Procalcitonin and lung ultrasound algorithm to diagnose severe pneumonia in critical paediatric patients (PROLUSP study). A randomised clinical trial

Lung ultrasound (LUS) in combination with a biomarker has not yet been studied. We propose a clinical trial where the primary aims are: 1. To assess whether an algorithm with LUS and procalcitonin (PCT) may be useful for diagnosing bacterial pneumonia; 2. To analyse the sensitivity and specificity of LUS vs chest X-ray (CXR). A 3-year clinical trial. Inclusion criteria: children younger than 18 years old with suspected pneumonia in a Paediatric Intensive Care Unit. Patients will be randomised into two groups: Experimental Group: LUS will be performed as first lung image. Control Group: CXR will be performed as first pulmonary image. Patients will be classified according to the image and the PCT: a) PCT 1 ng/mL, antibiotic therapy is recommended. This algorithm will help us to diagnose bacterial pneumonia and to prescribe the correct antibiotic treatment. A reduction of antibiotics per patient, of the treatment length, and of the exposure to ionizing radiation and in costs is expected

Inference of the stability of global states in cortical networks

Poste

White matter cortico-striatal tracts predict apathy subtypes in Huntington's disease

Apathy is the neuropsychiatric syndrome that correlates most highly with Huntington's disease progression, and, like early patterns of neurodegeneration, is associated with lesions to cortico-striatal connections. However, due to its multidimensional nature and elusive etiology, treatment options are limited. To disentangle underlying white matter microstructural correlates across the apathy spectrum in Huntington's disease. Forty-six Huntington's disease individuals (premanifest (N = 22) and manifest (N = 24)) and 35 healthy controls were scanned at 3-tesla and underwent apathy evaluation using the short-Problem Behavior Assessment and short-Lille Apathy Rating Scale, with the latter being characterized into three apathy domains, namely emotional, cognitive, and auto-activation deficit. Diffusion tensor imaging was used to study whether individual differences in specific cortico-striatal tracts predicted global apathy and its subdomains. We elucidate that apathy profiles may develop along differential timelines, with the auto-activation deficit domain manifesting prior to motor onset. Furthermore, diffusion tensor imaging revealed that inter-individual variability in the disruption of discrete cortico-striatal tracts might explain the heterogeneous severity of apathy profiles. Specifically, higher levels of auto-activation deficit symptoms significantly correlated with increased mean diffusivity in the right uncinate fasciculus. Conversely, those with severe cognitive apathy demonstrated increased mean diffusivity in the right frontostriatal tract and left dorsolateral prefrontal cortex to caudate nucleus tract. The current study provides evidence that white matter correlates associated with emotional, cognitive, and auto-activation subtypes may elucidate the heterogeneous nature of apathy in Huntington's disease, as such opening a door for individualized pharmacological management of apathy as a multidimensional syndrome in other neurodegenerative disorders

Influence of the processing method and antimicrobial agents on properties of starch-gelatin biodegradable films

[EN] Biodegradable films based on corn starch (CS), bovine gelatin (BG), glycerol as a plasticizer, and lysozyme or N--lauroyl-l-arginine ethyl ester monohydrochloride (LAE) as antimicrobial agents were obtained by both extension-drying (casting) of the aqueous dispersions and melt blending and compression moulding. Microstructural analyses revealed the lack of miscibility between CS and BG, which implied polymer phase separation, with the formation of domains rich in each polymer, with different arrangements for casting and melt blending processes. Thermoprocessed films were more permeable to water vapour (60%-115%) and oxygen (70%-355%) compared to the corresponding cast films and exhibited lower stiffness (50%-75%) and resistance to break (17%-33%) and greater extensibility (150%-190%) than casting films. LAE improved the water vapour barrier and reduced the oxygen barrier of both kinds of films, whereas the opposite effect was observed for lysozyme. Antimicrobial activity against Listeria innocua was observed for formulations containing LAE processed by both casting and compression moulding, all of which exhibited a bactericidal effect. (c) 2016 Society of Chemical IndustryThe authors acknowledge the financial support provided by the Ministerio de Economía y Competividad (Projects AGL2013- 42989-R) and the services rendered by the Electron Microscopy Service of the UPV. Olga Moreno Marro also thanks the Ministerio de Educación, Cultura y Deporte, for the FPU 2012–1121 grant.Moreno Marro, O.; Díaz, R.; Atarés Huerta, LM.; Chiralt, A. (2016). Influence of the processing method and antimicrobial agents on properties of starch-gelatin biodegradable films. Polymer International. 65(8):905-914. https://doi.org/10.1002/pi.5115S90591465

