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1.
medRxiv ; 2024 Apr 08.
Article in English | MEDLINE | ID: mdl-38645024

ABSTRACT

Continuous glucose monitors (CGM) provide patients and clinicians with valuable insights about glycemic control that aid in diabetes management. The advent of large language models (LLMs), such as GPT-4, has enabled real-time text generation and summarization of medical data. Further, recent advancements have enabled the integration of data analysis features in chatbots, such that raw data can be uploaded and analyzed when prompted. Studying both the accuracy and suitability of LLM-derived data analysis performed on medical time series data, such as CGM data, is an important area of research. The objective of this study was to assess the strengths and limitations of using an LLM to analyze raw CGM data and produce summaries of 14 days of data for patients with type 1 diabetes. This study used simulated CGM data from 10 different cases. We first evaluated the ability of GPT-4 to compute quantitative metrics specific to diabetes found in an Ambulatory Glucose Profile (AGP). Then, using two independent clinician graders, we evaluated the accuracy, completeness, safety, and suitability of qualitative descriptions produced by GPT-4 across five different CGM analysis tasks. We demonstrated that GPT-4 performs well across measures of accuracy, completeness, and safety when producing summaries of CGM data across all tasks. These results highlight the capabilities of using an LLM to produce accurate and safe narrative summaries of medical time series data. We highlight several limitations of the work, including concerns related to how GPT-4 may misprioritize highlighting instances of hypoglycemia and hyperglycemia. Our work serves as a preliminary study on how generative language models can be integrated into diabetes care through CGM analysis, and more broadly, the potential to leverage LLMs for streamlined medical time series analysis.

3.
J Nutr Metab ; 2021: 7463391, 2021.
Article in English | MEDLINE | ID: mdl-34868678

ABSTRACT

Chronic obstructive pulmonary disease (COPD) is a common, preventable, treatable lung disease characterized by persistent respiratory symptoms and airflow limitation and multiorgan impact. This affects the nutritional status of patients and requires multidimensional interventions including nutritional interventions according to individual metabolic needs. Our scoping review determined the effects of antioxidants in the treatment of COPD patients and their role in the decrease in the probability of exacerbations, hospital readmissions, and changes in lung function. The sources MEDLINE, LILACS, and Google Scholar were consulted and 19 studies were selected. The most indicated antioxidants are N-Acetylcysteine, vitamins E and D, and Zinc. Other antioxidants from plants or fruits extracts are also being investigated. The beneficial effect of antioxidants in stable or exacerbated patients is not clear, but theoretical and biological arguments of benefit justify lines of research that specify the impact on reducing oxidative stress and negative effects in COPD.

4.
Article in English | MEDLINE | ID: mdl-34769617

ABSTRACT

Workplace interventions that leverage social tactics to improve health and well-being are becoming more common. As an example, peer mental health support interventions aim to reduce stigma and promote treatment seeking in first responder populations. Given the social nature of these interventions, it is important to consider how the preexisting social context influences intervention outcomes. A peer mental health support intervention was delivered among first responders, and self-efficacy and intention to have supportive peer conversations were measured pre-and post-intervention. Trust in peers was measured prior to the intervention. Results suggest a floor effect may exist for self-efficacy, in which a foundational level of trust and pre-intervention self-efficacy may be needed to maximize intervention effectiveness. As the future of work brings complex safety and health challenges, collaborative solutions that engage multiple stakeholders (employees, their peers, and their organization) will be needed. This study suggests that more frequent attention to pre-existing intervention context, particularly social context in peer-focused intervention, will enhance intervention outcomes.


Subject(s)
Emergency Responders , Mental Health , Humans , Peer Group , Social Stigma , Workplace
5.
Pediatr Diabetes ; 22(7): 1040-1050, 2021 11.
Article in English | MEDLINE | ID: mdl-34232537

ABSTRACT

OBJECTIVE: It is widely recognized that Type 1 Diabetes (T1D) outcomes are worse among Hispanic children; however, little is published about the perspectives of these patients and their caregivers. Our intent was to characterize the lived experience of Hispanic caregivers of children with T1D, focusing on the role of language and culture and their perspectives on current medical care and alternative care models. We studied Hispanic caregivers of patients (age 2-17 years) with T1D of greater than 6 months' duration. RESEARCH DESIGN AND METHODS: We completed semi-structured interviews and focus-groups of a purposive sample of 20 members of our population of interest. We developed a codebook and completed multidisciplinary consensus coding, then conducted iterative thematic analysis using qualitative software and discussion to generate themes. RESULTS: We gathered data from 20 Hispanic caregivers of T1D patients (11.37 ± 3.00 years old, 4.80 ± 2.84 years since diagnosis). 85% of caregivers were female, 80% preferred Spanish, and 15% were college-educated. Our analysis yielded 4 themes across the participants: (1) Culturally-based nutrition challenges, (2) Social isolation and lack of support for T1D care, (3) Hesitancy to fully embrace diabetes technology, and (4) Deferential views of care experience and providers. Overarching all of these themes was support for Hispanic group-based models of care tailored to address these concerns. CONCLUSIONS: The unique concerns among Hispanic caregivers of children with T1D suggest the importance of culturally tailored interventions to improve care. With successful implementation, such interventions could diminish widening disparities in healthcare outcomes.


