Objetivo: Analizar los cambios en la frecuencia y la incidencia de la enfermedad del ojo seco (EOS) y los tiempos de exposición a pantallas al inicio de cursos en línea, y comparar estos cambios ...entre sexos. Secundariamente, correlacionar los tiempos de exposición con la gravedad de los síntomas. Método: Se aplicaron cuatro encuestas idénticas durante 6 semanas, las cuales contenían el Ocular Surface Disease Index (OSDI) que cuantifica la gravedad de los síntomas de EOS y preguntas sobre tiempos de exposición a pantallas. Se incluyeron universitarios que transicionaron de cursos presenciales a plataformas en línea. Resultados: La frecuencia de EOS entre los 97 participantes (54 mujeres y 43 hombres) alcanzó su máximo en la semana 4 (82.47%). Las puntuaciones OSDI aumentaron significativamente (p < 0.0001) entre la situación basal (27.01 ± 17.55) y la semana 6 (37.17 ± 24.64), reflejando un empeoramiento sintomatológico y una incidencia del 8.5%. Este empeoramiento se observó en las mujeres (p < 0.0001), pero no en los hombres (p = 0.11); se encontraron diferencias significativas entre sexos en la situación basal (p = 0.01), la semana 2 (p = 0.02) y la semana 6 (p = 0.008), pero no en la semana 4 (p = 0.11). El inicio de los cursos en línea aumentó el tiempo frente a la pantalla (p < 0.0001). Las horas basales fueron 25.52 ± 11.33 y alcanzaron su máximo en la semana 2, con 34.62 ± 10.90 horas. Las puntuaciones OSDI y los tiempos de exposición de los cursos en línea se correlacionaron significativamente (semana 2, R = 0.265; semana 4, R = 0.262; semana 6, R = 0.205). Conclusiones: Los universitarios sufren síntomas graves de EOS que se correlacionaron con el inicio de los cursos en línea. Las instituciones educativas deberían fomentar la salud ocular.
Consensus document on dog and cat allergy Dávila, I.; Domínguez‐Ortega, J.; Navarro‐Pulido, A. ...
Allergy (Copenhagen),
June 2018, 2018-06-00, 20180601, Letnik:
73, Številka:
6
Journal Article
Recenzirano
The prevalence of sensitization to dogs and cats varies by country, exposure time and predisposition to atopy. It is estimated that 26% of European adults coming to the clinic for suspected allergy ...to inhalant allergens are sensitized to cats and 27% to dogs. This document is intended to be a useful tool for clinicians involved in the management of people with dog or cat allergy. It was prepared from a consensus process based on the RAND/UCLA method. Following a literature review, it proposes various recommendations concerning the diagnosis and treatment of these patients, grounded in evidence and clinical experience. The diagnosis of dog and cat allergy is based on a medical history and physical examination that are consistent with each other and is confirmed with positive results on specific IgE skin tests. Sometimes, especially in polysensitized patients, molecular diagnosis is strongly recommended. Although the most advisable measure would be to avoid the animal, this is often impossible and associated with a major emotional impact. Furthermore, indirect exposure to allergens occurs in environments in which animals are not present. Immunotherapy is emerging as a potential solution to this problem, although further supporting studies are needed.
Common variable immunodeficiency (CVID) is the most frequent symptomatic primary immunodeficiency characterized by recurrent infections, hypogammaglobulinemia and poor response to vaccines. Its ...diagnosis is made based on clinical and immunological criteria, after exclusion of other diseases that can cause similar phenotypes. Currently, less than 20% of cases of CVID have a known underlying genetic cause. We have analyzed whole-exome sequencing and copy number variants data of 36 children and adolescents diagnosed with CVID and healthy relatives to estimate the proportion of monogenic cases. We have replicated an association of CVID to p.C104R in TNFRSF13B and reported the second case of homozygous patient to date. Our results also identify five causative genetic variants in
, and
, as well as other very likely causative variants in
, or
among others. We experimentally validate the effect of the
stop-gain mutation which abolishes protein production and downregulates the expression of CTLA4, and of the frameshift indel in
producing expression downregulation of the protein. Our results indicate a monogenic origin of at least 15-24% of the CVID cases included in the study. The proportion of monogenic patients seems to be lower in CVID than in other PID that have also been analyzed by whole exome or targeted gene panels sequencing. Regardless of the exact proportion of CVID monogenic cases, other genetic models have to be considered for CVID. We propose that because of its prevalence and other features as intermediate penetrancies and phenotypic variation within families, CVID could fit with other more complex genetic scenarios. In particular, in this work, we explore the possibility of CVID being originated by an oligogenic model with the presence of heterozygous mutations in interacting proteins or by the accumulation of detrimental variants in particular immunological pathways, as well as perform association tests to detect association with rare genetic functional variation in the CVID cohort compared to healthy controls.
