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2.
Article in English | MEDLINE | ID: mdl-36714292

ABSTRACT

Objective: Examine the impact of vaccination status on hospital cost and course for patients admitted with COVID-19 infection. Design: Retrospective cohort study characterizing vaccinated and unvaccinated individuals hospitalized for COVID-19 between April 2021 to January 2022. Setting: Large academic medical center. Methods: Patients were included if they were greater than 18 years old, fully vaccinated or unvaccinated against COVID-19, and admitted for COVID-19 infection. Patients: 437 consecutively admitted patients for COVID-19 infection met inclusion criteria. Of these, 79 were excluded for unknown or partial vaccination status, transfer from an outside hospital, or multiple COVID-19 related admissions. Results: Overall, 279 (77.9%) unvaccinated patients compared to 79 (22.1%) vaccinated patients were hospitalized with a diagnosis of COVID-19. Average length of stay was significantly lower in the vaccinated group (6.47 days versus 8.92 days, P = 0.03). Vaccinated patients experienced a 70.6% lower risk of ICU admission (OR = 0.29, 95% CI 0.12-0.71, P = 0.006). The unadjusted cost of hospitalization was not found to be statistically significant ($119,630 versus $191,146, P = 0.06). After adjusting for age and comorbidities, vaccinated patients experienced a 26% lower cost of hospitalization compared to unvaccinated patients (P = 0.004). Unvaccinated patients incurred a significantly higher cost of hospitalization per day ($29,425 vs $13,845 P < 0.0001). Unvaccinated patients (n = 118, 42.9%) were more likely than vaccinated patients (n = 16, 20.3%) to require high-flow oxygen or mechanical ventilation (OR = 2.95, 95% CI 1.62-5.38, P = 0.0004). Conclusion: Vaccinated patients experienced a lower cost of hospitalization after adjusting for age and comorbidities and shorter length of stay compared to unvaccinated patients admitted for COVID-19.

4.
Neurosci Lett ; 770: 136358, 2022 01 23.
Article in English | MEDLINE | ID: mdl-34822962

ABSTRACT

The 'at risk mental state' (ARMS) paradigm has been introduced in psychiatry to study prodromal phases of schizophrenia. With time it was seen that the ARMS state can also precede mental disorders other than schizophrenia, such as depression and anxiety. However, several problems hamper the paradigm's use in preventative medicine, such as varying transition rates across studies, the use of non-naturalistic samples, and the multifactorial nature of psychiatric disorders. To strengthen ARMS predictive power, there is a need for a holistic model incorporating-in an unbiased fashion-the small-effect factors that cause mental disorders. Bayesian networks, a probabilistic graphical model, was used in a populational cohort of 83 ARMS individuals to predict conversion to psychiatric illness. Nine predictors-including state, trait, biological and environmental factors-were inputted. Dopamine receptor 2 polymorphism, high private religiosity, and childhood trauma remained in the final model, which reached an 85.51% (SD = 0.1190) accuracy level in predicting conversion. This is the first time a robust model was produced with Bayesian networks to predict psychiatric illness among at risk individuals from the general population. This could be an important tool to strengthen predictive measures in psychiatry which should be replicated in larger samples to provide the model further learning.


Subject(s)
Mental Disorders/epidemiology , Adult , Adverse Childhood Experiences/statistics & numerical data , Bayes Theorem , Female , Humans , Machine Learning , Male , Mental Disorders/genetics , Mental Disorders/psychology , Polymorphism, Single Nucleotide , Receptors, Dopamine D2/genetics , Religion
7.
Int J Infect Dis ; 111: 211-218, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34461254