Effect of oral anticoagulants on the outcome of faecal immunochemical test

Background: We aimed to evaluate whether oral anticoagulants (OACs) alter faecal immunochemical test (FIT) performance in average-risk colorectal cancer (CRC) screening. Methods: Individuals aged 50–69 years were invited to receive one FIT sample (cutoff 75¿ng¿ml–1) between November 2008 and June 2011. Results: Faecal immunochemical test was positive in 9.3% (21 out of 224) of users of OAC and 6.2% (365 out of 5821) of non-users (P-trend=0.07). The positive predictive value (PPV) for advanced neoplasia (AN) in non-users was 50.4% vs 47.6% in users (odds ratio, 0.70; 95% CI, 0.3–1.8; P=0.5). The PPV for AN in OAC more antiplatelets (aspirin or clopidogrel) was 75% (odds ratio, 2; 95% CI, 0.4–10.8; P=0.4). Conclusions: Oral anticoagulant did not significantly modify the PPV for AN in this population-based colorectal screening program. The detection rate of advanced adenoma was higher in the combination OAC more antiplatelets

Implantació i Millora de l'European Project Semester (EPS) a l'EPSEVG

L'EPSEVG de la UPC va implantar l’European Project Semester (EPS) un programa formatiu innovador que respon a les demandes plantejades per la societat i l’Espai Europeu d’Ensenyament Superior (EEES) durant el curs 2007‐2008. L’EPS permet cobrir la demanda d’estudiants estrangers que volen venir a estudiar a l’escola, demanda, que, a nivell de grau en enginyeria no esta coberta en cap universitat catalana.L’EPS també és una oportunitat per augmentar el compromís de l’EPSEVG vers la sostenibilitat. El programa s’ha ambientalitzat d’acord amb les directrius del Pla UPC Sostenible 2015 essent la sostenibilitat un dels eixos transversals que li dona contingut i que identifica a tots els projectes desenvolupats. A més de la sostenibilitat, el programa inclou altres matèries transversals (com ara, la innovació, la gestió de projectes, l’accessibilitat...). L’EPS utilitza el model d’aprenentatge basat en projectes (Project Based Learning), i hi introdueix dos components nous: la docència en anglès i la interculturalitat dins de l’aula. Les noves tecnologies s’utilitzen tant per dinamitzar el treball dels grups com per facilitar el seu aprenentatge, doncs l’EPS inclou tallers i seminaris en la modalitat semipresencial.Peer Reviewe

IGFBP3 methylation is a novel diagnostic and predictive biomarker in colorectal cancer

