The Use of Corticosteroids or Tocilizumab in COVID-19 Based on Inflammatory Markers

SEMI-COVID-19 Network.[Background] The inflammatory cascade is the main cause of death in COVID-19 patients. Corticosteroids (CS) and tocilizumab (TCZ) are available to treat this escalation but which patients to administer it remains undefined.[Objective] We aimed to evaluate the efficacy of immunosuppressive/anti-inflammatory therapy in COVID-19, based on the degree of inflammation. .[Design] A retrospective cohort study with data on patients collected and followed up from March 1st, 2020, to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Patients under treatment with CS vs. those under CS plus TCZ were compared. Effectiveness was explored in 3 risk categories (low, intermediate, high) based on lymphocyte count, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and d-dimer values.[Patients] A total of 21,962 patients were included in the Registry by May 2021. Of these, 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ).[Main Measures] The primary outcome of the study was in-hospital mortality. Secondary outcomes were the composite variable of in-hospital mortality, requirement for high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIMV), invasive mechanical ventilation (IMV), or intensive care unit (ICU) admission.[Key Results] A total of 5940 met the inclusion criteria for the present study (5332 were treated with CS and 608 with CS plus TCZ). No significant differences were observed in either the low/intermediate-risk category (1.5% vs. 7.4%, p=0.175) or the high-risk category (23.1% vs. 20%, p=0.223) after propensity score matching. A statistically significant lower mortality was observed in the very high–risk category (31.9% vs. 23.9%, p=0.049).[Conclusions] The prescription of CS alone or in combination with TCZ should be based on the degrees of inflammation and reserve the CS plus TCZ combination for patients at high and especially very high risk.Peer reviewe

QUIJOTE scientific results - VIII. Diffuse polarized foregrounds from component separation with QUIJOTE-MFI

We derive linearly polarized astrophysical component maps in the Northern Sky from the QUIJOTE-MFI data at 11 and 13?GHz in combination with the Wilkinson Microwave Anisotropy Probe K and Ka bands (23 and 33?GHz) and all Planck polarized channels (30-353-GHz), using the parametric component separation method B-SeCRET. The addition of QUIJOTE-MFI data significantly improves the parameter estimation of the low-frequency foregrounds, especially the estimation of the synchrotron spectral index, [beta]s. We present the first detailed ?s map of the Northern Celestial Hemisphere at a smoothing scale of 2°. We find statistically significant spatial variability across the sky. We obtain an average value of ?3.08 and a dispersion of 0.13, considering only pixels with reliable goodness of fit. The power-law model of the synchrotron emission provides a good fit to the data outside the Galactic plane but fails to track the complexity within this region. Moreover, when we assume a synchrotron model with uniform curvature, cs, we find a value of cs = ?0.0797 ± 0.0012. However, there is insufficient statistical significance to determine which model is favoured, either the power law or the power law with uniform curvature. Furthermore, we estimate the thermal dust spectral parameters in polarization. Our cosmic microwave background, synchrotron, and thermal dust maps are highly correlated with the corresponding products of the PR4 Planck release, although some large-scale differences are observed in the synchrotron emission. Finally, we find that the ?s estimation in the high signal-to-noise synchrotron emission areas is prior-independent, while, outside these regions, the prior governs the [beta]s estimation.We thank the staff of the Teide Observatory for invaluable assistance in the commissioning and operation of QUIJOTE. The QUIJOTE experiment is being developed by the Instituto de Astrofisica de Canarias (IAC), the Instituto de Fisica de Cantabria (IFCA), and the Universities of Cantabria, Manchester, and Cambridge. Partial financial support was provided by the Spanish Ministry of Science and Innovation under the projects AYA2007-68058-C03-01, AYA2007- 68058-C03-02, AYA2010-21766-C03-01, AYA2010-21766-C03-02, AYA2014-60438-P, ESP2015-70646-C2-1-R, AYA2017-84185-P, ESP2017-83921-C2-1-R, AYA2017-90675-REDC (co-funded with EU FEDER funds), PGC2018-101814-B-I00, PID2019-110610RBC21, PID2020-120514GB-I00, IACA13-3E-2336, IACA15-BE3707, EQC2018-004918-P, the Severo Ochoa Programs SEV-2015- 0548 and CEX2019-000920-S, the Maria de Maeztu Program MDM2017-0765, and by the Consolider-Ingenio project CSD2010-00064 (EPI: Exploring the Physics of Inflation). We acknowledge support from the ACIISI, Consejeria de Economia, Conocimiento y Empleo del Gobierno de Canarias, and the European Regional Development Fund (ERDF) under grant with reference ProID2020010108. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement number 687312 (RADIOFOREGROUNDS). EdlH acknowledges financial support from the Concepcion´ Arenal Programme of the Universidad de Cantabria. DT acknowledges the support from the Chinese Academy of Sciences (CAS) President’s International Fellowship Initiative (PIFI) with grant no. 2020PM0042. FP acknowledges support from the Spanish State Research Agency (AEI) under grant number PID2019-105552RB-C43. The authors acknowledge the computer resources, technical expertise, and assistance provided by the Spanish Supercomputing Network (RES) node at Universidad de Cantabria. Some of the presented results are based on observations obtained with Planck (http://www.esa.int/Planck), an ESA science mission with instruments and contributions directly funded by ESA Member States, NASA, and Canada. We acknowledge the use of the Legacy Archive for Microwave Background Data Analysis (LAMBDA) and the Planck Legacy Archive (PLA). Support for LAMBDA is provided by the NASA Office of Space Science. Some of the results in this paper have been derived using the HEALPIX package (Gorski ´ et al. 2005), and the HEALPY (Zonca et al. 2019), NUMPY (Harris et al. 2020), EMCEE (ForemanMackey et al. 2013), and MATPLOTLIB (Hunter 2007) PYTHON packages

