The immense advances in computer power achieved in the last decades have had a significant impact in Earth science, providing valuable research outputs that allow the simulation of complex natural ...processes and systems, and generating improved forecasts. The development and implementation of innovative geoscientific software is currently evolving towards a sustainable and efficient development by integrating models of different aspects of the Earth system. This will set the foundation for a future digital twin of the Earth. The codification and update of this software require great effort from research groups and therefore, it needs to be preserved for its reuse by future generations of geoscientists. Here, we report on Geo-Soft-CoRe, a Geoscientific Software & Code Repository, hosted at the archive DIGITAL.CSIC. This is an open source, multidisciplinary and multiscale collection of software and code developed to analyze different aspects of the Earth system, encompassing tools to: 1) analyze climate variability; 2) assess hazards, and 3) characterize the structure and dynamics of the solid Earth. Due to the broad range of applications of these software packages, this collection is useful not only for basic research in Earth science, but also for applied research and educational purposes, reducing the gap between the geosciences and the society. By providing each software and code with a permanent identifier (DOI), we ensure its self-sustainability and accomplish the FAIR (Findable, Accessible, Interoperable and Reusable) principles. Therefore, we aim for a more transparent science, transferring knowledge in an easier way to the geoscience community, and encouraging an integrated use of computational infrastructure.
Systematic Review Registration
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The SARS-CoV-2 Omicron variant emerged showing higher transmissibility and possibly higher resistance to current COVID-19 vaccines than other variants dominating the global pandemic. In March 2020 we ...performed a study in clinical samples, where we found that a portion of genomes in the SARS-CoV-2 viral population accumulated deletions immediately before the S1/S2 cleavage site (furin-like cleavage site, PRRAR/S) of the spike gene, generating a frameshift and appearance of a premature stop codon. The main aim of this study was to determine the frequency of defective deletions in prevalent variants from the first to sixth pandemic waves in our setting and discuss whether the differences observed might support epidemiological proposals. The complete SARS-CoV-2 spike gene was deeply studied by next-generation sequencing using the MiSeq platform. More than 90 million reads were obtained from respiratory swab specimens of 78 COVID-19 patients with mild infection caused by the predominant variants circulating in the Barcelona city area during the six pandemic waves: B.1.5, B.1.1, B.1.177, Alpha, Beta, Delta, and Omicron. The frequency of defective genomes found in variants dominating the first and second waves was similar to that seen in Omicron, but differed from the frequencies seen in the Alpha, Beta and Delta variants. The changing pattern of mutations seen in the various SARS-CoV-2 variants driving the pandemic waves over time can affect viral transmission and immune escape. Here we discuss the putative biological effects of defective deletions naturally occurring before the S1/S2 cleavage site during adaption of the virus to human infection.
Survival in Copd Patients with Long-Term Oxygen Therapy García García, María Del Carmen; Hernández Borge, Jacinto; García García, Gema María ...
Open respiratory archives,
2021 Oct-Dec, 20211001, Letnik:
3, Številka:
4
Journal Article
Recenzirano
Continuous home oxygen therapy (CHOT), along with smoking cessation, is the first treatment that has been shown to increase the survival of patients with chronic obstructive pulmonary disease (COPD) ...and chronic hypoxemia.
To determine survival in a cohort of COPD patients receiving CHOT and to analyze the main causes and risk factors associated with their mortality.
Prospective study of a cohort of COPD patients receiving CHOT. Numerous variables, including survival and cause of death at the end of follow-up, were collected.
A total of 409 COPD patients receiving CHOT were included (85.6% men; mean age: 71.27 ± 9.74 years). Mean time of CHOT follow-up was 5.86 ± 3.24 years and median survival was 6 years (95% CI: 5.47-6.53). Mortality at the end of follow-up was 75.8%, the leading cause of death being respiratory (36.9%). Longer survival was significantly associated with lower age, correct CHOT compliance, absence of exacerbations in the previous year, use of long-acting anticholinergics (LAMA), less severe COPD, presence of sleep apnea-hypopnea syndrome/obesity hypoventilation syndrome (SAHS/SHO), absence of malignant disease, heart disease, cerebrovascular disease, and kidney disease.