ABSTRACT

OBJECTIVES: Thromboinflammation, resulting from a complex interaction between thrombocytopathy, coagulopathy, and endotheliopathy, contributes to increased mortality in COVID-19 patients. MR-proADM, as a surrogate of adrenomedullin system disruption, leading to endothelial damage, has been reported as a promising biomarker for short-term prognosis. We evaluated the role of MR-proADM in the mid-term mortality in COVID-19 patients. METHODS: A prospective, observational study enrolling COVID-19 patients from August to October 2020. A blood sample for laboratory test analysis was drawn on arrival in the emergency department. The primary endpoint was 90-day mortality. The area under the curve (AUC) and Cox regression analyses were used to assess discriminatory ability and association with the endpoint. RESULTS: A total of 359 patients were enrolled, and the 90-day mortality rate was 8.9%. ROC AUC for MR-proADM predicting 90-day mortality was 0.832. An optimal cutoff of 0.80 nmol/L showed a sensitivity of 96.9% and a specificity of 58.4%, with a negative predictive value of 99.5%. Circulating MR-proADM levels (inverse transformed), after adjusting by a propensity score including eleven potential confounders, were an independent predictor of 90-day mortality (HR: 0.162 [95% CI: 0.043-0.480]) CONCLUSIONS: Our data confirm that MR-proADM has a role in the mid-term prognosis of COVID-19 patients and might assist physicians with risk stratification.


Subject(s)
COVID-19 , Thrombosis , Adrenomedullin , Biomarkers , Humans , Inflammation , Prognosis , Prospective Studies , Protein Precursors , Risk Assessment , SARS-CoV-2
8.
Comput Biol Med ; 134: 104480, 2021 07.
Article in English | MEDLINE | ID: mdl-34049232

ABSTRACT

BACKGROUND: Information about short Atrial Fibrillation (AF) episodes can be gathered from the diagnostic records of cardiac implantable electronic devices (CIEDs). CIEDs are not accurate when detecting short arrhythmia episodes. The correlation between mode switching events and AF episodes is significant for long events but prone to errors for short episodes. METHODS: Expectation-maximization algorithms are used to estimate the parameters of a mathematical model from a list of AF episodes produced by the CIED. The durations of some of the episodes may be missing. Abnormal mode changes are detected and short episodes are joined into longer events when appropriate. The proposed method does not require that the sensitivity parameters of the device are altered. Post-processing of the data is limited to the detection of false negatives, thus paroxysmal arrhythmia diagnostic evaluations are safer. RESULTS: A three year-long study was carried out with patients with dual-chamber pacemakers (PM) at the Hospital Universitario Central de Asturias (Spain) between 2012 and 2015. The number of patients in which the proposed algorithm altered the final histogram was 40 out of 76. On average, the algorithm removes 2.79% of episodes shorter than 1 min in length and finds that 1% of the previously unaccounted episodes are longer than 30 min, of which 16% are longer than 24 h. CONCLUSION: The method is stable and guarantees that long arrhythmia episodes are never eliminated, and at the same time it is the most similar to the human expert in finding new long episodes.


Subject(s)
Atrial Fibrillation , Pacemaker, Artificial , Algorithms , Atrial Fibrillation/therapy , Humans , Spain
9.
Eur Heart J Acute Cardiovasc Care ; 10(8): 918-925, 2021 Oct 27.
Article in English | MEDLINE | ID: mdl-33993235

ABSTRACT

AIMS: New-onset right bundle branch block (RBBB) in myocardial infarction (MI) is often associated with ventricular fibrillation (VF) but the nature of this relationship has not been determined. METHODS AND RESULTS: Between 1998 and 2014, among other data, incidence and duration of RBBB and VF occurrence were prospectively collected in 5301 patients with ST-segment elevation MI (STEMI) admitted to two University Hospitals in Murcia (Spain). Multinomial adjusted logistic regression analyses were used to examine the association between RBBB, attending to its duration, and VF according to its primary VF (PVF) or secondary VF (SVF) character. Among 284 (5.4%) patients with new-onset RBBB, 158 were transient and 126 permanent. VF occurred in 339 (6.4%) patients, 201 PVF and 138 SVF, documented within the first 2 h of symptoms-onset in 78% and 60%, respectively. New-onset RBBB was more frequent in PVF (11.4%) and SVF (20.3%), than in non-VF (4.7%). Transient RBBB incidence was higher in PVF (9.0%) and SVF (9.4) than in non-VF (2.6%), whereas permanent RBBB was higher in SVF (10.9%) than PVF (2.5%) and non-VF (2.1%). New-onset RBBB 1.83 [95% confidence interval (CI): 1.07-3.11] and new-onset transient RBBB 2.39 (95% CI: 1.32-4.32) were independently associated with PVF. New-onset 3.03 (95% CI: 1.83-5.02), transient 2.40 (95% CI: 1.27-4.55), and permanent 2.99 (95% CI: 1.52-5.86) RBBB were independently associated with SVF. CONCLUSION: New-onset RBBB and VF in STEMI are independently associated and show particularities based on the duration of the conduction disturbance and/or the primary or secondary character of the arrhythmia.


