The aim of our study was to evaluate the diagnostic performance of two antigen rapid diagnostic tests (Ag‐RDTs) to diagnose severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. We ...evaluated Panbio and SD‐Biosensor Ag‐RDTs. We employed 186 polymerase chain reaction (PCR) negative samples to evaluate the specificity and 170 PCR positive samples to assess the sensitivity. We evaluated their sensitivity according to Cycle threshold (C
t) values and days post onset of symptoms (d.p.o.). Tests were compared using the McNemar's test. Agreement was evaluated using the kappa score. Specificity was 100% for Panbio and 97.3% for SD‐Biosensor. Sensitivity for samples with C
t ≤ 20 was 100% for both assays and for samples with C
t = 20–25 was 93.0% (Panbio) and 95.3% (SD‐Biosensor) (p = 1.000). Sensitivity decreased for samples wit C
t = 25–30 (Panbio: 41.3%, SD‐Biosensor: 52.2%, p = 0.125) and samples with C
t ≥ 30 (Panbio: 5.0%, SD‐Biosensor: 17.5%, p = 0.063). Sensitivity within seven d.p.o. was 87.7% for Panbio and 90.4% for SD‐Biosensor and notably decreased after seven d.p.o. Agreement with PCR was excellent for high viral load samples (C
t ≤ 25): Panbio, 98.9%, kappa = 0.974; SD‐Biosensor, 97.4%, kappa = 0.940. Agreement between Ag‐RDTs was excellent (94.9%, kappa = 0.882). Panbio and SD‐Biosensor Ag‐RDTs showed excellent agreement and diagnostic performance results for samples with high viral loads (C
t ≤ 25) or samples within seven d.p.o.
Highlights
Panbio and SD‐Biosensor Ag‐RDTs are reliable to diagnose SARS‐CoV‐2 infection.
They showed high specificity: 100% (Panbio) and 97.3% (SD‐Biosensor).
Sensitivity for samples with Ct ≤ 20 was 100% and for samples with Ct ≤ 25 was over 93%.
Their sensitivity was over 87% within 7 days after symptoms onset. Agreement between them was excellent (agreement = 94.9%, kappa = 0.882).
Chronic kidney disease (CKD) affects 11-13% of the world population. The main risk factors for CKD include diabetes, hypertension, and obesity. Metabolic syndrome (MS) is associated with the onset of ...CKD in the nondiabetic population. Obesity and MS are also risk factors for a worse progression of established CKD. Therapeutic exercise is an effective option to treat and manage obesity, MS, and diabetes in the general population. However, the evidence on the effect of exercise on patients with CKD, obesity, and MS is scarce.
We evaluated available evidence on the effect of therapeutic exercise in patients with CKD, excluding dialysis, particularly in improving the metabolic risk factors and main renal outcomes: renal function loss and albuminuria/proteinuria. This review includes prospective studies and clinical trials. A total of 44 studies were analysed in 1,700 subjects with renal disease (2-5), including patients with renal transplantation. Most studies did not prove a major effect of exercise on albuminuria/proteinuria, glomerular filtration rate (GFR), obesity, or MS. These results are intriguing and deserve attention. The exploratory nature of most studies, including a low number of cases and short follow-up, might explain the lack of efficacy of exercise in our analysis. Specific aspects like the type of exercise, frequency, intensity, duration, accommodation during follow-up, individualization, safety, and adherence are crucial to the success of therapeutic exercise. The beneficial role of exercise in patients with CKD remains to be determined.
Key messages of this review are as follows. (1) The effect of therapeutic exercise on renal and metabolic outcomes in patients with CKD remains to be determined. (2) According to the evidence selected, therapeutic exercise seems to be safe to treat patients with CKD. (3) Most studies are exploratory by nature, with results that need further investigation. (4) Therapeutic exercise is a complex procedure that must be specifically designed to treat patients with CKD.
Abstract
COVID-19 has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection ...in serum as a severity biomarker in COVID-19. Retrospective observational study including 193 patients admitted for COVID-19. Detection of SARS-CoV-2 RNA in serum (viremia) was performed with samples collected at 48–72 h of admission by two techniques from Roche and Thermo Fischer Scientific (TFS). Main outcome variables were mortality and need for ICU admission during hospitalization for COVID-19. Viremia was detected in 50–60% of patients depending on technique. The correlation of Ct in serum between both techniques was good (intraclass correlation coefficient: 0.612; p < 0.001). Patients with viremia were older (p = 0.006), had poorer baseline oxygenation (PaO
2
/FiO
2
; p < 0.001), more severe lymphopenia (p < 0.001) and higher LDH (p < 0.001), IL-6 (p = 0.021), C-reactive protein (CRP; p = 0.022) and procalcitonin (p = 0.002) serum levels. We defined "relevant viremia" when detection Ct was < 34 with Roche and < 31 for TFS. These thresholds had 95% sensitivity and 35% specificity. Relevant viremia predicted death during hospitalization (OR 9.2 3.8–22.6 for Roche, OR 10.3 3.6–29.3 for TFS; p < 0.001). Cox regression models, adjusted by age, sex and Charlson index, identified increased LDH serum levels and relevant viremia (HR = 9.87 4.13–23.57 for TFS viremia and HR = 7.09 3.3–14.82 for Roche viremia) as the best markers to predict mortality. Viremia assessment at admission is the most useful biomarker for predicting mortality in COVID-19 patients. Viremia is highly reproducible with two different techniques (TFS and Roche), has a good consistency with other severity biomarkers for COVID-19 and better predictive accuracy.
