1
|
Huang V, Roem J, Ng DK, McElrath Schwartz J, Everett AD, Padmanabhan N, Romero D, Joe J, Campbell C, Sigal GB, Wohlstadter JN, Bembea MM. Exploratory factor analysis yields grouping of brain injury biomarkers significantly associated with outcomes in neonatal and pediatric ECMO. Sci Rep 2024; 14:10790. [PMID: 38734737 PMCID: PMC11088671 DOI: 10.1038/s41598-024-61388-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024] Open
Abstract
In this two-center prospective cohort study of children on ECMO, we assessed a panel of plasma brain injury biomarkers using exploratory factor analysis (EFA) to evaluate their interplay and association with outcomes. Biomarker concentrations were measured daily for the first 3 days of ECMO support in 95 participants. Unfavorable composite outcome was defined as in-hospital mortality or discharge Pediatric Cerebral Performance Category > 2 with decline ≥ 1 point from baseline. EFA grouped 11 biomarkers into three factors. Factor 1 comprised markers of cellular brain injury (NSE, BDNF, GFAP, S100β, MCP1, VILIP-1, neurogranin); Factor 2 comprised markers related to vascular processes (vWF, PDGFRβ, NPTX1); and Factor 3 comprised the BDNF/MMP-9 cellular pathway. Multivariable logistic models demonstrated that higher Factor 1 and 2 scores were associated with higher odds of unfavorable outcome (adjusted OR 2.88 [1.61, 5.66] and 1.89 [1.12, 3.43], respectively). Conversely, higher Factor 3 scores were associated with lower odds of unfavorable outcome (adjusted OR 0.54 [0.31, 0.88]), which is biologically plausible given the role of BDNF in neuroplasticity. Application of EFA on plasma brain injury biomarkers in children on ECMO yielded grouping of biomarkers into three factors that were significantly associated with unfavorable outcome, suggesting future potential as prognostic instruments.
Collapse
Affiliation(s)
- Victoria Huang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Suite 6321, Baltimore, MD, 21287, USA
| | - Jennifer Roem
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Derek K Ng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jamie McElrath Schwartz
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Suite 6321, Baltimore, MD, 21287, USA
| | - Allen D Everett
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | | | | | | | - Melania M Bembea
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Suite 6321, Baltimore, MD, 21287, USA.
| |
Collapse
|
2
|
Granda P, Villamañán E, Heinz S, Laorden D, Romero D, Añón JM, Carpio C, Sobrino C, Collada V, Domínguez-Ortega J, Herrero A, Quirce S, Álvarez-Sala R. Compassionate Use of Reslizumab in a Life-threatening Asthma Exacerbation. J Investig Allergol Clin Immunol 2024; 34:60-61. [PMID: 37357596 DOI: 10.18176/jiaci.0920] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Affiliation(s)
- P Granda
- Pharmacy Department, Hospital Central de la Defensa Gómez- Ulla, Madrid, Spain
| | - E Villamañán
- Pharmacy Department, Hospital Universitario La Paz, Madrid, Spain
- IdiPAZ, Madrid, Spain
- Medicine Department, Universidad Autónoma de Madrid, Spain
| | - S Heinz
- Pharmacy Department, Hospital Central de la Defensa Gómez- Ulla, Madrid, Spain
| | - D Laorden
- IdiPAZ, Madrid, Spain
- Pulmonology Department, Hospital Universitario La Paz, Madrid, Spain
| | - D Romero
- IdiPAZ, Madrid, Spain
- Intensive Care Unit, Hospital Universitario La Paz, Instituto de Salud Carlos III, Madrid, Spain
| | - J M Añón
- IdiPAZ, Madrid, Spain
- CIBERES, Instituto de Salud Carlos III, Madrid, Spain
- Allergy Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - C Carpio
- IdiPAZ, Madrid, Spain
- Medicine Department, Universidad Autónoma de Madrid, Spain
- Pulmonology Department, Hospital Universitario La Paz, Madrid, Spain
| | - C Sobrino
- Pharmacy Department, Hospital Universitario La Paz, Madrid, Spain
- IdiPAZ, Madrid, Spain
| | - V Collada
- Pharmacy Department, Hospital Universitario La Paz, Madrid, Spain
- IdiPAZ, Madrid, Spain
| | - J Domínguez-Ortega
- IdiPAZ, Madrid, Spain
- Allergy Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - A Herrero
- Pharmacy Department, Hospital Universitario La Paz, Madrid, Spain
- IdiPAZ, Madrid, Spain
| | - S Quirce
- Allergy Department, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - R Álvarez-Sala
- IdiPAZ, Madrid, Spain
- Medicine Department, Universidad Autónoma de Madrid, Spain
- Pulmonology Department, Hospital Universitario La Paz, Madrid, Spain
| |
Collapse
|
3
|
Kanberg N, Grahn A, Stentoft E, Bremell D, Yilmaz A, Studahl M, Nilsson S, Schöll M, Gostner JM, Blennow K, Zetterberg H, Padmanabhan N, Cohen R, Misaghian S, Romero D, Campbell C, Mathew A, Wang M, Sigal G, Stengelin M, Edén A, Gisslén M. COVID-19 Recovery: Consistent Absence of Cerebrospinal Fluid Biomarker Abnormalities in Patients With Neurocognitive Post-COVID Complications. J Infect Dis 2024; 229:493-501. [PMID: 37874918 PMCID: PMC10873166 DOI: 10.1093/infdis/jiad395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/08/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND To investigate evidence of residual viral infection, intrathecal immune activation, central nervous system (CNS) injury, and humoral responses in cerebrospinal fluid (CSF) and plasma in patients recovering from coronavirus disease 2019 (COVID-19), with or without neurocognitive post-COVID condition (PCC). METHODS Thirty-one participants (25 with neurocognitive PCC) underwent clinical examination, lumbar puncture, and venipuncture ≥3 months after COVID-19 symptom onset. Healthy volunteers were included. CSF and plasma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid and spike antigen (N-Ag, S-Ag), and CSF biomarkers of immune activation and neuronal injury were analyzed. RESULTS SARS-CoV-2 N-Ag or S-Ag were undetectable in all samples and no participant had pleocytosis. We detected no significant differences in CSF and plasma cytokine concentrations, albumin ratio, IgG index, neopterin, β2M, or in CSF biomarkers of neuronal injury and astrocytic damage. Furthermore, principal component analysis (PCA1) analysis did not indicate any significant differences between the study groups in the marker sets cytokines, neuronal markers, or anti-cytokine autoantibodies. CONCLUSIONS We found no evidence of ongoing viral replication, immune activation, or CNS injury in plasma or CSF in patients with neurocognitive PCC compared with COVID-19 controls or healthy volunteers, suggesting that neurocognitive PCC is a consequence of events suffered during acute COVID-19 rather than persistent viral CNS infection or residual CNS inflammation.
Collapse
Affiliation(s)
- Nelly Kanberg
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Grahn
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Erika Stentoft
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Daniel Bremell
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Aylin Yilmaz
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Studahl
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Staffan Nilsson
- Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, United Kingdom
| | - Johanna M Gostner
- Institute of Medical Biochemistry, Biocenter, Medical University of Innsbruck, Innsbruck, Austria
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurodegenerative Disease, Dementia Research Centre, Institute of Neurology, University College London, London, United Kingdom
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute, University College London, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Rachel Cohen
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Daniel Romero
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Anu Mathew
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | - Mingyue Wang
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | - George Sigal
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Arvid Edén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Gisslén
- Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Infectious Diseases, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
4
|
Colque-Bayona M, Laorden D, Romero D, Quirce S, Domínguez-Ortega J. Anti-IL5/5R in the treatment of chronic eosinophilic pneumonia and severe asthma. Eur Ann Allergy Clin Immunol 2024. [PMID: 38223977 DOI: 10.23822/eurannaci.1764-1489.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Affiliation(s)
- M Colque-Bayona
- Department of Allergy, La Paz University Hospital, Madrid, Spain
| | - D Laorden
- Department of Pulmonology, La Paz University Hospital, Madrid, Spain
| | - D Romero
- Department of Pulmonology, La Paz University Hospital, Madrid, Spain
| | - S Quirce
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - J Domínguez-Ortega
- Department of Allergy, La Paz University Hospital, Madrid, Spain
- La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| |
Collapse
|
5
|
Filizzola R, Romero D, Mendez S, Brunstein D, Benitez A. Results of Radical Nephrectomy and Inferior Vena Caval Thrombectomy. J Vasc Surg 2023. [DOI: 10.1016/j.jvs.2023.01.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
|
6
|
Romero D, Jané R. Dynamic Bayesian Model for Detecting Obstructive Respiratory Events by Using an Experimental Model. Sensors (Basel) 2023; 23:3371. [PMID: 37050431 PMCID: PMC10097311 DOI: 10.3390/s23073371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
In this study, we propose a model-based tool for the detection of obstructive apnea episodes by using ECG features from a single lead channel. Several sequences of recurrent apnea were provoked in separate 15-min periods in anesthetized rats during an experimental model of obstructive sleep apnea (OSA). Morphology-based ECG markers and the beat-to-beat interval (RR) were assessed in each sequence. These markers were used to train dynamic Bayesian networks (DBN) with different orders and feature combinations to find a good tradeoff between network complexity and apnea-detection performance. By using a filtering approach, the resulting DBNs were used to infer the apnea probability signal for subsequent episodes in the same rat. These signals were then processed using by 15-s epochs to determine whether epochs were classified as apneic or nonapneic. Our results showed that fifth-order models provided suitable RMSE values, since higher order models become significantly more complex and present worse generalization. A global threshold of 0.2 gave the best overall performance for all combinations tested, with Acc = 81.3%, Se = 69.8% and Sp = 81.5%, using only two parameters including the RR and Ds (R-wave downslope) markers. We concluded that multivariate models using DBNs represent a powerful tool for detecting obstructive apnea episodes in short segments, which may also serve to estimate the number of total events in a given time period.
Collapse
Affiliation(s)
- Daniel Romero
- ESAII Department, Universitat Politècnica de Catalunya—BarcelonaTech (UPC), 08019 Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC-BIST), 08028 Barcelona, Spain
- CIBER of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| | - Raimon Jané
- ESAII Department, Universitat Politècnica de Catalunya—BarcelonaTech (UPC), 08019 Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC-BIST), 08028 Barcelona, Spain
- CIBER of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28029 Madrid, Spain
| |
Collapse
|
7
|
Laorden D, Hernández I, Domínguez-Ortega J, Romero D, Álvarez-Sala R, Quirce S. A real life cohort of Mepolizumab treatment in severe eosinophilic asthma. Eur Ann Allergy Clin Immunol 2023. [PMID: 36927725 DOI: 10.23822/eurannaci.1764-1489.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Summary Background. Mepolizumab, a monoclonal antibody that interacts with IL-5, was the first anti-IL-5 approved for uncontrolled severe eosinophilic asthma. In several randomised, placebo-controlled trials, treatment with mepolizumab has shown a significant improvement in asthma symptoms and the need to use of oral corticosteroids (OCS). Several studies have correlated blood levels of eosinophil cationic protein (ECP) with the degree of eosinophilic inflammation, which could make it an indirect marker of eosinophilic activity. Methods. This was a single-centre retrospective study that included all patients diagnosed with severe eosinophilic asthma under treatment with mepolizumab. We recorded the number of exacerbations, daily prednisone intake, asthma control test scores and forced expiratory volume in the first second. Results. We followed 22 patients, 14 of whom were OCS-dependent with a mean daily dose of 15.85 ± 15.62 mg prednisone. After 12 months, only five continued taking OCS and the mean daily dose was reduced by up to 2.50 ± 3.84 mg (p less than 0.007). The exacerbation rate at baseline was 2.91 ± 2.27 and decreased to 0.82 ± 1.14 in the following year (p less than 0.001). ACT scores increased significantly from 16.00 ± 5.85 to 20.71 ± 4.45 after six months (p = 0.003). We also observed a decrease in ECP from 81.46 ± 43.99 µg/L to 19.12 ± 18.80 µg/L (p > 0.001). Conclusions. These real-life results are consistent with previous clinical trials demonstrating the efficacy and safety of mepolizumab in routine clinical practice for severe uncontrolled eosinophilic asthma. We observed a significant decrease in blood eosinophil counts and in ECP levels, suggesting a reduction in eosinophil activity following mepolizumab treatment.
