Evaluation of the COVID-19 response in Spain: principles and requirements

A resurgence of COVID-19 infections is occurring in Spain, with some of the worst figures in Europe. In August, 2020, we urged the Spanish Central Government and regional governments to independently evaluate their COVID-19 response to identify areas where public health and the health and social care system need to be improved

Insight on how to assess and improve the response to the COVID-19 pandemic

La pandemia de COVID-19 ha afectado de manera particularmente intensa a España, pese a su nivel de desarrollo y la elogiada solidez de su Sistema Nacional de Salud. Para comprender qué ha pasado e identificar cómo mejorar la respuesta creemos imprescindible una evaluación independiente multidisciplinaria de la esfera sanitaria, política y socioeconómica. En este trabajo proponemos objetivos, principios, metodología y dimensiones a evaluar, además de esbozar el tipo de resultados y conclusiones esperadas. Nos inspiramos en los requerimientos formulados por el panel independiente de la Organización Mundial de la Salud y en las experiencias evaluativas en otros países, y detallamos la propuesta de aspectos multidimensionales que deben valorarse. La idea es comprender aspectos clave en los ámbitos estudiados y su margen de mejora en lo relativo a preparación, gobernanza, marco normativo, estructuras del Sistema Nacional de Salud (atención primaria, hospitalaria y de salud pública), sector de educación, esquemas de protección social, minimización del impacto económico, y marco y reformas en el ámbito laboral para una sociedad más resiliente. En definitiva, buscamos que este ejercicio sirva no solo para el presente, sino también para que en el futuro estemos mejor preparados y con más ágil capacidad de recuperación ante las amenazas pandémicas que puedan surgir.The COVID-19 pandemic has hit Spain particularly hard, despite being a country with a developed economy and being praised for the robustness of its national health system. In order to understand what happened and to identify how to improve the response, we believe that an independent multi-disciplinary evaluation of the health, political and socio-economic spheres is essential. In this piece we propose objectives, principles, methodology and dimensions to be evaluated, as well as outlining the type of results and conclusions expected. Inspired by the requirements formulated by the WHO Independent Panel for Pandemic Preparedness and Response and by experiences in other countries, we detail the multidimensional aspects to be evaluated. The goal is to understand key aspects in the studied areas and their scope for improvement in terms of preparedness, governance, regulatory framework, national health system structures (primary care, hospital, and public health), education sector, social protection schemes, minimization of economic impact, and labour framework and reforms for a more resilient society. We seek to ensure that this exercise serves not only at present, but also that in the future we are better prepared and more agile in terms of our ability to recover from any pandemic threats that may arise.Ayuda referencia: PI 18/01937 del Fondo de Investigación Sanitaria- Instituto de Salud Carlos III, España, con cofinanciación de Fondos FEDER

Inflammatory biomarkers in Alzheimer's disease plasma.

INTRODUCTION: Plasma biomarkers for Alzheimer's disease (AD) diagnosis/stratification are a "Holy Grail" of AD research and intensively sought; however, there are no well-established plasma markers. METHODS: A hypothesis-led plasma biomarker search was conducted in the context of international multicenter studies. The discovery phase measured 53 inflammatory proteins in elderly control (CTL; 259), mild cognitive impairment (MCI; 199), and AD (262) subjects from AddNeuroMed. RESULTS: Ten analytes showed significant intergroup differences. Logistic regression identified five (FB, FH, sCR1, MCP-1, eotaxin-1) that, age/APOε4 adjusted, optimally differentiated AD and CTL (AUC: 0.79), and three (sCR1, MCP-1, eotaxin-1) that optimally differentiated AD and MCI (AUC: 0.74). These models replicated in an independent cohort (EMIF; AUC 0.81 and 0.67). Two analytes (FB, FH) plus age predicted MCI progression to AD (AUC: 0.71). DISCUSSION: Plasma markers of inflammation and complement dysregulation support diagnosis and outcome prediction in AD and MCI. Further replication is needed before clinical translation

ICO-ICS Praxis para el tratamiento médico y con irradiación de cáncer colorrectal

