To evaluate the effects of Alimentación Normal con Ajuste de Insulina (ANAIS), a group-based, therapeutic education programme for Type 1 diabetes based on a flexible insulin regimen adjusted to the ...individual's food intake.
Participants with Type 1 diabetes and HbA
levels of 53-86 mmol/mol (7-10%) were recruited from outpatient clinics at a tertiary care centre. They were randomized (using opaque, sealed envelopes, with a 2:1 treatment allocation ratio) to attend the training course immediately (immediate ANAIS; intervention group) or a year later (delayed ANAIS; control group). The main outcome was HbA
level at 1 year. Secondary outcomes included lipid levels, weight, hypoglycaemic events, insulin dose, treatment satisfaction, self-perceived dietary freedom, quality of life and participant-defined goals.
A total of 48 participants were assigned to the intervention group and 32 to the control group. Twelve months after completing the training, adjusted HbA
was not significantly different in the intervention group 64 ± 1.3 vs 68 ± 1.6 mmol/mol (8.0 ±0.1% vs 8.4 ±0.1%); P=0.081. Treatment satisfaction was significantly higher in the intervention group, but no differences were found in hypoglycaemic events, weight, insulin dose or changes in dietary freedom. At 1 year after the intervention, 72% of the participants (vs 33% in the control group; P=0.046) reported exceeding their expectations regarding achievement of their main personal goal.
Promoting dietary freedom and empowering people with Type 1 diabetes through structured education programmes, such as ANAIS, improves treatment satisfaction and self-defined goals. No significant improvement in HbA
level was achieved.
A transient 3-D mathematical model for solar flat plate collectors has been developed. The model is based on setting mass and energy balances on finite volumes. The model allows the comparison of ...different configurations: parallel tubes collectors (PTC), serpentine tube collectors (STC), two parallel plate collectors (TPPC), and other non-usual possibilities like the use of absorbent fluids with semitransparent or transparent plates. Transparent honeycomb insulation between plate and cover can also be modelled. The effect of temperature on the thermal properties of the materials has also been considered. The model has been validated experimentally with a commercial PTC. The model is a useful tool to improve the design of plate solar collectors and to compare different configurations. In order to show the capabilities of the model, the performance of a PTC collector with non-uniformity flow is analysed and compared with experimental data from literature with good agreement.
Mesenchymal stem cells (MSC) have received particular attention due to their ability to inhibit inflammation caused by cytokine storm induced by COVID-19. In this way some patients have been treated ...successfully. The aim of this study was to evaluate the safety and describe the clinical changes after IV administration of allogeneic human umbilical cord MSC (ahUCMSC), in patients with bilateral pneumonia caused by COVID-19, complicated with severe ARDS, as compassionate treatment. This was a pilot, open-label, prospective, longitudinal study. Five patients that did not improve in their clinical conditions after 48 hours of receiving the standard medical management used by the Medical Center and with persistent PaO2/FiO2 less than 100 mmHg were enrolled. ahUCMSC were infused IV, at dose of 1x10
per Kg of body weight over 15 minutes. Patients were monitored after the infusion to detect adverse event. Pa02/FiO2, vital signs, D-dimer, C reactive protein and total lymphocytes were monitored for 21 days after the infusion or until the patient was discharged from the hospital. Descriptive statistics were used with means or medians and standard deviation or interquartile range according to the type of variable. The Wilcoxon's rank-sum was used for stationary samples. Adverse events occurred in three patients and were easily and quickly controlled. Immediately after the infusion of ahUCMSC, constant rise of PaO2/FiO2 was observed in all patients during the first 7 days, with statistical significance. Three patients survived and were extubated on the ninth day post-infusion. Two patients died at 13 and 15 days after infusion. The infusion of ahUCMSC in patients with severe ARDS caused by COVID-19, was safe, and demonstrated its anti-inflammatory capacity in the lungs, by improving the respiratory function expressed by PaO2 / FiO2, which allowed the survival of 3 patients, with extubation at 9 days.
Lupus nephritis (LN) is one of the most common manifestations of systemic lupus erythematosus (SLE), characterized by abnormal B cell activation and differentiation to memory or plasma effector ...cells. However, the role of these cells in the pathogenesis of LN is not fully understood, as well as the effect of induction therapy on B cell subsets, possibly associated with this manifestation, like aged-associated B cells (ABCs). Consequently, we analyzed the molecules defining the ABCs subpopulation (CD11c, T-bet, and CD21) through flow cytometry of blood samples from patients with lupus presenting or not LN, following up a small sub-cohort after six months of induction therapy. The frequency of ABCs resulted higher in LN patients compared to healthy subjects. Unexpectedly, we identified a robust reduction of a CD21
hi
subset that was almost specific to LN patients. Moreover, several clinical and laboratory lupus features showed strong and significant correlations with this undefined B cell subpopulation. Finally, it was observed that the induction therapy affected not only the frequencies of ABCs and CD21
hi
subsets but also the phenotype of the CD21
hi
subset that expressed a higher density of CXCR5. Collectively, our results suggest that ABCs, and more importantly the CD21
hi
subset, may work to assess therapeutic response since the reduced frequency of CD21
hi
cells could be associated with the onset of LN.
