Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic ...Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.展开更多
BACKGROUND: Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbid...BACKGROUND: Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbidity. The aim of this study was to examine the association of prehospital medication use with mortality in patients with acute respiratory disease.METHODS: A prospective, multicenter, emergency medical service(EMS) delivery cohort study was carried out in adults with unselected respiratory diseases managed by EMS who were transferred to the emergency department. From January 1, 2019, to October 31, 2023, six advanced life support units, thirty-eight basic life support units, and four hospitals in Spain participated in the study. Demographic data, vital signs, use of mechanical ventilation, prehospital respiratory diagnosis, and prehospital medication were collected. The primary outcome was 30-day in-hospital mortality.RESULTS: A total of 961 patients were included, with a mortality rate of 17.5%(168 patients). Age, an increasing number of comorbidities, the use of invasive mechanical ventilation(IMV), the use of major analgesics, hypnotics, and bicarbonate were risk factors. In contrast, elevated systolic blood pressure and Glasgow Coma Scale scores were found to be protective factors against mortality. The predictive capacity of the model reached an area under the curve(AUC) of 0.857(95% confidence interval [95% CI] 0.827–0.888).CONCLUSION: Our data revealed that IMV, major analgesics, hypnotics and bicarbonate administration were associated with elevated mortality. Adding prehospital drug therapy information to demographic variables and vital signs could improve EMS decision-making, allowing a better characterization of patients at risk of clinical worsening.展开更多
The nervous system function requires a precise but plastic neural architecture.The neuronal shape dictates how neurons interact with each other and with other cells,being the morphology of dendrites and axons the cent...The nervous system function requires a precise but plastic neural architecture.The neuronal shape dictates how neurons interact with each other and with other cells,being the morphology of dendrites and axons the central determinant of the functional properties of neurons and neural circuits.The topological and structural morphology of axons and dendrites defines and determines how synapses are conformed.The morphological diversity of axon and dendrite arborization governs the neuron’s inputs,synaptic integration,neuronal computation,signal transmission,and network circuitry,hence defining the particular connectivity and function of the different brain areas.展开更多
BACKGROUND:Oxygen supply is a common procedure performed by emergency medical services(EMS);however,whether prehospital oxygen or fraction of inspired oxygen(FiO2)therapy predict mortality has not been studied to date...BACKGROUND:Oxygen supply is a common procedure performed by emergency medical services(EMS);however,whether prehospital oxygen or fraction of inspired oxygen(FiO2)therapy predict mortality has not been studied to date.This study aims to determine mortality associated with oxygen therapy in unselected patients with acute disease who underwent prehospital care.METHODS:This was a prospective,observational,cohort,multicenter,EMS-delivery,ambulance-based study.Adults with unselected acute disease who were managed by EMS and evacuated with high priority to the emergency department of four hospitals in three Spanish provinces.Epidemiological variables,on-scene vital signs,and prehospital blood analysis data were collected.The primary outcome was short-(2-,7-,and 30-day),medium-(90-and 180-day),and long-term(365-day)all-cause cumulative mortality.The samples were a priori split according to thresholds of their received FiO2(FiO2=0.21,that is without oxygen therapy;FiO2 between 0.22 and 0.49;and FiO2≥0.5).The categorical variables FiO2,epidemiological variables,vital signs,prehospital point-of-care testing(POCT)and patient outcomes were fitted with a logistic regression model.Additionally,a propensity score matching and a survival analysis were used.RESULTS:The final sample included 7,494 patients,70.3%of whom did not receive oxygen therapy,15%with a FiO2 between 0.22 and 0.49,and 14.7%with a FiO2≥0.5.The 2-day mortality was 0.4%,5.3%,and 22.9%respectively(P<0.001).The 365-day mortality was 9.9%,33.1%,and 50.5%respectively(P<0.001).Finally,the FiO2 predictive capacities 2-,30-,and 365-day mortality were AUC=0.870(95%CI:0.840-0.899),0.810(95%CI:0.784-0.837),0.704(95%CI:0.679-0.728),respectively.CONCLUSION:Prehospital oxygen therapy by thresholds of FiO2 was linked to death and allowed mortality prediction.This finding could provide an aid for EMS providers,allowing to assess more individualized patient risk.展开更多
Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of t...Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of treatment, the success rate in left-sided IE is often limited,as nearly half of all patients eventually require surgical intervention for definitive management.^([2]) Heart failure is the main indication for surgery, but access to surgery is frequently restricted by several factors, particularly in patients with advanced age, often driven by the presence of comorbidities or hemodynamic instability.^([3,4])展开更多