The survival of COPD patients receiving CHOT was very long. The main causes of mortality were respiratory (36.9%). Independent predictors of mortality were age, presence of exacerbations in the previous year, previous diagnosis of cancer, and presence of cerebrovascular and renal disease.
La oxigenoterapia continua domiciliara (OCD) es el primer tratamiento que ha demostrado aumentar la supervivencia de los pacientes con enfermedad pulmonar obstructiva crónica (EPOC) e hipoxemia ...crónica, junto con el abandono del consumo de tabaco.
Conocer la supervivencia de una cohorte de pacientes con EPOC en OCD y analizar las principales causas y factores de riesgo que pueden relacionarse con su mortalidad.
Estudio prospectivo de una cohorte de pacientes EPOC en OCD. Se han recogido numerosas variables, además de la situación vital y causas de la muerte al final del seguimiento.
Se han incluido 409 pacientes EPOC en OCD (85,6% varones; edad media: 71,27 ± 9,74 años). La media de seguimiento en OCD fue de 5,86 ± 3,24 años y la mediana de supervivencia de 6 años (IC95%: 5,47-6,53). La mortalidad al final del seguimiento fue de un 75,8%, siendo la principal causa de muerte de origen respiratorio (36,9%). Una mayor supervivencia se relacionó de manera significativa con una menor edad, cumplimiento correcto OCD, ausencia de exacerbaciones el año previo, empleo de anticolinérgico de larga duración (LAMA), menor severidad de la EPOC, presencia de síndrome apnea-hipopnea del sueño/síndrome hipoventilación-obesidad (SAHS/SHO), ausencia de neoplasias, cardiopatía, enfermedad cerebrovascular y renal.
La supervivencia de los pacientes EPOC en OCD fue muy prolongada. Las principales causas de mortalidad han sido de origen respiratorio (36,9%). Fueron predictores independientes de mortalidad la edad, la presencia de exacerbaciones el año previo, el diagnóstico previo de cáncer, la presencia de enfermedad cerebrovascular y renal.
Continuous home oxygen therapy (CHOT), along with smoking cessation, is the first treatment that has been shown to increase the survival of patients with chronic obstructive pulmonary disease (COPD) and chronic hypoxemia.
To determine survival in a cohort of COPD patients receiving CHOT and to analyze the main causes and risk factors associated with their mortality.
Prospective study of a cohort of COPD patients receiving CHOT. Numerous variables, including survival and cause of death at the end of follow-up, were collected.
A total of 409 COPD patients receiving CHOT were included (85.6% men; mean age: 71.27 ± 9.74 years). Mean time of CHOT follow-up was 5.86 ± 3.24 years and median survival was 6 years (95% CI: 5.47-6.53). Mortality at the end of follow-up was 75.8%, the leading cause of death being respiratory (36.9%). Longer survival was significantly associated with lower age, correct CHOT compliance, absence of exacerbations in the previous year, use of long-acting anticholinergics (LAMA), less severe COPD, presence of sleep apnea-hypopnea syndrome/obesity hypoventilation syndrome (SAHS/SHO), absence of malignant disease, heart disease, cerebrovascular disease, and kidney disease.
The survival of COPD patients receiving CHOT was very long. The main causes of mortality were respiratory (36.9%). Independent predictors of mortality were age, presence of exacerbations in the previous year, previous diagnosis of cancer, and presence of cerebrovascular and renal disease.
Background
Post‐acute Covid‐19 syndrome (PACS) frequently refers to cognitive complaints. It is not yet clear whether there is an association between cognitive symptoms with brain changes or ...neuropsychiatric symptoms. Our aims are 1) to study cross‐sectional and longitudinal MRI brain measures in a cohort of PACS and 2) their association with cognitive performance and mood disturbances.