Subject(s)
Myocardial Infarction , ST Elevation Myocardial Infarction , Bundle-Branch Block/complications , Bundle-Branch Block/diagnosis , Bundle-Branch Block/epidemiology , Electrocardiography , Humans , Myocardial Infarction/complications , Myocardial Infarction/epidemiology , ST Elevation Myocardial Infarction/complications , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/epidemiology , Ventricular Fibrillation/epidemiology , Ventricular Fibrillation/etiology
10.
Podium (Pinar Río) ; 16(1): 233-247, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1155072

ABSTRACT

RESUMEN En el entrenamiento deportivo, se realizan valoraciones sobre el rendimiento utilizando los resultados de pruebas en las que se miden la manifestación global del fenotipo de las infantas, sin entrar a discriminar la influencia que tiene cada uno de los elementos que en él intervienen, tal es el caso del judo femenino en Camagüey, ya que se desconoce la relación entre la ratio de los dedos y las capacidades motrices. Es por ello que, se persigue como objetivo determinar la relación de la ratio de los dedos de las manos con las capacidades motrices en las atletas de judo escolares de Camagüey. Se desarrolló una investigación transversal en la que se emplean los métodos teóricos que constituyen los procesos lógicos del pensamiento y empíricos fundamentalmente la medición, así como la estadística descriptiva mediante la medida de tendencia central media: media, desviación típica, máximo y mínimo; así como estadística inferencial, determinando si existe correlación entre la ratio y las capacidades, para lo que se aplica el coeficiente de correlación de Pearson. Se concluye que en las atletas estudiadas se encontró una relación inversa entre la ratio de la mano derecha y las capacidades motrices fuerza y rapidez, no siendo fuerte. La relación que se encuentra entre las capacidades y la ratio no es lineal.


RESUMO No treino desportivo, as avaliações de desempenho são feitas utilizando os resultados de testes em que é medida a manifestação global do fenótipo das crianças, sem discriminar a influência de cada um dos elementos envolvidos no mesmo, como é o caso do Judô feminino em Camagüey, uma vez que a relação entre a ratio dos dedos e as capacidades motoras é desconhecida. É por isso que o objetivo é perseguido: determinar a relação entre a ratio dos dedos das mãos com as capacidades motoras nos atletas de judô da escola de Camagüey. Foi desenvolvida uma investigação transversal utilizando os métodos teóricos que constituem os processos lógicos do pensamento e métodos empíricos, fundamentalmente a medição, bem como a estatística descritiva através da medida da tendência central média: média, desvio padrão, máximo e mínimo; bem como a estatística inferencial, determinando se existe correlação entre a razão e as capacidades, à qual é aplicado o coeficiente de correlação de Pearson. Concluindo que nas atletas estudadas foi encontrada uma relação inversa entre a relação entre a mão direita e a força e velocidade motora, não sendo forte. A relação encontrada entre as capacidades e a ratio não é linear.


ABSTRACT In sports training, performance evaluations are made using the results of tests in which the global manifestation of the phenotype of the infants is measured, without discriminating the influence that each of the elements that intervene in it has, such is the case of female Judo in Camagüey, since the relationship between the ratio of the fingers and the motor capacities is unknown. That's why the objective is to determine the relationship between the ratio of the fingers with the motor skills in the school Judo women athletes of Camaguey. It was developed a transversal research in which the theoretical methods that constitute the logical processes of thought and empirical fundamentally the measurement are used, as well as the descriptive statistics by means of the measurement of average central tendency: mean, standard deviation, maximum and minimum; as well as inferential statistics, determining if there is correlation between the ratio and the capacities, for which Pearson's correlation coefficient is applied. Concluding that in the studied athletes an inverse relation was found between the ratio of the right hand and the motor capacities strength and speed, not being strong. The relationship found between the capacities and the ratio is not linear.