Collapse
Affiliation(s)
- D Laorden
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - I Hernández
- Department of Allergy, Hospital La Paz, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain.,Pfizer, Spain
| | - J Domínguez-Ortega
- Department of Allergy, Hospital La Paz, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - D Romero
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - R Álvarez-Sala
- Department of Pneumology, Hospital La Paz, Universidad Autónoma de Madrid, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| | - S Quirce
- Department of Allergy, Hospital La Paz, IdiPAZ, and CIBER of Respiratory Diseases, Madrid, Spain
| |
Collapse
|
8
|
Garza-González E, Camacho-Ortiz A, Ponce-de-Leon A, Ortiz-Brizuela E, López-Jácome LE, Colin C, Rojas-Larios F, Newton-Sánchez OA, Echaniz-Aviles G, Carnalla-Barajas MN, Soto A, Bocanegra-Ibarias P, Hernández-Dueñas AMDR, Velázquez-Acosta MDC, Avilés-Benítez LK, Mena-Ramirez JP, Romero D, Mora-Jiménez I, Alcaraz-Espejel M, Feliciano-Guzmán JM, López-García M, Rodriguez-Zulueta P, Quevedo-Ramos MA, Padilla-Ibarra C, Couoh-May CA, Rivera-Ferreira MC, Morales-de-la-Peña CT, Zubiate H, Peralta-Catalán R, Cetina-Umaña CM, Rincón-Zuno J, Perez-Ricardez ML, Hernández-Cordova IY, López-Gutiérrez E, Gil M, Aguirre-Burciaga E, Huirache-Villalobos GS, Munoz S, Barlandas-Rendón NRE, Bolado-Martinez E, Quintanilla-Cazares LJ, Gómez-Choel AC, Lopez L, Tinoco JC, Martínez-Gamboa RA, Molina A, Escalante-Armenta SP, Duarte L, Ruiz-Gamboa LA, Cobos-Canul DI, López D, Barroso-Herrera-y-Cairo IE, Rodriguez-Noriega E, Morfin-Otero R. Bacterial incidence and drug resistance from pathogens recovered from blood, cerebrospinal and pleural fluids in 2019-2020. Results of the Invifar network. PeerJ 2023; 11:e14411. [PMID: 36684666 PMCID: PMC9854381 DOI: 10.7717/peerj.14411] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/27/2022] [Indexed: 01/18/2023] Open
Abstract
Background Antimicrobial resistance is a global concern. Analysis of sterile fluids is essential because microorganisms are defined as significant in most cases. Blood, cerebrospinal, and pleural fluids are frequently received in the microbiology lab because they are associated with considerable rates of morbi-mortality. Knowledge of epidemiology in these samples is needed to choose proper empirical treatments due to the importance of reducing selection pressure. Methods We used retrospective laboratory data of blood, CSF, and pleural fluid collected from patients in Mexico between 2019 and 2020. Each laboratory identified the strains and tested susceptibility using its routine methods. For Streptococcus pneumoniae, a comparative analysis was performed with data from the broth microdilution method. Results Forty-five centers participated in the study, with 30,746 clinical isolates from blood, 2,429 from pleural fluid, and 2,275 from CSF. For blood and CSF, Staphylococcus epidermidis was the most frequent. For blood, among gram negatives, the most frequent was Escherichia coli. Among Enterobacterales, 9.8% of K. pneumoniae were carbapenem-resistant. For S. pneumoniae, similar resistance percentages were observed for levofloxacin, cefotaxime, and vancomycin. For CSF, the most frequent gram-negative was E. coli. In Acinetobacter baumannii, carbapenem resistance was 71.4%. The most frequent species detected for pleural fluid was E. coli; in A. baumannii, carbapenem resistance was 96.3%. Conclusion Gram-negative bacteria, with E. coli most prevalent, are frequently recovered from CSF, blood, and pleural fluid. In S. pneumoniae, the routine, conventional methods showed good agreement in detecting resistance percentages for erythromycin, levofloxacin, and vancomycin.
Collapse
Affiliation(s)
- Elvira Garza-González
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Adrian Camacho-Ortiz
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - Alfredo Ponce-de-Leon
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Edgar Ortiz-Brizuela
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Claudia Colin
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Fabian Rojas-Larios
- Facultad de Medicina, Universidad de Colima and Hospital Regional Universitario de los Servicios de Salud del Estado de Colima, Colima, Mexico
| | - Oscar A. Newton-Sánchez
- Facultad de Medicina, Universidad de Colima and Hospital Regional Universitario de los Servicios de Salud del Estado de Colima, Colima, Mexico
| | | | | | - Araceli Soto
- Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | - Paola Bocanegra-Ibarias
- Facultad de Medicina, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | | | - Juan Pablo Mena-Ramirez
- Hospital General de Zona No.21 IMSS, Centro Universitario de los Altos (CUALTOS), Universidad de Guadalajara, Guadalajara, Mexico
| | - Daniel Romero
- Análisis Bioquímico Clínicos “Louis Pasteur”, Toluca, Mexico
| | | | | | | | | | | | | | | | | | | | | | - Hector Zubiate
- Hospital General Lázaro Cárdenas, ISSSTE, Chihuahua, Mexico
| | | | | | | | | | | | | | - Mariana Gil
- Hospital Regional de Alta Especialidad del Bajío, Leon, Mexico
| | | | | | | | | | | | | | | | | | | | | | | | | | - Lizbeth Duarte
- Centro Integral de Atención a la Salud Sur ISSSTESON, Hermosillo, Mexico
| | | | | | - Dulce López
- Hospital Lic. Adolfo López Mateos, Ciudad Obregón, Mexico
| | | | - Eduardo Rodriguez-Noriega
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Rayo Morfin-Otero
- Hospital Civil de Guadalajara Fray Antonio Alcalde, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| |
Collapse
|
9
|
Arroyo-Morales R, Reques R, Real R, Romero D. Extreme weather event disrupts reproduction of an isolated western spadefoot toad population, Pelobates cultripes (Cuvier, 1829), at its southern range limit. Anim Biodiv Conserv 2022. [DOI: 10.32800/abc.2023.46.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pelobates cultripes can be considered among those amphibians most affected by climate change in Spain. Its long larval period and predicted shorter pond hydroperiods in its temporary breeding ponds may ultimately reduce population recruitment. We conducted surveys during its breeding season 2021–2022 in order to analyse one of the last remaining urban populations in its southern limit (coastal Malaga province). We recorded a decrease in rainfall and an increase in temperature compared to previous years. Although the species shortened its larval period in comparison with that previously reported, no post–metamorphic juveniles were observed. This interruption in reproduc tion highlights the need for improved monitoring of these isolated amphibian populations as it could be an early warning sign of global changes in the Mediterranean region.
Collapse
Affiliation(s)
- R. Arroyo-Morales
- Departamento de Biología Animal, Facultad de Ciencias, Universidad de Málaga, Spain
| | - R. Reques
- rea de Ecología, Facultad de Ciencias, Universidad de Córdoba, Spain
| | - R. Real
- Departamento de Biología Animal, Facultad de Ciencias, Universidad de Málaga, Spain
| | - D. Romero
- Departamento de Biología Animal, Facultad de Ciencias, Universidad de Málaga, Spain
| |
Collapse
|
10
|
Manze M, Kwan A, Jones H, Roberts L, Romero D. P094Sexual and reproductive health advocacy successes, failures, and needs in the US: Perspectives from key stakeholders. Contraception 2022. [DOI: 10.1016/j.contraception.2022.09.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
11
|
Trevijano-Contador N, Torres-Cano A, Carballo-González C, Puig-Asensio M, Martín-Gómez MT, Jiménez-Martínez E, Romero D, Nuvials FX, Olmos-Arenas R, Moretó-Castellsagué MC, Fernández-Delgado L, Rodríguez-Sevilla G, Aguilar-Sánchez MM, Ayats-Ardite J, Ardanuy-Tisaire C, Sanchez-Romero I, Muñoz-Algarra M, Merino-Amador P, González-Romo F, Megías-Lobón G, García-Campos JA, Mantecón-Vallejo MÁ, Alcoceba E, Escribano P, Guinea J, Durán-Valle MT, Fraile-Torres AM, Roiz-Mesones MP, Lara-Plaza I, de Ayala AP, Simón-Sacristán M, Collazos-Blanco A, Nebreda-Mayoral T, March-Roselló G, Alcázar-Fuoli L, Zaragoza O. Global Emergence of Resistance to Fluconazole and Voriconazole in Candida parapsilosis in Tertiary Hospitals in Spain During the COVID-19 Pandemic. Open Forum Infect Dis 2022; 9:ofac605. [PMID: 36467290 PMCID: PMC9709632 DOI: 10.1093/ofid/ofac605] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 11/03/2022] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Candida parapsilosis is a frequent cause of candidemia worldwide. Its incidence is associated with the use of medical implants, such as central venous catheters or parenteral nutrition. This species has reduced susceptibility to echinocandins, and it is susceptible to polyenes and azoles. Multiple outbreaks caused by fluconazole-nonsusceptible strains have been reported recently. A similar trend has been observed among the C. parapsilosis isolates received in the last 2 years at the Spanish Mycology Reference Laboratory. METHODS Yeast were identified by molecular biology, and antifungal susceptibility testing was performed using the European Committee on Antimicrobial Susceptibility Testing protocol. The ERG11 gene was sequenced to identify resistance mechanisms, and strain typing was carried out by microsatellite analysis. RESULTS We examined the susceptibility profile of 1315 C. parapsilosis isolates available at our reference laboratory between 2000 and 2021, noticing an increase in the number of isolates with acquired resistance to fluconazole, and voriconazole has increased in at least 8 different Spanish hospitals in 2020-2021. From 121 recorded clones, 3 were identified as the most prevalent in Spain (clone 10 in Catalonia and clone 96 in Castilla-Leon and Madrid, whereas clone 67 was found in 2 geographically unrelated regions, Cantabria and the Balearic Islands). CONCLUSIONS Our data suggest that concurrently with the coronavirus disease 2019 pandemic, a selection of fluconazole-resistant C. parapsilosis isolates has occurred in Spain, and the expansion of specific clones has been noted across centers. Further research is needed to determine the factors that underlie the successful expansion of these clones and their potential genetic relatedness.
Collapse
Affiliation(s)
- Nuria Trevijano-Contador
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
| | - Alba Torres-Cano
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
| | - Cristina Carballo-González
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
| | - Mireia Puig-Asensio
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-Institut d´Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- Center for Biomedical Research in Network in Infectious Diseases (CIBERINFEC, CB21/13/00009), Instituto de Salud Carlos III, Madrid, Spain
| | - María Teresa Martín-Gómez
- Department of Microbiology, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Emilio Jiménez-Martínez
- Department of Infectious Diseases, Hospital Universitari de Bellvitge-Institut d´Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | - Daniel Romero
- Department of Microbiology, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc Xavier Nuvials
- Intensive Care Unit, Vall D'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roberto Olmos-Arenas
- Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | | | | | | | | | - Josefina Ayats-Ardite
- Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Carmen Ardanuy-Tisaire
- Microbiology Department, Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
- Center for Biomedical Research Network in Respiratory Diseases (CIBERES-CB06/06/0037), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Sanchez-Romero
- Microbiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - María Muñoz-Algarra
- Microbiology Department, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | - Paloma Merino-Amador
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Fernando González-Romo
- Microbiology Department, Hospital Universitario Clínico San Carlos, Madrid, Spain
- Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- Department of Medicine, Universidad Complutense School of Medicine, Madrid, Spain
| | - Gregoria Megías-Lobón
- Department of Clinical Microbiology, Hospital Universitario de Burgos, Burgos, Castilla y León, Spain
| | - Jose Angel García-Campos
- Department of Clinical Microbiology, Hospital Universitario de Burgos, Burgos, Castilla y León, Spain
| | | | - Eva Alcoceba
- Clinical Microbiology Department, Hospital Universitari Son Espases, Mallorca, Spain
| | - Pilar Escribano
- Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Jesús Guinea
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Center for Biomedical Research Network in Respiratory Diseases (CIBERES-CB06/06/0058), Madrid, Spain
| | | | | | - María Pía Roiz-Mesones
- Microbiology Department, Marqués de Valdecilla Universitary Hospital and Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria,Spain
| | - Isabel Lara-Plaza
- Microbiology Department, Marqués de Valdecilla Universitary Hospital and Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria,Spain
| | | | - María Simón-Sacristán
- Microbiology and Parasitology Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Ana Collazos-Blanco
- Microbiology and Parasitology Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Teresa Nebreda-Mayoral
- Microbiology and Immunology Unit, Universitary Clinic Hospital of Valladolid, Valladolid, Spain
| | - Gabriel March-Roselló
- Microbiology and Immunology Unit, Universitary Clinic Hospital of Valladolid, Valladolid, Spain
| | - Laura Alcázar-Fuoli
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
- Center for Biomedical Research in Network in Infectious Diseases (CIBERINFEC-CB21/13/00105), Instituto de Salud Carlos III, Madrid, Spain
| | - Oscar Zaragoza
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto de Salud Carlos III. Carretera Majadahonda-Pozuelo, Madrid, Spain
- Center for Biomedical Research in Network in Infectious Diseases (CIBERINFEC-CB21/13/00105), Instituto de Salud Carlos III, Madrid, Spain
| |
Collapse
|
12
|
Sigal GB, Novak T, Mathew A, Chou J, Zhang Y, Manjula N, Bathala P, Joe J, Padmanabhan N, Romero D, Allegri-Machado G, Joerger J, Loftis LL, Schwartz SP, Walker TC, Fitzgerald JC, Tarquinio KM, Zinter MS, Schuster JE, Halasa NB, Cullimore ML, Maddux AB, Staat MA, Irby K, Flori HR, Coates BM, Crandall H, Gertz SJ, Randolph AG, Pollock NR. Measurement of Severe Acute Respiratory Syndrome Coronavirus 2 Antigens in Plasma of Pediatric Patients With Acute Coronavirus Disease 2019 or Multisystem Inflammatory Syndrome in Children Using an Ultrasensitive and Quantitative Immunoassay. Clin Infect Dis 2022; 75:1351-1358. [PMID: 35213684 PMCID: PMC8903440 DOI: 10.1093/cid/ciac160] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens in blood has high sensitivity in adults with acute coronavirus disease 2019 (COVID-19), but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery). METHODS Plasma was collected from inpatients (<21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n = 36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n = 53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n = 67) or within 24 hours of negative RT-PCR (n = 43). RESULTS Specificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays had 89%/64% sensitivity; sensitivities in patients with concurrent nasopharyngeal swab cycle threshold (Ct) ≤35 were 93%/63%. Antigen concentrations ranged from 1.28-3844 pg/mL (N) and 1.65-1071 pg/mL (S) and correlated with disease severity. In MIS-C, antigens were detected in 3/53 (5.7%) samples (3 N-positive: 1.7, 1.9, 121.1 pg/mL; 1 S-positive: 2.3 pg/mL); the patient with highest N had positive nasopharyngeal RT-PCR (Ct 22.3) concurrent with blood draw. CONCLUSIONS Ultrasensitive blood SARS-CoV-2 antigen measurement has high diagnostic yield in children with acute COVID-19. Antigens were undetectable in most MIS-C patients, suggesting that persistent antigenemia is not a common contributor to MIS-C pathogenesis.
Collapse
Affiliation(s)
| | - Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, and Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Anu Mathew
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | - Janet Chou
- Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Yubo Zhang
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, Massachusetts, USA
| | | | | | - Jessica Joe
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Daniel Romero
- Meso Scale Diagnostics, LLC, Rockville, Maryland, USA
| | | | - Jill Joerger
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
| | - Laura L Loftis
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Stephanie P Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina, USA
| | - Tracie C Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, North Carolina, USA
| | - Julie C Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Keiko M Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Matt S Zinter
- Divisions of Critical Care and Bone Marrow Transplantation, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer E Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Natasha B Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Melissa L Cullimore
- Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Aline B Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, Colorado, USA
| | - Mary A Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, Arkansas, USA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, Michigan, USA
| | - Bria M Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Shira J Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, New Jersey, USA
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, and Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Nira R Pollock
- Department of Laboratory Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | |
Collapse
|
13
|
Romero D, Blanco-Almazán D, Groenendaal W, Lijnen L, Smeets C, Ruttens D, Catthoor F, Jané R. Predicting 6-minute walking test outcomes in patients with chronic obstructive pulmonary disease without physical performance measures. Comput Methods Programs Biomed 2022; 225:107020. [PMID: 35905697 DOI: 10.1016/j.cmpb.2022.107020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 06/20/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Chronic obstructive pulmonary disease (COPD) requires a multifactorial assessment, evaluating the airflow limitation and symptoms of the patients. The 6-min walk test (6MWT) is commonly used to evaluate the functional exercise capacity in these patients. This study aims to propose a novel predictive model of the major 6MWT outcomes for COPD assessment, without physical performance measurements. METHODS Cardiopulmonary and clinical parameters were obtained from fifty COPD patients. These parameters were used as inputs of a Bayesian network (BN), which integrated three multivariate models including the 6-min walking distance (6MWD), the maximum HR (HRmax) after the walking, and the HR decay 3 min after (HRR3). The use of BN allows the assessment of the patients' status by predicting the 6MWT outcomes, but also inferring disease severity parameters based on actual patient's 6MWT outcomes. RESULTS Firstly, the correlation obtained between the estimated and actual 6MWT measures was strong (R = 0.84, MAPE = 8.10% for HRmax) and moderate (R = 0.58, MAPE = 15.43% for 6MWD and R = 0.58, MAPE = 32.49% for HRR3), improving the classical methods to estimate 6MWD. Secondly, the classification of disease severity showed an accuracy of 78.3% using three severity groups, which increased up to 84.4% for two defined severity groups. CONCLUSIONS We propose a powerful two-way assessment tool for COPD patients, capable of predicting 6MWT outcomes without the need for an actual walking exercise. This model-based tool opens the way to implement a continuous monitoring system for COPD patients at home and to provide more personalized care.
Collapse
Affiliation(s)
- Daniel Romero
- Universitat Politecnica de Catalunya · BarcelonaTech (UPC), Barcelona 08019, Spain; Institute for Bioengineering of Catalonia (IBEC-BIST), Barcelona 08019, Spain; Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid 28029, Spain.
| | - Dolores Blanco-Almazán
- Universitat Politecnica de Catalunya · BarcelonaTech (UPC), Barcelona 08019, Spain; Institute for Bioengineering of Catalonia (IBEC-BIST), Barcelona 08019, Spain; Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid 28029, Spain
| | | | | | | | | | | | - Raimon Jané
- Universitat Politecnica de Catalunya · BarcelonaTech (UPC), Barcelona 08019, Spain; Institute for Bioengineering of Catalonia (IBEC-BIST), Barcelona 08019, Spain; Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid 28029, Spain
| |
Collapse
|
14
|
Sohaei D, Ulndreaj A, Mathew A, Campbell C, Stengelin M, Sigal G, Joe J, Romero D, Padmanabhan N, Ren A, Ghorbani A, Soosaipillai A, Kulasingam V, Prassas I, Diamandis EP. Sensitive Serology Measurements in the Saliva of Individuals with COVID-19 Symptoms Using a Multiplexed Immunoassay. J Appl Lab Med 2022; 7:1354-1365. [PMID: 36179121 PMCID: PMC9619505 DOI: 10.1093/jalm/jfac073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022]
Abstract
Background There are numerous benefits to performing salivary serology measurements for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen for coronavirus disease 2019 (COVID-19). Here, we used a sensitive multiplex serology assay to quantitate salivary IgG against 4 SARS-CoV-2 antigens: nucleocapsid, receptor-binding domain, spike, and N-terminal domain. Methods We used single samples from 90 individuals with COVID-19 diagnosis collected at 0 to 42 days postsymptom onset (PSO) and from 15 uninfected control subjects. The infected individuals were segmented in 4 groups (0–7 days, 8–14 days, 15–21 days, and >21 days) based on days PSO, and values were compared to controls. Results Compared to controls, infected individuals showed higher levels of antibodies against all antigens starting from 8 days PSO. When applying cut-offs with at least 93.3% specificity at every time interval segment, nucleocapsid protein serology had the best sensitivity at 0 to 7 days PSO (60% sensitivity [35.75% to 80.18%], ROC area under the curve [AUC] = 0.73, P = 0.034). Receptor-binding domain serology had the best sensitivity at 8 to 14 days PSO (83.33% sensitivity [66.44%–92.66%], ROC AUC = 0.90, P < 0.0001), and all assays except for N-terminal domain had 92% sensitivity (75.03%–98.58%) at >14 days PSO. Conclusions This study shows that our multiplexed immunoassay can distinguish infected from uninfected individuals and reliably (93.3% specificity) detect seroconversion (in 60% of infected individuals) as early as the first week PSO, using easy-to-collect saliva samples.
Collapse
Affiliation(s)
- Dorsa Sohaei
- Department of Laboratory Medicine and Pathobiology, University of Toronto , Toronto, ON , Canada
- Department of Clinical Biochemistry, University Health Network , Toronto, ON , Canada
| | - Antigona Ulndreaj
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital , Toronto, ON , Canada
| | - Anu Mathew
- Meso Scale Diagnostics, LLC , Rockville, MD , USA
| | | | | | - George Sigal
- Meso Scale Diagnostics, LLC , Rockville, MD , USA
| | - Jessica Joe
- Meso Scale Diagnostics, LLC , Rockville, MD , USA
| | | | | | - Annie Ren
- Department of Laboratory Medicine and Pathobiology, University of Toronto , Toronto, ON , Canada
| | - Atefeh Ghorbani
- Department of Laboratory Medicine and Pathobiology, University of Toronto , Toronto, ON , Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital , Toronto, ON , Canada
| | - Antoninus Soosaipillai
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital , Toronto, ON , Canada
| | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto , Toronto, ON , Canada
- Department of Clinical Biochemistry, University Health Network , Toronto, ON , Canada
| | - Ioannis Prassas
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital , Toronto, ON , Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital , Toronto, ON , Canada
| | - Eleftherios P Diamandis
- Department of Laboratory Medicine and Pathobiology, University of Toronto , Toronto, ON , Canada
- Department of Clinical Biochemistry, University Health Network , Toronto, ON , Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital , Toronto, ON , Canada
| |
Collapse
|
15
|
Romero D, Escolano J, Fernández C, Martínez-Toldos JJ, Monera CE, Castilla G, Moyá A. The influence of the Artisan-Verisyse position on the postoperative outcomes: A systematic review and meta-analysis. Indian J Ophthalmol 2022; 70:3213-3221. [PMID: 36018090 DOI: 10.4103/ijo.ijo_880_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Iris-fixated intraocular lens (IOL) is considered a safe and effective option for the correction of aphakia in patients with insufficient capsular support. This systematic review aims to summarize the existing evidence about the Artisan/Verisyse IOLs and to assess the influence of the IOL position on the postoperative outcomes. Three different databases were used for this systematic review and metaanalysis (PubMED, Scopus, and Embase). We searched for case series or clinical trials comparing the prepupillary versus retropupillary Artisan/Verisyse implantation. The statistical analysis was performed with the programming language R (version 3.6.1 2019-07-05). The number of articles included in the meta-analysis was six, with 506 eyes included in total. We found no significant differences in postoperative corrected distance visual acuity (CDVA) (0.309 [0.089-0.528] vs. 0.32 [0.2-0.44]), spherical equivalent (SE) (0.0153 D [-0.362 to 0.393] vs. -0.329 D [-0.62 to - 0.038]), and central corneal cell density (CECD) (1669.85 cells [1605.949-2150.937] vs. 1635.99 cells [1413.64-1858.363]) between the prepupillary and the retropupillary implantation, respectively. There were no significant differences in the rates of cystoid macular edema (CME; 7.70% vs. 9.8%), pupil deformation (4.5% vs. 5.4% retropupillary), or IOL luxation (2.3% and 2.2%). We found little influence of the IOL position in the postoperative analyzed outcomes. Thus, the implant position should be based on the surgeon's technical experience. Double-blind randomized prospective studies would improve the available evidence on the best implant position for the Artisan/Verisyse IOL.
