A machine learning approach to personalized predictors of dyslipidemia: a cohort study

IntroductionMexico ranks second in the global prevalence of obesity in the adult population, which increases the probability of developing dyslipidemia. Dyslipidemia is closely related to cardiovascular diseases, which are the leading cause of death in the country. Therefore, developing tools that facilitate the prediction of dyslipidemias is essential for prevention and early treatment.MethodsIn this study, we utilized a dataset from a Mexico City cohort consisting of 2,621 participants, men and women aged between 20 and 50 years, with and without some type of dyslipidemia. Our primary objective was to identify potential factors associated with different types of dyslipidemia in both men and women. Machine learning algorithms were employed to achieve this goal. To facilitate feature selection, we applied the Variable Importance Measures (VIM) of Random Forest (RF), XGBoost, and Gradient Boosting Machine (GBM). Additionally, to address class imbalance, we employed Synthetic Minority Over-sampling Technique (SMOTE) for dataset resampling. The dataset encompassed anthropometric measurements, biochemical tests, dietary intake, family health history, and other health parameters, including smoking habits, alcohol consumption, quality of sleep, and physical activity.ResultsOur results revealed that the VIM algorithm of RF yielded the most optimal subset of attributes, closely followed by GBM, achieving a balanced accuracy of up to 80%. The selection of the best subset of attributes was based on the comparative performance of classifiers, evaluated through balanced accuracy, sensitivity, and specificity metrics.DiscussionThe top five features contributing to an increased risk of various types of dyslipidemia were identified through the machine learning technique. These features include body mass index, elevated uric acid levels, age, sleep disorders, and anxiety. The findings of this study shed light on significant factors that play a role in dyslipidemia development, aiding in the early identification, prevention, and treatment of this condition

Evaluating the extent and impact of the extreme Storm Gloria on Posidonia oceanica seagrass meadows

Extreme storms can trigger abrupt and often lasting changes in ecosystems by affecting foundational (habitat-forming) species. While the frequency and intensity of extreme events are projected to increase under climate change, its impacts on seagrass ecosystems remain poorly documented. In January 2020, the Spanish Mediterranean coast was hit by Storm Gloria, one of the most devastating recent climate events in terms of intensity and duration. We conducted rapid surveys of 42 Posidonia oceanica meadows across the region to evaluate the extent and type of impact (burial, unburial and uprooting). We investigated the significance of oceanographic (wave impact model), geomorphological (latitude, depth, exposure), and structural (patchiness) factors in predicting impact extent and intensity. The predominant impact of Storm Gloria was shoot unburial. More than half of the surveyed sites revealed recent unburial, with up to 40 cm of sediment removed, affecting over 50 % of the meadow. Burial, although less extensive, was still significant, with 10–80 % of meadow cover being buried under 7 cm of sediment, which is considered a survival threshold for P. oceanica. In addition, we observed evident signs of recently dead matte in some meadows and large amounts of detached drifting shoots on the sea bottom or accumulated as debris on the beaches. Crucially, exposed and patchy meadows were much more vulnerable to the overall impact than sheltered or continuous meadows. Given how slow P. oceanica is able to recover after disturbances, we state that it could take from decades to centuries for it to recoup its losses. Seagrass ecosystems play a vital role as coastal ecological infrastructure. Protecting vulnerable meadows from anthropogenic fragmentation is crucial for ensuring the resilience of these ecosystems in the face of the climate crisis.This study was funded by the CSIC project “Effects of storm Gloria on the western Mediterranean meadows (202030E052) and “Storms of change: as phenomena extreme weather alters Mediterranean coastal ecosystems, their services and their perception by society" (PID2020-113745RB-I00), state program of I+D+I Oriented to the Challenges of the Society and within the framework of the activities of the Spanish Government through the "Maria de Maeztu Centre of Excellence” accreditation to IMEDEA (CSIC-UIB) (CEX2021-001198). We want to thank the SPAS (Society of Fishing and Underwater Activities of Mataró) and the Mataró City Council, which has financed 25 years of the Alguer de Mataró project

