Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

La renovación de la palabra en el bicentenario de la Argentina : los colores de la mirada lingüística

El libro reúne trabajos en los que se exponen resultados de investigaciones presentadas por investigadores de Argentina, Chile, Brasil, España, Italia y Alemania en el XII Congreso de la Sociedad Argentina de Lingüística (SAL), Bicentenario: la renovación de la palabra, realizado en Mendoza, Argentina, entre el 6 y el 9 de abril de 2010. Las temáticas abordadas en los 167 capítulos muestran las grandes líneas de investigación que se desarrollan fundamentalmente en nuestro país, pero también en los otros países mencionados arriba, y señalan además las áreas que recién se inician, con poca tradición en nuestro país y que deberían fomentarse. Los trabajos aquí publicados se enmarcan dentro de las siguientes disciplinas y/o campos de investigación: Fonología, Sintaxis, Semántica y Pragmática, Lingüística Cognitiva, Análisis del Discurso, Psicolingüística, Adquisición de la Lengua, Sociolingüística y Dialectología, Didáctica de la lengua, Lingüística Aplicada, Lingüística Computacional, Historia de la Lengua y la Lingüística, Lenguas Aborígenes, Filosofía del Lenguaje, Lexicología y Terminología

Searching for a cell-based therapeutic tool for haemophilia A within the embryonic/foetal liver and the aorta-gonads-mesonephros region

The development of new strategies based on cell therapy approaches to correct haemophilia A (HA) requires further insights into new cell populations capable of producing coagulation factor VIII (FVIII) and presenting stable engraftment potential. The major producers of FVIII in the adult are liver sinusoidal endothelial cells (LSECs) and in a lesser degree bone marrowderived cells, both of which have been shown to ameliorate the bleeding phenotype in adult HA mice after transplantation. We have previously shown that cells from the foetal liver (FL) and the aorta-gonads-mesonephros (AGM) haematopoietic locations possess higher LSEC engraftment potential in newborn mice compared with adult-derived LSECs, constituting likely therapeutic targets for the treatment of HA in neonates. However, less is known about the production of FVIII in embryonic locations. Quantitative polymerase chain reaction and Western blot analysis were performed to assess the relative level of FVIII production in different embryonic tissues and at various developmental stages, identifying the FL and AGM region from day 12 (E12) as prominent sources of FVIII. Furthermore, FL-derived VEcadþCD45- Lyve1þ/ endothelial/endothelial progenitor cells, presenting vascular engraftment potential, produced high levels of F8 ribonucleic acid compared with CD45þ blood progenitors or Dlk1þ hepatoblasts. In addition, we show that the E11 AGM explant cultures expanded cells with LSEC repopulation activity, instrumental to further understand signals for in vitro generation of LSECs. Taking into account the capacity for FVIII expression, culture expansion and newborn engraftment potential, these results support the use of cells with foetal characteristics for correction of FVIII deficiency in young individuals

Searching for a Cell-Based Therapeutic Tool for Haemophilia A within the Embryonic/Foetal Liver and the Aorta-Gonads-Mesonephros Region

The development of new strategies based on cell therapy approaches to correct haemophilia A (HA) requires further insights into new cell populations capable of producing coagulation factor VIII (FVIII) and presenting stable engraftment potential. The major producers of FVIII in the adult are liver sinusoidal endothelial cells (LSECs) and in a lesser degree bone marrow-derived cells, both of which have been shown to ameliorate the bleeding phenotype in adult HA mice after transplantation. We have previously shown that cells from the foetal liver (FL) and the aorta-gonads-mesonephros (AGM) haematopoietic locations possess higher LSEC engraftment potential in newborn mice compared with adult-derived LSECs, constituting likely therapeutic targets for the treatment of HA in neonates. However, less is known about the production of FVIII in embryonic locations. Quantitative polymerase chain reaction and Western blot analysis were performed to assess the relative level of FVIII production in different embryonic tissues and at various developmental stages, identifying the FL and AGM region from day 12 (E12) as prominent sources of FVIII. Furthermore, FL-derived VE-cad+CD45-Lyve1+/− endothelial/endothelial progenitor cells, presenting vascular engraftment potential, produced high levels of F8 ribonucleic acid compared with CD45+ blood progenitors or Dlk1+ hepatoblasts. In addition, we show that the E11 AGM explant cultures expanded cells with LSEC repopulation activity, instrumental to further understand signals for in vitro generation of LSECs. Taking into account the capacity for FVIII expression, culture expansion and newborn engraftment potential, these results support the use of cells with foetal characteristics for correction of FVIII deficiency in young individuals.This work was supported by the Spanish Ministry of Science and Technology Grant BFU2010–15801; Junta de Andalucia Research Funding Program PAI-BIO-295 and the Andalusian Association of Haemophilia ASANHEMO FV2016–20

