8 research outputs found
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
Prevalence of postpartum major depression and depressive symptoms in Spanish women: A longitudinal study up to 1 year postpartum
Objective
Depression is a prevalent mental disorder in the postpartum period, with consequences for both the mother and her offspring. However, longitudinal studies determining the moments of greatest vulnerability and severity of depression during the postpartum period are scarce. The aims of this research were to determine the prevalence and trajectories of probable depression and major depression during the first year postpartum.
Design
Longitudinal study.
Setting
Interviews were conducted personally at three times: 2 months, 6 months and 1 year postpartum.
Participants
561 postpartum women.
Measurements and findings
Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders (DSM). Descriptive and comparative analyses have been carried out. The prevalence of probable depression at 2 months, 6 months and 1 year postpartum, using a cut-off point ≥ 10, was 30.3%, 26.0% and 25.3%, respectively; and that of major depression using SCID was 10.3%, 10.9% and 14.8, respectively. The prevalence of probable depression was highest at 2 months postpartum and that of major depression at 1 year postpartum. Probable depression followed a downward trajectory and major depression followed an upward trajectory.
Key conclusions and implications for practice
The clinical relevance of this research is that it has made it possible to demonstrate that depression is very prevalent in the first year postpartum and that, far from subsiding, the prevalence remains very high even at 1 year postpartum. Our findings highlight the importance of taking mental health care into account throughout at least the first year postpartumS
Temperature- and pH-sensitive nanohydrogels of Poly(N-Isopropylacrylamide) for food packaging applications: modelling the swelling-collapse behaviour
15 páginas, 5 tablas, 8 figuras.-- This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Temperature-sensitive poly(N-isopropylacrylamide) (PNIPA) nanohydrogels were synthesized by nanoemulsion polymerization in water-in-oil systems. Several cross-linking degrees and the incorporation of acrylic acid as comonomer at different concentrations were tested to produce nanohydrogels with a wide range of properties. The physicochemical properties of PNIPA nanohydrogels, and their relationship with the swelling-collapse behaviour, were studied to evaluate the suitability of PNIPA nanoparticles as smart delivery systems (for active packaging). The swelling-collapse transition was analyzed by the change in the optical properties of PNIPA nanohydrogels using ultraviolet-visible spectroscopy. The thermodynamic parameters associated with the nanohydrogels collapse were calculated using a mathematical approach based on the van't Hoff analysis, assuming a two-state equilibrium (swollen to collapsed). A mathematical model is proposed to predict both the thermally induced collapse, and the collapse induced by the simultaneous action of two factors (temperature and pH, or temperature and organic solvent concentration). Finally, van't Hoff analysis was compared with differential scanning calorimetry. The results obtained allow us to solve the problem of determining the molecular weight of the structural repeating unit in cross-linked NIPA polymers, which, as we show, can be estimated from the ratio of the molar heat capacity (obtained from the van't Hoff analysis) to the specific heat capacity (obtained from calorimetric measurements).This work was funded by grant (MAT 2006-11662-CO3-CO2-C01/MAT 2010-21509-C03-01/EUI 2008-00115) from the “Ministerio de Educación y Ciencia” (Spain). Clara Fuciños was funded by a predoctoral scholarship from University of Vigo (Spain)Peer reviewe
Dynamcis in the Ría de Vigo
Poster.-- Euroconference Water and Life-Oceanography, Meteorology and Marine Resources, Vigo, Mayo 2000Projects CICYT AM395-1084-C03 and the Xunta de Galicia (FEDER funds)N
Stems and roots growth and resilience index of Juniperus thurifera L. in two stages of forest expansion gradient
These datasets correspond to the manuscript "Increased recovery in coarse-root secondary growth improves resilience to drought in transition forests", published in Journal of Ecology. More detailed information about data collection and characteristics can be found in this manuscriptThis study was supported by the Spanish Ministry of Economy and Competitiveness (MINECO) grant: COMEDIAS (CGL2017-83170-R), FPI fellowship to BAM (PRE2018-083584), and Comunidad de Madrid grant: REMEDINAL TE (Ref. TE-CM. S2018/EMT-4338, 2019–2023-Comunidad de Madrid).Peer reviewe
The European Marine Observation and Data Network (EMODnet): Visions and Roles of the Gateway to Marine Data in Europe
Marine data are needed for many purposes: for acquiring a better scientific understanding of the marine environment, but also, increasingly, as marine knowledge for decision making as well as developing products and services supporting economic growth. Data must be of sufficient quality to meet the specific users' needs. It must also be accessible in a timely manner. And yet, despite being critical, this timely access to known-quality data proves challenging. Europe's marine data have traditionally been collected by a myriad of entities with the result that much of our data are scattered throughout unconnected databases and repositories. Even when data are available, they are often not compatible, making the sharing of the information and data aggregation particularly challenging. In this paper, we present how the European Marine Observation and Data network (EMODnet) has developed over the last decade to tackle these issues. Today, EMODnet is comprised of more than 150 organizations which gather marine data, metadata, and data products and make them more easily accessible for a wider range of users. EMODnet currently consists of seven sub-portals: bathymetry, geology, physics, chemistry, biology, seabed habitats, and human activities. In addition, Sea-basin Checkpoints have been established to assess the observation capacity in the North Sea, Mediterranean, Atlantic, Baltic, Artic, and Black Sea. The Checkpoints identify whether the observation infrastructure in Europe meets the needs of users by undertaking a number of challenges. To complement this, a Data Ingestion Service has been set up to tackle the problem of the wealth of marine data that remain unavailable, by reaching out to data holders, explaining the benefits of sharing their data and offering a support service to assist them in releasing their data and making them available through EMODnet. The EMODnet Central Portal (www.emodnet.eu) provides a single point of access to these services, which are free to access and use. The strategic vision of EMODnet in the next decade is also presented, together with key focal areas toward a more user-oriented service, including EMODnet for business, internationalization for global users, and stakeholder engagement to connect the diverse communities across the marine knowledge value chain