This study investigated the short-term effects of woody residues and compost on Orange-fleshed sweet potatoes(OFSP)focusing on plant growth,storage root production,and bioactive compounds.Conducted in a commercial orc...This study investigated the short-term effects of woody residues and compost on Orange-fleshed sweet potatoes(OFSP)focusing on plant growth,storage root production,and bioactive compounds.Conducted in a commercial orchard,the experiment compared different organic fertilization treatments with a control.Four treatments were established:Treatment 1(T1)received compost fertilization;Treatment 2,control,(T2)had no fertilization;and Treatments 3(T3)and 4(T4)were fertilized with high(15 kg·m^(-2))and low(7.5 kg·m^(-2))doses of woody plant residues,respectively.Although woody residue application initially hampered plant growth,it ultimately enhanced biological nitrogen fixation,phosphorus availability,and reduced stress and senescence.Agronomic production did not differ between the compost and woody residue treatments but was increased at the high woody residue dose compared to control.At late growth stages,ascorbic acid decreased in all treatments.At this time,the total phenolic content in storage roots remained high in the woody residue treatments.Conversely,compost reduced the bioactive compounds,without affecting growth,potentially due to oxidative stress in late growth stages.The lower crop senescence index and comparable agronomic production to the compost treatment suggest that woody residues were beneficial for OFSP growth and bioactive composition.The superior quality of the tuberous roots produced with woody residues indicates that this is an effective organic fertilization method for sweet potato production that can contribute to its resilience to environmental variations.展开更多
Regular physical activity is associated with lower adult cancer incidence and mortality,1 with this protective association seemingly independent of important risk factors (high body weight, smoking).2 The potential pr...Regular physical activity is associated with lower adult cancer incidence and mortality,1 with this protective association seemingly independent of important risk factors (high body weight, smoking).2 The potential preventive effect of an active lifestyle was presumed a long time ago by some visionary scientists.展开更多
The reduction of CO_(2)toward CO and CH_(4)over Ni-loaded MoS_(2)-like layered nanomaterials is investigated.The mild hydrothermal synthesis induced the formation of a molybdenum oxysulfide(MoO_(x)S_(y))phase,enriched...The reduction of CO_(2)toward CO and CH_(4)over Ni-loaded MoS_(2)-like layered nanomaterials is investigated.The mild hydrothermal synthesis induced the formation of a molybdenum oxysulfide(MoO_(x)S_(y))phase,enriched with sulfur defects and multiple Mo oxidation states that favor the insertion of Ni^(2+)cations via photo-assisted precipitation.The photocatalytic tests under LED irradiation at different wavelengths from 365 to 940 nm at 250℃rendered 1%CO_(2)conversion and continuous CO production up to 0.6 mmol/(gcat h).The incorporation of Ni into the MoO_(x)S_(y)structure boosted the continuous production of CO up to 5.1 mmol/(gcat h)with a CO_(2)conversion of 3.5%.In situ spectroscopic techniques and DFT simulations showed the O-incorporated MoS_(2)structure,in addition to Ni clusters as a supported metal catalyst.The mechanistic study of the CO_(2)reduction reaction over the catalysts revealed that the reverse water-gas shift reaction is favored due to the preferential formation of carboxylic species.展开更多
Deep phenotyping and genetic characterization of individuals are fundamental to assessing the metabolic status and determining nutrition-specific requirements.This study aimed to ascertain the utmost effectiveness of ...Deep phenotyping and genetic characterization of individuals are fundamental to assessing the metabolic status and determining nutrition-specific requirements.This study aimed to ascertain the utmost effectiveness of personalized interventions by aligning dietary adjustments with both the genotype and metabolotype of individuals.Therefore,we assessed here the usefulness of a polygenic score(PGS)characterizing a potential pro-inflammatory profile(PGSi)as a nutrigenetic tool to discern individuals from the Danish PREVENTOMICS cohort that could better respond to precision nutrition(PN)plans,specifically targeted at counteracting the low-grade inflammatory profile typically found in obesity.The cohort followed a PN plan to counteract the pro-inflammatory profile(PNi group)or generic dietary recommendations(Control)for 10 weeks.PGSi was applied for genetic stratification(Low/High).The effects of the intervention on anthropometrics and biomarkers related to inflammatory profile and carbohydrate metabolism were assessed.Around 30%of subjects had a high genetic predisposition to pro-inflammatory status(high-PGSi).These individuals demonstrated the most effective response to the dietary plan,experiencing improved body composition,with significant decreases in body weight(∆:-4.84%;P=0.039)and body fat(∆:-4.86%;P=0.007),and beneficial changes in pro-and anti-inflammatory biomarkers,with significant increases in IL-10(∆:71.3%;P=0.025)and decreases in TNF-α(∆:-3.0%;P=0.048),CRP(∆:-31.1%),ICAM1(∆:-5.8%),and MCP1(∆:-4.2%)circulating levels,compared to low-PGSi individuals.Both phenotypic and genetic stratification contributed to a better understanding of metabolic heterogeneity in response to diet.This approach allows for refinement of the prediction of individual requirements and potentially for better management of obesity.展开更多
