Currently, Coronavirus disease (COVID-19), one of the most infectious diseases in the 21st century, is diagnosed using RT-PCR testing, CT scans and/or Chest X-Ray (CXR) images. CT (Computed ...Tomography) scanners and RT-PCR testing are not available in most medical centers and hence in many cases CXR images become the most time/cost effective tool for assisting clinicians in making decisions. Deep learning neural networks have a great potential for building COVID-19 triage systems and detecting COVID-19 patients, especially patients with low severity. Unfortunately, current databases do not allow building such systems as they are highly heterogeneous and biased towards severe cases. This article is threefold: (i) we demystify the high sensitivities achieved by most recent COVID-19 classification models, (ii) under a close collaboration with Hospital Universitario Clínico San Cecilio, Granada, Spain, we built COVIDGR-1.0, a homogeneous and balanced database that includes all levelsof severity, from normal with Positive RT-PCR, Mild, Moderate to Severe. COVIDGR-1.0 contains 426 positive and 426 negative PA (PosteroAnterior) CXR views and (iii) we propose COVID Smart Data based Network (COVID-SDNet) methodology for improving the generalization capacity of COVID-classification models. Our approach reaches good and stable results with an accuracy of 97.72% ± 0.95%, 86.90% ± 3.20%, 61.80% ± 5.49% in severe, moderate and mild COVID-19 severity levels. Our approach could help in the early detection of COVID-19. COVIDGR-1.0 along with the severity level labels are available to the scientific community through this link https://dasci.es/es/transferencia/ open-data/covidgr/.
La Diabetes Mellitus Tipo 1 (DMT1) es una de las enfermedades actuales más dañinas que afectan a personas de cualquier edad incluyendo niños desde el nacimiento. Las inyecciones de insulina exógena ...siguen siendo el tratamiento más común para estos pacientes, sin embargo, no es el óptimo. La comunidad científica se ha esforzado en optimizar el suministro de insulina usando dispositivos electrónicos y de esta manera mejorar la esperanza de vida de los diabéticos. Existen numerosas limitaciones para que esta evolución biomédica sea realidad tales como la validación de algoritmos controladores, experimentación con dispositivos electrónicos, aplicabilidad en pacientes de diferentes edades, entre otras. Este trabajo presenta el prototipado de un controlador inteligente neuro-fuzzy en la tarjeta LAUNCHXL-F28069M de Texas Instruments para formar un esquema de hardware en el lazo (HIL). Esto es, el controlador embebido manda los datos de la tasa de suministro de insulina al computador donde se capturan por el software Uva/Padova y se integran a la simulación metabólica de pacientes diabéticos virtuales tratados con bomba de insulina. Una tarea principal del algoritmo inteligente embebido es determinar la tasa óptima de infusión insulínica para cada uno de los 30 pacientes virtuales disponibles, los cuales llevan un protocolo de comida. La novedad de este trabajo se centra en superar las limitaciones actuales a través de un primer enfoque de algoritmo de control inteligente aplicable al páncreas artificial (PA) y analizar la factibilidad de esta propuesta en la trascendencia con la edad ya que los resultados corresponden a pruebas in-silico en poblaciones de 10 adultos, 10 adolescentes y 10 niños.
B lymphocytes are recognized for their crucial role in the adaptive immunity since they represent the only leukocyte lineage capable of differentiating into Ab‐secreting cells. However, it has been ...demonstrated that these lymphocytes can exert several Ab‐independent functions, including engulfing and processing Ags for presentation to T cells, secreting soluble mediators, providing co‐stimulatory signals, and even participating in lymphoid tissues development. Beyond that, several reports claiming the existence of multiple B cell subsets contributing directly to innate immune responses have appeared. These “innate‐like” B lymphocytes, whose phenotype, development pathways, tissue distribution, and functions are in most cases notoriously different from those of conventional B cells, are crucial to early protective responses against pathogens by exerting “crossover” defensive strategies that blur the established boundaries of innate and adaptive branches of immunity. Examples of these mechanisms include the rapid secretion of the polyspecific natural Abs, increased susceptibility to innate receptors‐mediated activation, cytokine secretion, downstream priming of other innate cells, usage of specific variable immunoglobulin gene‐segments, and other features. As these new insights emerge, it is becoming preponderant to redefine the functionality of B cells beyond their classical adaptive‐immune tasks.
Beyond conventional populations, B cell compartment comprises several subsets developing “innate‐like” functions, implicated in early protection against pathogens mediated by different mechanisms besides antibody secretion.