BACKGROUND AND AIM: Aberrant hypermethylation of cancer-related genes has emerged as a promising strategy for the development of diagnostic, prognostic and predictive biomarkers in human cancer, including colorectal cancer (CRC). The aim of this study was to perform a systematic and comprehensive analysis of a panel of CRC-specific genes as potential diagnostic, prognostic and predictive biomarkers in a large, population-based CRC cohort. PATIENTS AND METHODS: Methylation status of the SEPT9, TWIST1, IGFBP3, GAS7, ALX4 and miR137 genes was studied by quantitative bisulfite pyrosequencing in a population-based cohort of 425 CRC patients. RESULTS: Methylation levels of all genes analyzed were significantly higher in tumor tissues compared to normal mucosa (p<0.0001); however, cancer-associated hypermethylation was most frequently observed for miR137 (86.7%) and IGFBP3 (83%) in CRC patients. Methylation analysis using the combination of these two genes demonstrated greatest accuracy for the identification of colonic tumors (sensitivity 95.5%; specificity 90.5%). Low levels of IGFBP3 promoter methylation emerged as an independent risk factor for predicting poor disease free survival in stage II and III CRC patients (HR = 0.49, 95% CI: 0.28-0.85, p = 0.01). Our results also suggest that stage II & III CRC patients with high levels of IGFBP3 methylation do not benefit from adjuvant 5FU-based chemotherapy. CONCLUSION: By analyzing a large, population-based CRC cohort, we demonstrate the potential clinical significance of miR137 and IGFBP3 hypermethylation as promising diagnostic biomarkers in CRC. Our data also revealed that IGFBP3 hypermethylation may serve as an independent prognostic and predictive biomarker in stage II and III CRC patients

Proactive and systematic multidimensional needs assessment in patients with advanced cancer approaching palliative care: a study protocol

Introduction: The benefits of palliative care rely on how healthcare professionals assess patients' needs in the initial encounter/s; crucial to the design of a personalised therapeutic plan. However, there is currently no evidence-based guideline to perform this needs assessment. We aim to design and evaluate a proactive and systematic method for the needs assessment using quality guidelines for developing complex interventions. This will involve patients, their relatives and healthcare professionals in all phases of the study and its communication to offer clinical practice a reliable approach to address the palliative needs of patients. Methods and analysis: To design and assess the feasibility of an evidence-based, proactive and systematic Multidimensional needs Assessment in Palliative care (MAP) as a semistructured clinical interview guide for initial palliative care encounter/s in patients with advanced cancer. This is a two-phase multisite project conducted over 36 months between May 2019 and May 2022. Phase I includes a systematic review, discussions with stakeholders and Delphi consensus. The evidence gathered from phase I will be the basis for the initial versions of the MAP, then submitted to Delphi consensus to develop a preliminary guide of the MAP for the training of clinicians in the feasibility phase. Phase II is a mixed-methods multicenter feasibility study that will assess the MAP's acceptability, participation, practicality, adaptation and implementation. A nested qualitative study will purposively sample a subset of participants to add preliminary clues about the benefits and barriers of the MAP. The evidence gathered from phase II will build a MAP user guide and educational programme for use in clinical practice. Ethics and dissemination: Ethical approval for this study has been granted by the university research ethics committee where the study will be carried out (approval reference MED-2018-10). Dissemination will be informed by the results obtained and communication will occur throughout

GABAergic and glutamatergic identities of developing midbrain Pitx2 neurons

Pitx2 , a paired-like homeodomain transcription factor, is expressed in post-mitotic neurons within highly restricted domains of the embryonic mouse brain. Previous reports identified critical roles for PITX2 in histogenesis of the hypothalamus and midbrain, but the cellular identities of PITX2-positive neurons in these regions were not fully explored. This study characterizes Pitx2 expression with respect to midbrain transcription factor and neurotransmitter phenotypes in mid-to-late mouse gestation. In the dorsal midbrain, we identified Pitx2 -positive neurons in the stratum griseum intermedium (SGI) as GABAergic and observed a requirement for PITX2 in GABAergic differentiation. We also identified two Pitx2 -positive neuronal populations in the ventral midbrain, the red nucleus, and a ventromedial population, both of which contain glutamatergic precursors. Our data suggest that PITX2 is present in regionally restricted subpopulations of midbrain neurons and may have unique functions that promote GABAergic and glutamatergic differentiation. Developmental Dynamics 240:333–346, 2011. © 2011 Wiley-Liss, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79425/1/22532_ftp.pd