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We explore here the systems-based regulatory mechanisms that determine human blood pressure patterns. This in the context of the reported negative association between hypertension and COVID-19 disease. We are particularly interested in the key role that plays angiotensin converting enzyme 2 (ACE2), one of the first identified receptors that enable the entry of the SARS-CoV-2 virus into a cell. Taking into account the two main systems involved in the regulation of blood pressure, that is, the Renin-Angiotensin system and the Kallikrein-Kinin system, we follow a Bottom-Up systems biology modeling approach in order to built the discrete Boolean model of the gene regulatory network that underlies both the typical hypertensive phenotype and the hypotensive/normotensive phenotype. These phenotypes correspond to the dynamic attractors of the regulatory network modeled on the basis of publicly available experimental information. Our model recovers the observed phenotypes and shows the key role played by the inflammatory response in the emergence of hypertension. Source code go to the next url: https://github.com/cxro-cc/red_ras_kks © 2023, EasyChair. All rights reserved.
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This paper deals with the functions that the judicial bodies can assume beyond what is their function par excellence: to judge and to enforce what is judged. This issue is addressed in view of the reforms made in the Administrative Justice Act to control the measures passed in the face of the covid-19 pandemic. To this end, this paper carries out a constitutional analysis of the functions that can be attributed to the judicial bodies based on Article 117(4) Spanish Constitution from the systema-tics of articles 24, 103, 106, 117 and 123 Spanish Constitution considering the Constitutional Court Judgment 70/2022. © 2022, Centro Estudios Politicos Constitucionales. All rights reserved.
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Objectives: To evaluate the effect of implementing Enhanced Recovery After Surgery (ERAS) and compliance to protocol in patients undergoing radical cystectomy (RC) and urinary diversion during the COVID-19 pandemic. Method(s): Since February 2020, a 14-point multimodal ERAS protocol has been implemented for patients undergoing elective CR and urinary diversion at our institution. We retrospectively evaluated 80 patients who underwent CR between February 2020 and February 2022. The effects of ERAS implantation for CR during the COVID-19 pandemic were validated. Result(s): With a mean age of 68.5 years [CI: 66.4-70.7], 80 patients who underwent RC were included in the analysis, 69 men (86%) and 11 women (14%). Main indication for surgery was muscle-invasive bladder cancer and laparoscopic or robot-assisted RC was performed in most cases (86%). Regarding urinary diversion, in 66 patients (82.5%) an ileal conduit was done and an orthotopic neobladder in 14 cases (17.5%). The attached table shows the percentage of compliance with each parameter of the 14-point ERAS protocol. Most of the compliance rates are above 80%, except for early mobilization. Efficiency item assesses whether the expected days of hospital admission are met. In this way, the median length of hospital stay (LOS) was 5 days [IQR 2.5]. In terms of follow-up, the hospital readmission rate one month after surgery was 6%. Before the application of the ERAS program this rate was 9.1%, thus it represents a significant reduction (p<0.05). [Formula presented] Conclusion(s): Our initial experience with the implementation of a 14-point enhanced recovery protocol after RC has been satisfactory achieving a 85% compliance rate and promising results regarding reduction of LOS and hospital readmission. Further cases and analysis are required to draw definitive conclusions. Disclosure of Interest: None declared Copyright © 2022
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In the 1980s, Chile’s Decree-Law No. 3500 introduced a new Pension System in Latin America based on individual savings by workers during their working life, thus discarding the distribution model. The system has been implemented in several countries in the region, such as Mexico, Uruguay, Peru, Colombia, Panama, Costa Rica, El Salvador, and the Dominican Republic, so that today in Latin America, two types of systems coexist, one with a public fund and the other with individual savings managed by private companies called Pension Fund Administrators (AFP). Since before the Pandemic, Latin America has had demographic, occupational, and other problems, which have deepened with COVID-19 and have had a negative impact on the economies of various countries in the region, and which have seen pension savings as a support option for overcoming the crisis. Different politicians and experts have analyzed the situation, if this withdrawal of savings from pension funds supports people to overcome one of the worst economic crises in recent years, risking the pension systems to get rid of assets in different markets, mainly where demand is weak and liquidity is low. This article seeks to explain the trend of the AFPs using the HJ-Biplot statistical method. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Graphene decorated with cooper nanostructures were prepared with and without ionic liquid (IL) using different milling times. The obtained samples were characterized by Raman, X-ray diffraction (XRD) and transmission electron microscopy (TEM), to analyze the effect of the grinding time on the copper particles adhesion to the graphene sheets. Composites of silicon with two contents of G/Cu, at two weight ratios, nanostructures were prepared and the crosslinking characteristics were analyzed by a rubber process analyzer. The thermal conductivity, electrical resistivity and antimicrobial characteristics against E. coli and S. aureus for these silicon/G/Cu composites were determined. It was found that the use of IL enhances the G/Cu nanostructures dispersion into the silicon polymer matrix with a noticeable improvement in thermal conductivity of 1.12 W/mK for a 7 wt% of G/Cu, a volume electrical resistivity of 4.1 × 1010 Ω cm with 7 wt% of G/Cu nanoparticles and antimicrobial response of 4.21 ± 0.11 to E. coli and 5.33 ± 0.11 to S. aureus with 7% of G/Cu nanoparticles. It was determined that π–π interactions between graphene and aromatic molecule of IL may be influencing the observed improvement in G/Cu dispersion and final composite performance. The novelty of this work is the use of IL to improve the G/Cu NPs dispersion into the silicon polymer matrix. This silicon/G/Cu composite could be an option to prepare medical devices for electrotherapy or face protection against COVID-19 or other silicon-based devices for medical applications. Graphic abstract: [Figure not available: see fulltext.]. © 2021, Iran Polymer and Petrochemical Institute.
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Background: Visceral Leishmaniasis (VL) is a zoonotic infection produced by the Leishmania spp parasite transmitted through the bite of the Phlebotomus or Lutzomya mosquito. It is more frequent in endemic areas and a common, although underdiagnosed, cause of secondary hemophagocytic lymphohistiocytosis (HHL), consisting of a dysregulation of T lymphocytes and NK cells and uncontrolled macrophage activation. The generated cytokines storm (IFN-gamma, IL-1, 6, 10, 12, and 18) and uncontrolled hemophagocytosis result in a life-threatening hyperinflammatory state. The clinical-analytical manifestations between HLH and VL may overlap, making diagnosis difficult. Amphotericin B is the treatment of choice, together with corticosteroids and immunoglobulins in case of LHHs and no response to initial treatment. Aims: To express the importance of controlling the cytokine storm in Hemophagocytic Lymphohistiocytosis to avoid the development of the hyperinflammation state. Methods: Description of clinical case and sample of response to treatment with Tocilizumab. The follow-up was carried out until January 31, 2021. Results: A 51-year-old man with a personal history of psoriasis arthritis treated with Adalimumab and Methotrexate and cutaneous leishmaniasis on the pinna in February 2019, untreated. Consultation in the Emergency Service for a 2-week fever and general malaise, presenting progressive pancytopenia without remarkable findings in the peripheral blood smear. Viral serologies and PCR for SARS-CoV2 were negative;antigenuria for Leishmania was positive. Abdominal CT showed mild hepatomegaly and splenomegaly of 19 cm. Treatment is started with Liposomal Amphotericin B. The subsequent analytical study showed CRP 77.4 mg/L, IL-6 19.2 pg/mL, Ferritin> 4,500 ng/mL, triglycerides 217 mg/dL, AST/ALT 221/135 U/L and CD25s> 7500 U/mL. A bone marrow aspirate was performed which, together with a positive Leishmania PCR in peripheral blood and bone marrow and HScore with a probability of 94% HLH-2004 score with 6/8 items completed, LHHs to LV were diagnosed, adding Dexamethasone according to the HLH- 2004 protocol and Gammaglobulin. Despite the instaured measures, pancytopenia, fever> 38oC, liver involvement and hyperinflammatory status with IL-6 87.5 pg/mL persisted, deciding to administer a single dose of Tocilizumab 8 mg/Kg. The fever disappeared and the laboratory abnormalities were normalized in 1.5 months. Dexamethasone decrease was performed according to protocol. Currently Adalimumab has been restarted and continues with monthly doses of Amphotericin B. Summary/Conclusion: There is little scientific evidence about the targeted management of the cytokine storm generated in LHHs. Blocking the action of IL-6 with Tocilizumab at standard doses allowed adequate management of the pro-inflammatory state and the infection, without side effects and with good tolerance. Experience with Tocilizumab in LV LHHs is extremely limited. Understanding the pathophysiology of this entity and its similarity to other states of hyperactivation and immune dysregulation will allow better therapeutic regimens to be established. There is little scientific evidence about the targeted management of the cytokine storm generated in LHHs. Blocking the action of IL-6 with Tocilizumab at standard doses allowed adequate management of the pro-inflammatory state and the infection, without side effects. Experience with Tocilizumab in LV LHHs is extremely limited. Understanding the pathophysiology of this entity and its similarity to other states of hyperactivation and immune dysregulation will allow to establish better therapeutic regimens.
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Events that occur during fetal and perinatal life can have consequences on the health and disease of the offspring. The pioneering work on the "Fetal Programming Hypothesis" focused on pregnant women exposed to a great famine that occurred in the Netherlands at the end of World War II. The intrauterine environment of the babies during that famine caused them to low birthweight and determined the appearance of cardiovascular diseases in themselves when they reached adulthood, a risk that was transmitted even to the following generation. In addition to the general stress that a pregnant woman may suffer as a result of the death of a family member, suffering a war or natural disaster such as the SARS-CoV-2 coronavirus, there is another specific type of stress that refers exclusively to the pregnancy process;this is the pregnancy specific-stress. Pregnancy-specific stress is capable of sensitively predicting negative maternal and neonatal outcomes. This type of stress refers to the specific stress of pregnant women related to medical problems, the health of the newborn, the changes that the pregnancy will produce in their social relationships, prematurity, physical changes of pregnancy and fear of labor and birth. The objective of this article was to offer an updated information on pregnancy-specific stress and its consequences for maternal and neonatal health. Thus, we also proposed to offer strategies that midwives and psychologists can use to reduce pregnancy-specific stress levels. In conclusion, midwives and psychologists can work together to reduce pregnancy-specific stress levels.
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OBJECTIVE: The pandemic caused by COVID-19, at a psychological level, can cause an increase in levels of stress and anxiety due to the fear of contagion and its consequences. Pregnant women are especially vulnerable to these psychological consequences. Thus, the objective of this study was to verify the efficacy of a cognitive-behavioral stress control program in reducing psychological stress and increasing resilience in pregnant women, which ended at the begining of the confinement due to COVID-19 in Spain. METHODS: The study included 22 pregnant women who were randomly divided into two groups: the experimental group (GT) consisted of 11 participants and the control group (GC) also consisted of 11 participants. Participants were recruited from the Hospital Universitario Clínico San Cecilio in the province of Granada (Spain), where the weekly cognitive behavioral intervention was also carried out, which was implemented between January 22 and March 11, 2020. They used the assessment instruments: Pregnancy Distress Questionnaire (PDQ), Perceived Stress Scale (EEP-14), Inventory of Vulnerability to Stress (IVE) and Connor Davidson Resilience Scale (CD-RISC). A mixed ANOVA of repeated measures 2*2 was performed, with the variable between groups having two levels (CG and GT), and the within-subject having two time periods (pre and post). RESULTS: The repeated measures ANOVA analysis showed group*time interaction effects between the therapy group and the control group and the CD-RISC scores (F(1,20)=10.658;p<0.02). Intrasubject differences in CD-RISC scores were found in the (GT) (t=-2.529;p<0.05), with a moderate effect size. CONCLUSIONS: It can be affirmed that cognitive behavioral intervention in pregnant women, administrated prior to confinement in Spain and during the COVID-19 pandemic, has resulted in increased levels of resilience in this population.
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Using nonlinear mathematical models and experimental data from laboratory and clinical studies, we have designed new combination therapies against COVID-19.
Subject(s)
COVID-19 , Models, Biological , Nonlinear Dynamics , SARS-CoV-2 , COVID-19/epidemiology , COVID-19/therapy , HumansABSTRACT
We present a general growth model based on nonextensive statistical physics. We show that the most common unidimensional growth laws such as power law, exponential, logistic, Richards, Von Bertalanffy, Gompertz can be obtained. This model belongs to a particular case reported in (Physica A 369, 645 (2006)). The new evolution equation resembles the "universality"revealed by West for ontogenetic growth (Nature 413, 628 (2001)). We show that for early times the model follows a power law growth as N(t) ≈ tD, where the exponent D 1 1-q classifies different types of growth. Several examples are given and discussed. © 2020 World Scientific Publishing Company.