Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings

Introduction and Objectives The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings. Methods Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh). Study population: individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis. Results 437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performancein the different settings and also regarding age, gender and smoking status. Conclusions The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8This research was partially supported by Fundación de la Sociedad Gallega de Patología Respiratoria (SOGAPAR), and funding from the European Union Seventh Framework Programme [FP7/REGPOT-2012-2013.1] under grant agreement n° 316265, BIOCAPSS

Eductive ability in adolescent students from Buenos Aires: a longitudinal study

Se presentan datos sobre un estudio de medidas repetidas, realizado sobre una muestra de 104 adolescentes de ambos sexos, residentes en la ciudad de Buenos Aires, Argentina, evaluados con una versión abreviada del Test de Matrices Progresivas de Raven, Escala General, mientras cursaban el 8° grado de la EGB (1994; media de edad= 13) y el 3er año del Polimodal (1998; media de edad= 17). Los resultados mostraron un incremento significativo de las puntuaciones tras los cuatro años de intervalo entre las medidas, asociado con el sexo de los examinados por una parte, y con el nivel educativo y ocupacional de los jefes de familia por el otro. La discusión se centra en el análisis de los resultados a la luz de la influencia escolar en el desarrollo de la capacidad eductivaData gathered from 104 adolescent subjects of both sexes, from Buenos Aires, Argentina, assessed in a test – retest procedure with a short version of Raven´s Standard Progressive Matrices, are analyzed in a longitudinal study. Subjects were 8th gradrers at the first measuring moment (1994; mean age= 13) and Senior High School students at retest moment (1998; mean age= 17). Results verified a significant gain of raw scores between test and retest, associated with sex and with parental educational and occupational level. Discussion focuses in school role on eductive ability developmentS

Screening for Chronic Obstructive Pulmonary Disease: Validity and Reliability of a Portable Device in Non-Specialized Healthcare Settings.

The underdiagnosis of chronic obstructive pulmonary disease (COPD) could be improved through screening using portable devices simpler than conventional spirometers in specific healthcare settings to reach a higher percentage of the at-risk population. This study was designed to assess the validity and reliability of the COPD-6 portable device to screen for COPD in non-specialized healthcare settings. Prospective cohort study to validate a diagnostic test. Three cohorts were recruited: primary care (PC), emergency services (ES) and community pharmacies (CPh). individuals with risk factors for COPD (>40 years, smoking >10 pack-years, with respiratory symptoms). The values measured using the COPD-6 were FEV1, FEV6 and the FEV1/FEV6 ratio. Subsequently, participants underwent conventional spirometry at hospital, using a post-bronchodilator FEV1/FVC value <0.7 as the gold standard criterion for the COPD diagnosis. 437 participants were included, 362 were valid for the analysis. COPD was diagnosed in 114 patients (31.5%). The area under the ROC curve for the COPD-6 for COPD screening was 0.8.The best cut-off point for the FEV1/FEV6 ratio was 0.8 (sensitivity, 92.1%) using spirometry with the bronchodilator test as the gold standard. There were practically no differences in the COPD-6 performance in the different settings and also regarding age, gender and smoking status. The COPD-6 device is a valid tool for COPD screening in non-specialized healthcare settings. In this context, the best cut-off point for the FEV1/FEV6 ratio is 0.8.Fundación de la Sociedad Gallega de Patología Respiratoria (SOGAPAR)European Union Seventh Framework Programme [FP7/REGPOT-2012-2013.1] under grant agreement n° 316265, BIOCAP

CRISPR-Cas, a Revolution in the Treatment and Study of ESKAPE Infections: Pre-Clinical Studies

This article belongs to the Special Issue Non-antimicrobial Agents as Adjuvants against Bacterial Infections[Abstract] One of the biggest threats we face globally is the emergence of antimicrobial-resistant (AMR) bacteria, which runs in parallel with the lack in the development of new antimicrobials. Among these AMR bacteria pathogens belonging to the ESKAPE group can be highlighted (Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter spp.) due to their profile of drug resistance and virulence. Therefore, innovative lines of treatment must be developed for these bacteria. In this review, we summarize the different strategies for the treatment and study of molecular mechanisms of AMR in the ESKAPE pathogens based on the clustered regularly interspaced short palindromic repeats (CRISPR) and CRISPR-associated (Cas) proteins’ technologies: loss of plasmid or cellular viability, random mutation or gene deletion as well directed mutations that lead to a gene’s loss of function.This study was funded by grants PI16/01163 and PI19/00878 awarded to M. Tomás within the State Plan for R+D+I 2013–2016 (National Plan for Scientific Research, Technological Development and Innovation 2008–2011) and cofinanced by the ISCIII-Deputy General Directorate for Evaluation and Promotion of Research-European Regional Development Fund “A way of Making Europe” and Instituto de Salud Carlos III FEDER, Spanish Network for the Research in Infectious Diseases (REIPI, RD16/0016/0006) and by the Study Group on Mechanisms of Action and Resistance to Antimicrobials, GEMARA (SEIMC, http://www.seimc.org/, Accessed on 21 June 2021). I. Bleriot was financially supported by pFIS program (ISCIII, FI20/00302). O. Pacios and M. López was financially supported by a grant IN606A-2020/035 and IN606B-2018/008, respectively, (GAIN, Xunta de Galicia), and M. Gonzalez-Bardanca was financially supported by the Rio Hortega program (ISCIII, CM20/00198)Xunta de Galicia; IN606A-2020/035Xunta de Galicia; IN606B-2018/00

