Blood Biomarker Panels for the Early Prediction of Stroke‐Associated Complications

Background Acute decompensated heart failure (ADHF) and respiratory tract infections (RTIs) are potentially life-threatening complications in patients experiencing stroke during hospitalization. We aimed to test whether blood biomarker panels might predict these complications early after admission. Methods and Results Nine hundred thirty-eight patients experiencing ischemic stroke were prospectively recruited in the Stroke-Chip study. Post-stroke complications during hospitalization were retrospectively evaluated. Blood samples were drawn within 6 hours after stroke onset, and 14 biomarkers were analyzed by immunoassays. Biomarker values were normalized using log-transformation and Z score. PanelomiX algorithm was used to select panels with the best accuracy for predicting ADHF and RTI. Logistic regression models were constructed with the clinical variables and the biomarker panels. The additional predictive value of the panels compared with the clinical model alone was evaluated by receiver operating characteristic curves. An internal validation through a 10-fold cross-validation with 3 repeats was performed. ADHF and RTI occurred in 19 (2%) and 86 (9.1%) cases, respectively. Three-biomarker panels were developed as predictors: vascular adhesion protein-1 >5.67, NT-proBNP (N-terminal pro-B-type natriuretic peptide) >4.98 and d-dimer >5.38 (sensitivity, 89.5%; specificity, 71.7%) for ADHF; and interleukin-6 >3.97, von Willebrand factor >3.67, and d-dimer >4.58 (sensitivity, 82.6%; specificity, 59.8%) for RTI. Both panels independently predicted stroke complications (panel for ADHF: odds ratio [OR] [95% CI], 10.1 [3-52.2]; panel for RTI: OR, 3.73 [1.95-7.14]) after adjustment by clinical confounders. The addition of the panel to clinical predictors significantly improved areas under the curve of the receiver operating characteristic curves in both cases. Conclusions Blood biomarkers could be useful for the early prediction of ADHF and RTI. Future studies should assess the usefulness of these panels in front of patients experiencing stroke with respiratory symptoms such as dyspnea

Factors associated with the clinical outcome of patients with relapsed/refractory CD19+acute lymphoblastic leukemia treated with ARI-0001 CART19-cell therapy

The prognosis of patients with relapsed/refractory (R/R) acute lymphoblastic leukemia (ALL) remains poor, particularly for those relapsing after allogeneic hema-topoietic cell transplantation (alloHCT). Novel agents such as inotuzumab ozogamicin or blinatumomab achieve increased response rates, but these are generally transient unless followed by alloHCT. Chimeric antigen receptors (CAR) targeting CD19 have shown promising results in R/R ALL, and one of these products (tisagenlecleucel) has been approved for the treatment of patients with R/R ALL up to 25 years of age

Why is the Winner the Best?

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multicenter study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and post-processing (66%). The “typical” lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work

Why is the winner the best?

International benchmarking competitions have become fundamental for the comparative performance assessment of image analysis methods. However, little attention has been given to investigating what can be learnt from these competitions. Do they really generate scientific progress? What are common and successful participation strategies? What makes a solution superior to a competing method? To address this gap in the literature, we performed a multicenter study with all 80 competitions that were conducted in the scope of IEEE ISBI 2021 and MICCAI 2021. Statistical analyses performed based on comprehensive descriptions of the submitted algorithms linked to their rank as well as the underlying participation strategies revealed common characteristics of winning solutions. These typically include the use of multi-task learning (63%) and/or multi-stage pipelines (61%), and a focus on augmentation (100%), image preprocessing (97%), data curation (79%), and post-processing (66%). The 'typical' lead of a winning team is a computer scientist with a doctoral degree, five years of experience in biomedical image analysis, and four years of experience in deep learning. Two core general development strategies stood out for highly-ranked teams: the reflection of the metrics in the method design and the focus on analyzing and handling failure cases. According to the organizers, 43% of the winning algorithms exceeded the state of the art but only 11% completely solved the respective domain problem. The insights of our study could help researchers (1) improve algorithm development strategies when approaching new problems, and (2) focus on open research questions revealed by this work

Estudio de las publicaciones periódicas españolas de tecnología e ingeniería mecánica y metalúrgica

18 páginas, 8 tablas.[EN] The present article studies the Spanish journals of mechanical and metallurgical technology and engineering, as a first approach to the current state of the main vehicles of diffusion of research in these areas of knowledge in Spain. Their formal features have been analyzed, the types of articles, the origin of contributions, etc. The sources for the analysis of the journals have been the ICYT data base and the original journals. The result is a classification of the Spanish journals of mechanical and metallurgical technology and engineering.[ES] En el presente artículo se ha realizado un estudio de las revistas españolas de tecnología e ingeniería mecánica y metalúrgica, con el objetivo de poder efectuar una primera aproximación al estado actual de los principales órganos de difusión de los avances de la investigación de este grupo de áreas de conocimiento en España. Para ello se ha analizado la presentación de las mismas, los tipos de artículos más frecuentes, la procedencia de las contribuciones, etc. Los instrumentos básicos para el análisis de las revistas han sido la base de datos ICYT y las propias revistas. Como resultado se ofrece una clasificación de las revistas españolas de tecnología e ingeniería mecánica y metalúrgica.Peer reviewe

Frecuencia de uso de las plataformas virtuales de enseñanza. Una comparación Moodle versus Sakai en los estudios de perfil económico

