45 research outputs found
Use of Aerial Laser Scanning to Assess the Effect on C Sequestration of Oak (Quercus ilex L. subsp. ballota [Desf.]Samp-Q. suber L.) Afforestation on Agricultural Land
Conversion of agricultural lands to forest plantations to mitigate rising atmospheric carbon dioxide (CO2) has been proposed, but it depends on accurate estimation of the on-site carbon (C) stocks distribution. The use of aerial laser scanning (ALS) data is a rapidly evolving technology for the quantification of C stocks. We evaluated the use of allometric models together with high-density ALS data for the quantification of biomass and soil C stocks in a 14-year-old Quercus ilex and Q. suber plantation in Southwestern Spain. In 2010, a field survey was performed and tree dasometric and biomass variables were measured. Forty-five soil profiles (N = 180 soil samples) were taken systematically and the soil organic C content (SOC) was determined. Biomass and soil organic C values were regressed against individual dasometric variables and total tree height was used as a predictor variable. Aerial laser scanning data were acquired with a point density of 12 points mâ2. Relationships among ALS metrics and tree height were determined using stepwise regression models and used in the allometric models to estimate biomass and SOC C stocks. Finally, a C stock map of the holm-cork oak cover in the study area was generated. We found a tree total biomass of 27.9 kg treeâ1 for holm oak and 41.1 kg treeâ1 for cork oak. In the holm oak plantation, the SOC content was 36.90 Mg haâ1 for the layer 0â40 cm (SOC40) under the tree crown and 29.26 Mg haâ1 for the inter-planted area, with significant differences from the reference agricultural land (33.35 Mg haâ1). Linear regression models were developed to predict the biomass and SOC at the tree scale, based on tree height (R2 >0.72 for biomass, and R2 >0.62 for SOC). The overall on-site C stock in the holm-cork oak plantation was 35.11 Mg haâ1, representing a net C stock rise of 0.47 Mg haâ1 yrâ1. The ALS data allows a reliable estimation of C stocks in holm and cork oak plantations and high-resolution maps of on-site C stocks are useful for silvicultural planning. The cost of ALS data acquisition has decreased and this method can be generalised to plantations of other Mediterranean species established on agricultural lands at regional scales. However, an increase of filed data and the availability of local biomass and, in particular, SOC will improve accurate quantification of the C stocks from allometric equations, and extrapolation to large planted areas
Pseudomonas aeruginosa Bloodstream Infections in Patients with Cancer: Differences between Patients with Hematological Malignancies and Solid Tumors
Objectives: To assess the clinical features and outcomes of Pseudomonas aeruginosa bloodstream infection (PA BSI) in neutropenic patients with hematological malignancies (HM) and with solid tumors (ST), and identify the risk factors for 30-day mortality. Methods: We performed a large multicenter, retrospective cohort study including onco-hematological neutropenic patients with PA BSI conducted across 34 centers in 12 countries (January 2006-May 2018). Episodes occurring in hematologic patients were compared to those developing in patients with ST. Risk factors associated with 30-day mortality were investigated in both groups. Results: Of 1217 episodes of PA BSI, 917 occurred in patients with HM and 300 in patients with ST. Hematological patients had more commonly profound neutropenia (0.1 x 10(9) cells/mm) (67% vs. 44.6%; p < 0.001), and a high risk Multinational Association for Supportive Care in Cancer (MASCC) index score (32.2% vs. 26.7%; p = 0.05). Catheter-infection (10.7% vs. 4.7%; p = 0.001), mucositis (2.4% vs. 0.7%; p = 0.042), and perianal infection (3.6% vs. 0.3%; p = 0.001) predominated as BSI sources in the hematological patients, whereas pneumonia (22.9% vs. 33.7%; p < 0.001) and other abdominal sites (2.8% vs. 6.3%; p = 0.006) were more common in patients with ST. Hematological patients had more frequent BSI due to multidrug-resistant P. aeruginosa (MDRPA) (23.2% vs. 7.7%; p < 0.001), and were more likely to receive inadequate initial antibiotic therapy (IEAT) (20.1% vs. 12%; p < 0.001). Patients with ST presented more frequently with septic shock (45.8% vs. 30%; p < 