Clustering COVID-19 ARDS patients through the first days of ICU admission. An analysis of the CIBERESUCICOVID Cohort

Background Acute respiratory distress syndrome (ARDS) can be classified into sub-phenotypes according to different inflammatory/clinical status. Prognostic enrichment was achieved by grouping patients into hypoinflammatory or hyperinflammatory sub-phenotypes, even though the time of analysis may change the classification according to treatment response or disease evolution. We aimed to evaluate when patients can be clustered in more than 1 group, and how they may change the clustering of patients using data of baseline or day 3, and the prognosis of patients according to their evolution by changing or not the cluster.Methods Multicenter, observational prospective, and retrospective study of patients admitted due to ARDS related to COVID-19 infection in Spain. Patients were grouped according to a clustering mixed-type data algorithm (k-prototypes) using continuous and categorical readily available variables at baseline and day 3.Results Of 6205 patients, 3743 (60%) were included in the study. According to silhouette analysis, patients were grouped in two clusters. At baseline, 1402 (37%) patients were included in cluster 1 and 2341(63%) in cluster 2. On day 3, 1557(42%) patients were included in cluster 1 and 2086 (57%) in cluster 2. The patients included in cluster 2 were older and more frequently hypertensive and had a higher prevalence of shock, organ dysfunction, inflammatory biomarkers, and worst respiratory indexes at both time points. The 90-day mortality was higher in cluster 2 at both clustering processes (43.8% [n = 1025] versus 27.3% [n = 383] at baseline, and 49% [n = 1023] versus 20.6% [n = 321] on day 3). Four hundred and fifty-eight (33%) patients clustered in the first group were clustered in the second group on day 3. In contrast, 638 (27%) patients clustered in the second group were clustered in the first group on day 3.Conclusions During the first days, patients can be clustered into two groups and the process of clustering patients may change as they continue to evolve. This means that despite a vast majority of patients remaining in the same cluster, a minority reaching 33% of patients analyzed may be re-categorized into different clusters based on their progress. Such changes can significantly impact their prognosis

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Short- and Long-Term Study of the Impact of Focal Blue Light-Emitting Diode-Induced Phototoxicity in Adult Albino Rats

Background: In adult rats we study the short- and long-term effects of focal blue light-emitting diode (LED)-induced phototoxicity (LIP) on retinal thickness and Iba-1+ activation. Methods: The left eyes of previously dark-adapted Sprague Dawley (SD) rats were photoexposed to a blue LED (20 s, 200 lux). In vivo longitudinal monitoring of retinal thickness, fundus images, and optical retinal sections was performed from 1 to 30 days (d) after LIP with SD-OCT. Ex vivo, we analysed the population of S-cone and Iba-1+ cells within a predetermined fixed-size circular area (PCA) centred on the lesion. Results: LIP resulted in a circular focal lesion readily identifiable in vivo by fundus examination, which showed within the PCAs a progressive thinning of the outer retinal layer, and a diminution of the S-cone population to 19% by 30 d. In parallel to S-cone loss, activated Iba-1+ cells delineated the lesioned area and acquired an ameboid morphology with peak expression at 3 d after LIP. Iba-1+ cells adopted a more relaxed-branched morphology at 7 d and by 14–30 d their morphology was fully branched. Conclusion: LIP caused a progressive reduction of the outer retina with loss of S cones and a parallel dynamic activation of microglial cells in the lesioned area

Pigment Epithelium-Derived Factor (PEDF) Fragments Prevent Mouse Cone Photoreceptor Cell Loss Induced by Focal Phototoxicity In Vivo

Here, we evaluated the effects of PEDF (pigment epithelium-derived factor) and PEDF peptides on cone-photoreceptor cell damage in a mouse model of focal LED-induced phototoxicity (LIP) in vivo. Swiss mice were dark-adapted overnight, anesthetized, and their left eyes were exposed to a blue LED placed over the cornea. Immediately after, intravitreal injection of PEDF, PEDF-peptide fragments 17-mer, 17-mer[H105A] or 17-mer[R99A] (all at 10 pmol) were administered into the left eye of each animal. BDNF (92 pmol) and bFGF (27 pmol) injections were positive controls, and vehicle negative control. After 7 days, LIP resulted in a consistent circular lesion located in the supratemporal quadrant and the number of S-cones were counted within an area centered on the lesion. Retinas treated with effectors had significantly greater S-cone numbers (PEDF (60%), 17-mer (56%), 17-mer [H105A] (57%), BDNF (64%) or bFGF (60%)) relative to their corresponding vehicle groups (≈42%). The 17-mer[R99A] with no PEDF receptor binding and no neurotrophic activity, PEDF combined with a molar excess of the PEDF receptor blocker P1 peptide, or with a PEDF-R enzymatic inhibitor had undetectable effects in S-cone survival. The findings demonstrated that the cone survival effects were mediated via interactions between the 17-mer region of the PEDF molecule and its PEDF-R receptor