Black garlic (BG) is obtained by the Maillard reaction under controlled conditions of temperature and humidity. This study describes the traditional processing (TT-BG) and the use of ohmic heating ...(OH) as pre-treatment (OH-BG) to improve time processing. Physicochemical composition and sensory properties were of particular interest in this study. The OH as a pretreatment causes the hydrolysis of fructans to fructose, which are degraded during storage under traditional treatment conditions (70 °C/94% RH) through the Maillard reaction causing the faster formation of compounds responsible for the color of black garlic compared to black garlic without pre-treatment. This reaction cuts down the time to attain the characteristic color of black garlic from 30 to 12 days. The 5-hydroxymethyl-2-furaldehyde (HMF) content was 3.6 times higher in OH-BG than in TT-BG. The polyphenol content and antioxidant capacity did not show differences between TT-BG and OH-BG, but their levels were superior to commercial sample. Both products (OH-BG and TT-BG) were sweet (36.8 and 31.6 °Bx, respectively) and had an excellent organoleptic acceptance (75 and 70%). These results highlight the potential of ohmic heating pretreatment in reducing the time to obtain good quality BG.
•OH pre-treatment reduces BG-time processing from 30 to 12 days.•Flavor and general acceptability were better evaluated in OH pre-treated BG.•OH-BG samples have more polyphenols and antioxidant capacity than commercial ones.•OH non-thermal effect facilitates the hydrolysis of fructans to fructose in the time.
► N-deficiency-induced senescence, the rise in ROS trigger oxidative stress. ► Transgenic plants expressing IPT gene coding the rate-limiting step in CKs synthesis. ► WT plants under N-limited, ...reduced biomass and increased the generation of ROS. ► Transgenic plants under N-limited, did not produce high ROS and maintained biomass. ► The expression of P
SARK∷IPT in plants could improve nitrogen use efficiency.
Wild type and transgenic tobacco plants expressing isopentenyltransferase, a gene coding the rate-limiting step in cytokinin synthesis, were grown under limited nitrogen (N) conditions. Our results indicated that the WT plants subjected to N deficiency displayed reduced biomass and relative growth rates, increased levels of oxidative damage and reduced foliar concentrations of the different N forms. However, the transgenic plants expressing P
SARK∷IPT, in spite of showing a significant decline in all the N forms in the leaf, avoided the alteration of the oxidative metabolism and maintained biomass and the relative growth rates at control levels, under suboptimal N conditions. These results suggest that the increased cytokinin synthesis in the transgenic plants is an effective mechanism to improve N-use efficiency.
Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer-related death in the Western world. The number of diagnosed cases and the mortality rate are almost equal as the majority ...of patients present with advanced disease at diagnosis. Between 4 and 10% of pancreatic cancer cases have an apparent hereditary background, known as hereditary pancreatic cancer (HPC) and familial pancreatic cancer (FPC), when the genetic basis is unknown. Surveillance of high-risk individuals (HRI) from these families by imaging aims to detect PDAC at an early stage to improve prognosis. However, the genetic basis is unknown in the majority of HRIs, with only around 10–13% of families carrying known pathogenic germline mutations. The aim of this study was to assess an individual’s genetic cancer risk based on sex and personal and family history of cancer. The Best Linear Unbiased Prediction (BLUP) methodology was used to estimate an individual’s predicted risk of developing cancer during their lifetime. The model uses different demographic factors in order to estimate heritability. A reliable estimation of heritability for pancreatic cancer of 0.27 on the liability scale, and 0.07 at the observed data scale as obtained, which is different from zero, indicating a polygenic inheritance pattern of PDAC. BLUP was able to correctly discriminate PDAC cases from healthy individuals and those with other cancer types. Thus, providing an additional tool to assess PDAC risk HRI with an assumed genetic predisposition in the absence of known pathogenic germline mutations.
SETTING: There remains a lack of effective and inexpensive diagnostic tools for active tuberculosis (TB) disease. Testing immune responses to proteins secreted by Mycobacterium tuberculosis, such as ...MPT64, may be a diagnostic option.OBJECTIVE: To evaluate the sensitivity
and specificity of a patch test using MPT64 for the diagnosis of active TB disease.DESIGN: This randomised, double-blind, placebo-controlled, prospective study in Lima, Peru, involved 55 healthy controls and 457 symptomatic individuals referred for routine TB testing by the National TB
Control Programme. All subjects underwent a comprehensive diagnostic workup, and received an active patch on one arm and a placebo patch on the opposite arm, which were read after 4 days.RESULTS: Eighty-one (18%) of the symptomatic participants were classified as having definite TB, while
an additional 98 (21%) had probable TB. The patch tests performed the same in both groups, with a sensitivity of 27% and specificity of 74%. The area under the receiver operating characteristic curve was 0.495 (95%CI 0.425-0.565).CONCLUSIONS: Contrary to existing literature, the
MPT64 patch was not sensitive and specific to detect active TB. Given the potential of the test, understanding possible differences in the protein source or underlying genetic factors should be explored further.