Subject(s)
Caregivers/psychology , Diabetes Mellitus, Type 1/therapy , Hispanic or Latino/psychology , Adolescent , Adult , Aged , Child , Culture , Diet/ethnology , Diet, Healthy/ethnology , Family , Female , Focus Groups , Health Knowledge, Attitudes, Practice/ethnology , Healthcare Disparities/ethnology , Humans , Male , Middle Aged , Qualitative Research , Social Isolation
6.
Proc Natl Acad Sci U S A ; 118(14)2021 04 06.
Article in English | MEDLINE | ID: mdl-33795519

ABSTRACT

Vascular calcification predicts atherosclerotic plaque rupture and cardiovascular events. Retrospective studies of women taking bisphosphonates (BiPs), a proposed therapy for vascular calcification, showed that BiPs paradoxically increased morbidity in patients with prior acute cardiovascular events but decreased mortality in event-free patients. Calcifying extracellular vesicles (EVs), released by cells within atherosclerotic plaques, aggregate and nucleate calcification. We hypothesized that BiPs block EV aggregation and modify existing mineral growth, potentially altering microcalcification morphology and the risk of plaque rupture. Three-dimensional (3D) collagen hydrogels incubated with calcifying EVs were used to mimic fibrous cap calcification in vitro, while an ApoE-/- mouse was used as a model of atherosclerosis in vivo. EV aggregation and formation of stress-inducing microcalcifications was imaged via scanning electron microscopy (SEM) and atomic force microscopy (AFM). In both models, BiP (ibandronate) treatment resulted in time-dependent changes in microcalcification size and mineral morphology, dependent on whether BiP treatment was initiated before or after the expected onset of microcalcification formation. Following BiP treatment at any time, microcalcifications formed in vitro were predicted to have an associated threefold decrease in fibrous cap tensile stress compared to untreated controls, estimated using finite element analysis (FEA). These findings support our hypothesis that BiPs alter EV-driven calcification. The study also confirmed that our 3D hydrogel is a viable platform to study EV-mediated mineral nucleation and evaluate potential therapies for cardiovascular calcification.


Subject(s)
Calcinosis/chemically induced , Diphosphonates/adverse effects , Extracellular Vesicles/drug effects , Plaque, Atherosclerotic/complications , Vascular Calcification/chemically induced , Animals , Cells, Cultured , Finite Element Analysis , Humans , Hydrogels , In Vitro Techniques , Mice , Mice, Knockout, ApoE
7.
J Med Case Rep ; 15(1): 36, 2021 Jan 30.
Article in English | MEDLINE | ID: mdl-33514446

ABSTRACT

BACKGROUND: Neuropsychological rehabilitation is a crucial component of medical care for patients with diffuse axonal injury (DAI). However, current cognitive intervention programs directed to favor the training of specific domains individually have shown controversial results. Here, we evaluated the effectiveness of a neuropsychological rehabilitation program directed to favor training of attention, memory, visuospatial abilities, and executive functioning together in a patient with severe traumatic brain injury (TBI)-associated DAI. CASE PRESENTATION: A 26-year-old Hispanic woman with a recent history of a severe TBI attended our center complaining of memory problems, dysarthria, and difficulty in planning. A comprehensive cognitive assessment revealed dysfunction in sustained, selective, and divided attention, alterations in memory, planning, and organization of executive behavior, as well as impairment of visuospatial cognitive functions. The patient underwent a 24-week neuropsychological rehabilitation program directed to favor attention, memory, visuospatial abilities, and executive functioning together. After the cognitive intervention, we observed a better patient's performance in tasks requiring sustained, selective, and divided attention, improvement of encoding and retrieval memory problems, use of spatial relationships, planning, and organization of behavior skills. We also observed generalization effects on other domains, such as learning, mental flexibility, inhibition functions, and language. CONCLUSIONS: In conclusion, our results suggest that neuropsychological rehabilitation programs favoring multiple domains together are useful in reestablishing cognitive deficits in patients with severe DAI.


