKAGES, USING A TABICON MANUFACTURING PROCESS AS A CASE STUDY)

Resumen En el presente documento se realiza el análisis comparativo entre dos softwares de simulación, continuo y discreto, de un sistema de producción de tabicón ligero. A partir del tiempo estándar de cada una de las etapas del proceso, se definieron las variables y elementos necesarios para realizar los modelos de simulación. El análisis con el software Vensim (continuo) involucra ecuaciones matemáticas que reflejan el flujo de los materiales durante cada etapa, y con el sofware FlexSim (discreto), se obtuvieron resultados visuales además de gráficos estadísticos del proceso. En ambos modelos se evaluaron indicadores claves del proceso, como capacidad de producción, tiempos de entrega e inventario. Esto permitió demostrar que, al establecer adecuadamente las variables y parámetros, ambos softwares resultan ser una herramienta útil para la representación del proceso. Se pretende que este estudio sirva de apoyo, para comprender las ventajas y desventajas al realizar simulaciones mediante análisis continuo y discreto. Palabras clave: FlexSim, inventario en proceso, sistema push, Vensim. Abstract In this document, the comparative analysis between two simulation software, continuous and discrete, of a light partition production system. Starting from the standard time of each of the stages of the process, the variables and elements necessary to realice the simulation models were defined. The analysis with the Vensim software (continuous) involves mathematical equations that reflect the flow of the materials during each stage, and with the FlexSim software (discrete), visual results were obtained in addition to statistical graphics of the process. In both models, key indicators of the process were evaluated, such as production capacity, delivery times and inventory. This made it possible to demonstrate that, by properly setting the variables and parameters, both softwares turn out to be a useful tool for the representation of the process. This study is intended to provide support in understanding the advantages and disadvantages of performing simulations using continuous and discrete analysis Keywords: FlexSim, push system, Vensim, work in process

AI is a viable alternative to high throughput screening: a 318-target study

: High throughput screening (HTS) is routinely used to identify bioactive small molecules. This requires physical compounds, which limits coverage of accessible chemical space. Computational approaches combined with vast on-demand chemical libraries can access far greater chemical space, provided that the predictive accuracy is sufficient to identify useful molecules. Through the largest and most diverse virtual HTS campaign reported to date, comprising 318 individual projects, we demonstrate that our AtomNet® convolutional neural network successfully finds novel hits across every major therapeutic area and protein class. We address historical limitations of computational screening by demonstrating success for target proteins without known binders, high-quality X-ray crystal structures, or manual cherry-picking of compounds. We show that the molecules selected by the AtomNet® model are novel drug-like scaffolds rather than minor modifications to known bioactive compounds. Our empirical results suggest that computational methods can substantially replace HTS as the first step of small-molecule drug discovery

Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.

Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

“Teatro social y comunitario. Talleres y grupos. 4 experiencias paralelas en construcción en Córdoba, Argentina.” 2012-2013.

Estos escritos se decidieron publicar en forma de “bocetos para compartir, sin estar pulidos e intentando poder conservar la heterogeneidad y su riqueza creativa. Cada persona y experiencia son mundos en sí mismos. Nuestras historias y modos de contar son muy diferentes y se unen porque estuvimos compartiendo un proyecto de investigación dentro de la Universidad Nacional de Córdoba, y allí conversamos, reflexionamos y anduvimos intercambiando. Eso. Y que se disfrute.Los cinco relatos de las integrantes del Equipo “Teatro social y comunitario. Talleres y grupos. Cuatro experiencias paralelas en construcción en Córdoba, Argentina” pretenden ser una reflexión sobre nuestra práctica como teatristas provenientes de la universidad en algunos barrios de Córdoba. Pero no nos referimos al teatro que presenta su obra en una sala y que establece una comunicación esporádica del/de la artista con el público, ya que ese es un público que elige asistir a partir de una oferta y una grilla cada vez más amplia de espectá- culos teatrales en la ciudad. Nuestra deliberación está vinculada a un Teatro que tiene su origen en una inquietud de teatristas comprometidas con una política cultural que reconoce al Teatro como un hacer y un placer que permite expresarse y dar forma a la realidad de forma conjunta. Estas políticas culturales vienen impulsándose en las universidades nacionales a lo largo de la última década, particularmente desde las Secretarías de Extensión, así como también desde algunas cátedras. Tal es nuestro caso, en que iniciamos un proyecto de investigación1 ante la necesidad de compartir experiencias de grupos teatrales cuya coordinación está a cargo de estudiantes, egresadas/os o docentes universitarias/os. Por otra parte, observamos que algunas tesis de egresados/as en el último lustro se inclinan por abordar temáticas de teatro social2, lo que nos reafirma que es posible y es vital que el mundo académico se vincule e intercambie con aquellos saberes colectivos, populares, heterogéneos y movilizadores de sectores sociales que hasta ahora no han tenido acceso a una práctica artística tan enriquecedora como el teatro. Hemos encuadrado las distintas experiencias realizadas en ciertos barrios y lugares cordobeses dentro de lo que se denomina Teatro Comunitario, al que definimos de manera simple como un teatro de vecinos y vecinas, abierto a todos los que quieran formar parte, y que ocupan para sus actividades algún lugar público de la zona. Es un teatro que proviene de sectores con carencias y su público es el mismo vecindario al que pertenecen, u otros vecindarios donde son invitados y que generalmente no frecuentan el teatro. La investigadora Marcela Bidegain considera que el fenó- meno de teatros comunitarios “se multiplica y enlaza conformando red en diferentes lugares del país con vecinos que entienden el arte y la producción cultural como un lugar de participación ciudadana y transformación social.”3 Hasta la fecha se han realizado once encuentros nacionales con grupos de todas las provincias y si bien las experiencias cordobesas son en su mayoría embrionarias, algunas se han consolidad

Estudios multidisciplinarios en Ciencias de la Salud

Es una distinción, como miembro de la Comisión del Programa del Doctorado en Ciencias de la Salud de la Universidad Autónoma del Estado de México, presentar el libro titulado Estudios multidisciplinarios en Ciencias de la Salud, en el que distinguidos y reconocidos investigadores, entusiastas y comprometidos alumnos del programa nos dan a conocer los resultados de sus proyectos de investigación, trabajos que forman parte de los requisitos para acceder al grado de doctor. Entre las razones que invitan a la lectura del libro destaca su contenido conformado con la participación de autores en cuatro áreas en el campo de la salud: Odontología, Ciencias Médicas y Nutrición, Ciencias de la Conducta, y Enfermería y Obstetricia, quienes contribuyen a incrementar el acervo del conocimiento en cada área, en favor de la ciencia, la tecnología, y la salud física y mental de la población.Universidad Autónoma del Estado de México

The complete mitochondrial and plastid genomes of Corallina chilensis (Corallinaceae, Rhodophyta) from Tomales Bay, California, USA

Genomic analysis of the marine alga Corallina chilensis from Tomales Bay, California, USA, resulted in the assembly of its complete mitogenome (GenBank accession number MK598844) and plastid genome (GenBank MK598845). The mitogenome is 25,895 bp in length and contains 50 genes. The plastid genome is 178,350 bp and contains 233 genes. The organellar genomes share a high-level of gene synteny to other Corallinales. Comparison of rbcL and cox1 gene sequences of C. chilensis from Tomales Bay reveals it is identical to three specimens from British Columbia, Canada and very similar to a specimen of C. chilensis from southern California. These genetic data confirm that C. chilensis is distributed in Pacific North America