11.
Eur J Clin Invest ; 51(5): e13511, 2021 May.
Article in English | MEDLINE | ID: mdl-33569769

ABSTRACT

BACKGROUND: Early identification of patients at high risk of progression to severe COVID-19 constituted an unsolved challenge. Although growing evidence demonstrates a direct association between endotheliitis and severe COVID-19, the role of endothelial damage biomarkers has been scarcely studied. We investigated the relationship between circulating mid-regional proadrenomedullin (MR-proADM) levels, a biomarker of endothelial dysfunction, and prognosis of SARS-CoV-2-infected patients. METHODS: Prospective observational study enrolling adult patients with confirmed COVID-19. On admission to emergency department, a blood sample was drawn for laboratory test analysis. Primary and secondary endpoints were 28-day all-cause mortality and severe COVID-19 progression. Area under the curve (AUC) and multivariate regression analysis were employed to assess the association of the biomarker with the established endpoints. RESULTS: A total of 99 patients were enrolled. During hospitalization, 25 (25.3%) cases progressed to severe disease and the 28-day mortality rate was of 14.1%. MR-proADM showed the highest AUC to predict 28-day mortality (0.905; [CI] 95%: 0.829-0.955; P < .001) and progression to severe disease (0.829; [CI] 95%: 0.740-0.897; P < .001), respectively. MR-proADM plasma levels above optimal cut-off (1.01 nmol/L) showed the strongest independent association with 28-day mortality risk (hazard ratio [HR]: 10.470, 95% CI: 2.066-53.049; P < .005) and with progression to severe disease (HR: 6.803, 95% CI: 1.458-31.750; P = .015). CONCLUSION: Mid-regional proadrenomedullin was the biomarker with highest performance for prognosis of death and progression to severe disease in COVID-19 patients and represents a promising predictor for both outcomes, which might constitute a potential tool in the assessment of prognosis in early stages of this disease.


Subject(s)
Adrenomedullin/blood , COVID-19/blood , Endothelium, Vascular/metabolism , Inflammation/blood , Mortality , Peptide Fragments/blood , Protein Precursors/blood , Aged , Aged, 80 and over , Area Under Curve , COVID-19/mortality , Cause of Death , Disease Progression , Endothelium, Vascular/physiopathology , Female , Humans , Intensive Care Units/statistics & numerical data , Male , Middle Aged , Prognosis , Proportional Hazards Models , Prospective Studies , Respiration, Artificial/statistics & numerical data , SARS-CoV-2 , Severity of Illness Index
13.
Arq. bras. cardiol ; 115(2): 253-260, ago., 2020. tab, graf
Article in English, Portuguese | LILACS, Sec. Est. Saúde SP | ID: biblio-1131283

