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The main aim of this study was to assess the utility of differential white cell count and cell population data (CPD) for the detection of COVID-19 in patients admitted for ...community-acquired pneumonia (CAP) of different etiologies.
This was a multicenter, observational, prospective study of adults aged ≥18 years admitted to three teaching hospitals in Spain from November 2019 to November 2021 with a diagnosis of CAP. At baseline, a Sysmex XN-20 analyzer was used to obtain detailed information related to the activation status and functional activity of white cells.
The sample was split into derivation and validation cohorts of 1065 and 717 patients, respectively. In the derivation cohort, COVID-19 was confirmed in 791 patients and ruled out in 274 patients, with mean ages of 62.13 (14.37) and 65.42 (16.62) years, respectively (p<0.001). There were significant differences in all CPD parameters except MO-Y. The multivariate prediction model showed that lower NE-X, NE-WY, LY-Z, LY-WY, MO-WX, MO-WY, and MO-Z values and neutrophil-to-lymphocyte ratio were related to COVID-19 etiology with an AUC of 0.819 (0.790, 0.846). No significant differences were found comparing this model to another including biomarkers (p=0.18).
Abnormalities in white blood cell morphology based on a few cell population data values as well as NLR were able to accurately identify COVID-19 etiology. Moreover, systemic inflammation biomarkers currently used were unable to improve the predictive ability. We conclude that new peripheral blood biomarkers can help determine the etiology of CAP fast and inexpensively.
Introduction. Patients with asthma also tend to have anxiety and depression. These comorbidities may affect asthma control and quality of life. The objective of this study was to assess the impact of ...anxiety and depression on asthma control and quality of life. Patients and methods. Cross-sectional study of asthma outpatients was conducted at two hospitals in the Basque Country (northern Spain). Data collected included sociodemographic variables, asthma symptoms, treatment, number of exacerbations, level of control, quality of life, presence of psychological morbidities, and level of physical activity. Spirometry was performed in accordance with the recommendations of the Spanish Society of Pneumology and Thoracic Surgery. Results. Among 354 asthmatics, 77% had poor or partial control of their condition, 31% had anxiety alone, 2% had depression alone, and 10% had anxiety plus depression. Poor asthma control was associated with anxiety plus depression (odds ratio (OR): 3.61; 95% confidence interval (CI): 1.05-12.41) as well as with female patients (OR: 1.85; 95% CI: 1.11-3.10). Anxiety had an independent effect on reduced quality of life across all domains; anxiety plus depression had an even greater effect. Conclusion. Among patients with asthma, anxiety and depression adversely affect asthma control and quality of life, raising the possibility that treating these psychological comorbidities could improve asthma control and quality of life.
Restrictive spirometry pattern is an under-recognised disorder with a poor morbidity and mortality prognosis. We compared physical activity levels between adults with a restrictive spirometry pattern ...and with normal spirometry.
Restrictive spirometry pattern was defined as a having post-bronchodilator FEV1/FVC ≥ Lower Limit of Normal and a FVC<80% predicted in two population-based studies (ECRHS-III and SAPALDIA3). Physical activity was measured using the International Physical Activity Questionnaire. The odds of having low physical activity (<1st study-specific tertile) was evaluated using adjusted logistic regression models.
Subjects with a restrictive spirometry pattern (n = 280/4721 in ECRHS, n = 143/3570 in SAPALDIA) reported lower levels of physical activity than those with normal spirometry (median of 1770 vs 2253 MET·min/week in ECRHS, and 3519 vs 3945 MET·min/week in SAPALDIA). Subjects with a restrictive spirometry pattern were more likely to report low physical activity (meta-analysis odds ratio: 1.41 95%CI 1.07–1.86) than those with a normal spirometry. Obesity, respiratory symptoms, co-morbidities and previous physical activity levels did not fully explain this finding.
Adults with a restrictive spirometry pattern were more likely to report low levels of physical activity than those with normal spirometry. These results highlight the need to identify and act on this understudied but prevalent condition.
•Subjects with a restrictive spirometry pattern had low level of physical activity.•Low physical activity was not due to obesity, respiratory symptoms or comorbidities.•These results raise awareness about this understudied prevalent condition.
“Take home” message: This analysis of data from two large population-based studies shows that adults with a restrictive spirometry pattern have low levels of physical activity. This may be one of the reason why higher mortality and morbidity is observed among these subjects.
