Insulin regulates neurovascular coupling through astrocytes.

Circulating insulin enters the brain through mechanisms incompletely characterized. We now report that mice lacking insulin receptors (IR) in astrocytes (GFAP-IR KO mice) show blunted brain responses to insulin, uncoupling of brain blood flow with glucose uptake with concomitant changes in brain vasculature and glucose transporter 1 levels. IR-deficient astrocytes show increased expression of HIF-1α/VEGF, promote growth of co-cultured endothelial cells, display increased reactive oxidant species (ROS) and disturbed mitochondrial activity. Treatment with the antioxidant N-acetylcysteine (NAC), ameliorated high ROS levels, normalized angiogenic signaling, and mitochondrial function including mitochondrial glucose and oxygen sensors. In vivo treatment with NAC also normalized brain perfusion. Thus, insulin receptors in astrocytes regulate neuro-vascular coupling.pre-print4711 K

Opinions and beliefs held by Spanish teenagers regarding tobacco and alcohol consumption: A descriptive study

Background: Preventive strategies are the most effective approach for dealing with issues of substance abuse, particularly in teenagers. Such strategies adapt well to this target population. Our objective was to reveal the opinions and beliefs held by teenagers about tobacco and alcohol as types of drugs, and their effects on health. Methods: In this cross-sectional study, participants completed a self-administered questionnaire based on the World Health Organization “Health Behaviour of School-aged Children” study. Our sample included 1,005 schoolchildren aged between 11 and 13 years, resident in the province of Co´rdoba in Spain. Descriptive and univariate analyses were performed using a chi-squared test. Results: Of respondents, 25% (95% confidence interval [CI]: 22.2–27.6%) and 61% (95% CI: 58.0–64.1%), respectively, did not consider tobacco or alcohol to be drugs. No relationship was found between tobacco and alcohol use, and the belief that these are drugs (p = 0.477 and p = 0.217, respectively). A total 98.2% of adolescents surveyed (95% CI: 97.3–99.1%) believed that tobacco causes physical damage, mainly to the lungs, heart, and to the developing fetus. Additionally, 92.4% (95% CI: 90.6–94.0%) believed that alcohol is detrimental to health and identified the liver as the organ most frequently damaged by alcohol consumption. The media was identified as the main source of information about these substances by 78.0% of respondents (95% CI: 75.4–80.6%). Conclusions: Teenagers possess an acceptable level of knowledge and information about the negative effects of tobacco and alcohol on health; however, many of them do not consider these substances to be drug

