Racial and Ethnic Differences in Diabetes Mellitus among People with and without Psychiatric Disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Objective: This study examined racial/ethnic differences in the prevalence of diabetes mellitus in a nationally representative sample of adults with and without common psychiatric disorders. Method: Data were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N= 34,653). Logistic regression models adjusting for sociodemographic variables and diabetes risk factors were used to examine racial/ethnic differences in 12-month prevalence rates of diabetes by psychiatric status. Results: Among people without psychiatric disorders, African Americans, Hispanics, and American Indians/Alaska Natives, but not Asians/Pacific Islanders, had significantly higher rates of diabetes than non-Hispanic whites even after adjusting for socio-demographic variables and diabetes risk factors. In the presence of psychiatric disorders, these health disparities persisted for African Americans and Hispanics, but not for American Indians/Alaska Natives. No significant interactions between race/ethnicity and psychiatric disorders in the odds of diabetes were found across any group. Conclusion: Policies and services that support culturally appropriate prevention and treatment strategies are needed to reduce racial/ethnic disparities in diabetes among people with and without psychiatric disabilities

A 5LCHB Inverter for PV transformerless applications with reduced leakage ground current

Transformerless inverters for photovoltaic systems are widely used as it features low cost, volume, and weight. Thus, in recent years, its study has been of great interest to the research community. In this paper a transformerless cascade multilevel inverter for photovoltaic applications with leakage ground current compensation capability is presented. The proposed solution involves a second-order LC output filter with a particular connection, which is referred to as the DC-link-tied LC output filter. This solution is aimed to deal with the leakage-ground current issue, regardless of the considered PWM strategy. The mathematical model of the system involving such a particular LC output passive filter configuration is presented, out of which, both the differential-mode and the common-mode models are obtained. These models are used to explain the leakage-ground current improvement of the proposed DC-link-tied LC output filter. This hardware solution is evaluated under different modulation schemes to contrast the converter output response and the leakage-ground current performance. Finally, simulation and experimental results are performed using a 1 kW academic prototype to assess the performance of the proposed DC-link-tied LC output filter used in a transformerless inverter application.Peer ReviewedObjectius de Desenvolupament Sostenible::7 - Energia Assequible i No ContaminantObjectius de Desenvolupament Sostenible::11 - Ciutats i Comunitats SosteniblesPostprint (published version

Quantitative HDL Proteomics Identifies Peroxiredoxin-6 as a Biomarker of Human Abdominal Aortic Aneurysm

High-density lipoproteins (HDLs) are complex protein and lipid assemblies whose composition is known to change in diverse pathological situations. Analysis of the HDL proteome can thus provide insight into the main mechanisms underlying abdominal aortic aneurysm (AAA) and potentially detect novel systemic biomarkers. We performed a multiplexed quantitative proteomics analysis of HDLs isolated from plasma of AAA patients (N = 14) and control study participants (N = 7). Validation was performed by western-blot (HDL), immunohistochemistry (tissue), and ELISA (plasma). HDL from AAA patients showed elevated expression of peroxiredoxin-6 (PRDX6), HLA class I histocompatibility antigen (HLA-I), retinol-binding protein 4, and paraoxonase/arylesterase 1 (PON1), whereas alpha-2 macroglobulin and C4b-binding protein were decreased. The main pathways associated with HDL alterations in AAA were oxidative stress and immune-inflammatory responses. In AAA tissue, PRDX6 colocalized with neutrophils, vascular smooth muscle cells, and lipid oxidation. Moreover, plasma PRDX6 was higher in AAA (N = 47) than in controls (N = 27), reflecting increased systemic oxidative stress. Finally, a positive correlation was recorded between PRDX6 and AAA diameter. The analysis of the HDL proteome demonstrates that redox imbalance is a major mechanism in AAA, identifying the antioxidant PRDX6 as a novel systemic biomarker of AAA.We thank Simon Bartlett for language and scientific editing. This study was supported by the Spanish Ministry of Economy and Competitiveness (MINECO) (SAF2016-80843-R, BIO2012-37926 and BIO2015-67580-P), Fondo de Investigaciones Sanitarias ISCiii-FEDER (PRB2) (IPT13/0001, ProteoRed, Redes RIC RD12/0042/00038 and RD12/0042/0056, Biobancos RD09/0076/00101 and CA12/00371), Centro de Investigacion Biomedica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), and FRIAT. The CNIC is supported by the Spanish Ministry of Economy and Competitiveness (MINECO) and the Pro-CNIC Foundation, and is a Severo Ochoa Center of Excellence (MINECO award SEV-2015-0505).S