So far the most common way in which the teaching process is carried out at college levels is through a mixed system (b-learning) in which classes will be complemented by a virtual system using any of the Learning Content Management Systems. One indicator of the successful implementation of these platforms is the frequency of use of the system, because when users have a more favourable attitude toward using the platform they use the system frequently and intensely. This paper presents a comparative analysis of the frequency of use stated by the students of two of the most popular free platforms (Moodle vs Sakai) and analyse the factors that have influence in a more intensive use comparing both systems. A survey of 606 students from two universities is used as a research tool. The results show the importance of several factors (perceived usefulness, ease of use and social influence) in the frequency of use and the equity of both platforms where only differences are found in Sakai users when access is performed with mobile devices.Con diferencia, la forma más habitual en la que se realiza el proceso de enseñanza-aprendizaje a niveles universitarios es mediante un sistema mixto (b-learning) en el que las clases presenciales se complementan con un sistema virtual que utiliza alguna de las plataformas virtuales de enseñanza. Uno de los indicadores del éxito en la implantación de estas plataformas es la frecuencia de uso del sistema, puesto que cuando los usuarios tienen una actitud más favorable hacia la plataforma la utilizan con mayor frecuencia. En este trabajo se realiza un análisis comparado de la frecuencia de uso declarada por los alumnos de dos de las plataformas libres de mayor implantación (Moodle vs Sakai) y se evalúan los factores que inciden en un uso más intensivo comparando ambos sistemas. Se utiliza como instrumento de investigación una encuesta a 606 alumnos de dos universidades. Los resultados muestran la importancia que tienen varios factores en el uso del sistema (utilidad percibida, facilidad de uso e influencia social) y la equidad de ambas plataformas donde solo se encuentran diferencias en la facilidad de uso de Sakai cuando el acceso se realiza con dispositivos móviles

Problemas de salud y la vulnerabilidad social en pacientes inmigrantes ingresados con patología infecciosa: estudio caso-control

Introducción. La necesidad de recursos sanitarios de la población inmigrante ha aumentado en los últimos años. El estudio de los problemas de salud y la vulnerabilidad social planteados durante el ingreso hospitalario de estos pacientes ayudaría a mejorar su cuidado. Pacientes y métodos. Estudio caso-control realizado en el Hospital Clínic de Barcelona. Se incluyeron pacientes inmigrantes ingresados con patología infecciosa de octubre de 2002 a septiembre de 2003. Los casos fueron apareados por edad, sexo e infección por virus de la inmunodeficiencia humana (VIH). Se evaluaron variables clínicas (visitas a Urgencias, días y número de ingresos, cantidad de procedimientos y fármacos, diagnóstico etiológico y control post alta) y de vulnerabilidad social (utilización de trabajo social, tarjeta sanitaria, cuidador de referencia, consumo de tóxicos, barrera idiomática y alta de enfermería). Resultados. Se estudiaron 102 pacientes (51 casos y 51 controles, todos varones). El 56% estaban infectados por VIH en ambos grupos. El número de procedimientos diagnósticos o terapéuticos fue mayor en el grupo de inmigrantes (p = 0,02), se llegó en menor proporción a un diagnóstico etiológico (el 82% frente al 98%, p = 0,021) y el número de visitas post alta fue inferior (el 55% frente al 77%, p = 0,04). Los pacientes inmigrantes tuvieron unos índices de vulnerabilidad social mayores que la población autóctona y en un 35% de ellos existía una barrera idiomática. Un menor número tenían tarjeta sanitaria (el 63% frente al 94%, p < 0,0001) y un número mayor tuvieron necesidad de traslado a un centro sociosanitario (el 16% frente al 2%, p = 0,01). Discusión La vulnerabilidad social de los pacientes inmigrantes influye en una menor obtención del diagnóstico etiológico, mayor número de procedimientos durante la hospitalización y un menor seguimiento posterior al alta

Suplementación de yodo en la gestación y lactancia

l beneficio de la suplementación con yodo durante la gestación en las áreas con deficiencia grave de yodo está bien establecido. En el año 2004 la Organización Mundial de la Salud incluyó a España entre los países con adecuada ingesta de yodo y varios estudios recientes confirman que la ingesta de yodo es suficiente en la población española. Los profesionales españoles, sin embargo, se han encontrado con recomendaciones contradictorias, lo que ha generado confusión e incertidumbre en la práctica a seguir en cuanto a la suplementación de yodo a la mujer gestante o en periodo de lactancia. A los clínicos e investigadores les preocupa que las situaciones de déficit de yodo leve o moderado puedan relacionarse con un peor desarrollo de los niños, pero la suplementación rutinaria de yodo en la gestación no está exenta de riesgo. PrevInfad considera que, al tratarse de una medida profiláctica que afecta a dos individuos -madre e hijo- y que se aplica al conjunto de una población sana, debe primar el principio de precaución y que no existen pruebas de calidad suficiente para determinar el balance entre los beneficios y los riesgos de la suplementación farmacológica de yodo durante la gestación y la lactancia, por lo que sugiere que no se realice esta intervención. The benefits of Iodine supplementation in Iodine-deficient areas are well established. The World Health Organization included Spain among the countries with an adequate Iodine intake in 2004 and some recent research papers confirm that Iodine intake is adequate in the Spanish population. Nevertheless, Spanish health professionals have been faced with contradictory recommendations, producing confusion and uncertainty in clinical practice referring to Iodine supplementation in pregnancy and breastfeeding mothers. Clinicians and researchers are concerned that mild or moderate Iodine deficiency could be related to underdevelopment in children, but routine Iodine supplementation in pregnancy is not risk free. The working group PrevInfad (Prevention in Childhood and Adolescence) considers that being a preventive intervention that applies to the total healthy population, the precaution principle must be prioritized, and that there is no evidence on the balance risk-benefit in the pharmacological Iodine supplementation during pregnancy and breastfeeding. For these reasons they suggest not making this intervention