Universities attract a large number of students and staff who generate thousands of journeys every day. This affects transport systems in European cities and contributes to increasing CO2 emissions, ...since a significant percent of the journeys are made by car. Therefore, there is a need to influence the academic community's travel behavior and to encourage staff and students to reduce car journeys and to increase travel by public transport, bike, or by foot. This would result in reduction of the negative effects from car usage, including air pollution. This paper deals with the issue of university mobility and its impact on CO2 emission. It presents the activities and the outputs of the EU U-MOB LIFE project, which aims to provide European universities with innovative tools and support in the field of planning, implementation, monitoring and assessments of the effects of activities shaping sustainable travel behaviour of students and staff. The paper also presents the European Network for Sustainable Mobility at University, which serves as a platform for exchanging information and transferring knowledge of best practices on sustainable university mobility.
La religión se vuelve y se mantiene digital Míriam Díez Bosch; Adriana Chiva Polvillo; Sílvia Pascual Fontanilles
Comunicación en la era postcovid, medios audiovisuales y análisis,
10/2021
Book Chapter
La religión tradicional, conocida como los patrones de creencias y rituales vinculados a comunidades históricamente arraigadas (Campbell, 2020), ha dejado espacio a un nuevo concepto de religión ...donde las iniciativas online son integradas como nueva manera de interactuar con las comunidades. Así, aparece la religión digital, que emerge como consecuencia de un compromiso religioso online en la era digital.
Este escenario aparece cuando confluyen las prácticas religiosas con el mundo digital, donde aparecen nuevas normas y lógicas que dan forma a la religión de manera que se establecen otras formas de ser y de convicciones en la realidad. También, las
Introducción. La cuantificación de ganancias y pérdidas en los usos de suelo y vegetación permite conocer la dinámica de cambios en las áreas naturales protegidas.Objetivo. Analizar los cambios de ...uso de suelo y vegetación en la Zona Protectora Forestal de los ríos del sur de Querétaro.Materiales y métodos. Se cuantificaron las superficies de los usos de suelo y vegetación en los años 1997, 2009 y 2016. Los cambios y tendencias se analizaron con sistemas de información geográfica. Se indagaron las posibles causas de la dinámica de cambios a partir de visitas de campo y un cuestionario socioeconómico en cinco localidades (94 hogares) del área de influencia.Resultados. Durante los 20 años, en términos netos, se registraron pérdidas de 1 026 ha (16 %) de bosque de encino y 472 ha (100 %) de bosque de pino-encino. La vegetación secundaria arbustiva de bosque de encino aumentó de 21 ha a 1 088 ha (+5 000 %). La vegetación asociada a actividades productivas como el pastizal inducido incrementó 119 ha (98 %), mientras que la agricultura se amplió 128 ha (6 %). La información del cuestionario señala que 11 % se dedica a la agricultura y 30 % usa leña como fuente energética; además, 90 % percibe que la tala ilegal está asociada con la producción alta de carbón.Conclusión. La dinámica de cambios del uso de suelo y vegetación de 1997 a 2016 es moderada con pérdidas de importancia forestal como el bosque de encino, causadas por actividades antrópicas de acuerdo con la percepción de los pobladores.
Introduction. Measuring gains and losses in land use and vegetation allows us to understand the dynamics of changes in natural protected areas.Objectives. To analyze changes in land use and vegetation in the Forest Protected Area of the southern rivers of Querétaro.Materials and Methods. The areas of land use and vegetation were quantified for the years 1997, 2009, and 2016. Changes and trends were analyzed using geographic information systems. Possible causes of the dynamics of change were examined based on field visits and a socioeconomic survey in five localities (94 households) within the area of influence.Results. The net loss over the 20 years was 1 026 ha (16 %) of oak forest and 472 ha (100 %) of pine-oak forest. Secondary shrubby oak forest increased from 21 ha to 1 088 ha (+5 000 %). Vegetation associated with productive activities such as induced pastureland increased 119 ha (98 %), while agriculture expanded 128 ha (6 %). Survey information indicates that 11 % are engaged in agriculture and 30 % use firewood as an energy source; furthermore, 90 % perceive that illegal logging is associated with high charcoal production.Conclusion. The dynamics of land use and vegetation changes from 1997 to 2016 is moderate with losses of forest importance such as oak forest, caused by human activities according to the perception of the villagers.
To investigate the pharmacokinetics, safety and tolerability of aclidinium bromide 200 μg and 400 μg after a single dose and repeated once-daily doses in younger and elderly patients with moderate or ...severe chronic obstructive pulmonary disease (COPD).
Younger (40-59 years; n = 12) and elderly (≥ 70 years; n = 12) patients were treated with aclidinium via the Genuair® inhaler. Patients received once-daily aclidinium 200 μg for 3 days; after a 7-day washout period, patients received once-daily aclidinium 400 μg for 3 days. Pharmacokinetic analyses were conducted on plasma and urine on Days 1 and 3 of both treatment periods. Safety and tolerability were assessed.