Caracterización clínica –epidemiológica de pacientes con fisura anal crónica tratados con lisado plaquetario alogénico

Introducción: La fisura anal es un desgarro o ulceración en el revestimiento epidérmico del conducto anal distal. Constituye uno de los problemas proctológicos más frecuentes en la población occidental cuya incidencia es igual para ambos sexos. Objetivo: Caracterizar clínica y epidemiológicamente a los pacientes con fisuras anales crónicas tratados con lisado plaquetario alogénico. Método: Se realizó un estudio longitudinal prospectivo en el Hospital General Docente Comandante Pinares, San Cristóbal, Artemisa, Cuba,  desde enero de 2015 hasta junio de 2017. La muestra quedó constituida por 231 pacientes, 123 (lisado plaquetario) y 108 (convencional), de ambos sexos, con el diagnóstico de fisura anal. A todos los pacientes se les solicitó la firma de consentimiento informado, se utilizaron medidas de tendencia central y de dispersión. Se utilizó la prueba de McNemar para evaluar la efectividad, con un nivel de significación del 5%. Resultados: Predominaron los pacientes jóvenes menores de 60 años, femeninas con localización posterior de la fisura. Mejoría clínica en pacientes tratados con lisado a los seis meses. El tiempo de respuesta de la lesión constituyó la característica distintiva entre ambos tratamientos, no se detectaron complicaciones. Conclusiones: El efecto final en los pacientes con fisuras anales crónicas, tratados con la aplicación de lisado plaquetario alogénico fue positivo y puede representar una alternativa  para el tratamiento de esta enfermedad. Palabras clave: fisuras anales crónicas, factores de crecimiento plaquetario, lisado de plaqueta

Public-private partnerships and sustainable development goals: proposal for the implementation of the 2030 Agenda

The importance of non-governmental organizations of achieving the sustainable development goals: The fight against racial discrimination of Roma in Europe / Cristina Hermida del Llano (pp. 15-26). -- Investiment promotion regimes for least developed countries / María Ángeles Cano Linares (pp. 27-45). -- Alliances with international organizations: How the OSCE has contributed to the SDGs / Elena C. Díaz Galán (pp. 47-58). -- Spanish commitment to official development aid with gender perspective / Diana M. Verdiales López (pp. 59-77). -- Project of entrepreneurship of the Guambiano indigenous community: Public-private alliances in the Republic of Colombia / Cristina del Pardo Higuera (pp. 79-95). -- The contribution of petroleum companies to enviromental protection in a framework of compliance with the 2030 Agenda: a necessary alliance / María Sagrario Morán Blanco (pp. 97-122). -- Public-private partnerships and access to water and sanitation in Latin America (SDG 6) / Manuel Rodríguez Barrigón (123-138). -- The renewed commercial and investment agreements: the progressive incorporation of Human Rights and sustainable development goals / Jorge Urbaneja Cillán (pp. 139-152). -- Towards using data as a development lever for cities: the case of Singapore and the smart nation initiative / Benoît Lopez (pp. 153-162). -- Which access to green technologies for developing countries? / Dayana Morales Mina (pp. 163-172). -- Strenght institutional and normative framework to implement effective capacity building actions: a critical regional analysis / Andrés Bautista-Hernáez (pp. 173-185)

Características microbiológicas de infecciones en pacientes pediátricos con cáncer del eje cafetero colombiano, 2014-2016