Consenso mexicano sobre dolor torácico no cardiaco

Introducción: Dolor torácico no cardíaco (DTNC) se define como un síndrome clínico caracte-rizado por dolor retroesternal semejante a la angina de pecho, pero de origen no cardiaco ygenerado por enfermedades esofágicas, osteomusculares, pulmonares o psiquiátricas.Objetivo: Presentar una revisión consensuada basada en evidencias sobre definición, epidemio-logía, fisiopatología, diagnóstico y opciones terapéuticas para pacientes con DTNC.Métodos: Tres coordinadores generales realizaron una revisión bibliográfica de todas las publi-caciones en inglés y espa˜nol sobre el tema y elaboraron 38 enunciados iniciales divididosen tres categorías principales: 1) definiciones, epidemiología y fisiopatología; 2) diagnóstico,y 3) tratamiento. Los enunciados fueron votados (3 rondas) utilizando el sistema Delphi, y losque alcanzaron un acuerdo > 75% fueron considerados y calificados de acuerdo con el sistemaGRADE. Resultados y conclusiones: El consenso final incluyó 29 enunciados Todo paciente que debutacon dolor torácico debe ser inicialmente evaluado por un cardiólogo. La causa más común deDTNC es la enfermedad por reflujo gastroesofágico (ERGE). Como abordaje inicial, si no existensíntomas de alarma, se puede dar una prueba terapéutica con inhibidor de bomba de pro-tones (IBP) por 2-4 semanas. Si hay disfagia o síntomas de alarma, se recomienda hacer unaendoscopia. La manometría de alta resolución es el mejor método para descartar trastornosmotores espásticos y acalasia. La pHmetría ayuda a demostrar exposición esofágica anormal alácido. El tratamiento debe ser dirigido al mecanismo fisiopatológico, y puede incluir IBP, neu-romoduladores y/o relajantes de músculo liso, intervención psicológica y/o terapia cognitiva,y ocasionalmente cirugía o terapia endoscópica. ABSTRACT Introduction: Non-cardiac chest pain is defined as a clinical syndrome characterized by retros-ternal pain similar to that of angina pectoris, but of non-cardiac origin and produced byesophageal, musculoskeletal, pulmonary, or psychiatric diseases.Aim: To present a consensus review based on evidence regarding the definition, epidemiology,pathophysiology, and diagnosis of non-cardiac chest pain, as well as the therapeutic options forthose patients. Methods: Three general coordinators carried out a literature review of all articles published inEnglish and Spanish on the theme and formulated 38 initial statements, dividing them into 3 maincategories: (i) definitions, epidemiology, and pathophysiology; (ii) diagnosis, and (iii) treatment.The statements underwent 3 rounds of voting, utilizing the Delphi system. The final statementswere those that reached > 75% agreement, and they were rated utilizing the GRADE system.Results and conclusions: The final consensus included 29 statements. All patients presentingwith chest pain should initially be evaluated by a cardiologist. The most common cause ofnon-cardiac chest pain is gastroesophageal reflux disease. If there are no alarm symptoms, the initial approach should be a therapeutic trial with a proton pump inhibitor for 2-4 weeks. Ifdysphagia or alarm symptoms are present, endoscopy is recommended. High-resolution mano-metry is the best method for ruling out spastic motor disorders and achalasia and pH monitoringaids in demonstrating abnormal esophageal acid exposure. Treatment should be directed at thepathophysiologic mechanism. It can include proton pump inhibitors, neuromodulators and/orsmooth muscle relaxants, psychologic intervention and/or cognitive therapy, and occasionallysurgery or endoscopic therapy

The Mexican consensus on non-cardiac chest pain

Introduction: Non-cardiac chest pain is defined as a clinical syndrome characterized by ret-rosternal pain similar to that of angina pectoris, but of non-cardiac origin and produced byesophageal, musculoskeletal, pulmonary, or psychiatric diseases. Aim: To present a consensus review based on evidence regarding the definition, epidemiology,pathophysiology, and diagnosis of non-cardiac chest pain, as well as the therapeutic options forthose patients. Methods Three general coordinators carried out a literature review of all articles published inEnglish and Spanish on the theme and formulated 38 initial statements, dividing them into 3 maincategories: 1) definitions, epidemiology, and pathophysiology, 2) diagnosis, and 3) treatment.The statements underwent 3 rounds of voting, utilizing the Delphi system. The final statementswere those that reached > 75% agreement, and they were rated utilizing the GRADE system. Results and conclusions The final consensus included 29 statements. All patients presentingwith chest pain should initially be evaluated by a cardiologist. The most common cause of non-cardiac chest pain is gastroesophageal reflux disease. If there are no alarm symptoms, the initialapproach should be a therapeutic trial with a proton pump inhibitor for 2-4 weeks. If dysphagiaor alarm symptoms are present, endoscopy is recommended. High-resolution manometry isthe best method for ruling out spastic motor disorders and achalasia and pH monitoring aidsin demonstrating abnormal esophageal acid exposure. Treatment should be directed at thepathophysiologic mechanism. It can include proton pump inhibitors, neuromodulators and/orsmooth muscle relaxants, psychologic intervention and/or cognitive therapy, and occasionallysurgery or endoscopic therapy