Background:Mammalian cells possess molecular clocks,the adequate functioning of which is decisive for metabolic health.Exercise is known to modulate these clocks,potentially having distinct effects on metabolism depen...Background:Mammalian cells possess molecular clocks,the adequate functioning of which is decisive for metabolic health.Exercise is known to modulate these clocks,potentially having distinct effects on metabolism depending on the time of day.This study aimed to investigate the impact of morning vs.evening moderate-intensity aerobic exercise on glucose regulation and energy metabolism in healthy men and women.It also aimed to elucidate molecular mechanisms within skeletal muscle.Methods:Using a randomized crossover design,healthy men(n=18)and women(n=17)performed a 60-min bout of moderate-intensity aerobic exercise in the morning and evening.Glucose regulation was continuously monitored starting 24 h prior to the exercise day and continuing until 48 h post-exercise for each experimental condition.Energy expenditure and substrate oxidation were measured by indirect calorimetry during exercise and at rest before and after exercise for 30 min.Skeletal muscle biopsies were collected immediately before and after exercise to assess mitochondrial function,transcriptome,and mitochondrial proteome.Results:Results indicated similar systemic glucose,energy expenditure,and substrate oxidation during and after exercise in both sexes.Notably,transcriptional analysis,mitochondrial function,and mitochondrial proteomics revealed marked sexual dimorphism and time of day variations.Conclusion:The sexual dimorphism and time of day variations observed in the skeletal muscle in response to exercise may translate into observable systemic effects with higher exercise-intensity or chronic exercise interventions.This study provides a foundational molecular framework for precise exercise prescription in the clinical setting.展开更多
Alzheimer’s disease is a neurodegenerative disorder characterized by the amyloid accumulation in the brains of patients with Alzheimer’s disease.The pathogenesis of Alzheimer’s disease is mainly mediated by the pho...Alzheimer’s disease is a neurodegenerative disorder characterized by the amyloid accumulation in the brains of patients with Alzheimer’s disease.The pathogenesis of Alzheimer’s disease is mainly mediated by the phosphorylation and aggregation of tau protein.Among the multiple causes of tau hyperphosphorylation,brain insulin resistance has generated much attention,and inositols as insulin sensitizers,are currently considered candidates for drug development.The present narrative review revises the interactions between these three elements:Alzheimer’s disease-tau-inositols,which can eventually identify targets for new disease modifiers capable of bringing hope to the millions of people affected by this devastating disease.展开更多
The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial comp...The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity(NRC)and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitratereducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals(P < 0.05 in all five datasets with n = 20–82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate(a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment(P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria(P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.展开更多
Background:This study aimed to determine the effect of different carbohydrate(CHO)doses on exercise capacity in patients with McArdle disease—the paradigm of“exercise intolerance”,characterized by complete muscle g...Background:This study aimed to determine the effect of different carbohydrate(CHO)doses on exercise capacity in patients with McArdle disease—the paradigm of“exercise intolerance”,characterized by complete muscle glycogen unavailability—and to determine whether higher exogenous glucose levels affect metabolic responses at the McArdle muscle cell(in vitro)level.Methods:Patients with McArdle disease(n=8)and healthy controls(n=9)underwent a 12-min submaximal cycling constant-load bout followed by a maximal ramp test 15 min after ingesting a non-caloric placebo.In a randomized,double-blinded,cross-over design,patients repeated the tests after consuming either 75 g or 150 g of CHO(glucose:fructose=2:1).Cardiorespiratory,biochemical,perceptual,and electromyographic(EMG)variables were assessed.Additionally,glucose uptake and lactate appearance were studied in vitro in wild-type and McArdle mouse myotubes cultured with increasing glucose concentrations(0.35,1.00,4.50,and 10.00 g/L).Results:Compared with controls,patients showed the“classical”second-wind phenomenon(after prior disproportionate tachycardia,myalgia,and excess electromyographic activity during submaximal exercise,all p<0.05)and an impaired endurance exercise capacity(-51%ventilatory threshold and55%peak power output,both p<0.001).Regardless of the CHO dose(p<0.05 for both doses compared with the placebo),CHO intake increased blood glucose and lactate levels,decreased fat oxidation rates,and attenuated the second wind in the patients.However,only the higher dose increased ventilatory threshold(+27%,p=0.010)and peak power output(+18%,p=0.007).In vitro analyses revealed no differences in lactate levels across glucose concentrations in wild-type myotubes,whereas a doseresponse effect was observed in McArdle myotubes.Conclusion:CHO intake exerts beneficial effects on exercise capacity in McArdle disease,a condition associated with total muscle glycogen unavailability.Some of these benefits are dose dependent.展开更多