Objetivo: Describir características microbiológicas de las infecciones en pacientes pediátricos con cáncer en un centro de referencia del Eje Cafetero Colombiano 2014 – 2016. Materiales y métodos. Estudio descriptivo, corte transversal de pacientes oncológicos menores de 18 años hospitalizados en una institución de referencia en Colombia; los cuales hayan presentado una infección y se les haya realizado un cultivo con antibiograma. La ficha de recolección validada por expertos es reportada a través de WHONET 5.6. Análisis estadísticos descriptivos fueron realizados con STATA 14.2, versión oficial. Resultados. 2691 cultivos de 596 pacientes fueron incluidos. 53,86% correspondió a sexo masculino, la edad media fue de 8,86 años. El 76,89% de los cultivos se realizaron en el área de hospitalización. El 74,36% de los cultivos fueron de sangre, con un 22,04% de reportes positivos. La segunda muestra con mayor número de cultivos fue orina con 16,16%, con 25,75% de cultivos positivos. El mayor porcentaje de cultivos positivos fue para heces y biopsias con 71,21% y 53,13%, respectivamente. Se presentó una tasa de positividad global del 25.75%. Los tres principales microorganismos aislados fueron Gram negativos. Los microorganismos de mayor aislamiento fueron K. pneumoniae (24,4%), E. coli (21,06%) y P. aeruginosa (17,46%). Conclusión. Se presenta un patrón de infecciones similar al reportado en adultos, siendo los Gram negativos los más comunes. Recomendamos establecer políticas de dispensación de antibióticos y mejorar la vigilancia epidemiológica.Objective: To describe microbiological characteristics of infections in pediatric patients with cancer in a reference center of the Colombian coffee region, 2014-2016. Materials and methods. Cross-sectional, descriptive study including underaged oncological inpatients managed in a reference institution in Colombia; who have been dated an infection with a subsequent antibiogram done. The collection sheet validated by experts is reported through WHONET 5.6. Descriptive statistical analyzes were performed with STATA 14.2, official version. Results. 2691 cultures from 596 patients were included. 53.86% were male, the mean age was 8.86 years. 76.89% of the cultures were performed in the hospitalization area. 74.36% of the cultures were blood, with 22.04% positive reports. The second sample with the highest number of cultures was urine with 16.16%, with 25.75% positive cultures. The highest percentage of positive cultures was for feces and biopsies with 71.21% and 53.13%, respectively. An overall positivity rate of 25.75% was presented. The three main microorganisms isolated were Gram negative. The most isolated microorganisms were K. pneumoniae (24.4%), E. coli (21.06%) and P. aeruginosa (17.46%). Conclusion. Infection pattern similar to the one reported in adults, being the Gram-negatives the most prevalent agents. We recommend establishing antibiotic dispensing policies thus achieving microbiological risk control and improving epidemiological surveillance

Cognitive Performance and Health-Related Quality of Life in Patients with Neuromyelitis Optica Spectrum Disorder

Background: The frequency of cognitive impairment (CI) reported in neuromyelitis optica spectrum disorder (NMOSD) is highly variable, and its relationship with demographic and clinical characteristics is poorly understood. We aimed to describe the cognitive profile of NMOSD patients, and to analyse the cognitive differences according to their serostatus; furthermore, we aimed to assess the relationship between cognition, demographic and clinical characteristics, and other aspects linked to health-related quality of life (HRQoL). Methods: This cross-sectional study included 41 patients (median age, 44 years; 85% women) from 13 Spanish centres. Demographic and clinical characteristics were collected along with a cognitive z-score (Rao's Battery) and HRQoL patient-centred measures, and their relationship was explored using linear regression. We used the Akaike information criterion to model which characteristics were associated with cognition. Results: Fourteen patients (34%) had CI, and the most affected cognitive domain was visual memory. Cognition was similar in AQP4-IgG-positive and -negative patients. Gender, mood, fatigue, satisfaction with life, and perception of stigma were associated with cognitive performance (adjusted R-2 = 0.396, p < 0.001). Conclusions: The results highlight the presence of CI and its impact on HRQoL in NMOSD patients. Cognitive and psychological assessments may be crucial to achieve a holistic approach in patient care