Rapid decrease in titer and breadth of neutralizing anti-HCV antibodies in HIV/HCV-coinfected patients who achieved SVR

The main targets for neutralizing anti-hepatitis C virus (HCV) antibodies (HCV-nAbs) are the E1 and E2 envelope glycoproteins. We have studied the characteristics of HCV-nAbs through a retrospective study involving 29 HIV/HCV-coinfected patients who achieved sustained virological response (SVR) with peg-IFNα + ribavirin anti-HCV therapy. Plasma samples at baseline and week 24 after SVR were used to perform neutralization assays against five JFH1-based HCV recombinant viruses coding for E1 and E2 from genotypes 1a (H77), 1b (J4), 2a (JFH1), 3a (S52) and 4a (ED43). At baseline, the majority of plasma samples neutralized 1a, 1b, 2a, and 4a, but not 3a, genotypes. Twenty-four weeks following SVR, most neutralizing titers declined substantially. Furthermore, titers against 3a and 2a were not detected in many patients. Plasma samples with high HCV-nAb titers neutralized all genotypes, and the highest titers at the starting point correlated with the highest titers at week 24 after SVR. In conclusion, high titers of broad-spectrum HCV-nAbs were detected in HIV/HCV-coinfected individuals, however, those titers declined soon after SVR

Assessment of plasma chitotriosidase activity, CCL18/PARC concentration and NP-C suspicion index in the diagnosis of Niemann-Pick disease type C : A prospective observational study

Niemann-Pick disease type C (NP-C) is a rare, autosomal recessive neurodegenerative disease caused by mutations in either the NPC1 or NPC2 genes. The diagnosis of NP-C remains challenging due to the non-specific, heterogeneous nature of signs/symptoms. This study assessed the utility of plasma chitotriosidase (ChT) and Chemokine (C-C motif) ligand 18 (CCL18)/pulmonary and activation-regulated chemokine (PARC) in conjunction with the NP-C suspicion index (NP-C SI) for guiding confirmatory laboratory testing in patients with suspected NP-C. In a prospective observational cohort study, incorporating a retrospective determination of NP-C SI scores, two different diagnostic approaches were applied in two separate groups of unrelated patients from 51 Spanish medical centers (n = 118 in both groups). From Jan 2010 to Apr 2012 (Period 1), patients with ≥2 clinical signs/symptoms of NP-C were considered 'suspected NP-C' cases, and NPC1/NPC2 sequencing, plasma chitotriosidase (ChT), CCL18/PARC and sphingomyelinase levels were assessed. Based on findings in Period 1, plasma ChT and CCL18/PARC, and NP-C SI prediction scores were determined in a second group of patients between May 2012 and Apr 2014 (Period 2), and NPC1 and NPC2 were sequenced only in those with elevated ChT and/or elevated CCL18/PARC and/or NP-C SI ≥70. Filipin staining and 7-ketocholesterol (7-KC) measurements were performed in all patients with NP-C gene mutations, where possible. In total across Periods 1 and 2, 10/236 (4%) patients had a confirmed diagnosis o NP-C based on gene sequencing (5/118 [4.2%] in each Period): all of these patients had two causal NPC1 mutations. Single mutant NPC1 alleles were detected in 8/236 (3%) patients, overall. Positive filipin staining results comprised three classical and five variant biochemical phenotypes. No NPC2 mutations were detected. All patients with NPC1 mutations had high ChT activity, high CCL18/PARC concentrations and/or NP-C SI scores ≥70. Plasma 7-KC was higher than control cut-off values in all patients with two NPC1 mutations, and in the majority of patients with single mutations. Family studies identified three further NP-C patients. This approach may be very useful for laboratories that do not have mass spectrometry facilities and therefore, they cannot use other NP-C biomarkers for diagnosis

Effect of accompanying antiretroviral drugs on virological response to pegylated interferon and ribavirin in patients co-infected with HIV and hepatitis C virus