Controlling the magnetic ground states at the nanoscale is a long-standing basic research problem and an important issue in magnetic storage technologies. Here, we designed a nanostructured material ...that exhibits very unusual hysteresis loops due to a transition between vortex and double pole states. Arrays of 700 nm diamond-shaped nanodots consisting of Py(30 nm)/Ru(t Ru)/Py(30 nm) (Py, permalloy (Ni80Fe20)) trilayers were fabricated by interference lithography and e-beam evaporation. We show that varying the Ru interlayer spacer thickness (t Ru) governs the interaction between the Py layers. We found this interaction mainly mediated by two mechanisms: magnetostatic interaction that favors antiparallel (antiferromagnetic, AFM) alignment of the Py layers and exchange interaction that oscillates between ferromagnetic (FM) and AFM couplings. For a certain range of Ru thicknesses, FM coupling dominates and forms magnetic vortices in the upper and lower Py layers. For Ru thicknesses at which AFM coupling dominates, the magnetic state in remanence is a double pole structure. Our results showed that the interlayer exchange coupling interaction remains finite even at 4 nm Ru thickness. The magnetic states in remanence, observed by magnetic force microscopy (MFM), are in good agreement with corresponding hysteresis loops obtained by the magneto-optic Kerr effect (MOKE) and micromagnetic simulations.
•Nanomaterial δ-MnO2 in a flower-like structure was synthesized.•δ-MnO2 was tested as a cathode in a Li-ion battery.•δ-MnO2 showed capacities of 44 and 24 mAhg−1 at 1000 and 2000 mAg−1, ...respectively.•Flower-like structure cathode is desirable instead of a solid structure in a LIB.
Cathodes of lithium-ion batteries (LIBs) present stability and performance issues, therefore, the search of new cathodes is still a major concern. Manganese dioxide in delta phase (δ-MnO2) seems to be a suitable candidate since is low-cost, non-toxic and possesses a theoretical capacity of 308 mAhg−1 for one-electron transfer. In this work, we prepared δ-MnO2 by a hydrothermal method at two different reaction times. At 2 h, a flower-like nanostructure was obtained, while for a 3 h reaction time, a solid nanostructure was achieved. Both materials were tested as cathode in a LIB, finding that at slow charge-discharge rates (20 mAg−1), a material with homogeneous nanosized morphology is enough in order to obtain good capacities. But, at higher rates, our flower-like structure provides a better discharge capacity.
Aim
Tunnelled haemodialysis (HD) catheters can be used instantly, but there are several anatomical variables that could impact it survival. This study aimed to examine the impact of different novel ...anatomic variables, with catheter replacement.
Methods
In a single‐centre a prospective cohort in chronic kidney disease G5 patients were conducted. The primary outcome was to determine the factors associated with catheter replacement during the first 6‐month of follow‐up. All procedures were performed without fluoroscopy. Three anatomic regions for catheter tip position were established: considered as superior vena cava (SVC), cavo‐atrial junction (CAJ) and mid‐to deep atrium (MDA). Many other anatomical variables were measured. Catheter‐related bloodstream infection was also included.
Results
Between January 2019 and January 2020 a total of 75 patients with tunnelled catheter insertion were analysed. Catheter replacement at 6‐month occur in 10 (13.3%) patients. By multivariate analysis, the incorrect catheter tip position (SVC) (OR 1.23, 95% CI 1.07–1.42, p <.004), the presence of extrasystoles during the procedure (OR 0.88, 95% CI 0.78–0.98, p = .03), incorrect catheter tug (OR 1.31, 95% CI 1.10–1.55, p = .003), incorrect catheter top position (kinking; OR 1.40, 95% CI 1.04–1.88, p = .02) and catheter‐related bloodstream infection (OR 2.60, 95% CI 2.09–3.25, p <.001) were the only variables associated with catheter replacement at 6‐month follow‐up.
Conclusion
The risk of catheter replacement at 6‐month follow‐up could be attenuated by avoiding incorrect catheter tug and top position, and by placing the vascular catheter tip in the CAJ and MDA.
SUMMARY AT A GLANCE
The success of tunnelled haemodialysis catheters depends on delivery of good blood flow, absence of infection and longevity of function. This study examines a variety of anatomical variables that would seem intuitively valid but have not been studied and their impact on the chances of catheter replacement over 6 months.