Background
Stratification of the severity of infection is currently based on the Sequential Organ Failure Assessment (SOFA) score, which is difficult to calculate outside the ICU. Biomarkers could ...help to stratify the severity of infection in surgical patients.
Methods
Levels of ten biomarkers indicating endothelial dysfunction, 22 indicating emergency granulopoiesis, and six denoting neutrophil degranulation were compared in three groups of patients in the first 12 h after diagnosis at three Spanish hospitals.
Results
There were 100 patients with infection, 95 with sepsis and 57 with septic shock. Seven biomarkers indicating endothelial dysfunction (mid‐regional proadrenomedullin (MR‐ProADM), syndecan 1, thrombomodulin, angiopoietin 2, endothelial cell‐specific molecule 1, vascular cell adhesion molecule 1 and E‐selectin) had stronger associations with sepsis than infection alone. MR‐ProADM had the highest odds ratio (OR) in multivariable analysis (OR 11·53, 95 per cent c.i. 4·15 to 32·08; P = 0·006) and the best area under the curve (AUC) for detecting sepsis (0·86, 95 per cent c.i. 0·80 to 0·91; P < 0·001). In a comparison of sepsis with septic shock, two biomarkers of neutrophil degranulation, proteinase 3 (OR 8·09, 1·34 to 48·91; P = 0·028) and lipocalin 2 (OR 6·62, 2·47 to 17·77; P = 0·002), had the strongest association with septic shock, but lipocalin 2 exhibited the highest AUC (0·81, 0·73 to 0·90; P < 0·001).
Conclusion
MR‐ProADM and lipocalin 2 could be alternatives to the SOFA score in the detection of sepsis and septic shock respectively in surgical patients with infection.
Antecedentes
La estratificación de la gravedad de una infección se basa actualmente en la puntuación SOFA (Sequential Organ Failure Assessment), que es difícil de calcular fuera de la unidad de cuidados intensivos. Los biomarcadores podrían ayudar a estratificar la gravedad de la infección en pacientes quirúrgicos.
Métodos
Se compararon las concentraciones de 10 biomarcadores que denotan disfunción endotelial, 22 que indican granulopoyesis de emergencia y 6 que expresan la degranulación de neutrófilos en tres grupos de pacientes de tres hospitales españoles (100 con infección, 95 con sepsis y 57 con shock séptico) en las primeras doce horas después del diagnóstico.
Resultados
Siete biomarcadores que expresan disfunción endotelial (proadrenomedulina, sindecan‐1, trombomodulina, angiopoyetina‐2, endocan‐1, molécula de adhesión endotelial 1 y E‐selectina) mostraron una fuerte asociación con la sepsis en comparación con la infección aislada. La proadrenomedulina presentó el valor más alto de la razón de oportunidades (odds ratio, OR) en el análisis multivariable (OR 11,53, i.c. del 95% 4,15‐32,08, P = 0,006) y la mejor área bajo la curva para detectar sepsis (AUC 0,86, i.c. del 95% 0,80‐0,91, P < 0,001). En la comparación entre sepsis y shock séptico, los biomarcadores que mostraron la asociación más estrecha con el shock séptico fueron dos biomarcadores de degranulación de neutrófilos (proteinasa‐3 y lipocalina‐2) (OR 8,09, i.c. del 9% 1,34‐48,91, P = 0,028; OR 6.62, i.c. del 95% 2,47‐17,77, P = 0,002), pero la lipocalina‐2 presentó la mejor AUC (0,81, i.c. del 95% 0,73‐0,90, P < 0,001).
Conclusión
la proadrenomedulina y la lipocalina‐2 podrían representar alternativas a la puntuación SOFA para detectar sepsis y shock séptico en pacientes quirúrgicos con infección.
In surgical patients, endothelial dysfunction is an early indicator differentiating sepsis from simple infection, whereas neutrophil degranulation is an early indicator differentiating septic shock from sepsis. Mid‐regional proadrenomedullin and lipocalin 2 are the most representative biomarkers of sepsis and septic shock respectively.
Useful biomarkers that merit validation elsewhere.
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