Subject(s)
Brain Injuries, Traumatic , Cognition Disorders , Diffuse Axonal Injury , Adult , Brain Injuries, Traumatic/complications , Cognition , Cognition Disorders/etiology , Diffuse Axonal Injury/complications , Executive Function , Female , Humans , Neuropsychological Tests
8.
Diabetes Spectr ; 33(4): 331-338, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33223771

ABSTRACT

OBJECTIVE | To explore expectations for transition to adult care and experiences with transition planning among adolescents and young adults with type 1 diabetes and an A1C >9% at a tertiary care U.S. pediatric center. METHODS | We conducted semi-structured interviews in a purposive sample of patients 14-23 years of age who had had type 1 diabetes for at least 1 year and had an A1C >9%. A multidisciplinary team conducted iterative thematic analysis with deductive and inductive coding aided by NVivo software. RESULTS | Fourteen subjects participated (nine adolescents and five young adults, mean age 17.1 ± 3.2 years, 57% male, 79% Caucasian, 14% Hispanic, diabetes duration 8.2 ± 4.6 years, mean A1C 10.0 ± 0.8% for adolescents and 10.1 ± 0.7% for young adults). Qualitative analysis yielded four key themes. The first was lack of formal preparation; participants of all ages demonstrated a lack of preparation for transition and ignorance about the process, describing it as coming "out of the blue." The second was a desire for delayed and gradual transition; participants wanted to defer being "serious" about transition to a later/uncertain date, with a preference to "wait until I'm older" among all ages. Participants described ideal transition as a gradual process, taking place "a little at a time." The third was attachment to pediatric providers; participants demonstrated a nearly universal attachment to and "familiarity" with their pediatric diabetes care providers and expressed worries about an "uncomfortable" transition to adult providers. The fourth was concern about an impersonal adult care setting: participants perceived adult care as "formal," "scarier," and "tougher," with increased criticism about poor control; participants expressed fear that adult providers would not "know me" or appreciate "my diabetes journey." CONCLUSION | We demonstrated a lack of transition preparation and anxiety about transition and adult care among youth with type 1 diabetes and elevated A1C. Our results may help guide early, iterative pediatric transition counseling, with a special focus on addressing attachment and fears about adult diabetes care.

9.
Educ. med. (Ed. impr.) ; 21(2): 127-136, mar.-abr. 2020. graf, tab
Article in Spanish | IBECS | ID: ibc-194481

ABSTRACT

OBJETIVO: Analizar las competencias específicas y los resultados de aprendizaje en destrezas en el Grado de Podología de la Universidad de Barcelona. MATERIAL Y MÉTODOS: Estudio descriptivo, transversal y prospectivo mediante un cuestionario de 60 preguntas. RESULTADOS: La competencia mejor valorada fue la morfología, estructura y funciones del pie normal, sus manifestaciones patológicas y métodos de exploración y diagnóstico, mientras que la menos valorada fue la capacidad de comunicar en los foros científicos los avances profesionales. Las asignaturas con mejores resultados de aprendizaje fueron Principios y técnicas en quiropodología y Ortopodología aplicada. CONCLUSIÓN: Este estudio permitirá aplicar cambios de mejora en los planes docentes


OBJECTIVE: To analyze the specific competences and the learning results in skills in the Degree of Podiatry of the University of Barcelona. MATERIAL AND METHODS: Prospective, cross-sectional descriptive study through a questionnaire of 60 questions. RESULTS: The best rated competition was the morphology, structure and functions of the normal foot, its pathological manifestations and methods of exploration and diagnosis. The lowest valued was the ability to communicate professional advances in scientific forums. The subjects with the best learning results were Principles and Techniques in Chiropodology and Applied Orthopedics. CONCLUSION: This study will allow to apply improvement changes in the teaching plans


Subject(s)
Humans , Educational Measurement/methods , Aptitude , Clinical Competence , Podiatry/education , Curriculum/standards , Cross-Sectional Studies , Prospective Studies , Surveys and Questionnaires
10.
Phys Med Biol ; 64(3): 035007, 2019 01 22.
Article in English | MEDLINE | ID: mdl-30561380

ABSTRACT

Fluorescence molecular tomography (FMT) is widely used in preclinical oncology research. FMT is the only imaging technique able to provide 3D distribution of fluorescent probes within thick highly scattering media. However, its integration into clinical medicine has been hampered by its low spatial resolution caused by the undetermined and ill-posed nature of its reconstruction algorithm. Another major factor degrading the quality of FMT images is the large backscattered excitation light component leaking through the rejection filters and coinciding with the weak fluorescent signal arising from a low tissue fluorescence concentration. In this paper, we present a new method based on the use of a novel thermo-sensitive fluorescence probe. In fact, the excitation light leakage is accurately estimated from a set of measurements performed at different temperatures and then is corrected for in the tomographic data. The obtained results show a considerable improvement in both spatial resolution and quantitative accuracy of FMT images due to the proper correction of fluorescent signals.


