MicroRNAs (miRNAs) are endogenous, short RNA oligonucleotides that regulate the expression of hundreds of proteins to control cells' function in physiological and pathological conditions. miRNA ...therapeutics are highly specific, reducing the toxicity associated with off-target effects, and require low doses to achieve therapeutic effects. Despite their potential, applying miRNA-based therapies is limited by difficulties in delivery due to their poor stability, fast clearance, poor efficiency, and off-target effects. To overcome these challenges, polymeric vehicles have attracted a lot of attention due to their ease of production with low costs, large payload, safety profiles, and minimal induction of the immune response. Poly(
-ethyl pyrrolidine methacrylamide) (EPA) copolymers have shown optimal DNA transfection efficiencies in fibroblasts. The present study aims to evaluate the potential of EPA polymers as miRNA carriers for neural cell lines and primary neuron cultures when they are copolymerized with different compounds. To achieve this aim, we synthesized and characterized different copolymers and evaluated their miRNA condensation ability, size, charge, cytotoxicity, cell binding and internalization ability, and endosomal escape capacity. Finally, we evaluated their miRNA transfection capability and efficacy in Neuro-2a cells and rat primary hippocampal neurons. The results indicate that EPA and its copolymers, incorporating β-cyclodextrins with or without polyethylene glycol acrylate derivatives, can be promising vehicles for miRNA administration to neural cells when all experiments on Neuro-2a cells and primary hippocampal neurons are considered together.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Information on experience/management of severe hypoglycaemic events (SHEs) among people with insulin-treated diabetes (PWD) and caregivers (CGs) providing care to PWD was sought.
An online ...cross-sectional survey was conducted in eight countries. Inclusion criteria: PWD (aged≥18 years; self-reported type 1 T1D or insulin-treated type 2 T2D diabetes; experienced ≥1 SHE hypoglycaemia requiring external assistance in past 3 years); CGs (layperson aged ≥18 years; caring for PWD meeting all criteria above except age ≥4 years). This descriptive analysis provides data from Spain. SHE-associated data relate to the most recent SHE.
Across all groups (T1D PWD, n=106; T2D PWD, n=88, T1D CG, n=87; T2D CG, n=96), 76–89% reported that the SHE occurred at home; most common cause was eating less than planned (38–53%). Most usual action during the SHE was to intake carbohydrates (67–84%); glucagon use was low (9–36%). Discussion of the SHE with their healthcare provider (HCP) was reported by 70–75% of PWD. During the SHE, 35–69% of PWD/CGs reported feeling scared, unprepared and/or helpless.
Most SHEs occurred outside the healthcare setting; treatment therefore depends greatly on CGs. SHEs have a negative emotional impact on PWD/CGs, underscoring the need for HCPs to discuss SHEs with PWD/CGs, and to provide tools and strategies to prevent and effectively manage SHEs.
Se recopiló información sobre la experiencia y el manejo de episodios de hipoglucemia grave (EHG) entre personas con diabetes (PCD) tratadas con insulina y sus cuidadores.
Se realizó una encuesta transversal online en ocho países. Criterios de inclusión: PCD de ≥18 años con diabetes tipo 1 (DT1) o diabetes tipo 2 (DT2) tratada con insulina autoinformada y ≥ 1 EHG en los últimos tres años, que requirió asistencia externa; cuidador no profesional de ≥ 18 años que proporciona atención a PCD que cumplen los criterios anteriores excepto la edad (≥ cuatro años). Este análisis descriptivo proporciona información de España. Los datos de EHG se refieren al episodio más reciente.
En todos los grupos (PCD DT1, n = 106; PCD DT2, n = 88; cuidador DT1, n = 87; cuidador DT2, n = 96), un 76 a 89% refirió que el EHG ocurrió en casa; la causa más común fue comer menos de lo planeado (38 a 53%). La acción más habitual durante el EHG fue ingerir carbohidratos (67 a 84%); en pocos casos se usó glucagón (9 a 36%). El 70 a 75% de las PCD comentó el EHG con su profesional sanitario. Un 35 a 69% de las PCD/cuidadores refirieron que se sintieron asustadas, no preparadas y/o indefensas durante el EHG.