Enfermedad cerebrovascular en pacientes ingresados en cuidados intensivos

Introduction: cerebrovascular diseases are a global health problem and represent the third cause of death, the first cause of disability and the second cause of dementia. Objective: to characterize clinical and epidemiologically cerebrovascular disease in patients admitted to intensive care.Methods: observational, descriptive and cross-sectional study was conducted at Comandante Pinares General Hospital, Artemisa province, for the period of 2016-2018. A probabilistic and at simple random sample of 200 patients suffering from cerebrovascular disease was chosen. The study of the clinical histories allowed the collection of output information to the studied variables, using for its presentation methods of descriptive statistics. Medical ethics was respected.Results: patients from 80 years and older predominated (26 %), male sex (56 %). Ischemic cerebrovascular strokes (83 %), thrombotic type (33 %) were frequent, where hypertension (93,5 %) and smoking (82 %) stated as the main risk factors, having the therapeutic window of 3-6 hours (73,5 %) as the most common, alive patients with sequelae at hospital discharged predominated (48,5 %).Conclusions: patients older than 80 years and male, with hypertension and smoking addiction were prone to cerebrovascular stroke, where ischemic and thrombotic types were the most common, with a therapeutic window of three to six hours in the ajority of the cases. The greatest number of patients was admitted with obnubilation and they were discharged alive with sequelae.Introducción: las enfermedades cerebrovasculares son un problema de salud mundial y representan la tercera causa de muerte, la primera de discapacidad y segunda de demencia.Objetivo: caracterizar clínica y epidemiológicamente la enfermedad cerebrovascular en pacientes ingresados con cuidados intensivos.Métodos: estudio observacional, descriptivo y transversal, efectuado en el Hospital “Comandante Pinares”, de la provincia de Artemisa, entre 2016 y 2018. De forma probabilística, aleatoria simple, fue seleccionada una muestra de 200 pacientes con enfermedad cerebrovascular. El estudio de las historias clínicas permitió la obtención de información que dio salida a las variables estudiadas, se emplearon para su presentación, métodos de estadística descriptiva. Se respetó la ética médica.Resultados: predominaron los pacientes con 80 años y más (26 %), del sexo masculino (56 %). Fueron frecuentes los accidentes cerebrovasculares isquémicos (83 %) de tipo trombótico (33 %), donde la hipertensión arterial (93,5 %) y el tabaquismo (82 %) fueron los principales factores de riesgo; se tuvo la ventana terapéutica de tres a seis horas (73,5 %) como la más común, predominaron los pacientes vivos, con secuelas al egreso hospitalario (48,5 %).Conclusiones: los pacientes mayores de 80 años y masculinos con factores de riesgos como la hipertensión arterial y tabaquismo, fueron los más propensos al accidente cerebrovascular; los isquémicos y de tipo trombóticos los más comunes, con ventana terapéutica de tres a seis horas en la mayoría de los casos. El mayor número llegó obnubilado y fueron egresados vivos con secuelas.

Remote sensing chlorophyll a of optically complex waters (rias Baixas, NW Spain): Application of a regionally specific chlorophyll a algorithm for MERIS full resolution data during an upwelling cycle

This study takes advantage of a regionally specific algorithm and the characteristics of Medium Resolution Imaging Spectrometer (MERIS) in order to deliver more accurate, detailed chlorophyll a (chla) maps of optically complex coastal waters during an upwelling cycle. MERIS full resolution chla concentrations and in situ data were obtained on the Galician (NW Spain) shelf and in three adjacent rias (embayments), sites of extensive mussel culture that experience frequent harmful algal events. Regionally focused algorithms (Regional neural network for rias Baixas or NNRB) for the retrieval of chla in the Galician rias optically complex waters were tested in comparison to sea-truth data. The one that showed the best performance was applied to a series of six MERIS (FR) images during a summer upwelling cycle to test its performance. The best performance parameters were given for the NN trained with high-quality data using the most abundant cluster found in the rias after the application of fuzzy c-mean clustering techniques (FCM). July 2008 was characterized by three periods of different meteorological and oceanographic states. The main changes in chla concentration and distribution were clearly captured in the images. After a period of strong upwelling favorable winds a high biomass algal event was recorded in the study area. However, MERIS missed the high chlorophyll upwelled water that was detected below surface in the ria de Vigo by the chla profiles, proving the necessity of in situ observations. Relatively high biomass “patches” were mapped in detail inside the rias. There was a significant variation in the timing and the extent of the maximum chla areas. The maps confirmed that the complex spatial structure of the phytoplankton distribution in the rias Baixas is affected by the surface currents and winds on the adjacent continental shelf. This study showed that a regionally specific algorithm for an ocean color sensor with the characteristics of MERIS in combination with in situ data can be of great help in chla monitoring, detection and study of high biomass algal events in an area affected by coastal upwelling such as the rias Baixas