Subject(s)
Fluorescent Dyes/chemistry , Light , Temperature , Tomography/methods , Algorithms , Phantoms, Imaging
11.
Appl Opt ; 56(25): 7146-7157, 2017 Sep 01.
Article in English | MEDLINE | ID: mdl-29047975

ABSTRACT

We present the feasibility of structured-light-based diffuse optical tomography (DOT) to quantify the breast density with an extensive simulation study. This study is performed on multiple numerical breast phantoms built from magnetic resonance imaging (MRI) images. These phantoms represent realistic tissue morphologies and are given typical breast optical properties. First, synthetic data are simulated at five wavelengths using our structured-light-based DOT forward problem. Afterwards, the inverse problem is solved to obtain the absorption images and subsequently the chromophore concentration maps. Parameters, such as segmented volumes and mean concentrations, are extracted from these maps and used in a regression model to estimate the percent breast densities. These estimations are correlated with the true values from MRI, r=0.97, showing that our new technique is promising in measuring breast density.


Subject(s)
Algorithms , Breast Density , Breast/diagnostic imaging , Phantoms, Imaging , Tomography, Optical/methods , Feasibility Studies , Female , Humans , Magnetic Resonance Imaging/methods
12.
J Physiol ; 594(11): 2915-27, 2016 06 01.
Article in English | MEDLINE | ID: mdl-27040360

ABSTRACT

Epidemiological evidence conclusively demonstrates that calcium burden is a significant predictor of cardiovascular morbidity and mortality; however, the underlying mechanisms remain largely unknown. These observations have challenged the previously held notion that calcification serves to stabilize the atherosclerotic plaque. Recent studies have shown that microcalcifications that form within the fibrous cap of the plaques lead to the accrual of plaque-destabilizing mechanical stress. Given the association between calcification morphology and cardiovascular outcomes, it is important to understand the mechanisms leading to calcific mineral deposition and growth from the earliest stages. We highlight the open questions in the field of cardiovascular calcification and include a review of the proposed mechanisms involved in extracellular vesicle-mediated mineral deposition.


Subject(s)
Calcinosis/pathology , Cardiovascular Diseases/pathology , Plaque, Atherosclerotic/pathology , Animals , Calcinosis/etiology , Calcinosis/metabolism , Cardiovascular Diseases/metabolism , Humans , Plaque, Atherosclerotic/etiology , Plaque, Atherosclerotic/metabolism
13.
Rev. chil. nutr ; 43(1): 54-61, mar. 2016. ilus
Article in Spanish | LILACS | ID: lil-787093

ABSTRACT

The main inclicator of iodine nutritional status of salt for human con-sumption is the urinary concentration of iodine, which is useful in monitoring universal levels in salt. Paraguay has suffered deficiency in salt with highprevalence of goiter in thepopulation reaching48.6%. In 2000, results of the ThyroidMobileproject in Latin America showed a goiter prevalence of 17% but 79.6% of the consumed iodized salt was adequate in paraguayan households (more than 15 ppm of iodine). The average values of iodine urinary concentration in 4487 scholars was 437 µg/L, 30% of the average value was between the ideal of 100 to 199 µg/L and 46.1% were above 300 mg/L, with risk of excess iodine. Urinary concentration of iodine during pregnancy was measure for the first time in Paraguay in 200 women; the average was 484 µg/L but diabetes and hypothyroidism during pregnancy was observe in 50% of them. Objective: Determine iodine concentration in urine of the school population in 17 departments of the country and measure the levels of iodine in urine in 200 pregnant women from 15-37 years of age and their levels of glycaemia, and thyroid TSH. Methods: During the years, 2006 and 2007 were evaluated 4487 school randomized, in a probabilistic sample, 3198 in rural areas and 1,289 in urban areas; casual urine samples was collected to determine iodine content. The urinary concentration of iodine in two hundredpregnant women, concentration of iodine in salt, and levels of glycaemia and TSH were also included in the present study All candidates agreed with the informed consent under the ethics rules. Results: These data showed by comparing the levels of iodine in urine concentration in more than adequate and excessive level but this last was markedly elevated (93.8%). The median level greater than 300 µg/L was observed in 100% of the 4,487 urine samples, while the median urinary iodine levels of300-500 µg/L was 91.3% and above 500 was 9.7%. These levels showed the risk of developing thyroid autoimmune diseases. In 200 pregnancy women the average of urine concentration of iodine was 498 pcg/L, subclinical and clinical hypothyroidism and gestational diabetes was 50% of both. Conclu-sion: To obtain normal median urinary iodine levels is necessary to decrease the amount of iodine in salt. The main recommendation is to insist on adequate monitoring of iodized salt consumption. Also continue surveillance and monitoring in sentinel sites reporting the importance of adequate iodine intake of the population especially in pregnant women that also need to be warm about the diabetes during pregnancy but also a regimen is necessary to keep them within the normal levels of glycemia. The subclinical hypothyroidism has been also studied in the same patients.


