Validation of a Virtual Assistant for Improving Medication Adherence in Patients with Comorbid Type 2 Diabetes Mellitus and Depressive Disorder

Virtual assistants are programs that interact with users through text or voice messages simulating a human-based conversation. The development of healthcare virtual assistants that use messaging platforms is rapidly increasing. Still, there is a lack of validation of these assistants. In particular, this work aimed to validate the effectiveness of a healthcare virtual assistant, integrated within messaging platforms, with the aim of improving medication adherence in patients with comorbid type 2 diabetes mellitus and depressive disorder. For this purpose, a nine-month pilot study was designed and subsequently conducted. The virtual assistant reminds patients about their medication and provides healthcare professionals with the ability to monitor their patients. We analyzed the medication possession ratio (MPR), measured the level of glycosylated hemoglobin (HbA1c), and obtained the patient health questionnaire (PHQ-9) score in the patients before and after the study. We also conducted interviews with all participants. A total of thirteen patients and five nurses used and evaluated the proposed virtual assistant using the messaging platform Signal. Results showed that on average, the medication adherence improved. In the final interview, 69% of the patients agreed with the idea of continuing to use the virtual assistant after the study

Distributional and Ecological Notes on the Halfbeaks of Eastern Gulf of Mexico, with a Provisional Key for Their Identification

Several fishes of the halfbeak genus Hyporhamphus occurring in the Mexican Gulf of Mexico and Caribbean Sea have been misidentified or confused in the literature. Most of it has centered around the taxonomic status of H. unifasciatus (including its synonym H. roberti), which is shown to comprise a complex of three species, H. unifasciatus, the recently described H. meeki, from the western Atlantic region, and an undescribed species from the eastern Pacific Ocean. Another eastern Mexico halfbeak is the freshwater form H. mexicanus. Using Banford and Collette (1993), we examined specimens from collections at UANL, UNAM, IPN, and ECOCH and have clarified the Mexican distribution of these species. We here report additional Mexican records of H. meeki, previously known only from United States waters and from the coast of Yucatán, clarify the distribution of H. unifasciatus, and provide the first marine record of the freshwater species H. mexicanus. A distribution map and keys for identification of the eastern Mexican species are provided

INFLUENCE OF FOOTWEAR ON THE ANKL SPRAIN PRODUCTION MECHANISM IN BASKETBALL

INTRODUCTION: Vertical jump is a usual movement pattern in basketball, and it is related to ankle injuries, mainly during rebound actions when falling on another player's foot. The aim of the present study IS to determine the influence of the introduction of certain elements in the footwear on ankle protection when falling on an irregular surface. The study consisted in simulating a rebound action in which the player jumps and falls on an irregular surface, simulated by a 20" inclined plane. 12 footwear prototypes were studied, making a factorial design with the following elements: high or low top, upper vamp stabilizer, hollow midsole at midfoot level and lace anchors. 3 test subjects, students of Physical Education, took part. They performed 36 jumps each, in series of 3, with a recovering time of 3 s between jumps and 3 m between series. Each series was done wearing one of the 12 prototypes at random. Each jump was filmed at 150 Hz and then digitized. The angles of knee and ankle were calculated as a function of time. For the statistical analysis an analysis of variance (ANOVA) was made, considering as factors the elements introduced in the footwear and a level of significance of 0,05 was chosen. RESULTS: The results indicate the high top footwear limited the range of movement during ankle flexion-extension and they produce higher values of inversion than low top. With an upper vamp stabilizer, higher values of inversion were obtained than without it. On the other hand, with a hollow midsole, inversion values were lower. Introducing a movement control system in the rearfoot, by means of lace anchors, did not show influence on the studied movements. CONCLUSIONS: In this way, after landing on an irregular surface, the high top as well as an upper vamp stabilizer increase the degree of inversion, probably because these elements rigidify vertically the footwear and increase the adherence to the floor or to the irregular surface on which the subject IS. However, it must be considered that epidemiological studies state that high top footwear diminish the risk of acute ankle injuries in basketball players. The upper vamp stabilizer, on the contrary, only rigidifies vertically the footwear and it dos not offer any extra reinforcement of the joint, increasing the risk of suffering ankle injuries. REFERENCES: Stacoff, A.; Kalin, X.; Stiitsi, E. (1 989) Torsional movements of the foot during landing. Abstracs of the XI1 Congress of the International Society of Biomechanics. Los Angeles, 1085. Sussman, D. H.; Hamill, J.; Miller, M. (1988) Effect of shoe height and prophylactic taping on ankle joint motion during s~mulated basketball rebounding. In De Groot, G., Hollander, A.P.; Huijing, P.A.; Van lngen Schenau, G.J. (Eds.) Biomechanics XI-6

