Data analysis from the Spanish Registry of Cardiac Surgery (RECC) 2021-2022

Cardiovascular surgery; Acquired cardiac disease; Aortic surgeryCirurgia cardiovascular; Cardiopaties adquirides; Cirurgia aòrticaCirugía cardiovascular; Cardiopatías adquiridas; Cirugía aórticaIntroducción Desde el 8 de febrero de 2021, la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE) puso en marcha el Registro Español de Cirugía Cardiaca (RECC) que está disponible para las diferentes unidades de cirujanos cardiovasculares de nuestro país. Es una herramienta que permite recopilar datos de pacientes sometidos a cirugía cardiaca, vascular o endovascular. Tras dos años de desarrollo, hemos llevado a cabo un análisis de la calidad de la información obtenida para adquirir una visión general de su contenido. Métodos La información ha sido analizada de forma anónima a nivel de paciente, hospital y provincia. Para la estimación de la mortalidad ajustada por riesgo se utilizó la escala de estimación de riesgo preoperatorio EuroSCORE II. Resultados Se han incluido en el RECC un total de 7.087 intervenciones, de las cuales 6.267 se trataban de cirugías cardiacas mayores. Del total de intervenciones mayores, 53,9% eran cirugías valvulares, 25,2% de revascularización miocárdica y 14,9% de aorta. La mortalidad global de la serie fue de 5,0% y el índice de mortalidad ajustada al riesgo (IMAR) de 0,88. La calibración del EuroSCORE II en la muestra global fue buena en los pacientes de riesgo más bajo, aunque sobreestimó la mortalidad en los de alto riesgo. Conclusiones El RECC se trata de una base de datos clínica nacional que permite el análisis de datos de pacientes con el fin de evaluar de forma precisa el volumen de la actividad, riesgo y resultados. A nivel local, podría utilizarse como una herramienta para mejorar la calidad de la atención y el desarrollo de programas correctivos.Introduction Since February 8, 2021, the Spanish Society of Cardiovascular and Endovascular Surgery got under way the Spanish Registry of Cardiac Surgery (RECC), which is available for the different units of cardiovascular surgeons in our country. It is a tool that allows collect patient-level data of patients undergoing cardiac, vascular or endovascular surgery. After two years of development, we have carried out an analysis of the quality of the information obtained in order to acquire an overview of its content. Methods The information has been analyzed anonymously at patient, hospital and province level. For risk-adjusted mortality estimation, the EuroSCORE II preoperative risk estimation scale was used. Results A total of 7087 interventions have been included. Six thousand two hundred and sixty-seven were major cardiac surgeries: 53.9% valvular, 25.2% coronary artery bypass grafting, and 14.9% aortic procedures. The overall mortality was 5.0% and the risk-adjusted mortality rate was 0.88. The EuroSCORE II calibration in the overall sample was good in the lowest-risk patients, although it overestimated mortality in high-risk patients. Conclusions RECC is a nationally defined clinical database in the field of cardiovascular surgery. RECC allows a patient-level data analysis in order to perform an accurate analysis of the volumen of activity, risk adjustment and results. Locally, it could be used as a tool to improve the quality of care and development of corrective programs

Biochemical and structural characterization of a novel thermophilic esterase EstD11 provide catalytic insights for the HSL family

[Abstract]: A novel esterase, EstD11, has been discovered in a hot spring metagenomic library. It is a thermophilic and thermostable esterase with an optimum temperature of 60 C. A detailed substrate preference analysis of EstD11 was done using a library of chromogenic ester substrate that revealed the broad substrate specificity of EstD11 with significant measurable activity against 16 substrates with varied chain length, steric hindrance, aromaticity and flexibility of the linker between the carboxyl and the alcohol moiety of the ester. The tridimensional structures of EstD11 and the inactive mutant have been determined at atomic resolutions. Structural and bioinformatic analysis, confirm that EstD11 belongs to the family IV, the hormone-sensitive lipase (HSL) family, from the α/β-hydrolase superfamily. The canonical a/b hydrolase domain is completed by a cap domain, composed by two subdomains that can unmask of the active site to allow the substrate to enter. Eight crystallographic complexes were solved with different substrates and reaction products that allowed identification of the hot-spots in the active site underlying the specificity of the protein. Crystallization and/or incubation of EstD11 at high temperature provided unique information on cap dynamics and a first glimpse of enzymatic activity in vivo. Very interestingly, we have discovered a unique Met zipper lining the active site and the cap domains that could be essential in pivotal aspects as thermo-stability and substrate promiscuity in EstD11Ministerio de Ciencia e Innovación; BFU2017-90030-

Structural brain abnormalities in the common epilepsies assessed in a worldwide ENIGMA study

Progressive functional decline in the epilepsies is largely unexplained. We formed the ENIGMA-Epilepsy consortium to understand factors that influence brain measures in epilepsy, pooling data from 24 research centres in 14 countries across Europe, North and South America, Asia, and Australia. Structural brain measures were extracted from MRI brain scans across 2149 individuals with epilepsy, divided into four epilepsy subgroups including idiopathic generalized epilepsies (n =367), mesial temporal lobe epilepsies with hippocampal sclerosis (MTLE; left, n = 415; right, n = 339), and all other epilepsies in aggregate (n = 1026), and compared to 1727 matched healthy controls. We ranked brain structures in order of greatest differences between patients and controls, by meta-Analysing effect sizes across 16 subcortical and 68 cortical brain regions. We also tested effects of duration of disease, age at onset, and age-by-diagnosis interactions on structural measures. We observed widespread patterns of altered subcortical volume and reduced cortical grey matter thickness. Compared to controls, all epilepsy groups showed lower volume in the right thalamus (Cohen's d = \uc3\ua2 '0.24 to \uc3\ua2 '0.73; P < 1.49 \uc3\u97 10 \uc3\ua2 '4), and lower thickness in the precentral gyri bilaterally (d = \uc3\ua2 '0.34 to \uc3\ua2 '0.52; P < 4.31 \uc3\u97 10 \uc3\ua2 '6). Both MTLE subgroups showed profound volume reduction in the ipsilateral hippocampus (d = \uc3\ua2 '1.73 to \uc3\ua2 '1.91, P < 1.4 \uc3\u97 10 \uc3\ua2 '19), and lower thickness in extrahippocampal cortical regions, including the precentral and paracentral gyri, compared to controls (d = \uc3\ua2 '0.36 to \uc3\ua2 '0.52; P < 1.49 \uc3\u97 10 \uc3\ua2 '4). Thickness differences of the ipsilateral temporopolar, parahippocampal, entorhinal, and fusiform gyri, contralateral pars triangularis, and bilateral precuneus, superior frontal and caudal middle frontal gyri were observed in left, but not right, MTLE (d = \uc3\ua2 '0.29 to \uc3\ua2 '0.54; P < 1.49 \uc3\u97 10 \uc3\ua2 '4). Contrastingly, thickness differences of the ipsilateral pars opercularis, and contralateral transverse temporal gyrus, were observed in right, but not left, MTLE (d = \uc3\ua2 '0.27 to \uc3\ua2 '0.51; P < 1.49 \uc3\u97 10 \uc3\ua2 '4). Lower subcortical volume and cortical thickness associated with a longer duration of epilepsy in the all-epilepsies, all-other-epilepsies, and right MTLE groups (beta, b < \uc3\ua2 '0.0018; P < 1.49 \uc3\u97 10 \uc3\ua2 '4). In the largest neuroimaging study of epilepsy to date, we provide information on the common epilepsies that could not be realistically acquired in any other way. Our study provides a robust ranking of brain measures that can be further targeted for study in genetic and neuropathological studies. This worldwide initiative identifies patterns of shared grey matter reduction across epilepsy syndromes, and distinctive abnormalities between epilepsy syndromes, which inform our understanding of epilepsy as a network disorder, and indicate that certain epilepsy syndromes involve more widespread structural compromise than previously assumed

I know people who can and who cannot: A measure of the perception of economic inequality in everyday life

Versión preprintThis paper describes the development of the Perceived Economic Inequality in Everyday Life (PEIEL) scale. It is written and validated in Spanish. We first carried out an exploratory study, using a sample of 205 participants (52.2% men and 47.8% women; age: M = 24.69, SD = 8.95). We then conducted a confirmatory study with a sample size of 215 individuals (43.7% men and 56.3% women; age: M = 23.83, SD = 6.46). Results showed that the PEIEL scale is a valid and reliable unidimensional instrument. This scale negatively predicted tolerance of economic inequality over and above perceived inequality measured by wage gap estimates. In addition, perceived economic inequality in everyday life was negatively associated with tolerance of inequality, particularly in individuals with right-wing political ideology.Universidad de Costa Rica/[OAICE-006-2017]/UCR/Costa RicaUCR::Sedes Regionales::Sede de Occident