El principal indicador del impacto de la yodación de la sal de consumo humano es la concentración urinaria de yodo la cual es útil en el monitoreo de la sal. En la encuesta del año 1988 realizada en el Paraguay, se alcanzó una prevalencia de bocio de 48,6% en la población escolar con un déficit de yodo en la sal, pero el año 2000 en el estudio del proyecto de Tiroides Móvil, se redujo por el método ecográfico a 17%. Ese mismo año la mediana de los niveles urinarios en niños escolares de 6-12 años fue 258 µg/L, considerando que 30% se encontraba entre el valor ideal de 100 a 199 µg/L y 46,1% sobre 300 µg/L, implicando un riesgo de exceso de yodo en dicha población con las posibles consecuencias de aparición tanto de hipo como de hipertiroidismo. El 93% presentó exceso de yodo en la sal y la mediana urinaria fue 437 ug/ mL. Un grupo de embarazadas han sido estudiadas en el Hospital San Pablo por primera vez en el Paraguay para la determinación de la yoduria, yodo en sal, diabetes gestacional, hipotiroidismo en el embarazo y sus valores antropométricos resultando un hipotiroidismo subclínico del 50% y diabetes gestacional del 50%. Objetivo: Determinar las yodurias en la población escolar de 6-12 años pre púber de ambos sexos en 17 departamentos del país y en una submuestra en embarazadas y también niveles de glicemia en el embarazo en un hospital de Asunción. Sujetos y Métodos: En el periodo del 2006-2007 fueron evaluados 4.487 escolares randomizados, en una muestra probabilística, 3.198 en el área rural y 1.289 en el área urbana con muestras en orina casual. El año 2015, doscientas embarazadas fueron estudiadas con muestras de glicemia en ayunas y 2 horas post prandial, dosaje de TSH, yodo en sal de 100 gramos de la sal de consumo en sus hogares y de orina para ver la concentración de yodo en sal y urinaria de yodo. Todos los candidatos fueron estudiados bajo consentimiento autorizado y de acuerdo a normas éticas. Resultados: Al comparar los niveles de yodo en orina en el nivel más que adecuado y el excesivo de la yoduria se vió que éste último nivel estaba marcadamente elevado (93.8%), que la mediana de los niveles mayores a 300 ug/L era del 100% del total de las 4.487 muestras de orina, mientras que la mediana de los niveles de yoduria entre 300-500 µg/L fue de 91,3% y por encima de 500 fue 9.7% lo cual implicó el riesgo de desarrollar enfermedades tiroideas autoinmunes. Las embarazadas presentaron una mediana urinaria de yodo 484 µg/L, diabetes gestacional e hipotiroidismo subclínico en 50%. Conclusión: Para normalizar los niveles de yoduria, es necesario disminuir la cantidad de yodo en la sal. La recomendación es insistir en el monitoreo de la adecuada yodación de las sales de consumo familiar y continuar con la vigilancia y el monitoreo constante en sitios centinelas divulgando la importancia de la adecuada ingesta de yodo a la población. Un régimen dietético a las embarazadas es necesario implementar en el primer trimestre del embarazo.


