Hip fracture in hospitalized medical patients

BACKGROUND: The aim of the present study is to analyze the incidence of hip fracture as a complication of admissions to internal medicine units in Spain. METHODS: We analyzed the clinical data of 2,134,363 adults who had been admitted to internal medicine wards. The main outcome was a diagnosis of hip fracture during hospitalization. Outcome measures included rates of in-hospital fractures, length of stay and cost. RESULTS: A total of 1127 (0.057%) admittances were coded with an in-hospital hip fracture. In hospital mortality rate was 27.9% vs 9.4%; p < 0.001, and the mean length of stay was significantly longer for patients with a hip fracture (20.7 days vs 9.8 days; p < 0.001). Cost were higher in hip-fracture patients (6927€ per hospitalization vs 3730€ in non fracture patients). Risk factors related to fracture were: increasing age by 10 years increments (OR 2.32 95% CI 2.11-2.56), female gender (OR 1.22 95% CI 1.08-1.37), admission from nursing home (OR 1.65 95% CI 1.27-2.12), dementia (1.55 OR 95% CI1.30-1.84), malnutrition (OR 2.50 95% CI 1.88-3.32), delirium (OR 1.57 95% CI 1.16-2.14), and anemia (OR 1.30 95%CI 1.12-1.49). CONCLUSIONS: In-hospital hip fracture notably increased mortality during hospitalization, doubling the mean length of stay and mean cost of admission. These are reasons enough to stress the importance of designing and applying multidisciplinary plans focused on reducing the incidence of hip fractures in hospitalized patients

Social Restrictions versus Testing Campaigns in the COVID-19 Crisis: A Predictive Model Based on the Spanish Case

The global COVID-19 spread has forced countries to implement non-pharmacological interventions (NPI) (i.e., mobility restrictions and testing campaigns) to preserve health systems. Spain is one of the most severely impacted countries, both clinically and economically. In an effort to support policy decision-making, we aimed to assess the impacts of different NPI on COVID-19 epidemiology, healthcare costs and Gross Domestic Product (GDP). A modified Susceptible-Exposed-Infectious-Removed epidemiological model was created to simulate the pandemic evolution. Its output was used to populate an economic model to quantify healthcare costs and GDP variation through a regression model which correlates NPI and GDP change from 42 countries. Thirteen scenarios combining different NPI were consecutively simulated in the epidemiological and economic models. Both increased testing and stringency could reduce cases, hospitalizations and deaths. While policies based on increased testing rates lead to higher healthcare costs, increased stringency is correlated with greater GDP declines, with differences of up to 4.4% points. Increased test sensitivity may lead to a reduction of cases, hospitalizations and deaths and to the implementation of pooling techniques that can increase throughput testing capacity. Alternative strategies to control COVID-19 spread entail differing economic outcomes. Decision-makers may utilize this tool to identify the most suitable strategy considering epidemiological and economic outcomes

J-PLUS: A wide-field multi-band study of the M15 globular cluster. Evidence of multiple stellar populations in the RGB

The Javalambre Photometric Local Universe Survey (J-PLUS) provides wide field-of-view images in 12 narrow, intermediate and broad-band filters optimized for stellar photometry. Here we have applied J-PLUS data for the first time for the study of Galactic GCs using science verification data obtained for the very metal-poor GC M\,15. Our J-PLUS data provide low-resolution spectral energy distributions covering the near-UV to the near-IR, allowing us to search for MPs based on pseudo-spectral fitting diagnostics. J-PLUS CMDs are found to be particularly useful to search for splits in the sequences formed by the upper red giant branch (RGB) and asymptotic giant branch (AGB) stars. We interpret these split sequences as evidence for the presence of MPs. This demonstrates that the J-PLUS survey will have sufficient spatial coverage and spectral resolution to perform a large statistical study of GCs through multi-band photometry in the coming years.Comment: 11 pages, 11 figures. Accepted for publication @ A&