Collapse
Affiliation(s)
- Daniel Romero
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Jaime Escolano
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Cristian Fernández
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | | | - Carlos E Monera
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Germán Castilla
- Department of Ophthalmology, General University Hospital of Elche, Elche, Alicante, Spain
| | - Alejandro Moyá
- Department of Ophthalmology; Department of Statistics, General University Hospital of Elche, Elche, Alicante, Spain
| |
Collapse
|
16
|
Campbell C, Roblin D, Padmanabhan N, Romero D, Joe J, Fathi L, Whiting T, Williamson J, Goodwin P, Mckie C, Deneal A, Greenberg L, Sigal G. Saliva-based SARS-CoV-2 serology using at-home collection kits returned via mail. Sci Rep 2022; 12:14061. [PMID: 35982133 PMCID: PMC9387411 DOI: 10.1038/s41598-022-17057-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 07/20/2022] [Indexed: 12/16/2022] Open
Abstract
Serology provides tools for epidemiologic studies, and may have a role in vaccine prioritization and selection. Automated serologic testing of saliva, especially specimens that are self-collected at home and sent to a laboratory via the mail without refrigeration, could be a highly-scalable strategy for population-wide testing. In this prospective study, non-vaccinated patients were recruited after PCR testing to self-collect saliva and return their specimens via mail. Longitudinal specimens were analyzed in order to monitor seroconversion in the weeks after a diagnostic PCR test for SARS-CoV-2. Diverse users self-collected saliva and returned specimens via mail in compliance with shipping regulations. At our pre-established threshold (0.963 AU/mL), salivary IgG reactivity to full-length spike protein achieved 95.8% sensitivity and 92.4% specificity at 2–4 weeks after diagnostic testing, which is comparable to the typical sensitivity and specificity achieved for serum testing. Reactivity to N antigen also was detected with 92.6% sensitivity and 90.7% specificity at 4–8 weeks after diagnostic testing. Moreover, serologic testing for endemic coronaviruses performed in multiplex with SARS-CoV-2 antigens has the potential to identify samples that may require retesting due to effects of pre-analytical factors. The easy-to-use saliva collection kit, coupled with thresholds for positivity and methods of flagging samples for retest, provides a framework for large-scale serosurveillance of SARS-CoV-2.
Collapse
Affiliation(s)
- Christopher Campbell
- Meso Scale Diagnostics, LLC., Rockville, MD, USA. .,Meso Scale Diagnostics, LLC, 16020 Industrial Drive, Gaithersburg, MD, 20877, USA.
| | - Douglas Roblin
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | | | | | - Jessica Joe
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | - Lily Fathi
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Thomas Whiting
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Jared Williamson
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Paul Goodwin
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | - Charmaine Mckie
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Adrienne Deneal
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - Leslie Greenberg
- Mid-Atlantic Permanente Research Institute, Kaiser Permanente, Rockville, MD, USA
| | - George Sigal
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| |
Collapse
|
17
|
Romero D, Jane R. Detecting Obstructive Apnea Episodes using Dynamic Bayesian Networks and ECG-based Time-Series. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:3273-3276. [PMID: 36085676 DOI: 10.1109/embc48229.2022.9870930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
In this study, we proposed an automatic detector for obstructive apnea episodes using only ECG-based time-series from a single-ECG channel. Several obstructive apnea episodes were provoked for different separated sequences of 15 minutes in anesthetized Sprague-Dawley rats. In this recurrent obstructive sleep apnea (OSA) model, each episode lasted 15s, while the number of total events per sequence was randomly selected. The beat-to-beat interval ( RR) and the R-wave amplitude ( Ra) time-series were extracted and processed for each sequence, and used to train Dynamic Bayesian Networks with different lags. An optimal trade-off between the lag ( L) and RMSE values was considered to select the best model to be used when detecting apnea episodes. The selected models were then used to estimate the occurrence probability of apnea episodes, p(At), by using a filtering approach. Finally, the time-series of the estimated probabilities were post-processed using non-overlapped 15-s epochs, to determine whether they are classified as apneic or non-apneic segments. Results showed that those lagged models with orders greater than 5, presented suitable RMSE values and become more sensitive as the order increased. A detection threshold of 0.2 seems to provide the best apnea detection performance overall, with Acc=0.81, Se=0.83 and Sp=0.79, using two ECG parameters and L=10. Clinical relevance- Dynamic Bayesian Networks represent a powerful tool to develop personalized models for apnea detection and diagnosis in OSA patients.
Collapse
|
18
|
Abstract
BACKGROUND Upward shift in the air conducted (AC) frequency tuning of vestibular evoked myogenic potentials (VEMPs) as an effect of aging is hypothesized to be due to the microstructural stiffening changes in the inner ear. However, with an AC stimulus, it may be possible that the shift in the frequency tuning of VEMPs as an effect of aging may also be due to contributions from the middle ear. PURPOSE The main aim of this study was to examine the effects of age on the frequency tuning of the cervical VEMP (cVEMP) and ocular VEMP (oVEMP) and determine the role of middle ear transmission characteristics in shaping these effects. RESEARCH DESIGN Standard group comparison. STUDY SAMPLE One-hundred seven participants divided in three groups: young adult, middle-age, and older adults with "normal" middle ear and negative history of neurological or vestibular complaints. DATA COLLECTION AND ANALYSES Middle ear measures included static admittance and middle ear resonant frequency. cVEMP and oVEMPs were elicited with AC tone bursts at 500, 750, and 1,000 Hz. RESULTS No significant effect of age was observed on any of the middle ear measures. There was a significant effect of age on the amplitude of the cVEMP, but this effect was frequency specific. The age-related reduction in cVEMP corrected amplitude was only observed when the eliciting stimulus was 500 or 750 Hz, with no significant effect observed with a 1,000 Hz stimulus. For the oVEMP, the effects of age were apparent at all stimulus frequencies. We also observed a general upward shift in the frequency tuning of both the cVEMP and oVEMP for middle-age and older adults, with 750 and 1,000 Hz yielding higher response rates and larger amplitudes among middle-aged and older adults. Measurements of middle ear did not significantly contribute to the observed findings. CONCLUSIONS The upward shift in frequency tuning of VEMPs among middle age and older adults could be due to the changes in the vestibular system and not from the middle ear. These results support the use of different frequency stimuli (i.e., 750 or 1,000 Hz) to elicit a VEMP if a response is absent using a 500 Hz stimulus, especially in patients over the age of 40.
Collapse
Affiliation(s)
- Raghav Hira Jha
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia
| | - Erin G Piker
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia
| | - Daniel Romero
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, Virginia
| |
Collapse
|
19
|
Ren A, Sohaei D, Ulndreaj A, Pons-Belda OD, Fernandez-Uriarte A, Zacharioudakis I, Sigal GB, Stengelin M, Mathew A, Campbell C, Padmanabhan N, Romero D, Joe J, Soosaipillai A, Kulasingam V, Mazzulli T, Li XA, McGeer A, Diamandis EP, Prassas I. Ultrasensitive assay for saliva-based SARS-CoV-2 antigen detection. Clin Chem Lab Med 2022; 60:771-777. [PMID: 35170269 DOI: 10.1515/cclm-2021-1142] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/28/2022] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Widespread SARS-CoV-2 testing is invaluable for identifying asymptomatic/pre-symptomatic individuals. There remains a technological gap for highly reliable, easy, and quick SARS-CoV-2 diagnostic tests suitable for frequent mass testing. Compared to nasopharyngeal (NP) swab-based tests, saliva-based methods are attractive due to easier and safer sampling. Current saliva-based SARS-CoV-2 rapid antigen tests (RATs) are hindered by limited analytical sensitivity. Here, we report one of the first ultrasensitive, saliva-based SARS-CoV-2 antigen assays with an analytical sensitivity of <0.32 pg/mL, corresponding to four viral RNA copies/µL, which is comparable to that of PCR-based tests. METHODS Using the novel electrochemiluminescence (ECL)-based immunoassay, we measured the SARS-CoV-2 nucleocapsid (N) antigen concentration in 105 salivas, obtained from non-COVID-19 and COVID-19 patients. We then verified the results with a second, independent cohort of 689 patients (3.8% SARS-CoV-2 positivity rate). We also compared our method with a widely used point-of-care rapid test. RESULTS In the first cohort, at 100% specificity, the sensitivity was 92%. Our assay correctly identified samples with viral loads up to 35 CT cycles by saliva-based PCR. Paired NP swab-based PCR results were obtained for 86 cases. Our assay showed high concordance with saliva-based and NP swab-based PCR in samples with negative (<0.32 pg/mL) and strongly positive (>2 pg/mL) N antigen concentrations. In the second cohort, at 100% specificity, sensitivity was also 92%. Our assay is about 700-fold more sensitive than the Abbott Panbio Rapid Test. CONCLUSIONS We demonstrated the ultrasensitivity and specificity assay and its concordance with PCR. This novel assay is especially valuable when compliance to frequent swabbing may be problematic.
Collapse
Affiliation(s)
- Annie Ren
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Dorsa Sohaei
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Antigona Ulndreaj
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Oscar D Pons-Belda
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | | | | | | | | | - Anu Mathew
- Meso Scale Diagnostics, LLC. (MSD), Rockville, MD, USA
| | | | | | - Daniel Romero
- Meso Scale Diagnostics, LLC. (MSD), Rockville, MD, USA
| | - Jessica Joe
- Meso Scale Diagnostics, LLC. (MSD), Rockville, MD, USA
| | | | - Vathany Kulasingam
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada
| | - Tony Mazzulli
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Department of Microbiology, University Health Network, Mount Sinai Hospital, Toronto, Canada
| | - Xinliu A Li
- Department of Microbiology, University Health Network, Mount Sinai Hospital, Toronto, Canada
| | - Allison McGeer
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Department of Microbiology, University Health Network, Mount Sinai Hospital, Toronto, Canada
| | - Eleftherios P Diamandis
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
- Department of Clinical Biochemistry, University Health Network, Toronto, ON, Canada
| | - Ioannis Prassas
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Canada
| |
Collapse
|
20
|
Campbell C, Padmanabhan N, Romero D, Joe J, Gebremeskel M, Manjula N, Wohlstadter N, Wohlstadter R, Goodwin P, Quintero L, Debad J, Sigal G, Wohlstadter J. Quantitative serology for SARS-CoV-2 using self-collected saliva and finger-stick blood. Sci Rep 2022; 12:6560. [PMID: 35449177 PMCID: PMC9021827 DOI: 10.1038/s41598-022-10484-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/29/2022] [Indexed: 11/29/2022] Open
Abstract
Convenient and widespread serology testing may alter the trajectory of the COVID-19 pandemic. This study seeks to leverage high-throughput, multiplexed serologic assays, which have been adopted as benchmarks for vaccine efficacy, to support large-scale surveys of SARS-CoV-2 immunity using finger-stick blood and/or saliva. Specifically, we optimized MSD’s serology assays, which were analytically validated for serum, to test self-collected finger-stick blood and saliva samples to identify prior infection. We show that these assays can be used with FDA-registered specimen collection devices to obtain quantitative measurements for self-collected samples. First, we show that salivary antibodies are stable without refrigeration or preservatives for at least 5 days. We selected classification thresholds for antibodies against SARS-CoV-2 N, RBD and Spike in finger-stick blood and saliva that provided 98% specificity in a set of individuals without known COVID-19 exposure. Using matched samples, we show that testing of saliva and finger-stick blood equivalently identified individuals with humoral responses to CoV-2 antigens. Moreover, we piloted a simple saliva collection kit that can be used to safely send samples through the mail using written instructions only. This work establishes key parameters to robustly assay self-collected finger-stick blood and saliva using quantitative immunoassays that could support large-scale serology testing.
Collapse
Affiliation(s)
- Christopher Campbell
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA.
| | - Nikhil Padmanabhan
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Daniel Romero
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Jessica Joe
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Mikias Gebremeskel
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Navaratnam Manjula
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Noah Wohlstadter
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Rachel Wohlstadter
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Paul Goodwin
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Lillian Quintero
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Jeff Debad
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - George Sigal
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| | - Jacob Wohlstadter
- Meso Scale Diagnostics, LLC., 16020 Industrial Drive, Gaithersburg, MD, 20877, USA
| |
Collapse
|
21
|
Galindo G, Navarro J, Reales J, Castro J, Romero D, Rodriguez A. S, Rivera-Royero D. Immigrants resettlement in developing countries: A data-driven decision tool applied to the case of Venezuelan immigrants in Colombia. PLoS One 2022; 17:e0262781. [PMID: 35077473 PMCID: PMC8789124 DOI: 10.1371/journal.pone.0262781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
Immigrants’ choice of settlement in a new country can play a fundamental role in their socio-economic integration. This is especially relevant if there are important gaps among these locations in terms of significant factors such as job opportunities, quality of health service, among others. This research presents a methodology to perform a recommended geographic redistribution of immigrants to improve their chances of socio-economic integration. The proposed methodology adapts a data-driven algorithm developed by the Immigration Policy Lab at Stanford University to allocate immigrants based on a socio-economic integration outcome across available locations. We extend their approach to study the immigration process between two developing countries. Specifically, we focus on the case of the arrival of immigrants from Venezuela to Colombia. We consider the absorptive capacity of locations in Colombia and include the health and education needs of immigrants in our analysis. From the application in the Venezuelan-Colombian context, we find that the proposed redistribution increases the probability that immigrants access formal employment by more than 50%. Furthermore, we identify variables associated with immigrants’ formal employment and discuss specific strategies to improve the probability of success of vulnerable immigrants.
Collapse
Affiliation(s)
- Gina Galindo
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
- * E-mail:
| | - Jose Navarro
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
| | - Jhonattan Reales
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
| | - Jhoan Castro
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
| | - Daniel Romero
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
| | | | - Daniel Rivera-Royero
- Department of Industrial Engineering, Universidad del Norte, Barranquilla, Colombia
| |
Collapse
|
22
|
Sigal GB, Novak T, Mathew A, Chou J, Zhang Y, Manjula N, Bathala P, Joe J, Padmanabhan N, Romero D, Allegri-Machado G, Joerger J, Loftis LL, Schwartz SP, Walker TC, Fitzgerald JC, Tarquinio KM, Zinter MS, Schuster JE, Halasa NB, Cullimore ML, Maddux AB, Staat MA, Irby K, Flori HR, Coates BM, Crandall H, Gertz SJ, Randolph AG, Pollock NR. Measurement of SARS-CoV-2 antigens in plasma of pediatric patients with acute COVID-19 or MIS-C using an ultrasensitive and quantitative immunoassay. medRxiv 2021:2021.12.08.21267502. [PMID: 34909787 PMCID: PMC8669854 DOI: 10.1101/2021.12.08.21267502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Detection of SARS-CoV-2 antigens in blood has high sensitivity in adults with acute COVID-19, but sensitivity in pediatric patients is unclear. Recent data suggest that persistent SARS-CoV-2 spike antigenemia may contribute to multisystem inflammatory syndrome in children (MIS-C). We quantified SARS-CoV-2 nucleocapsid (N) and spike (S) antigens in blood of pediatric patients with either acute COVID-19 or MIS-C using ultrasensitive immunoassays (Meso Scale Discovery). METHODS Plasma was collected from inpatients (<21 years) enrolled across 15 hospitals in 15 US states. Acute COVID-19 patients (n=36) had a range of disease severity and positive nasopharyngeal SARS-CoV-2 RT-PCR within 24 hours of blood collection. Patients with MIS-C (n=53) met CDC criteria and tested positive for SARS-CoV-2 (RT-PCR or serology). Controls were patients pre-COVID-19 (n=67) or within 24h of negative RT-PCR (n=43). RESULTS Specificities of N and S assays were 95-97% and 100%, respectively. In acute COVID-19 patients, N/S plasma assays had 89%/64% sensitivity, respectively; sensitivity in patients with concurrent nasopharyngeal swab cycle threshold (Ct) ≤ 35 were 93%/63%. Antigen concentrations ranged from 1.28-3,844 pg/mL (N) and 1.65-1,071 pg/mL (S) and correlated with disease severity. In MIS-C, antigens were detected in 3/53 (5.7%) samples (3 N-positive: 1.7, 1.9, 121.1 pg/mL; 1 S-positive: 2.3 pg/mL); the patient with highest N had positive nasopharyngeal RT-PCR (Ct 22.3) concurrent with blood draw. CONCLUSIONS Ultrasensitive blood SARS-CoV-2 antigen measurement has high diagnostic yield in children with acute COVID-19. Antigens were undetectable in most MIS-C patients, suggesting that persistent antigenemia is not a common contributor to MIS-C pathogenesis. KEY POINTS In a U.S. pediatric cohort tested with ultrasensitive immunoassays, SARS-CoV-2 nucleocapsid antigens were detectable in most patients with acute COVID-19, and spike antigens were commonly detectable. Both antigens were undetectable in almost all MIS-C patients.
Collapse
Affiliation(s)
| | - Tanya Novak
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, USA
| | - Anu Mathew
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | - Janet Chou
- Department of Pediatrics, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Yubo Zhang
- Institutional Centers for Clinical and Translational Research, Boston Children’s Hospital, Boston, MA, USA
| | | | | | - Jessica Joe
- Meso Scale Diagnostics, LLC., Rockville, MD, USA
| | | | | | | | - Jill Joerger
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA USA
| | - Laura L. Loftis
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Stephanie P. Schwartz
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, NC, USA
| | - Tracie C. Walker
- Department of Pediatrics, University of North Carolina at Chapel Hill Children’s Hospital, Chapel Hill, NC, USA
| | - Julie C. Fitzgerald
- Division of Critical Care, Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Keiko M. Tarquinio
- Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Matt S. Zinter
- Department of Pediatrics, Divisions of Critical Care and Bone Marrow Transplantation, University of California, San Francisco, San Francisco, CA, USA
| | - Jennifer E. Schuster
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City MO, USA
| | - Natasha B. Halasa
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Melissa L. Cullimore
- Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Aline B. Maddux
- Department of Pediatrics, Section of Critical Care Medicine, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO, USA
| | - Mary A. Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Katherine Irby
- Section of Pediatric Critical Care, Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, AR, USA
| | - Heidi R. Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Mott Children’s Hospital and University of Michigan, Ann Arbor, MI, USA
| | - Bria M. Coates
- Division of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Hillary Crandall
- Division of Pediatric Critical Care, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Shira J. Gertz
- Division of Pediatric Critical Care, Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ, USA
| | - Adrienne G. Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, Boston, MA, USA
| | - Nira R. Pollock
- Department of Laboratory Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
23
|
Romero D, Vargas P, Ornosa C. Algunos rasgos de la biología de la abeja roja de los caracoles, Rhodanthidium sticticum (Fabricius, 1787): fenología, preferencia floral, uso de conchas, capacidad de vuelo y comportamiento territorial. Graellsia 2021. [DOI: 10.3989/graellsia.2021.v77.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
La ecología y el comportamiento de la mayoría de las especies de abejas mediterráneas (fenología, comportamiento solitario o social, apareamiento, nidificación, especialización en plantas) son aún poco conocidos o no han sido descritos en profundidad, salvo para contadas especies. Tal es el caso de la abeja roja de los caracoles, Rhodanthidium sticticum (Hymenoptera, Megachilidae), una especie mediterránea, solitaria y territorial cuya biología ha sido tratada muy superficialmente. En este trabajo se describe su fenología, el uso que hace de conchas de caracol más allá de la nidificación, la polilectia y las plantas que visita, su capacidad de vuelo, la territorialidad y el apareamiento, todo ello basado en observaciones de campo propias. La biología de R. sticticum es parecida a la de otros Anthidiini, pero con particularidades. Es una especie primaveral, univoltina, muy activa en días soleados durante las horas centrales. Cuando las condiciones meteorológicas son adversas se refugia en el interior de conchas de caracol, pudiendo compartirlas varios individuos (de la misma especie o incluso de otras). A pesar de ser claramente poliléctica, muestra preferencia por plantas con flores melitófilas, en especial del género Antirrhinum. Los machos defienden sus territorios, tanto contra otros machos conespecíficos como interespecíficamente, con un comportamiento que permite asegurar su propio éxito reproductivo.
Collapse
|
24
|
Romero D, Jane R. Relationship between Sleep Stages and HRV response in Obstructive Sleep Apnea Patients. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:5535-5538. [PMID: 34892378 DOI: 10.1109/embc46164.2021.9630148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Patients suffering from obstructive sleep apnea (OSA) usually present an increased sympathetic activity caused by the intermittent hypoxia effect on autonomic control. This study evaluated the relationship between sleep stages and the apnea duration, frequency, and type, as well as their impact on HRV markers in different groups of disease severity. The hypnogram and R-R interval signals were extracted in 81 OSA patients from night polysomnographic (PSG) recordings. The apnea-hypopnea index (AHI) defined patient classification as mild-moderate (AHI<=30, n=44) or severe (AHI>30, n=37). The normalized power in VLH, LF, and HF bands of RR series were estimated by a time-frequency approach and averaged in 1-min epochs of normal and apnea segments. The autonomic response and the impact of sleep stages were assessed in both segments to compare patient groups. Deeper sleep stages (particularly S2) concentrated the shorter and mild apnea episodes (from 10 to 40 s) compared to light (SWS) and REM sleep. Longer episodes (>50 s) although less frequent, were of similar incidence in all stages. This pattern was more pronounced for the group of severe patients. Moreover, during apnea segments, LFnu was higher (p=0.044) for the severe group, since V LFnu and HFnu presented the greatest changes when compared to normal segments. The non-REM sleep seems to better differentiate OSA patients groups, particularly through VLFnu and HFnu(p<0.001). A significant difference in both sympathetic and vagal modulation between REM and non-REM sleep was only found within the severe group. These results confirm the importance of considering sleep stages for HRV analysis to further assess OSA disease severity, beyond the traditional and clinically limited AHI values.Clinical relevance-Accounting for sleep stages during HRV analysis could better assess disease severity in OSA patients.
Collapse
|
25
|
Romero D, Calvo M, Le Rolle V, Béhar N, Mabo P, Hernández A. Multivariate ensemble classification for the prediction of symptoms in patients with Brugada syndrome. Med Biol Eng Comput 2021; 60:81-94. [PMID: 34709544 DOI: 10.1007/s11517-021-02448-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 09/18/2021] [Indexed: 10/20/2022]
Abstract
Identification of asymptomatic patients at higher risk for suffering cardiac events remains controversial and challenging in Brugada syndrome (BS). In this work, we proposed an ECG-based classifier to predict BS-related symptoms, by merging the most predictive electrophysiological features derived from the ventricular depolarization and repolarization periods, along with autonomic-related markers. The initial feature space included local and dynamic ECG markers, assessed during a physical exercise test performed in 110 BS patients (25 symptomatic). Morphological, temporal and spatial properties quantifying the ECG dynamic response to exercise and recovery were considered. Our model was obtained by proposing a two-stage feature selection process that combined a resampled-based regularization approach with a wrapper model assessment for balancing, simplicity and performance. For the classification step, an ensemble was constructed by several logistic regression base classifiers, whose outputs were fused using a performance-based weighted average. The most relevant predictors corresponded to the repolarization interval, followed by two autonomic markers and two other makers of depolarization dynamics. Our classifier allowed for the identification of novel symptom-related markers from autonomic and dynamic ECG responses during exercise testing, suggesting the need for multifactorial risk stratification approaches in order to predict future cardiac events in asymptomatic BS patients. Graphical abstract Pipeline for feature selection and predictive modeling of symptoms in Brugada syndrome.