Subject(s)
Humans , Students , Thyroid Gland , Blood Glucose , Nutritional Status , Diabetes, Gestational , Pregnant Women , Hypothyroidism , Iodine , Eating
14.
Nat Mater ; 15(3): 335-43, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26752654

ABSTRACT

Clinical evidence links arterial calcification and cardiovascular risk. Finite-element modelling of the stress distribution within atherosclerotic plaques has suggested that subcellular microcalcifications in the fibrous cap may promote material failure of the plaque, but that large calcifications can stabilize it. Yet the physicochemical mechanisms underlying such mineral formation and growth in atheromata remain unknown. Here, by using three-dimensional collagen hydrogels that mimic structural features of the atherosclerotic fibrous cap, and high-resolution microscopic and spectroscopic analyses of both the hydrogels and of calcified human plaques, we demonstrate that calcific mineral formation and maturation results from a series of events involving the aggregation of calcifying extracellular vesicles, and the formation of microcalcifications and ultimately large calcification areas. We also show that calcification morphology and the plaque's collagen content-two determinants of atherosclerotic plaque stability-are interlinked.


Subject(s)
Atherosclerosis/metabolism , Extracellular Vesicles/physiology , Animals , Apolipoproteins E/genetics , Apolipoproteins E/metabolism , Calcium/metabolism , Carotid Arteries/pathology , Collagen/metabolism , Coronary Disease/metabolism , Extracellular Matrix , Humans , Mice , Mice, Knockout
15.
PLoS One ; 10(12): e0143068, 2015.
Article in English | MEDLINE | ID: mdl-26630491

ABSTRACT

Aquaporins (AQP) are water channel proteins and the genes coding for AQP2, AQP5, and AQP6 are clustered in 12q13. Since AQP5 is expressed in serous acinar cells of salivary glands, we investigated its involvement in caries. DNA samples from 1,383 individuals from six groups were studied. Genotypes of eight single nucleotide polymorphisms covering the aquaporin locus were tested for association with caries experience. Interaction with genes involved in enamel formation was tested. The association between enamel microhardness at baseline, after creation of artificial caries lesion, and after exposure to fluoride and the genetic markers in AQP5 was tested. Finally, AQP5 expression in human whole saliva, after exposure to fluoride in a mammary gland cell line, which is known to express AQP5, and in Wistar rats was also verified. Nominal associations were found between caries experience and markers in the AQP5 locus. Since these associations suggested that AQP5 may be inhibited by levels of fluoride in the drinking water that cause fluorosis, we showed that fluoride levels above optimal levels change AQP5 expression in humans, cell lines, and rats. We have shown that AQP5 is involved in the pathogenesis of caries and likely interacts with fluoride.


Subject(s)
Aquaporin 5/metabolism , Dental Caries/metabolism , Fluorides/metabolism , Adolescent , Adult , Animals , Aquaporin 5/genetics , Cell Line, Tumor , Child , Child, Preschool , Dental Caries/genetics , Female , Genetic Markers/genetics , Genotype , Humans , Male , Mammary Glands, Human/metabolism , Middle Aged , Polymorphism, Single Nucleotide/genetics , Rats , Rats, Wistar , Saliva/metabolism , Young Adult
16.
Travel Med Infect Dis ; 13(5): 415-21, 2015.
Article in English | MEDLINE | ID: mdl-26169583

ABSTRACT

BACKGROUND: The invasive mosquito Aedes albopictus, with proven vectorial ability to transmit European autochthonous cycles of dengue and chikungunya virus, has currently colonized every coastal department of Eastern Spain. The main objective of the study was to define the epidemiological and clinical characteristics as well as the trends of these two arboviral diseases in a European area heavily colonized by Ae. albopictus. METHOD: A voluntarily-based, prospective and multicenter surveillance study was performed in all medical units of the North Metropolitan area of Barcelona (406,000 inhabitants, Catalonia; Spain) with diagnostic capability from 2009 to 2013. Since any possible increase in arboviral cases could be justified by changes in traveling behaviors along the study period (especially longer trips) the trend showed by these two arboviral diseases was compared with that displayed by malaria cases during the same period. RESULTS: 38 out of 52 (73.1%) suspected cases could be serologically confirmed (IgM+): dengue 34/38 (89.5%) and chikungunya 4/38 (11.5%). No autochthonous cases were identified. The overall incidence of both arboviruses was 0.19 cases/10,000 inhabitants-year (95% CI: 0.07-0.3); dengue = 0.17 cases/10,000 inhabitants-year (95% CI: 0.05-0.3), and chikungunya = 0.02 cases/10,000 inhabitants-year (95% CI: 0.001-0.03). The Incidence Relative Risk of arboviral disease between 2009 and 2013 shown a significant trend (IRR = 1.27. IC 95%: 1.01-1.59; p = 0.043) when compared with that displayed by malaria (IRR = 1.04. IC 95%: 0.924-1.192). If no unexpected circumstances concur, the arboviral disease incidence tax would equal that of malaria about 2021-2022. CONCLUSIONS: The incidence of dengue and chikungunya is steadily increasing in the North Metropolitan area of Barcelona, a region densely colonized by Ae. albopictus, at the entire expense of imported cases (especially Visiting Friends and Relatives travelers). To date, no secondary autochthonous cases have been identified and, thus, they have not taken part in this rise.


Subject(s)
Aedes , Arbovirus Infections/epidemiology , Arbovirus Infections/transmission , Adult , Animals , Arbovirus Infections/diagnosis , Arbovirus Infections/virology , Chikungunya virus , Dengue Virus , Female , Humans , Incidence , Male , Middle Aged , Prospective Studies , Spain/epidemiology , Travel , Young Adult
17.
Rev Neurol ; 60 Suppl 1: S81-5, 2015 Feb 25.
Article in Spanish | MEDLINE | ID: mdl-25726829

ABSTRACT

INTRODUCTION: Early identification of the factors involved in the development of learning difficulties in mathematics is essential to be able to understand their origin and implement successful interventions. This study analyses the capacity of executive functioning and of variables from the motivational belief system to differentiate and classify preschool children with and without risk of having difficulties in mathematics. SUBJECTS AND METHODS: A total of 146 subjects from the third year of preschool education took part in the study, divided into risk/no risk according to the score obtained on the operations subtest of the TEDI-MATH test. Working memory (verbal and visuospatial) and inhibition (with auditory and visual stimuli) neuropsychological tasks were applied. Teachers filled in a questionnaire on the children's motivation with regard to learning. RESULTS AND CONCLUSIONS: Significant differences were found between the two groups on the working memory and inhibition-auditory factors, as well as on all the motivation variables. The results also show a similar power of classification, with percentages above 80%, for both groups of variables. The implications of these findings for educational practice are discussed.


TITLE: Funcionamiento ejecutivo y motivacion en niños de educacion infantil con riesgo de dificultades en el aprendizaje de las matematicas.Introduccion. La identificacion temprana de los factores implicados en el desarrollo de las dificultades de aprendizaje de las matematicas es esencial para comprender su origen e intervenir con garantias de exito. Este estudio analiza la capacidad del funcionamiento ejecutivo y de variables del sistema motivacional de creencias para diferenciar y clasificar a niños de educacion infantil con y sin riesgo de dificultades en matematicas. Sujetos y metodos. Participaron 146 sujetos de tercer curso de educacion infantil divididos en riesgo/no riesgo en funcion de la puntuacion obtenida en los subtest de operaciones de la prueba TEDI-MATH. Se aplicaron tareas neuropsicologicas de memoria de trabajo (verbal y visuoespacial) e inhibicion (con estimulos auditivos y visuales). Los profesores cumplimentaron un cuestionario de motivacion de los niños hacia el aprendizaje. Resultados y conclusiones. Se encontraron diferencias significativas entre ambos grupos en los factores de memoria de trabajo e inhibicion-auditiva, asi como en todas las variables de motivacion. Los resultados muestran, igualmente, un poder de clasificacion similar, con porcentajes superiores al 80%, de ambos grupos de variables. Se comentan las implicaciones para la practica educativa de estos hallazgos.


Subject(s)
Executive Function/physiology , Learning Disabilities/diagnosis , Mathematics , Motivation , Child , Child, Preschool , Female , Humans , Learning Disabilities/epidemiology , Male , Risk Assessment
18.
Cardiovasc Pathol ; 24(4): 207-12, 2015.
Article in English | MEDLINE | ID: mdl-25797772

ABSTRACT

Cardiovascular calcification is a commonly observed but incompletely understood mechanism of increased atherosclerotic plaque instability and accelerated aortic valve stenosis. Traditional histological staining and imaging techniques are nonspecific for the type of mineral present in calcified tissues, information that is critical for proper validation of in vitro and in vivo models. This review highlights current gaps in our understanding of the biophysical implications and the cellular mechanisms of valvular and vascular calcification and how they may differ between the two tissue types. We also address the hindrances of current cell culture systems, discussing novel platforms and important considerations for future studies of cardiovascular calcification.