Comparative study of the nutritional status in two samples of young adults

La revista permite a los autores reutilizar su fichero para depositarlo en su web o repositorio institucional, sin ánimo de lucro y mencionando la fuente original.[EN] The current nutritional status of two samples of both sexes young adults, aged 18 to 29 years and of two different socio-economic status (mean class or SES1 and low class or SES2) living in the Basque Country is compared. One of the samples is composed by 546 university students (159 males and 387 females) of the University of the Basque Country (UPV-EHU), and the second sample consists in 86 su bjects (23males and 63 females) who participated as users of different social assistance programs of Caritas Diocesana de Bilbao (CDB). The nutritional information provided by the body composition study of each subject through anthropometry and through bioelectric impedance analysis (BIA) was used. At the anthropometric level, the higher body height of the SES1 samples is noted as well as their greater homogeneity regarding direct measurements. The comparison did not reveal great differences in body composition, except a greater fat percentage in university males. This points out that the sample considered as low socioeconomic level is beginning to recover helped by the sanitary and social attention perceived, which has undoubtedly improved the nutritional indicators.[ES] Se compara el estado nutricional actual de dos muestras de jóvenes adultos, de ambos sexos, con edades comprendidas entre los 18 y los 29 años, de dos niveles socioeconómicos diferentes (clase media, SES1 y clase desfavorecida, SES2), residentes en la Comunidad Autónoma Vasca (CAV). Una de las muestras está formada por 546 universitarios (159 varones y 387 mujeres) de la Universidad del País Vasco (UPV-EHU), y la otra la forman 86 personas (23 hombres y 63 mujeres) que entre los años 1997 y 1998 participaban como usuarios en diversos programas de asistencia social de Cáritas Diocesana de Bilbao (CDB). Se ha utilizado la información nutricional que aporta el estudio de la composición corporal de cada sujeto, tanto por antropometría como por análisis de impedancia bioeléctrica (BIA). A nivel antropométrico destaca la mayor estatura de las muestras SES1 y su mayor homogeneidad en cuanto a las variables de medición directa. La comparación no ha puesto de manifiesto grandes diferencias en la composición corporal, con la excepción de un mayor porcentaje de grasa en los varones universitarios, lo que indica que la muestra considerada como de nivel bajo se encuentra en vías de recuperación, gracias a la atención sanitaria y social recibida, lo que ha hecho mejorar sin duda los indicadores nutricionales

Chimeric antigen receptor T-cell therapy for multiple myeloma: a consensus statement from The European Myeloma Network

Adoptive cellular therapy using chimeric antigen receptor T-cell (CART) therapy is currently being evaluated in patients with relapsed / refractory multiple myeloma (MM). The majority of CAR-T cell programs now being tested in clinical trials are targeting B-cell maturation antigen. Several recent phase I / II trials show promising preliminary results in patients with MM progressing on proteasome inhibitors, immunomodulatory drugs and monoclonal antibodies targeting CD38. CAR-T cell therapy is a potentially life-threatening strategy that can only be administered in experienced centers. For the moment, CAR-T cell therapy for MM is still experimental, but once this strateg

Down-Regulation of hsa-miR-10a in Chronic Myeloid Leukemia CD34+ Cells Increases USF2-Mediated Cell Growth

MicroRNAs (miRNA) are small noncoding, single-stranded RNAs that inhibit gene expression at a posttranscriptional level, whose abnormal expression has been described in different tumors. The aim of our study was to identify miRNAs potentially implicated in chronic myeloid leukemia (CML). We detected an abnormal miRNA expression profile in mononuclear and CD34+ cells from patients with CML compared with healthy controls. Of 157 miRNAs tested, hsa-miR-10a, hsa-miR-150, and hsa-miR-151 were down-regulated, whereas hsa-miR-96 was up-regulated in CML cells. Down-regulation of hsa-miR-10a was not dependent on BCR-ABL1 activity and contributed to the increased cell growth of CML cells. We identified the upstream stimulatory factor 2 (USF2) as a potential target of hsa-miR-10a and showed that overexpression of USF2 also increases cell growth. The clinical relevance of these findings was shown in a group of 85 newly diagnosed patients with CML in which expression of hsa-miR-10a was down-regulated in 71% of the patients, whereas expression of USF2 was up-regulated in 60% of the CML patients, with overexpression of USF2 being significantly associated with decreased expression of hsa-miR-10a (P = 0.004). Our results indicate that down-regulation of hsa-miR-10a may increase USF2 and contribute to the increase in cell proliferation of CML implicating a miRNA in the abnormal behavior of CML

2021 European Myeloma Network review and consensus statement on smoldering multiple myeloma: how to distinguish (and manage) Dr. Jekyll and Mr. Hyde

According to the updated International Myeloma Working Group criteria, smoldering multiple myeloma (SMM) is an asymptomatic plasma cell disorder characterized by an M-component >3 g/dL, bone marrow plasma cell infiltration >10% and <60%, and absence of any myeloma-defining event. Active multiple myeloma is preceded by SMM, with a median time to progression of approximately 5 years. Cases of SMM range from the extremes of monoclonal gammopathy of undetermined significance-like, in which patients never progress during their lifetimes, to early multiple myeloma, in which transformation into symptomatic disease, based on genomic evolution, may be rapid and devastating. Such a split personality makes the prognosis and management of individual patients challenging, particularly with regard to the identification and possible early treatment of high-risk SMM. Outside of clinical trials, the conventional approach to SMM generally remains close observation until progression to active multiple myeloma. However, two prospective, randomized trials have recently demonstrated a significant clinical benefit in terms of time to progression, and of overall survival in one of the two studies, for some patients with higher-risk SMM treated with lenalidomide +/- dexamethasone, raising the question of whether such an approach should be considered a new standard of care. In this paper, experts from the European Myeloma Network describe current biological and clinical knowledge on SMM, focusing on novel insights into its molecular pathogenesis, new prognostic scoring systems proposed to identify SMM patients at higher risk of early transformation, and updated results of completed or ongoing clinical trials. Finally, some practical recommendations for the real-life management of these patients, based on Delphi consensus methodology, are provided

J-PLUS: Detecting and studying extragalactic globular clusters. The case of NGC 1023.