Within Industry 4.0, drones appear as intelligent devices that have brought a new range of innovative applications to the industrial sector. The required knowledge and skills to manage and ...appropriate these technological devices are not being developed in most universities. This paper presents an unmanned aerial vehicle (UAV)-based smart educational mechatronics system that makes use of a motion capture (MoCap) laboratory and hardware-in-the-loop (HIL) to teach UAV knowledge and skills, within the Educational Mechatronics Conceptual Framework (EMCF). The macro-process learning construction of the EMCF includes concrete, graphic, and abstract levels. The system comprises a DJI Phantom 4, a MoCap laboratory giving the drone location, a Simulink drone model, and an embedded system for performing the HIL simulation. The smart educational mechatronics system strengthens the assimilation of the UAV waypoint navigation concept and the capacity for drone flight since it permits the validation of the physical drone model and testing of the trajectory tracking control. Moreover, it opens up a new range of possibilities in terms of knowledge construction through best practices, activities, and tasks, enriching the university courses.
We studied surveillance, incidence and outcome of viral infections in children undergoing allogeneic hematopoietic cell transplantation (HCT) in the main pediatric transplant units in Spain. We ...prospectively collected data from first year post-HCT in every consecutive allogeneic HCT performed during 3 years (N = 215): first HCT = 188 and second HCT = 27; median age = 6.6 years (0.1-20.7). Most patients had acute leukemia (N = 137) and 135 recipients (63%) were CMV seropositive. A total of 46 patients underwent cord blood transplant, 133 patients underwent HCT from alternative donors (62%) and 101 patients received anti-thymocyte globulin. Observational time was completed in 137 patients, whereas the remaining 78 died after a median survival time of 99 days (3-352). CMV was monitored in all patients; adenovirus (ADV) and human herpesvirus 6 (HHV-6) were monitored in 101 and 33 patients, respectively. We found 145 viral infections in 103 patients: CMV (n = 42), ADV (n = 32), HHV-6 (n = 7), polyomavirus (n = 20), EBV (n = 6), VZV (n=17) and others (n = 8). CMV infection was significantly higher in seropositive patients (25 vs 7%) (P = 0.02). Extensive chronic GVHD (cGVHD) was significantly associated with an increased rate of viral infections (12 of 16 patients with cGVHD had infections vs 91 of 199 without GVHD) (P = 0.035). In total, 10 patients (4.6%) died of viral infections (CMV = 5, ADV = 3, respiratory = 2). We found a high incidence of viral infection, but mortality was low.
Varnimcabtagene autoleucel (var-cel) is an academic anti-CD19 chimeric antigen receptor (CAR) product used for the treatment of non-Hodgkin lymphoma (NHL) in the CART19-BE-01 trial. Here we report ...updated outcomes of patients with NHL treated with var-cel. B-cell recovery was compared with patients with acute lymphoblastic leukaemia (ALL). Forty-five patients with NHL were treated. Cytokine release syndrome (any grade) occurred in 84% of patients (4% grade ≥3) and neurotoxicity in 7% (2% grade ≥3). The objective response rate was 73% at Day +100, and the 3-year duration of response was 56%. The 3-year progression-free and overall survival were 40% and 52% respectively. High lactate dehydrogenase was the only covariate with an impact on progression-free survival. The 3-year incidence of B-cell recovery was lower in patients with NHL compared to ALL (25% vs. 60%). In conclusion, in patients with NHL, the toxicity of var-cel was manageable, while B-cell recovery was significantly prolonged compared to ALL. This trial was registered as NCT03144583.
Thyroid cancer is the single most prevalent endocrine malignancy; differentiated thyroid cancer (DTC) accounts for more than 90 % of all malignancies and its incidence has been rising steadily. For ...more patients, surgical treatment, radioactive iodine (RAI) ablation, and thyroid-stimulating hormone (TSH) suppressive therapy achieve an overall survival (OS) rate of 97.7 % at 5 years. Nevertheless, locoregional recurrence occurs in up to 20 % and distant metastases in approximately 10 % at 10 years. Two-thirds of these patients will never be cured with radioactive iodine therapy and will become RAI-refractory, with a 3-year OS rate of less than 50 %. Over the last decade, substantial progress has been made in the management of RAI-refractory DTC. Given the controversy in some areas, the Spanish Task Force for Thyroid Cancer on behalf of Spanish Society of Endocrinology Thyroid Cancer Working Group (GTSEEN) and the Spanish Rare Cancer Working Group (GETHI) have created a national joint task force to reach a consensus addressing the most challenging aspects of management in these patients. In this way, multidisciplinary management should be mandatory and nuclear medicine targeted therapy, novel molecular targeted agents, and combinations are currently changing the natural history of RAI-refractory DTC.
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