The effects of antiretroviral drugs on the response to pegylated interferon plus ribavirin remain uncertain. We evaluated whether antiretroviral drugs affected the response to pegylated interferon plus ribavirin in patients co-infected with HIV and hepatitis C virus (HCV). We conducted a retrospective analysis of two cohorts of HIV/HCV-co-infected patients treated with pegylated interferon plus ribavirin between 2001 and 2007 in Spain. The outcome measure was sustained virological response (SVR). Logistic regression models were used to test possible associations between non-response and pre-treatment characteristics, including accompanying antiretroviral drugs. The study sample comprised 1701 patients: 63% were infected with HCV genotype (G) 1 or 4 and 88% were taking highly active antiretroviral therapy (HAART). Factors independently associated with increased odds of SVR were G2 or 3, HVC RNA <500,000 IU/mL and CDC clinical category A or B. When we adjusted for these prognostic factors and dose of ribavirin/kg, the adjusted odds ratio (AOR) of SVR for patients without HAART was 1.31 [95% confidence interval (CI) 0.91-1.88; P = 0.144]. Taking the backbone of tenofovir and lamivudine/emtricitabine as a reference, we found that, with the exception of regimens including zidovudine, the effect of other nucleoside reverse transcriptase inhibitor backbones had little effect on SVR. The AOR of SVR for zidovudine and lamivudine was 0.65 (95% CI 0.46-0.93, P = 0.017). We carried out several sensitivity analyses, the results of which were consistent with the findings of the primary analysis. In conclusion, our results suggest that, with the exception of regimens including zidovudine, accompanying antiretroviral drugs have little effect on the virological response to pegylated interferon plus ribavirin in HIV/HCV-co-infected patients.5.068 JCR (2011) Q1, 7/70 Infectious diseases, 18/114 Microbiology, 20/261 Pharmacology & pharmac

Evaluation of Nutritional Practices in the Critical Care patient (The ENPIC study) : Does nutrition really affect ICU mortality?

The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients. Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported. We included 639 patients among whom 448 (70.1%) and 191 (29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6 ± 3.3 vs 8.4 ± 3.7; P < 0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8 ± 2.1 vs 5.2 ± 1.7; P < 0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008-1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036-1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025-1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168-4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015-1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263-0.977; P=0.042). Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes. ClinicaTrials.gov NCT: 03634943

