The factors that predispose an individual to a higher risk of death from COVID-19 are poorly understood. The goal of the study was to identify factors associated with risk of death among patients ...with COVID-19. This is a retrospective cohort study of people with laboratory-confirmed SARS-CoV-2 infection from February to May 22, 2020. Data retrieved for this study included patient sociodemographic data, baseline comorbidities, baseline treatments, other background data on care provided in hospital or primary care settings, and vital status. Main outcome was deaths until June 29, 2020. In the multivariable model based on nursing home residents, predictors of mortality were being male, older than 80 years, admitted to a hospital for COVID-19, and having cardiovascular disease, kidney disease or dementia while taking anticoagulants or lipid-lowering drugs at baseline was protective. The AUC was 0.754 for the risk score based on this model and 0.717 in the validation subsample. Predictors of death among people from the general population were being male and/or older than 60 years, having been hospitalized in the month before admission for COVID-19, being admitted to a hospital for COVID-19, having cardiovascular disease, dementia, respiratory disease, liver disease, diabetes with organ damage, or cancer while being on anticoagulants was protective. The AUC was 0.941 for this model’s risk score and 0.938 in the validation subsample. Our risk scores could help physicians identify high-risk groups and establish preventive measures and better follow-up for patients at high risk of dying.
ClinicalTrials.gov Identifier
: NCT04463706
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Active-fixation leads have been associated with higher incidence of cardiac perforation. Large series specifically evaluating this complication are lacking. We sought to evaluate the incidence and ...predictors of clinically relevant cardiac perforation in a consecutive series of patients implanted with active-fixation pacing and defibrillation leads.
We conducted a retrospective observational study including all consecutive patients implanted with an active-fixation pacing/defibrillation lead at our institution from July 2008 to July 2015. The incidence of clinically relevant cardiac perforation and cardiac tamponade was evaluated. Univariate and multivariate analyses were used to identify predictors of cardiac perforation. Acute and long-term management of these patients was also investigated. A total of 3822 active-fixation pacing (n = 3035) and defibrillation (n = 787) leads were implanted in 2200 patients. Seventeen patients (0.8%) had clinically relevant cardiac perforation (13 acute and 4 subacute perforations), and 13 (0.5%) had cardiac tamponade resolved with pericardiocentesis. None of the patients with cardiac perforation required surgical treatment. In multivariate analysis, an age >80 years (OR 3.84, 95% CI 1.14-12.87, P = 0.029), female sex (OR 3.14, 95% CI 1.07-9.22, P = 0.037), and an apical position of the right ventricular lead (OR 3.37, 95% CI 1.17-9.67, P = 0.024) were independent predictors of cardiac perforation.
Implantation of active-fixation leads is associated with a low incidence of clinically relevant cardiac perforation. Older and female patients have a higher risk of perforation as well as those patients receiving the ventricular lead in an apical position.
The NOTCH family of receptors and ligands is involved in numerous cell differentiation processes, including adipogenesis. We recently showed that overexpression of each of the four NOTCH receptors in ...3T3-L1 preadipocytes enhances adipogenesis and modulates the acquisition of the mature adipocyte phenotype. We also revealed that DLK proteins modulate the adipogenesis of 3T3-L1 preadipocytes and mesenchymal C3H10T1/2 cells in an opposite way, despite their function as non-canonical inhibitory ligands of NOTCH receptors. In this work, we used multipotent C3H10T1/2 cells as an adipogenic model. We used standard adipogenic procedures and analyzed different parameters by using quantitative-polymerase chain reaction (qPCR), quantitative reverse transcription-polymerase chain reaction (qRT-PCR), luciferase, Western blot, and metabolic assays. We revealed that C3H10T1/2 multipotent cells show higher levels of NOTCH receptors expression and activity and lower
gene expression levels than 3T3-L1 preadipocytes. We found that the overexpression of NOTCH receptors enhanced C3H10T1/2 adipogenesis levels, and the overexpression of NOTCH receptors and DLK (DELTA-like homolog) proteins modulated the conversion of cells towards a brown-like adipocyte phenotype. These and our prior results with 3T3-L1 preadipocytes strengthen the idea that, depending on the cellular context, a precise and highly regulated level of global NOTCH signaling is necessary to allow adipogenesis and determine the mature adipocyte phenotype.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Photoactivation with ultraviolet C light can reverse the effects derived from biological ageing by restoring a hydrophilic surface. Ten titanium discs were randomly divided into three groups: a ...control group, a 6 W group, and an 85 W group. A drop of double-distilled, deionized, and sterile 10 µL water was applied to each of the discs. Each disc was immediately photographed in a standardized and perpendicular manner. Measurements were taken based on the irradiation time (15, 30, 60, and 120 min). UVC irradiation improved the control values in both groups. There was no difference in its effect between the 6 W group and the other groups during the first 30 min. However, after 60 min and up to 120 min, 85 W had a significantly stronger effect. The contact angles with the 85 W ultraviolet light source at 60 and 120 min were 19.43° and 31.41°, respectively, whereas the contact angles for the 6 W UVC source were 73.8° and 61.45°. Power proved to be the most important factor, and the best hydrophilicity result was obtained with a power of 85 W for 60 min at a wavelength of 254 nm.
