Sistema de apoyo a la decisión para transpante de páncreas en pacientes con diabetes tipo 1 basado en modelado de datos

This master thesis is focused on the development of a clinical decision support system to help Clinicians on the decision about pancreas and kidney transplant in patients with type 1 Diabetes Mellitus. To do so, an exploratory data analysis has been performed using a group of 82 patients, which have been transplanted in La Fe health department between 2002 and 2015. This analysis allows to describe the sample population and all the variables from the study. Among them, the most significant indicators are used for developing a classification model to predict the transplant success and failure. Afterwards, the model is integrated into a distributed system so the users can interact with the model through a web interface. The information exchange is performed as means as an orchestrated system, implemented as an distributed and autonomous system to predict the pancreas loss with a 82,9% accuracy with a short group of variables.Este proyecto se centra en el desarrollo de un sistema de ayuda a profesionales sanitarios en la toma de decisión respecto a la realización de trasplantes de páncreas y riñón en pacientes con Diabetes Mellitus tipo 1. Se ha realizado un análisis exploratorio del conjunto de datos de 82 pacientes sometidos a trasplante de páncreas y riñón entre los años 2002 y 2015 en el departamento de salud La Fe. Este análisis permite determinar la presencia de indicadores del éxito o fracaso de la intervención. Los indicadores más significativos son utilizados para el desarrollo de un modelo de clasificación que permite realizar predicciones en función de los datos de entrada de un nuevo paciente. El usuario accede al modelo a través de un interfaz web y el intercambio de información se realiza mediante un sistema de comunicaciones basado en la orquestación de servicios. Con todo esto, se ha conseguido implementar un sistema distribuido y autónomo que permite predecir antes de realizar la intervención, en base a un número reducido de variables, si un paciente trasplantado es susceptible de perder el páncreas a largo plazo con una precisión del 82,9 %.Moreno Alfaro, P. (2017). Sistema de apoyo a la decisión para transpante de páncreas en pacientes con diabetes tipo 1 basado en modelado de datos. http://hdl.handle.net/10251/91709TFG

Trematodos del ganado vacuno lechero al pastoreo en Cajamarca, Perú: Fasciola hepatica y Calicophoron microbothrioides

The study determines the prevalence of trematodes through coproparasitology in grazing dairy cattle in six districts of the Cajamarca region. The analyzes and processing of the faecal samples were carried out by natural sedimentation. The proportion of parasitized animals was 50.4 ± 2.1% (1092/2169), only Fasciola hepatica 32.4 ± 2.0% (703/2169), Calicophoron microbothrioides 17.9 ± 1.6% (389/2169) and coinfection by both parasites was 7.51 ± 1.11% (163/2169). The prevalence by district in Cajamarca was 49.5±5.0% (188/380), Baños del Inca 61.2±5.6% (181/296), La Encañada 80.7±4.1% (284/352), Celendín 45.4±5.0% (171 /377), San Juan 50.0±5.0% (190/380) and Chota 20.3±4.0% (78/384). There was no statistical association in the presence of both trematodes in the animals (p>0.95), nor was a correlation found between the altitude of each district and the presence of faecal eggs (r=0.19). It is concluded that the prevalence of trematodes in extensively reared dairy cattle in Cajamarca is high, with the greatest presence of F. hepatica, followed by C. microbothrioides and their coexistence.El estudio determina la prevalencia de trematodos mediante coproparasitología en ganado vacuno lechero de crianza al pastoreo en seis distritos de la región Cajamarca. Los análisis y procesamiento de las muestras fecales se realizaron mediante sedimentación natural. La proporción de animales parasitados fue de 50.4±2.1% (1092/2169), de Fasciola hepatica de 32.4±2.0% (703/2169) y Calicophoron microbothrioides de 17.9±1.6% (389/2169), en tanto que la coinfección por ambos parásitos fue de 7.51±1.11% (163/2169). Las prevalencias por distrito fueron en Cajamarca de 49.5±5.0% (188/380), Baños del Inca 61.2±5.6% (181/296), La Encañada 80.7±4.1% (284/352), Celendín 45.4±5.0% (171/377), San Juan 50.0±5.0% (190/380) y Chota 20.3±4.0% (78/384). No hubo asociación estadística en la presentación de ambos trematodos en los animales (p>0.95), ni se encontró correlación entre la altitud de cada distrito y la presencia de huevos fecales (r=0.19). Se concluye que, la prevalencia de trematodos en ganado vacuno lechero de crianza extensiva en Cajamarca es alta, con mayor presencia de F. hepatica, seguido de C. microbothrioides y su coexistencia

