625 research outputs found
Analysis and Classification of Oximetry Recordings to Predict Obstructive Sleep Apnea Severity in Children
Producción CientíficaCurrent study is focused around the potential use
of oximetry to determine the obstructive sleep apnea-hypopnea
syndrome (OSAHS) severity in children. Single-channel SpO2
recordings from 176 children were divided into three severity
groups according to the apnea-hypopnea index (AHI): AHI<1
events per hour (e/h), 1≤AHI<5 e/h, and AHI ≥5 e/h. Spectral
analysis was conducted to define and characterize a frequency
band of interest in SpO2. Then we combined the spectral data
with the 3% oxygen desaturation index (ODI3) by means of a
multi-layer perceptron (MLP) neural network, in order to
classify children into one of the three OSAHS severity groups.
Following our MLP multiclass approach, a diagnostic protocol
with capability to reduce the need of polysomnography tests by
46% could be derived. Moreover, our proposal can be also
evaluated, in a binary classification task for two common AHI
diagnostic cutoffs (AHI = 1 e/h and AHI= 5 e/h). High
diagnostic ability was reached in both cases (84.7% and 85.8%
accuracy, respectively) outperforming the clinical variable
ODI3 as well as other measures reported in recent studies.
These results suggest that the information contained in SpO2
could be helpful in pediatric OSAHS severity detection.Junta de Castilla y León (project VA059U13
Nocturnal Oximetry-based Evaluation of Habitually Snoring Children
Rationale: The vast majority of children around the world
undergoing adenotonsillectomy for obstructive sleep
apnea–hypopnea syndrome (OSA) are not objectively diagnosed by
nocturnal polysomnography because of access availability and cost
issues. Automated analysis of nocturnal oximetry (nSpO2), which is
readily and globally available, could potentially provide a reliable and
convenient diagnostic approach for pediatric OSA.
Methods: DeidentifiednSpO2 recordings froma total of 4,191 children
originating from13 pediatric sleep laboratories around the worldwere
prospectively evaluated after developing and validating an automated
neural network algorithm using an initial set of single-channel nSpO2
recordings from 589 patients referred for suspected OSA.
Measurements and Main Results: The automatically
estimated apnea–hypopnea index (AHI) showed high
agreement with AHI from conventional polysomnography
(intraclass correlation coefficient, 0.785) when tested in 3,602
additional subjects. Further assessment on the widely used AHI
cutoff points of 1, 5, and 10 events/h revealed an incremental
diagnostic ability (75.2, 81.7, and 90.2% accuracy; 0.788, 0.854, and
0.913 area under the receiver operating characteristic curve,
respectively).
Conclusions: Neural network–based automated analyses of
nSpO2 recordings provide accurate identification of OSA
severity among habitually snoring children with a high pretest
probability of OSA. Thus, nocturnal oximetry may enable a
simple and effective diagnostic alternative to nocturnal
polysomnography, leading to more timely interventions and
potentially improved outcomes.Supported in part by project VA037 U16 from the Consejer´ıa de Educacio´ n de la Junta de Castilla y Leo´ n and the European Regional Development Fund (FEDER), project RTC-2015-3446-1 from the Ministerio de Econom´ıa y Competitividad and FEDER, and project 153/2015 of the Sociedad Espan˜ ola de Neumolog´ıa y Cirug´ıa Tora´ cica (SEPAR). L.K.-G. is supported by NIH grant 1R01HL130984. M.F.P. was supported by a Fellowship Educational grant award from the Kingdom of Saudi Arabia. D.´A. was in receipt of a Juan de la Cierva grant from the Ministerio de Econom´ıa y Competitividad. The funders played no role in the study design, data collection, data analysis, interpretation, and writing of the manuscript
Compilation of parameterized seismogenic sources in Iberia for the SHARE European-scale seismic source model
Pre-treatment and extraction techniques for recovery of added value compounds from wastes throughout the agri-food chain
Pre-treatment and extraction techniques for recovery of added value compounds from wastes throughout the agri-food chain
The enormous quantity of food wastes discarded annually force to look for alternatives for this interesting feedstock. Thus, food bio-waste valorisation is one of the imperatives of the nowadays society. This review is the most comprehensive overview of currently existing technologies and processes in this field. It tackles classical and innovative physical, physico-chemical and chemical methods of food waste pre-treatment and extraction for recovery of added value compounds and detection by modern technologies and are an outcome of the COST Action EUBIS, TD1203 Food Waste Valorisation for Sustainable Chemicals, Materials and Fuels
