Directiva (UE) 2019/790 del Parlamento Europeo y del Consejo sobre los derechos de autor y derechos afines en el mercado único digital y por la que se modifican las directivas 96/9/CE y 2001/29/CE

Recently, the Proposal for a Directive on copyright in the digital single market has been approved. This is a legislative initiative initiated several years ago by the European Commission, which aims to adapt the legislation on copyright to a new reality marked by the evolution of digital technologies, establishing a uniform legal framework that allows adequate protection of intellectual property in the digital environment of the European Union. However, this new chapter of adaptation of the regulation on intellectual property to technological change, as in previous occasions, is marked by the complexity that characterizes and surrounds this issue of copyright. So much so that the Proposal for a Directive has met with numerous obstacles from the very beginning of its processing to its final approval, motivated by both the existing pressures and the rejection it has suffered from public opinion, which considered that some of their proposals posed a threat to freedom of expression on the Internet. After its final approval, once it has been transposed into the national legislations of the different member states, it will remain to be seen what consequences its application will have in the digital environment.Recientemente ha sido aprobada la Propuesta de Directiva sobre derechos de autor en el mercado único digital. Se trata de una iniciativa legislativa iniciada varios años atrás por la Comisión Europea, con la que se pretende adaptar la legislación sobre derechos de autor a una nueva realidad marcada por la evolución de las tecnologías digitales, estableciendo un marco legal uniforme que permita la protección adecuada de la propiedad intelectual en el entorno digital de la Unión Europea. Sin embargo, este nuevo capítulo de adaptación de la normativa sobre propiedad intelectual al cambio tecnológico, al igual que en ocasiones precedentes, está marcado por la complejidad que caracteriza y rodea a esta temática de los derechos de autor. Tanto es así que la Propuesta de Directiva se ha encontrado con numerosos obstáculos desde el mismo inicio de su tramitación hasta su definitiva aprobación, motivados tanto por las presiones existentes como por el rechazo que ha sufrido de parte de la opinión pública, que consideraba que algunas de sus propuestas suponían una amenaza a la libertad de expresión en Internet. Tras su definitiva aprobación, una vez sea objeto de transposición a las legislaciones nacionales de los diferentes Estados miembro, quedará por ver qué consecuencias tendrá su aplicación en el entorno digital

Antihypertensive and Antioxidant Activity of Chia Protein Techno-Functional Extensive Hydrolysates

Twelve high-quality chia protein hydrolysates (CPHs) were produced from chia protein isolate (CPI) in a pilot plant of vegetable proteins. To obtain functional hydrolysate, four CPHs were hydrolyzed by the action of Alcalase, an endoprotease, and the other eight CPHs were hydrolyzed by the action of Flavourzyme, an exoprotease. Alcalase-obtained CPHs showed significant antihypertensive properties particularly, the CPH obtained after 15 min of hydrolysis with Alcalase (CPH15A), which showed a 36.2% hydrolysis degree. In addition, CPH15A increased the antioxidant capacity compared to CPI. The CPH15A physicochemical composition was characterized and compared to chia defatted flour (CDF) and CPI, and its techno-functional properties were determined by in vitro experiments through the analysis of its oil absorption capacity, as well as the capacity and stability of foaming and emulsifying, resulting in an emulsifier and stabilizer better than the intact protein. Therefore, the present study revealed that CPH15A has potent antihypertensive and antioxidant properties and can constitute an effective alternative to other plant protein ingredients sources that are being used in the food industry.Spanish Ministry of Science, Innovation, and Universities grant CYTED-2019/119RT056

Hemp peptides (Cannabis sativa L.) modulate the neuro-inflammatory process via inflamasome