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

Estudio de los Ecosistemas Marinos Vulnerables en aguas internacionales del Atlántico Sudoccidental

En este libro, basado en la mejor información científica disponible hasta la fecha, se presentan los resultados y conclusiones de una serie de trece campañas de investigación multidisciplinar realizadas entre octubre de 2007 y abril de 2010 por los componentes del Grupo ATLANTIS a bordo del B/O MIGUEL OLIVER, propiedad de la Secretaría General de Pesca (SGP). El estudio surge a raíz de la solicitud por parte de la SGP (anteriormente denominada Secretaría General del Mar) al Instituto Español de Oceanografía (IEO), para la realización de una serie de campañas de investigación multidisciplinar en aguas internacionales del Atlántico Sudoccidental, dirigidas al estudio de los Ecosistemas Marinos Vulnerables (EMVs) y de las posibles interacciones con las actividades pesqueras. El objetivo final de dichas campañas era el estudio y la identificación cuantitativa, cualitativa y geográfica de los EMVs y de los grupos taxonómicos de organismos sensibles que pudieran existir en la zona de estudio, incluyendo la propuesta de posibles zonas marinas a proteger, para una explotación sostenible de los recursos pesqueros en el ámbito del respeto a los EMVs. Los resultados que se presentan en este libro comprenden los obtenidos a través de los trabajos de geología, geomorfología, bentos, pesca, oceanografía física y análisis de contaminantes en la zona de aguas internacionales del Atlántico Sudoccidental comprendida entre los paralelos 42º y 48ºS, y la isobata de los 1500 m de profundidad (Figura 2.2). Entre estos resultados se incluye el cartografiado y una batimetría detallada de la zona, la descripción del substrato geológico y de los aspectos bentónicos, el análisis de la distribución y abundancia de las especies de mayor interés comercial, la huella de la pesquería, la identificación y descripción preliminar de los EMVs, y la propuesta de Zonas de Protección, basada en criterios Geológicos, Geomorfológicos y Biológicos. Toda esta información ha sido incorporada para su tratamiento en una plataforma SIG (Sistema de Información Geográfica) y los resultados obtenidos y presentados en este libro vienen acompañados de abundante información gráfica, como imágenes batimétricas en 3D, fotografías de bentos (infauna y epifauna), imágenes tomadas con un ROV (Remotely Operated Vehicle) y con una cámara digital submarina, así como una serie de mapas de distribución, capturas y densidad de las principales especies de interés pesquero. Se incluye también un mapa con la huella de la pesquería (1989-2010) que permita observar la incidencia de las Zonas de Protección propuestas en el área en la que faena habitualmente la flota española de arrastre de fondo. Como información adicional a la obtenida en las trece campañas de investigación, también se ha utilizado la base de datos creada con la información recogida por el Programa de Observadores del IEO entre los años 1989-2010, referente a datos comerciales, biológicos, oceanográficos y físicos (batimetría, temperatura superficial del mar y temperatura del fondo). Entre octubre de 2007 y abril de 2010 se han realizado un total de trece campañas de investigación multidisciplinar, que se han concretado en los siguientes trabajos: • 347 días efectivos de mar • Prospección de una superficie total de 59.105 km2 • Realización de un total de 91.905 km de perfiles geofísicos • 102 muestreos con draga de roca • 209 muestreos con draga box corer • 519 estaciones de CTD • 413 lances de pesca • 413 muestras de sedimentos con el colector de red • Recogida de varios miles de lotes de muestras de bentos que representan varios centenares de miles de especímenes y/o colonias • Realización de miles de fotografías de especies bentónicas, centenares de imágenes digitales de alta resolución y decenas de horas de vídeo realizadas con el ROV del barco Entre los principales resultados de los trabajos de investigación multidisciplinar presentados en este libro hay que destacar la identificación, descripción y delimitación de los EMVs, siguiendo criterios biológicos, geológicos y mixtos; la identificación de los principales grupos bentónicos indicadores de EMVs; la determinación de los valores que representan una captura significativa de los distintos taxones considerados como vulnerables según criterios de la ONU y OSPAR, y finalmente, la propuesta de áreas marinas que deberían ser consideradas como candidatas a ser protegidas. En total se proponen nueve polígonos de diferente superficie para su valoración como zonas de protección (Figura 7.5) y se hace referencia a la incidencia que el cierre de dichas zonas podría tener sobre la actividad de la flota, es decir, el grado de solapamiento entre las zonas de protección y la huella de la pesquería (Figura 7.6). Todos estos resultados se presentan acompañados de abundantes gráficas, figuras y mapas.Instituto Español de OceanografíaVersión del edito

