Association of Candidate Gene Polymorphisms With Chronic Kidney Disease: Results of a Case-Control Analysis in the Nefrona Cohort

Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2, 445 CKD cases and 559 controls. Genotyping was performed with matrix assisted laser desorption ionizationtime of flight mass spectrometry. We used logistic regression models considering different genetic inheritance models to assess the association of the SNPs with the prevalence of CKD, adjusting for known risk factors. Eight SNPs (rs1126616, rs35068180, rs2238135, rs1800247, rs385564, rs4236, rs2248359, and rs1564858) were associated with CKD even after adjusting by sex, age and race. A model containing five of these SNPs (rs1126616, rs35068180, rs1800247, rs4236, and rs2248359), diabetes and hypertension showed better performance than models considering only clinical risk factors, significantly increasing the area under the curve of the model without polymorphisms. Furthermore, one of the SNPs (the rs2248359) showed an interaction with hypertension, being the risk genotype affecting only hypertensive patients. We conclude that 5 SNPs related to proteins implicated in mineral metabolism disturbances (Osteopontin, osteocalcin, matrix gla protein, matrix metalloprotease 3 and 24 hydroxylase) are associated to an increased risk of suffering CKD

Prácticum virtual en Educación Física: entre pandemia e incertidumbre

The current health situation has hampered many face-to-face training processes, affecting Professional Synthesis Practices (PSP) and causing students to complete their Training Process (TP) in virtually. The objective of the investigation was to know the perception of students regarding the Virtual Practice of Professional Synthesis. The methodology had a quantitative approach and the data was collected through a descriptive survey, applied to 47 Physical Education (PE) teachers who graduated from a Chilean university during 2020. It is concluded that the graduates were prepared to the changes that occurred during the health crisis, accepting the situation given this year and adapting to it, which should be considered as an opportunity for innovation in the subject.A situação atual de saúde tem dificultado muitos processos de formação presencial, impactando as Práticas de Síntese Profissional (PSP), fazendo com que os alunos concluam seu Processo de Formação (PF) na virtualidade. O objetivo da pesquisa foi conhecer a percepção de alunos de Educação Física (EF) sobre a Prática Virtual de Síntese Profissional. A metodologia teve abordagem quantitativa e os dados foram coletados por meio de uma pesquisa descritiva, aplicada a 47 formandos de EF de uma universidade chilena durante o ano de 2020. Conclui-se que os formandos foram preparados para as mudanças ocorridas durante a crise de saúde, aceitando a situação atendendo este ano e adaptando-se a ele, o que deve ser considerado uma oportunidade de inovação no assunto.La situación sanitaria actual ha obstaculizado muchos procesos formativos de modalidad presencial impactando en las Prácticas de Síntesis Profesional (PSP), provocando que estudiantes finalicen su Proceso Formativo (PF) en la virtualidad. La investigación tuvo como objetivo conocer la percepción de estudiantes de Educación Física (EF) frente a la Práctica Virtual de Síntesis Profesional. La metodología tuvo un enfoque cuantitativo y la recolección de los datos fue a través de una encuesta de tipo descriptiva, aplicada a 47 egresados de EF de una universidad chilena durante el 2020. Se concluye que los egresados se encontraban preparados para los cambios que se presentaron durante la crisis sanitaria, aceptando la situación dada este año y adaptándose a ella, la cual debe considerarse como una oportunidad de innovación de la asignatura

Desarrollo de productos y marketing de los centros de producción de la Universidad Cooperativa de Colombia seccional Bucaramanga.