Plant proteins have generated great interest in recent years because they are a potential source of peptides with biological activity. In this sense, extensive protein hydrolysates with high degree of hydrolysis obtained by enzymatic hydrolysis are used in specialized feeding to prevent or treat chronic diseases. In this study, different hemp protein hydrolysates were used to test their neuroprotective effects on BV-2 microglial cells. Motivation: The current trend on organic farming and sustainability has increased interest in the cultivation of industrial hemp (Cannabis sativa L.) in recent years for its multiple applications in a wide range of sectors. The cultivation of industrial hemp, a fast-growing plant with low tetrahydrocannabinol (THC) < 0.2%, is considered sustainable because it does not require herbicide fertilizers or pesticides. Its seeds have a high nutritional value due to their richness in fatty acids, proteins, essential amino acids, carbohydrates, vitamins and minerals, as well as functional, due to their content in antioxidant, anti-inflammatory and neuroprotective bioactive compounds. Recent data link NLRP3 inflammation, a macromolecular complex, IL-1β , and IL-18, in the development and evolution of neurodegenerative diseases. Methods: From hemp seeds, a protein isolate was obtained and subsequently hydrolyzed with the enzymes Alcalase and Flavourzyme. Two hemp protein hydrolysates (HP20A, HP60A+15AF) were characterized and used in BV2 microglial cells previously stimulated with lipopolysacchaid (LPS), in order to evaluate their anti-inflammatory activity. Results: Both protein hydrolysates HP20A and HP60A+15AF showed a potential neuroprotective effect via inflamasome by suppressing the gene expression of IL-18 and IL-1β pro-inflammatory cytokines

Comparative external validation of the PRECISE-DAPT and PARIS risk scores in 4424 acute coronary syndrome patients treated with prasugrel or ticagrelor

Background: The PRECISE-DAPT and PARIS risk scores (RSs) were recently developed to help clinicians at individualizing the optimal dual antiplatelet therapy duration (DAPT) after percutaneous coronary intervention (PCI). Nevertheless, external validation of these RSs it has not yet been performed in ACS (acute coronary syndrome) patients treated with prasugrel or ticagrelor in a real- world scenario. Methods: 4424 ACS patients who underwent PCI and survived to hospital discharge, from January 2012 to December 2016 at 12 European centers, were included. PRECISE-DAPT and PARIS bleeding RS, as well as PARIS ischemic RS, were computed, and their performance at predicting major bleeding (MB; BARC type 3 or 5) and ischemic events (MI and stent thrombosis) during follow up was compared. Results: After a median follow-up of 14 (interquartile range 12–20.9) months, 83 (1.88%) patients developed MB and 133 (3.0%) suffered an ischemic episode. PRECISE-DAPT performed better than PARIS bleeding RS (c-statistic = 0.653 vs. 0.593; p =.01 for comparison) in predicting MB. The RSs performance for MB prediction remained consistent in STEMI patients (c-statistic = 0.632 vs 0.575) or in those treated with prasugrel (c-statistic = 0.623 vs 0.586). PARIS ischemic RS exhibited superior discrimination in predicting ischemic complications compared to PRECISE-DAPT (c-statistic = 0.604 vs 0.568 p =.05 for comparison). Conclusion: Our data provide support to the use of PRECISE-DAPT in MB risk stratification for patients receiving DAPT in form of aspirin and prasugrel or ticagrelor whereas the PARIS ischemic RS has potential to complement the risk prediction with respect to ischemic events

Average daily ischemic versus bleeding risk in patients with ACS undergoing PCI: Insights from the BleeMACS and RENAMI registries

Background: The risk of recurrent ischemia and bleeding after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) may vary during the first year of follow-up according to clinical presentation, and medical and interventional strategies. Methods: BleeMACS and RENAMI are 2 multicenter registries enrolling patients with ACS treated with PCI and clopidogrel, prasugrel, or ticagrelor. The average daily ischemic and bleeding risks (ADIR and ADBR) in the first year after PCI were the primary end points. The difference between ADBR and ADIR was calculated to estimate the potential excess of bleeding/ischemic events in a given period or specific subgroup. Results: A total of 19,826 patients were included. Overall, in the first year after PCI, the ADBR was 0.008085%, whereas ADIR was 0.008017% (P =.886). In the first 2 weeks ADIR was higher than ADBR (P =.013), especially in patients with ST-segment elevation myocardial infarction or incomplete revascularization. ADIR continued to be, albeit non-significantly, greater than ADBR up to the third month, whereas ADBR became higher, although not significantly, afterward. Patients with incomplete revascularization had an excess in ischemic risk (P =.003), whereas non–ST-segment elevation ACS patients and those on ticagrelor had an excess of bleeding (P =.012 and P =.022, respectively). Conclusions: In unselected ACS patients, ADIR and ADBR occurred at similar rates within 1 year after PCI. ADIR was greater than ADBR in the first 2 weeks, especially in ST-segment elevation myocardial infarction patients and those with incomplete revascularization. In the first year, ADIR was higher than ADBR in patients with incomplete revascularization, whereas ADBR was higher in non–ST-segment elevation ACS patients and in those discharged on ticagrelor

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

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