La mayoría de los EHG no ocurrieron dentro del sistema sanitario y, por tanto, el tratamiento depende fundamentalmente de los cuidadores. Los EHG tienen un impacto emocional negativo en las PCD y en los cuidadores, destacando la necesidad de que los profesionales sanitarios hablen con ellos sobre este tema y de proporcionar herramientas y estrategias para prevenir y controlar eficazmente los EHG.
To determine the prevalence of chronic kidney disease (CKD) and the factors associated with impaired renal function in the population attended in primary care (PC).
Cross-sectional and multicentre ...study carried out in the baseline patients of the IBERICAN study (Identificación de la poBlación Española de RIesgo CArdiovascular y reNal). CKD was considered with an estimated glomerular filtration (eGF) <60ml/min/1.73 m
or elevated albuminuria (≥ 30mg/g). According to the eGF, the CKD was classified in six stages (1, 2, 3a, 3b, 4 and 5) and according to albuminuria in three stages (A1 or normal / slightly increased, A2 or moderately increased and A3 or severely increased). The clinical characteristics and the relationship of CKD with the main cardiovascular risk factors (CVRF) and other variables of interest were analysed using unconditional logistic regression.
7,895 patients were included (mean age 57.9±14.8 years; 54.5% women). 14.4% (95% CI: 13.6-15.1) had CKD; 16.1% (95% CI: 14.9-17.3) in men and 12.9% (95% CI: 11.9-14.0) in women. A continuous increase of the prevalence was observed with age (24.8% in≥65 years) and with CVFR aggregation. The variables that were most associated with the probability of suffering CKD were left ventricular hypertrophy (OR: 1.95; p <.001), diabetes (OR: 1.58; P<.001) and hypertension (OR: 1.56; P<.001).
Fourteen out of every 100 patients included in the IBERICAN study have CKD. The prevalence of CKD affects a quarter of patients ≥ 65 years and increases exponentially with the aggregation of FRCV.
The aim of this systematic literature review (SLR) was to provide an overview of the Spanish research landscape of observational studies conducted with antidiabetic drugs in T2DM patients, published ...in the last five years, with special focus on the objectives, methodology and main research areas. Twenty-two articles, corresponding to 20 studies, were included in the analysis. Around 82% of the studies employed a longitudinal study design, collected data retrospectively (72.7%), and were based on secondary data use (63.6%). Pharmacotherapeutical groups most frequently studied were insulin (31.8%) and DPP4i (13.6%). Analytic design was employed most in the studies (68.2%), followed by descriptive analysis (22.7%). In the top five of the most studied variables are those related to effectiveness assessed according to glycaemic control (91%), treatment patterns (82%), safety (hypoglycaemia) (59%), the identification of effectiveness predictive factors (45%) and effectiveness according to other control measures such as anthropometric control or cardiovascular risk factors (36%).