0.001), and presented worse outcomes, with increased 7-day (38% vs. 24.2%; p < 0.001) and 30-day (49% vs. 37.3%; p < 0.001) case-fatality rates. Risk factors for 30-day mortality in hematologic patients were high risk MASCC index score, IEAT, pneumonia, infection due to MDRPA, and septic shock. Risk factors for 30-day mortality in patients with ST were high risk MASCC index score, IEAT, persistent BSI, and septic shock. Therapy with granulocyte colony-stimulating factor was associated with survival in both groups. Conclusions: The clinical features and outcomes of PA BSI in neutropenic cancer patients showed some differences depending on the underlying malignancy. Considering these differences and the risk factors for mortality may be useful to optimize their therapeutic management. Among the risk factors associated with overall mortality, IEAT and the administration of granulocyte colony-stimulating factor were the only modifiable variables
Pseudomonas aeruginosa Bloodstream Infections Presenting with Septic Shock in Neutropenic Cancer Patients: Impact of Empirical Antibiotic Therapy
This large, multicenter, retrospective cohort study including onco-hematological neutropenic patients with Pseudomonas aeruginosa bloodstream infection (PABSI) found that among 1213 episodes, 411 (33%) presented with septic shock. The presence of solid tumors (33.3% vs. 20.2%, p < 0.001), a high-risk Multinational Association for Supportive Care in Cancer (MASCC) index score (92.6% vs. 57.4%; p < 0.001), pneumonia (38% vs. 19.2% p < 0.001), and infection due to multidrug-resistant P. aeruginosa (MDRPA) (33.8% vs. 21.1%, p < 0.001) were statistically significantly higher in patients with septic shock compared to those without. Patients with septic shock were more likely to receive inadequate empirical antibiotic therapy (IEAT) (21.7% vs. 16.2%, p = 0.020) and to present poorer outcomes, including a need for ICU admission (74% vs. 10.5%; p < 0.001), mechanical ventilation (49.1% vs. 5.6%; p < 0.001), and higher 7-day and 30-day case fatality rates (58.2% vs. 12%, p < 0.001, and 74% vs. 23.1%, p < 0.001, respectively). Risk factors for 30-day case fatality rate in patients with septic shock were orotracheal intubation, IEAT, infection due to MDRPA, and persistent PABSI. Therapy with granulocyte colony-stimulating factor and BSI from the urinary tract were associated with improved survival. Carbapenems were the most frequent IEAT in patients with septic shock, and the use of empirical combination therapy showed a tendency towards improved survival. Our findings emphasize the need for tailored management strategies in this high-risk population
Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)
Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters.
Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs).
Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001).
Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative
Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research
1er. Coloquio de educación para el diseño en la sociedad 5.0
Las memorias del 1er. Coloquio de EducaciĂłn para el Diseño en la Sociedad 5.0 debenser entendidas como un esfuerzo colectivo de la comunidad de acadĂ©micos de la DivisiĂłn de Ciencias y Artes para el Diseño, que pone de manifiesto los retos y oportunidades que enfrenta la educaciĂłn en diseño en un contexto de cambio acelerado y rompimiento de paradigmas.El evento se realizĂł el pasado mes de mayo de 2018 y se recibieron mĂĄs de 50 ponencias por parte de las profesoras y profesores de la DivisiĂłn.Las experiencias y/o propuestas innovadoras en cuanto a procesos de enseñanza y aprendizaje que presentan los autores en cada uno de sus textos son una invitaciĂłn a reflexionar sobre nuestra situaciĂłn actual en la materia, y emprender acciones en la DivisiĂłn para continuar brindando una educaciĂłn de calidad en diseño a nuestras alumnas, alumnos y la sociedad.Adicionalmente, se organizaron tres conferencias magistrales sobre la situaciĂłn actual de la educaciĂłn en Diseño y de las Instituciones de EducaciĂłn Superior, impartidas por el Mtro. Luis Sarale, profesor de la Universidad Nacional de Cuyo en Mendoza (Argentina), y Presidente en su momento, de la Red de Carreras de Diseño en Universidades PĂșblicas Latinoamericanas (DISUR), el Dr. Romualdo LĂłpez ZĂĄrate, Rector de la Unidad