ABSTRACT

Resumo Fundamento A ecocardiografia é essencial para o diagnóstico e a quantificação da insuficiência aórtica (IA). A integral velocidade-tempo (IVT) do fluxo da IA pode estar relacionada à gravidade da IA. Objetivo Este estudo tem por objetivo avaliar se a IVT é um marcador ecocardiográfico de gravidade da IA. Métodos Foram incluídos todos os pacientes com IA nativa moderada ou grave e ritmo sinusal que visitaram o nosso laboratório de imagem entre janeiro e outubro de 2016. Todos os indivíduos foram submetidos a um ecocardiograma completo com medição da IVT da IA. A associação entre a IVT e a gravidade da IA foi analisada por regressão logística e modelos de regressão multivariada. Valores p<0,05 foram considerados estatisticamente significativos. Resultados Entre os 62 pacientes incluídos (68,5±14,9 anos; 64,5%: IA moderada; 35,5%: IA grave), a IVT foi maior em indivíduos com IA moderada em comparação àqueles com IA grave (2,2±0,5 m versus 1,9±0,5 m, p=0,01). Pacientes com IA grave apresentaram valores maiores de diâmetro diastólico final do ventrículo esquerdo (DDFVE) (56,1±7,1 mm versus 47,3±9,6 mm, p=0,001), volume diastólico final do ventrículo esquerdo (VDFVE) (171±36,5 mL versus 106±46,6 mL, p<0,001), orifício regurgitante efetivo (0,44±0,1 cm2 versus 0,18±0,1 cm2, p=0,002) e volume regurgitante (71,3±25,7 mL versus 42,5±10,9 mL, p=0,05), assim como menor fração de ejeção do ventrículo esquerdo (FEVE) (54,1±11,2% versus 63,2±13,3%, p=0,012). A IVT mostrou ser um marcador de gravidade da IA, independentemente do DDFVE, VDFVE e FEVE ( odds ratio 0,160, p=0,032) e da frequência cardíaca e pressão arterial diastólica (PAD) ( odds ratio 0,232, p=0,044). Conclusões A IVT do fluxo da IA apresentou associação inversa com a gravidade da IA, independentemente do diâmetro e volume do ventrículo esquerdo, frequência cardíaca, PAD e FEVE. A IVT pode ser um marcador de gravidade da IA em pacientes com IA nativa e ritmo sinusal. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Abstract Background Echocardiography is essential for the diagnosis and quantification of aortic regurgitation (AR). Velocity-time integral (VTI) of AR flow could be related to AR severity. Objective This study aims to assess whether VTI is an echocardiographic marker of AR severity. Methods We included all patients with moderate or severe native AR and sinus rhythm who visited our imaging laboratory from January to October 2016. All individuals underwent a complete echocardiogram with AR VTI measurement. The association between VTI and AR severity was analyzed by logistic regression and multivariate regression models. A p-value<0,05 was considered statistically significant. Results Among the 62 patients included (68.5±14.9 years old; 64.5%: moderate AR; 35.5%: severe AR), VTI was higher in individuals with moderate AR compared to those with severe AR (2.2±0.5 m vs. 1.9±0.5 m, p=0.01). Patients with severe AR presented greater values of left ventricular end-diastolic diameter (LVEDD) (56.1±7.1 mm vs. 47.3±9.6 mm, p=0.001), left ventricular end-diastolic volume (LVEDV) (171±36.5 mL vs. 106±46.6 mL, p<0.001), effective regurgitant orifice (0.44±0.1 cm2vs. 0.18±0.1 cm2, p=0.002), and regurgitant volume (71.3±25.7 mL vs. 42.5±10.9 mL, p=0.05), as well as lower left ventricular ejection fraction (LVEF) (54.1±11.2% vs. 63.2±13.3%, p=0.012). The VTI proved to be a marker of AR severity, irrespective of LVEDD, LVEDV, and LVEF (odds ratio 0.160, p=0.032) and of heart rate and diastolic blood pressure (DBP) (odds ratio 0.232, p=0.044). Conclusions The VTI of AR flow was inversely associated with AR severity regardless of left ventricular diameter and volume, heart rate, DBP, and LVEF. VTI could be a marker of AR severity in patients with native AR and sinus rhythm. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)


Subject(s)
Humans , Aged , Aged, 80 and over , Aortic Valve Insufficiency/diagnostic imaging , Stroke Volume , Time , Severity of Illness Index , Echocardiography , Ventricular Function, Left , Middle Aged
14.
Arq Bras Cardiol ; 115(2): 253-260, 2020 07 15.
Article in English, Portuguese | MEDLINE | ID: mdl-32696853

ABSTRACT

BACKGROUND: Echocardiography is essential for the diagnosis and quantification of aortic regurgitation (AR). Velocity-time integral (VTI) of AR flow could be related to AR severity. OBJECTIVE: This study aims to assess whether VTI is an echocardiographic marker of AR severity. METHODS: We included all patients with moderate or severe native AR and sinus rhythm who visited our imaging laboratory from January to October 2016. All individuals underwent a complete echocardiogram with AR VTI measurement. The association between VTI and AR severity was analyzed by logistic regression and multivariate regression models. A p-value<0,05 was considered statistically significant. RESULTS: Among the 62 patients included (68.5±14.9 years old; 64.5%: moderate AR; 35.5%: severe AR), VTI was higher in individuals with moderate AR compared to those with severe AR (2.2±0.5 m vs. 1.9±0.5 m, p=0.01). Patients with severe AR presented greater values of left ventricular end-diastolic diameter (LVEDD) (56.1±7.1 mm vs. 47.3±9.6 mm, p=0.001), left ventricular end-diastolic volume (LVEDV) (171±36.5 mL vs. 106±46.6 mL, p<0.001), effective regurgitant orifice (0.44±0.1 cm2vs. 0.18±0.1 cm2, p=0.002), and regurgitant volume (71.3±25.7 mL vs. 42.5±10.9 mL, p=0.05), as well as lower left ventricular ejection fraction (LVEF) (54.1±11.2% vs. 63.2±13.3%, p=0.012). The VTI proved to be a marker of AR severity, irrespective of LVEDD, LVEDV, and LVEF (odds ratio 0.160, p=0.032) and of heart rate and diastolic blood pressure (DBP) (odds ratio 0.232, p=0.044). CONCLUSIONS: The VTI of AR flow was inversely associated with AR severity regardless of left ventricular diameter and volume, heart rate, DBP, and LVEF. VTI could be a marker of AR severity in patients with native AR and sinus rhythm. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).