► Band gap modification of DLC by oxygen plasma treatment (OPT). ► OPT-DLC as p-layer for a-Si:H p-i-n solar cell. ► Improved efficiency with enhancement in p-layer band gap. ► DLC as hard, ...protective and encapsulate layer for a-Si:H based p-i-n solar cells.
Solar thermal driven cooling systems for residential applications are a promising alternative to electric compression chillers, although its market introduction still represents a challenge, mainly due to the higher investment costs. The most common system configuration is an absorption chiller driven by a solar thermal system, backed up by a secondary heating source, normally a gas boiler. Heat storage in the primary (solar) circuit is mandatory to stabilize and extend the operation of the chiller, whereas a cold storage tank is not so common.
This paper deals with the selection of the most suitable configuration for residential cooling systems with solar energy. In Spain, where cooling needs are usually higher than heating needs, the interest of a reversible heat pump as auxiliary system and a secondary cooling storage are analyzed.
A complete TRNSYS model has been developed to compare a configuration with just hot storage (of typical capacity40L/m2 of solar collector surface) and a configuration with both, hot and cool storages. The most suitable configuration is very sensible to the solar collector area. As the collector area increases, the advantages of a cool storage vanish. Increasing the collector area tends to increase the temperature of the hot storage, leading to higher thermal losses in both the collector and the tank. When the storage volume is concentrated in one tank, these effects are mitigated. The effect of other variables on the optimal configuration are also analyzed: collector efficiency curve, COP of the absorption chiller, storage size, and temperature set-points of the chillers.
At present, the analysis of the performance of air handling units based on desiccant wheels is a complex task for a HVAC&R designer. It is difficult to access a simple model that can represent, with ...enough accuracy, the behaviour of commercialized desiccant wheels operating with variable inlet states and variable airflows.
This work is devoted to investigate the feasibility of a simplified simulation method based on the effectiveness concept. Additionally, an analysis is made of the appropriateness of using a new pair of independent effectiveness parameters instead of the classical approach based on the combined potentials. The first running tests performed with two manufacturers’ software and with a detailed numerical model show that the airflow inlet states have a non negligible influence on the effectiveness parameters. As expected, it is also observed that the effectiveness parameters depend strongly on the airflows rates. So, the effectiveness method based on constant values is not recommended to be used in practise.
A new approach using 2D linear interpolation on an irregular grid to take into account the effectiveness dependence on the inlet states of both airflows is presented. A correlation of exponential type is proposed for predicting the effectiveness parameters in case of variable balanced airflows rates, and it is subsequently tested either separately or combined with 2D linear interpolation approach. The proposed methodology requires a reduced amount of data to model a given desiccant wheel, and the predicted results evidence good accuracy. This approach can be used with great advantages in the generalised dynamic analysis of systems integrating a desiccant wheel including the effects of variable inlet states and of variable balanced airflows rates.
► Investigation of a simplified simulation method based on the effectiveness concept. ► Comparison of predicted results with reference data. ► The proposed approach evidences a good agreement.
► Investigation of a simplified simulation method based on the effectiveness concept. ► Influence of the inlet states on the effectiveness parameters. ► Test of different interpolation procedures. ► ...Good accuracy of the results.
The prediction of the dynamic global behaviour of solid-desiccant air conditioning system continues being a complex task. It is still difficult to get access to a simple model representing with enough accuracy the behaviour of commercialized desiccant wheels.
The present work is focussed on the investigation of the feasibility of different interpolation procedures based on the effectiveness concept to predict the influence of the inlet states of the process and regeneration airflows on the pair of independent effectiveness parameters and, consequently, on the global behaviour of a desiccant wheel. The interpolation procedures require a relatively low number of reference operating cases, which can be obtained experimentally, provided directly by the manufacture or derived by validated software.
A comprehensive set of airflow inlet states is considered, covering the typical range of inlet states in real operating conditions of dehumidification wheels. The output results of the different version of the interpolation procedure are compared with a set of reference data for desiccant wheels having process–regeneration splits of 50–50% and 67–33%. Moreover, the approach is tested using different number of base points to define the interpolation domains for the process and regeneration inlet air states. The results of this study lead to the conclusion that: (i) the version A with only one operating point in each domain, an approach corresponding to the constant effectiveness assumption, is not recommended if it is to cover the whole range of inlet states considered, (ii) good results are obtained if the interpolation is based only on the four basic points defining each domain; (iii) the best agreement is achieved with versions of type B using 6 points in the regeneration air domain, provided that the two additional points refer to the same air temperature and different moisture contents, (iv) the best option is version B1, requiring only a total of 24 operating cases for the interpolation.
The approach can be seen as an easy and quick prediction method of the global behaviour of a real desiccant wheel, suitable to be used in dynamic simulation tools for complete HVAC&R systems like TRNSYS or EnergyPlus.