Enfermedad cerebrovascular en pacientes ingresados en cuidados intensivos

Introduction: cerebrovascular diseases are a global health problem and represent the third cause of death, the first cause of disability and the second cause of dementia. Objective: to characterize clinical and epidemiologically cerebrovascular disease in patients admitted to intensive care.Methods: observational, descriptive and cross-sectional study was conducted at Comandante Pinares General Hospital, Artemisa province, for the period of 2016-2018. A probabilistic and at simple random sample of 200 patients suffering from cerebrovascular disease was chosen. The study of the clinical histories allowed the collection of output information to the studied variables, using for its presentation methods of descriptive statistics. Medical ethics was respected.Results: patients from 80 years and older predominated (26 %), male sex (56 %). Ischemic cerebrovascular strokes (83 %), thrombotic type (33 %) were frequent, where hypertension (93,5 %) and smoking (82 %) stated as the main risk factors, having the therapeutic window of 3-6 hours (73,5 %) as the most common, alive patients with sequelae at hospital discharged predominated (48,5 %).Conclusions: patients older than 80 years and male, with hypertension and smoking addiction were prone to cerebrovascular stroke, where ischemic and thrombotic types were the most common, with a therapeutic window of three to six hours in the ajority of the cases. The greatest number of patients was admitted with obnubilation and they were discharged alive with sequelae.Introducción: las enfermedades cerebrovasculares son un problema de salud mundial y representan la tercera causa de muerte, la primera de discapacidad y segunda de demencia.Objetivo: caracterizar clínica y epidemiológicamente la enfermedad cerebrovascular en pacientes ingresados con cuidados intensivos.Métodos: estudio observacional, descriptivo y transversal, efectuado en el Hospital “Comandante Pinares”, de la provincia de Artemisa, entre 2016 y 2018. De forma probabilística, aleatoria simple, fue seleccionada una muestra de 200 pacientes con enfermedad cerebrovascular. El estudio de las historias clínicas permitió la obtención de información que dio salida a las variables estudiadas, se emplearon para su presentación, métodos de estadística descriptiva. Se respetó la ética médica.Resultados: predominaron los pacientes con 80 años y más (26 %), del sexo masculino (56 %). Fueron frecuentes los accidentes cerebrovasculares isquémicos (83 %) de tipo trombótico (33 %), donde la hipertensión arterial (93,5 %) y el tabaquismo (82 %) fueron los principales factores de riesgo; se tuvo la ventana terapéutica de tres a seis horas (73,5 %) como la más común, predominaron los pacientes vivos, con secuelas al egreso hospitalario (48,5 %).Conclusiones: los pacientes mayores de 80 años y masculinos con factores de riesgos como la hipertensión arterial y tabaquismo, fueron los más propensos al accidente cerebrovascular; los isquémicos y de tipo trombóticos los más comunes, con ventana terapéutica de tres a seis horas en la mayoría de los casos. El mayor número llegó obnubilado y fueron egresados vivos con secuelas.

Machine Learning Methods Applied to the Prediction of Pseudo-nitzschia spp. Blooms in the Galician Rias Baixas (NW Spain)

This work presents new prediction models based on recent developments in machine learning methods, such as Random Forest (RF) and AdaBoost, and compares them with more classical approaches, i.e., support vector machines (SVMs) and neural networks (NNs). The models predict Pseudo-nitzschia spp. blooms in the Galician Rias Baixas. This work builds on a previous study by the authors (doi.org/10.1016/j.pocean.2014.03.003) but uses an extended database (from 2002 to 2012) and new algorithms. Our results show that RF and AdaBoost provide better prediction results compared to SVMs and NNs, as they show improved performance metrics and a better balance between sensitivity and specificity. Classical machine learning approaches show higher sensitivities, but at a cost of lower specificity and higher percentages of false alarms (lower precision). These results seem to indicate a greater adaptation of new algorithms (RF and AdaBoost) to unbalanced datasets. Our models could be operationally implemented to establish a short-term prediction system

Missing observations in ARIMA models: skipping strategy versus additive outlier approach