FUNDAMENTO: A ecocardiografia é essencial para o diagnóstico e a quantificação da insuficiência aórtica (IA). A integral velocidade-tempo (IVT) do fluxo da IA pode estar relacionada à gravidade da IA. OBJETIVO: Este estudo tem por objetivo avaliar se a IVT é um marcador ecocardiográfico de gravidade da IA. MÉTODOS: Foram incluídos todos os pacientes com IA nativa moderada ou grave e ritmo sinusal que visitaram o nosso laboratório de imagem entre janeiro e outubro de 2016. Todos os indivíduos foram submetidos a um ecocardiograma completo com medição da IVT da IA. A associação entre a IVT e a gravidade da IA foi analisada por regressão logística e modelos de regressão multivariada. Valores p<0,05 foram considerados estatisticamente significativos. RESULTADOS: Entre os 62 pacientes incluídos (68,5±14,9 anos; 64,5%: IA moderada; 35,5%: IA grave), a IVT foi maior em indivíduos com IA moderada em comparação àqueles com IA grave (2,2±0,5 m versus 1,9±0,5 m, p=0,01). Pacientes com IA grave apresentaram valores maiores de diâmetro diastólico final do ventrículo esquerdo (DDFVE) (56,1±7,1 mm versus 47,3±9,6 mm, p=0,001), volume diastólico final do ventrículo esquerdo (VDFVE) (171±36,5 mL versus 106±46,6 mL, p<0,001), orifício regurgitante efetivo (0,44±0,1 cm2 versus 0,18±0,1 cm2, p=0,002) e volume regurgitante (71,3±25,7 mL versus 42,5±10,9 mL, p=0,05), assim como menor fração de ejeção do ventrículo esquerdo (FEVE) (54,1±11,2% versus 63,2±13,3%, p=0,012). A IVT mostrou ser um marcador de gravidade da IA, independentemente do DDFVE, VDFVE e FEVE ( odds ratio 0,160, p=0,032) e da frequência cardíaca e pressão arterial diastólica (PAD) ( odds ratio 0,232, p=0,044). CONCLUSÕES: A IVT do fluxo da IA apresentou associação inversa com a gravidade da IA, independentemente do diâmetro e volume do ventrículo esquerdo, frequência cardíaca, PAD e FEVE. A IVT pode ser um marcador de gravidade da IA em pacientes com IA nativa e ritmo sinusal. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).


Subject(s)
Aortic Valve Insufficiency , Aged , Aged, 80 and over , Aortic Valve Insufficiency/diagnostic imaging , Echocardiography , Humans , Middle Aged , Severity of Illness Index , Stroke Volume , Time , Ventricular Function, Left
15.
Sensors (Basel) ; 20(13)2020 Jun 28.
Article in English | MEDLINE | ID: mdl-32605285

ABSTRACT

An iterative algorithm is proposed for determining the optimal chassis design of an electric vehicle, given a path and a reference time. The proposed algorithm balances the capacity of the battery pack and the dynamic properties of the chassis, seeking to optimize the tradeoff between the mass of the vehicle, its energy consumption, and the travel time. The design variables of the chassis include geometrical and inertial values, as well as the characteristics of the powertrain. The optimization is constrained by the slopes, curves, grip, and posted speeds of the different sections of the track. Particular service constraints are also considered, such as limiting accelerations due to passenger comfort or cargo safety. This methodology is applicable to any vehicle whose route and travel time are known in advance, such as delivery vehicles, buses, and race cars, and has been validated using telemetry data from an internal combustion rear-wheel drive race car designed for hill climb competitions. The implementation of the proposed methodology allows to reduce the weight of the battery pack by up to 20%, compared to traditional design methods.