Method
We performed a prospective single‐center study with 3T‐T1w MRI of 49 PACS patients at a cross‐sectional level. These participants had confirmed SARS‐CoV2 infection, ≥ 8 weeks after symptoms onset and cognitive complaints. All participants completed a comprehensive neuropsychological battery (NPS) and questionnaires assessing depression, anxiety, and subjective cognitive complaints (SCD). We obtained global MRI measures (e.g; gray and white matter volumes and mean cortical thickness) with FreeSurfer. We measured correlations of global MRI measures with SCD, memory and executive function outcomes, anxiety, and depression. All analyses were corrected for multiple comparisons. 44 PACS subjects had a 6‐month follow‐up MRI: in these, we performed longitudinal analyses with Generalized Linear Mixed‐Effects Models to study changes between visits in global MRI measures.
Result
Demographics are shown in Table 1. We did not find any correlation between clinical outcomes (SCD, anxiety, depression) and MRI findings. Visual memory (Rey figure’s recall) and cognitive interference inhibition and processing speed ((Stroop’s color‐word condition) were positively correlated with global gray and white matter volume measures (Figure 1). We did not identify changes in global MRI measures at 6 months in PACS participants.
Conclusion
In PACS, worse visual memory and executive function, but not other clinical outcomes, were associated with lower global structural MRI indexes. We did not observe global longitudinal changes in MRI.
Background
Despite previous studies establishing cognitive impairment as a major complaint in post‐acute COVID‐19 syndrome (PACS), a deeper understanding of the neuropsychological features and ...underlying causes is needed. We aimed to characterize the cognitive profile of patients affected with cognitive PACS and the influence of biological and psychological factors.
Method
We performed a prospective single‐center study. We included participants with confirmed SARS‐CoV‐2 infection and long‐term symptoms ≥ 8 weeks after onset who were referred to our unit because of cognitive complaints. All participants completed a comprehensive neuropsychological battery (NPS) and questionnaires assessing depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), apathy (Starkstein Apathy Scale) and fatigue (Multidimensional Fatigue Inventory) at baseline and +1, +3 and +6 months. We collected blood samples and cerebrospinal fluid (CSF) to obtain biochemical and immunological profiles. Group comparisons, correlations and Principal component analysis (PCA) were performed. Longitudinal analyses are ongoing.
Result
Forty‐nine participants were included (79.6% female, mean age 50.1 (SD 7.9). At the time of assessment, they presented multiple symptoms other than cognitive complaints (88% fatigue, 61% headache, 63% dyspnea, and 10% fever). The NPS showed that executive functions were the most affected (up to 29% of the sample had at least one test altered), followed by memory (at least one test altered in 25%) (Figure 1). On the contrary, language and praxis were preserved. Participants presented with anxiety symptoms (minimal 8.7%, mild in 34.8%, moderate 26.1%, severe 30.4%), depressive symptoms (none 34.8%, mild 26.1%, borderline clinical depression 23.9%, moderate 8.7%, severe 6.5%), and clinically relevant apathy in 64.4%.
The sample presented a mean score of total fatigue of 58 (min 48, max 68), (scores 20‐100). Fever and or moderate/severe anxiety were associated with lower scores in some memory and executive functions subtests (Figure 2). Most of the variability in the sample was explained by executive functions subtests (PCA, Figure 3). Patients presented increased levels of interleukins (IL) IL‐1b, IL‐17a and IL‐18 in CSF compared to controls.
Conclusion
Cognitive PACS predominantly affected executive functions and memory. Fever and moderate/severe anxiety were associated with worse cognitive outcomes. Several inflammatory markers were altered in cognitive PACS.