Tractament mèdic; Tractament amb irradiació; Còlon; Recte; CàncerMedical treatment; Irradiation treatment; Colon; Rectum; CancerTratamiento médico; Tratamiento con irradiación; Colon; Recto; CáncerEl càncer de còlon i recte (CCR) és el més freqüent a Catalunya segons dades del Pla director d’oncologia estimades per a 2017. La incidència del CCR és superior en homes, amb un increment anual de l'1,3% en els homes i el 0,5% en les dones des de 1994. A Espanya, segons l’informe de la SEOM, que recull dades de la REDECAN, posiciona el CCR com un dels més freqüents i probables de diagnosticar el 2019, amb 44.937 nous casos. Segons les dades dels registres de GLOBOCAN 2018, el CCR és el segon càncer amb més incidència a Europa. La incidència distribuïda per sexes és del 16,7% en homes i del 13,3% en dones. Els objectius d'aquesta guia són: -Desenvolupar, difondre, implementar i avaluar resultats de la ICO-ICSPraxi de càncer colorectal. -Disminuir la variabilitat terapèutica entre els pacients tractats als diferents centres d'aquesta institució. -Implementar els resultats de la terapèutica en els pacients amb adenocarcinoma de pàncrees tractats d'acord amb les recomanacions d'aquesta guia

Dickkopf-1 Overexpression in vitro Nominates Candidate Blood Biomarkers Relating to Alzheimer's Disease Pathology

Previous studies suggest that Dickkopf-1 (DKK1), an inhibitor of Wnt signaling, plays a role in amyloid-induced toxicity and hence Alzheimer's disease (AD). However, the effect of DKK1 expression on protein expression, and whether such proteins are altered in disease, is unknown. We aim to test whether DKK1 induced protein signature obtained in vitro were associated with markers of AD pathology as used in the amyloid/tau/neurodegeneration (ATN) framework as well as with clinical outcomes. We first overexpressed DKK1 in HEK293A cells and quantified 1,128 proteins in cell lysates using aptamer capture arrays (SomaScan) to obtain a protein signature induced by DKK1. We then used the same assay to measure the DKK1-signature proteins in human plasma in two large cohorts, EMIF (n = 785) and ANM (n = 677). We identified a 100-protein signature induced by DKK1 in vitro. Subsets of proteins, along with age and apolipoprotein E ɛ 4 genotype distinguished amyloid pathology (A + T-N-, A+T+N-, A+T-N+, and A+T+N+) from no AD pathology (A-T-N-) with an area under the curve of 0.72, 0.81, 0.88, and 0.85, respectively. Furthermore, we found that some signature proteins (e.g., Complement C3 and albumin) were associated with cognitive score and AD diagnosis in both cohorts. Our results add further evidence for a role of DKK regulation of Wnt signaling in AD and suggest that DKK1 induced signature proteins obtained in vitro could reflect theATNframework as well as predict disease severity and progression in vivo

A metabolite-based machine learning approach to diagnose Alzheimer’s-type dementia in blood: Results from the European Medical Information Framework for Alzheimer's Disease biomarker discovery cohort

INTRODUCTION: Machine learning (ML) may harbor the potential to capture the metabolic complexity in Alzheimer’s Disease (AD). Here we set out to test the performance of metabolites in blood to categorise AD when compared to CSF biomarkers. METHODS: This study analysed samples from 242 cognitively normal (CN) people and 115 with AD-type dementia utilizing plasma metabolites (n=883). Deep Learning (DL), Extreme Gradient Boosting (XGBoost) and Random Forest (RF) were used to differentiate AD from CN. These models were internally validated using Nested Cross Validation (NCV). RESULTS: On the test data, DL produced the AUC of 0.85 (0.80-0.89), XGBoost produced 0.88 (0.86-0.89) and RF produced 0.85 (0.83-0.87). By comparison, CSF measures of amyloid, p-tau and t-tau (together with age and gender) produced with XGBoost the AUC values of 0.78, 0.83 and 0.87, respectively. DISCUSSION: This study showed that plasma metabolites have the potential to match the AUC of well-established AD CSF biomarkers in a relatively small cohort. Further studies in independent cohorts are needed to validate whether this specific panel of blood metabolites can separate AD from controls, and how specific it is for AD as compared with other neurodegenerative disorders

Orientational Effects and Random Mixing in 1-Alkanol + Alkanone Mixtures

1-Alkanol + alkanone systems have been investigated through the data analysis of molar excess functions, enthalpies, isobaric heat capacities, volumes and entropies, and using the Flory model and the formalism of the concentrationconcentration structure factor (SCC(0)). The enthalpy of the hydroxyl-carbonyl interactions has been evaluated. These interactions are stronger in mixtures with shorter alcohols (methanol-1-butanol) and 2-propanone or 2-butanone. However, effects related to the self-association of alcohols and to solvation between unlike molecules are of minor importance when compared with those which arise from dipolar interactions. Physical interactions are more relevant in mixtures with longer 1-alkanols. The studied systems are characterized by large structural effects. The variation of the molar excess enthalpy with the alcohol size along systems with a given ketone or with the alkanone size in solutions with a given alcohol are discussed in terms of the different contributions to this excess function. Mixtures with methanol show rather large orientational effects. The random mixing hypothesis is attained to a large extent for mixtures with 1-alkanols ≠ methanol and 2-alkanones. Steric effects and cyclization lead to stronger orientational effects in mixtures with 3-pentanone, 4-heptanone, or cyclohexanone. The increase of temperature weakens orientational effects. Results from SCC(0) calculations show that homocoordination is predominant and support conclusions obtained from the Flory model.Ministerio de Ciencia e Innovación, under Project FIS2010-1695