Este trabajo de grado contiene un estudio detallado de los Centros de Producción Pecuarios de la Universidad Cooperativa de Colombia, ubicados en los municipios de Piedecuesta, San Gil y Santa Marta; donde en la actualidad se encuentran produciendo diferentes tipos de explotaciones pecuarias, entre estas y siendo el objeto de este estudio, las producciones porcícolas y piscícolas. Para la realización de este trabajo de grado, se analizó y evaluó las condiciones, estado y capacidad de producción que se manejan en la actualidad de dichos centros; correspondientes a las producciones porcina y piscícola. Se censo la población de productores existentes hasta el momento, se realizo el estudio de mercados correspondiente de acuerdo a los resultados arrojados por el censo. Con dichos resultados se procedió a una auto evaluación de los centros de Producción Pecuaria de Guatiguara, el Ciruelo y Tayronaca, arrojando un resultado no muy favorable para la producción de cerdos, peces y alevinos en dichos Centros de Producción. No obstante se recomienda la reactivación de manera técnica para un mejor servicio y calidad de los productos; ya que se cuenta con mano de obra calificada, como una alternativa para disminuir costos se procede a dietas no convencionales con productos cultivados en los Centros de Producción, también se da una alternativa en la parte de reproducción, brindando los servicios técnicos en dicha área a las granjas cercanas a nuestros Centros de Producción y por ultimo en relación a la parte técnica y veterinaria se ofrece un bienestar animal para un buen producto final. Teniendo en cuenta el estudio de mercados, basado en un censo realizado en las regiones donde se cuentan con estos Centros de Producción, podemos optar por hacer un mercadeo estratégico aprovechando el mercado interno de la Universidad Cooperativa de Colombia; para ofrecer nuestro producto terminado y así; hacer la producción auto sostenible basándose en una economía sólida y favorable para nuestros productos los cuales llevarían el respaldo de centros de producción que buscan el beneficio y bienestar animal para ofrecer un productos de excelente calidad; ya sea en alevinos, pez cebado, lechones y cerdo cebado. No olvidando de antemano, lo importante que es reactivar económicamente nuestros Centros de Producción para así ser auto sostenibles y entrar a competir en el mercado con precios bajos y de excelente calidad.Introducción. -- 1. Problema. -- 1.1 Definición. -- 1.2 Antecedentes del problema. -- 2. Justificación. -- 3. Objetivos. -- 3.1 General. -- 3.2 Específicos. -- 4. Marco teórico. -- 4.1 Alimentación. -- 4.1.1 Alimentación no convencional. -- 4.1.2 Alternativas de alimentación no convencional. -- 4.2 Bienestar animal. -- 4.2.1 El bienestar y la calidad de la canal o la carne. -- 4.2.2 Requisitos para adherirse al convenio de producción limpia. -- 4.3 Reproducción. -- 4.3.1 Servicio. -- 4.3.2 Chequeos visuales. -- 4.3.3 Hembras repetidoras. -- 4.3.4 Chequeo de preñez. -- 4.3.5 Inseminación artificial. -- 4.4 Construcciones. -- 4.4.1 Instalaciones. -- 5. Esquema temático. -- 5.1 Alimentación. -- 5.1.1 Composición de los alimentos. -- 5.1.2 Alternativas de alimentación no convencional. -- 5.2 Bienestar animal. -- 5.2.1 Sanidad preventiva (biológicos). -- 5.2.2 Reproducción limpia. -- 5.3 Reproducción. -- 5.3.1 Centro de monta. -- 5.4 Construcciones. -- 5.4.1 Instalaciones. -- 5.5 Costos de producción. -- 5.5.1 Costo del lechón al destete. -- 5.5.2 Costo del lechón hasta el 15 kg. -- 5.5.3 Costo de engorde hasta el 95 kg. -- 6. Observaciones. -- 7. Recomendaciones. -- 8. Conclusiones. -- Bibliografía. -- Anexos. [email protected]@[email protected]@[email protected]@[email protected]@[email protected]@[email protected]@[email protected]@[email protected]ñ[email protected]@[email protected]@[email protected]@[email protected]@[email protected]ú[email protected]

Physico-Chemical and Structural Interpretation of Discrete Derivative Indices on N-Tuples Atoms

This report examines the interpretation of the Graph Derivative Indices (GDIs) from three different perspectives (i.e., in structural, steric and electronic terms). It is found that the individual vertex frequencies may be expressed in terms of the geometrical and electronic reactivity of the atoms and bonds, respectively. On the other hand, it is demonstrated that the GDIs are sensitive to progressive structural modifications in terms of: size, ramifications, electronic richness, conjugation effects and molecular symmetry. Moreover, it is observed that the GDIs quantify the interaction capacity among molecules and codify information on the activation entropy. A structure property relationship study reveals that there exists a direct correspondence between the individual frequencies of atoms and Hückel’s Free Valence, as well as between the atomic GDIs and the chemical shift in NMR, which collectively validates the theory that these indices codify steric and electronic information of the atoms in a molecule. Taking in consideration the regularity and coherence found in experiments performed with the GDIs, it is possible to say that GDIs possess plausible interpretation in structural and physicochemical terms. © 2016 by the authors; licensee MDPI, Basel, Switzerland.Pharmaceutical Preparation