BackgroundPatients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of ...COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD.MethodsA multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared.ResultsTwo thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, p = 0.031 in asthma patients), (11 vs. 9 days, p = 0.018 in COPD patients); although they also had more comorbidity burden.ConclusionsPatients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.
The rates of exclusive breastfeeding at 6 months in Spain are far from recommended by the World Health Organization, which is 50% by 2025. Evidence of the effectiveness of group interventions in late ...postpartum is limited. The objective of this study was to evaluate the effectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6 months compared to the usual practice in primary care.
Multicentre cluster randomized clinical trial. A total of 434 mother-child dyads who breastfed exclusively in the first 4 weeks of the children's life and agreed to participate were included. The main outcome was exclusive breastfeeding at 6 months. Secondary variables were type of breastfeeding, reasons for abandonment, degree of adherence and satisfaction with the intervention. To study the effectiveness, the difference in the proportions of dyads with exclusive breastfeeding at 6 months was calculated, and the relative risk (RR) and number needed to treat (NNT) were calculated with their 95% CIs. To study the factors associated with the maintenance of exclusive breastfeeding at 6 months, a multilevel logistic regression model was fitted. All analyses were performed to intention to treat.
The percentage of dyads with exclusive breastfeeding at 6 months was 22.4% in the intervention group and 8.8% in the control group. PROLACT intervention obtained an RR =2.53 (95% CI: 1.54-4.15) and an NNT = 7 (95%CI: 5-14). The factors associated with exclusive breastfeeding at 6 months were the PROLACT intervention, OR = 3.51 (95%CI: 1.55-7.93); age > 39 years, OR = 2.79 (95%CI: 1.02-7.6); previous breastfeeding experience, OR = 2.61 (95%CI: 1.29-5.29); income between 500 and 833.33 €, OR = 3.52 (95%CI 1.47-8.47).); planning to start work before the infant was 6 months old, OR = 0.35 (0.19-0.63) .
The PROLACT intervention in primary care is more effective than the usual practice for maintaining exclusive breastfeeding at 6 months, and can therefore be considered evidence-based practice for implementation in standard practice.
The trial was registered with ClinicalTrials.gov under code number NCT01869920 (03/06/2013).
The role of repeat kidney biopsy in lupus nephritis (LN) with renal remission is unclear. The aim of this study was to assess this role in a real-life scenario. This retrospective, single-centre ...study included 56 patients with LN diagnosed from 1998 to 2019, with an initial kidney biopsy (KB1) at the onset of LN and a second kidney biopsy (KB2) after achieving renal remission. A total of 51 (91.1%) patients were women with a median age of 29.9 years interquartile range (IQR) 23.4-40.6 at the time of LN diagnosis. KB2s were performed after 41.1 months (IQR 30.1-52.5) of KB1. At the time of KB2, complete renal response was achieved in 51 (91.1%) patients. The median activity index decreased from a baseline value of 6.5 (IQR 2.8-11) to 0 (IQR 0-2) (
< .001). The chronicity index worsened from 1 (IQR 0-2) to 2 (IQR 1-3) (
= .01). In patients with proliferative/mixed forms at KB2, the chronicity index median value increased to 3 (IQR 1.5-4), as well as interstitial fibrosis and tubular atrophy Formula: see text25%, from 5.4% to 13.5%. Persistent histological active LN (activity index ≥2) was present in 11 (19.6%) KB2s. There were no differences when comparing immunological parameters between both groups (activity index ≥2 versus <2) at KB2, nor in the percentage of patients who presented renal flare. Immunosuppressive treatment was withdrawn in 35 (62.5%) patients and maintained/switched in 21 (37.5%). Afterward, new renal flare occurred in 9 patients per group (25.7% and 43%, respectively), after a median time of 39 months (IQR 6.5-55) and 7 months (IQR 6-30), respectively. There was no difference in the number of patients who developed chronic kidney disease
= 14 (25%) according to the treatment. In conclusion, KB2 provides valuable information to guide immunosuppressive maintenance therapy.
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