Suelo y planta. Índices. Volumen 2

Effects of the landspreading of pig slurry on the yield and composition of capsi cum annuum. M. P. Bernal, A. Roig, J. Cegarra and R. Madrid.-- Características micromorfológicas de suelos de humedales en zonas semiáridas (Cuenca del Duero). J. Benayas, M. a T. de la Cruz y J. M. a Rey. Benayas.-- Aplicación de la técnica de porosimetría por intrusión de mercurio en el estudio de la porosidad de un conjunto de suelos del NW de España. E. Benito, A. Paz y R. Pini.-- Cambios físicos y químicos durante la maduración de Vitis vinífera, variedad Monastrell, en la D. O. Jumilla. G. Navarro, F. Pardo, P. Jiménez, J. Oliva y S. Navarro.-- Micorrizas vesículo - arbusculares en parcelas que se encuentran en sucesión- regeneración en Jos Andes tropicales. M. Montilla, R. A. Herrera y M. Monasterio.-- Efectos de los incendios forestales sobre el suelo. J. González, M. C. Fernández y G.P. Gimeno.-- Mineralogía de suelos formados sobre calizas en Galicia. M. T. Taboada, M. B. Silva y M. c. Villar.-- Efecto de tratamientos foliares con Ti (IV) sobre nutrición, producción y calidad de fruto en plantas de Capsicum annuum, L. F. Martínez-Sánchez, J. L. Giménez, M. Carvajal, A. Moreno, J. L. Fuentes y C. F. Alcaraz.-- Poder discriminante de las clasificaciones: aplicación a los suelos de la depresión Guadix- Baza (Granada). A. Iriarte, E. Barahona y C. Gil de Carrasco.-- Aspects of elm propagation by soft and hardwood cuttings. L. Mittempergher, G. Bartolini, F. Ferrini and M. Panicucci.-- Metales pesados en las escombreras de la mina Puentes (La Coruña): influencia de las condiciones Eh- pH. F. Macíass, M. T. Barral, C. Monterroso y R. M. Calvo.-- Incidencia del fósforo en la mineralización del nitrógeno orgánico de un lodo de depuradora en dos suelos calizos. Extracción mediante EUF. l. Verdú, l. Gómez, F. Burló y J, Mataix.-- Dinámica del proceso de sorción de fósforo en suelos. Definición de indicadores. T. Crisanto y P. P. Iturbe.-- Estudio de la adsorción de atrazina por polimeros modelos y por un ácido homico mediante la técnica de diálisis. M. Schiavon, J. M. Portal, F. Andreux y G. Bertin.-- Oxidos de hierro sintéticos y agregación en muestras de caolinita y cuarzo. M. Arias, M. T. Barraly F. Díaz-Fierros.-- Fertilization with NPK and humate NPK: Plant yield and nutrient dynamics. A. Benedetti, A. Figliolia, C. Izza, R. lndiati and S. Canali.-- Aplicación de un método de fraccionamiento de especies alumínicas a soluciones de suelos de Galicia. E. Alvarez y R. Calvo.-- Contenido y evolución de 9 elementos químicos en pimiento piquillo a lo largo de su desarrollo. R. Y. Cavero, A. Echeverría, F. Iribarren y M. L. López.-- Distribución del tamaño de poros, porosidad total y su variabilidad con la dedicación en el horizonte orgánico de un cambisol gleico. A. Paz y E. Benito.-- Caracterización de la textura superficial de granos de cuarzo en suelos con horizontes texturalmente contrastados. M. T. Martín Patino, R. J. Ballesta, V. Cala y A. Alvarez .-- Utilización de un lodo aerobio como sustitutivo de fertilizantes fosforados inorgánicos. M. Ayuso, T. Hernández, C. García y F. Costa.-- Movilidad de aldicarb y de carbofurano en columnas de suelo. A. Apaolaza, F. J. Arranz y E. Revilla.-- Degradación de clorofila en cloroplastos incubados en medio isotónico con la fracción celular extracloroplástica. J. Cuello, A. Lahora y B. Stibater.-- Especiación química de zinc y cadmio en suelos de cultivo. V. Cala, A. M. Alvarez, R. Vigil de la Villa y M. Gasea.-- Germination with alternate temperatures of weeds infesting irrigated vegetables. R. González Ponce, A. Herce and M. L. Salas.-- Evaluación de la fertilidad de los vertisoles de la provincia de Badajoz (España) mediante cultivos experimentales. Producción en materia seca y nutrientes del cultivo. A. García y A. López.-- Isozymes peroxidase in cytokinin treated seedlings of Corylus avellana L. C. Colinas, C. Díaz-Sala and R. Rodríguez.-- Respuestas de las plantas a la contaminación por metales pesados. J. Barceló y Ch. Poschenrieder.-- N, P and K balance in winter wheat in the pampean semiarid region of Argentina. R. A. Rosell, M. R. Landriscini and J. A. Galantini.-- Utilización de residuos urbanos como fertilizantes orgánicos. T. Hernández, C. García, F. Costa, J. A. Valero y M. Ayuso.-- Inducción de organogénesis en cotiledones de Pinus canariensis. C. Martínez Pulido.-- Hidróxidos de aluminio sintéticos y agregación en muestras de caolinita y cuarzo . . M. Arias, M. T. Barral y F. Díaz-Fierros.-- Producción de endoglucanasas por Glomus mosseae y su posible implicación en la colonización de raf<::es de cebolla. J. M. García-Garrido, l. García-Romera y J. A. Ocampo.