A multi-taxa assessment of aquatic non-indigenous species introduced into Iberian freshwater and transitional waters

Aquatic ecosystems are particularly vulnerable to the introduction of non-indigenous species (NIS), leading to multi-faceted ecological, economic and health impacts worldwide. The Iberian Peninsula comprises an exceptionally biodiverse Mediterranean region with a high number of threatened and endemic aquatic species, most of them strongly impacted by biological invasions. Following a structured approach that combines a systematic review of available information and expert opinion, we provide a comprehensive and updated multi-taxa inventory of aquatic NIS (fungi, macroalgae, vascular plants, invertebrates and vertebrates) in Iberian inland waters. Moreover, we assess overall patterns in the establishment status, introduction pathways, native range and temporal introduction trends of listed NIS. In addition, we discuss the legal coverage provided by both national (Spanish and Portuguese) and European NIS regulations. We inventoried 326 aquatic NIS in Iberian inland waters, including 215 established, 96 with uncertain establishment status and 15 cryptogenic taxa. Invertebrates (54.6%) and vertebrates (24.5%) were the groups with the highest number of NIS, with Arthropoda, Mollusca, and Chordata being the most represented phyla. Recorded NIS originated from diverse geographic regions, with North and South America being the most frequent. Vertebrates and vascular plants were mostly introduced through intentional pathways (i.e. release and escape), whereas invertebrates and macroalgae arrived mostly through unintentional ways (i.e. contaminant or stowaway). Most of the recorded NIS were introduced in Iberian inland waters over the second half of the 20th century, with a high number of NIS introductions being reported in the 2000s. While only 8% of the recorded NIS appear in the European Union list of Invasive Alien Species of Union concern, around 25% are listed in the Spanish and Portuguese NIS regulations. This study provides the most updated checklist of Iberian aquatic NIS, meeting the requirements set by the EU regulation and providing a baseline for the evaluation of its application. We point out the need for coordinated transnational strategies to properly tackle aquatic invasions across borders of the EU members

36-month clinical outcomes of patients with venous thromboembolism: GARFIELD-VTE

Background: Venous thromboembolism (VTE), encompassing both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a leading cause of morbidity and mortality worldwide.Methods: GARFIELD-VTE is a prospective, non-interventional observational study of real-world treatment practices. We aimed to capture the 36-month clinical outcomes of 10,679 patients with objectively confirmed VTE enrolled between May 2014 and January 2017 from 415 sites in 28 countries.Findings: A total of 6582 (61.6 %) patients had DVT alone, 4097 (38.4 %) had PE +/- DVT. At baseline, 98.1 % of patients received anticoagulation (AC) with or without other modalities of therapy. The proportion of patients on AC therapy decreased over time: 87.6 % at 3 months, 73.0 % at 6 months, 54.2 % at 12 months and 42.0 % at 36 months. At 12-months follow-up, the incidences (95 % confidence interval [CI]) of all-cause mortality, recurrent VTE and major bleeding were 6.5 (7.0-8.1), 5.4 (4.9-5.9) and 2.7 (2.4-3.0) per 100 person-years, respectively. At 36-months, these decreased to 4.4 (4.2-4.7), 3.5 (3.2-2.7) and 1.4 (1.3-1.6) per 100 person-years, respectively. Over 36-months, the rate of all-cause mortality and major bleeds were highest in patients treated with parenteral therapy (PAR) versus oral anti-coagulants (OAC) and no OAC, and the rate of recurrent VTE was highest in patients on no OAC versus those on PAR and OAC. The most frequent cause of death after 36-month follow-up was cancer (n = 565, 48.6 %), followed by cardiac (n = 94, 8.1 %), and VTE (n = 38, 3.2 %). Most recurrent VTE events were DVT alone (n = 564, 63.3 %), with the remainder PE, (n = 236, 27.3 %), or PE in combination with DVT (n = 63, 7.3 %).Interpretation: GARFIELD-VTE provides a global perspective of anticoagulation patterns and highlights the accumulation of events within the first 12 months after diagnosis. These findings may help identify treatment gaps for subsequent interventions to improve patient outcomes in this patient population

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine