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Martinez-Murcia FJ, Arco JE, Jimenez-Mesa C, Segovia F, Illan IA, Ramirez J, Gorriz JM. Bridging Imaging and Clinical Scores in Parkinson's Progression Via Multimodal Self-Supervised Deep Learning. Int J Neural Syst 2024:2450043. [PMID: 38770651 DOI: 10.1142/s0129065724500436] [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: 05/22/2024]
Abstract
Neurodegenerative diseases pose a formidable challenge to medical research, demanding a nuanced understanding of their progressive nature. In this regard, latent generative models can effectively be used in a data-driven modeling of different dimensions of neurodegeneration, framed within the context of the manifold hypothesis. This paper proposes a joint framework for a multi-modal, common latent generative model to address the need for a more comprehensive understanding of the neurodegenerative landscape in the context of Parkinson's disease (PD). The proposed architecture uses coupled variational autoencoders (VAEs) to joint model a common latent space to both neuroimaging and clinical data from the Parkinson's Progression Markers Initiative (PPMI). Alternative loss functions, different normalization procedures, and the interpretability and explainability of latent generative models are addressed, leading to a model that was able to predict clinical symptomatology in the test set, as measured by the unified Parkinson's disease rating scale (UPDRS), with R2 up to 0.86 for same-modality and 0.441 cross-modality (using solely neuroimaging). The findings provide a foundation for further advancements in the field of clinical research and practice, with potential applications in decision-making processes for PD. The study also highlights the limitations and capabilities of the proposed model, emphasizing its direct interpretability and potential impact on understanding and interpreting neuroimaging patterns associated with PD symptomatology.
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Affiliation(s)
- Francisco J Martinez-Murcia
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Center for Advanced Studies, Ludwig-Maximilien Universität München, München, Germany
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
| | - Juan Eloy Arco
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
| | - Carmen Jimenez-Mesa
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
| | - Fermin Segovia
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
| | - Ignacio A Illan
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
| | - Javier Ramirez
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
| | - Juan Manuel Gorriz
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain
- Center for Advanced Studies, Ludwig-Maximilien Universität München, München, Germany
- Andalusian Research Institute in Data Science and Computational Intelligence (DaSCI), University of Granada, Granada, Spain
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2
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Sanchez‐Martinez S, Nguyen K, Biswas S, Nicholson V, Romanyuk AV, Ramirez J, Kc S, Akter A, Childs C, Meese EK, Usher ET, Ginell GM, Yu F, Gollub E, Malferrari M, Francia F, Venturoli G, Martin EW, Caporaletti F, Giubertoni G, Woutersen S, Sukenik S, Woolfson DN, Holehouse AS, Boothby TC. Labile assembly of a tardigrade protein induces biostasis. Protein Sci 2024; 33:e4941. [PMID: 38501490 PMCID: PMC10949331 DOI: 10.1002/pro.4941] [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: 11/01/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 03/20/2024]
Abstract
Tardigrades are microscopic animals that survive desiccation by inducing biostasis. To survive drying tardigrades rely on intrinsically disordered CAHS proteins, which also function to prevent perturbations induced by drying in vitro and in heterologous systems. CAHS proteins have been shown to form gels both in vitro and in vivo, which has been speculated to be linked to their protective capacity. However, the sequence features and mechanisms underlying gel formation and the necessity of gelation for protection have not been demonstrated. Here we report a mechanism of fibrillization and gelation for CAHS D similar to that of intermediate filament assembly. We show that in vitro, gelation restricts molecular motion, immobilizing and protecting labile material from the harmful effects of drying. In vivo, we observe that CAHS D forms fibrillar networks during osmotic stress. Fibrillar networking of CAHS D improves survival of osmotically shocked cells. We observe two emergent properties associated with fibrillization; (i) prevention of cell volume change and (ii) reduction of metabolic activity during osmotic shock. We find that there is no significant correlation between maintenance of cell volume and survival, while there is a significant correlation between reduced metabolism and survival. Importantly, CAHS D's fibrillar network formation is reversible and metabolic rates return to control levels after CAHS fibers are resolved. This work provides insights into how tardigrades induce reversible biostasis through the self-assembly of labile CAHS gels.
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Affiliation(s)
| | - K. Nguyen
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - S. Biswas
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - V. Nicholson
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - A. V. Romanyuk
- School of ChemistryUniversity of BristolBristolUK
- Max Planck‐Bristol Centre for Minimal BiologyUniversity of BristolBristolUK
| | - J. Ramirez
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - S. Kc
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - A. Akter
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - C. Childs
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - E. K. Meese
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
| | - E. T. Usher
- Department of Biochemistry and Molecular BiophysicsWashington University School of MedicineSt. LouisMissouriUSA
- Center for Biomolecular CondensatesWashington University in St. LouisSt. LouisMissouriUSA
| | - G. M. Ginell
- Department of Biochemistry and Molecular BiophysicsWashington University School of MedicineSt. LouisMissouriUSA
- Center for Biomolecular CondensatesWashington University in St. LouisSt. LouisMissouriUSA
| | - F. Yu
- Quantitative Systems Biology ProgramUniversity of California MercedMercedCaliforniaUSA
| | - E. Gollub
- Department of Chemistry and BiochemistryUniversity of California MercedMercedCaliforniaUSA
| | - M. Malferrari
- Dipartimento di Chimica “Giacomo Ciamician”Università di BolognaBolognaItaly
| | - F. Francia
- Laboratorio di Biochimica e Biofisica Molecolare, Dipartimento di Farmacia e Biotecnologie, FaBiTUniversità di BolognaBolognaItaly
| | - G. Venturoli
- Laboratorio di Biochimica e Biofisica Molecolare, Dipartimento di Farmacia e Biotecnologie, FaBiTUniversità di BolognaBolognaItaly
- Consorzio Nazionale Interuniversitario per le Scienze Fisiche della Materia (CNISM), c/o Dipartimento di Fisica e Astronomia (DIFA)Università di BolognaBolognaItaly
| | - E. W. Martin
- Department of Structural BiologySt. Jude Children's Research HospitalMemphisTennesseeUSA
| | - F. Caporaletti
- Van't Hoff Institute for Molecular SciencesUniversity of AmsterdamAmsterdamThe Netherlands
| | - G. Giubertoni
- Van't Hoff Institute for Molecular SciencesUniversity of AmsterdamAmsterdamThe Netherlands
| | - S. Woutersen
- Van't Hoff Institute for Molecular SciencesUniversity of AmsterdamAmsterdamThe Netherlands
| | - S. Sukenik
- Quantitative Systems Biology ProgramUniversity of California MercedMercedCaliforniaUSA
- Department of Chemistry and BiochemistryUniversity of California MercedMercedCaliforniaUSA
| | - D. N. Woolfson
- School of ChemistryUniversity of BristolBristolUK
- Max Planck‐Bristol Centre for Minimal BiologyUniversity of BristolBristolUK
- School of BiochemistryUniversity of Bristol, Biomedical Sciences BuildingBristolUK
| | - A. S. Holehouse
- Department of Biochemistry and Molecular BiophysicsWashington University School of MedicineSt. LouisMissouriUSA
- Center for Biomolecular CondensatesWashington University in St. LouisSt. LouisMissouriUSA
| | - T. C. Boothby
- Department of Molecular BiologyUniversity of WyomingLaramieWyomingUSA
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Jimenez-Mesa C, Arco JE, Martinez-Murcia FJ, Suckling J, Ramirez J, Gorriz JM. Applications of machine learning and deep learning in SPECT and PET imaging: General overview, challenges and future prospects. Pharmacol Res 2023; 197:106984. [PMID: 37940064 DOI: 10.1016/j.phrs.2023.106984] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/04/2023] [Accepted: 11/04/2023] [Indexed: 11/10/2023]
Abstract
The integration of positron emission tomography (PET) and single-photon emission computed tomography (SPECT) imaging techniques with machine learning (ML) algorithms, including deep learning (DL) models, is a promising approach. This integration enhances the precision and efficiency of current diagnostic and treatment strategies while offering invaluable insights into disease mechanisms. In this comprehensive review, we delve into the transformative impact of ML and DL in this domain. Firstly, a brief analysis is provided of how these algorithms have evolved and which are the most widely applied in this domain. Their different potential applications in nuclear imaging are then discussed, such as optimization of image adquisition or reconstruction, biomarkers identification, multimodal fusion and the development of diagnostic, prognostic, and disease progression evaluation systems. This is because they are able to analyse complex patterns and relationships within imaging data, as well as extracting quantitative and objective measures. Furthermore, we discuss the challenges in implementation, such as data standardization and limited sample sizes, and explore the clinical opportunities and future horizons, including data augmentation and explainable AI. Together, these factors are propelling the continuous advancement of more robust, transparent, and reliable systems.
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Affiliation(s)
- Carmen Jimenez-Mesa
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain
| | - Juan E Arco
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain; Department of Communications Engineering, University of Malaga, 29010, Spain
| | | | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, 18010, Spain; Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK.
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Guertin MP, Lee Y, Stewart SJ, Ramirez J, Nguyen A, Paraliticci G, Pretell-Mazzini JA. Soft Tissue Sarcomas in Octogenarian Patients: Are Treatment Options and Oncological Outcomes Different? A SEER Retrospective Study. Clin Oncol (R Coll Radiol) 2023; 35:269-277. [PMID: 36710153 DOI: 10.1016/j.clon.2023.01.002] [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: 11/09/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
AIMS As the US population continues to age, oncological strategies and outcomes for soft tissue sarcomas (STSs) should continue to be examined for varying age groups. The aim of this study was analyse and compare treatment strategies and oncological outcomes for octogenarian patients with STSs. MATERIALS AND METHODS Data from the Surveillance, Epidemiology and End Results (SEER) national database were used. Varying treatment modalities were studied when utilised for specific tumour staging with respect to the eighth edition of the American Joint Committee on Cancer. RESULTS In total, 24 666 patients were included for analysis, where 3341 (14%) were 80 years old or older. The octogenarian group was diagnosed with more advanced disease (stages II-IV), relative to their younger counterparts (85% versus 75%, P < 0.001). However, a smaller proportion of the older patients underwent surgical resection (74% versus 86%, P < 0.001). Likewise, the octogenarians received less chemotherapy (4% versus 21%, P < 0.001) and radiotherapy (29% versus 42%, P = 0.010). Surgical resection and chemotherapy significantly improved overall survival for those older patients with stage II STS, whereas surgical resection and radiotherapy improved mortality in this cohort with both stage III and IV STS. Overall survival at 1 and 5 years of follow-up was lower within the octogenarian group compared with the younger group (1 year: 68% versus 88%, P < 0.001 and 5 years: 7% versus 58%, P < 0.001). CONCLUSIONS Octogenarian patients, in most cases, are diagnosed with stage III or metastatic disease. Surgical resection of the primary tumour was beneficial in both age cohorts, with radiotherapy correlating to better overall survival when used in those patients with higher stage STS. Chemotherapy was associated with better mortality in the younger cohort with respect to tumour stage. The octogenarian overall survival at 1 and 5 years was lower than for younger patients.
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Affiliation(s)
- M P Guertin
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA.
| | - Y Lee
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - S J Stewart
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - J Ramirez
- Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - A Nguyen
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | - G Paraliticci
- Musculoskeletal Oncology Division, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
| | - J A Pretell-Mazzini
- Musculoskeletal Oncology Division, Miami Cancer Institute, Baptist Health South Florida, Miami, Florida, USA
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Sanchez-Sandoval UA, Figueroa-Zamudio JJ, Ramirez J, Walker HL, Löest CA, Soto-Navarro SA, Smythe BG. Influence of Monensin and Diflubenzuron on the Control of Immature Horn Fly and House Fly (Diptera: Muscidae) and Chemical Composition of Cattle Feces. J Med Entomol 2023; 60:417-421. [PMID: 36539325 DOI: 10.1093/jme/tjac187] [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: 06/22/2022] [Indexed: 06/17/2023]
Abstract
Twelve Angus × Hereford crossbred heifers were used in a completely randomized design to evaluate the effects of monensin and diflubenzuron feed additives on horn fly (Haematobia irritans) (L.) and house fly (Musca domestica) (L.) immature development. Heifers were randomly assigned to one of four treatment groups; 1) monensin fed at label rate, 2) diflubenzuron fed at label rate, 3) monensin and diflubenzuron fed at label rates together, and 4) nonsupplemented control. All treatments were administered from SD 0 to 28, followed by a 16-d wash-out period for a total study duration of 45 d and assayed to assess adult fly emergence, as well as fecal pH and fecal bacterial and total protein. A treatment × day interaction (P < 0.01) was observed for adult fly emergence. Fly emergence was not affected (P ≥ 0.05) by monensin, but was reduced during the 28 d treatment period when diflubenzuron was present (P = 0.01). Fecal pH, fecal bacterial protein, and total protein were not affected by any of the treatments (P ≥ 0.13). It is concluded that diflubenzuron is effective against both horn and house fly development regardless of the presence of monensin.
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Affiliation(s)
- U A Sanchez-Sandoval
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM, 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM, 80003, USA
| | - J J Figueroa-Zamudio
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM, 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM, 80003, USA
| | - J Ramirez
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM, 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM, 80003, USA
| | - H L Walker
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM, 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM, 80003, USA
| | - C A Löest
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM, 80003, USA
| | - S A Soto-Navarro
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM, 80003, USA
| | - B G Smythe
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM, 80003, USA
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Kumarasinghe L, Garcia-Gimeno MA, Ramirez J, Mayor U, Zugaza JL, Sanz P. P-Rex1 is a novel substrate of the E3 ubiquitin ligase Malin associated with Lafora disease. Neurobiol Dis 2023; 177:105998. [PMID: 36638890 PMCID: PMC10682699 DOI: 10.1016/j.nbd.2023.105998] [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: 09/01/2022] [Revised: 12/29/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Laforin and Malin are two proteins that are encoded by the genes EPM2A and EPM2B, respectively. Laforin is a glucan phosphatase and Malin is an E3-ubiquitin ligase, and these two proteins function as a complex. Mutations occurring at the level of one of the two genes lead to the accumulation of an aberrant form of glycogen meant to cluster in polyglucosans that go under the name of Lafora bodies. Individuals affected by the appearance of these polyglucosans, especially at the cerebral level, experience progressive neurodegeneration and several episodes of epilepsy leading to the manifestation of a fatal form of a rare disease called Lafora disease (LD), for which, to date, no treatment is available. Despite the different dysfunctions described for this disease, many molecular aspects still demand elucidation. An effective way to unknot some of the nodes that prevent the achievement of better knowledge of LD is to focus on the substrates that are ubiquitinated by the E3-ubiquitin ligase Malin. Some substrates have already been provided by previous studies based on protein-protein interaction techniques and have been associated with some alterations that mark the disease. In this work, we have used an unbiased alternative approach based on the activity of Malin as an E3-ubiquitin ligase. We report the discovery of novel bonafide substrates of Malin and have characterized one of them more deeply, namely PIP3-dependent Rac exchanger 1 (P-Rex1). The analysis conducted upon this substrate sets the genesis of the delineation of a molecular pathway that leads to altered glucose uptake, which could be one of the origin of the accumulation of the polyglucosans present in the disease.
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Affiliation(s)
- L Kumarasinghe
- Instituto de Biomedicina de Valencia, IBV-CSIC, 46010, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)-ISCIII, 28029 Madrid, Spain
| | - M A Garcia-Gimeno
- Department of Biotechnology, Escuela Técnica Superior de Ingeniería Agronómica y del Medio Natural (ETSIAMN), Universitat Politécnica de València, 46022, Valencia, Spain
| | - J Ramirez
- Department of Biochemistry and Molecular Biology, Faculty of Science and Technology, UPV/EHU, Leioa, Bizkaia, Spain
| | - U Mayor
- Department of Biochemistry and Molecular Biology, Faculty of Science and Technology, UPV/EHU, Leioa, Bizkaia, Spain; Ikerbasque, Basque Foundation for Science, Plaza Euskadi, 48009 Bilbao, Spain
| | - J L Zugaza
- Ikerbasque, Basque Foundation for Science, Plaza Euskadi, 48009 Bilbao, Spain; Achucarro Basque Center for Neuroscience, Scientific Park UPV/EHU, 48940 Leioa, Bizkaia, Spain; Department of Genetics, Physical Anthropology and Animal Physiology, Faculty of Science and Technology, UPV/EHU, 48940 Leioa, Bizkaia, Spain
| | - P Sanz
- Instituto de Biomedicina de Valencia, IBV-CSIC, 46010, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)-ISCIII, 28029 Madrid, Spain.
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Wuestney K, Ramirez J, Cook D, Fritz R. SMART HOME DATA VISUALIZATION FOR PROACTIVE HEALTH MONITORING OF COMMUNITY DWELLING OLDER ADULTS. Innov Aging 2022. [PMCID: PMC9766535 DOI: 10.1093/geroni/igac059.2233] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The role of Ambient Assistive Living and smart home technologies, which utilize unobtrusive sensors to detect changes in health, is becoming increasingly important in the delivery of healthcare services to older adults. However, these technologies must be designed to meaningfully incorporate into clinicians’ decision making. Research has shown when clinicians are engaged in the design process of smart home systems, the accuracy and efficacy of the systems are improved. We present the process undertaken by a team of nurse researchers and computer science engineers to design clinically meaningful behavior markers derived from smart home sensor data that can be used by nurses to proactively identify changes in patient status. During the first phase of design, nurse researchers qualitatively analyzed time series from smart home sensors installed in the homes of community dwelling older adults and identified patterns in these data related to significant health changes. From this analysis, we assembled a candidate list of 15 sensor-based behavior metrics, such as percent time spent in each room or frequency of bathroom use. During the second phase of design, we will build on lessons we learned from participatory design to create behavior markers and visualizations that are inspired by clinical experience. These include visualizing behavior change over time, highlighting behavioral anomalies at multiple time scales, and calculating markers that are not directly observable such as time spent out of home. Lessons learned from clinicians using the data visualizations to proactively screen for health changes in near real time will also be discussed.
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Affiliation(s)
| | - Javier Ramirez
- Washington State University, Pullman, Washington, United States
| | - Diane Cook
- Washington State University, Pullman, Washington, United States
| | - Roschelle Fritz
- Washington State University, Vancouver, Washington, United States
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Valenzuela ED, Mercado P, Pairumani R, Medel JN, Petruska E, Ugalde D, Morales F, Eisen D, Araya C, Montoya J, Gonzalez A, Rovegno M, Ramirez J, Aguilera J, Hernández G, Bruhn A, Slama M, Bakker J. Cardiac function in critically ill patients with severe COVID: A prospective cross-sectional study in mechanically ventilated patients. J Crit Care 2022; 72:154166. [PMID: 36244256 PMCID: PMC9557772 DOI: 10.1016/j.jcrc.2022.154166] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 08/29/2022] [Accepted: 09/18/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate cardiac function in mechanically ventilated patients with COVID-19. MATERIALS AND METHODS Prospective, cross-sectional multicenter study in four university-affiliated hospitals in Chile. All consecutive patients with COVID-19 ARDS requiring mechanical ventilation admitted between April and July 2020 were included. We performed systematic transthoracic echocardiography assessing right and left ventricular function within 24 h of intubation. RESULTS 140 patients aged 57 ± 11, 29% female were included. Cardiac output was 5.1 L/min [IQR 4.5-6.2] and 86% of the patients required norepinephrine. ICU mortality was 29% (40 patients). Fifty-four patients (39%) exhibited right ventricle dilation out of whom 20 patients (14%) exhibited acute cor pulmonale (ACP). Eight out of the twenty patients with ACP exhibited pulmonary embolism (40%). Thirteen patients (9%) exhibited left ventricular systolic dysfunction (ejection fraction <45%). In the multivariate analysis acute cor pulmonale and PaO2/FiO2 ratio were independent predictors of ICU mortality. CONCLUSIONS Right ventricular dilation is highly prevalent in mechanically ventilated patients with COVID-19 ARDS. Acute cor pulmonale was associated with reduced pulmonary function and, in only 40% of patients, with co-existing pulmonary embolism. Acute cor pulmonale is an independent risk factor for ICU mortality.
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Affiliation(s)
- Emilio Daniel Valenzuela
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Pablo Mercado
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile
| | - Ronald Pairumani
- Unidad de Cuidados Intensivos, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Juan Nicolás Medel
- Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Edward Petruska
- Unidad de Cuidados Intensivos, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Diego Ugalde
- Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Felipe Morales
- Unidad de Cuidados Intensivos, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Daniela Eisen
- Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Carla Araya
- Unidad de Cuidados Intensivos, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Jorge Montoya
- Unidad de Pacientes Críticos, Departamento de Medicina, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Alejandra Gonzalez
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maximiliano Rovegno
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javier Ramirez
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Javiera Aguilera
- Departamento de Paciente Crítico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana - Universidad del Desarrollo, Santiago, Chile
| | - Glenn Hernández
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro Bruhn
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Michel Slama
- Medical Intensive Care Unit, CHU Sud Amiens, Amiens, France
| | - Jan Bakker
- Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,Department of intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, Netherlands,Department of Pulmonary and Critical Care, New York University, NYU Langone Health, New York, USA,Department of Pulmonary and Critical Care, Columbia University Medical Center, New York, USA
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Schoeller E, Jespersen S, La E, Ramirez J, Hong D, Rives M, Mannaerts B. P-568 The effect of recombinant hCG on FSH-induced ovarian stimulation in rats depends on the FSH dose and can be detrimental at high concentrations. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.524] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the effect of choriogonadotropin beta (CG beta) on FSH-induced ovarian stimulation and multifollicular development in a rat model?
Summary answer
CG beta dose-dependently potentiates effects of low-to-mid FSH doses but has inhibitory effects at high concentrations: optimal CG beta/FSH ratio depends on the FSH dose.
What is known already
Similarly to follitropin delta (rFSH), CG beta (FE 999302) is a novel recombinant hCG purified from the human PER.C6®cell line. A recent placebo-controlled trial in women undergoing ovarian stimulation with follitropin delta demonstrated that the addition of 1 to 12 µg CG beta reduced the number of intermediate follicles and related hormones. This observation required further preclinical research to (1) evaluate whether the pharmacology of CG beta at LH/CGR was different than other hCG forms used in the clinic and/or (2) assess the effect of high concentrations of hCG and different hCG/FSH ratios on multiple follicular development and follicle atresia.
Study design, size, duration
Signaling properties of CG beta and other LH/hCG forms were compared at downstream pathways of LH/CGR in recombinant systems and human granulosa cells. To evaluate the effects of FSH±hCG in vivo, juvenile female rats were injected subcutaneously twice daily with follitropin delta ± CG beta/alfa for three days followed by an ovulatory dose of hCG. Oviducts were then collected for oocyte enumeration, ovaries and uteri were weighed, and ovaries were fixed for histological analysis.
Participants/materials, setting, methods
The pharmacology of CG beta and other LH/hCG forms was evaluated in a cAMP assay in human granulosa cells from follicular fluid from IVF patients and in recombinant systems, at the Gs, Gq and arrestin pathways. In the rat model, a dose response of follitropin delta (Rekovelle) was first evaluated, followed by evaluation of the dose-dependent effects of CG beta (0.00117-2.4 µg/kg), or CG alfa (Ovidrel/Ovitrelle), in combination with 1, 3 or 10 µg/kg rFSH.
Main results and the role of chance
The in vitro pharmacology (potency and efficacy) of CG beta was similar to recombinant LH, urinary hCG and recombinant hCG (CG alfa) tested at all proximal pathways evaluated downstream of LH/CGR as well as in human granulosa cells.
In vivo, treatment with follitropin delta induced a bell-shaped dose-response curve for oocyte release with a maximum response of 40-50 oocytes at 8-10 µg/kg follitropin delta dose.
The addition of CG beta dose-dependently potentiated the effects at low-to-mid follitropin delta doses but had inhibitory effects on the number of ovulated oocytes at high CG beta concentrations. The lowest CG beta dose that clearly reduced the number of ovulated oocytes was 2.4, 0.6 and 0.3 µg/kg in combination with a fixed dose of 1, 3 and 10 µg/kg follitropin delta, respectively, which indicated that the optimal hCG/FSH ratio and corresponding hCG efficacious dose was inversely related to the FSH dose. There was no difference between CG beta and CG alfa for the dose effect on the number of ovulated oocytes or ovarian weight. Histology data indicated many cystic follicles following high CG beta exposure which may represent atretic follicles prior to triggering follicular maturation and ovulation.
Limitations, reasons for caution
This is the first study demonstrating that the FSH dose in combination with the hCG dose determines the effect on multiple follicle growth, ovulation, and atresia. These observations need to be confirmed in clinical research, as doses and ratios applied in the rat cannot be extrapolated to the clinical setting.
Wider implications of the findings
A better understanding of the effect of different FSH to hCG ratios will help to improve current mixed protocols and design future recombinant combination products providing the optimal treatment outcome for each individual patient.
Trial registration number
not applicable
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Affiliation(s)
- E Schoeller
- Ferring Pharmaceuticals, Reproductive Health Research , San Diego, U.S.A
| | - S Jespersen
- Ferring Pharmaceuticals, Global Pharmaceutical R&D , Copenhagen, Denmark
| | - E La
- Ferring Pharmaceuticals, In Vivo Pharmacology , San Diego, U.S.A
| | - J Ramirez
- Ferring Pharmaceuticals, Molecular and Cellular Pharmacology , San Diego, U.S.A
| | - D Hong
- Ferring Pharmaceuticals, Molecular and Cellular Pharmacology , San Diego, U.S.A
| | - M.L Rives
- Ferring Pharmaceuticals, Molecular and Cellular Pharmacology , San Diego, U.S.A
| | - B Mannaerts
- Ferring Pharmaceuticals, Reproductive Medicine & Maternal Health , San Diego, U.S.A
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10
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Burastero O, Defelipe LA, Gola G, Tateosian NL, Lopez ED, Martinena CB, Arcon JP, Traian MD, Wetzler DE, Bento I, Barril X, Ramirez J, Marti MA, Garcia-Alai MM, Turjanski AG. Cosolvent Sites-Based Discovery of Mycobacterium Tuberculosis Protein Kinase G Inhibitors. J Med Chem 2022; 65:9691-9705. [PMID: 35737472 PMCID: PMC9344462 DOI: 10.1021/acs.jmedchem.1c02012] [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] [Indexed: 02/08/2023]
Abstract
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Computer-aided
drug discovery methods play a major role in the
development of therapeutically important small molecules, but their
performance needs to be improved. Molecular dynamics simulations in
mixed solvents are useful in understanding protein–ligand recognition
and improving molecular docking predictions. In this work, we used
ethanol as a cosolvent to find relevant interactions for ligands toward
protein kinase G, an essential protein of Mycobacterium
tuberculosis (Mtb).
We validated the hot spots by screening a database of fragment-like
compounds and another one of known kinase inhibitors. Next, we performed
a pharmacophore-guided docking simulation and found three low micromolar
inhibitors, including one with a novel chemical scaffold that we expanded
to four derivative compounds. Binding affinities were characterized
by intrinsic fluorescence quenching assays, isothermal titration calorimetry,
and the analysis of melting curves. The predicted binding mode was
confirmed by X-ray crystallography. Finally, the compounds significantly
inhibited the viability of Mtb in infected
THP-1 macrophages.
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Affiliation(s)
- Osvaldo Burastero
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,European Molecular Biology Laboratory Hamburg, Notkestrasse 85, Hamburg D-22607, Germany
| | - Lucas A Defelipe
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,European Molecular Biology Laboratory Hamburg, Notkestrasse 85, Hamburg D-22607, Germany
| | - Gabriel Gola
- Departamento de Química Orgánica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Unidad de Microanálisis y Métodos Físicos Aplicados a Química Orgánica (UMYMFOR), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires. CONICET, Buenos Aires C1428EGA, Argentina
| | - Nancy L Tateosian
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Elias D Lopez
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Camila Belen Martinena
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Juan Pablo Arcon
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Martín Dodes Traian
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Diana E Wetzler
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Isabel Bento
- European Molecular Biology Laboratory Hamburg, Notkestrasse 85, Hamburg D-22607, Germany
| | - Xavier Barril
- Catalan Institution for Research and Advanced Studies (ICREA), Passeig Lluís Companys 23, Barcelona 08010, Spain.,Faculty of Pharmacy and Institute of Biomedicine (IBUB), University of Barcelona, Av.Joan XXIII 27-31, Barcelona 08028, Spain
| | - Javier Ramirez
- Departamento de Química Orgánica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Unidad de Microanálisis y Métodos Físicos Aplicados a Química Orgánica (UMYMFOR), Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires. CONICET, Buenos Aires C1428EGA, Argentina
| | - Marcelo A Marti
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
| | - Maria M Garcia-Alai
- European Molecular Biology Laboratory Hamburg, Notkestrasse 85, Hamburg D-22607, Germany
| | - Adrián G Turjanski
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina.,Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires, Ciudad Universitaria, Pabellón 2, Buenos Aires C1428EGA, Argentina
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11
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Seoane-Mato D, Queiró Silva R, Laiz A, Galindez E, Montilla-Morales CA, Park HS, Pinto Tasende JA, Bethencourt Baute JJ, Joven-Ibáñez B, Toniolo E, Ramirez J, Serrano García A. AB0931 Characteristics associated with the perception of high-impact disease (PsAID ≥4) in patients with recent-onset psoriatic arthritis. Model based on machine learning. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1952] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe Psoriatic Arthritis Impact of Disease (PsAID) questionnaire is the standard tool for evaluating the impact of psoriatic arthritis (PsA) on quality of life [1]. Variables associated with high disease impact were studied in patients with long-standing established disease. The characteristics associated with high-impact PsAID in recent-onset PsA remain unknown.ObjectivesTo evaluate which patient and disease characteristics are associated with the perception of high-impact disease (PsAID ≥4) in recent-onset PsA.All patients gave their informed consent. The study was approved by the Clinical Research Ethics Committee of the Principality of Asturias.We conducted a cross-sectional analysis. The dataset was generated using data for the independent variables at the 3 visits (baseline, first year, and second year of follow-up) matched with the PsAID values at each of the 3 visits. PsAID was categorized into two groups, namely, <4 and ≥4 [1]. We trained logistic regression models and a random forest–type machine learning algorithm to analyze the association between the outcome measure and the variables selected in the bivariate analysis (statistical significance defined as p value <0.05). We used a confusion matrix to visualize the performance of the final model. This matrix shows the real class of the data items, together with the class predicted by the machine learning algorithm, and records the number of hits and misses.ResultsThe sample comprised 158 patients. 20.9% were lost to follow-up. Of the patients who attended the clinic, 45.8% scored PsAID ≥4 at baseline; 27.1%, at the first follow-up visit, and 23.0%, at the second follow-up visit. The variables associated with PsAID ≥4 selected in the logistic regression analysis were HAQ, patient global pain during the previous week, educational level, and level of physical activity in the previous week. The association was positive for the first 2 variables and for level of physical activity and negative for educational level. When physical activity was introduced as a categorical variable, a possible negative association was observed for a moderate level (although this was not statistically significant) and a positive association was observed for a high level (Table 1).Table 1.Variables associated with PsAID ≥4: Logistic regression analysis.VariableRegression coefficient95% CIp value (Wald test)HAQ10.394[7.777, 13.011]<0.001Patient global pain in the previous week5.668[4.016, 7.320]<0.001Educational level-2.064[-3.515, -0.613]0.005Moderate level of physical activity in the previous week-0.341[-1.255, 0.573]0.465High level of physical activity in the previous week1.221[0.158, 2.283]0.024When the random forest–type machine learning algorithm was trained with these 4 variables, the order of importance (from more to less) attributed by the model was: patient global pain, HAQ, educational level, and physical activity. The percentage of hits in the confusion matrix was 86.14%.ConclusionPain control and control of the disease as a whole, preventing patients from suffering a decrease in their functional capacity, are first-order treatment objectives. PsA patients should take regular physical exercise, but with a moderate or low impact on their joints and entheses.References[1]Orbai A, Holland R, Leung YY, Tillett W, Goel N, McHugh N et al. PsAID12 provisionally endorsed at OMERACT 2018 as core outcome measure to assess psoriatic arthritis-specific health- related quality of life in clinical trials. J Rheumatol 2019;46:990–95.AcknowledgementsThe authors would like to acknowledge José Luis Fernández Sueiro for his contribution to the conception of the study; José Miguel Carrasco for his contribution to the design of the study; Nuria Montero and Cristina Oliva for her contribution to data monitoring; Ana González Marcos and Cristina Pruenza for her contribution to data analysis; Thomas O´Boyle for the translation of the manuscript; and non-author investigators of Proyecto REAPSER Study GroupDisclosure of InterestsNone declared
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12
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Queiró Silva R, Seoane-Mato D, Laiz A, Galindez E, Montilla-Morales CA, Park HS, Pinto Tasende JA, Bethencourt Baute JJ, Joven-Ibáñez B, Toniolo E, Ramirez J, Serrano García A. POS1074 MINIMAL DISEASE ACTIVITY (MDA) IN PATIENTS WITH RECENT-ONSET PSORIATIC ARTHRITIS. PREDICTIVE MODEL BASED ON MACHINE LEARNING. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1841] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundVery few data are available on predictors of minimal disease activity (MDA) in patients with recent-onset psoriatic arthritis (PsA). Such data are crucial, since the therapeutic measures used to change the adverse course of PsA are more likely to succeed if we intervene early.ObjectivesTo detect patient and disease variables associated with achieving MDA in patients with recent-onset PsA.MethodsWe performed a multicenter observational prospective study (2-year follow-up, regular annual visits), promoted by the Spanish Society of Rheumatology. Patients aged ≥18 years who fulfilled the CASPAR criteria, with less than 2 years since the onset of symptoms, were included. The intention at the baseline visit was to reflect the patient’s situation before disease progress was modified by the treatments prescribed by the rheumatologist.All patients gave their informed consent. The study was approved by the Clinical Research Ethics Committee of the Principality of Asturias.MDA was defined as fulfillment of at least 5 of the following: ≤1 tender joint; ≤1 swollen joint; PASI ≤1 or BSA ≤3%; score on the visual analog scale (VAS) for pain provided by the patient ≤1.5; overall score for disease activity provided by the patient ≤2; HAQ score ≤0.5; ≤1 painful enthesis [1].The dataset contained data for the independent variables from the baseline visit and from follow-up visit number 1. These were matched with the outcome measures from follow-up visits 1 and 2, respectively. We trained a random forest–type machine learning algorithm to analyze the association between the outcome measure and the variables selected in the bivariate analysis. In order to understand how the model uses the variables to make its predictions, we applied the SHAP technique. This approach assigns a SHAP value to each value of each variable according to the extent to which it affects the prediction of the model (the higher the absolute SHAP value, the greater the influence of this data item on prediction) and to how it affects the prediction (if the SHAP value is positive, the data item positively affects the prediction, that is, it confers a higher value on the prediction). The SHAP summary graphs order the predictors by their importance in the predictions of the model. This importance is calculated with the mean of the SHAP values assigned to each data item of a variable; mean values <0.01 indicate the low importance of the variable in the model. We used a confusion matrix to visualize the performance of the model. This matrix shows the real class of the data items, together with the predicted class, and records the number of hits and misses.ResultsThe sample comprised 158 patients. 14.6% were lost to follow-up. 55.5% and 58.3% of the patients had MDA at the first and second follow-up visit, respectively. The importance of the variables in the model according to the mean of the SHAP values is shown in Table 1. The variables with the greatest predictive ability were global pain, impact of the disease (PsAID), patient global assessment of disease and physical function (HAQ-Disability Index). The SHAP values for each value of each variable are shown in Figure 1. The percentage of hits in the confusion matrix was 85.94%.Table 1.Variables in the predictions of the random forest for MDA according to the SHAP method.VariableImportance according to SHAP1Global pain0.069PsAID0.064Patient global assessment of disease0.047HAQ0.044Articular pattern at diagnosis0.029Physician global assessment of disease0.023Tender joint count0.014Sex0.009Weekly alcohol consumption0.0091Mean of the SHAP values for each value of the variable.MDA: minimal disease activity.Figure 1.SHAP summary graph.ConclusionA key objective in the management of PsA should be control of pain, which is not always associated with inflammatory burden, and the establishment of measures to better control the various domains of PsA.References[1]Coates LC, Fransen J, Helliwell PS. Defining minimal disease activity in psoriatic arthritis: a proposed objective target for treatment. Ann Rheum Dis. 2010;69:48-53.AcknowledgementsThe authors would like to acknowledge José Luis Fernández Sueiro for the conception of the study; José Miguel Carrasco for his contribution to the design of the study; Nuria Montero and Cristina Oliva for her contribution to data monitoring; Ana González Marcos and Cristina Pruenza for her contribution to data analysis; and Thomas O´Boyle for the translation of the manuscript.Disclosure of InterestsNone declared
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Miranda Ruiz E, Marimón Muñoz E, Stoppa Montserrat A, Fernandez I, Arroyo M, Borras N, Ferreiro S, Ramirez J. Use of Electro-Convulsive Therapy as a Bipolar Disorder Treatment: A Systematic Review. Eur Psychiatry 2022. [PMCID: PMC9567957 DOI: 10.1192/j.eurpsy.2022.1058] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Electro-convulsive Therapy (ECT) has been considered a useful for the treatment of depression and other affective disorders, however it is considered as a last resort given the risks and possible adverse effects. Objectives The objective of this review is to assess the use of ECT (in terms of efficacy and tolerability) for patients diagnosed with bipolar disorder and how it can be compared with other treatments more commonly used to treat this disorder. Methods A search was carried out in Medline and in the Virtual Health Library as well as in the Trripdatabase with the search terms “Bipolar disorder”, “Bipolar Depression”, “ECT”, “ECT treatment” and “Mania” in English and narrowing the search to the last 5 years. 8 articles were included for the review after applying inclusion and exclusion criteria. Results A favorable and well tolerated response was observed when applied ECT on patients with Bipolar disorder, especially the elderly populations. It was observed that the administration of unilateral and bilateral ECT are both equally effective. A better response was detected to ECT compared to newer treatments like ketamine, as well as lower suicide rate when ECT was used compared to other treatments. Conclusions ECT is considered an effective and safe treatment for Bipolar Disorder and should be taken into account not only as a last resort. Even so, given the limitations observed, it is necessary to carry out further investigation on the matter. Disclosure No significant relationships.
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González O, Picado C, Arismendi E, Alobid I, Ramirez J, Valero A, Bobolea I. Eosinophilic sialodochitis: a rare comorbidity of severe asthma. J Investig Allergol Clin Immunol 2022; 33:139-140. [PMID: 35503510 DOI: 10.18176/jiaci.0817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- O González
- Allergy Department, General University Hospital of Ciudad Real, Ciudad Real, Spain
| | - C Picado
- Allergy Section, Pulmonology and Respiratory Allergy Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - E Arismendi
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Pulmonology Department, Hospital Clínic, Barcelona, Spain
| | - I Alobid
- Otorhinolaryngology Department, Hospital Clínic, University of Barcelona, Spain
| | - J Ramirez
- Histopathology Department, Hospital Clínic, Barcelona, Spain
| | - A Valero
- Allergy Section, Pulmonology and Respiratory Allergy Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - I Bobolea
- Allergy Section, Pulmonology and Respiratory Allergy Department, Hospital Clínic, Barcelona, Spain
- Centro de Investigaciones Biomédicas en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
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Sanchez-Sandoval UA, Figueroa-Zamudio JJ, Ramirez J, Löest CA, Soto-Navarro SA, Smythe BG. The Effect of Horn Fly (Diptera: Muscidae) Infestation on Behavior, Water, and Feed Intake, and Digestion Characteristics of Beef Cattle. J Econ Entomol 2022; 115:365-370. [PMID: 34922372 DOI: 10.1093/jee/toab208] [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: 08/11/2021] [Indexed: 06/14/2023]
Abstract
Seven mature Angus × Hereford crossbreed cows (544 ± 23.2 kg of body weight) fitted with duodenal and ruminal cannulas were used in a crossover design to evaluate the effects of horn fly (Haematobia irritans) (L.) infestation on horn fly-induced defensive behaviors, feed and water intake, as well as digestion characteristics of beef cows. Cows were randomly assigned to one of two treatment groups: 1) a horn fly infested (1,000 flies per cow) or 2) a noninfested control group. All cows were housed in individual screened pens. Fly counts and infestations were performed daily to maintain consistent populations throughout the study. Sudan hay (11.4 % crude protein, dry matter basis) was selected to mimic forage quality that range cattle frequently graze in the southwest region. Horn fly-induced host defensive behaviors were greater (P ≤ 0.0002) for horn fly infested cattle. Intake of water, dry matter, organic matter, crude protein, and neutral detergent fiber were similar (P ≥ 0.4765) among infested and noninfested cows. However, total volatile fatty acid concentration tended to increase (P = 0.0967) when horn flies were present. Dry matter fecal excretion and total tract digestion were not affected (P ≥ 0.2602) by horn fly infestation. These data indicate that horn fly infestations do not affect forage intake or digestion characteristics of beef cattle (Bos taurus) in confinement settings.
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Affiliation(s)
- U A Sanchez-Sandoval
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM 80003, USA
| | - J J Figueroa-Zamudio
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM 80003, USA
| | - J Ramirez
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM 80003, USA
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM 80003, USA
| | - C A Löest
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM 80003, USA
| | - S A Soto-Navarro
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, NM 80003, USA
| | - B G Smythe
- Veterinary Entomology Research Laboratory, New Mexico State University, Las Cruces, NM 80003, USA
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Arco JE, Ortiz A, Ramirez J, Martinez-Murcia FJ, Zhang YD, Broncano J, Berbis MA, Royuela-del-Val J, Luna A, Gorriz JM. Probabilistic Combination of Non-Linear Eigenprojections For Ensemble Classification. IEEE Trans Emerg Top Comput Intell 2022. [DOI: 10.1109/tetci.2022.3210582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Juan E. Arco
- Department of Signal Theory, Networking and Communications, Andalusian Research Institute in Data Science and Computational Intelligence (DASCI), University of Granada, Granada, Spain
| | - Andres Ortiz
- Department of Signal Theory, Networking and Communications, Andalusian Research Institute in Data Science and Computational Intelligence (DASCI), University of Malaga, Málaga, Spain
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, Andalusian Research Institute in Data Science and Computational Intelligence (DASCI), University of Granada, Granada, Spain
| | - Francisco J. Martinez-Murcia
- Department of Signal Theory, Networking and Communications, Andalusian Research Institute in Data Science and Computational Intelligence (DASCI), University of Granada, Granada, Spain
| | - Yu-Dong Zhang
- School of Informatics, University of Leicester, Leicester, U.K
| | - Jordi Broncano
- Department of Radiology, Hospital San Juan de Dios, HT Médica, Cádiz, Spain
| | - M. Alvaro Berbis
- Department of Radiology, Hospital San Juan de Dios, HT Médica, Cádiz, Spain
| | | | - Antonio Luna
- Department of Radiology, Hospital San Juan de Dios, HT Médica, Cádiz, Spain
| | - Juan M. Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
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Ramirez J, Jones C, Leow TW, Rozwadowski S, Wijeyaratne M, Jones A, Hoffman C, Kirkham E. 1174 The Reporting of Centre and Surgeon Experience in Studies of Robot Assisted Cholecystectomy: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.811] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Over 90% of cholecystectomies are performed using minimally invasive techniques. Robotic cholecystectomy (RC) has been developed to overcome technical limitations of laparoscopy, including improved range of movement and visualisation. Despite becoming increasingly widespread, the safety and efficacy of RC remain unestablished. This review aims to analyse the quality assurance reporting through centre and surgeon expertise in RC.
Method
A systematic search was conducted to identify all published studies reporting RC. Data on quality assurance measures were collected, including: centres involved, surgeons’ experience and training.
Results
Of the 1425 abstracts screened, 90 full-text papers were included. Sixty-four studies (71%) were single institutions. Of the thirty studies (33%) reporting centre type, 28 were conducted in specialist/regional/tertiary centres. Only four stated their caseload of RC. No studies described pre-specified criteria or minimum experience required for a surgeon to participate. Fifty-two (58%) reported the number of surgeons operating and 13 (14%) stated surgeons’ training grade. Two quantified previous RC experience, 7 stated prior laparoscopic experience. Only 21 (23%) described training prior to the surgeons’ first in-human procedure; animal based (n = 12), simulation (n = 12), observation (n = 4), lab-based (n = 3). Specific mentorship was reported in 8 studies, and 13 described dual operating.
Conclusions
Little information was provided about the experience and training of operating surgeons, making it difficult to ascertain whether replicable techniques were utilised which would allow development of a learning curve. This highlights the need for better transparency when reporting surgical innovation, to ensure the safe, evidence-based adoption of new technologies into clinical practice.
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Affiliation(s)
- J Ramirez
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - C Jones
- North Bristol NHS Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - T W Leow
- University of Bristol, Bristol, United Kingdom
| | - S Rozwadowski
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | | | - A Jones
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - C Hoffman
- University of Bristol, Bristol, United Kingdom
| | - E Kirkham
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
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Higginbotham G, Zucker B, Ramirez J, Kirkham EN, Jones CS. 1096 Robot-Assisted Minimally Invasive Oesophagectomy: Comparing the Geography of Research Publication with The Global Burden of Disease. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.793] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Robot-assisted minimally invasive oesophagectomy (RAMIE) is increasingly used in the management of oesophageal tumours. It is unclear if there is equitable access to this innovative technique worldwide, specifically in areas of greatest need. This study aimed to map the geographic distribution of publications on RAMIE and compare this to global disease burden.
Method
Systematic searches identified all studies of RAMIE from inception to 2020. The country of origin of each study was identified. The incidence and age standardised rate (ASR) of oesophageal cancer for each country was obtained from The Global Cancer Observatory (GLOBOCAN) database. World Bank classifications of countries by income level were obtained.
Results
A total of 103 studies were identified. The majority (81%) were published in high-income countries, 15% in upper-middle, and 5% in lower-middle income countries. Thirty-four were published in the USA, the country with the fifth-highest incidence of oesophageal cancer worldwide, but 90th by ASR. The greatest incidence was in China (54% of global incidence) but was the source of only 15% of studies. Of the ten countries with the highest incidence, five were represented in published studies, in comparison to one of the top 10 by ASR.
Conclusions
There is evident disparity in the geographical distribution of published studies of RAMIE. This disparity may represent unequal access to surgical technologies, or a lack of evaluation of the technology in different healthcare settings. This may impact the generalisability of research findings. Equitable access to novel surgical technologies is ethical and can help address global disease burden.
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Affiliation(s)
- G Higginbotham
- North Bristol NHS Trust, Bristol, United Kingdom
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - B Zucker
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - J Ramirez
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - E N Kirkham
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - C S Jones
- North Bristol NHS Trust, Bristol, United Kingdom
- Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
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Ramirez J, Jones C, Gourbault L, Hurst W, Abbas A, Zucker B, Shah M, Scroggie D. 1158 Summarising the Reporting of Study Outcomes in Robotic Oesophagectomy: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.795] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
There is an increasing adoption of robotic oesophagectomy in place of standard techniques for oesophageal cancer resection. This is potentially due to its perceived technical benefits and improved short-term outcomes. Consistency in outcome selection, definition and reporting between studies is required for effective evidence synthesis and prevention of research waste. The aim of this review is to perform an in-depth analysis of outcome reporting in robotic oesophagectomy.
Method
Systematic searches were conducted using key words for robotic surgery and oesophageal cancer, from inception to February 2020. Studies reporting any outcome for robotic oesophagectomy were included. Outcomes in each study were recorded verbatim and categorised into twelve domains. Outcomes were independently categorised by two reviewers. Where reported, the follow-up period was also recorded.
Results
Of 954 abstracts screened, 226 full texts were reviewed and 102 included. Only one study was a RCT. A total of 1422 outcomes were reported. Each study had a median of 14 reported outcomes (range 1-25). Outcomes related to complications (n = 578, 99 studies), technical/operative factors (n = 290, 90 studies), and pathology (e.g., resection margin) (n = 197, 83 studies) were reported most frequently. No single outcome, or outcome domain was reported in all studies. No studies used a core outcome set for reporting. Forty-five studies stated a follow-up period, ranging from <1 month to 58 months.
Conclusions
There is significant heterogeneity in the selection and reporting of outcomes in robotic oesophagectomy. This calls for the use of a core outcome set to allow standardisation and transparency of outcome reporting.
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Affiliation(s)
- J Ramirez
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - C Jones
- University of Bristol, Bristol, United Kingdom
- North Bristol NHS Trust, Bristol, United Kingdom
| | - L Gourbault
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - W Hurst
- North Bristol NHS Trust, Bristol, United Kingdom
| | - A Abbas
- University of Bristol, Bristol, United Kingdom
| | - B Zucker
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- University of Bristol, Bristol, United Kingdom
| | - M Shah
- University of Bristol, Bristol, United Kingdom
| | - D Scroggie
- University of Bristol, Bristol, United Kingdom
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Gorriz JM, Jimenez-Mesa C, Segovia F, Ramirez J, Suckling J. A connection between pattern classification by machine learning and statistical inference with the General Linear Model. IEEE J Biomed Health Inform 2021; 26:5332-5343. [PMID: 34347610 DOI: 10.1109/jbhi.2021.3101662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A connection between the general linear model (GLM) with frequentist statistical testing and machine learning (MLE) inference is derived and illustrated. Initially, the estimation of GLM parameters is expressed as a Linear Regression Model (LRM) of an indicator matrix; that is, in terms of the inverse problem of regressing the observations. Both approaches, i.e. GLM and LRM, apply to different domains, the observation and the label domains, and are linked by a normalization value in the least-squares solution. Subsequently, we derive a more refined predictive statistical test: the linear Support Vector Machine (SVM), that maximizes the class margin of separation within a permutation analysis. This MLE-based inference employs a residual score and associated upper bound to compute a better estimation of the actual (real) error. Experimental results demonstrate how parameter estimations derived from each model result in different classification performance in the equivalent inverse problem. Moreover, using real data, the MLE-based inference including model-free estimators demonstrates an efficient trade-off between type I errors and statistical power.
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Rojas E, Valinotti V, Vazquez M, Roman L, Maidana M, Ramirez J, Cabrera-Villalba S. AB0193 PRESENCE OF SUBLINICAL SYNOVITIS IN A ESTABLISHED RHEUMATOID ARTHRITIS COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4208] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Some studies prove that a significant percentage of patients with rheumatoid arthritis (RA) in sustained clinical remission has radiological progression or joint damage, and the presence of residual activity objectified by imaging studies such as ultrasonography could be related to a relapse or flare of RA.(1,2)Objectives:To determine the presence of subclinical synovitis measured by ultrasonography in patients with RA on sustained clinical remission from the Rheumatology service at Hospital de Clínicas, San Lorenzo, Paraguay.Materials and Methods:Prospective, cross sectional, descriptive study, in RA patients meeting ACR/EULAR 2010 criteria, older than 18 years, on sustained clinical remission (≥6 months), measured by ESR-DAS28 (<2,6), doing follow-ups on our service. A healthy control group was included. All groups signed informed consent. Synovial hypertrophy (SH) and intraarticular vascularization grades on Power Doppler (PD) mode were determined according to EULAR recommendations and OMERACT 7 group definitions. Clinical data were obtained from the service’s registries.SPSS 23rd version was used for data analysis. Quantitative variables were presented as means and qualitative as frequencies. Chi square test was performed for comparisons between dichotomous variables and t Student for continuous. For comparisons between variables the Spearman’s rank correlation coefficient was performed, and p≤0.05 for statistical significance. Factors predicting subclinical synovitis were analyzed with Odds Ratio (OR) CI 95%.Results:From 147 patients, 31 (21%) met remission criteria; 87.1% women, mean age 51.9±14.8 years. Mean disease duration was 9,06±10,81 years. 64,5% were RF and ACPA positive and 25,9% had erosions.Ultrasonograms were made in 20 joints of both hands: radiocarpals (RC), metacarpophalangeals (MCP) and proximal interphalangeals (PIP). 12 patients (38.7%) presented subclinical synovitis (SH≥2+PD), more frequently on RC (29% right, 22.6% left), and MCP (9.7% on 2RMCP, 9.7% 4LMCP). These patients had greater CDAI (3.9±1.37 vs 2.89±1.15, p=0.03), HAQ (0.14±0.29 vs 0.00±0.00, p=0.04), CRP (9.90±7.46 vs 4.74±2.30, p=0.00) RF levels (502.67±275.66 vs 200.92±158.43, p=0,00), greater prednisone (16.5% vs 3.2%, p=0.04), and methotrexate use (20.16±5.54 vs 17.50±3.98, p=0.01). None of the healthy controls presented subclinical synovitis.In binary logistic regression CRP levels, RF titers and methotrexate doses were associated to subclinical synovitis. This association is not found in multivariate logistic regression. Negative association was found between subclinical synovitis and two csDMARDs use.Conclusion:This is the first study of its type in Paraguayan patients, which clearly evidenced that an important part of RA patients in clinical remission still presented subclinical synovitis (HS≥2 + PD). It was associated with CRP, RF and methotrexate dose.References:[1]Płaza M, Nowakowska-Płaza A, Pracoń G, Sudoł-Szopińska I. Role of ultrasonography in the diagnosis of rheumatic diseases in light of ACR/EULAR guidelines. J Ultrason. marzo de 2016;16(64):55-64.[2]Foltz V, Gandjbakhch F, Etchepare F, Rosenberg C, Tanguy ML, Rozenberg S, et al. Power Doppler ultrasound, but not low-field magnetic resonance imaging, predicts relapse and radiographic disease progression in rheumatoid arthritis patients with low levels of disease activity. Arthritis & Rheumatism. 2012;64(1):67-76.Disclosure of Interests:None declared
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Miller R, Ambler G, Ramirez J, Rees J, Hinchliffe R, Twine C, Rudd S, Blazeby J, Avery K. Patient Reported Outcome Measures for Major Lower Limb Amputation Caused by Peripheral Artery Disease or Diabetes: A Systematic Review. J Vasc Surg 2021. [DOI: 10.1016/j.jvs.2021.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zhang YD, Dong Z, Wang SH, Yu X, Yao X, Zhou Q, Hu H, Li M, Jiménez-Mesa C, Ramirez J, Martinez FJ, Gorriz JM. Advances in multimodal data fusion in neuroimaging: Overview, challenges, and novel orientation. Inf Fusion 2020; 64:149-187. [PMID: 32834795 PMCID: PMC7366126 DOI: 10.1016/j.inffus.2020.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/06/2020] [Accepted: 07/14/2020] [Indexed: 05/13/2023]
Abstract
Multimodal fusion in neuroimaging combines data from multiple imaging modalities to overcome the fundamental limitations of individual modalities. Neuroimaging fusion can achieve higher temporal and spatial resolution, enhance contrast, correct imaging distortions, and bridge physiological and cognitive information. In this study, we analyzed over 450 references from PubMed, Google Scholar, IEEE, ScienceDirect, Web of Science, and various sources published from 1978 to 2020. We provide a review that encompasses (1) an overview of current challenges in multimodal fusion (2) the current medical applications of fusion for specific neurological diseases, (3) strengths and limitations of available imaging modalities, (4) fundamental fusion rules, (5) fusion quality assessment methods, and (6) the applications of fusion for atlas-based segmentation and quantification. Overall, multimodal fusion shows significant benefits in clinical diagnosis and neuroscience research. Widespread education and further research amongst engineers, researchers and clinicians will benefit the field of multimodal neuroimaging.
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Affiliation(s)
- Yu-Dong Zhang
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Zhengchao Dong
- Department of Psychiatry, Columbia University, USA
- New York State Psychiatric Institute, New York, NY 10032, USA
| | - Shui-Hua Wang
- Department of Information Systems, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- School of Architecture Building and Civil engineering, Loughborough University, Loughborough, LE11 3TU, UK
- School of Mathematics and Actuarial Science, University of Leicester, LE1 7RH, UK
| | - Xiang Yu
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Xujing Yao
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Qinghua Zhou
- School of Informatics, University of Leicester, Leicester, LE1 7RH, Leicestershire, UK
| | - Hua Hu
- Department of Psychiatry, Columbia University, USA
- Department of Neurology, The Second Affiliated Hospital of Soochow University, China
| | - Min Li
- Department of Psychiatry, Columbia University, USA
- School of Internet of Things, Hohai University, Changzhou, China
| | - Carmen Jiménez-Mesa
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Francisco J Martinez
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
| | - Juan Manuel Gorriz
- Department of Signal Theory, Networking and Communications, University of Granada, Granada, Spain
- Department of Psychiatry, University of Cambridge, Cambridge CB21TN, UK
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Sequero Lopez S, Guarino J, Castillo-Barnes D, Jurado García J, Ramirez J, Salas-Gonzalez D, Gorriz J. 896P Analysis of DLBCL genetic databases using machine learning. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.014] [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: 10/23/2022] Open
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Castellanos-Moreira R, Rodriguez-Garcia S, Cajiao K, Jimenez G, Gomara MJ, Ruiz V, Casafont-Solé I, Ramirez J, Gomez Puerta J, Holgado Pérez S, Cañete JDD, Haro I, Sanmartí R. SAT0030 A NOVEL ASSOCIATION BETWEEN ANTI-CARBAMYLATED ANTIBODIES AND INTERSTITIAL LUNG DISEASE IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1993] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Interstitial lung disease (ILD) is associated with a significant increase in morbidity and mortality in patients with rheumatoid arthritis (RA). Therefore, an early diagnosis is fundamental. Anti-carbamylated proteins (Anti-CarP) have been described in different chronic respiratory diseases without a previous history of RA.Objectives:The aim of this study was to analyse the association between Anti-CarP and ILD in RA patients.Methods:We performed a cross-sectional study, including RA patients fulfilling the 2010 ACR/EULAR criteria. The main population comprised 2 groups: 1) RA patients diagnosed with ILD (RA-ILD group) and 2) RA patients without ILD (non-ILD RA group). ILD was diagnosed by high-resolution tomography and confirmed by a multidisciplinary committee. Three IgG Anti-CarP autoantibodies against fetal calf serum (Anti-FCS), fibrinogen (Anti-Fib), and fibrine/filagrine homocitrullinated peptide (Anti-CFFHP) and one IgA against FCS (Anti-FCS-IgA) were determined by home-made ELISA. Associations between Anti-CarPs and ILD were explored using multivariable logistic regression adjusted by a set of variables known to be related to the development of ILD: smoking, sex, age, RA disease duration, RF and ACPA. An independent replication sample was obtained to validate our findings from another hospital.Results:The main population included 179 patients: 37 were included in the RA-ILD group, and 142 in the non-ILD RA group. Most patients were female (79%), with a mean age of 59.7±13 years with a mean disease duration of 6.6±5 years. Baseline features are shown in table 1. The replication sample was composed of 25 patients in the RA-ILD group and 50 patients in the non-ILD RA group. We found that Anti-CarPs specificities were more frequent in RA-ILD patients (Anti-FCS 70% vs. 43%; Anti-Fib 73% vs. 51%; Anti-CFFHP 38% vs. 19%; Anti-CarP-IgA 51% vs. 20%, p<0.05 for all comparisons). Serum mean titers of Anti-CarPs were higher in RA-ILD patients with significant statistical differences for all of them, except Anti-Fib. The multivariate analysis showed that Anti-CarPs specificities were independently associated with ILD (Anti-FCS (OR: 3.42; CI95%: 1.13-10.40), Anti-Fib (OR: 2.85; CI95%: 0.83-9.70), Anti-CFFHP (OR: 3.11; CI95%: 1.06-9.14) and Anti-FCS-IgA (OR: 4.30; CI95%: 1.41-13.04). In the replication sample our findings were validated only for Anti-FCS (OR: 10.42; CI95%: 1.68-64.46).TABLE 1.Main population demographic, clinical, therapeutic, and autoantibody status features.RA-ILDn:37Non-ILD RAn:142p valueFemale (%)25 (68)116 (82)NSAge mean (±SD)67.3 (10.1)57.7 (12.9)<0.005Mean disease duration (±SD)11.6 (7.1)5.3 (13.3)<0.005Ever smokers (%)21 (57)62 (44)NSSmoking cumulative dose (±SD)30.7 (11.1)21.8 (12)<0.005Caucasian (%)31 (84)120 (85)NSTreatmentGlucocorticoids (%)25 (68)81 (57)NScsDMARDs (%)33 (89)132 (86)NSMTX (%)20 (54)95 (67)NSbDMARDs (%)11 (30)36 (25)NSMean DAS28 (±SD)3.71 (1.35)2.74 (1.05)<0.005Erosive disease (%)26 (70)63 (44)<0.005Mean HAQ-DI (CI-95%)0.69 (0.53-0.85)0.31 (0.24-0.38)<0.005ACPA positive (%)29 (78)99 (70)NSMedian titer ACPA (IQR) CU674 (2,215)143 (1,132)NSRF positive (%)28 (76)83 (59)NSMedian titer RF (IQR) IU105 (298)34 (110)NSConclusion:A strong association between RA-ILD and Anti-CarP was found independently of cofounders, including RF and ACPA. Our findings suggest a possible link between Anti-CarP and the development of ILD.Disclosure of Interests:Raul Castellanos-Moreira Speakers bureau: Lilly, MSD, Sanofi, UCB, Sebastian Rodriguez-Garcia: None declared, Katherine Cajiao: None declared, Gabriela Jimenez: None declared, Maria Jose Gomara: None declared, Virginia Ruiz Speakers bureau: Lilly, Pfizer, Ivette Casafont-Solé: None declared, Julio Ramirez: None declared, José Gomez Puerta Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer, Susana Holgado Pérez: None declared, Juan de Dios Cañete: None declared, Isabel Haro: None declared, Raimón Sanmartí Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer
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Azuaga-Piñango AB, Frade-Sosa B, Gumucio R, Cajiao K, Cuervo A, Celis R, Gómez-Puerta JA, Sanmartí R, Cañete JDD, Ramirez J. FRI0053 PROLIFERATIVE SYNOVITIS, AN ULTRASOUND PATTERN ASSOCIATED WITH ACPA POSITIVE RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Seronegative (sero-) and seropositive (sero+) Rheumatoid Arthritis (RA) have different genetic, immunopathological and vascular morphology features, but no previous studies have analyzed if US characteristics differ between sero+ or sero- RA. Our preliminary studies suggest that sero+ RA is associated with an expansive synovitis pattern that we have called “proliferative synovitis” (PS)Objectives:To analyze potential differences between patients with RA according to their autoantibody status by using ultrasonography (US). We aimed to assess whether PS is associated with ACPA+ ptsMethods:We collected clinical, epidemiological data and bilateral carpal and hand US images of pts with RA. Synovial hypertrophy (SH), Power Doppler signal (PD) and total score (sum of scores of SH and PD) in wrist and hand (1-5 metacarpophalangeal) were assessed. We evaluated the presence of PS, defined as expansive synovial growth encompassing the concepts of synovial SH grade II and III. We performed synovial biopsies of a subgroup of pts using arthroscopy or US guided in order to see immunohistochemistry differences between “proliferative” and “flat” (non-proliferative) synovitis. Serum levels of angiogenic and inflammatory biomarkers were performedResults:Two hundred and five RA patients were collected. Overall, 173 (84.8%) pts were sero+ for RF (68.7%) or ACPA (74.6%), general characteristics are summarized in Table. No significant differences between sero+ and sero- pts in terms of disease activity or therapy were found. PS was present in 55.5% of sero+ pts (55.3% in RF+ and 58.2% in ACPA+ pts) and 16.1% of sero- pts (p=0.0001). Globally, 101 pts (49.2%) had PS. Ninety-six (95.0%) were RF or ACPA positive. Only 5 pts with sero- RA had PS (p=0.001). In the univariate analysis, significantly more pts with PS had erosive disease (72.3% vs 35.0% p=0.0001), higher US scores (p=0.0001) and more of them were taking conventional synthetic Disease-modifying anti-rheumatic drugs (csDMARD) (81.8% vs 69.6% p=0.05). No differences regarding disease activity were found.In the multivariate analysis erosions [OR 4.90 CI 95% (2.17-11.07) p=0.0001] and ACPA [OR 3.5 CI 95% (1.39-10.7) p=0.09] but not RF status [OR 0.74 CI 95% (0.31-1.71) p=0.483] were independently associated with the presence of PS.We immunostained synovial biopsies from 23 pts with PS (13 pts) or non-PS (10 pts). PS was significantly associated with higher density of vessels (p=0.042) and a strong trend to a higher density of B, T, Mast cells and macrophages (figure 1). Significantly higher serum levels of angiogenic (Activin A, bFGF, IL18, IL20, PIGF, SDF-1 and VEGF-D) and pro-inflammatory (IL23) cytokines were found in patients with PS (figure 2).Conclusion:The presence of “proliferative Synovitis” was significantly associated with ACPA and erosive disease in patients with RA. PS pattern also was associated with higher density of synovial vessels and higher serum levels of angiogenic and inflammatory mediatorsTable .Total US pattern p valueN=205Proliferative (N=101)Non proliferative (N=104)Female, n (%)162 (79.4)79 (78.2)83 (80.6)0.57Age, mean (SD) years57.1 (± 14,1)56.3 (± 12.0)58.0 (± 15.9)0.40Current Smoker, n (%)47 (26.9)22 (25.6)25 (28.1)0.73Disease duration, mean (SD) months113.3 (± 105.7)127.7 (± 111.1)99.3 (± 99.3)0.05Erosion, n (%)108 (53.7)73 (72.3)35 (35.0)0.00ACPA, n (%)153 (75.4)89 (89)64 (62.1)0.00RF, n (%)99 (68.3)78 (78)63 (61.2)0.01DAS 28–CRP, mean (SD)2.55 (±1.03)2.66 (±1.04)2.44 (±1.02)0.17GC, n (%)99 (49.3)45 (45.5)54 (52.9)0.32cDMARDs, n (%)152 (75.6)81 (81.8)71 (69.6)0.05bDMARD, n (%)69 (34.3)35 (35.4)34 (33.3)0.76Total US score14.9 (± 11.5)18.8 (± 11.8)11.1 (± 9.9)0.00*ACPA anti-citrullinated protein antibodies, RF rheumatoid factor, DAS28-CRP Disease Activity Score 28-joint count, CRP C-reactive protein, GC glucocorticoids, bDMARD biological disease-modifying antirheumatic drugsDisclosure of Interests:Ana Belén Azuaga-Piñango: None declared, Beatriz Frade-Sosa: None declared, Roberto Gumucio: None declared, Katherine Cajiao: None declared, Andrea Cuervo: None declared, Raquel Celis: None declared, Jose A. Gómez-Puerta Speakers bureau: Abbvie, BMS, GSK, Lilly, Pfizer, Roche, Raimón Sanmartí Speakers bureau: Abbvie, Eli Lilly, BMS, Roche and Pfizer, Juan de Dios Cañete: None declared, Julio Ramirez: None declared
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Galindez E, Prieto-Peña D, Martín-Varillas JL, Joven-Ibáñez B, Rusinovich O, Almodovar R, Alegre-Sancho JJ, Mendez Diaz L, Sellas-Fernández A, Martínez-Ferrer À, Garcia de Vicuna R, Ventín-Rodríguez C, Ramirez J, Moreno M, Moreno MJ, Castro Villegas MDC, Crespo Golmar A, Palmou-Fontana N, Ortiz Sanjuan F, Larco Rojas XE, Mas AJ, Soleto CY, Gorostiza I, González-Gay MA, Blanco R. AB0768 TREATMENT WITH TOFACITINIB IN REFRACTORY PSORIATIC ARTHRITIS. MULTICENTER STUDY OF 87 PATIENTS IN CLINICAL PRACTICE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Tofacitinib (TOFA) is the first JAKi approved for psoriatic arthritis (PsA) in Europe (July 2018). TOFA has shown efficacy in refractory patients to anti-TNF in Randomized Clinical Trials (RCT) (Gladman D. NEJM 2017; 377: 1525-36).Objectives:To assess efficacy and safety of TOFA in clinical practice (CP). To compare the profile of CP with RCTMethods:Study of 87 patients of CP with PsA treated with TOFA; Results are expressed as percentage, mean±SD or median [IRQ].Results:87 patients (28♀/59♂), mean age of 52.8±11.4 years (Table 1). Pattern of joint involvement was: peripheral (n=60), axial (1) and mixed (26). Presented also enthesitis (49.4%), nail involvement (30.2%) and dactylitis (31%).Prior TOFA, most patients (80%) received oral prednisone, synthetic immunosuppressants (mean 2.3±0.9) and biological therapy (BT) (3.6±1.9): etanercept (n=58), adalimumab (54), infliximab (31), golimumab (37), certolizumab (30), secukinumab (54), ustekinumab (39) and ixekizumab (2). Apremilast was used in 17.After a mean follow-up of 12.3±9.3 years from PsA diagnosis, TOFA was started (5 mg/12 h). In 48 (55.2%) TOFA was used in combined therapy: methotrexate (30) and leflunomide (15). In the remaining 39, monotherapy was prescribed.Patients of CP compared with RCT have a longer duration of PsA, worst functional disability (HAQ) and received a higher proportion of corticosteroids and BT (anti-TNF and non-anti-TNF) (Table 1).Patients improved in activity indexes (PASI, DAS28, DAPSA) and laboratory test (table 2). Minor side effects were reported in 21 patients (gastrointestinal symptoms), and TOFA was discontinued in 29 due to inefficiency mainly.Conclusion:Patients of CP had a longer evolution and received a greater number of biologics than those of RCT. TOFA as in RCT seems effective, rapid and relatively safe for refractory PsA.Table 1.Baseline featuresCLINICAL TRIALGladmanN=131CLINICAL PRACTICEN=87Age, years (mean±SD)49.5±12.352.8±11.4Sex, n (%)67M/64F (51/49)59M/28F (68/32.2)Duration PsA, years (mean±SD)9.6±7.612,3±9.3HAQ-DI1.3±0.71.4±0.7 (n=26)Swollen joint count, mean±SD12.1±10.65.7±5.8Painful joint count, mean±SD20.5±13.08.0±6.6Elevated CRP, n (%)85 (65)55 (63.2)PASI score, median [IQR]7.6 [0.6-32.2]9.0 [4.2-15]Oral glucocorticoid, n (%)37(28)44(50.5)Concomitant synthetic DMARDs, n (%)- Methotrexate98 (75)30 (34.4)- Leflunomide12 (9)15 (17.2)- Sulfasalazine21 (16)6 (6.9)- Others2 (2)N. of previous TNF inhibitors, mean±SD1.7±1.02.4±1.4Previous use of other biological no anti-TNF, n (%)11 (8)68 (78.2)Table 2.Table 2. Improvement at 1st, 6thand 12thmonthBaselinen=871st monthn=776th monthn=5212th monthn=20Nail involvement, n (%)17 (19.5)Improvement, n (%)5 (35.7)6 (60)5 (83.3)Enthesitis, n (%)28 (32.2)Improvement, n (%)8 (47.1)10 (58.8)3 (50)Dactylitis, n (%)16 (18.4)Improvement, n (%)9 (69.2)6 (85.7)0 (0)CRP mg/dl, median [IQR]1.9 [0.3-5]0.5 [0.1-2.2]0.5 [0.3-1.2]0.4 [0.4-3.7]p (vs baseline)0.0040.0050.66DAS28, median [IQR]4.8 [4.1-5.403.7 [2.8-4.6]2.8 [2.2-3.8]2.9 [2.2-3.7]p (vs baseline)<0.001<0.001<0.001DAPSA, median [IQR]28 [18.41-34.05]15.5 [10.1-25.7]9 [6.07-15]4.3 [2.4-8]p (vs baseline)<0.001<0.001<0.001PASI, median [IQR]5 [1-14]1.4 [0-7]0 [0-4]0.05 [0-2.7]p (vs baseline)0.1920.1050.300Disclosure of Interests:E. Galindez: None declared, D. Prieto-Peña: None declared, José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Janssen and Celgene, Speakers bureau: Pfizer and Lilly, Beatriz Joven-Ibáñez Speakers bureau: Abbvie, Celgene, Janssen, Merck Sharp & Dohme, Novartis, Pfizer, Olga Rusinovich: None declared, RAQUEL ALMODOVAR Speakers bureau: Abbvie, Celgene, Janssen, Lilly, Novartis, Pfizer., Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis, LARA MENDEZ DIAZ: None declared, Agusti Sellas-Fernández Speakers bureau: Abbott, Lilly, Celgene, Pfizer, Schering-Plough, Janssen, Novartis, and Nordic Pharma, À Martínez-Ferrer: None declared, Rosario Garcia de Vicuna Grant/research support from: BMS, Lilly, MSD, Novartis, Roche, Consultant of: Abbvie, Biogen, BMS, Celltrion, Gebro, Lilly, Mylan, Pfizer, Sandoz, Sanofi, Paid instructor for: Lilly, Speakers bureau: BMS, Lilly, Pfizer, Sandoz, Sanofi, Clara Ventín-Rodríguez: None declared, Julio Ramirez: None declared, Manuel Moreno: None declared, Maria jose Moreno: None declared, María del Carmen Castro Villegas: None declared, Antia Crespo Golmar: None declared, Natalia Palmou-Fontana: None declared, FRANCISCO ORTIZ SANJUAN: None declared, Ximena Elizabeth Larco Rojas: None declared, Antonio Juan Mas: None declared, Christian Y Soleto: None declared, Iñigo Gorostiza: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Ricardo Blanco Grant/research support from: AbbVie, MSD, and Roche, Speakers bureau: AbbVie, Pfizer, Roche, Bristol-Myers, Janssen, and MSD
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Martinez-Murcia FJ, Ortiz A, Gorriz JM, Ramirez J, Lopez-Abarejo PJ, Lopez-Zamora M, Luque JL. EEG Connectivity Analysis Using Denoising Autoencoders for the Detection of Dyslexia. Int J Neural Syst 2020; 30:2050037. [PMID: 32466692 DOI: 10.1142/s0129065720500379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/24/2023]
Abstract
The Temporal Sampling Framework (TSF) theorizes that the characteristic phonological difficulties of dyslexia are caused by an atypical oscillatory sampling at one or more temporal rates. The LEEDUCA study conducted a series of Electroencephalography (EEG) experiments on children listening to amplitude modulated (AM) noise with slow-rythmic prosodic (0.5-1[Formula: see text]Hz), syllabic (4-8[Formula: see text]Hz) or the phoneme (12-40[Formula: see text]Hz) rates, aimed at detecting differences in perception of oscillatory sampling that could be associated with dyslexia. The purpose of this work is to check whether these differences exist and how they are related to children's performance in different language and cognitive tasks commonly used to detect dyslexia. To this purpose, temporal and spectral inter-channel EEG connectivity was estimated, and a denoising autoencoder (DAE) was trained to learn a low-dimensional representation of the connectivity matrices. This representation was studied via correlation and classification analysis, which revealed ability in detecting dyslexic subjects with an accuracy higher than 0.8, and balanced accuracy around 0.7. Some features of the DAE representation were significantly correlated ([Formula: see text]) with children's performance in language and cognitive tasks of the phonological hypothesis category such as phonological awareness and rapid symbolic naming, as well as reading efficiency and reading comprehension. Finally, a deeper analysis of the adjacency matrix revealed a reduced bilateral connection between electrodes of the temporal lobe (roughly the primary auditory cortex) in DD subjects, as well as an increased connectivity of the F7 electrode, placed roughly on Broca's area. These results pave the way for a complementary assessment of dyslexia using more objective methodologies such as EEG.
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Affiliation(s)
- Francisco J Martinez-Murcia
- Department of Communications Engineering, University of Malaga, Malaga, Spain.,DaSCI Andalusian Institute of Data Science and Computational Intelligence, University of Granada, Granada, Spain
| | - Andres Ortiz
- Department of Communications Engineering, University of Malaga, Malaga, Spain.,DaSCI Andalusian Institute of Data Science and Computational Intelligence, University of Granada, Granada, Spain
| | - Juan Manuel Gorriz
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain.,DaSCI Andalusian Institute of Data Science and Computational Intelligence, University of Granada, Granada, Spain
| | - Javier Ramirez
- Department of Signal Processing, Networking and Communications, University of Granada, Granada, Spain.,DaSCI Andalusian Institute of Data Science and Computational Intelligence, University of Granada, Granada, Spain
| | | | - Miguel Lopez-Zamora
- Department of Evolutive Psychology and Education, University of Malaga, Malaga, Spain
| | - Juan Luis Luque
- Department of Evolutive Psychology and Education, University of Malaga, Malaga, Spain
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Riva E, Schütz N, Peña C, Ruiz-Argüelles G, Hopkins CR, Bove V, Villano F, Andino L, Suárez L, Martínez H, Navarro J, López-Vidal H, Da Costa O, Pineda MR, Rubio Y, Ramirez J, Choque J, Fantl D. Significant differences in access to tests and treatments for multiple myeloma between public and private systems in Latin America. Results of a Latin American survey. GELAMM (Grupo de Estudio Latino Americano de Mieloma Múltiple). Ann Hematol 2020; 99:1025-1030. [PMID: 32157420 DOI: 10.1007/s00277-020-03983-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 03/01/2020] [Indexed: 12/14/2022]
Abstract
The incidence of multiple myeloma (MM) has increased in the last 20 years, particularly in middle and low-middle income countries. Access to diagnostic and prognostic tests and the availability of effective care is highly variable globally. Latin America represents 10% of the world population, distributed in countries of varied size, population, and socio-economic development. In the last decade, great improvements have been made in the diagnosis and treatment of MM. Applying these advances in real life is a challenge in our region. Local data regarding MM standards of care and outcomes are limited. A survey was carried out among hematologists from 15 Latin American countries to describe access to MM diagnostic and prognostic tests and the availability of effective care options. This study provides real-world data for MM in our region, highlighting striking differences between public and private access to essential analyses and therapeutic options.
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Affiliation(s)
- Eloísa Riva
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay.
| | - N Schütz
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - C Peña
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | | | - C Rojas Hopkins
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - V Bove
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - F Villano
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - L Andino
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - L Suárez
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - H Martínez
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - J Navarro
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - H López-Vidal
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - O Da Costa
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | | | - Y Rubio
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - J Ramirez
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - J Choque
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - D Fantl
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
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Ramirez J, Monedero S, Silva CA, Cardil A. Stochastic decision trigger modelling to assess the probability of wildland fire impact. Sci Total Environ 2019; 694:133505. [PMID: 31394328 DOI: 10.1016/j.scitotenv.2019.07.311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 06/10/2023]
Abstract
The ability to estimate both the time and probability of a wildfire reaching an area to be protected is critically important to preventing loss of human life and property, and damage to ecological and economic assets. Wildfire decision trigger modelling has been used to assess fire exposure and create evacuation trigger buffers around the communities providing a specific amount of warning time. This approach has been applied in multiple scenarios including household-level and community-level evacuation planning and during suppression operations. However, little attention has been paid to input data uncertainty using this modelling approach. This study presents an innovative stochastic fire simulation decision trigger modelling method that produces a probability map of the fire arrival to areas to be protected by simulating (n) wildfire decision trigger buffers with varied input data according to a potential range of deviations. The Tubbs fire (USA) was used as case study to show the applicability of this approach to estimate the probability of wildland fire impact. Our results highlighted the importance of considering input data uncertainty in operational environments to estimate fire progression and decision trigger buffers to better develop suppression tactic and strategy. The method presented may be solved in real-time and used with any empirical fire propagation model as a core engine. Practical real-time implications of this fire simulation mode are discussed.
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Affiliation(s)
- J Ramirez
- Technosylva, UCSD Calit2 Qualcomm Institute, La Jolla, CA 92037, USA
| | - S Monedero
- Tecnosylva, Parque Tecnológico de León, 24009 León, Spain
| | - C A Silva
- NASA Goddard Space Flight Center, Biospheric Sciences Lab, Greenbelt, MD, USA; Department of Geographical Sciences, University of Maryland, College Park, MD, USA
| | - A Cardil
- Technosylva, UCSD Calit2 Qualcomm Institute, La Jolla, CA 92037, USA; Tecnosylva, Parque Tecnológico de León, 24009 León, Spain.
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Kotowicz N, Bhardwaj R, Ferreira W, Hong H, Olender A, Ramirez J, Cutting S. Safety and probiotic evaluation of two Bacillus strains producing antioxidant compounds. Benef Microbes 2019; 10:759-771. [DOI: 10.3920/bm2019.0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Bacillus species are becoming increasingly relevant for use as probiotics or feed additives where their heat stability can ensure survival in the food matrix or enable long-term storage at ambient temperature. Some Bacillus species are pigmented and in this study, we have examined two strains, one Bacillus pumilus (pigmented red) and the other Bacillus megaterium (pigmented yellow) for their safety for potential use in humans as dietary supplements. In addition, we have set out to determine if they might confer any potential health benefits. Both strains produce C30 carotenoids while the B. pumilus strain also produced large quantities of riboflavin equivalent to genetically modified Bacillus strains and most probably contributing to this strain’s pigmentation. Riboflavin’s and carotenoids are antioxidants, and we have evaluated the ability of vegetative cells and/or spores to influence populations of Faecalibacterium prausnitzii in the colon of mice. While both strains increased levels of F. prausnitzii, spores of the B. pumilus strain produced a significant increase in F. prausnitzii levels. If found to be reproducible in humans such an effect might, potentially, confer health benefits particularly for those suffering from inflammatory bowel disease.
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Affiliation(s)
- N. Kotowicz
- SporeGen Ltd., Bourne Labs, Egham, Surrey, TW20 OEX, United Kingdom
| | - R.K. Bhardwaj
- School of Biological Sciences, Royal Holloway University of London, Egham, Surrey, TW20 OEX, United Kingdom
| | - W.T. Ferreira
- School of Biological Sciences, Royal Holloway University of London, Egham, Surrey, TW20 OEX, United Kingdom
| | - H.A. Hong
- School of Biological Sciences, Royal Holloway University of London, Egham, Surrey, TW20 OEX, United Kingdom
| | - A. Olender
- Department of Medical Microbiology, Medical University of Lublin, Chodzki 1 Street, Lublin, 20-093, Poland
| | - J. Ramirez
- Enviromedica, 2301 Scarbrough Drive, Suite 300, Austin, TX 78728, USA
| | - S.M. Cutting
- SporeGen Ltd., Bourne Labs, Egham, Surrey, TW20 OEX, United Kingdom
- School of Biological Sciences, Royal Holloway University of London, Egham, Surrey, TW20 OEX, United Kingdom
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Ramirez J. MS17.02 Major Pathological Evaluation in Neoadjuvant Immunotherapy. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.378] [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: 11/29/2022]
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Alcaraz J, Carrasco J, Laura M, Martínez-Romero A, De Cos JS, Rami-Porta R, Seijo L, Ramirez J, Reguart N, Barreiro E, Monsó E. MA15.10 Stromal Markers of Activated Tumor Associated Fibroblasts Predict Poor Survival and Are Associated with Necrosis in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Castellano J, Navarro A, Molins L, Canals J, Marrades R, Viñolas N, Moises J, Casadevall M, Li Y, Han B, Martinez D, Martin J, Garisoain A, Muñoz C, Ramirez J, Monzo M. Pulmonary tumour-draining vein exosomal lincRNA-p21 levels impacts non-small cell lung cancer prognosis. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz258.005] [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: 11/13/2022] Open
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Dudek C, Ramirez J, Little I, Wiser K, Papa L, Ibrahim J. 375 Is the Use of Thromboelastography in the Acute Young Trauma Patient Associated With Outcome and the Type and Amount of Blood Products Received? Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.336] [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: 11/16/2022]
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Martinez-Murcia FJ, Ortiz A, Gorriz JM, Ramirez J, Castillo-Barnes D. Studying the Manifold Structure of Alzheimer's Disease: A Deep Learning Approach Using Convolutional Autoencoders. IEEE J Biomed Health Inform 2019; 24:17-26. [PMID: 31217131 DOI: 10.1109/jbhi.2019.2914970] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Many classical machine learning techniques have been used to explore Alzheimer's disease (AD), evolving from image decomposition techniques such as principal component analysis toward higher complexity, non-linear decomposition algorithms. With the arrival of the deep learning paradigm, it has become possible to extract high-level abstract features directly from MRI images that internally describe the distribution of data in low-dimensional manifolds. In this work, we try a new exploratory data analysis of AD based on deep convolutional autoencoders. We aim at finding links between cognitive symptoms and the underlying neurodegeneration process by fusing the information of neuropsychological test outcomes, diagnoses, and other clinical data with the imaging features extracted solely via a data-driven decomposition of MRI. The distribution of the extracted features in different combinations is then analyzed and visualized using regression and classification analysis, and the influence of each coordinate of the autoencoder manifold over the brain is estimated. The imaging-derived markers could then predict clinical variables with correlations above 0.6 in the case of neuropsychological evaluation variables such as the MMSE or the ADAS11 scores, achieving a classification accuracy over 80% for the diagnosis of AD.
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Ortiz A, Lozano F, Gorriz JM, Ramirez J, Martinez Murcia FJ. Discriminative Sparse Features for Alzheimer's Disease Diagnosis Using Multimodal Image Data. Curr Alzheimer Res 2019; 15:67-79. [PMID: 28934923 DOI: 10.2174/1567205014666170922101135] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 11/21/2016] [Revised: 09/13/2017] [Accepted: 09/22/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Feature extraction in medical image processing still remains a challenge, especially in high-dimensionality datasets, where the expected number of available samples is considerably lower than the dimension of the feature space. This is a common problem in real-world data, and, specifically, in medical image pro- cessing as, while images are composed of hundreds of thousands voxels, only a reduced number of patients are available. OBJECTIVE Extracting descriptive and discriminative features to represent each sample (image) by a small number of features, which is particularly important in classification task, due to the curse of dimensionality problem. METHODS In this paper we solve this recognition problem by means of sparse representations of the data, which also provides an arena to multimodal image (PET and MRI) data classification by combining specialized classifiers. Thus, a novel method to effectively combine SVC classifiers is presented here, which uses the distance to the hyperplane computed for each class in each classifier allowing to select the most discriminative image modality in each case. The discriminative power of each modality also provides information about the illness evolution; while functional changes are clearly found in Alzheimer's diagnosed patients (AD) when compared to control subjects (CN), structural changes seem to be more relevant at the early stages of the illness, affecting Mild Cognitive Impairment (MCI) patients. RESULTS Classification experiments using 68 CN, 70 AD and 111 MCI images from the Alzheimer's Disease Neuroimaging Initiative database have been performed and assessed by cross-validation to show the effectiveness of the proposed method. Accuracy values of up to 92% and 84% for CN/AD and CN/MCI classification are achieved. CONCLUSIONS The method presented in this work shows that sparse representations of brain images are of importance for codifying and transferring relevant image features, as they may capture the salient features while maintaining lightweight data transactions. In fact, the method proposed in this work outperforms the classification results obtained using projection methods such as Principal Component Analysis for extracting representative features of the images.
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Affiliation(s)
- Andres Ortiz
- Department of Communications Engineering, University of Malaga, Malaga 29071. Spain
| | - F Lozano
- Department of Communications Engineering, University of Malaga, Malaga 29071. Spain
| | - Juan M Gorriz
- Department of Psychiatry, Robinson Way, CB2 0SZ, University of Cambridge. United Kingdom
| | - Javier Ramirez
- Department of Signal Theory, Networking and Communications , University of Granada, Granada 18071. Spain
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Gonzalez Barrallo I, Perez Fidalgo J, Ramirez J, Burgues O, Sorlí J, Portoles O, Hernando C, Salas D, Lluch A. No effect of length time bias on the genomic risk in ER+ HER2-stage I-IIA breast cancer (BC) patients according to diagnosis in a screening programme: An exploratory analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy297.034] [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: 11/12/2022] Open
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Górriz JM, Iglesias-González E, Ramirez J. Multivariate Approaches in Neuroimaging: Assessing the Connectome of Alzheimer’s Disease. J Alzheimers Dis 2018; 65:693-695. [DOI: 10.3233/jad-180654] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Gibney N, Cerda J, Davenport A, Ramirez J, Singbartl K, Leblanc M, Ronco C. Volume Management by Renal Replacement Therapy in Acute Kidney Injury. Int J Artif Organs 2018; 31:145-55. [DOI: 10.1177/039139880803100207] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Management of fluid balance is one of the basic but vital tasks in the care of critically ill patients. Hypovolemia results in a decrease in cardiac output and tissue perfusion and may lead to progressive multiple organ dysfunction, including the development of acute renal injury (AKI). However, in an effort to reverse pre-renal oliguria, it is not uncommon for patients with established oliguric acute renal failure, particularly when associated with sepsis, to receive excessive fluid resuscitation, leading to fluid overload. In patients with established oliguria, renal replacement therapy may be required to treat hypervolemia. Safe prescription of fluid loss during RRT requires intimate knowledge of the patient's underlying condition, understanding of the process of ultrafiltration and close monitoring of the patient's cardiovascular response to fluid removal. To preserve tissue perfusion in patients with AKI, it is important that RRT be prescribed in a way that optimizes fluid balance by removing fluid without compromising the effective circulating fluid volume. In patients who are clinically fluid overloaded, it is equally important that the amount of fluid removed be as exact as possible. Fluid balance errors can occur as a result of inappropriate prescription, operator error or machine error. Some CRRT machines have potential for significant fluid errors if alarms can be overridden. Threshold values for fluid balance error have been developed which can be used to predict the severity of harm. It is important that RRT education programs emphasize the risk associated with fluid balance errors and with overriding machine alarms.
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Affiliation(s)
- N. Gibney
- Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton - Canada
| | - J. Cerda
- Division of Nephrology, Albany Medical College and Capital District Renal Physicians, Albany, New York - USA
| | - A. Davenport
- Centre for Nephrology, Royal Free Hospital and University College Medical School, London - UK
| | - J. Ramirez
- Surgical Intensive Care Unit, Hospital Dr. Rafel Ángel Calderón Guardia, San Jose - Costa Rica
| | - K. Singbartl
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania - USA
| | - M. Leblanc
- Division of Nephrology and Critical Care, Maisonneuve - Rosemont Hospital, Montreal - Canada
| | - C. Ronco
- Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital - International Renal Research Institute Vicenza (IRRIV), Vicenza - Italy
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41
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Goldberg D, Kallan MJ, Fu L, Ciccarone M, Ramirez J, Rosenberg P, Arnold J, Segal G, Moritsugu KP, Nathan H, Hasz R, Abt PL. Changing Metrics of Organ Procurement Organization Performance in Order to Increase Organ Donation Rates in the United States. Am J Transplant 2017; 17:3183-3192. [PMID: 28726327 DOI: 10.1111/ajt.14391] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 03/14/2017] [Revised: 06/05/2017] [Accepted: 06/05/2017] [Indexed: 01/25/2023]
Abstract
The shortage of deceased-donor organs is compounded by donation metrics that fail to account for the total pool of possible donors, leading to ambiguous donor statistics. We sought to assess potential metrics of organ procurement organizations (OPOs) utilizing data from the Nationwide Inpatient Sample (NIS) from 2009-2012 and State Inpatient Databases (SIDs) from 2008-2014. A possible donor was defined as a ventilated inpatient death ≤75 years of age, without multi-organ system failure, sepsis, or cancer, whose cause of death was consistent with organ donation. These estimates were compared to patient-level data from chart review from two large OPOs. Among 2,907,658 inpatient deaths from 2009-2012, 96,028 (3.3%) were a "possible deceased-organ donor." The two proposed metrics of OPO performance were: (1) donation percentage (percentage of possible deceased-donors who become actual donors; range: 20.0-57.0%); and (2) organs transplanted per possible donor (range: 0.52-1.74). These metrics allow for comparisons of OPO performance and geographic-level donation rates, and identify areas in greatest need of interventions to improve donation rates. We demonstrate that administrative data can be used to identify possible deceased donors in the US and could be a data source for CMS to implement new OPO performance metrics in a standardized fashion.
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Affiliation(s)
- D Goldberg
- Division of Gastroenterology, University of Pennsylvania, Philadelphia, PA.,Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Philadelphia, PA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - M J Kallan
- Department of Epidemiology, Biostatistics, and Informatics, University of Pennsylvania, Philadelphia, PA
| | - L Fu
- The Bridgespan Group, New York, NY
| | | | | | | | | | | | - K P Moritsugu
- Former Acting Surgeon General of the United States, Great Falls, MT
| | - H Nathan
- Gift of Life Institute, Philadelphia, PA
| | - R Hasz
- Gift of Life Institute, Philadelphia, PA
| | - P L Abt
- Division of Transplant Surgery, University of Pennsylvania, Philadelphia, PA
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42
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El-Husseini A, Aghil A, Ramirez J, Sawaya B, Rajagopalan N, Baz M, Mei X, Davenport DL, Gedaly R. Outcome of kidney transplant in primary, repeat, and kidney-after-nonrenal solid-organ transplantation: 15-year analysis of recent UNOS database. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.13108] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2017] [Indexed: 01/17/2023]
Affiliation(s)
- A. El-Husseini
- Division of Nephrology; University of Kentucky; Lexington KY USA
- Division of Nephrology; Mansoura University; Mansoura Egypt
| | - A. Aghil
- Division of Nephrology; University of Kentucky; Lexington KY USA
| | - J. Ramirez
- Division of Nephrology; University of Kentucky; Lexington KY USA
| | - B. Sawaya
- Division of Nephrology; University of Kentucky; Lexington KY USA
| | - N. Rajagopalan
- Division of Cardiology; University of Kentucky; Lexington KY USA
| | - M. Baz
- Transplant Center; University of Kentucky; Lexington KY USA
| | - X. Mei
- Transplant Center; University of Kentucky; Lexington KY USA
| | - D. L. Davenport
- Department of Surgery; University of Kentucky; Lexington KY USA
| | - R. Gedaly
- Transplant Center; University of Kentucky; Lexington KY USA
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43
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Kaidar-Person O, Deal A, Anders C, Ewend M, Carey L, Dees E, Camporeale J, Ramirez J, Benbow J, Marks L, Zagar T. EP-1101: Leptomeningeal spread after stereotactic radiation for brain metastases from breast cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31537-2] [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: 11/26/2022]
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44
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DeLay K, Ramirez J, Nyguyen HMT, Yafi F, Hellstrom W. PD31-08 SUCCESSFUL TREATMENT OF RESIDUAL CURVATURE IN PEYRONIE’S DISEASE IN MEN PREVIOUSLY TREATED WITH INTRALESIONAL CLOSTRIDIUM COLLAGENASE HISTOLYTICUM. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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45
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Rocha TC, Ramirez J, Carpenter BB, Howell C, King J, Machado TJ, Stanko RL. 073 Prostaglandin at Initiation of 7-d CO-Synch + Cidr Protocol Improves Estrus Response but Not Pregnancy Rate in a Modified Split-Time AI Program. J Anim Sci 2016. [DOI: 10.2527/ssasas2017.073] [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: 11/13/2022] Open
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46
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Ramirez J, House L, Ratain M. Influence of N-acetyltransferase 2 (NAT2) gene polymorphisms on the in vitro metabolism of the epidermal growth factor receptor inhibitor rociletinib. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32688-0] [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: 10/20/2022]
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47
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Cañete J, Pinto J, Gratacos J, Queiro R, Montilla C, Torre-Alonso J, Perez-Venegas J, Fernández Nebro A, Muñoz S, Gonzalez C, Roig D, Zarco P, Erra A, Rodriguez J, Castañeda S, Rubio E, Salvador G, Diaz C, Blanco R, Willisch A, Mosquera J, Vela P, Tornero J, Sanchez S, Corominas H, Ramirez J, Lopez-Lasanta M, Lόpez-Corbeto M, Tortosa R, Julià A, Marsal S. AB0007 Genome-Wide Association Study of Clinical Phenotypes in Psoriatic Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3575] [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: 11/04/2022]
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48
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Li Bassi G, Amaro R, Chiurazzi C, Aguilera Xiol E, Travierso C, Fernandez Barat L, Motos A, Schultz M, Carbonara M, Rigol M, Marti D, Saco M, Comaru T, Ramirez J, Torres A. Development and characterization of a novel model of invasive pneumococcal pneumonia in invasively ventilated PIGS. Intensive Care Med Exp 2015. [PMCID: PMC4797883 DOI: 10.1186/2197-425x-3-s1-a619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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49
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Carugati M, Franzetti F, Wiemken T, Kelley R, Peyrani P, Blasi F, Ramirez J, Aliberti S. Corrigendum to “De-escalation therapy among bacteraemic patients with community-acquired pneumonia” [Clin Microbiol Infect 21 (2015) 936.e11–936.e18]. Clin Microbiol Infect 2015. [DOI: 10.1016/j.cmi.2015.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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50
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Bordon JM, Fernandez-Botran R, Wiemken TL, Peyrani P, Uriarte SM, Arnold FW, Rodriquez-Hernandez L, Rane MJ, Kelley RR, Binford LE, Uppatla S, Cavallazzi R, Blasi F, Aliberti S, Restrepo MI, Fazeli S, Mathur A, Rahmani M, Ayesu K, Ramirez J. Bacteremic pneumococcal pneumonia: clinical outcomes and preliminary results of inflammatory response. Infection 2015; 43:729-38. [PMID: 26424683 DOI: 10.1007/s15010-015-0837-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 12/23/2014] [Accepted: 08/24/2015] [Indexed: 12/24/2022]
Abstract
PURPOSE Further examination of clinical outcomes and inflammatory response of bacteremic pneumococcal community-acquired pneumonia (CAP) is of great interest to enhance the care of patients with pneumococcal CAP. METHODS This is a secondary analysis of the Community Acquired Pneumonia Organization (CAPO) to compare the time to clinical stability (TCS), length of hospital stay (LOS), and in-hospital mortality of hospitalized pneumococcal CAP patients with and without bacteremia. To measure the effect of bacteremia in pneumococcal CAP patients on outcomes, we modeled all-cause in-hospital mortality using a Poisson regression model, and TCS and LOS using Cox proportional hazards models. Adjusted multivariate regression models were also used to predict the probability of occurrence of each of the study outcomes. To investigate the inflammatory response, we measured the plasma levels of pro- and anti-inflammatory cytokines [tumor necrosis factor (TNF)-α, interleukin (IL)-1rα, IL-6, IL-8, IL-10], inflammatory biomarkers [C-reactive protein (CRP), pro-calcitonin (PCT), and B-type natriuretic peptide (BNP)], and peripheral blood neutrophil responses in 10 patients, 4 bacteremic and 6 non-bacteremic pneumococcal CAP, upon admission and every other day during the first 6 days of hospitalization. Functional data were presented as median and standard error of the median (SEM); due to small number of samples no statistical comparisons were performed between groups. RESULTS From 833 pneumococcal CAP patients, 394 patients (47 %) were bacteremic. Bacteremic pneumococcal CAP were less likely to reach TCS with an adjusted hazard ratio (AHR) of 0.82 (95 % CI 0.69-0.97; p = 0.02) and had higher in-hospital mortality with an AHR of 1.63 (95 % CI 1.06-2.50, p = 0.026). Bacteremic pneumococcal CAP patients had a longer LOS than non-bacteremic pneumococcal CAP (p < 0.003). Higher plasma levels of CRP, PCT, and BNP were found in bacteremic than in non-bacteremic patients. The bacteremic group had consistently higher plasma levels of both pro- and anti-inflammatory cytokines. The blood neutrophil functional responses were similar in both groups of patients. CONCLUSIONS Bacteremic pneumococcal CAP patients were significantly associated with higher in-hospital mortality, lower TCS, and longer LOS. HIV-infected patients showed a greater mortality which was not statistically significant. Bacteremic pneumococcal CAP patients had higher levels of biomarkers and systemic cytokines.
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Affiliation(s)
- J M Bordon
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA.
| | - R Fernandez-Botran
- Department of Pathology and Laboratory Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - T L Wiemken
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - P Peyrani
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - S M Uriarte
- Division of Nephrology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - F W Arnold
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - L Rodriquez-Hernandez
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - M J Rane
- Division of Nephrology, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - R R Kelley
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - L E Binford
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - S Uppatla
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - R Cavallazzi
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - F Blasi
- Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ca` Granda Ospedale Maggiore, Milan, Italy
| | - S Aliberti
- Respiratory Unit, Department of Health Science, University of Milan Bicocca, AO San Gerardo, Monza, Italy
| | - M I Restrepo
- Department of Pulmonary Diseases, South Texas Veterans Health Care System and University of Texas at San Antonio, San Antonio, TX, USA
| | - S Fazeli
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA
| | - A Mathur
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA
| | - M Rahmani
- Section of Infectious Diseases, Providence Hospital, Washington, DC, 20017, USA
| | - K Ayesu
- Department of Internal Medicine, Orlando Health, Florida, USA
| | - J Ramirez
- Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.,Veterans Administration Medical Center, Louisville, KY, USA
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