Collapse
Affiliation(s)
- Daniel Romero
- Institute for Bioengineering of Catalonia (IBEC), Campus Besòs EEBE-UPC, Ave. E. Maristany 16, Building C, L5.3, Barcelona, E-08019, Spain
| | - Mireia Calvo
- Institute for Bioengineering of Catalonia (IBEC), Campus Besòs EEBE-UPC, Ave. E. Maristany 16, Building C, L5.3, Barcelona, E-08019, Spain
| | - Virginie Le Rolle
- CHU Rennes, Inserm, University of Rennes, LTSI - UMR 1099, F-35000, Rennes, France
| | - Nathalie Béhar
- CHU Rennes, Inserm, University of Rennes, LTSI - UMR 1099, F-35000, Rennes, France
| | - Phillipe Mabo
- CHU Rennes, Inserm, University of Rennes, LTSI - UMR 1099, F-35000, Rennes, France
| | - Alfredo Hernández
- CHU Rennes, Inserm, University of Rennes, LTSI - UMR 1099, F-35000, Rennes, France.
| |
Collapse
|
26
|
Pérez-Vegas A, Pérez-López M, Barcala E, Trofimova E, Romero D, Muñoz P. Organochlorine pesticides and PCBs in European eel (Anguilla anguilla) from Spanish Balearic coastal lagoons. Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00672-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
27
|
Gaona J, González F, Sánchez D, González C, Rueda R, Ortiz J, Romero D, Robles P, Osma A, Martínez D, Díaz H, Monterroza F, Zuluaga M, Vanegas M, Rueda E. Prospective evaluation of the association between varicocele and benign prostatic hyperplasia in men over 40 years of age. Andrologia 2021; 53:e13933. [PMID: 33586806 DOI: 10.1111/and.13933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/26/2020] [Accepted: 11/18/2020] [Indexed: 01/19/2023] Open
Abstract
We investigated the association between varicocele and benign prostatic hyperplasia in men over the age of 40 years. A total of 296 outpatients were evaluated. Prostate volume was measured with transrectal ultrasound. Varicocele was diagnosed by physical examination and ultrasound. Prostatic hyperplasia was defined as prostate volume greater than or equal to 40 ml. Two groups were compared: patients with prostate volume less than 40 ml and patients with prostate volume greater than or equal to 40 ml. There was a statistically significant difference between the groups in terms of mean age, post-void residual, International Prostate Symptom Score and PSA. The percentage of patients with clinical varicocele in the group with a volume less than 40 ml and the group with a volume equal to or greater than 40 ml was 38.2% and 47.7% respectively (p = .12). There were no differences between the two groups in the percentage of patients with clinical or subclinical varicocele (43.2% vs. 52.2%, respectively, p = .12). No differences were found in the percentage of patients with varicocele when comparing men with prostates smaller than 40 ml and greater than or equal to 40 ml.
Collapse
Affiliation(s)
- José Gaona
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Fabio González
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Daniel Sánchez
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Cesar González
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Raul Rueda
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Jairo Ortiz
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Daniel Romero
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Pablo Robles
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Andres Osma
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Daniela Martínez
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Hernán Díaz
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Fernando Monterroza
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Margarita Zuluaga
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Marlio Vanegas
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| | - Edward Rueda
- Urology Research Group, Instituto Uromédica, Universidad de Santander, Universidad Industrial de Santander, Bucaramanga, Colombia
| |
Collapse
|
28
|
Romero D, Jane R. Hypoxia-induced Effects on ECG Depolarization by Time Warping Analysis during Recurrent Obstructive Apnea. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:2626-2629. [PMID: 33018545 DOI: 10.1109/embc44109.2020.9176409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In this work, we evaluated a non-linear approach to estimate morphological variations in ECG depolarization, in the context of intermittent hypoxia (IH). Obstructive apnea sequences were provoked for 15 minutes in anesthetized Sprague-Dawley rats, alternating with equal periods of normal breathing, in a recurrent obstructive sleep apnea (OSA) model. Each apnea episode lasted 15 s, while the frequency used for each sequence was randomly selected. Average heartbeats obtained before the start and at the end of each episode, were delineated to extract only the QRS wave. Then, the segmented QRS waves were non-linearly aligned using the dynamic time warping (DWT) algorithm. Morphological QRS changes in both the amplitude and temporal domains were estimated from this alignment procedure. The hypoxic and basal segments were analyzed using ECG (lead I) recordings acquired during the experiment. To assess the effects of IH over time, the changes relative to the basal QRS wave were determined, in the intervals prior to each successive events until the end of the experiment. The results showed a progressive increase in the amplitude and time-domain morphological markers of the QRS wave along the experiment, which were strongly correlated with the changes in traditional QRS markers (r ≈ 0.9). Significant changes were found between pre-apnea and hypoxic measures only for the time-domain analysis (p<0.001), probably due to the short duration of the simulated apnea episodes.Clinical relevance Increased variability in ECG depolarization morphology during recurrent hypoxic episodes would be closely related to the expression of cardiovascular dysfunction in OSA patients.
Collapse
|
29
|
Mellinger S, Romero D, Visich A, Chanampa S, Ivetich G, Burgos M, Orzuza G. Not Described Variant of Notch3 Gen for Cadasil Disease. J Stroke Cerebrovasc Dis 2020; 29:104803. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.104803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 02/09/2020] [Accepted: 03/02/2020] [Indexed: 10/24/2022] Open
|
30
|
Romero D, Behar N, Mabo P, Hernandez AI. Differences in Brugada Syndrome Patients Through Ventricular Repolarization Analysis During Sleep. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:5638-5641. [PMID: 31947132 DOI: 10.1109/embc.2019.8857930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Brugada syndrome (BS) is a genetic pathology that might cause sudden cardiac death (SCD) in patients with a structurally normal heart. Repolarization disorders have been postulated as a potential substrate for triggering cardiac arrhythmia in BS, that usually occur at rest or during sleep. In this paper, we have characterized ventricular repolarization markers during sleep on patients suffering from BS. To this end, standard 12-lead ECG recordings were analyzed in a population of 110 BS patients (25 symptomatic). The QT and the T-wave peak to T-wave end intervals (respectively QT and Tpe) were assessed from lead V5. The linear relationship between these markers and the instantaneous heart rate period (RR interval) are determined during each hour and for the whole sleep period. From the models obtained, corrected QT and Tpe measures were then estimated for each patient at 60 beats/min (QT60 and Tpe60) and at the mean heart rate observed during the involved time interval (QTHR and TpeHR). Results show larger values for symptomatic patients in all markers, with significant differences with respect to the asymptomatic group in the case of Tpe (Tpe60: p = 0.0012; TpeHR: p = 0.0014). Moreover, the temporal profiles of these markers reveal major differences among BS subgroups during the last 3 hours of sleep, where symptomatic patients presented increased QT60/HR (p = 0.01) and Tpe60/HR (p <; 0.001), as compared to the initial sleep hours. We conclude that BS patients present different repolarization properties according to their symptomatology, especially during the final stage of sleep.
Collapse
|
31
|
Zamarron E, Romero D, Fernández-Lahera J, Villasante C, Pinilla I, Barranco P, Dominguez-Ortega J, Álvarez-Sala Walther R R. Should we consider paranasal and chest computed tomography in severe asthma patients? Respir Med 2020; 169:106013. [PMID: 32442110 DOI: 10.1016/j.rmed.2020.106013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/04/2020] [Accepted: 05/05/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND It is essential to recognize and treat findings that can simulate or worsen symptoms to improve asthma control and thereby to reduce costs. Guidelines highlight a paranasal (PS) and chest computed tomography (CT) scan as a tool for disease evaluation and, although they suggest its indication in patients whom presentation is atypical, there are not well-defined criteria. OBJECTIVES To describe the most common findings in the PS and chest CT in severe asthma patients and to analyse the characteristics of asthmatics with the finding of nasal polyps or bronchiectasis. METHODS We retrospectively reviewed the medical records of 161 adults with confirmed severe asthma who had undergone to PS and/or chest CT. Clinical data from their electronic health record and the findings from a PS and/or chest CT within the last five years were collected. RESULTS In the PS CT, 70.5% of patients presented mucous thickening and 46.7% presented nasal polyps. Both findings were associated with male gender and level of blood eosinophils. In chest CT, 28% of individuals showed atelectasis, 16.5% air trapping, 17.7% affectation of the small airway, 11.6% pulmonary infiltrates and 10.4% emphysema. Bronchiectasis were identified in 60.4% of subjects, who were older and had poorer lung function. CONCLUSION Paranasal and thoracic computed tomography are important tools in the treatment of severe asthma because they allow us to detect highly prevalent findings in this disease that can lead to poorer control of it.
Collapse
Affiliation(s)
- E Zamarron
- Department of Pulmonary, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.
| | - D Romero
- Department of Pulmonary, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - J Fernández-Lahera
- Department of Pulmonary, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - C Villasante
- Department of Pulmonary, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - I Pinilla
- Department of Radiology, Hospital Universitario La Paz, Madrid, Spain
| | - P Barranco
- Department of Allergology, Hospital Universitario La Paz, Madrid, Spain
| | | | - R Álvarez-Sala Walther R
- Department of Pulmonary, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain; School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| |
Collapse
|
32
|
Romero D, Jane R. Non-linear HRV Analysis to Quantify the Effects of Intermittent Hypoxia Using an OSA Rat Model. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:4994-4997. [PMID: 31946981 DOI: 10.1109/embc.2019.8857636] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
In this paper, a non-linear HRV analysis was performed to assess fragmentation signatures observed in heartbeat time series after intermittent hypoxia (IH). Three markers quantifying short-term fragmentation levels, PIP, IALS and PSS, were evaluated on R-R interval series obtained in a rat model of recurrent apnea. Through airway obstructions, apnea episodes were periodically simulated in six anesthetized Sprague-Dawley rats. The number of apnea events per hour (AHI index) was varied during the first half of the experiment while apnea episodes lasted 15 s. For the second part, apnea episodes lasted 5, 10 or 15 s, but the AHI index was fixed. Recurrent apnea was repeated for 15-min time intervals in all cases, alternating with basal periods of the same duration. The fragmentation markers were evaluated in segments of 5 minutes, selected at the beginning and end of the experiment. The impact of the heart and breathing rates (HR and BR, respectively) on the parameter estimates was also investigated. The results obtained show a significant increase (from 5 to 10%, p <; 0.05) in fragmentation measures of heartbeat time series after IH, indicating a clear deterioration of the initial conditions. Moreover, there was a strong linear relationship (r > 0.9) between these markers and BR, as well as with the ratio given by HR/BR. Although fragmentation may be impacted by IH, we found that it is highly dependent on HR and BR values and thus, they should be considered during its calculation or used to normalize the fragmentation estimates.
Collapse
|
33
|
Piker EG, Jacobson GP, Romero D, Wang Y, Smith K. The Clinical Significance of the Failure to Perceive Vertigo in the Postcaloric Period Despite a Robust Caloric Response. Am J Audiol 2020; 29:50-58. [PMID: 32073288 DOI: 10.1044/2019_aja-19-00036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose The purpose of this project was to explore the association between the perception of motion during caloric testing and two tasks associated with central vestibular processing: postural stability and visuospatial memory. Method This was a prospective study of 25 patients who were found to have nonvestibular etiologies of their symptoms and normal vestibular function test results and who underwent caloric testing with a mean maximum slow phase eye velocity for each irrigation of 15° or greater. Following each caloric irrigation, patients were asked whether they had any sensation of movement. Patients were grouped based on the presence or absence of motion during the caloric exam (motion perception vs. absent perception). Postural stability was assessed using computerized dynamic posturography, and visuospatial memory was assessed using a memory match card game application. Results There were no significant differences between groups on any measures of peripheral vestibular function. However, the Absent Perception Group showed greater postural instability during Condition 5 of posturography and performed significantly worse on a task of visuospatial working memory. Both age and absence of motion perception predicted abnormal performance on measures of postural stability and visuospatial working memory. Conclusions There appears to be clinical implications to a lack of motion perception during the caloric exam in patients with an otherwise normal peripheral vestibular system. Based on the current findings, we are unable to determine whether differences in postural stability and visuospatial memory were due to age or a central vestibular processing deficit.