Galectin-1 prevents pathological vascular remodeling in atherosclerosis and abdominal aortic aneurysm

Pathological vascular remodeling is the underlying cause of atherosclerosis and abdominal aortic aneurysm (AAA). Here, we analyzed the role of galectin-1 (Gal-1), a β-galactoside-binding protein, as a therapeutic target for atherosclerosis and AAA. Mice lacking Gal-1 (Lgals1 −/− ) developed severe atherosclerosis induced by pAAV/D377Y-mPCSK9 adenovirus and displayed higher lipid levels and lower expression of contractile markers of vascular smooth muscle cells (VSMCs) in plaques than wild-type mice. Proteomic analysis of Lgals1 −/− aortas showed changes in markers of VSMC phenotypic switch and altered composition of mitochondrial proteins. Mechanistically, Gal-1 silencing resulted in increased foam cell formation and mitochondrial dysfunction in VSMCs, while treatment with recombinant Gal-1 (rGal-1) prevented these effects. Furthermore, rGal-1 treatment attenuated atherosclerosis and elastase-induced AAA, leading to higher contractile VSMCs in aortic tissues. Gal-1 expression decreased in human atheroma and AAA compared to control tissue. Thus, Gal-1-driven circuits emerge as potential therapeutic strategies in atherosclerosis and AAA. Galectin-1 plays an essential role in prevention of atherosclerosis and abdominal aortic aneurysm

Neurological Disorders in Takotsubo Syndrome: Clinical Phenotypes and Outcomes

Background: Neurological disorders as a risk factor for Takotsubo syndrome (TTS) are not well characterized. The aim of the study was to evaluate TTS-associated neurological phenotypes and outcome. Methods and results: Patients with TTS enrolled in the international multicenter GEIST (German Italian Spanish Takotsubo) registry were analyzed. Prevalence, clinical characteristics, and short- and long-term outcomes of patients with TTS were recorded. A subgroup analysis of the 5 most represented neurological disorders was performed. In total, 400 (17%) of 2301 patients had neurological disorders. The most represented neurological conditions were previous cerebrovascular events (39%), followed by neurodegenerative disorders (30.7%), migraine (10%), epilepsy (9.5%), and brain tumors (5%). During hospitalization, patients with neurological disorders had longer in-hospital stay (8 [interquartile range, 5-12] versus 6 [interquartile range, 5-9] days; P&lt;0.01) and more often experienced in-hospital complications (27% versus 16%; P=0.01) mainly driven by cardiogenic shock and in-hospital death (12% versus 7.6% and 6.5% versus 2.8%, respectively; both P&lt;0.01). Survival analysis showed a higher mortality rate in neurological patients both at 60 days and long-term (8.8% versus 3.4% and 23.5% versus 10.1%, respectively; both P&lt;0.01). Neurological disorder was an independent predictor of both the 60-day and long-term mortality rate (odds ratio, 1.78 [95% CI, 1.07-2.97]; P=0.02; hazard ratio, 1.72 [95% CI, 1.33-2.22]; both P&lt;0.001). Patients with neurodegenerative disorders had the worst prognosis among the neurological disease subgroups, whereas patients with TTS with migraine had a favorable prognosis (long-term mortality rates, 29.2% and 9.7%, respectively). Conclusions: Neurological disorders identify a high-risk TTS subgroup for enhanced short- and long-term mortality rate. Careful recognition of neurological disorders and phenotype is therefore needed

Enfrentando los riesgos socionaturales

El objetivo del libro es comprender la magnitud de los Riesgos Socionaturales en México y Latinoamérica, para comprender el peligro que existe por algún tipo de desastre, ya sea inundaciones, sismos, remoción en masa, entre otros, además conocer qué medidas preventivas, correctivas y de contingencias existen para estar atentos ante alguna señal que la naturaleza esté enviando y así evitar alguna catástrofe. El libro se enfoca en los aspectos básicos de análisis de los peligros, escenarios de riesgo, vulnerabilidad y resiliencia, importantes para la gestión prospectiva o preventiva