The protective role of(poly)phenols against metabolic disorders has been extensively studied in adults but not in adolescents.To assess associations of dietary(poly)phenols and their subclasses with cardiometabolic he...The protective role of(poly)phenols against metabolic disorders has been extensively studied in adults but not in adolescents.To assess associations of dietary(poly)phenols and their subclasses with cardiometabolic health parameters in adolescents.A cross-sectional study was conducted in 944 individuals aged 11–14 years enrolled in the SI!Program for Secondary Schools trial(NCT03504059).(Poly)phenol intake was assessed using semiquantitative food frequency questionnaires and the Phenol-Explorer database.The measured cardiometabolic parameters were waist circumference(WC)age-sex Z-score,blood pressure(BP)age-sex Z-score,blood glucose(BG),triglycerides(TG),and high-density lipoprotein cholesterol(HDL-c).Multilevel mixedeffect linear regression models were applied to examine the association between(poly)phenol quintiles and cardiometabolic health parameters.Compared to the lowest quintile,adolescents in the highest quintile of total(poly)phenol intake had lower WC Z-scores,mean arterial pressure Z-scores,and HDL-c after multivariable adjustment.The WC Z-scores and HDL-c were lower in the highest quintile of flavonoid intake compared to the lowest quintile.The highest quintile of phenolic acid intake was associated with a lower WC Z-score and TG levels,and the highest quintile of stilbene intake with lower BG and TG,and with higher HDL-c compared to the lowest quintile.A higher intake of(poly)phenols,especially flavonoids,phenolic acids,and stilbenes,was associated with better cardiometabolic parameters in adolescents.展开更多
Objectives To assess the effects of an exercise training program combining power-oriented resistance training(RT)and high-intensity interval training(HIIT)on metabolic syndrome(MetS)markers in older people with COPD.M...Objectives To assess the effects of an exercise training program combining power-oriented resistance training(RT)and high-intensity interval training(HIIT)on metabolic syndrome(MetS)markers in older people with COPD.Methods Twenty-nine older people(66–90 years old)with COPD were randomly assigned to 12 weeks of exercise training(ET;power-oriented RT+HIIT)or a control group(CON).Waist circumference,diastolic(DBP)and systolic blood pressure(SBP),and serum fasting glucose,triglycerides and HDL cholesterol levels were assessed at baseline and after 12 weeks.Linear mixed-effects models were used to assess the effects of the intervention,and data were reported as mean and 95%confidence interval values.Results Waist circumference increased in the CT group,but not in the ET group(2.0[0.2,3.7]vs.1.0[−1.3,3.2]cm,respectively).No changes in fasting glucose(−4.1[−10.3,2.1]vs.−1.0[−8.7,6.7]mg dL−1),triglycerides(3.9[−13.4,21.3]vs.−13.9[−35.6,7.7]mg dL−1)or HDL cholesterol(1.0[−3.4,5.4]vs.2.9[−2.6,8.4]mg dL−1)were found in the CT or ET group,respectively.The ET group exhibited decreased DBP(−5.2[−9.5,−0.8]mmHg)and SBP(−2.7[−22.7,−2.7]mmHg),while no changes were found in the CT group(0.3[−3.2,3.7]and−3.5[−11.4,4.5]mmHg).MetS z-score declined in ET but remained unchanged in CT(−0.88[−1.74,−0.03]vs.0.07[−0.62,0.76],respectively).Conclusions A 12-week exercise training program led to a reduction in blood pressure and MetS z-score in older people with COPD.展开更多
With increasing life expectancy,neurodegenerative diseases have become one of the leading causes of illhealth in the elderly.Preventive strategies include following healthy diets,such as the Mediterranean diet,which i...With increasing life expectancy,neurodegenerative diseases have become one of the leading causes of illhealth in the elderly.Preventive strategies include following healthy diets,such as the Mediterranean diet,which is particularly rich in polyphenols,bioactive compounds with neuroprotective properties.The aim of this study was to assess the association of microbial phenolic metabolites(MPM)with cognition.This cross-sectional analysis was performed with 200 participants of the PREDIMED trial(Barcelona-Clinic recruitment center).A novel method based on liquid chromatography coupled to mass spectrometry was used to identify urinary MPM(protocatechuic acid,enterodiol glucuronide,enterolactone glucuronide,urolithin B glucuronide,and vanillic acid glucuronide),and cognitive function was evaluated with neuropsychological tests.Multivariable-adjusted ordinary least squares regression was used to assess the associations between cognitive function and MPM,and a score was calculated as the weighted sum of MPM.A higher MPM score was associated with better frontal lobe function.Among individual metabolites,vanillic acid glucuronide was correlated with frontal cognitive performance.Participants with higher concentrations of vanillic acid glucuronide and urolithin B glucuronide obtained better scores in the Color Trail Test part 2.A higher score for urinary multiMPM was associated with better frontal cognitive performance in an older Mediterranean population.展开更多
In recent years,the number of known disease genes has exponentially grown due to the widespread adoption of cost-effective massive parallel sequencing.To identify new disease variants,especially in monogenic disorders...In recent years,the number of known disease genes has exponentially grown due to the widespread adoption of cost-effective massive parallel sequencing.To identify new disease variants,especially in monogenic disorders,a frequency-based filtering approach has proved very useful(Dopazo et al.,2016).展开更多
目的临床指南需要根据相关研究结果定期审查以确保其可靠性,但在更新临床指南的过程中仍然缺乏对于更新过程表述的优先报告条目。本文旨在介绍更新版指南报告清单(Checklist for the Reporting of Updated Guidelines,Check Up)及其制...目的临床指南需要根据相关研究结果定期审查以确保其可靠性,但在更新临床指南的过程中仍然缺乏对于更新过程表述的优先报告条目。本文旨在介绍更新版指南报告清单(Checklist for the Reporting of Updated Guidelines,Check Up)及其制定过程。方法基于临床指南更新的研究证据的概述,指南研究与评价工具(Appraisal of Guidelines for Research and EvaluationⅡ,AGREEⅡ)和报告清单专家组(33位)的建议开发了初始清单的各条目。然后,使用多个步骤对本清单进行了完善,包括评估10个现有的更新版临床指南,对关键信息提供者进行访谈[应答率为54.2%(13/24)],清单制定专家组内部进行的一个三轮的德尔菲(Delphi)共识调查,以及来自于临床指南方法学专家[应答率为90%(53/59)]和指南使用者[应答率为55.6%(10/18)]的外部评审意见。结果清单最终包括16个条目,主要涉及:(1)更新版指南的呈现;(2)编辑独立性;(3)更新过程采用的方法。结论更新版指南的报告清单作为一个工具可用于评估更新版指南报告的完整性,并为指南制定者提供撰写报告的要求。展开更多
Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by hyper...Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by hyperglycemia.However,retinal neurodegeneration is already present before any microcirculatory abnormalities can be detected in ophthalmoscopic examination.In other words,retinal neurodegeneration is an early event in the pathogenesis of DR which predates and participates in the microcirculatory abnormalities that occur in DR.Therefore,the study of the mechanisms that lead to neurodegeneration will be essential to identify new therapeutic targets in the early stages of DR.Elevated levels of glutamate and the overexpression of the renin-angiotensin-system play an essential role in the neurodegenerative process that occurs in diabetic retina.Among neuroprotective factors,pigment epithelial derived factor,somatostatin and erythropoietin seem to be the most relevant and these will be considered in this review.Nevertheless,it should be noted that the balance between neurotoxic and neuroprotective factors rather than levels of neurotoxic factors alone will determine the presence or absence of retinal neurodegeneration in the diabetic eye.New strategies,based on either the delivery of neuroprotective agents or the blockade of neurotoxic factors,are currently being tested in experimental models and in clinical pilot studies.Whether these novel therapies will eventually supplement or prevent the need for laser photocoagulation or vitrectomy awaits the results of additional clinical research.展开更多
文摘Background There is scarce data about comparisons between geriatric assessment tools in patients with aortic stenosis(AS).We aimed to describe the geriatric profile of patients with AS undergoing transcatheter aortic valve implantation(TAVI)and to analyze the ability of different tools for predicting clinical outcomes in this context.Methods This was a single center retrospective registry including patients with AS undergoing TAVI and surviving to hospital discharge.The primary endpoint was all-cause mortality or need for urgent readmission one year after TAVI.Results A total of 377 patients were included(mean age of 80.4 years).Most patients were independent or mildly dependent,with an optimal cognitive status.The proportion of frailty ranged from 17.6%to 49.8%.A total of 20 patients(5.3%)died and 110/377 patients(29.2%)died or were readmitted during follow up.Overall,most components of the geriatric assessment showed an association with clinical outcomes.Disability for instrumental activities showed a significant association with mortality and a strong association with the rate of mortality or readmission.The association between frailty and clinical outcomes was higher for short physical performance battery(SPPB),essential frailty toolset(EFT)and the frailty index based on comprehensive geriatric assessment(IF-VIG)and lower for Fried criteria and FRAIL scale.Conclusions AS patients from this series presented a good physical performance,optimal cognitive status and a reasonably low prevalence of frailty.The best predictive ability was observed for disability for instrumental activities and frailty as measured by the EFT,SPPB and the IF-VIG.
基金supported by the Institute of Health Carlos Ⅲ (Spain)co-financed by the European Union (DTS23/00010) for FMR。
文摘BACKGROUND: Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbidity. The aim of this study was to examine the association of prehospital medication use with mortality in patients with acute respiratory disease.METHODS: A prospective, multicenter, emergency medical service(EMS) delivery cohort study was carried out in adults with unselected respiratory diseases managed by EMS who were transferred to the emergency department. From January 1, 2019, to October 31, 2023, six advanced life support units, thirty-eight basic life support units, and four hospitals in Spain participated in the study. Demographic data, vital signs, use of mechanical ventilation, prehospital respiratory diagnosis, and prehospital medication were collected. The primary outcome was 30-day in-hospital mortality.RESULTS: A total of 961 patients were included, with a mortality rate of 17.5%(168 patients). Age, an increasing number of comorbidities, the use of invasive mechanical ventilation(IMV), the use of major analgesics, hypnotics, and bicarbonate were risk factors. In contrast, elevated systolic blood pressure and Glasgow Coma Scale scores were found to be protective factors against mortality. The predictive capacity of the model reached an area under the curve(AUC) of 0.857(95% confidence interval [95% CI] 0.827–0.888).CONCLUSION: Our data revealed that IMV, major analgesics, hypnotics and bicarbonate administration were associated with elevated mortality. Adding prehospital drug therapy information to demographic variables and vital signs could improve EMS decision-making, allowing a better characterization of patients at risk of clinical worsening.
基金supported by the Wellcome Trust(grant No.103852).
文摘The nervous system function requires a precise but plastic neural architecture.The neuronal shape dictates how neurons interact with each other and with other cells,being the morphology of dendrites and axons the central determinant of the functional properties of neurons and neural circuits.The topological and structural morphology of axons and dendrites defines and determines how synapses are conformed.The morphological diversity of axon and dendrite arborization governs the neuron’s inputs,synaptic integration,neuronal computation,signal transmission,and network circuitry,hence defining the particular connectivity and function of the different brain areas.
基金supported by the Institute of Health Carlos III(Spain)and co-financed by the European Union[grant numbers DTS23/00010]for FM-R。
文摘BACKGROUND:Oxygen supply is a common procedure performed by emergency medical services(EMS);however,whether prehospital oxygen or fraction of inspired oxygen(FiO2)therapy predict mortality has not been studied to date.This study aims to determine mortality associated with oxygen therapy in unselected patients with acute disease who underwent prehospital care.METHODS:This was a prospective,observational,cohort,multicenter,EMS-delivery,ambulance-based study.Adults with unselected acute disease who were managed by EMS and evacuated with high priority to the emergency department of four hospitals in three Spanish provinces.Epidemiological variables,on-scene vital signs,and prehospital blood analysis data were collected.The primary outcome was short-(2-,7-,and 30-day),medium-(90-and 180-day),and long-term(365-day)all-cause cumulative mortality.The samples were a priori split according to thresholds of their received FiO2(FiO2=0.21,that is without oxygen therapy;FiO2 between 0.22 and 0.49;and FiO2≥0.5).The categorical variables FiO2,epidemiological variables,vital signs,prehospital point-of-care testing(POCT)and patient outcomes were fitted with a logistic regression model.Additionally,a propensity score matching and a survival analysis were used.RESULTS:The final sample included 7,494 patients,70.3%of whom did not receive oxygen therapy,15%with a FiO2 between 0.22 and 0.49,and 14.7%with a FiO2≥0.5.The 2-day mortality was 0.4%,5.3%,and 22.9%respectively(P<0.001).The 365-day mortality was 9.9%,33.1%,and 50.5%respectively(P<0.001).Finally,the FiO2 predictive capacities 2-,30-,and 365-day mortality were AUC=0.870(95%CI:0.840-0.899),0.810(95%CI:0.784-0.837),0.704(95%CI:0.679-0.728),respectively.CONCLUSION:Prehospital oxygen therapy by thresholds of FiO2 was linked to death and allowed mortality prediction.This finding could provide an aid for EMS providers,allowing to assess more individualized patient risk.
文摘Infective endocarditis(IE) remains a severe and life-t hreatening disease, with rising incidence and a particularly high mortality rate, especially among elderly patients.^([1]) While antibiotics are the mainstay of treatment, the success rate in left-sided IE is often limited,as nearly half of all patients eventually require surgical intervention for definitive management.^([2]) Heart failure is the main indication for surgery, but access to surgery is frequently restricted by several factors, particularly in patients with advanced age, often driven by the presence of comorbidities or hemodynamic instability.^([3,4])
基金funded by the Ministry of Science and Innovation and Universities(AEI/FEDER,UE)with the project Hortbiosol(TED2021-130783B-C21)the National Institute of Health CarlosⅢ,ISCⅢ,with the project CIBEROBN+2 种基金the Generalitat de Catalunya(GC)+European Funds of Rural Development 56301262021 P4 Regensol demonstration projectINSA-UB is María de Maeztu Unit of Excellence(Grant CEX2021-001234-M funded by MICIN/AEI/FEDER,UE)the National Scholarship Program of Paraguay“Carlos Antonio Lo pez”(BECAL 183/2021)。
文摘This study investigated the short-term effects of woody residues and compost on Orange-fleshed sweet potatoes(OFSP)focusing on plant growth,storage root production,and bioactive compounds.Conducted in a commercial orchard,the experiment compared different organic fertilization treatments with a control.Four treatments were established:Treatment 1(T1)received compost fertilization;Treatment 2,control,(T2)had no fertilization;and Treatments 3(T3)and 4(T4)were fertilized with high(15 kg·m^(-2))and low(7.5 kg·m^(-2))doses of woody plant residues,respectively.Although woody residue application initially hampered plant growth,it ultimately enhanced biological nitrogen fixation,phosphorus availability,and reduced stress and senescence.Agronomic production did not differ between the compost and woody residue treatments but was increased at the high woody residue dose compared to control.At late growth stages,ascorbic acid decreased in all treatments.At this time,the total phenolic content in storage roots remained high in the woody residue treatments.Conversely,compost reduced the bioactive compounds,without affecting growth,potentially due to oxidative stress in late growth stages.The lower crop senescence index and comparable agronomic production to the compost treatment suggest that woody residues were beneficial for OFSP growth and bioactive composition.The superior quality of the tuberous roots produced with woody residues indicates that this is an effective organic fertilization method for sweet potato production that can contribute to its resilience to environmental variations.
基金supported in part by NIH Grant No. U01 TR002004 (REACH project)Research by TP and CFL is funded by the Spanish Ministry of Science and Innovation and (Fondo de Investigaciones Sanitarias, ISCIII)+3 种基金Fondos FEDER (grant numbers PI22/00201 (TP)PI20/00645 and PI23/00396 (CF-L))Research by CFL is also funded by ISCIII (FORT23/00023)Research by AL and CF-L is funded by Wereld Kanker Onderzoek Fonds (WKOF) as part of the World Cancer Research Fund International grant programme (IIG_FULL_2021_007).
文摘Regular physical activity is associated with lower adult cancer incidence and mortality,1 with this protective association seemingly independent of important risk factors (high body weight, smoking).2 The potential preventive effect of an active lifestyle was presumed a long time ago by some visionary scientists.
基金Financial support from the Spanish Ministry of Science and Universities through CEX2023-001286-S,PID2020-114926RB-I00,and CTQ2016-77144-Rthe MICINN Scholarship.