Collapse
Affiliation(s)
- Erin G Piker
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Gary P Jacobson
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
| | - Daniel Romero
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Ye Wang
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN
| | - Kaylee Smith
- Division of Audiology, Department of Otolaryngology, Henry Ford Health System, Detroit, MI
| |
Collapse
|
34
|
Romero D, Behar N, Petit B, Probst V, Sacher F, Mabo P, Hernández AI. Dynamic changes in ventricular depolarization during exercise in patients with Brugada syndrome. PLoS One 2020; 15:e0229078. [PMID: 32126115 PMCID: PMC7053736 DOI: 10.1371/journal.pone.0229078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 01/29/2020] [Indexed: 11/18/2022] Open
Abstract
Brugada syndrome (BS) is a genetic pathological condition associated with a high risk for sudden cardiac death (SCD). Ventricular depolarization disorders have been suggested as a potential electrophysiological mechanism associated with high SCD risk on patients with BS. This paper aims to characterize the dynamic changes of ventricular depolarization observed during physical exercise in symptomatic and asymptomatic BS patients. To this end, cardiac ventricular depolarization features were automatically extracted from 12-lead ECG recordings acquired during standardized exercise stress test in 110 BS patients, of whom 25 were symptomatic. Conventional parameters were evaluated, including QRS duration, R and S wave amplitudes ( AR, AS), as well as QRS morphological features, such as up-stroke and down-stroke slopes of the R and S waves ( UR, DR and US). The effects of physical exercise and recovery on the dynamics of these markers were assessed in both BS populations. Features showing significantly different dynamics between the studied groups were used alone and in combination with the clinical characteristics of the patients in a logistic regression analysis. Results show larger changes in the second half of the QRS complex through AS and US measured in the right precordial leads for asymptomatic patients, especially during recovery, when the vagal tone is more pronounced. Multivariate analysis involving both types of features resulted in a reduced model of three relevant features ( ΔAS in lead V2, Sex and heart rate recovery, HRR), which achieved a suitable discrimination performance between groups; sensitivity = 80% and specificity = 75% (AUC = 83%). However, after controlling the model for possible confounding factors, only one feature ( ΔAS) remained meaningful. This adjusted model significantly improved the overall discrimination performance by up to: sensitivity = 84% and specificity = 100% (AUC = 94%). The study highlights the importance of physical exercise test to unmask differentiated behaviors between symptomatic and asymptomatic BS patients through depolarization dynamic analysis. This analysis together with the obtained model may help to identify asymptomatic patients at low or high risk of future cardiac events, but it should be confirmed by further prospective studies.
Collapse
Affiliation(s)
- Daniel Romero
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Nathalie Behar
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | - Bertrand Petit
- Service Cardiologie, GH Sud. Saint Pierre La Réunion, Saint-Pierre, France
| | | | | | - Philippe Mabo
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France
| | | |
Collapse
|
35
|
Henríquez-Hernández LA, Romero D, González-Antuña A, Gonzalez-Alzaga B, Zumbado M, Boada LD, Hernández AF, López-Flores I, Luzardo OP, Lacasaña M. Biomonitoring of 45 inorganic elements measured in plasma from Spanish subjects: A cross-sectional study in Andalusian population. Sci Total Environ 2020; 706:135750. [PMID: 31841855 DOI: 10.1016/j.scitotenv.2019.135750] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 10/24/2019] [Accepted: 11/23/2019] [Indexed: 06/10/2023]
Abstract
Heavy metals and other toxic elements are frequently detected in humans. Rare earth elements (REE) have arisen as a novel group of substances considered as emerging pollutants due to its dependence for high tech industry. We designed a study aimed to conduct the biomonitoring a total of 45 inorganic elements in the population of Andalusia (Spain). A total of 419 participants were recruited and their plasma samples analyzed. Concentration of elements, including elements in the ATSDR's priority pollutant list and REE were measured by ICP-MS in the blood plasma of participants. Arsenic, copper, lead, selenium, antimony, strontium, and bismuth were detected in ˃98% of subjects. Median values of arsenic, mercury and lead were 1.49, 1.46, and 5.86 ng/mL, respectively. These concentrations did not exceed reference values published by international agencies. We observed a positive correlation between age and plasma concentrations of arsenic, mercury, antimony and strontium. Sum of elements was lower in the group of subjects younger than 45 years old (P = 0.002). Positive correlations were observed between body mass index (BMI) and plasma concentrations of barium, cerium, osmium, tin, and ytterbium. 7 out of 26 REEs showed a percentage of detection ≥ 90%. Bismuth, yttrium, and cerium were quantified at the highest concentrations (median value = 7.7, 0.19, and 0.16 ng/mL, respectively). We found that plasma levels of 6 REEs were higher among males, and a positive correlation between REEs and age was detected. The present results suggest a potential interaction with the human physiology that deserves additional research. Given the high persistence of these elements in the environment, and the significant technological dependence on them, future studies are needed to elucidate the potential sources of exposure and possible adverse effects on health, especially in the most vulnerable populations.
Collapse
Affiliation(s)
- L A Henríquez-Hernández
- Toxicology Unit, Clinical Sciences Department, Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Spain; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Spain
| | - D Romero
- Department of Statistics and Operational Research, Faculty of Sciences, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Toxicology Unit, Clinical Sciences Department, Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain
| | - A González-Antuña
- Toxicology Unit, Clinical Sciences Department, Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Spain; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Spain
| | - B Gonzalez-Alzaga
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Andalusian School of Public Health, Granada, Spain
| | - M Zumbado
- Toxicology Unit, Clinical Sciences Department, Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Spain; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Spain
| | - L D Boada
- Toxicology Unit, Clinical Sciences Department, Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Spain; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Spain
| | - A F Hernández
- Department of Legal Medicine, Toxicology and Physical Anthropology, University of Granada, Granada, Spain
| | - I López-Flores
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Department of Genetics, Faculty of Sciences, University of Granada, Granada, Spain
| | - O P Luzardo
- Toxicology Unit, Clinical Sciences Department, Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Spain; Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Spain.
| | - M Lacasaña
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain; Andalusian School of Public Health, Granada, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| |
Collapse
|
36
|
Achilleos AP, Kritikos K, Rossini A, Kapitsaki GM, Domaschka J, Orzechowski M, Seybold D, Griesinger F, Nikolov N, Romero D, Papadopoulos GA. The cloud application modelling and execution language. J Cloud Comp 2019. [DOI: 10.1186/s13677-019-0138-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractCloud computing offers a flexible pay-as-you-go model for provisioning application resources, which enables applications to scale on-demand based on the current workload. In many cases, though, users face the single vendor lock-in effect, missing opportunities for optimal and adaptive application deployment across multiple clouds. Several cloud modelling languages have been developed to support multi-cloud resource management, but still they lack holistic cloud management of all aspects and phases. This work defines the Cloud Application Modelling and Execution Language (CAMEL), which (i) allows users to specify the full set of design time aspects for multi-cloud applications, and (ii) supports the models@runtime paradigm that enables capturing an application’s current state facilitating its adaptive provisioning. CAMEL has been already used in many projects, domains and use cases due to its wide coverage of cloud management features. Finally, CAMEL has been positively evaluated in this work in terms of its usability and applicability in several domains (e.g., data farming, flight scheduling, financial services) based on the technology acceptance model (TAM).
Collapse
|
37
|
Sánchez-Jareño M, Barranco P, Romero D, Domínguez-Ortega J, Quirce S. Severe Eosinophilic Allergic Asthma Responsive to Mepolizumab After Failure of 2 Consecutive Biologics. J Investig Allergol Clin Immunol 2019; 29:79-81. [PMID: 30785114 DOI: 10.18176/jiaci.0340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M Sánchez-Jareño
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - P Barranco
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,CIBER de Enfermedades Respiratorias, Ciberes, Madrid, Spain
| | - D Romero
- Department of Pneumology, Hospital La Paz, Madrid, Spain
| | - J Domínguez-Ortega
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - S Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,CIBER de Enfermedades Respiratorias, Ciberes, Madrid, Spain
| |
Collapse
|
38
|
|
39
|
Calvo M, Rolle VL, Romero D, Behar N, Gomis P, Mabo P, Hernandez AI. Global Sensitivity Analysis of a Cardiovascular Model for the Study of the Autonomic Response to Head-up Tilt Testing. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2018:5458-5461. [PMID: 30441572 DOI: 10.1109/embc.2018.8513536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This paper proposes the integration and analysis of a mathematical model representing the cardiovascular system and its short-term autonomic response to head-up tilt (HUT) testing. A Latin Hypercube Sampling method was applied to design an optimal experimental space, including 19 model parameters coming from the cardiovascular and baroreflex control systems. Then, a global, variance-based sensitivity analysis was applied to quantity the effects of these parameters on heart rate and systolic blood pressure. Results highlight the relevant influence of the intrinsic heart rate and the sympathetic and parasympathetic baroreflex gains on heart rate regulation, as well as the impact of left ventricle diastolic parameters on systolic blood pressure. Moreover, a significant effect of right ventricle dynamics on blood pressure was noted. These results provide valuable information for the application of such an integrated model for the analysis of the autonomic mechanisms regulating the cardiovascular response induced by postural changes. In particular, they suggest a convenient set of parameters to be identified in a subject-specific manner.
Collapse
|
40
|
Romero D, Olivero J, Real R. Accounting for uncertainty in assessing the impact of climate change on biodiversity hotspots in Spain. Anim Biodiv Conserv 2019. [DOI: 10.32800/abc.2019.42.0355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Our limited understanding of the complexity of nature generates uncertainty in mathematical and cartographical models used to predict the effects of climate change on species’ distributions. We developed predictive models of distributional range shifts of threatened vertebrate species in mainland Spain, and in their accumulation in biodiversity hotspots due to climate change. We considered two relevant sources of climatological uncertainty that affect predictions of future climate: general circulation models and socio–economic scenarios. We also examined the relative importance of climate as a driver of species’ distribution and taxonomic uncertainty as additional biogeographical causes of uncertainty. Uncertainty was detected in all the forecasts derived from models in which climate was a significant explanatory factor, and in the species with taxonomic uncertainty. Uncertainty in forecasts was mainly located in areas not occupied by the species, and increased with time difference from the present. Mapping this uncertainty allowed us to assess the consistency of predictions regarding future changes in the distribution of hotspots of threatened vertebrates in Spain.