Seafloor Morphology and Processes in the Alboran Sea

The seafloor of the Alboran Sea reflects its complex tectonic, sedimentary, and oceanography dynamics as a consequence of the geological context, involving interaction between the Eurasian and African plates, and oceanographic context, as it is where the Atlantic and Mediterranean waters meet. Their physiography has a semi-enclosed configuration characterized by two margins (the Spanish Iberian and North Africa—mostly Moroccan margins) enclosing deep basins. Tectonic activity is mainly attested by folds and faults that predominantly affect the central and eastern seafloor sectors, as well as numerous seamounts and fluid-flow features (pockmarks, mud volcanoes, and diapirs) that dot the seafloor. The sedimentary and oceanographic processes allow us to distinctly define two principal environments in the Alboran Sea: the shallow proximal margin (continental shelf); and the deep distal margin (continental slope and base of the slope) with the adjacent sub-basins. The shelf mostly comprises prodeltaic and infralittoral prograding wedges, with local bedform fields, submarine valleys, and wave-cut terraces. Coastal and fluvio-marine sedimentary processes, acting since the last glacial period, are responsible for these features. The deep marine environment is characterised by the ubiquity of contourites, whose continuity is interrupted by turbidite systems, canyons, and landslides. The alongslope action of the Mediterranean waters and their interfaces with the Atlantic water has been the main process governing transport, seafloor reworking, and sedimentation of contourites. Mass-movement processes are responsible for the formation of: (1) turbidite systems—turbidity flows and mass flows were dominant during the last glacial sea-level lowstand, evolving to dilute gravity flows during present interglacial high stand; and (2) landslides—the main triggering factors comprising over-steepening, seismicity, under consolidation due to overpressure by interstitial fluids, stratigraphy, and high sedimentation rates. Locally, still-undetermined biological activity in the Spanish and coral activity in the Moroccan margin generated fields of mounded bioconstructions. The seafloor morphology of the Alboran Sea offers interesting clues for assessing the main potential geological hazards, with tectonic seismicity and landslides (as well as their related tsunamis) being some of the most important potential hazards affecting coastal populations. In addition, the seafloor morphology in combination with assemblages of habitat-forming species enables habitat identification and mapping.En prens

New discoveries of mud volcanoes on the Moroccan Atlantic continental margin (Gulf of Cádiz): morpho-structural characterization