Long daytime napping is associated with increased adiposity and type 2 diabetes in an elderly population with metabolic syndrome

Research examining associations between objectively-measured napping time and type 2 diabetes (T2D) is lacking. This study aimed to evaluate daytime napping in relation to T2D and adiposity measures in elderly individuals from the Mediterranean region. A cross-sectional analysis of baseline data from 2190 elderly participants with overweight/obesity and metabolic syndrome, in the PREDIMED-Plus trial, was carried out. Accelerometer-derived napping was measured. Prevalence ratios (PR) and 95% confidence intervals (CI) for T2D were obtained using multivariable-adjusted Cox regression with constant time. Linear regression models were fitted to examine associations of napping with body mass index (BMI) and waist circumference (WC). Participants napping ≥90 min had a higher prevalence of T2D (PR 1.37 (1.06, 1.78)) compared with those napping 5 to <30 min per day. Significant positive associations with BMI and WC were found in those participants napping ≥30 min as compared to those napping 5 to <30 min per day. The findings of this study suggest that longer daytime napping is associated with higher T2D prevalence and greater adiposity measures in an elderly Spanish population at high cardiovascular risk

Identification of potential invasive alien species in Spain through horizon scanning

Invasive alien species have widespread impacts on native biodiversity and ecosystem services. Since the number of introductions worldwide is continuously rising, it is essential to prevent the entry, establishment and spread of new alien species through a systematic examination of future potential threats. Applying a three-step horizon scanning consensus method, we evaluated non-established alien species that could potentially arrive, establish and cause major ecological impact in Spain within the next 10 years. Overall, we identified 47 species with a very high risk (e.g. Oreochromis niloticus, Popillia japonica, Hemidactylus frenatus, Crassula helmsii or Halophila stipulacea), 61 with high risk, 93 with moderate risk, and 732 species with low risk. Many of the species categorized as very high or high risk to Spanish biodiversity are either already present in Europe and neighbouring countries or have a long invasive history elsewhere. This study provides an updated list of potential invasive alien species useful for prioritizing efforts and resources against their introduction. Compared to previous horizon scanning exercises in Spain, the current study screens potential invaders from a wider range of terrestrial, freshwater, and marine organisms, and can serve as a basis for more comprehensive risk analyses to improve management and increase the efficiency of the early warning and rapid response framework for invasive alien species. We also stress the usefulness of measuring agreement and consistency as two different properties of the reliability of expert scores, in order to more easily elaborate consensus ranked lists of potential invasive alien species.This work is one of the main results of the InvaNET network (RED2018-102571-T, RED2022-134338-T, https://invasiber.org/InvaNET/), financially supported by MCIN/AEI/10.13039/501100011033. We thank Guido Jones, funded by the Cabildo de Tenerife under the TFinnova Programme supported by MEDI and FDCAN, for revising the English.Peer reviewe

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

Dietary diversity and nutritional adequacy among an older Spanish population with Metabolic Syndrome in the PREDIMED-Plus study: a cross-sectional analysis

