Clinical validation of risk scoring systems to predict risk of delayed bleeding after EMR of large colorectal lesions

[Background and Aims]: The Endoscopic Resection Group of the Spanish Society of Endoscopy (GSEED-RE) model and the Australian Colonic Endoscopic Resection (ACER) model were proposed to predict delayed bleeding (DB) after EMR of large superficial colorectal lesions, but neither has been validated. We validated and updated these models.[Methods]: A multicenter cohort study was performed in patients with nonpedunculated lesions ≥20 mm removed by EMR. We assessed the discrimination and calibration of the GSEED-RE and ACER models. Difficulty performing EMR was subjectively categorized as low, medium, or high. We created a new model, including factors associated with DB in 3 cohort studies.[Results]: DB occurred in 45 of 1034 EMRs (4.5%); it was associated with proximal location (odds ratio [OR], 2.84; 95% confidence interval [CI], 1.31-6.16), antiplatelet agents (OR, 2.51; 95% CI, .99-6.34) or anticoagulants (OR, 4.54; 95% CI, 2.14-9.63), difficulty of EMR (OR, 3.23; 95% CI, 1.41-7.40), and comorbidity (OR, 2.11; 95% CI, .99-4.47). The GSEED-RE and ACER models did not accurately predict DB. Re-estimation and recalibration yielded acceptable results (GSEED-RE area under the curve [AUC], .64 [95% CI, .54-.74]; ACER AUC, .65 [95% CI, .57-.73]). We used lesion size, proximal location, comorbidity, and antiplatelet or anticoagulant therapy to generate a new model, the GSEED-RE2, which achieved higher AUC values (.69-.73; 95% CI, .59-.80) and exhibited lower susceptibility to changes among datasets.[Conclusions]: The updated GSEED-RE and ACER models achieved acceptable prediction levels of DB. The GSEED-RE2 model may achieve better prediction results and could be used to guide the management of patients after validation by other external groups. (Clinical trial registration number: NCT 03050333.)Research support for this study was received from “La Caixa/Caja Navarra” Foundation (ID 100010434;project PR15/11100006)

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Ahora / Ara

La cinquena edició del microrelatari per l’eradicació de la violència contra les dones de l’Institut Universitari d’Estudis Feministes i de Gènere «Purificación Escribano» de la Universitat Jaume I vol ser una declaració d’esperança. Aquest és el moment en el qual les dones (i els homes) hem de fer un pas endavant i eliminar la violència sistèmica contra les dones. Ara és el moment de denunciar el masclisme i els micromasclismes començant a construir una societat més igualitària. Cadascun dels relats del llibre és una denúncia i una declaració que ens encamina cap a un món millor

In situ photopolymerization of biomaterials by thiol-yne click chemistry

The thiol-yne click chemistry reaction has been used for the in situ photocrosslinking of an aliphatic hyperbranched polyester. The biocompatibility of the resulting networks has been studied and marked cytotoxicity was not found for HeLa (human cervical carcinoma) tumoral cells and COS7 fibroblasts. The photoinduced thiol-yne process allows the generation of patterned structures with different geometries in films by DLW and these materials can be used as substrates for cell adhesion. The influence of the substrate geometry on cell adhesion has been studied by culturing cells onto these substrates and a preference for the photopatterned polymeric material can be seen in some of the structures by contrast phase microscopy. Actin and vinculin fluorescent staining revealed different adhesion behavior for HeLa cells and COS7 fibroblasts and this could be assigned to the different motility of cells. The thiol-yne photoreaction has proven to be an attractive approach for the preparation of micropatterned biomaterials.This work was supported by the Spanish MEC projects MAT2008-06522-C02 and CTQ2008-03739/PPQ, DGA project PI018/08, ARAID project for young scientists, CSIC project PIE 200960I168, and FEDER funding (EU). M. Lomba thanks the Gobierno de Aragón (Spain) for his PhD Grant. J. M. de la Fuente thanks ARAID for financial support.Peer Reviewe

Análisis de rentabilidad de una empresa integradora de aprovechamiento de madera de pino