Nutrición parenteral domiciliaria en España 2018. Informe del Grupo de Nutrición Artificial Domiciliaria y Ambulatoria NADYA

Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadya-senpe.com) del año 2018. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE del 1 de enero al 31 de diciembre de 2018. Resultados: se registraron 278 pacientes (54, 7% mujeres), 23 niños y 255 adultos, procedentes de 45 hospitales españoles, lo que representa una tasa de prevalencia de 5, 95 pacientes/millón de habitantes/año 2018. El diagnóstico más frecuente en adultos fue “oncológico paliativo” (22, 0%), seguido de “otros”. En niños fue la enfermedad de Hirschsprung junto con la enterocolitis necrotizante, con cuatro casos (17, 4%). El primer motivo de indicación fue síndrome de intestino corto tanto en niños (60, 9%) como en adultos (35, 7%). El tipo de catéter más utilizado fue el tunelizado tanto en niños (81, 0%) como en adultos (41, 1%). Finalizaron 75 episodios, la causa más frecuente fue el fallecimiento (52, 0%) y el paso a vía oral (33, 3%). Conclusiones: el número de centros y profesionales colaboradores en el registro de pacientes que reciben NPD se mantiene estable, así como las principales indicaciones y los motivos de finalización de la NPD. Aim: To communicate home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe.  com) for the year 2018. Material and methods: Descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1st, 2018 to December 31st, 2018.  Results: There were 278 patients from 45 Spanish hospitals (54.7% women), 23 children and 255 adults, which represent a prevalence rate of 5.95 patients/million inhabitants/year 2018. The most frequent diagnosis in adults was “palliative cancer” (22.0%), followed by “others”. In children it was Hirschsprung’s disease together with necrotizing enterocolitis, with four cases (17.4%). The first indication was short bowel syndrome in both children (60.9%) and adults (35.7%). The most frequently used type of catheter was tunneled in both children (81.0%) and adults (41.1%). Ending 75 episodes, the most frequent cause was death (52.0%) and change to oral feeding (33.3%). Conclusions: The number of centers and collaborating professionals in the registry of patients receiving HPN remains stable, as well as the main indications and reasons for termination of HPN

Development and validation of HERWIG 7 tunes from CMS underlying-event measurements

This paper presents new sets of parameters (“tunes”) for the underlying-event model of the HERWIG7 event generator. These parameters control the description of multiple-parton interactions (MPI) and colour reconnection in HERWIG7, and are obtained from a fit to minimum-bias data collected by the CMS experiment at s=0.9, 7, and 13Te. The tunes are based on the NNPDF 3.1 next-to-next-to-leading-order parton distribution function (PDF) set for the parton shower, and either a leading-order or next-to-next-to-leading-order PDF set for the simulation of MPI and the beam remnants. Predictions utilizing the tunes are produced for event shape observables in electron-positron collisions, and for minimum-bias, inclusive jet, top quark pair, and Z and W boson events in proton-proton collisions, and are compared with data. Each of the new tunes describes the data at a reasonable level, and the tunes using a leading-order PDF for the simulation of MPI provide the best description of the dat

Measurement of t(t)over-bar normalised multi-differential cross sections in pp collisions at root s=13 TeV, and simultaneous determination of the strong coupling strength, top quark pole mass, and parton distribution functions

Peer reviewe