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Congreso Nacional SEPAR (49º. 2016. Granada)
Producción CientíficaEl síndrome de apnea hipopnea obstructiva del sueño (SAHS) en niños se ha convertido en un problema médico frecuente en las últimas 2-3 décadas. Es una patología que si no se trata se asocia a comorbilidades graves relacionadas con el sistema nervioso central y los sistemas cardiovascular y metabólico. La PSG hospitalaria es la prueba gold standard para su diagnóstico, pero es una técnica compleja, costosa y a veces inaccesible. La SpO2 de la pulsioximetría nocturna podría proporcionar información simplificando el proceso diagnóstico. El objetivo de nuestro estudio ha sido diseñar y evaluar un clasificador automatizado destinado a diagnosticar el SAHS.Junta de Castilla y León (programa de apoyo a proyectos de investigación – Ref. VA302U13
Immortalization and functional screening of natively paired human T cell receptor repertoires
Abstract
Functional analyses of the T cell receptor (TCR) landscape can reveal critical information about protection from disease and molecular responses to vaccines. However, it has proven difficult to combine advanced next-generation sequencing technologies with methods to decode the peptide-major histocompatibility complex (pMHC) specificity of individual TCRs. We developed a new high-throughput approach to enable repertoire-scale functional evaluations of natively paired TCRs. In particular, we leveraged the immortalized nature of physically linked TCRα:β amplicon libraries to analyze binding against multiple recombinant pMHCs on a repertoire scale, and to exemplify the utility of this approach, we also performed affinity-based functional mapping in conjunction with quantitative next-generation sequencing to track antigen-specific TCRs. These data successfully validated a new immortalization and screening platform to facilitate detailed molecular analyses of disease-relevant antigen interactions with human TCRs.</jats:p
Immortalization and functional screening of natively paired human T cell receptor repertoires
Functional analyses of the T cell receptor (TCR) landscape can reveal critical information about protection from disease and molecular responses to vaccines. However, it has proven difficult to combine advanced next-generation sequencing technologies with methods to decode the peptide-major histocompatibility complex (pMHC) specificity of individual TCRs. We developed a new high-throughput approach to enable repertoire-scale functional evaluations of natively paired TCRs. In particular, we leveraged the immortalized nature of physically linked TCRα:β amplicon libraries to analyze binding against multiple recombinant pMHCs on a repertoire scale, and to exemplify the utility of this approach, we also performed affinity-based functional mapping in conjunction with quantitative next-generation sequencing to track antigen-specific TCRs. These data successfully validated a new immortalization and screening platform to facilitate detailed molecular analyses of disease-relevant antigen interactions with human TCRs
Understanding the extreme luminosity of DES14X2fna
ABSTRACT
We present DES14X2fna, a high-luminosity, fast-declining Type IIb supernova (SN IIb) at redshift z = 0.0453, detected by the Dark Energy Survey (DES). DES14X2fna is an unusual member of its class, with a light curve showing a broad, luminous peak reaching Mr ≃ −19.3 mag 20 d after explosion. This object does not show a linear decline tail in the light curve until ≃60 d after explosion, after which it declines very rapidly (4.30 ± 0.10 mag 100 d−1 in the r band). By fitting semi-analytic models to the photometry of DES14X2fna, we find that its light curve cannot be explained by a standard 56Ni decay model as this is unable to fit the peak and fast tail decline observed. Inclusion of either interaction with surrounding circumstellar material or a rapidly-rotating neutron star (magnetar) significantly increases the quality of the model fit. We also investigate the possibility for an object similar to DES14X2fna to act as a contaminant in photometric samples of SNe Ia for cosmology, finding that a similar simulated object is misclassified by a recurrent neural network (RNN)-based photometric classifier as an SN Ia in ∼1.1–2.4 per cent of cases in DES, depending on the probability threshold used for a positive classification
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