Evaluation of functional status among patients undergoing maintenance treatments for opioid use disorders

Background: Methadone and buprenorphine are the most prevalent types of opioid maintenance programs in Andalusia. The main objective is comparing the functional status of patients with pharmacological opioid maintenance treatments according to diferent socio-demographic characteristic, health and disabilities domains and sexual difculties. Methods: A total of 593 patients from the Andalusia community, 329 were undergoing methadone treatment and 264 were undergoing buprenorphine treatment. The patients were interviewed by socio-demographic and opioid related variables, assessed by functioning, disability and health domains (WHODAS 2.0.) and for sexual problems (PRSexDQ-SALSEX). Results: We found signifcant diferences in the socio-demographic and the opioid-related variables as the onset of opioid use, being on previous maintenance programs, opioid intravenous use, the length of previous maintenance programs, polydrug use and elevated seroprevalence rates (HCV and HIV) between the methadone group and the buprenorphine group. Regarding health and disability domains there were diferences in the Understanding and communication domain, Getting around domain, Participation in society domain and in the WHODAS 2.0. simple and complex score, favoring buprenorphine-treated patients. The methadone group referred elevated sexual impairments compared with the buprenorphine group. Opioid-related variables as seroprevalence rates, other previous lifetime maintenance program, the daily opioid dosage and the daily alcohol use are the most discriminative variables between both groups. Participation in society variables and sexual problems were the most important clinical variables in distinguishing the methadone group from the buprenorphine group regarding their functional status. Conclusions: The methadone group showed higher prevalence in opioid dependence-related variables, elevated disabilities in participation in society activities and sexual problems compared with the buprenorphine group. This study shows the importance of carry out a functional evaluation in the healthcare follow-up, especially in those areas related with social activity and with sexual problems.This work has been funded by Sociedad Médica Andaluza de Adicciones y Patologías Médicas Asociadas (SOMAPA) and supported by Research Project funded by Consejería de Salud y Bienestar Social, Junta de Andalucía Fundación Progreso y Salud (PI-0140-2018). NGM holds a Sara Borrell research contract (CD19/00019) funded by Instituto de Salud Carlos III (ISC-III) and European Regional Development Funds-European Union (ERDF-EU).Ye

Structural and magnetic characterization of oleic acid and oleylamine-capped gold nanoparticles

In this work the study of oleic acid and oleylamine-capped gold nanoparticles is presented. The structural characterization of the sample shows 6.7 nm gold nanoparticles with a narrow size distribution. The experimental optical absorption spectrum has a maximum at 2.35 eV. The calculated optical absorption spectrum is shifted and narrower than the experimental one, indicating that the oleic acid and oleylamine do not merely passivate the metallic nanoparticles but modify its electronic structure. These gold nanoparticles show in addition a kind of magnetic order similar to other organic passivated gold nanoparticles as thiol-capped gold nanoparticles. Although the magnetic interactions seem to be weaker than in thiol-capped ones, the magnetic behavior looks similar to that, i.e., an invariant temperature dependence of the magnetization from 5 to 300 K and a noticeable coercive field. We analyze the influence of the organic layer bonding the nanoparticles on the magnetic behavior. © 2006 American Institute of Physics.Financial support from the Spanish MCyT under Project No. MAT2002–04246-c05–05 and CAM under Project No. S-0505/MAT/0194 are acknowledged.Peer Reviewe

Management of wet age-related macular degeneration in Spain: challenges for treat and extend implementation in routine clinical practice

Age-related macular degeneration; Ophthalmology services; Anti-VEGFDegeneración macular relacionada con la edad; Servicios de oftalmología; Anti-VEGFDegeneració macular relacionada amb l’edat; Serveis d’oftalmologia; Anti-VEGFPurpose. To ascertain wet AMD (wAMD) management patterns in Spain. Methods. A two-round Delphi study conducted through a questionnaire-based survey designed from literature review and validated by an independent Steering Committee. Results. Forty-nine retina specialists experienced in wAMD participated by answering the two-round study questionnaire. Retina specialists are the main responsible for wAMD diagnosis and monitoring, including visits and associated procedures, with a median time per visit of 15 minutes. Standard treatment strategies are based on anti-VEGF administration, including standard loading dose administration followed by maintenance with aflibercept or ranibizumab (81% of patients). Although treat and extend (T&E) dosing strategy is considered as optimal for wAMD management (78% of the panelists), the main routine healthcare limitations (i.e., visits overload, reduced staff, short visit time, coordination issues, lack of facilities) conduct to self-defined “flexible” strategies, based on T&E and pro-re-nata (PRN) protocols. Conclusion. Proactive treatment patterns (T&E) are the preferred ones by the retina specialists in Spain. However, their proper implementation is difficult due to healthcare resource limitations, as well as organisation and logistic issues. The use of anti-VEGF agents with longer duration of action could facilitate the use of strict T&E approaches according to routine clinical practices