Potassium voltage-gated channel, subfamily H (eag-related), member 1 (KCNH1) potassium channels are potential tumour markers and cancer therapeutic targets and are up-regulated by oestrogens and ...human papilloma virus (HPV) oncogenes. However, the role of KCNH1 in normal tissues is poorly understood, and its expression in pregnancy is unknown. We wondered whether KCNH1 channels are expressed in cervical cells from pregnant patients and whether progesterone (P4) regulates KCNH1. The association with HPV was also investigated. KCNH1 protein expression was studied by immunocytochemistry in liquid-based cervical cytologies; 93 samples were obtained from pregnant patients at different trimesters, and 15 samples were obtained from non-pregnant women (controls). The presence of HPV was studied by PCR with direct sequencing and nested multiplex PCR. HeLa cervical cancer cells were transfected with human progesterone receptor-B (PR-B) and treated with P4. KCNH1 mRNA expression in these cultures was studied by real-time PCR. KCNH1 protein was detected in 100% of the pregnancy samples and in 26% of the controls. We found 18 pregnant patients infected with HPV and detected 14 types of HPV. There was no association between the percentage of cells expressing KCNH1 and either the presence or type of HPV. P4 induced KCNH1 mRNA and protein expression in cells transfected with human PR-B. No regulation of KCNH1 by P4 was observed in non-transfected cells. We show for the first time the expression of an ion channel during human pregnancy at different trimesters and KCNH1 regulation by P4 in human cells. These data raise a new research field for KCNH1 channels in human tissues.
AbstractIntroduction and objectivesTo analyze the percutaneous revascularization strategy for severe lesions in the secondary branches (SB) (diameter ≥ 2 mm) of major epicardial arteries compared ...with conservative treatment. MethodsThis study analyzed patients with severe SB lesions who underwent percutaneous revascularization treatment compared with patients who received pharmacological treatment. The study examined the percentage of branch-related events (cardiovascular death, myocardial infarction attributable to SB, or the need for revascularization of the SB).ResultsWe analyzed 679 SB lesions (662 patients). After a mean follow-up of 22.2 ± 10.5 months, there were no significant differences between the 2 treatment groups regarding the percentage of death from cardiovascular causes (1.7% vs 0.4%; P= .14), nonfatal acute myocardial infarction (AMI) (1.7% vs 1.7%; P= .96), the need for SB revascularization (4.1% vs 5.4%; P= .45) or in the total percentage of events (5.1% vs 6.3%; P= .54). The variables showing an association with event occurrence on multivariate analysis were diabetes (SHR, 2.87; 95%CI, 1.37-5.47; P= .004), prior AMI (SHR, 3.54; 95%CI, 1.77-7.30; P< .0001), SB reference diameter (SHR, 0.16; 95%CI, 0.03-0.97; P= .047), and lesion length (SHR, 3.77; 95%CI, 1.03-1.13; P< .0001). These results remained the same after the propensity score analysis. ConclusionsThe percentage of SB-related events during follow-up is low, with no significant differences between the 2 treatment strategies. The variables associated with event occurrence in the multivariate analysis were the presence of diabetes mellitus, prior AMI, and greater lesion length.
Familial hypercholesterolemia (FH) remains underdiagnosed and undertreated.
Report the results of the first years (2017-2019) of the Mexican FH registry.
There are 60 investigators, representing 28 ...federal states, participating in the registry. The variables included are in accordance with the European Atherosclerosis Society (EAS) FH recommendations.
To date, 709 patients have been registered, only 336 patients with complete data fields are presented. The mean age is 50 (36-62) years and the average time since diagnosis is 4 (IQR: 2-16) years. Genetic testing is recorded in 26.9%. Tendon xanthomas are present in 43.2%. The prevalence of type 2 diabetes is 11.3% and that of premature CAD is 9.8%. Index cases, male gender, hypertension and smoking were associated with premature CAD. The median lipoprotein (a) level is 30.5 (IQR 10.8-80.7) mg/dl. Statins and co-administration with ezetimibe were recorded in 88.1% and 35.7% respectively. A combined treatment target (50% reduction in LDL-C and an LDL-C <100 mg/dl) was achieved by 13.7%. Associated factors were index case (OR 3.6, 95%CI 1.69-8.73, P = .002), combination therapy (OR 2.4, 95%CI 1.23-4.90, P = .011), type 2 diabetes (OR 2.8, 95%CI 1.03-7.59, P = .036) and age (OR 1.023, 95%CI 1.01-1.05, P = .033).
The results confirm late diagnosis, a lower than expected prevalence and risk of ASCVD, a higher than expected prevalence of type 2 diabetes and undertreatment, with relatively few patients reaching goals. Recommendations include, the use of combination lipid lowering therapy, control of comorbid conditions and more frequent genetic testing in the future.
•Familial hypercholesterolemia remains underdiagnosed and undertreated in Mexico.•We present the results of the Mexican Familial Hypercholesterolemia Registry.•Over 60 investigators in 28 federal states participated in the registry.•We discuss the findings and challenges to overcome in this population.
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