The development of effective array biosensors relies heavily on careful control of the density of surface-immobilized ligands on the transducing platform. In this paper we describe the synthesis of ...new dextran–lipase conjugates for use in immobilizing low molecular weight haptens onto glass planar waveguides for immunosensor development. The conjugates were synthesized by immobilizing bacterial thermoalkalophilic lipases (Geobacillus thermocatenulatus lipase 2, BTL2) on agarose macroporous beads, followed by covalent coupling to dextran networks of variable molecular weight (1500–40000). The chimeras were immobilized via nonspecific hydrophobic interactions onto glass planar waveguides modified with 1,1,1,3,3,3-hexamethyldisilazane to obtain highly ordered and homogeneous molecular architectures as confirmed by atomic force microscopy. Microcystin LR (MCLR) was covalently bound to the dextran–BTL2 conjugates. The usefulness of this approach in immunosensor development was demonstrated by determining amounts of MCLR down to a few picograms per liter with an automated array biosensor and evanescent wave excitation for fluorescence measurements of attached DyLight649-labeled secondary antibody. Modifying BTL2 with dextrans of an increased molecular weight (>6000) provided surfaces with an increased loading capacity that was ascribed to the production of three-dimensional surfaces by the effect of analyte binding deep in the volume, leading to expanded dynamic ranges (0.09–136.56 ng L–1), lower limits of detection (0.007 ± 0.001 ng L–1), and lower IC50 values (4.4 ± 0.7 ng L–1). These results confirm the effectiveness of our approach for the development of high-performance biosensing platforms.
Arrays of polymer/SWCNT (single‐wall carbon nanotube) nanowires supported on a residual nanocomposite film are prepared by melt wetting using porous anodic aluminum oxide (AAO) as a template. The ...aggregation parameter of SWCNTs extracted from the analysis of their Raman radial breathing modes gives the highest value for native SWCNTs, indicating that they tend to organize into bundles giving rise to a high degree of aggregation. However, the lowest value achieved at the interface between the nanocomposite film and the nanoarray is explained considering that the forces acting during infiltration are able to disrupt the SWCNT bundles inducing nanotube dispersion. In addition, scanning the nanoarrays along the nanowires length by Raman microscopy has shown a diameter selection of SWCNTs by the AAO membrane. The results reported in this work reveal that it is possible to fabricate arrays of nanowires with homogeneous SWCNT distribution along tens of microns, optimizing nanotube dispersion.
One‐dimensional nanoarrays consisting of polymer/SWCNT (single‐wall carbon nanotube) nanowires with homogeneous SWCNT distribution along tens of microns are prepared by melt wetting. Raman microscopy studies indicate that the use of an anodic aluminum oxide (AAO) membrane allows the selection of SWCNTs by their diameter PBT: poly(butylene terephthalate).
Sleep-time blood pressure (BP) is a stronger risk factor for cardiovascular disease (CVD) events than awake and 24 h BP means, but the potential role of asleep BP as therapeutic target for ...diminishing CVD risk is uncertain. We investigated whether CVD risk reduction is most associated with progressive decrease of either office or ambulatory awake or asleep BP mean.
We prospectively evaluated 18 078 individuals with baseline ambulatory BP ranging from normotension to hypertension. At inclusion and at scheduled visits (mainly annually) during follow-up, ambulatory BP was measured for 48 consecutive hours. During the 5.1-year median follow-up, 2311 individuals had events, including 1209 experiencing the primary outcome (composite of CVD death, myocardial infarction, coronary revascularization, heart failure, and stroke). The asleep systolic blood pressure (SBP) mean was the most significant BP-derived risk factor for the primary outcome hazard ratio 1.29 (95% CI) 1.22-1.35 per SD elevation, P < 0.001, regardless of office 1.03 (0.97-1.09), P = 0.32, and awake SBP 1.02 (0.94-1.10), P = 0.68. Most important, the progressive attenuation of asleep SBP was the most significant marker of event-free survival 0.75 (95% CI 0.69-0.82) per SD decrease, P < 0.001, regardless of changes in office 1.07 (0.97-1.17), P = 0.18, or awake SBP mean 0.96 (0.85-1.08), P = 0.47 during follow-up.
Asleep SBP is the most significant BP-derived risk factor for CVD events. Furthermore, treatment-induced decrease of asleep, but not awake SBP, a novel hypertension therapeutic target requiring periodic patient evaluation by ambulatory monitoring, is associated with significantly lower risk for CVD morbidity and mortality.