Open Access article, published by EDP Sciences, under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Context. Extragalactic globular clusters (GCs) are key objects in studies of galactic histories. The advent of wide-field surveys, such as the Javalambre Photometric Local Universe Survey (J-PLUS), offers new possibilities for the study of these systems. Aims. We performed the first study of GCs in J-PLUS to recover information on the history of NGC 1023, taking advantage of wide-field images and 12 filters. Methods. We developed the semiautomatic pipeline GCFinder for detecting GC candidates in J-PLUS images, which can also be adapted to similar surveys. We studied the stellar population properties of a sub-sample of GC candidates using spectral energy distribution (SED) fitting. Results. We found 523 GC candidates in NGC 1023, about 300 of which are new. We identified subpopulations of GC candidates, where age and metallicity distributions have multiple peaks. By comparing our results with the simulations, we report a possible broad age-metallicity relation, supporting the notion that NGC 1023 has experienced accretion events in the past. With a dominating age peak at 1010 yr, we report a correlation between masses and ages that suggests that massive GC candidates are more likely to survive the turbulent history of the host galaxy. Modeling the light of NGC 1023, we find two spiral-like arms and detect a displacement of the galaxy’s photometric center with respect to the outer isophotes and center of GC distribution (~700pc and ~1600pc, respectively), which could be the result of ongoing interactions between NGC 1023 and NGC 1023A. Conclusions. By studying the GC system of NGC 1023 with J-PLUS, we showcase the power of multi-band surveys for these kinds of studies and we find evidence to support the complex accretion history of the host galaxy. © D. de Brito Silva et al. 2022.D.B.S. also acknowledges Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) process number 2017J00204-6 for the financial support provided for the development of this project. P.C. acknowledges support from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) under grant 310041/2018-0 and from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) process number 2018J05392-8. A.C.S. acknowledges funding from CNPq and the Rio Grande do Sul Research Foundation (FAPERGS) through grants CNPq-403580/2016-1, CNPq-11153/2018-6, PqG/FAPERGS-17/2551-0001, FAPERGS/CAPES 19/2551-0000696-9 and L’Oréal UNESCO ABC Para Mulheres na Ciência and the Chinese Academy of Sciences (CAS) President’s International Fellowship Initiative (PIFI) through grant E085201009. G.B. acknowledges financial support from the National Autonomous University of México (UNAM) through grant DGAPA/PAPIIT IG100319 and from CONACyT through grant CB2015-252364. J.V. acknowledges the technical members of the UPAD for their invaluable work: Juan Castillo, Tamara Civera, Javier Hernández, Ángel López, Alberto Moreno, and David Muniesa. J.A.H.J. acknowledges Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), process number 2021J08920-8. A.E. acknowledges the financial support from the Spanish Ministry of Science and Innovation and the European Union – NextGenerationEU through the Recovery and Resilience Facility project ICTS-MRR-2021-03-CEFCA and from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) under grant 313285/2020-9 D.A.F. thanks the ARC for financial assistance via DP170102344. Y.J.-T has received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 898633. Y.J-T. also acknowledges financial support from the State Agency for Research of the Spanish MCIU through the “Center of Excellence Severo Ochoa” award to the Instituto de Astrofísica de Andalucía (SEV-2017-0709). Based on observations made with the JAST80 telescope telescope/s at the Observatorio Astrofísico de Javalambre, in Teruel, owned, managed, and operated by the Centro de Estudios de Física del Cosmos de Aragón. We thank the Centro de Estudios de Física del Cosmos de Aragón for the allocation of the Director’s Discretionary Time to this program. We thank the OAJ Data Processing and Archiving Unit (UPAD) for reducing and calibrating the OAJ data used in this work. Funding for the J-PLUS Project has been provided by the Governments of Spain and Aragón through the Fondo de Inversiones de Teruel; the Aragón Government through the Research Groups E96, E103, and E16_17R; the Spanish Ministry of Science, Innovation, and Universities (MCIU/AEI/FEDER, UE) with grants PGC2018-097585-B-C21 and PGC2018-097585-B-C22; the Spanish Ministry of Economy and Competitiveness (MINECO) under AYA2015-66211-C2-1-P, AYA2015-66211-C2-2, AYA2012-30789, and ICTS-2009-14; and European FEDER funding (FCDD10-4E-867, FCDD13-4E-2685). The Brazilian agencies FINEP, FAPESP, and the National Observatory of Brazil have also contributed to this project. This work has made use of the computing facilities of the Laboratory of Astroinformatics (IAG/USP, NAT/Unicsul), whose purchase was made possible by the Brazilian agency FAPESP (grant 2009/54006-4) and the INCT-A.Peer reviewe