Subject(s)
Aortic Valve Stenosis , Aortic Valve/pathology , Arteries , Atherosclerosis , Calcinosis , Vascular Calcification , Animals , Aortic Valve/metabolism , Aortic Valve/physiopathology , Aortic Valve Stenosis/metabolism , Aortic Valve Stenosis/pathology , Aortic Valve Stenosis/physiopathology , Arteries/metabolism , Arteries/pathology , Arteries/physiopathology , Atherosclerosis/metabolism , Atherosclerosis/pathology , Atherosclerosis/physiopathology , Biomechanical Phenomena , Calcinosis/metabolism , Calcinosis/pathology , Calcinosis/physiopathology , Cell Communication , Cell Culture Techniques , Cells, Cultured , Humans , Phenotype , Plaque, Atherosclerotic , Vascular Calcification/metabolism , Vascular Calcification/pathology , Vascular Calcification/physiopathology
19.
Rev. neurol. (Ed. impr.) ; 60(supl.1): s81-s85, mar. 2015. tab, graf
Article in Spanish | IBECS | ID: ibc-134377

ABSTRACT

Introducción. La identificación temprana de los factores implicados en el desarrollo de las dificultades de aprendizaje de las matemáticas es esencial para comprender su origen e intervenir con garantías de éxito. Este estudio analiza la capacidad del funcionamiento ejecutivo y de variables del sistema motivacional de creencias para diferenciar y clasificar a niños de educación infantil con y sin riesgo de dificultades en matemáticas.Sujetos y métodos. Participaron 146 sujetos de tercer curso de educación infantil divididos en riesgo/no riesgo en función de la puntuación obtenida en los subtest de operaciones de la prueba TEDI-MATH. Se aplicaron tareas neuropsicológicas de memoria de trabajo (verbal y visuoespacial) e inhibición (con estímulos auditivos y visuales). Los profesores cumplimentaron un cuestionario de motivación de los niños hacia el aprendizaje. Resultados y conclusiones. Se encontraron diferencias significativas entre ambos grupos en los factores de memoria de trabajo e inhibición-auditiva, así como en todas las variables de motivación. Los resultados muestran, igualmente, un poder de clasificación similar, con porcentajes superiores al 80%, de ambos grupos de variables. Se comentan las implicaciones para la práctica educativa de estos hallazgos (AU)


Introduction. Early identification of the factors involved in the development of learning difficulties in mathematics is essential to be able to understand their origin and implement successful interventions. This study analyses the capacity of executive functioning and of variables from the motivational belief system to differentiate and classify preschool children with and without risk of having difficulties in mathematics. Subjects and methods. A total of 146 subjects from the third year of preschool education took part in the study, divided into risk/no risk according to the score obtained on the operations subtest of the TEDI-MATH test. Working memory (verbal and visuospatial) and inhibition (with auditory and visual stimuli) neuropsychological tasks were applied. Teachers filled in a questionnaire on the children’s motivation with regard to learning. Results and conclusions. Significant differences were found between the two groups on the working memory and inhibition-auditory factors, as well as on all the motivation variables. The results also show a similar power of classification, with percentages above 80%, for both groups of variables. The implications of these findings for educational practice are discussed (AU)


Subject(s)
Humans , Male , Female , Child , Learning Disabilities/complications , Learning Disabilities/genetics , Mathematics/education , Primary Health Care/methods , Learning Disabilities/psychology , Learning Disabilities/therapy , Mathematics/methods , Primary Health Care , 35172
20.
BMC Med Genet ; 15: 81, 2014 Jul 15.
Article in English | MEDLINE | ID: mdl-25023176

ABSTRACT

BACKGROUND: Congenital forms of hearing impairment can be caused by mutations in the estrogen related receptor beta (ESRRB) gene. Our initial linkage studies suggested the ESRRB locus is linked to high caries experience in humans. METHODS: We tested for association between the ESRRB locus and dental caries in 1,731 subjects, if ESRRB was expressed in whole saliva, if ESRRB was associated with the microhardness of the dental enamel, and if ESRRB was expressed during enamel development of mice. RESULTS: Two families with recessive ESRRB mutations and DFNB35 hearing impairment showed more extensive dental destruction by caries. Expression levels of ESRRB in whole saliva samples showed differences depending on sex and dental caries experience. CONCLUSIONS: The common etiology of dental caries and hearing impairment provides a venue to assist in the identification of individuals at risk to either condition and provides options for the development of new caries prevention strategies, if the associated ESRRB genetic variants are correlated with efficacy.


Subject(s)
Dental Caries/genetics , Hearing Loss, Sensorineural/pathology , Receptors, Estrogen/genetics , Tooth Demineralization/genetics , Adolescent , Adult , Animals , Cell Line, Tumor , Child , Child, Preschool , Chromosomes, Human, Pair 14 , Dental Enamel/growth & development , Female , Genetic Association Studies , Hearing Loss, Sensorineural/genetics , Humans , Linkage Disequilibrium , Male , Mice , Pedigree , Polymorphism, Single Nucleotide , Receptors, Estrogen/physiology , Young Adult
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