We assess the consistency of measures of individual local ecological knowledge obtained through peer evaluation against three standard measures: identification tasks, structured questionnaires, and ...self-reported skills questionnaires. We collected ethnographic information among the Baka (Congo), the Punan (Borneo), and the Tsimane’ (Amazon) to design site-specific but comparable tasks to measure medicinal plant and hunting knowledge. Scores derived from peer ratings correlate with scores of identification tasks and self-reported skills questionnaires. The higher the number of people rating a subject, the larger the association. Associations were larger for the full sample than for subsamples with high and low rating scores. Peer evaluation can provide a more affordable method in terms of difficulty, time, and budget to study intracultural variation of knowledge, provided that researchers (1) do not aim to describe local knowledge; (2) select culturally recognized domains of knowledge; and (3) use a large and diverse (age, sex, and kinship) group of evaluators.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Although subsistence hunting is cross-culturally an activity led and practiced mostly by men, a rich body of literature shows that in many small-scale societies women also engage in hunting in varied ...and often inconspicuous ways. Using data collected among two contemporary forager-horticulturalist societies facing rapid change (the Tsimane' of Bolivia and the Baka of Cameroon), we compare the technological and social characteristics of hunting trips led by women and men and analyze the specific socioeconomic characteristics that facilitate or constrain women's engagement in hunting. Results from interviews on daily activities with 121 Tsimane' (63 women and 58 men) and 159 Baka (83 women and 76 men) show that Tsimane' and Baka women participate in subsistence hunting, albeit using different techniques and in different social contexts than men. We also found differences in the individual and household socioeconomic profiles of Tsimane' and Baka women who hunt and those who do not hunt. Moreover, the characteristics that differentiate hunter and non-hunter women vary from one society to the other, suggesting that gender roles in relation to hunting are fluid and likely to change, not only across societies, but also as societies change. Keywords Baka (Cameroon). Gender. Small-scale societies. Social-ecological transformations. Tsimane' (Bolivia) Across societies, subsistence hunting is an activity led and practiced mostly by men; nevertheless, a rich body of literature shows that in many small-scale societies women also engage in hunting in many different and sometimes inconspicuous ways, often
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Although subsistence hunting is cross-culturally an activity led and practiced mostly by men, a rich body of literature shows that in many small-scale societies women also engage in hunting in varied ...and often inconspicuous ways. Using data collected among two contemporary forager-horticulturalist societies facing rapid change (the Tsimane' of Bolivia and the Baka of Cameroon), we compare the technological and social characteristics of hunting trips led by women and men and analyze the specific socioeconomic characteristics that facilitate or constrain women's engagement in hunting. Results from interviews on daily activities with 121 Tsimane' (63 women and 58 men) and 159 Baka (83 women and 76 men) show that Tsimane' and Baka women participate in subsistence hunting, albeit using different techniques and in different social contexts than men. We also found differences in the individual and household socioeconomic profiles of Tsimane' and Baka women who hunt and those who do not hunt. Moreover, the characteristics that differentiate hunter and non-hunter women vary from one society to the other, suggesting that gender roles in relation to hunting are fluid and likely to change, not only across societies, but also as societies change.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, ODKLJ, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site ...infection (SSI) in patients scheduled for abdominal surgery.
We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality.
We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk RR: 0.94; 95% confidence interval CI: 0.59–1.50; P=0.90). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48–1.25; P=0.38) and myocardial ischaemia (0.6% n=2 vs 0% n=0; P=0.47) did not differ between groups.
An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found.
NCT02776046.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
AbstractThe aim of this systematic literature review (SLR) was to provide an overview of the Spanish research landscape of observational studies conducted with antidiabetic drugs in T2DM patients, ...published in the last five years, with special focus on the objectives, methodology and main research areas.Twenty-two articles, corresponding to 20 studies, were included in the analysis. Around 82% of the studies employed a longitudinal study design, collected data retrospectively (72.7%), and were based on secondary data use (63.6%). Pharmacotherapeutical groups most frequently studied were insulin (31.8%) and DPP4i (13.6%). Analytic design was employed most in the studies (68.2%), followed by descriptive analysis (22.7%). In the top five of the most studied variables are those related to effectiveness assessed according to glycaemic control (91%), treatment patterns (82%), safety (hypoglycaemia) (59%), the identification of effectiveness predictive factors (45%) and effectiveness according to other control measures such as anthropometric control or cardiovascular risk factors (36%).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The Monitoring Studies (MS) program, the approach developed by RedETS to generate postlaunch real-world evidence (RWE), is intended to complement and enhance the conventional health technology ...assessment process to support health policy decision making in Spain, besides informing other interested stakeholders, including clinicians and patients. The MS program is focused on specific uncertainties about the real effect, safety, costs, and routine use of new and insufficiently assessed relevant medical devices carefully selected to ensure the value of the additional research needed, by means of structured, controlled, participative, and transparent procedures. However, despite a clear political commitment and economic support from national and regional health authorities, several difficulties were identified along the development and implementation of the first wave of MS, delaying its execution and final reporting. Resolution of these difficulties at the regional and national levels and a greater collaborative impulse in the European Union, given the availability of an appropriate methodological framework already provided by EUnetHTA, might provide a faster and more efficient comparative RWE of improved quality and reliability at the national and international levels.
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