文摘The reduction of CO_(2)toward CO and CH_(4)over Ni-loaded MoS_(2)-like layered nanomaterials is investigated.The mild hydrothermal synthesis induced the formation of a molybdenum oxysulfide(MoO_(x)S_(y))phase,enriched with sulfur defects and multiple Mo oxidation states that favor the insertion of Ni^(2+)cations via photo-assisted precipitation.The photocatalytic tests under LED irradiation at different wavelengths from 365 to 940 nm at 250℃rendered 1%CO_(2)conversion and continuous CO production up to 0.6 mmol/(gcat h).The incorporation of Ni into the MoO_(x)S_(y)structure boosted the continuous production of CO up to 5.1 mmol/(gcat h)with a CO_(2)conversion of 3.5%.In situ spectroscopic techniques and DFT simulations showed the O-incorporated MoS_(2)structure,in addition to Ni clusters as a supported metal catalyst.The mechanistic study of the CO_(2)reduction reaction over the catalysts revealed that the reverse water-gas shift reaction is favored due to the preferential formation of carboxylic species.
基金supported through the European Union’s Horizon 2020 Research and Innovation Program(818318)。
文摘Deep phenotyping and genetic characterization of individuals are fundamental to assessing the metabolic status and determining nutrition-specific requirements.This study aimed to ascertain the utmost effectiveness of personalized interventions by aligning dietary adjustments with both the genotype and metabolotype of individuals.Therefore,we assessed here the usefulness of a polygenic score(PGS)characterizing a potential pro-inflammatory profile(PGSi)as a nutrigenetic tool to discern individuals from the Danish PREVENTOMICS cohort that could better respond to precision nutrition(PN)plans,specifically targeted at counteracting the low-grade inflammatory profile typically found in obesity.The cohort followed a PN plan to counteract the pro-inflammatory profile(PNi group)or generic dietary recommendations(Control)for 10 weeks.PGSi was applied for genetic stratification(Low/High).The effects of the intervention on anthropometrics and biomarkers related to inflammatory profile and carbohydrate metabolism were assessed.Around 30%of subjects had a high genetic predisposition to pro-inflammatory status(high-PGSi).These individuals demonstrated the most effective response to the dietary plan,experiencing improved body composition,with significant decreases in body weight(∆:-4.84%;P=0.039)and body fat(∆:-4.86%;P=0.007),and beneficial changes in pro-and anti-inflammatory biomarkers,with significant increases in IL-10(∆:71.3%;P=0.025)and decreases in TNF-α(∆:-3.0%;P=0.048),CRP(∆:-31.1%),ICAM1(∆:-5.8%),and MCP1(∆:-4.2%)circulating levels,compared to low-PGSi individuals.Both phenotypic and genetic stratification contributed to a better understanding of metabolic heterogeneity in response to diet.This approach allows for refinement of the prediction of individual requirements and potentially for better management of obesity.
基金funded by the Spanish Ministry of Culture and Sport,Consejo Superior de Deportes,Plan de Recuperación,Transformación y Resiliencia,Unión Europea,Next Generation EUAyudas Europeas a Proyectos de Investigaci on Aplicada a la Actividad Física Beneficiosa para la Salud y la Medicina Deportiva(EXP_77437)+9 种基金by the Spanish Ministry of Science and Innovation(PID2022-141506OB-I00)the European Regional Development Funds(ERDF)by the University of Granada Plan Propio de Investigación-Excellence actions:Unit of Excellence on Exercise Nutrition and Health(UCEENS)supported by the Spanish Ministry of Education,Culture and Sport(FPU19/03745 and FPU20/05530,respectively)supported by the Juan de la Cierva Formación Grant FJC2020-044453-I funded by Ministerio de Ciencia e Innovaci on/Agencia Estatal de Investigaci on MCIN/AEI/10.13039/501100011033European Union Next Generation,Plan de Recuperación,Transformación y Resilencia(EU/PRTR)“Ramón y Cajal fellowship 2013-2017”funded by MCIN/AEI/10.13039/501100011033 and“El Fondo Social Europeo invierte en tu futuro”partially supported by the Grant PID2020-114054RA-I001001100482funded by MCIN/AEI/10.13039/501100011033supported by a grant from the MCIN/AEI/10.13039/501100011033,Spain,and the ERDF(PID2021-126788OB-I00).
文摘Background:Mammalian cells possess molecular clocks,the adequate functioning of which is decisive for metabolic health.Exercise is known to modulate these clocks,potentially having distinct effects on metabolism depending on the time of day.This study aimed to investigate the impact of morning vs.evening moderate-intensity aerobic exercise on glucose regulation and energy metabolism in healthy men and women.It also aimed to elucidate molecular mechanisms within skeletal muscle.Methods:Using a randomized crossover design,healthy men(n=18)and women(n=17)performed a 60-min bout of moderate-intensity aerobic exercise in the morning and evening.Glucose regulation was continuously monitored starting 24 h prior to the exercise day and continuing until 48 h post-exercise for each experimental condition.Energy expenditure and substrate oxidation were measured by indirect calorimetry during exercise and at rest before and after exercise for 30 min.Skeletal muscle biopsies were collected immediately before and after exercise to assess mitochondrial function,transcriptome,and mitochondrial proteome.Results:Results indicated similar systemic glucose,energy expenditure,and substrate oxidation during and after exercise in both sexes.Notably,transcriptional analysis,mitochondrial function,and mitochondrial proteomics revealed marked sexual dimorphism and time of day variations.Conclusion:The sexual dimorphism and time of day variations observed in the skeletal muscle in response to exercise may translate into observable systemic effects with higher exercise-intensity or chronic exercise interventions.This study provides a foundational molecular framework for precise exercise prescription in the clinical setting.