Optimal estimation of missing values in ARMA models is typically performed by using the Kalman Filter for likelihood evaluation, "skipping" in the computations the missing observations, obtaining the maximum likelihood (ML) estimators of the model parameters, and using some smoothing algorithm. The same type of procedure has been extended to nonstationary ARIMA models in G6mez Maravall (1994). An alternative procedure suggests filling in the holes in the series with arbitrary values and then performing ML estimation of the ARIMA model with Additive Outliers (AO). When the model parameters are not known the two methods differ, since the AO likelihood is affected by the arbitrary values. We develop the proper likelihood for the AO approach in the general non-stationary case and show the equivalence of this and the skipping method. Computationally efficient ways to apply both procedures, based on an Augmented Kalman Filter, are detailed. Finally, the two methods are compared through simulation, and their relative advantages assessed; the comparison also includes the AO method with the uncorrected likelihood

Comportamiento de la cetoacidosis diabética en una Unidad de Cuidados Intensivos

Introduction: diabetes mellitus is a health problem, having an impact on all systems and which can trigger episodes of diabetic ketoacidosis.Objective: to characterize clinically and epidemiologically the patients with diabetic ketoacidosis admitted to the Intensive Care Unit.Methods: an observational, descriptive and cross-sectional study was conducted in patients diagnosed with diabetic ketoacidosis. The target group comprised 37 patients; all of them were included in the study. The variables were processed in the statistical package SPSS version 21 and descriptive statistical methods were applied.Results: patients between 31 and 40 years of age (37,84 %) and female gender (64,86 %) predominated, with an average age of 34,5 ± 5.71 years; 100 % of the patients presented dry mucous membranes, polypnea and tachycardia. Pneumonia (64,86 %) and urinary tract infection (54,05 %) prevailed as triggering causes. Shock was the main complication related to diabetes mellitus (27,03 %). Patients with moderate ketoacidosis were the majority (51,35 %).Conclusions: diabetic patients, between the second and third decade of life, and mostly female gender are prone to suffer from diabetic ketoacidosis. Clinically they manifest with dryness of the mucous membranes, polypnea and tachycardia mainly. Pneumonia and urinary tract infections are frequent triggering factors, shock is the main complication; patients with moderate ketoacidosis represented the greater numbers.Introducción: la diabetes mellitus representa en la actualidad un reciente problema de salud, de impacto en todos los sistemas y que puede desencadenar episodios de cetoacidosis diabética.Objetivo: caracterizar clínica y epidemiológicamente los pacientes con cetoacidosis diabética ingresados en la Unidad de Cuidados IntensivosMétodo: se realizó un estudio observacional, descriptivo y transversal, en pacientes diagnosticados con cetoacidosis diabética. El universo estuvo constituido por 37 pacientes, trabajándose con la totalidad. Las variables fueron procesadas en el paquete estadístico SPSS versión 21 y se utilizó la estadística descriptiva.Resultados: predominaron los pacientes entre 31 a 40 años de edad (37,84 %), y femeninas (64,86 %), con una edad media de 34,5 ± 5,71 años. El 100 % de los pacientes presentó sequedad de las mucosas, polipnea y taquicardia. Predominó la neumonía (64,86 %) y la infección urinaria (54,05 %) como causas desencadenantes. El estado de shock fue la principal complicación relacionada con la diabetes mellitus (27,03 %). Predominaron los pacientes con cetoacidosis moderada (51,35 %). Conclusiones: los pacientes diabéticos, entre la segunda y tercera década de vida, y mayormente las féminas son propensas a sufrir de cetoacidosis diabética. Clínicamente se manifiestan con sequedad de las mucosas, polipnea y taquicardia principalmente. La neumonía y la infección urinaria son causas desencadenantes frecuentes, siendo el estado de shock la principal complicación; encontrándose en mayor cuantía pacientes con cetoacidosis moderada.