18.
Scand J Clin Lab Invest ; 79(6): 455-458, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31244337

ABSTRACT

Natriuretic peptides are a laboratory tool with significant implications for the diagnosis and prognosis of heart failure (HF). The International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) recommended that assays must be examined for sample stability because there appears to be assay dependent. We aimed to evaluate the in vitro stability of B-type natriuretic peptide (BNP) under different handling conditions and using a BNP assay from Fujirebio Diagnostics (Tokyo, Japan). BNP concentrations were measured in plasma EDTA samples from 11 subjects to evaluate the in vitro stability at room temperature and at 4 °C and in 10 subjects to check the in vitro stability of samples stored at -20 °C during 1 and 3 months. Stability limit was defined according to Spanish Society of Laboratory Medicine (SEQC-ML) recommendations. At room temperature and 4 °C, BNP concentrations decreased progressively in samples collected in both groups, remaining stable within four hours from collection. BNP concentrations also were stable within four hours from collection in whole blood at room temperature. Finally, at -20 °C, BNP concentrations remained stable in both groups at 1 and 3 months, respectively. According to our results, BNP, stored at room temperature or at 4 °C, should be assayed in the first four hours after collection. Besides, BNP was shown to be stable in whole blood for at least four hours at room temperature. If the testing cannot be performed within the first four hours, the plasma should be frozen and kept at -20 °C for up to 3 months.


Subject(s)
Natriuretic Peptide, Brain/chemistry , Plasma/chemistry , Specimen Handling/methods , Heart Failure/diagnosis , Humans , Protein Stability , Temperature , Time Factors
19.
Emergencias ; 31(3): 161-166, 2019 Jun.
Article in English, Spanish | MEDLINE | ID: mdl-31210447

ABSTRACT

OBJECTIVES: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). METHODS: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. RESULTS: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). CONCLUSION: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes.


OBJETIVO: Evaluar si la exposición a episodios de polvo sahariano predice los ingresos hospitalarios de los pacientes con insuficiencia cardiaca aguda (ICA) atendidos en un servicio de urgencias hospitalario (SUH). METODO: Estudio unicéntrico, de cohorte retrospectiva, de pacientes con ICA atendidos en un SUH. La población de estudio se dividió en 2 grupos: pacientes ingresados por ICA y pacientes con ICA dados de alta directa a domicilio desde el SUH. Se analizaron las concentraciones medias de material partículado (PMx) (respirables, diámetro aerodinámico, da< 10 µm), PM2,5 (finas, da <2,5 µm) y PM2,5-10 (gruesas, da 2,5-10 µm) desde el día de la llegada al SUH hasta 5 días previos. Se definió exposición intensa al polvo sahariano cuando las concentraciones medias diarias de PM10 estaban entre 50 y 200 µg/m3. La relación para estimar el riesgo de ingresar por ICA en función de la exposición de PMx durante los 5 días previos a su llegada a urgencias se analizó mediante análisis multivariable. RESULTADOS: Se incluyeron 1.097 pacientes con ICA, ingresaron 318 pacientes (29%), 779 (71%) se dieron de alta. Los pacientes ingresados por ICA tenían mayor edad, elevada comorbilidad y mayor proporción de pacientes expuestos a episodios intensos de polvo sahariano (p < 0,0001). En el análisis multivariable la exposición a episodios de polvo sahariano intensos se relacionó con el ingreso hospitalario en los pacientes con ICA (OR = 2,36; IC 95% 1,21-4,58; p = 0,01). CONCLUSIONES: En ausencia de estudios prospectivos, los resultados obtenidos de la serie analizada sugieren que la presencia de concentraciones elevadas de polvo sahariano (PM10: 50-200 µg/m3) puede constituir un factor precipitante de ingreso por ICA.