Dietary guidelines emphasize the importance of a varied diet to provide an adequate nutrient intake. However, an older age is often associated with consumption of monotonous diets that can be nutritionally inadequate, increasing the risk for the development or progression of diet-related chronic diseases, such as metabolic syndrome (MetS). To assess the association between dietary diversity (DD) and nutrient intake adequacy and to identify demographic variables associated with DD, we cross-sectionally analyzed baseline data from the PREDIMED-Plus trial: 6587 Spanish adults aged 55–75 years, with overweight/obesity who also had MetS. An energy-adjusted dietary diversity score (DDS) was calculated using a 143-item validated semi-quantitative food frequency questionnaire (FFQ). Nutrient inadequacy was defined as an intake below 2/3 of the dietary reference intake (DRI) forat least four of 17 nutrients proposed by the Institute of Medicine (IOM). Logistic regression models were used to evaluate the association between DDS and the risk of nutritionally inadequate intakes. In the higher DDS quartile there were more women and less current smokers. Compared with subjects in the highest DDS quartile, those in the lowest DDS quartile had a higher risk of inadequate nutrient intake: odds ratio (OR) = 28.56 (95% confidence interval (CI) 20.80–39.21). When we estimated food varietyfor each of the food groups, participants in the lowest quartile had a higher risk of inadequate nutrient intake for the groups of vegetables, OR = 14.03 (95% CI 10.55–18.65), fruits OR = 11.62 (95% CI 6.81–19.81), dairy products OR = 6.54 (95% CI 4.64–9.22) and protein foods OR = 6.60 (95% CI 1.96–22.24). As DDS decreased, the risk of inadequate nutrients intake rose. Given the impact of nutrient intake adequacy on the prevention of non-communicable diseases, health policies should focus on the promotion of a healthy varied diet, specifically promoting the intake of vegetables and fruit among population groups with lower DDS such as men, smokers or widow(er)s. View Full-Tex

Informe final del escaneo de horizonte sobre futuras especies exóticas invasoras en España

73 p.La introducción de especies exóticas invasoras (EEI) es una de las principales causas de la pérdida de biodiversidad a nivel global, que provoca grandes costes socioeconómicos. Sin embargo, el número de nuevas introducciones continúa creciendo año tras año. Por lo tanto, urge identificar posibles futuras EEI con el objetivo de diseñar e implementar medidas que prevengan y mitiguen los efectos negativos de su introducción. Así, el objetivo de este estudio es prospectar qué especies exóticas no establecidas en España podrían llegar fácilmente en los próximos 10 años, establecerse y causar importantes impactos ecológicos. Para ello, se ha realizado un escaneo de horizonte, siguiendo la metodología establecida en trabajos previos, siendo el primero para el conjunto de las especies exóticas invasoras en España. Se añadieron en el análisis especies que no son autóctonas de España, incluyendo los archipiélagos de Canarias y Baleares, y que no están establecidas en España. Un total de 39 científicos, expertos en distintos grupos taxonómicos y ecosistemas, ha evaluado 933 especies. Con el objetivo de analizar el acuerdo entre las evaluaciones individuales de los expertos y su consistencia, se llevaron a cabo dos análisis de fiabilidad complementarios, cuyos resultados se discuten en este informe. Como resultado del escaneo, se obtuvo una lista priorizada de 105 especies (46 con riesgo muy alto y 59 con riesgo alto). La mayoría de estas especies (84,8%), sin embargo, no están incluidas actualmente en el Catálogo Español de Especies Exóticas Invasoras. Por lo tanto, se recomienda la realización de un análisis de riesgo más detallado de estas especies y, si se confirma el riesgo alto, la solicitud de su incorporación en dicho catálogo o en el Listado de especies alóctonas susceptibles de competir con las especies silvestres autóctonas, alterar su pureza genética o los equilibrios ecológicos. Del mismo modo, se propone la realización de escaneos de horizonte específicos para los archipiélagos de Canarias y Baleares, ya que muchas de las especies autóctonas de la Península no lo son de las islas y podrían tener un gran impacto si allí se introdujeran. Este informe también analiza la afinidad taxonómica (i.e. filo) y funcional (i.e. productor primario, depredador, omnívoro, herbívoro o filtrador) de las especies de la lista priorizada, su origen geográfico y las principales vías de introducción. Por último, discute los mecanismos de impacto de dichas especies.Ministerio de Ciencia e Innovació

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 17

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, Volumen 17 de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada, de acceso abierto a todas las áreas del conocimiento, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico. Con esta colección, se aspira contribuir con el cultivo, la comprensión, la recopilación y la apropiación social del conocimiento en cuanto a patrimonio intangible de la humanidad, con el propósito de hacer aportes con la transformación de las relaciones socioculturales que sustentan la construcción social de los saberes y su reconocimiento como bien público