Inflammatory biomarkers in Alzheimer's disease plasma

Introduction:Plasma biomarkers for Alzheimer’s disease (AD) diagnosis/stratification are a“Holy Grail” of AD research and intensively sought; however, there are no well-established plasmamarkers.Methods:A hypothesis-led plasma biomarker search was conducted in the context of internationalmulticenter studies. The discovery phase measured 53 inflammatory proteins in elderly control (CTL;259), mild cognitive impairment (MCI; 199), and AD (262) subjects from AddNeuroMed.Results:Ten analytes showed significant intergroup differences. Logistic regression identified five(FB, FH, sCR1, MCP-1, eotaxin-1) that, age/APOε4 adjusted, optimally differentiated AD andCTL (AUC: 0.79), and three (sCR1, MCP-1, eotaxin-1) that optimally differentiated AD and MCI(AUC: 0.74). These models replicated in an independent cohort (EMIF; AUC 0.81 and 0.67). Twoanalytes (FB, FH) plus age predicted MCI progression to AD (AUC: 0.71).Discussion:Plasma markers of inflammation and complement dysregulation support diagnosis andoutcome prediction in AD and MCI. Further replication is needed before clinical translatio

The Potential Use of Marine Microalgae and Cyanobacteria in Cosmetics and Thalassotherapy

The use of microalgae and cyanobacteria for nutritional purposes dates back thousands of years; during the last few decades, microalgae culture has improved to become one of the modern biotechnologies. This has allowed high amounts of algal biomass to be obtained for use in different applications. Currently, the global production of microalgae and cyanobacteria is predominately aimed at applications with high added value given that algal biomass contains pigments, proteins, essential fatty acids, polysaccharides, vitamins, and minerals, all of which are of great interest in the preparation of natural products, both as food and in cosmetics. Hence, the bioactive components from microalgae can be incorporated in cosmetic and cosmeceutical formulations, and can help achieve benefits including the maintenance of skin structure and function. Thalassotherapy involves using seawater and all related marine elements, including macroalgae, however, there has been limited use of microalgae. Microalgae and cyanobacteria could be incorporated into health and wellness treatments applied in thalassotherapy centers due to their high concentration of biologically active substances that are of interest in skin care. This paper briefly reviews the current and potential cosmetic and cosmeceutical applications of marine microalgae and cyanobacteria compounds and also recommends its use in thalassotherapy well-being treatments

Hydrobiome of Thermal Waters: Potential Use in Dermocosmetics

Over the course of the last 20 years, numerous studies have identified the benefits of thermal waters on different skin conditions. Consequently, several investigations have been carried out on their effects on the skin, which are linked to their chemical composition, and, recently, scientists have turned their attention to the role of the thermal spring’s microbiota, named “hydrobiome”, regarding these therapeutic effects. At the same time, the development of cosmetics based on pre, pro, and postbiotics has reached great relevance and research is increasing every day. This review gathers information on the biological diversity of thermal spring waters and their potential use in obtaining biological compounds, metabolites, or bacterial extracts for use in dermocosmetics as active ingredients. These bioactive compounds are able to improve dermatological diseases such as atopic dermatitis or rosacea and ameliorate pruritus and xerosis; moreover, they can increase protection against UV exposure, strengthen barrier function, maintain good homeostasis of skin defenses, repair damaged skin, promote wound healing, improve skin condition, reduce uneven skin pigmentation, and prevent skin aging. From a future perspective, fruitful cooperation among researchers, hydrologists, thermal spa centers, and cosmetic industries will drive this sector toward a better understanding of the role of the hydrobiome of thermal spring waters on healthy skin and dermatological diseases and consider the inclusion of derivatives of this hydrobiome (in the form of fermenters, lysates, extracts, etc.) in dermocosmetic formulations. Therefore, and being aware of the potential of the hydrobiome in dermatological and skin care applications, the future prospects for the use of bioactive substances derived from it in dermocosmetic formulations are promising