Machine Learning Improves Risk Stratification in Myelofibrosis: An Analysis of the Spanish Registry of Myelofibrosis

Myelofibrosis (MF) is a myeloproliferative neoplasm (MPN) with heterogeneous clinical course. Allogeneic hematopoietic cell transplantation remains the only curative therapy, but its morbidity and mortality require careful candidate selection. Therefore, accurate disease risk prognostication is critical for treatment decision-making. We obtained registry data from patients diagnosed with MF in 60 Spanish institutions (N = 1386). These were randomly divided into a training set (80%) and a test set (20%). A machine learning (ML) technique (random forest) was used to model overall survival (OS) and leukemia-free survival (LFS) in the training set, and the results were validated in the test set. We derived the AIPSS-MF (Artificial Intelligence Prognostic Scoring System for Myelofibrosis) model, which was based on 8 clinical variables at diagnosis and achieved high accuracy in predicting OS (training set c-index, 0.750; test set c-index, 0.744) and LFS (training set c-index, 0.697; test set c-index, 0.703). No improvement was obtained with the inclusion of MPN driver mutations in the model. We were unable to adequately assess the potential benefit of including adverse cytogenetics or high-risk mutations due to the lack of these data in many patients. AIPSS-MF was superior to the IPSS regardless of MF subtype and age range and outperformed the MYSEC-PM in patients with secondary MF. In conclusion, we have developed a prediction model based exclusively on clinical variables that provides individualized prognostic estimates in patients with primary and secondary MF. The use of AIPSS-MF in combination with predictive models that incorporate genetic information may improve disease risk stratification

Effect of hydroxypropylmethylcellulose and chitosan coatings with and without bergamot essential oil on quality and safety of cold-stored grapes

[EN] Biodegradable coatings based on hydroxypropylmethylcellulose (HPMC) or chitosan (CH) with and without bergamot essential oil were applied to table grapes, cv. Muscatel, in order to find environmentally friendly, healthy treatments with which to better preserve fresh fruit quality and safety during postharvest cold storage. Physicochemical properties (weight loss, °Brix, total phenols, antioxidant activity, colour and texture), respiration rates and microbial counts of samples were determined throughout cold storage. The coatings had a significant effect on the development of quality variables, with the additional effect of essential oil addition as a function of the polysaccharide matrix being especially notable. Although incorporation of essential oil resulted in smaller weight losses and a greater antimicrobial effect, it also led to browner samples when using CH. Chitosan coatings containing bergamot oil were more effective than pure CH and HPMC coatings at inhibiting respiration rates. All the coatings improved the mechanical resistance of the samples at the end of storage. The most recommended coating for Muscatel table grapes is CH containing bergamot oil since, despite only contributing slightly to the sample colour, this showed the highest antimicrobial activity and the greatest control of respiration rates with a reasonably good control of water loss during storage. © 2010 Elsevier B.V.The authors acknowledge the financial support provided by Ministerio de Educacion y Ciencia (Project AGL2007-65503).Sánchez González, L.; Pastor Navarro, C.; Vargas, M.; Chiralt, A.; González Martínez, MC.; Cháfer Nácher, MT. (2011). Effect of hydroxypropylmethylcellulose and chitosan coatings with and without bergamot essential oil on quality and safety of cold-stored grapes. Postharvest Biology and Technology. 60(1):57-63. https://doi.org/10.1016/j.postharvbio.2010.11.004S576360

Guia sobre la infecció pel VIH i la sida a l’atenció primària

Sida; Transmissió; Atenció socialAIDS; Transmission; Social careSida; Transmisión; Atención socialAquesta nova Guia sobre la infecció pel VIH i la sida a l’atenció primària vol ser una eina útil i facilitadora per als professionals del primer nivell assistencial a l’hora d’establir estratègies preventives i actuacions clíniques relacionades amb la infecció pel VIH amb la finalitat de contribuir a la millora de l’atenció a les persones afectades

Investigación joven con perspectiva de género VI

Actas del VI Congreso Internacional de Jóvenes Investigadorxs con perspectiva de género (Getafe, 16 - 18 de junio de 2021) organizado por el Instituto Universitario de Estudios de Género de la Universidad Carlos III de Madrid.El concepto de la vejes en la literatura griega arcaica / María Secades Fonseca se inscribe en el marco del Proyectos de I+D+i del Ministerio de Ciencia e Innovación, titulado Vulnerabilidad intrafamiliar y política en el mundo antiguo y dirigido por Susana Reboreda Morillo y Rosa María Cid López (Ref. PID2020-116349GB-I00).Generando una interpretación del Derecho en clave de igualdad de género / Alicia Cárdenas Cordón y Gloria Serrano Valverde es un trabajo elaborado y presentado en el marco del Proyecto de Investigación RTI2018-10669-B-100 ‘‘GEN-DER: Generando una interpretación del Derecho en clave de igualdad de género’’, enmarcado en el Programa Estatal de I+D+i Orientada a los Retos de la Sociedad- Ministerio de Ciencia e Innovación (2019-2021)