Novel Bayesian Networks for Genomic Prediction of Developmental Traits in Biomass Sorghum.

The ability to connect genetic information between traits over time allow Bayesian networks to offer a powerful probabilistic framework to construct genomic prediction models. In this study, we phenotyped a diversity panel of 869 biomass sorghum (Sorghum bicolor (L.) Moench) lines, which had been genotyped with 100,435 SNP markers, for plant height (PH) with biweekly measurements from 30 to 120 days after planting (DAP) and for end-of-season dry biomass yield (DBY) in four environments. We evaluated five genomic prediction models: Bayesian network (BN), Pleiotropic Bayesian network (PBN), Dynamic Bayesian network (DBN), multi-trait GBLUP (MTr-GBLUP), and multi-time GBLUP (MTi-GBLUP) models. In fivefold cross-validation, prediction accuracies ranged from 0.46 (PBN) to 0.49 (MTr-GBLUP) for DBY and from 0.47 (DBN, DAP120) to 0.75 (MTi-GBLUP, DAP60) for PH. Forward-chaining cross-validation further improved prediction accuracies of the DBN, MTi-GBLUP and MTr-GBLUP models for PH (training slice: 30-45 DAP) by 36.4-52.4% relative to the BN and PBN models. Coincidence indices (target: biomass, secondary: PH) and a coincidence index based on lines (PH time series) showed that the ranking of lines by PH changed minimally after 45 DAP. These results suggest a two-level indirect selection method for PH at harvest (first-level target trait) and DBY (second-level target trait) could be conducted earlier in the season based on ranking of lines by PH at 45 DAP (secondary trait). With the advance of high-throughput phenotyping technologies, our proposed two-level indirect selection framework could be valuable for enhancing genetic gain per unit of time when selecting on developmental traits

Effect of different dietary vitamin E levels on growth, fish composition, fillet quality and liver histology of meagre (Argyrosomus regius)

Seven experimental isonitrogenous (50%) and isolipidic (16%) diets with different levels of α-tocopherol acetate (16, 100, 190, 285, 430, 880 and 1300 mg kg−1) were tested during 72 days to evaluate growth performance, tissue composition, fillet oxidation and liver histology in meagre juveniles, Argyrosomus regius. Growth performance, feed conversion ratio (FCR) and tissue composition were similar among treatments (P>0.05). In the liver, no major differences were recorded in lipid and fatty acid composition but higher lipid vacuolization were observed in diets E100, E190 and E880. Muscle fatty acid profiles showed an increment of the highly unsaturated fatty acid (HUFA) and a decrease of the saturated fatty acid with the increase of dietary vitamin E, which was accompanied with a reduction of the muscle TBARS responses.  Therefore, is suggested that diets for this species should be supplemented with 451mg kg−1of DL-α-tocopherol acetate (496 UI of vitamin E), as determine by broken-line regression analysis of muscle TBARS, to provide good overall growth performance and improved fish quality and storage stability. Moreover, results suggest that vitamin E deficiency or excess may deteriorate fish health.  Statement of relevance  The optimization of the dietary vitamin E level will contribute to formulate a suitable diet for meagre, a candidate for European aquaculture diversification, that until now is being fed with diets specific for other species. This study will narrow the knowledge gap that exists regarding meagre nutritional needs

Extracellular NK histones promote immune cell anti-tumor activity by inducing cell clusters through binding to CD138 receptor.