Encapsulation of bioactive compounds of food interest: applications, current advances, challenges, and opportunities.

Objective: The encapsulation of bioactive compounds of food interest provide protection against ambiental factors and degradation reactions. Therefore, the encapsulation of these compounds, was studied and analyzed considering the applications, current advances, challenges, and opportunities on the topic. Design/methodology/approach: Wall materials, bioactive compounds of food interest, encapsulation methods, applications, current advances, challenges, and opportunities in encapsulation of bioactive compounds were explored, described, and discussed considering the principal literature on the topic, and scientific databases were used for the bibliographic research. Results: Encapsulation process is a novel technology that allows the increasing the stability of aromas, flavors, pigments, and microorganisms, beside of improve the sensory, physical chemical and functional properties, quality, and the extend the shelf-life. Limitations on study/implications: Foods contain bioactive compounds that are susceptible to oxidation and degradation, which can reduce their quality and shelf life. To preserve these compounds, is important to develop other encapsulation systems considering alternative wall materials from different sources that can be applied under different process conditions from laboratory, pilot to industrial scale.  Findings/conclusions: Encapsulation process provide protection to bioactive compounds enhancing the sensory, physical chemical and functional properties, quality, and extend the shelf-life considering the integral and sustainable use of agricultural products

Conocer para amar lo que tenemos. Iberá para nivel inicial en escuelas periféricas de la ciudad de Corrientes, Argentina

El presente artículo pretende resolver algunas de las problemáticas que existen en nuestra Comunidad Educativa respecto al conocimiento y estado de Conservación de la Fauna Regional. Se presenta una secuencia de actividades didáctica utilizadas como recursos motivadores para que los niños y niñas del Nivel Inicial fortalezcan y profundicen sus conocimientos relacionados con nuestra fauna autóctona del Sistema Iberá.

Glycated Hemoglobin and Subclinical Atherosclerosis in People Without Diabetes.

The metabolic injury caused by protein glycation, monitored as the level of glycated hemoglobin (HbA1c), is not represented in most risk scores (i.e., Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease risk scale). The purpose of this study was to assess the association between HbA1c and the extent of subclinical atherosclerosis (SA) and to better identify individuals at higher risk of extensive SA using HbA1c on top of key cardiovascular risk factors (CVRFs). A cohort of 3,973 middle-aged individuals from the PESA (Progression of Early Subclinical Atherosclerosis) study, with no history of cardiovascular disease and with HbA1c in the nondiabetic range, were assessed for the presence and extent of SA by 2-dimensional vascular ultrasound and noncontrast cardiac computed tomography. After adjusting for established CVRFs, HbA1c showed an association with the multiterritorial extent of SA (odds ratio: 1.05, 1.27, 1.27, 1.36, 1.80, 1.87, and 2.47 for HbA1c 4.9% to 5.0%, 5.1% to 5.2%, 5.3% to 5.4%, 5.5% to 5.6%, 5.7% to 5.8%, 5.9% to 6.0%, and 6.1% to 6.4%, respectively; reference HbA1c ≤4.8%; p < 0.001). The association was significant in all pre-diabetes groups and even below the pre-diabetes cut-off (HbA1c 5.5% to 5.6% odds ratio: 1.36 [95% confidence interval: 1.03 to 1.80]; p = 0.033). High HbA1c was associated with an increased risk of SA in low-risk individuals (p < 0.001), but not in moderate-risk individuals (p = 0.335). Relative risk estimations using Systematic Coronary Risk Estimation or atherosclerotic cardiovascular disease predictors confirmed that inclusion of HbA1c modified the risk of multiterritorial SA in most risk categories. Routine use of HbA1c can identify asymptomatic individuals at higher risk of SA on top of traditional CVRFs. Lifestyle interventions and novel antidiabetic medications might be considered to reduce both HbA1c levels and SA in individuals without diabetes.The PESA study is funded by the Centro Nacional de Investigaciones Cardiovasculares (CNIC) and Banco Santander. The study also receives funding from the Instituto de Salud Carlos III (ISCIII, PI15/ 02019, PI17/00590, and PI20/00819) and the European Regional Development Fund (ERDF) “A way to make Europe.” The CNIC is supported by the ISCIII, the Ministerio de Ciencia e Innovación, and the Pro CNIC Foundation. Dr. Bueno has received grants from the Instituto de Salud Carlos III; has received consultancy fees from Bayer, Novartis, Ferrer, MEDSCAPE-the Heart-org, and Janssen; has received grants, consultancy fees, and nonfinancial support from AstraZeneca; and has received grants and consultancy fees from Bristol Myers Squibb-Pfizer, all unrelated to the present study. Dr. Ibanez is supported by the European Commission (ERC-CoG grant No 819775), the Spanish Ministry of Science and Innovation (MCN, ‘RETOS 2019’ grant No PID2019-107332RB-I00), and the Comunidad de Madrid (S2017/BMD-3867 RENIM-CM). The funders had no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.S

Circulating Tumor Cells Enumeration from the Portal Vein for Risk Stratification in Early Pancreatic Cancer Patients

[Simple Summary] Effective biomarkers are needed to enable personalized medicine for pancreatic cancer patients. This study analyzes the prognostic value, in early pancreatic cancer, of circulating tumor cells and clusters from the central venous catheter and portal blood. Circulating tumor cells were isolated using an immunomagnetic selection and were detected by microscopy using immunocytochemistry staining. In conclusion, the circulating tumor cell number in portal blood identifies a death risk in patients with early pancreatic cancer.[Abstract] Background. Effective biomarkers are needed to enable personalized medicine for pancreatic cancer patients. This study analyzes the prognostic value, in early pancreatic cancer, of single circulating tumor cell (CTC) and CTC clusters from the central venous catheter (CVC) and portal blood (PV). Methods. In total, 7 mL of PV and CVC blood from 35 patients with early pancreatic cancer were analyzed. CTC were isolated using a positive immunomagnetic selection. The detection and identification of CTC were performed by immunocytochemistry (ICC) and were analyzed by Epi-fluorescence and confocal microscopy. Results. CTC and the clusters were detected both in PV and CVC. In both samples, the CTC number per cluster was higher in patients with grade three or poorly differentiated tumors (G3) than in patients with well (G1) or moderately (G2) differentiated. Patients with fewer than 185 CTC in PV exhibited a longer OS than patients with more than 185 CTC (24.5 vs. 10.0 months; p = 0.018). Similarly, patients with fewer than 15 clusters in PV showed a longer OS than patients with more than 15 clusters (19 vs. 10 months; p = 0.004). These significant correlations were not observed in CVC analyses. Conclusions. CTC presence in PV could be an important prognostic factor to predict poor prognosis in early pancreatic cancer. In addition, the number of clustered-CTC correlate to a tumor negative differentiation degree and, therefore, could be used as a diagnostic biomarker for pancreatic cancer.This research was funded by Carlos III Health Institute (Health Research Fund) grant number PI16/01465 and PI19/01821 (Co-financed by the European Regional Development Fund “A way to make Europe”)

Tailoring hyper-heuristics to specific instances of a scheduling problem using affinity and competence functions

Hyper-heuristics are high level heuristics which coordinate lower level ones to solve a given problem. Low level heuristics, however, are not all as competent/good as each other at solving the given problem and some do not work together as well as others. Hence the idea of measuring how good they are (competence) at solving the problem and how well they work together (their affinity). Models of the affinity and competence properties are suggested and evaluated using previous information on the performance of the simple low level heuristics. The resulting model values are used to improve the performance of the hyper-heuristic by tailoring it not only to the specific problem but the specific instance being solved. The test case is a hard combinatorial problem, namely the Hybrid Flow Shop scheduling problem. Numerical results on randomly generated as well as real-world instances are included