III Jornadas de Jóvenes Investigadores en Arqueología: Libro de Actas

Libro de Actas de las III Jornadas de Jóvenes Investigadores en Arqueologí

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

The tryptophan system in cocaine-induced depression

Major depression disorder (MDD) is the most prevalent psychiatric comorbid condition in cocaine use disorder (CUD). The comorbid MDD might be primary-MDD (CUD-primary-MDD) or cocaine-induced MDD (CUD-induced-MDD), and their accurate diagnoses and treatment is a challenge for improving prognoses. This study aimed to assess the tryptophan/serotonin (Trp/5-HT) system with the acute tryptophan depletion test (ATD), and the kynurenine pathway in subjects with CUD-primary-MDD, CUD-induced-MDD, MDD and healthy controls. The ATD was performed with a randomized, double-blind, crossover, and placebo-controlled design. Markers of enzymatic activity of indoleamine 2,3-dioxygenase/tryptophan 2,3-dioxygenase, kynurenine aminotransferase (KAT) and kynureninase were also established. Following ATD, we observed a decrease in Trp levels in all groups. Comparison between CUD-induced-MDD and MDD revealed significant differences in 5-HT plasma concentrations (512 + 332 ng/mL vs. 107 + 127 ng/mL, p = 0.039) and the Kyn/5-HT ratio (11 + 15 vs. 112 + 136; p = 0.012), whereas there were no differences between CUD-primary-MDD and MDD. Effect size coefficients show a gradient for all targeted markers (d range 0.72-1.67). Results suggest different pathogenesis for CUD-induced-MDD, with lower participation of the tryptophan system, probably more related to other neurotransmitter pathways and accordingly suggesting the need for a different pharmacological treatment approach.This work was supported by grants from the Instituto de Salud Carlos III–ISCIII Red de Trastornos Adictivos 2016 (RD16/0017/0010, RD16/0017/0003; Fondo de Investigación Sanitaria (FIS) (PI09/02121, PI12/01838, PI14/00178, PI16/00603); National R + D+I and funded by the Instituto de Salud Carlos III (ISCIII) and the European Regional Development Fund (FEDER) grant Juan Rodes (JR 16/00020); Ministerio de Sanidad, Política Social e Igualdad, Plan Nacional Sobre Drogas (PNSD) (2012I054); Suport Grups de Recerca AGAUR-Gencat (2017 SGR 316, 2017 SGR 530); Acció instrumental d’Intensificació de Professionals de la Salut - Facultatius especialistes (PERIS) (SLT006/17/00014); and Ministerio de Economía y Competitividad (MTM2015-64465-C2-1-R). The funding agencies had no role in study design, data collection, interpretation, or had influence on the writing

Complex Care Needs in Multiple Chronic Conditions: Population Prevalence and Characterization in Primary Care. A Study Protocol

Background: Chronicity, and particularly complex care needs for people with chronic diseases is one of the main challenges of health systems. Objective: To determine the population prevalence of people with chronic diseases and complex care needs and to characterize these needs considering features of health and social complexity in Primary Care. Design: Cross-sectional population-based study. Scope: Patients who have one or more chronic health conditions from three Primary Care urban centres of a reference population of 43.647 inhabitants older than 14 years old. Methodology: Data will be obtained from the review of electronical medical records. Complexity will be defined by: 1) the independent clinical judgment of primary care physicians and nurses and 2) the aid of three complexity domains (clinical and social). Patients with advanced chronic disease and limited life prognosis will be also described. Conclusions: This research protocol intends to describe and analyse complex care needs from a primary care professional perspective in order to improve knowledge of complexity beyond multimorbidity and previous consumption of health resources. Knowing about health and social complexity with a more robust empirical basis could help for a better integration of social and health policies and a more proactive and differentiated care approach in this most vulnerable population

Analysis of Differentially Expressed MicroRNAs in Serum and Lung Tissues from Individuals with Severe Asthma Treated with Oral Glucocorticoids

Nowadays, microRNAs (miRNAs) are increasingly used as biomarkers due to their potential contribution to the diagnosis and targeted treatment of a range of diseases. The aim of the study was to analyze the miRNA expression profiles in serum and lung tissue from patients with severe asthma treated with oral corticosteroids (OCS) and those without OCS treatment. For this purpose, serum and lung tissue miRNAs of OCS and non-OCS asthmatic individuals were evaluated by miRNAs-Seq, and subsequently miRNA validation was performed using RT-qPCR. Additionally, pathway enrichment analysis of deregulated miRNAs was conducted. We observed altered expression by the next-generation sequencing (NGS) of 11 miRNAs in serum, of which five (hsa-miR-148b-3p, hsa-miR-221-5p, hsa-miR-618, hsa-miR-941, and hsa-miR-769-5p) were validated by RT-qPCR, and three miRNAs in lung tissue (hsa-miR-144-3p, hsa-miR-144-5p, and hsa-miR-451a). The best multivariate logistic regression model to differentiate individuals with severe asthma, treated and untreated with OCS, was to combine the serum miRNAs hsa-miR-221-5p and hsa-miR-769-5p. Expression of hsa-miR-148b-3p and hsa-miR-221-5p correlated with FEV/FVC (%) and these altered miRNAs act in key signaling pathways for asthma disease and the regulated expression of some genes (FOXO3, PTEN, and MAPK3) involved in these pathways. In conclusion, there are miRNA profiles differentially expressed in OCS-treated individuals with asthma and could be used as biomarkers of OCS treatment