Subject(s)
Air Pollutants/toxicity , Desert Climate , Dust , Heart Failure/epidemiology , Hospitalization/statistics & numerical data , Acute Disease , Africa, Northern , Age Factors , Aged , Dust/analysis , Environmental Exposure/statistics & numerical data , Female , Humans , Male , Middle Aged , Multivariate Analysis , Particle Size , Particulate Matter/analysis , Particulate Matter/toxicity , Patient Discharge/statistics & numerical data , Retrospective Studies , Spain
20.
Emergencias (Sant Vicenç dels Horts) ; 31(3): 161-166, jun. 2019. graf, tab
Article in Spanish | IBECS | ID: ibc-182725

ABSTRACT

Objetivo: Evaluar si la exposición a episodios de polvo sahariano predice los ingresos hospitalarios de los pacientes con insuficiencia cardiaca aguda (ICA) atendidos en un servicio de urgencias hospitalario (SUH). Método: Estudio unicéntrico, de cohorte retrospectiva, de pacientes con ICA atendidos en un SUH. La población de estudio se dividió en 2 grupos: pacientes ingresados por ICA y pacientes con ICA dados de alta directa a domicilio desde el SUH. Se analizaron las concentraciones medias de material partículado (PMx) (respirables, diámetro aerodinámico, da < 10 µm), PM2,5 (finas, da < 2,5 µm) y PM2,5-10 (gruesas, da 2,5-10 µm) desde el día de la llegada al SUH hasta 5 días previos. Se definió exposición intensa al polvo sahariano cuando las concentraciones medias diarias de PM10 estaban entre 50 y 200 µg/m3. La relación para estimar el riesgo de ingresar por ICA en función de la exposición de PMx durante los 5 días previos a su llegada a urgencias se analizó mediante análisis multivariable. Resultados: Se incluyeron 1.097 pacientes con ICA, ingresaron 318 pacientes (29%), 779 (71%) se dieron de alta. Los pacientes ingresados por ICA tenían mayor edad, elevada comorbilidad y mayor proporción de pacientes expuestos a episodios intensos de polvo sahariano (p < 0,0001). En el análisis multivariable la exposición a episodios de polvo sahariano intensos se relacionó con el ingreso hospitalario en los pacientes con ICA (OR = 2,36; IC 95% 1,21-4,58; p = 0,01). Conclusiones: En ausencia de estudios prospectivos, los resultados obtenidos de la serie analizada sugieren que la presencia de concentraciones elevadas de polvo sahariano (PM10: 50-200 µg/m3) puede constituir un factor precipitante de ingreso por ICA


Objective: To explore whether episodes of exposure to atmospheric Saharan dust is a risk factor for hospitalization in patients with acute heart failure (AHF) attended in a hospital emergency department (ED). Methods: Single-center retrospective study of patients with AHF. The cohort was analyzed in 2 groups: ED patients hospitalized with AHF and patients discharged home from the ED. Air pollution on the 5 days leading to ED admission for AHF was recorded as the average concentration of breathable particulate matter with an aerodynamic diameter of no more than 10 µm (PM10) in the following ranges: fine PM (diameter less than 2.5 µm) or coarse PM (diameters between 2.5 and 10 µm). High Saharan dust pollution exposure was defined by mean daily PM10 concentrations between 50 and 200 µg/m3. Multivariable analysis was used to estimate risk for AHF in relation to PM10 exposure in the 5 days before the ED visit. Results: A total of 1097 patients with AHF were treated in the ED; 318 of them (29%) were hospitalized and 779 (71%) were discharged home. Hospitalized patients were older, had more concomitant illnesses, and more episodes of exposure to Saharan dust (P < .0001). Multivariable analysis confirmed the association between Saharan dust exposure and hospital admission in these patients (odds ratio, 2.36; 95% CI, 1.21-4.58; P = .01). Conclusions: In the absence of prospective studies, the results of this series suggest that exposure to high levels of Saharan dust (PM10 concentrations between 50 and 200 µg/m3) may be a precipitating factor for hospitalization in AHF episodes


Subject(s)
Humans , Male , Female , Middle Aged , 19045/adverse effects , Heart Failure/epidemiology , Emergency Medical Services , Hospitalization/trends , Environmental Exposure/adverse effects , Particulate Matter/adverse effects , Multivariate Analysis , Retrospective Studies , Patient Admission/statistics & numerical data
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