Balanced plankton net community metabolism in the oligotrophic North Atlantic subtropical gyre from Lagrangian observations

Characterization of the microbial plankton metabolism in oligotrophic oceans is of relevance for the quantification of the global carbon balance; however whether the plankton community metabolism in oligotrophic gyres is net autotrophic or heterotrophic is still under debate. Discrepancies have been in part attributed to the difficulties of the standard snapshot estimations, based on in vitro measurements, to adequately represent the temporal scale of trophic processes. This work presents concurrent measurements of gross primary production and community respiration carried out in the North Atlantic Oligotrophic Gyre throughout two 7-day Lagrangian experiments that allowed us to investigate the effect of short term (daily) variability on the microbial metabolism quantification. Physicochemical and biological variables showed a low variability in each Lagrangian experiment and a balanced net plankton metabolism was found in 83% of the sampling days.Ministerio de Educación y Ciencia | Ref. REN2003-09532-C03-0

Alnus airborne pollen trends during the last 26 years for improving machine learning-based forecasting methods

Black alder (Alnus glutinosa (L.) Gaertn.) is a species of tree widespread along Europe and belongs to mixed hardwood forests. In urban environments, the tree is usually located along watercourses, as is the case in the city of Ourense. This taxon belongs to the betulaceae family, so it has a high allergenic potential in sensitive people. Due to the high allergenic capacity of this pollen type and the increase in global temperature produced by climate change, which induces a greater allergenicity, the present study proposes the implementation of a Machine Learning (ML) model capable of accurately predicting high-risk periods for allergies among sensitive people. The study was carried out in the city of Ourense for 28 years and pollen data were collected by means of the Hirst trap model Lanzoni VPPS-2000. During the same period, meteorological data were obtained from the meteorological station of METEOGALICIA in Ourense. We observed that Alnus airborne pollen was present in the study area during winter months, mainly in January and February. We found statistically significant trends for the end of the main pollen season with a lag trend of 0.68 days per year, and an increase in the annual pollen integral of 112 pollen grains per year and approximately 12 pollen grains/m3 per year during the pollen peak. A Spearman correlation test was carried out in order to select the variables for the ML model. The best ML model was Random Forest, which was able to detect those days with medium and high labels.Xunta de Galicia | Ref. ED431C 2022/03-GRCXunta de Galicia | Ref. CO-0034-2021 00V

Predictive value of a series of inflammatory markers in COPD for lung cancer diagnosis: a case-control study

Background: There is a relationship between Chronic Obstructive Pulmonary Disease (COPD) and the development of lung cancer (LC). The aim of this study is to analyse several blood markers and compare their concentrations in patients with only COPD and LC + COPD. Methods: Case-control study with cases presenting combined LC and COPD and two control groups (patients presenting only COPD and patients presenting only LC). We also included LC patients with descriptive purposes. In both groups, peripheral blood analyses of TNF-α, IL-6, IL-8, total leukocyte, lymphocyte and neutrophil counts, neutrophil-to-lymphocyte ratio, total platelet count, mean platelet volume, platelet-to-lymphocyte ratio, alpha 1-antitripsin (A1AT), IgE, C-reactive protein, fibrinogen, cholesterol and bilirubin were performed. We developed univariate and multivariate analyses of these markers, as well as a risk score variable, and we evaluated its performance through ROC curves. Results: We included 280 patients, 109 cases (LC + COPD), 83 controls (COPD) and 88 LC without COPD. No differences were observed in the distribution by sex, age, BMI, smoking, occupational exposure, lung function, GOLD stage or comorbidity. Patients with LC + COPD had significantly higher levels of neutrophils [OR 1.00 (95%CI 1.00–1.00), p = 0.03] and A1AT [OR 1.02 (95%CI 1.01–1.03), p = 0.003] and lower cholesterol levels [OR 0.98 (95%CI 0.97–0.99), p = 0.009] than COPD controls. We developed a risk score variable combining neutrophils, A1AT and cholesterol, achieving a sensitivity of 80%, a negative predictive value of 90.7% and an area under the curve of 0.78 (95%CI 0.71–0.86). Conclusions: COPD patients who also have LC have higher levels of neutrophils and A1AT and lower of cholesterol. These parameters could be potentially predicting biomarkers of LC in COPD patients.This work was supported by the project 110/2016 of the Spanish Society of Respiratory Pathology (SEPAR)S

Phenotypic and Genomic Comparison of Klebsiella pneumoniae Lytic Phages: vB_KpnM-VAC66 and vB_KpnM-VAC13