Pseudo-nitzschia Blooms in a Coastal Upwelling System: Remote Sensing Detection, Toxicity and Environmental Variables

The NW coast of the Iberian Peninsula is dominated by extensive shellfish farming, which places this region as a world leader in mussel production. Harmful algal blooms in the area frequent lead to lengthy harvesting closures threatening food security. This study developed a framework for the detection of Pseudo-nitzschia blooms in the Galician rias from satellite data (MERIS full-resolution images) and identified key variables that affect their abundance and toxicity. Two events of toxin-containing Pseudo-nitzschia were detected (up to 2.5 μg L−1 pDA) in the area. This study suggests that even moderate densities of Pseudo-nitzschia in this area might indicate high toxin content. Empirical models for particulate domoic acid (pDA) were developed based on MERIS FR data. The resulting remote-sensing model, including MERIS bands centered around 510, 560, and 620 nm explain 73% of the pDA variance (R2 = 0.73, p < 0.001). The results show that higher salinity values and lower Si(OH)4/N ratios favour higher Pseudo-nitzschia spp. abundances. High pDA values seem to be associated with relatively high PO43, low NO3− concentrations, and low Si(OH)4/N. While MERIS FR data and regionally specific algorithms can be useful for detecting Pseudo-nitzschia blooms, nutrient relationships are crucial for predicting the toxicity of these blooms

Variables clínicas y epidemiológicas de pacientes diagnosticados con enfermedad de Parkinson

Introduction: Parkinson's disease is a complex degenerative process of the central nervous system.Objective: to characterize patients diagnosed with Parkinson's disease at Comandante Pinares General Teaching Hospital, from January 2013 to December 2018.Methods: an observational, descriptive and cross-sectional study was conducted in patients diagnosed with Parkinson's disease. The target group consisted of 43 patients, working with all of them. The variables were processed in the statistical package SPSS version 21 and descriptive statistics was applied.Results: the age group from 61 to 70 was the most affected (46,51 %), with an average age of 65,31+12,22 years; and male sex (58,14 %). Rest tremor was the main clinical manifestation (100 %). Mild stage (58,14 %) predominated at diagnosis, and age > 60 years (88,37 %) was the predisposing factor. Levodopa (100%) and carbidopa (93%) were the drugs most commonly used.Conclusions: patients between 61 and 70 years of age and male have a higher risk of developing Parkinson's disease, ages over 60 is one of the most important predisposing factor. These refer to resting tremor as the main clinical manifestation, being diagnosed in mild stage mainly. The initial drug therapy with levodopa and carbidopa constitutes the first line of treatment. Introducción: la enfermedad de Parkinson es un proceso degenerativo complejo del sistema nervioso central.Objetivo: caracterizar a los pacientes diagnosticados con enfermedad de Parkinson en el Hospital General Docente “Comandante Pinares”, en el periodo de enero 2013 a diciembre de 2018.Método: se realizó un estudio observacional, descriptivo y transversal, en pacientes diagnosticados con enfermedad de Parkinson. El universo estuvo constituido por 43 pacientes, trabajándose con la totalidad. Las variables fueron procesadas en el paquete estadístico SPSS versión 21 y se utilizó la estadística descriptiva.Resultados: el grupo de edades entre 61 y 70 años fue el más afectado (46,51 %), con una edad media de 65,31+12,22 años; al igual que el sexo masculino (58,14 %). El temblor de reposo fue la principal manifestación clínica (100 %). Predominó el estadio leve (58,14%) en el momento del diagnóstico, y la edad > 60 años (88,37 %) como factor predisponente. La levodopa (100 %) y carbidopa (93%) constituyeron los medicamentos más empleados.Conclusiones: los pacientes entre 61 y 70 años de edad y sexo masculino poseen mayor riesgo de desarrollar enfermedad de Parkinson, siendo la edad mayor de 60 años un factor predisponente importante. Estos refieren el temblor de reposo como principal manifestación clínica, siendo diagnosticados en estadio leve fundamentalmente. La terapéutica medicamentosa inicial con levodopa y carbidopa constituye el primer eslabón