-- Estudio comparado de la fracción mineral del suelo de cultivo· y de las heces' de Allolobophora molleri (Lumbricidae) Rosa, 1889.D. Trigo y D. J. Díaz Cosín.-- Determinación de la homogeneidad múltiple utilizando diferentes niveles de taxones en perfiles de suelos de la cuenca media y alta del río Motatán. Estados Mérida y Trujillo. Venezuela. J. Jaimes, J. Oballos y G. Ochoa.-- Adsorción - desorción de picloram por arcillas y óxidos. E. A. Ferreiro, S. G. de Bussetti.-- Influencia de la carga y el potencial hídrico durante la compactación sobre la resistencia a la tracción de unidades estructurales de suelo en estado seco. A. Paz y J. Guérif.-- Residuos orgánicos: Incidencia de su aplicación sobre la composición mineral del fruto del tomate, I. Gómez, J. Navarro-Pedreño y J. Mataix.-- Growth, cell wall elasticity and plasticity in Zea mays L. coleoptiles exposed to cadmium. B. Gunsé, M. Llugany, Ch. Poschenrieder and J. Barceló.-- Effects of high zinc and cadmium concentrations on the metallophyte Thlaspi caerulescens J. et C. Presl. (Brassicaceae). J. Módico, Ch. Poschenrieder, M. D. Vázquez and J. Barceló.--Determinación del grado ·de contaminación de los rlos mediante el estudio conjunto de la composición de sus aguas y sedimentos. A. Bustos, C. Ortega y I. Sastre.-- Influencia del grado de madurez de un residuo urbano sobre la germinación y disponibilidad de nitrógeno. M. Ayuso, T. Hernández, F. Costa, C. García y J. A. Pascual.-- Influencia del nitrógeno sobre el desarrollo in vitro del portainjerto de vid.--A. Villegas, C. Mozuelos, M. Cantos y A. Troncoso.-- Efecto del alpechín sobre la solubilización de metales pesados. M. Bejarano y L. Madrid.-- Aporte foliar de titanio a plantas de pimiento pimentonero. Influencia sobre el balance de nutrición en pericarpio de fruto. M. Carvajal, M. J. Frutos, J. L. Giménez, C. F. Alcaraz y F. Martínez-Sánchez.-- Effects of phosphate, sulfate and molibdate on the uptake and distribution of technetium-99 in bush bean plants. A. Bennássar, C. Cabot, J. Barceló y Ch. Poschenrieder.-- Uptake, translocation and efficiency of nutrients in Phaseolus vulgaris L. cv. contender exposed to aluminum. N. Massot, Ch. Poschenrieder and J. Barceló.-- Efecto del cadmio sobre Ü1. absorción y distribución de manganeso en distintas variedades de Lactuca. A. Gárate, I. Ramos y J. J. Lucena.-- Efecto residual de diferentes residuos orgánicos sobre un cultivo de cebada. F. Costa, T. Hernández, C. García, M. Ayuso, J. A. Pascual y A. Polo.-- Beneficial effects of low chromium III concentrations in iron deficient maize plants. Ch. Poschenrieder, M. D. Vázquez, A. Bonet and J. Barceló.-- Depresión en el rendimiento del maíz causado por altas concentraciones de N residual en el suelo. C. Pozo, C. Cruces, J. M. Ramos, y L. F. García del Moral.-- Selección y caracterización de una línea celular de limonero tolerante a estrés salino. A. Piquera y E. Hellín.-- Efectos del As en el comportamiento vegetal de Lycopersicum esculentum Mili. Relación del As en hojas y frutos con parámetros físicos. F. Burló, A. Carbonell y J. Mataix.--Niveles críticos y equilibrios óptimos de macronutrientes en la fertilización diferenciada de la vid. R. Sarmiento, J. L. García, M. C. Grande, M. C. Vil/alón, A. de Castro y C. Mozuelos.-- Niveles críticos y equilibrios óptimos de micronutrientes en la fertilización diferenciada de la vid. R. Sarmiento, J. L. García, M. C. Grande, M. C. Vil/alón, A. de Castro y C. Mozuelos.-- Efecto de un compost de lodo residual sobre el rendimiento y contenido de Cd y Ni en diversos cultivos. I. Walter, R. Miralles y M. Bigeriego.-- Estudio del eflujo neto de H+ por raíces aeropónicas estériles de plantulas de girasol (Helianthus annuus L.) bajo condiciones de toxicidad de B. F. Espinosa y M. C. Alvarez-Tinaut-- Efecodel riego con aguas residuales urbanas depuradas sobre la disponibilidad de metales pesados para la planta. A. Inglés, M. Gómez y R. Nogales.-- Diferential response of four maize (Zea mays L.) varieties to aluminum toxicity. P. Guevara, Ch. Poschenrieder and Barceló.-- Comparación de los efectos de molibdeno y vanadio en Phaseo/us vulgaris L.: Crecimiento, proteínas y actividades enzimáticas de la nitrato-reducción. D. Saco, M. Alvarez y S. Martín.-- Influencia de la fertirrigación N, P, K sobre diversos nutrientes totales y solubles. Su evolución temporal. J. L. Va/enzuela, A. del Río, A. Sánchez, l. López-Cantarero y L. Romero.-- Valoración de métodos de extracción de mercurio en suelos contaminados. J. J. Lucena, L. E. Hernández, S. Olmos y R. Carpena Ruiz.-- Relaciones entre contenidos totales de Zn, Pb, Cu y Cd en suelos y plantas. A. M. Moreno, L. Pérez y J. González.-- Effect of N-nutrition and irrigation water on Carob-Tree (Ceratonia si/iqua L.). Growth responses. P. Correia y M. A. Martins-LouçaoPeer reviewe