Aclidinium showed similar linear and time-independent pharmacokinetics in younger and elderly patients at each dose level and day of treatment. For both age groups at each dose level and day, aclidinium appeared rapidly in the plasma with a median tmax between 10 and 15 min; concentrations of aclidinium in the plasma declined rapidly with a t1/2 between 1 and 3 h. Plasma exposure with the 400 μg dose was ~ 2-fold higher than for the 200 μg dose in both age groups on both days. For both age groups, urinary excretion of aclidinium over 24 h was < 0.15% of the dose at each dose and day. Aclidinium 200 μg and 400 μg were safe and well tolerated in both age groups.
These data suggest that no dose adjustment of aclidinium is required when treating elderly patients with COPD.
In this note we present the increased prevalence of silicosis found in a marble factory after exposure to a new presentation of silica. A prospective, observational study was conducted on 11 workers ...who were exposed to different presentations of quartz surfaces since 1995. The jobs were divided into two groups: 4 subjects worked in the cutting workshop; the rest of the workers worked in assembly. Up to that date they had not used any specific respiratory protection apparatus. Six cases of silicosis have been diagnosed, which assumes a disease prevalence in this environment of 54.5%. Of the 6 affected, 5 (83.3% are assemblers. We highlight the high risk of developing silicosis in the handling of different products which make up the range of quartz surfaces.
Abstract
Background: Pancreatic cancer is one of the most devastating malignancies due to the development of intrinsic chemoresistance following chemotherapy. Extracellular matrix (ECM) proteins are ...intimately linked to cellular proliferation, invasion, and acquisition of chemoresistance in PDAC cells, making them promising therapeutic targets in this malignancy. Naturally occurring dietary botanicals, including berberine (BER) and emodin (EMO), have been shown to suppress ECM as one of the mechanism(s) for their anti-tumorigenic activity, along with their time-tested safety and cost-effectiveness. In addition, both BER and EMO are also known to induce apoptosis by modulating different pathways and regulating pro-apoptotic genes. Herein, we hypothesized that combined treatment with BER and EMO might exhibit synergistic anticancer efficacy by targeting the ECM and apoptotic pathways in PDAC cells.
Methods: We undertook genomewide transcriptomic profiling analysis to identify critical ECM-related genes differentially expressed in PDAC. Subsequently, the TCGA dataset was analyzed to identify the prognostic significance of ECM-associated genes with overall survival (OS) and disease-free survival (DFS) in PDAC. A series of cell culture experiments were performed using PDAC cells, followed by their validation in patient-derived organoids to examine the synergistic anti-proliferative and chemopreventive effects of BER and EMO against PDAC.
Results: Transcriptomic profiling identified that LAMB3 expression was significantly upregulated in PDAC tissue (P < 0.01) and was significantly associated with poor OS and DFS in PDAC patients (P < 0.01). The combination of BER and EMO displayed superior synergistic anti-tumor potential in PDAC cells vs. individual compounds, as revealed by cell proliferation, clonogenicity, migration, and invasion assays. The combination of BER and EMO also altered the expression of key proteins involved in cellular apoptosis, epithelial-mesenchymal-transition, and EGFR/ERK//AKT growth factor signaling pathways. Finally, these findings were successfully validated in PDAC patient-derived 3D organoids.
Conclusions: We provide the first evidence that combined treatment with berberine and emodin exerts synergistic anti-cancer activity in PDAC, primarily regulated through the LAMB3-mediated interaction with other members of the EGFR-signaling pathway.
Citation Format: CAIMING XU, SILEI SUI, Keisuke Okuno, Silvia Pascual-Sabater, Cristina Fillat, Ajay Goel. Berberine and emodin synergistically suppress the EGFR signaling cascade by targeting LAMB3 in pancreatic ductal adenocarcinoma. abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3821.
This paper, developed by consensus of staff physicians of accredited asthma units for the management of severe asthma, presents information on the process and requirements for already-existing asthma ...units to achieve official accreditation by the Spanish Society of Pneumology and Thoracic Surgery (SEPAR). Three levels of specialized asthma care have been established based on available resources, which include specialized units for highly complex asthma, specialized asthma units, and basic asthma units. Regardless of the level of accreditation obtained, the distinction of "excellence" could be granted when more requirements in the areas of provision of care, technical and human resources, training in asthma, and teaching and research activities were met at each level. The Spanish experience in the process of accreditation of specialized asthma units, particularly for the care of patients with difficult-to-control asthma, may be applicable to other health care settings.
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