Bajo el signo de la luz : la fundación de una utopía andaluza

Esta publicación obtuvo el Primer Premio Joaquín Guichot a investigaciones, experiencias y materiales sobre Andalucía y su cultura en la edición XXVI del curso 2013/2014Se trata de un proyecto intercentros en el que se pretende convertir en aula a la comunidad. Nace para dar respuesta a las inquietudes de un alumnado y una población que ignoran, en buena medida, sus orígenes y los de sus antepasados. Como respuesta a esa necesidad, se vuelve sobre las huellas del tiempo para descubrir la epopeya de las nuevas poblaciones de Sierra Morena y Andalucía; una iniciativa que respondió a los ideales del Siglo de las Luces y a la necesidad de poblar los extensos terrenos que bordeaban el Camino Real. Con el formato de aprendizaje-servicio a la comunidad, el alumnado descubrirá que sus raíces culturales, sus apellidos y tradiciones, lejos de los localismos, provienen de Europa Central y suponen un ejemplo de integración cultural. "Bajo el signo de la luz" va más allá y sueña con llevar la utopía a la educación e intenta convertirse en un paradigma de integración del trabajo de Educación Infantil, Primaria y Secundaria, o de cualesquiera otras enseñanzas, y se apoya en el deseo idealista de dar a conocer la cultura andaluza al alumnado de nuestra Comunidad Autónoma.AndalucíaES

Anales de Edafología y Agrobiología Tomo 41 Número 9-10

Suelos. Características petroquímicas y micromorfológicas de Haploxeralfs, por P. Arévalo. J. Gallardo y J. Benayas.-- Determinación de manganeso total en suelos, por J. Moreno Caselles, M. Guillén y M. Romero.-- Rendolles de la Sierra de María (Almería), por L J. Alias y J. Martínez.-- Estudio de tres perfiles de suelos de La Alpujarra, por Barahona. E., García Chicano. J. L. Guardiola. J. L. lriarte. A, Pérez-Pujalte, A. y Quirantes, J.-- Detección de concordancias fisonómico-edáficas por J. M. Gómez. R. Rodríguez González. A. García Miranda y C. de Hoyos Alonso.-- Suelos y sedimentos de zonas semiáridas, por A. García Rodríguez, J. Forteza Bonnin y L F. Lorenzo Martín.-- Suelos sobre jumillita de la Sierra de las Cabras (Albacete), por Joaquín Hernández Bastida, María Teresa Fernández Tapia y Francisco Alcaraz Ariza.-- Estudio microscópico de aridisoles de las Islas Canarias, por A. Rodríguez Rodríguez, M. C. Pérez Angles. M. C. Díez de la Lastra Bosch y E. Fernández Caldas.-- El material original: propiedades de los suelos de Galicia, por F. Macias. R. M. Calvo, C. García. E. García-Rodeja y B. Silva.-- Las sierras de Queixa e invernadeiro y sus estribaciones, por Grupo de Edafólogos de Santiago.-- Suelos forestales de la cordillera costero-catalana, por A. Escuredo. V. R. Vallejo y J. Bech.-- Materia orgánica de suelos forestales, por A. Escuredo. V. Vallejo y J. Bech.--Dificultades en el empleo del sistema "USDA-Soil Taxonomy", por Carlos Roquero de Laburu.-- Nematodos fitoparásitos de la superfamilia "criconematoidea", por A. Bello y Ma. Paz Lara.—Silicatos. Retención del diazinon por montmorillonita, sepiolita y caolinita, por G. Dios Cancela, S. González García y M. Martín Aguilar.—Geoquímica. Alteración de minerales de estaño, por Guijarro, J. Casas, J. y Hoyos, M.A.—Nutrición y Fisiología Vegetal.-- Capacidad fotosintética de maíz, por U. Velázquez, M. Lasaña y J. Cardus.-- El alerce en Chile. II. Su nutrición mineral, por M. Lachica, C. González O. y M. Baez. C. Anomalías por deficiencias de Ca o de Mg en raíces de plantas de zea mays L., por José Manuel Pozuelo Guanche.-- Competencia de avena sterilis L .. por R. González Ponce.-- Abcisión de las hojas de phaseolus vulgaris, por Ana María Vieitez y María Luisa Vieitez. El castaño y su resistencia a phytophthora cinnamomi y Ph. cambivora, por Ernesto Vieitez, María Luisa Vieitez y Ana María Vieitez.-- Observaciones sobre el injerto juvenil.del castaño, por María Luisa Vieitez y Ana María Vieitez.-- Crecimiento y nutrición del trébol violeta, por J. Arines y R. Fábregas.-- La proliferación celular en meristemos. por G. Giménez-Manín, J. F. López-Sáez, A. González-Fernández. C. de la Torre y M. H. Navarrete.—Microbiología.-- Formaciones quiméricas anómalas en cultivos bacterianos, por Román de Vicente. Análisis.-- Determinación de fenoles y formas de N en aguas, por Bolarin, M. C. Romero, M. y Caro, M.-- Agua Reutilización de aguas y lodos residuales. I., por Sa/got, M. y Cardus, J. II por Felipo M. T., Garau, M. A., Pascual, M. D. y Cardus, J.-- Ecología. Aspectos ecológicos de sotos y riberas, por Pedro Montserrat Recoder.-- Control Sanitario.Evolución de clorobencilato en brotes de limonero, por J. Ma. Abrisqueta, A. Onuño, J. Gómez y A. Hernansáez.-- Riesgos de los productos químicos potencialmente tóxicos, por Eugenio Laborda. Eduardo de la Peña y Elina Valcarece.-- Geografía. Otra crítica del neomalthusianismo, por María Isabel Bodega Fernández, Sici/ia Gutiérrez Ronco, María Asunción Martín Lou, Antonio Higueras Arnal y José Manuel Casas Torres.-- Notas.-- BibligrafíaPeer reviewe

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)