10th International Conference on Gas in Marine Sediments, 6-11 September 2010, Listvyanka, RussiaDuring the MVSEIS-08 cruise of 2008, ten new mud volcanoes (MVs) were discovered on the offshore Moroccan continental margin (Gulf of Cádiz) at water depths between 750 and 1,600 m, using multibeam bathymetry, backscatter imagery, high-resolution seismic and gravity core data. Mud breccias were recovered in all cases, attesting to the nature of extrusion of these cones. The mud volcanoes are located in two fields: the MVSEIS, Moundforce, Pixie, Las Negras, Madrid, Guadix, Almanzor and El Cid MVs in the western Moroccan field, where mud volcanoes have long been suspected but to date not identified, and the Boabdil and Al Gacel MVs in the middle Moroccan field. Three main morphologies were observed: asymmetric, sub-circular and flat-topped cone-shaped types, this being the first report of asymmetric morphologies in the Gulf of Cádiz. Based on morpho-structural analysis, the features are interpreted to result from (1) repeated constructive (expulsion of fluid mud mixtures) and destructive (gravity-induced collapse and submarine landsliding) episodes and (2) interaction with bottom currentsDivisión de Geología Marina, Instituto Geológico y Minero de España, EspañaCentro Oceanográfico de Málaga, Instituto Español de Oceanografía, EspañaFacultad de Ciencias del Mar, Universidad de Cádiz, EspañaFacultad de Ciencias Geológicas, Universidad Complutense de Madrid, Españ

Higher versus lower nut consumption and changes in cognitive performance over two years in a population at risk of cognitive decline: a cohort study

Background: Tree nuts and peanuts (henceforth, nuts) are nutrient-dense foods rich in neuroprotective components; thus, their consumption could benefit cognitive health. However, evidence to date is limited and inconsistent regarding the potential benefits of nuts for cognitive function. Objective: To prospectively evaluate the association between nut consumption and 2-y changes in cognitive performance in older adults at cognitive decline risk. Methods: A total of 6,630 participants aged 55 to 75 y (mean age 65.0±4.9 y, 48.4% women) with overweight/obesity and metabolic syndrome completed a validated semi-quantitative food frequency questionnaire and a comprehensive battery of neuropsychological tests at baseline and a 2-y follow-up. Composite cognitive scores were used to assess global, general, attention, and executive function domains. Nut consumption was categorized as Results: Nut consumption was positively associated with 2-y changes in general cognitive function (P-trend Conclusion: Frequent nut consumption was associated with a smaller decline in general cognitive performance over 2 y in older adults at risk of cognitive decline. Randomized clinical trials to verify our findings are warranted

Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours : results from the COPPADIS cohort

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose

Epidemiological trends of HIV/HCV coinfection in Spain, 2015-2019

Altres ajuts: Spanish AIDS Research Network; European Funding for Regional Development (FEDER).Objectives: We assessed the prevalence of anti-hepatitis C virus (HCV) antibodies and active HCV infection (HCV-RNA-positive) in people living with HIV (PLWH) in Spain in 2019 and compared the results with those of four similar studies performed during 2015-2018. Methods: The study was performed in 41 centres. Sample size was estimated for an accuracy of 1%. Patients were selected by random sampling with proportional allocation. Results: The reference population comprised 41 973 PLWH, and the sample size was 1325. HCV serostatus was known in 1316 PLWH (99.3%), of whom 376 (28.6%) were HCV antibody (Ab)-positive (78.7% were prior injection drug users); 29 were HCV-RNA-positive (2.2%). Of the 29 HCV-RNA-positive PLWH, infection was chronic in 24, it was acute/recent in one, and it was of unknown duration in four. Cirrhosis was present in 71 (5.4%) PLWH overall, three (10.3%) HCV-RNA-positive patients and 68 (23.4%) of those who cleared HCV after anti-HCV therapy (p = 0.04). The prevalence of anti-HCV antibodies decreased steadily from 37.7% in 2015 to 28.6% in 2019 (p < 0.001); the prevalence of active HCV infection decreased from 22.1% in 2015 to 2.2% in 2019 (p < 0.001). Uptake of anti-HCV treatment increased from 53.9% in 2015 to 95.0% in 2019 (p < 0.001). Conclusions: In Spain, the prevalence of active HCV infection among PLWH at the end of 2019 was 2.2%, i.e. 90.0% lower than in 2015. Increased exposure to DAAs was probably the main reason for this sharp reduction. Despite the high coverage of treatment with direct-acting antiviral agents, HCV-related cirrhosis remains significant in this population