Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

A communal catalogue reveals Earth's multiscale microbial diversity

Our growing awareness of the microbial world's importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth's microbial diversity.Peer reviewe

A communal catalogue reveals Earth’s multiscale microbial diversity

Our growing awareness of the microbial world’s importance and diversity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community samples collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of diversity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial diversity

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Health care effects of cultural beliefs about physicians and perceived discrimination

Background: Healthcare inequities may hamper physical and mental health. Aim: To examine perceived discrimination in healthcare services in relation to socio-structural and cultural antecedents as well as their effect on psychological processes and health. Material and Methods: Questionnaires on beliefs about physicians, perceived discrimination, emotions and affective states and avoidance consequences in health were answered by 337 child caregivers (85% women) attending preventive health care appointments at primary health care centers. Results: Negative beliefs about healthcare professionals are directly associated with avoidance behaviors in health and perceived discrimination. The latter perception has no direct effects on avoidance behaviors, but it has an indirect effect through negative emotions associated with discrimination. Conclusions: There is an association between cultural, psychological and structural factors in health care. These results contribute to understand the phenomenon of discrimination and its negative consequences

To get vaccinated or not? Social psychological factors associated with vaccination intent for COVID-19

Pandemic control not only requires effective COVID-19 vaccines but also that they are accepted by at least 80% of the population. For this reason, understanding the social psychological variables associated with vaccination intent is essential to achieve herd immunity. Drawing on the theory of reasoned action, this study seeks to analyze vaccination intent using the beliefs about vaccine effectiveness, conspiracy theories, and injunctive norms as predictors. A non-probabilistic national online survey was conducted during December 2020. A sample of 1,033 people in Chile answered a questionnaire with the study variables. Using structural equation models, it was found that vaccination intent was explained in 62.1% by beliefs about vaccine effectiveness and injunctive norms, controlling for age, political orientation, socioeconomic status, educational level, and gender. Specifically, beliefs about vaccine effectiveness are based on people's experience with previous immunization processes, which predict vaccination intent. Regarding injunctive norms, they act by influencing and encouraging vaccination by seeking the approval of significant others. Contrary to expected, conspiracy beliefs were not directly associated with the intention to receive a COVID-19 vaccine but were highly related to lower beliefs about vaccine effectiveness. This study suggests that to enhance the vaccination intent, socio-psychological and structural variables need to be considered

Healthcare mistreatment attributed to discrimination among mapuche patients and discontinuation of diabetes care

Background: The negative impact of perceived discrimination on health outcomes is well established. However, less attention has been directed towards understanding the effect of perceived discrimination on health behaviors relevant for the treatment of diabetes in ethnic minorities. Aim: To examine the effects of healthcare mistreatment attributed to discrimination on the continuity of Type 2 Diabetes (DM2) care among mapuche patients in a southern region of Chile. Material and Methods: A non-probabilistic sample of 85 mapuche DM2 patients were recruited from public and private health systems. Eligibility criteria included having experienced at least one incident of interpersonal healthcare mistreatment. All participants answered an instrument designed to measure healthcare mistreatment and continuity of diabetes care. Results: Healthcare mistreatment attributed to ethnic discrimination was associated with the discontinuation of diabetes care. Conclusions: Healthcare mistreatment attributed to discrimination negatively impacted the continuity of diabetes care, a fact which may provide a better understanding of health disparities in ethnic minorities

The Chilean social crisis and mental health: a glance from the life cycle

During 2019, Chilean society witnessed massive citizen demonstrations motivated by historical inequalities. The objective of this study is to compare the perception of young adults and adults about the social protests and its relation to mental health and social well-being. 711 people answered the online survey on the study factors. The results indicate that adults above the age of 30 show more interest in politics and both groups categorically reject the use of violence during the civilian protests. Moreover, the young adults showed higher results in anomie and negative affectivity, whereas adults show better social well-being and satisfaction with live. The Chilean social protest has had political and socio-emotional consequences, which remain until today

Development of an instrument to assess cultural beliefs about physicians

Background: Beliefs about professionals' healthcare may influence healthcare behaviors. Such beliefs are in part the result of the interactions that professionals have with their patients. Recent studies highlight the importance of beliefs about physicians, their effect on health-care behaviors, and the requirement of culturally appropriate tools to measure such beliefs. Aim: To develop and validate a culturally appropriate instrument to measure beliefs about physicians. Material and Methods: Based on a 'bottom-up' methodology, a culturally pertinent scale of beliefs about physicians was developed and then validated by expert judges. The resulting scale, with 26 items, was applied to 337 participants aged 31 +/- 7 years (85% women). Results: Two factors, grouping 24 items, emerged from the exploratory factor analysis. The first was called negative beliefs about doctors (Cronbach's alpha = 0.96) and the second was called positive beliefs about doctors (Cronbach's alpha = 0.95). Both factors explain 70 % of the scale variance. Conclusions: The devised instrument has adequate psychometric properties and is also culturally relevant. It allows the assessment of cultural beliefs about physicians