Objectives
This study aimed to externally validate the diagnostic accuracy of the Select MDx test for Significant prostate cancer (Sig PCa) (ISUP > 1), in a contemporaneous, prospective, multicenter ...cohort with a prostate‐specific antigen (PSA) between 3 and 10 ng/ml and a non‐suspicious digital rectal examination.
Methods and Participants
For all enrolled patients, the Select Mdx test, the risk calculator ERSPC3 + DRE, and a prostatic magnetic resonance imaging (MRI) were carried out. Subsequently, a systematic 12‐core trans‐rectal biopsy and a targeted biopsy, in the case of a prostate imaging–reporting and data system (PIRADS) > 2 lesion (max three lesions), were performed. To assess the accuracy of the Select MDx test in the detection of clinically Sig PCa, the test sensitivity was evaluated. Secondary objectives were specificity, negative predictive value (NPV), positive predictive value (PPV), and area under the curve (AUC). A direct comparison with the ERSPC + DRE risk calculator and MRI were also performed. We also studied the predictive ability to diagnose Sig PCa from the combination of the Select MDx test with MRI using clinical decision‐curve analysis.
Results
There were 163 patients enrolled after meeting the inclusion criteria and study protocol. The Select MDx test showed a sensitivity of 76.9% (95% CI, 63.2–87.5), 49.6% specificity (95% CI, 39.9–59.2), 82.09% (95% CI, 70.8–90.4) NPV, and 41.67% (95% CI, 31.7–52.2) PPV for the diagnosis of Sig PCa. COR analysis was also performed, which showed an AUC of 0.63 (95% CI, 0.56–0.71). There were no differences in the accuracy of Select MDx, ERSPC + DRE, or MRI. The combination of Select MDX + MRI showed the highest impact in the decision‐curve analysis, with an NPV of 93%.
Conclusion
Our study showed a worse performance for the SelectMdx test than previously reported, within a cohort of patients with a PSA 3–10 ng/ml and a normal DRE, with results similar to those from ERSPC + DRE RC and MRI, but with an improvement in the usual PSA pathway. A combination of the Select Mdx test and MRI could improve accuracy, but studies specifically evaluating this scenario with a cost‐effective analysis are needed.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
To determine whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, the cause of COVID-19 disease) exposure in pregnancy, compared to non-exposure, is associated with infection-related ...obstetric morbidity.
We conducted a multicentre prospective study in pregnancy based on a universal antenatal screening program for SARS-CoV-2 infection. Throughout Spain 45 hospitals tested all women at admission on delivery ward using polymerase-chain-reaction (PCR) for COVID-19 since late March 2020. The cohort of positive mothers and the concurrent sample of negative mothers was followed up until 6-weeks post-partum. Multivariable logistic regression analysis, adjusting for known confounding variables, determined the adjusted odds ratio (aOR) with 95% confidence intervals (95% CI) of the association of SARS-CoV-2 infection and obstetric outcomes.
Preterm delivery (primary), premature rupture of membranes and neonatal intensive care unit admissions.
Among 1009 screened pregnancies, 246 were SARS-CoV-2 positive. Compared to negative mothers (763 cases), SARS-CoV-2 infection increased the odds of preterm birth (34 vs 51, 13.8% vs 6.7%, aOR 2.12, 95% CI 1.32-3.36, p = 0.002); iatrogenic preterm delivery was more frequent in infected women (4.9% vs 1.3%, p = 0.001), while the occurrence of spontaneous preterm deliveries was statistically similar (6.1% vs 4.7%). An increased risk of premature rupture of membranes at term (39 vs 75, 15.8% vs 9.8%, aOR 1.70, 95% CI 1.11-2.57, p = 0.013) and neonatal intensive care unit admissions (23 vs 18, 9.3% vs 2.4%, aOR 4.62, 95% CI 2.43-8.94, p < 0.001) was also observed in positive mothers.