Collapse
Affiliation(s)
- D. Romero
- Facultad de Ciencias de la Universidad de la República (Udelar), Uruguay
| | | | - R. Real
- Universidad de Málaga, Spain
| |
Collapse
|
41
|
Marques-Mejías MA, Barranco P, Laorden D, Romero D, Quirce S. Worsening of Severe Asthma Due to Menstruation and Sensitization to Albumins. J Investig Allergol Clin Immunol 2019; 28:330-332. [PMID: 30350784 DOI: 10.18176/jiaci.0273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M A Marques-Mejías
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - P Barranco
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - D Laorden
- Pneumology Department, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - D Romero
- Pneumology Department, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
| | - S Quirce
- Department of Allergy, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain.,CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| |
Collapse
|
42
|
Comas Martínez M, Sánchez M, Romero D, Fidilio E, Ortiz A, Burgos R, Ciudin A. PT06.5: The Loss of Fat-Free Mass: An Early Event in Patients with Morbid Obesity Undergoing Bariatric Surgery. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32575-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
43
|
Riggs SA, Carver KS, Romero D, Morissette SB, Wilson J, Campbell R, McGuffin J. Attachment, Communication, and Relationship Functioning Among College Student Veterans and Nonveterans. Journal of College Counseling 2019. [DOI: 10.1002/jocc.12124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Kellye S. Carver
- Department of PsychologyUniversity of North Texas at Denton
- Now at Veterans Affairs North Texas Health Care System Dallas Texas
| | - Daniel Romero
- Department of PsychologyUniversity of North Texas at Denton
- Now at Brooke Army Medical Center San Antonio Texas
| | - Sandra B. Morissette
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans and Texas A&M Health Science CenterCollege of Medicine
- Now at the Department of PsychologyUniversity of Texas at San Antonio
| | - Jamie Wilson
- Veterans Affairs North Texas Health Care System Dallas Texas
- Now in private practice in Dallas Texas
| | - Robyn Campbell
- Department of PsychologyUniversity of North Texas at Denton
- Now at the South Texas Veterans Health Care System San Antonio Texas
| | - James McGuffin
- Department of PsychologyUniversity of North Texas at Denton
| |
Collapse
|
44
|
Martin-Gomez T, Cano A, Barroso F, Romero D. P097 Burden of antimicrobial resistance (AMR) in Pseudomonas aeruginosa (Pa) isolated from cystic fibrosis patients: the 2017 experience of a referral centre. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
45
|
Plaza-Puche AB, Salerno LC, Versaci F, Romero D, Alio JL. Clinical evaluation of the repeatability of ocular aberrometry obtained with a new pyramid wavefront sensor. Eur J Ophthalmol 2018; 29:585-592. [PMID: 30516061 DOI: 10.1177/1120672118816060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the intrasubject repeatability of the ocular aberrometry obtained with a new ocular pyramidal aberrometer technology in a sample of normal eyes. METHODS A total of 53 healthy eyes of 53 subjects with ages ranging from 18 to 45 years were included in this study. In all cases, three consecutive acquisitions were obtained. Intrasubject repeatability of the measurements with a pyramidal aberrometer was calculated. Intrasubject repeatability for 4.0- and 6.0-mm pupils was evaluated within the subject standard deviation (Sw) and intraclass correlation coefficient. RESULTS Low values of the Sw and intraclass correlation coefficient outcomes close to 1 were observed for the sphere and cylinder at 3.0-mm pupil size. Most low Sw and intraclass correlation coefficient values close to 1 were observed for total, low-order aberrations and higher-order aberrations root mean square and for each Zernike coefficient analysis (intraclass correlation coefficient ⩾0.798) at 4.0-mm pupil size, with more limited outcomes for the aberrometric coefficient of Z(4, 4) with an intraclass correlation coefficient of 0.683. For a 6.0 mm pupil diameter, low Sw and intraclass correlation coefficient values close to 1 were observed for all aberrometric parameters or Zernike coefficients analyzed (intraclass correlation coefficient ⩾0.850). CONCLUSION The new pyramidal aberrometer Osiris provides repeatable and consistent measurements of ocular aberrometry measurements in normal eyes.
Collapse
Affiliation(s)
| | | | - Francesco Versaci
- R&D Department, Costruzione Strumenti Oftalmici (CSO), Florence, Italy
| | - Daniel Romero
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| | - Jorge L Alio
- Vissum, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| |
Collapse
|
46
|
Calvo M, Le Rolle V, Romero D, Béhar N, Gomis P, Mabo P, Hernández AI. Recursive model identification for the analysis of the autonomic response to exercise testing in Brugada syndrome. Artif Intell Med 2018; 97:98-104. [PMID: 30503015 DOI: 10.1016/j.artmed.2018.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/05/2018] [Accepted: 11/20/2018] [Indexed: 02/05/2023]
Abstract
This paper proposes the integration and analysis of a closed-loop model of the baroreflex and cardiovascular systems, focused on a time-varying estimation of the autonomic modulation of heart rate in Brugada syndrome (BS), during exercise and subsequent recovery. Patient-specific models of 44 BS patients at different levels of risk (symptomatic and asymptomatic) were identified through a recursive evolutionary algorithm. After parameter identification, a close match between experimental and simulated signals (mean error = 0.81%) was observed. The model-based estimation of vagal and sympathetic contributions were consistent with physiological knowledge, enabling to observe the expected autonomic changes induced by exercise testing. In particular, symptomatic patients presented a significantly higher parasympathetic activity during exercise, and an autonomic imbalance was observed in these patients at peak effort and during post-exercise recovery. A higher vagal modulation during exercise, as well as an increasing parasympathetic activity at peak effort and a decreasing vagal contribution during post-exercise recovery could be related with symptoms and, thus, with a worse prognosis in BS. This work proposes the first evaluation of the sympathetic and parasympathetic responses to exercise testing in patients suffering from BS, through the recursive identification of computational models; highlighting important trends of clinical relevance that provide new insights into the underlying autonomic mechanisms regulating the cardiovascular system in BS. The joint analysis of the extracted autonomic parameters and classic electrophysiological markers could improve BS risk stratification.
Collapse
Affiliation(s)
- Mireia Calvo
- Univ Rennes, CHU Rennes, Inserm, LTSI UMR 1099, F-35000 Rennes, France
| | - Virginie Le Rolle
- Univ Rennes, CHU Rennes, Inserm, LTSI UMR 1099, F-35000 Rennes, France.
| | - Daniel Romero
- Institute for Bioengineering of Catalonia, E-08930 Barcelona, Spain
| | - Nathalie Béhar
- Univ Rennes, CHU Rennes, Inserm, LTSI UMR 1099, F-35000 Rennes, France
| | - Pedro Gomis
- Universitat Politècnica de Catalunya, E-08028 Barcelona, Spain; CIBER of Bioengineering, Biomaterials and Nanomedicine, E-50018 Zaragoza, Spain
| | - Philippe Mabo
- Univ Rennes, CHU Rennes, Inserm, LTSI UMR 1099, F-35000 Rennes, France
| | | |
Collapse
|
47
|
Calvo M, Le Rolle V, Romero D, Béhar N, Gomis P, Mabo P, Hernández AI. Model-based analysis of the autonomic response to head-up tilt testing in Brugada syndrome. Comput Biol Med 2018; 103:82-92. [PMID: 30342270 DOI: 10.1016/j.compbiomed.2018.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/13/2018] [Accepted: 10/08/2018] [Indexed: 12/15/2022]
Abstract
The etiology of Brugada syndrome (BS) is complex and multifactorial, making risk stratification in this population a major challenge. Since changes in the autonomic modulation of these patients are commonly related to arrhythmic events, we analyze in this work whether the response to head-up tilt (HUT) testing on this population may provide useful, complementary information for risk stratification. In order to perform this analysis, a coupled physiological model integrating the cardiac electrical activity, the cardiovascular system and the baroreceptors reflex control of the autonomic function, in response to HUT is proposed. A sensitivity analysis was performed, based on a screening method, evidencing the influence of cardiovascular parameters on blood pressure and of baroreflex regulation on heart rate. The most sensitive parameters have been identified on a set of 20 subjects (8 controls and 12 BS patients), so as to assess subject-specific model parameters. According to the results, controls showed an increased sympathetic modulation after tilting, as well as a reduced left ventricular contractility was observed in symptomatic, with respect to asymptomatic BS patients. These results provide new insights regarding the autonomic mechanisms regulating the cardiovascular system in BS which might be used as a complementary source of information, along with classical electrophysiological parameters, for BS risk stratification.
Collapse
Affiliation(s)
- Mireia Calvo
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, F-35000, France
| | - Virginie Le Rolle
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, F-35000, France.
| | - Daniel Romero
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, F-35000, France
| | - Nathalie Béhar
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, F-35000, France
| | - Pedro Gomis
- Dept ESAII, EEBE, CREB, Universitat Politècnica de Catalunya, Barcelona, E-08028, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Zaragoza, E-50018, Spain
| | - Philippe Mabo
- Univ Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, F-35000, France
| | | |
Collapse
|
48
|
Manze M, Ramos M, Romero D. Perceptions of control over pregnancy: beyond the notion of “intendedness”. Contraception 2018. [DOI: 10.1016/j.contraception.2018.07.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
49
|
Otero XL, de la Peña-Lastra S, Romero D, Nobrega GN, Ferreira TO, Pérez-Alberti A. Trace elements in biomaterials and soils from a Yellow-legged gull (Larus michahellis) colony in the Atlantic Islands of Galicia National Park (NW Spain). Mar Pollut Bull 2018; 133:144-149. [PMID: 30041301 DOI: 10.1016/j.marpolbul.2018.05.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/28/2018] [Accepted: 05/13/2018] [Indexed: 06/08/2023]
Abstract
Seabird colonies drastically transform the sites that they inhabit. Although the influence of seabirds on nutrient cycling has been investigated in numerous studies, the effects on trace elements has scarcely been considered. In this study, we determined the total contents of 9 trace elements in biomaterials (excrement, pellets, feathers and eggs) and soils in relation to the presence the Yellow-legged gull Larus michahellis. The concentrations of Zn, Cu and As were particularly high in the pellets and excrement. The total contents of the trace elements were significantly higher in the soils in the sub-colonies in which Yellow-legged gulls predominate than in soil from the control zone (with no gulls). The difference was even higher for the most reactive geochemical fractions. We observed that the oxidizable fraction was the most relevant fraction for almost all trace elements, indicating the importance of organic matter in trace element retention in sandy soils.
Collapse
Affiliation(s)
- X L Otero
- Departamento de Edafoloxía e Química Agrícola, Facultade de Bioloxía, Universidade de Santiago de Compostela, Galicia, Spain.
| | - S de la Peña-Lastra
- Departamento de Edafoloxía e Química Agrícola, Facultade de Bioloxía, Universidade de Santiago de Compostela, Galicia, Spain
| | - D Romero
- Departamento de Solos, Escola Superior de Agronomia Luiz Queiroz, Universidade de Sao Paulo, Brazil
| | - G N Nobrega
- Departamento de Solos, Escola Superior de Agronomia Luiz Queiroz, Universidade de Sao Paulo, Brazil
| | - T O Ferreira
- Departamento de Solos, Escola Superior de Agronomia Luiz Queiroz, Universidade de Sao Paulo, Brazil
| | - A Pérez-Alberti
- Departamento de Xeografía, Facultade de Xeografía e Historia, Universidade de Santiago de Compostela, Spain
| |
Collapse
|
50
|
Calvo M, Le Rolle V, Romero D, Béhar N, Gomis P, Mabo P, Hernández AI. Heart rate differences between symptomatic and asymptomatic Brugada syndrome patients at night. Physiol Meas 2018; 39:065002. [PMID: 29767628 DOI: 10.1088/1361-6579/aac550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Ventricular arrhythmias in Brugada syndrome (BS) mainly occur at rest, especially during nighttime, suggesting that parasympathetic activity at night may play an important role in the arrhythmogenesis of the disease. This study examined and compared the autonomic function of symptomatic and asymptomatic BS patients overnight. APPROACH We analyzed various heart rate variability (HRV) and heart rate complexity (HRC) markers in a clinical series including 87 BS patients, where 23 were symptomatic. MAIN RESULTS Statistically significant differences were found in markers MIRR, SDNN, SDANN, [Formula: see text] and SampEn, suggesting that symptomatic patients may be related to lower heart rate variability and complexity values, as well as to greater circadian fluctuations overnight. SIGNIFICANCE The results provide further evidence for the role of autonomic imbalance in the pathophysiology of BS, highlighting the relevance of nighttime analysis to the unmasking of significant ANS changes. Based on these outcomes, the role of HRV and HRC assessment at night could be a step forward towards the understanding of BS and the risk for the occurrence of symptoms in these patients, with a potential future impact on therapeutic strategies.
Collapse
Affiliation(s)
- M Calvo
- Univ Rennes, CHU Rennes, Inserm, LTSI-UMR 1099, F-35000, Rennes, France. Dept ESAII, CREB, Universitat Politècnica de Catalunya, E-08028, Barcelona, Spain
| | | | | | | | | | | | | |
Collapse
|