For the implementation of femtosecond (fs) laser cleaning methodologies of light-sensitive substrates as those encountered in artistic paintings, the interaction between fs laser pulses and painting ...components has to be well characterized. In this work, the modifications induced by fs laser irradiation of paints are examined in unvarnished aged model temperas. Irradiation at fluences below or above the ablation thresholds by 120
fs pulses at 795
nm from a Ti:Sapphire laser of unpigmented and traditional artist's pigment temperas (cinnabar and chrome yellow) is shown to result in various degrees of discolouration and changes of the laser-induced fluorescence signal. Fourier transform FT-Raman (at 1064
nm) and micro-Raman (at 785
nm) spectroscopic measurements were carried out to assess the changes induced. Noticeable modifications of the Raman bands of the pigments are absent while build-up of extra bands of amorphous carbon (indicative of carbonization or charring) does not take place, in contrast with previous observations upon irradiation with 248
nm, 25
ns pulses. It is concluded that IR fs irradiation provides a high degree of control over the induced modifications, a feature of interest in the design of new laser restoration schemes.
This study aims to analyze the effects of supercritical carbonation (CO2 at 20 MPa and 318 K) on the physicochemical properties of ordinary Portland cement pastes. The evolution of the main ...crystalline phases of the cement pastes during carbonation was determined by means of X-ray diffraction and thermogravimetric analysis. The pore structure was analyzed by low-temperature N2 adsorption−desorption and mercury intrusion porosimetry techniques. Finally, the microstructure of the samples was observed by using scanning electron microscopy coupled with energy-dispersive X-ray detection for chemical analysis. For a natural carbonation process, diffusion of CO2 into the pores of the cement paste is considered as the rate-controlling step. Instead, the accelerated reaction kinetics of calcium carbonate precipitation in the supercritical process was chemically controlled by the detachment of calcium ions from solid portlandite or CSH gel. The total pore volume of the studied cement pastes decreased with carbonation, which was associated with the deposition of the formed CaCO3. Samples carbonated under the supercritical conditions developed a higher volume of gel pores than those obtained by natural carbonation.
El título del libro es un resumido anticipo de sus componentes esenciales; esto es, las respuestas jurídicas a la corrupción política direccionadas hacia la doble dimensión de dicha corrupción que va ...desde la contabilidad irregular en procesos electorales a los delitos de financiación ilegal de los partidos políticos. Ello posibilita una puesta en escena de múltiples posibilidades. La corrupción en general, y la política en particular, en sus diversas manifestaciones, se muestran como una especie de monstruo de las mil cabezas adaptado perfectamente a las más heterogéneas formas y maneras de convivencia ciudadana; universal en cuanto a su presencia y desarrollo, aparece igual, sin atención a los regímenes políticos existentes en los diversos países obviamente sobre contestaciones muy diferentes; no está afecto o integrado en una determinada ideología, pero convive con la mayoría de ellas. Como fenómeno social negativo afecta a la propia credibilidad del sistema, en cuanto semejante corrupción es la muestra, posiblemente con mayor dimensión, de dañinas perturbaciones a los principios más básicos del orden constitucional democrático. En consecuencia, requiere de respuestas contundentes, imaginativas y solidariamente compartidas. En esta obra, desde una perspectiva realista y, fundamentalmente, jurídica, pluridisciplinar y valorativa, se plantean las cuestiones de mayor relevancia en relación a la corrupción política, tanto sobre ella desde un planteamiento general, como en lo concreto acerca de procesos electorales y corrupción, financiación ilegal de los partidos políticos, prevención, personas y consecuencias jurídicas, procedimiento procesal, fiscalidad, contratación y acceso a la función pública, delitos de carácter instrumental -cohecho, blanqueo de capitales, malversación propia, tráfico de influencias-, perspectiva comparada de política criminal. Todo esto concluye con un amplio epígrafe dedicado a resultados de la investigación y propuestas de lege ferenda, a manera de conclusiones. Se construye de tal forma un sólido armazón científico, dogmático, práctico y político criminal que ha de servir como oferta unificada de lucha contra la plaga corrupta.
In this work, femtosecond (fs) laser irradiation of ancient parchment is evaluated as a novel cleaning technique that, in comparison with nanosecond (ns) irradiation, could considerably reduce the ...thermal and chemical damage to the substrate. To investigate the interaction of ultrashort laser pulses with parchment, two historical specimens were exposed to Ti:Sapphire laser using the fundamental and second harmonic emission (795 and 398
nm, 120
fs pulses). The ablation threshold fluences were determined resulting in values of 1.1 and 0.15
J/cm
2 at 795 and 398
nm respectively. A study of the effects of the fs laser–parchment interaction as a function of fluence and wavelength was carried out and the results were compared with those obtained for Nd:YAG laser irradiation (532 and 355
nm, pulse duration 6
ns). FT-Raman spectra show the disappearance of the amorphous carbon bands upon fs treatment, indicative of the removal of the carbonaceous contamination of the parchment. At the same time the parchment structural bands remain unaffected. Spectrofluorimetric measurements reveal an enhancement of photodegradation products in the substrate. Results are discussed in terms of the comparison between expected mechanisms operating in the fs and ns irradiation regimes.
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