[Abstract] Klebsiella pneumoniae is a human pathogen that worsens the prognosis of many immunocompromised patients. Here, we annotated and compared the genomes of two lytic phages that infect clinical strains of K. pneumoniae (vB_KpnM-VAC13 and vB_KpnM-VAC66) and phenotypically characterized vB_KpnM-VAC66 (time of adsorption of 12 min, burst size of 31.49 ± 0.61 PFU/infected cell, and a host range of 20.8% of the tested strains). Transmission electronic microscopy showed that vB_KpnM-VAC66 belongs to the Myoviridae family. The genomic analysis of the phage vB_KpnM-VAC66 revealed that its genome encoded 289 proteins. When compared to the genome of vB_KpnM-VAC13, they showed a nucleotide similarity of 97.56%, with a 93% of query cover, and the phylogenetic study performed with other Tevenvirinae phages showed a close common ancestor. However, there were 21 coding sequences which differed. Interestingly, the main differences were that vB_KpnM-VAC66 encoded 10 more homing endonucleases than vB_KpnM-VAC13, and that the nucleotidic and amino-acid sequences of the L-shaped tail fiber protein were highly dissimilar, leading to different three-dimensional protein predictions. Both phages differed significantly in their host range. These viruses may be useful in the development of alternative therapies to antibiotics or as a co-therapy increasing its antimicrobial potential, especially when addressing multidrug resistant (MDR) pathogens.This study was funded by grants PI19/00878 awarded to M. Tomás within the State Plan for R+D+I 2013-2016 (National Plan for Scientific Research, Technological Development and Innovation 2008–2011) and co-financed by the ISCIII-Deputy General Directorate for Evaluation and Promotion of Research—European Regional Development Fund “A way of Making Europe” and Instituto de Salud Carlos III FEDER, Spanish Network for the Research in Infectious Diseases (REIPI, RD16/0016/0001, RD16/0016/0006 and RD16/CIII/0004/0002) and by the Study Group on Mechanisms of Action and Resistance to Antimicrobials, GEMARA (SEIMC, http://www.seimc.org/ accessed on 1 February 2021) and project PID2020-112835RA-I00 funded by MCIN/AEI /10.13039/501100011033, and project SEJIGENT/2021/014 funded by Conselleria d’Innovació, Universitats, Ciència i Societat Digital (Generalitat Valenciana). M. Tomás was financially supported by the Miguel Servet Research Programme (SERGAS and ISCIII). O. Pacios, L. Fernández-García and M. López were financially supported by the grants IN606A-2020/035, IN606B-2021/013 and IN606B-2018/008, respectively (GAIN, Xunta de Galicia). I. Bleriot was financially supported by pFIS program (ISCIII, FI20/00302). P. Domingo-Calap was financially supported by a Ramón y Cajal contract RYC2019-028015-I funded by MCIN/AEI /10.13039/501100011033, ESF Invest in your futureGeneralitat Valenciana; SEJIGENT/2021/014Xunta de Galicia; IN606A-2020/035Xunta de Galicia; IN606B-2021/013Xunta de Galicia; IN606B-2018/00

Genomic Analysis of Molecular Bacterial Mechanisms of Resistance to Phage Infection

[Abstract] To optimize phage therapy, we need to understand how bacteria evolve against phage attacks. One of the main problems of phage therapy is the appearance of bacterial resistance variants. The use of genomics to track antimicrobial resistance is increasingly developed and used in clinical laboratories. For that reason, it is important to consider, in an emerging future with phage therapy, to detect and avoid phage-resistant strains that can be overcome by the analysis of metadata provided by whole-genome sequencing. Here, we identified genes associated with phage resistance in 18 Acinetobacter baumannii clinical strains belonging to the ST-2 clonal complex during a decade (Ab2000 vs. 2010): 9 from 2000 to 9 from 2010. The presence of genes putatively associated with phage resistance was detected. Genes detected were associated with an abortive infection system, restriction–modification system, genes predicted to be associated with defense systems but with unknown function, and CRISPR-Cas system. Between 118 and 171 genes were found in the 18 clinical strains. On average, 26% of these genes were detected inside genomic islands in the 2000 strains and 32% in the 2010 strains. Furthermore, 38 potential CRISPR arrays in 17 of 18 of the strains were found, as well as 705 proteins associated with CRISPR-Cas systems. A moderately higher presence of these genes in the strains of 2010 in comparison with those of 2000 was found, especially those related to the restriction–modification system and CRISPR-Cas system. The presence of these genes in genomic islands at a higher rate in the strains of 2010 compared with those of 2000 was also detected. Whole-genome sequencing and bioinformatics could be powerful tools to avoid drawbacks when a personalized therapy is applied. In this study, it allows us to take care of the phage resistance in A. baumannii clinical strains to prevent a failure in possible phage therapy.This study was funded by grants PI16/01163 and PI19/00878 awarded to MT within the State Plan for R + D + I 2013–2016 (National Plan for Scientific Research, Technological Development and Innovation 2008–2011) and co-financed by the ISCIII-Deputy General Directorate of evaluation and Promotion of Research-European Regional Development Fund “A way of Making Europe” and Instituto de Salud Carlos III FEDER. MT was financially supported by the Miguel Servet Research Programme (SERGAS and ISCIII