A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study

Background: The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU. Methods: This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group. Results: Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR < 0.05). Cox regression analysis revealed that low expression levels of eight miRNAs were associated with a higher risk of death (HR from 1.56 to 2.61). LASSO regression for variable selection was used to construct a miRNA classifier. A 4-blood miRNA signature composed of miR-16-5p, miR-192-5p, miR-323a-3p and miR-451a predicts the risk of all-cause in-ICU mortality (HR 2.5). Kaplan‒Meier analysis confirmed these findings. The miRNA signature provides a significant increase in the prognostic capacity of conventional scores, APACHE-II (C-index 0.71, DeLong test p-value 0.055) and SOFA (C-index 0.67, DeLong test p-value 0.001), and a risk model based on clinical predictors (C-index 0.74, DeLong test-p-value 0.035). For 28-day and 90-day mortality, the classifier also improved the prognostic value of APACHE-II, SOFA and the clinical model. The association between the classifier and mortality persisted even after multivariable adjustment. The functional analysis reported biological pathways involved in SARS-CoV infection and inflammatory, fibrotic and transcriptional pathways. Conclusions: A blood miRNA classifier improves the early prediction of fatal outcomes in critically ill COVID-19 patients.11 página

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Ruta de arquitectura: romanticismo nórdico

Esta guía es fruto del viaje de estudios realizado del 26 de abril al 3 de mayo de 2015. Actividad recogida en el Proyecto docente de la asignatura de Proyectos 8, grupos 4.03 y 4.04. Curso 2014-2015. AULA TALLER F. Departamento de Proyectos Arquitectónicos. E.T.S. de Arquitectura de Sevilla. Universidad de Sevilla. La arquitectura de los países escandinavos constituye un apartado singular de alto interés en el panorama cultural del siglo XX y debe observarse en relación a sus países vecinos, Finlandia y Dinamarca. Se mezclan y suceden generaciones: en Finlandia, Alvar Aalto, Erik Brygman, Heiki y Kaija Siren o Reima Pietilä; en Suecia, Gunnar Asplund y Sigurd Lewerentz junto a Sven Markelius, anteceden a las figuras de Ralph Erskine o de Peter Celsing; en Dinamarca serán Arne Jacobsen y posteriormente Jorn Utzon; en Noruega, Sverre Fhen para la buena práctica arquitectónica y Christian Norberg–Schulz para la construcción de nuevas teorías. El romanticismo nórdico había surgido a principios del siglo XX como otros movimientos de pre–vanguardia, en oposición a la situación academicista heredada del siglo XIX. Esta situación de tránsito define un contexto propio en Suecia que será reconocible en el pensamiento y en las arquitecturas que construyeran Lewerentz y sobre todo Asplund.This guide is the result of the study tour made from 26 April to 3 May 2015. Activity included in the Teaching Project of Project 8, groups 4.03 and 4.04. 2014-2015 school year. AT-F. Department of Architectural Projects. Higher Technical School of Architecture. University of Seville. The architecture of the Scandinavian countries is a unique case of high interest in the cultural scene of the twentieth century and must be observed in relation to its neighboring countries, Finland and Denmark. They mix and happen generations: in Finland, Alvar Aalto, Erik Brygman, Heiki and Kaija Siren or Reima Pietilä; in Sweden, Gunnar Asplund and Sigurd Lewerentz with Sven Markelius, precede the figures of Ralph Erskine) or Peter Celsing; in Denmark will be Arne Jacobsen and later Jorn Utzon; in Norway, Sverre Fhen for good architectural practice and Christian Norberg-Schulz for the construction of new theories. Nordic romanticism had emerged in the early twentieth century as other pre-vanguard movements, as opposition to the academic situation inherited from the nineteenth century.Universidad de Sevill

Importance of Vaccination against SARS-CoV-2 in Patients with Interstitial Lung Disease Associated with Systemic Autoimmune Disease.

Objectives: To describe the frequency of COVID-19 and the effect of vaccination in patients with interstitial lung disease and systemic autoimmune disease (ILD-SAD) and to identify factors associated with infection and severity of COVID-19. Methods: We performed a cross-sectional multicenter study of patients with ILD-SAD followed between June and October 2021. The main variable was COVID-19 infection confirmed by a positive polymerase chain reaction (PCR) result for SARS-CoV-2. The secondary variables included severity of COVID-19, if the patient had to be admitted to hospital or died of the disease, and vaccination status. Other variables included clinical and treatment characteristics, pulmonary function and high-resolution computed tomography. Two logistic regression was performed to explore factors associated with “COVID-19” and “severe COVID-19”. Results: We included 176 patients with ILD-SAD: 105 (59.7%) had rheumatoid arthritis, 49 (27.8%) systemic sclerosis, and 22 (12.54%) inflammatory myopathies. We recorded 22/179 (12.5%) SARS-CoV-2 infections, 7/22 (31.8%) of them were severe and 3/22 (13.22%) died. As to the vaccination, 163/176 (92.6%) patients received the complete doses. The factors associated with SARS-CoV-2 infection were FVC (OR (95% CI), 0.971 (0.946−0.989); p = 0.040), vaccination (OR (95% CI), 0.169 (0.030−0.570); p = 0.004), and rituximab (OR (95% CI), 3.490 (1.129−6.100); p = 0.029). The factors associated with severe COVID-19 were the protective effect of the vaccine (OR (95% CI), 0.024 (0.004−0.170);

“En los bordes del archivo: escrituras periféricas, escrituras efímeras en los Virreinatos de Indias”

En los bordes del archivo es el sitio web de "En los bordes del archivo: escrituras periféricas, escrituras efímeras en los Virreinatos de Indias”, proyecto coordinado entre dos equipos de investigación de la Universidad Complutense de Madrid (UCM) y del Consejo Superior de Investigaciones Científicas (CSIC).© En los bordes del archivo - 2017. Algunos derechos reservados. Licencia Creative Commons.. Consulta realizada en 2019-03-22.La finalidad que orienta el Proyecto Coordinado “En los bordes del archivo: escrituras periféricas, escrituras efímeras en los Virreinatos de Indias” queda definida en la voz que encabeza su título, estudiada en relación con la escritura hispanoamericana colonial y abordada desde una comprensión amplia del término, no sólo en su sentido más positivista, en tanto acumulación o repositorio de documentos para la conformación de la verdad historiográfica y la imposición del poder imperial, sino en las acepciones paralelas de “lugar de la memoria” y de “metáfora epistémica”, de herramienta que permite la interpretación “arqueológica” de los saberes.Peer reviewe