BACKGROUND: Natural killer (NK) cells are important anti-tumor cells of our innate immune system. Their anti-cancer activity is mediated through interaction of a wide array of activating and inhibitory receptors with their ligands on tumor cells. After activation, NK cells also secrete a variety of pro-inflammatory molecules that contribute to the final immune response by modulating other innate and adaptive immune cells. In this regard, external proteins from NK cell secretome and the mechanisms by which they mediate these responses are poorly defined. METHODS: TRANS-stable-isotope labeling of amino acids in cell culture (TRANS-SILAC) combined with proteomic was undertaken to identify early materials transferred between cord blood-derived NK cells (CB-NK) and multiple myeloma (MM) cells. Further in vitro and in vivo studies with knock-down of histones and CD138, overexpression of histones and addition of exogenous histones were undertaken to confirm TRANS-SILAC results and to determine functional roles of this material transferred. RESULTS: We describe a novel mechanism by which histones are actively released by NK cells early after contact with MM cells. We show that extracellular histones bind to the heparan sulfate proteoglycan CD138 on the surface of MM cells to promote the creation of immune-tumor cell clusters bringing immune and MM cells into close proximity, and thus facilitating not only NK but also T lymphocyte anti-MM activity. CONCLUSION: This study demonstrates a novel immunoregulatory role of NK cells against MM cells mediated by histones, and an additional role of NK cells modulating T lymphocytes activity that will open up new avenues to design future immunotherapy clinical strategies

Reducing residual thrombotic risk in patients with peripheral artery disease : impact of the COMPASS trial

Altres ajuts: Writing and editorial assistance was funded by Bayer Hispania.Patients with peripheral artery disease (PAD) are at a high risk not only for the classical cardiovascular (CV) outcomes (major adverse cardiovascular events; MACE) but also for vascular limb events (major adverse limb events; MALE). Therefore, a comprehensive approach for these patients should include both goals. However, the traditional antithrombotic approach with only antiplatelet agents (single or dual antiplatelet therapy) does not sufficiently reduce the risk of recurrent thrombotic events. Importantly, the underlying cause of atherosclerosis in patients with PAD implies both platelet activation and the initiation and promotion of coagulation cascade, in which Factor Xa plays a key role. Therefore, to reduce residual vascular risk, it is necessary to address both targets. In the Cardiovascular Outcomes for People Using Anticoagulation Strategies (COMPASS) trial that included patients with stable atherosclerotic vascular disease, the rivaroxaban plus aspirin strategy (versus aspirin) markedly reduced the risk of both CV and limb outcomes, and related complications, with a good safety profile. In fact, the net clinical benefit outcome composed of MACE; MALE, including major amputation, and fatal or critical organ bleeding was significantly reduced by 28% with the COMPASS strategy, (hazard ratio: 0.72; 95% confidence interval: 0.59-0.87). Therefore, the rivaroxaban plus aspirin approach provides comprehensive protection and should be considered for most patients with PAD at high risk of such events

Altered patterns of expression of members of the heterogeneous nuclear ribonucleoprotein (hnRNP) family in lung cancer

hnRNP A2/B1 has been suggested as a useful early detection marker for lung carcinoma. hnRNP A2/B1 is a member of a large family of heterogeneous nuclear ribonucleoproteins (hnRNP proteins) involved in a variety of functions, including regulation of transcription, mRNA metabolism, and translation. In lung cancer, we have evaluated the expression and cellular localization of several members of the hnRNP family, hnRNP A1, A2, B1, C1, C2 and K. 16 cell lines (SCLC and NSCLC) and biopsies from 32 lung cancer patients were analyzed. Our results suggest that, besides hnRNP A2/B1, the expression of other members of the hnRNP family is altered both in SCLC and NSCLC. In the biopsies, negative or low expression of the hnRNP proteins analyzed was observed in normal epithelial cells whereas lung cancer cells showed highly intense nuclear or cytoplasmic immunolocalization. In all the lung cancer cell lines, the mRNA for all the hnRNP proteins was detected. In general, higher levels of hnRNP mRNAs were found in SCLC as compared with NSCLC. Our results also suggest that the expression and processing of each hnRNP protein in lung cancer is independently regulated and is not exclusively related to proliferation status. In SCLC cell lines, hnRNP A1 protein expression correlated with that of Bcl-x(L). In the lung cancer cell lines, hnRNP K protein localization varied with the cellular confluence