Las pequeñas y medianas empresas tienen que buscar la forma de mantenerse, compitiendo con las grandes empresas, pues han avanzado sus mercados provocando la desaparición de muchas de estas y las empresas integradoras surgen con la finalidad de agrupar a pequeñas y medianas empresas con el propósito de que a través de esta unión se obtengan ventajas de rentabilidad y competitividad para ellas. Se evaluó la rentabilidad financiera del aprovechamiento de madera de pino de una empresa integradora ubicada en Ixtlán de Juárez, Oaxaca utilizando encuestas para recopilar información y realizar la evaluación de rentabilidad financiera como empresa integradora mediante el cálculo de indicadores valor actual neto (VAN), tasa interna de retorno (TIR), relación beneficio costo. Los resultados obtenidos fueron: VAN= 481 952.4, TIR= 33% y relación beneficio costo= 1.01. Con los cuales se encontró que durante la vida útil del proyecto a una tasa de actualización de 31%, se va obtener una utilidad neta de 481 952.4 pesos. Con respecto a la relación beneficio/ costo a una actualización de 31%, por cada peso invertido se tendrá 1.01 centavos de beneficios y durante la vida útil del proyecto y de acuerdo a los resultados de la TIR se recupera la inversión y se obtiene una rentabilidad en promedio de 33%. Estos indicadores muestran que la empresa tiene una rentabilidad financiera positivaSmall and medium-sized companies have to find a way to keep up competing with large companies, as they have upgrade their markets leading to the disappearance of many of them; and integrating companies have emerged with the purpose of grouping small and medium-sized companies so through this union they would obtain profitability and competitiveness advantages. The financial profitability of pine harvesting of an integrating company located in Ixtlán de Juárez, Oaxaca, was evaluated using surveys to gather information and to perform the financial profitability assessment as an integrating company by calculating indicators as net present value (NPV), Internal return rate (IRR), cost benefit ratio. The results obtained were: NPV= 481 952.4, IRR= 33% and cost benefit ratio= 1.01. It was found that during the useful life of the project at an updating rate of 31%, a net profit of 481 952.4 Mexican pesos will be obtained. Regarding to the cost/benefit ratio to an update of 31%, for invested peso there will be 1.01 cents of benefits and over the project existance and according to the results of the IRR the investment would be recovered and an average profitability of 33% would be obtained. These indicators show that the company has a positive financial return

Influence of Boron Content on the Solidification Structure, Magnetic Properties and Hot Mechanical Behavior in an Advanced As-Cast TWIP Steel

This research work reports the effect of boron micro-additions (180 and 470 ppm) on the solidification structure, magnetic properties and hot ductility behavior of an advanced low-carbon highly alloyed twinning-induced plasticity (TWIP) steel. For this purpose, three experimental TWIP steels were fabricated by melting commercial raw materials and casting into metallic molds. Solidification structure was characterized by means of optical and scanning electron microscopy techniques, and a statistical study was carried out to measure dendrite features. A vibrating sample magnetometer was used, at room temperature, to determine magnetic properties, and a X-ray diffraction analysis was performed in order to identify the related phases during magnetic measurements. Finally, the hot ductility in the as-cast condition was evaluated at 700, 900 and 1100 °C, under a constant strain rate of 0.001 s−1. The results indicate that boron micro-additions cause an overall refining solidification structure and austenitic grain size. However, as the boron content increases, segregation of this element promotes formation of ferrite and ε-martensite, leading to ferromagnetic behavior. Nonetheless, with subsequent hot- and cold-rolling, the single austenitic phase is achieved, and this behavior is eliminated. Hot tensile tests revealed that boron micro-addition is beneficial to the hot ductility behavior. The greatest influence was observed for the higher concentration of boron (470 ppm). In comparison with the steel without boron content, the reduction of area (RA) is more than the triple of the hot workability during straining at 900 °C. Thus, present results demonstrate that boron micro-addition has an excellent potential for refining dendritic microstructure and improving the hot-deformation behavior of present low-carbon highly alloyed TWIP steel

WHO Ordinal Scale and Inflammation Risk Categories in COVID-19

Background: The WHO ordinal severity scale has been used to predict mortality and guide trials in COVID-19. However, it has its limitations. Objective The present study aims to compare three classificatory and predictive models: the WHO ordinal severity scale, the model based on inflammation grades, and the hybrid model. Design Retrospective cohort study with patient data collected and followed up from March 1, 2020, to May 1, 2021, from the nationwide SEMI-COVID-19 Registry. The primary study outcome was in-hospital mortality. As this was a hospital-based study, the patients included corresponded to categories 3 to 7 of the WHO ordinal scale. Categories 6 and 7 were grouped in the same category. Key Results A total of 17,225 patients were included in the study. Patients classified as high risk in each of the WHO categories according to the degree of inflammation were as follows: 63.8% vs. 79.9% vs. 90.2% vs. 95.1% (p<0.001). In-hospital mortality for WHO ordinal scale categories 3 to 6/7 was as follows: 0.8% vs. 24.3% vs. 45.3% vs. 34% (p<0.001). In-hospital mortality for the combined categories of ordinal scale 3a to 5b was as follows: 0.4% vs. 1.1% vs. 11.2% vs. 27.5% vs. 35.5% vs. 41.1% (p<0.001). The predictive regression model for in-hospital mortality with our proposed combined ordinal scale reached an AUC=0.871, superior to the two models separately. Conclusions The present study proposes a new severity grading scale for COVID-19 hospitalized patients. In our opinion, it is the most informative, representative, and predictive scale in COVID-19 patients to date