This prospective multicentre study demonstrated that pregnant women infected with SARS-CoV-2 have more infection-related obstetric morbidity. This hypothesis merits evaluation of a causal association in further research.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
(1) Background: Both sarcopenia and disease-related malnutrition (DRM) are unfortunately underdiagnosed and undertreated in our Western hospitals, which could lead to worse clinical outcomes. Our ...objectives included to determine the impact of low muscle mass (MM) and strength, and also DRM and sarcopenia, on clinical outcomes (length of stay, death, readmissions at three months, and quality of life). (2) Methodology: Prospective cohort study in medical inpatients. On admission, MM and hand grip strength (HGS) were assessed. The Global Leadership Initiative on Malnutrition (GLIM) criteria were used to diagnose DRM and EWGSOP2 for sarcopenia. Assessment was repeated after one week and at discharge. Quality of life (EuroQoL-5D), length of stay (LoS), readmissions and mortality are reported. (3) Results: Two hundred medical inpatients, median 76.0 years-old and 68% with high comorbidity. 27.5% met GLIM criteria and 33% sarcopenia on admission, increasing to 38.1% and 52.3% on discharge. Both DRM and sarcopenia were associated with worse QoL. 6.5% died and 32% readmission in 3 months. The odds ratio (OR) of mortality for DRM was 4.36 and for sarcopenia 8.16. Readmissions were significantly associated with sarcopenia (OR = 2.25) but not with DRM. A higher HGS, but not MM, was related to better QoL, less readmissions (OR = 0.947) and lower mortality (OR = 0.848) after adjusting for age, sex, and comorbidity. (4) Conclusions: In medical inpatients, mostly polymorbid, both DRM but specially sarcopenia are associated with poorer quality of life, more readmissions, and higher mortality. Low HGS proved to be a stronger predictor of worse outcomes than MM.
The aim of this study was to evaluate the effect of lactic acid bacteria-based postbiotic supplementation on semen characteristics and hematological and biochemical profiles in rabbits. A total of 28 ...males were randomly allocated into two groups. Males received a Control diet and Enriched diet supplemented with postbiotic for 15 weeks (4 weeks of adaptation period and 11 weeks of experimental period). Body weight, feed intake and semen characteristics were recorded weekly. Hematological profile was recorded at the beginning and end of the experiment and biochemical profile at 0, 5, 10 and 15 weeks. Bayesian methodology was used for the statistical analysis. Feed intake was higher in Control diet (125.2 g) than in the Enriched diet (118.6 g,
= 1.00). The percentages of abnormal spermatozoa were higher in Control diet than in Enriched diet (30% and 22%;
= 0.93) and the acrosome integrity percentage was lower (97% and 96%;
= 0.87). The hematological profile was within the range for healthy rabbits. The plasmatic level of alanine aminotransferase was higher in Control diet than Enriched diet at 5 and 10 weeks (
= 0.93 and
= 0.94, respectively) and alkaline phosphatase was similar in Control diet throughout the experiment, but decreased in Enriched diet (
= 0.97). No difference was found in kidney parameters (uric nitrogen and creatinine). Enriched diet showed higher total protein and globulin than Control diet (
= 0.99). Phosphorus was lower (
= 0.92) in Control diet than in Enriched diet. In conclusion, the addition of the postbiotic based on lactic acid bacteria seems to improve the quality of the semen and the liver profile in rabbits.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Multi-label learning is a challenging task in data mining which has attracted growing attention in recent years. Despite the fact that many multi-label datasets have continuous features, general ...algorithms developed specially to transform multi-label datasets with continuous attributes’ values into a finite number of intervals have not been proposed to date. Many classification algorithms require discrete values as the input and studies have shown that supervised discretization may improve classification performance. This paper presents a Label-Attribute Interdependence Maximization (LAIM) discretization method for multi-label data. LAIM is inspired in the discretization heuristic of CAIM for single-label classification. The maximization of the label-attribute interdependence is expected to improve labels prediction in data separated through disjoint intervals. The main aim of this paper is to present a discretization method specifically designed to deal with multi-label data and to analyze whether this can improve the performance of multi-label learning methods. To this end, the experimental analysis evaluates the performance of 12 multi-label learning algorithms (transformation, adaptation, and ensemble-based) on a series of 16 multi-label datasets with and without supervised and unsupervised discretization, showing that LAIM discretization improves the performance for many algorithms and measures.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
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