Azcapotzalco, asĂ como del Mtro. Luis Antonio Rivera DĂaz, Jefe de Departamento de TeorĂa y Procesos del Diseño de la DivisiĂłn de la Ciencias de la ComunicaciĂłn y Diseño, en la Unidad Cuajimalpa de nuestra instituciĂłn.La publicaciĂłn de estas memorias son un esfuerzo divisional, organizado desde la CoordinaciĂłn de Docencia Divisional y la CoordinaciĂłn de TecnologĂas del Aprendizaje, del Conocimiento y la ComunicaciĂłn, para contribuir a los objetivos planteados en el documento ACCIONES:Agenda CyAD2021, en particular al eje de InnovaciĂłn Educativa. Es necesario impulsar a todos los niveles de la DivisiĂłn espacios de discusiĂłn orientados a reflexionar sobre el presente y futuro en la educaciĂłn del diseñador, que contribuya a mejorar la calidad de la docencia y favorezca al fortalecimiento de los procesos de enseñanza y aprendizaje.Finalmente, extiendo un amplio reconocimiento a todos los miembros de la DivisiĂłn que hicieron posible este evento, asĂ como a todos los ponentes y participantes por compartir su conocimiento para que la DivisiĂłn sea cada dĂa mejor
Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19
Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe
Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies
There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity
VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad
Acta de congresoLa conmemoraciĂłn de los cien años de la Reforma Universitaria de 1918 se presentĂł como una ocasiĂłn propicia para debatir el rol de la historia, la teorĂa y la crĂtica en la formaciĂłn y en la prĂĄctica profesional de diseñadores, arquitectos y urbanistas.
En ese marco el VIII Encuentro de Docentes e Investigadores en Historia del Diseño, la Arquitectura y la Ciudad constituyĂł un espacio de intercambio y reflexiĂłn cuya realizaciĂłn ha sido posible gracias a la colaboraciĂłn entre Facultades de Arquitectura, Urbanismo y Diseño de la Universidad Nacional y la Facultad de Arquitectura de la Universidad CatĂłlica de CĂłrdoba, contando ademĂĄs con la activa participaciĂłn de mayorĂa de las Facultades, Centros e Institutos de Historia de la Arquitectura del paĂs y la regiĂłn.
Orientado en su convocatoria tanto a docentes como a estudiantes de Arquitectura y Diseño Industrial de todos los niveles de la FAUD-UNC promovió el debate de ideas a partir de experiencias concretas en instancias tales como mesas temåticas de caråcter interdisciplinario, que adoptaron la modalidad de presentación de ponencias, entre otras actividades.
En el ĂĄmbito de VIII Encuentro, desarrollado en la sede Ciudad Universitaria de CĂłrdoba, se desplegaron numerosas posiciones sobre la enseñanza, la investigaciĂłn y la formaciĂłn en historia, teorĂa y crĂtica del diseño, la arquitectura y la ciudad; sumĂĄndose el aporte realizado a travĂ©s de sus respectivas conferencias de Ana Clarisa AgĂŒero, Bibiana Cicutti, Fernando Aliata y Alberto Petrina. El conjunto de ponencias que se publican en este Repositorio de la UNC son el resultado de dos intensas jornadas de exposiciones, cuyos contenidos han posibilitado actualizar viejos dilemas y promover nuevos debates.
El evento recibiĂł el apoyo de las autoridades de la FAUD-UNC, en especial de la SecretarĂa de InvestigaciĂłn y de la Biblioteca de nuestra casa, como asĂ tambiĂ©n de la Facultad de Arquitectura de la UCC; va para todos ellos un especial agradecimiento
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprungâs disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprungâs disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36â39) and median bodyweight at presentation was 2·8 kg (2·3â3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
pâ€0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88â4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59â2·79], p<0·0001), sepsis at presentation (1·20
[1·04â1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4â5 vs ASA 1â2, 1·82 [1·40â2·35], p<0·0001; ASA 3 vs ASA 1â2, 1·58, [1·30â1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02â1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41â2·71], p=0·0001; parenteral nutrition 1·35, [1·05â1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47â0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50â0·86], p=0·0024) or percutaneous central line (0·69 [0·48â1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030