基金supported by the European Regional Development Funds-European Union(ERDF-EU),FATZHEIMER project(EU-LAC HEALTH 2020,16/T010131 to FRdF),“Una manera de hacer Europa”Ministerio de Economía,Industria y Competitividad,Gobierno de Espa?a,Programa Estatal de Investigación,Desarrollo e Innovación Orientada a los Retos de la Sociedad(RTC2019-007329-1 to FRdF)+2 种基金Consejería de Economía,Conocimiento y Universidad,Junta de Andalucía,Plan Andaluz de Investigación,Desarrollo e Innovación(P18TP-5194 to FRdF)Instituto de Salud CarlosⅢ(DTS22/00021 to FRdF)DMV(FI20/00227)holds a“PFIS’’predoctoral contract from the National System of Health,EU-ERDF-Instituto de Salud CarlosⅢ。
文摘Alzheimer’s disease is a neurodegenerative disorder characterized by the amyloid accumulation in the brains of patients with Alzheimer’s disease.The pathogenesis of Alzheimer’s disease is mainly mediated by the phosphorylation and aggregation of tau protein.Among the multiple causes of tau hyperphosphorylation,brain insulin resistance has generated much attention,and inositols as insulin sensitizers,are currently considered candidates for drug development.The present narrative review revises the interactions between these three elements:Alzheimer’s disease-tau-inositols,which can eventually identify targets for new disease modifiers capable of bringing hope to the millions of people affected by this devastating disease.
基金funded by grants from EU Marie Curie ITN RAPID(grant number 290246)Versus Arthritis(Grant Number 20823)+4 种基金the BBSRC(BB/P504567/1)supported by a student stipend from the University of Glasgow and Dentsply Sirona(Project Number 300881)supported by a grant from the European Regional Development Fund and the Spanish Ministry of Science,Innovation and Universities with the reference RTI2018-102032-B-I00the Valencian Innovation Agency with the reference INNVAL20/19/006supported by an FPI fellowship from the Spanish Ministry of Science,Innovation,and Universities with the reference Bio2015-68711-R。
文摘The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity(NRC)and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitratereducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals(P < 0.05 in all five datasets with n = 20–82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate(a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment(P < 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria(P < 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies.
基金supported by a Sara Borrell postdoctoral contract granted by Instituto de Salud Carlos III(CD21/00138).PLV,DB-G and AL are funded by the Spanish Ministry of Economy and Competitiveness and Fondos Feder(Alejandro Lucia,Grant No.PI18/00139)TP is funded by the Spanish Ministry of Economy and Competitiveness and Fondos Feder(Tomas Pinos,Grant No.PI22/00201).
文摘Background:This study aimed to determine the effect of different carbohydrate(CHO)doses on exercise capacity in patients with McArdle disease—the paradigm of“exercise intolerance”,characterized by complete muscle glycogen unavailability—and to determine whether higher exogenous glucose levels affect metabolic responses at the McArdle muscle cell(in vitro)level.Methods:Patients with McArdle disease(n=8)and healthy controls(n=9)underwent a 12-min submaximal cycling constant-load bout followed by a maximal ramp test 15 min after ingesting a non-caloric placebo.In a randomized,double-blinded,cross-over design,patients repeated the tests after consuming either 75 g or 150 g of CHO(glucose:fructose=2:1).Cardiorespiratory,biochemical,perceptual,and electromyographic(EMG)variables were assessed.Additionally,glucose uptake and lactate appearance were studied in vitro in wild-type and McArdle mouse myotubes cultured with increasing glucose concentrations(0.35,1.00,4.50,and 10.00 g/L).Results:Compared with controls,patients showed the“classical”second-wind phenomenon(after prior disproportionate tachycardia,myalgia,and excess electromyographic activity during submaximal exercise,all p<0.05)and an impaired endurance exercise capacity(-51%ventilatory threshold and55%peak power output,both p<0.001).Regardless of the CHO dose(p<0.05 for both doses compared with the placebo),CHO intake increased blood glucose and lactate levels,decreased fat oxidation rates,and attenuated the second wind in the patients.However,only the higher dose increased ventilatory threshold(+27%,p=0.010)and peak power output(+18%,p=0.007).In vitro analyses revealed no differences in lactate levels across glucose concentrations in wild-type myotubes,whereas a doseresponse effect was observed in McArdle myotubes.Conclusion:CHO intake exerts beneficial effects on exercise capacity in McArdle disease,a condition associated with total muscle glycogen unavailability.Some of these benefits are dose dependent.
基金supported by the SHE Foundation,“la Caixa”Foundation(LCF/PR/CE16/10700001)the Fundacióla Maratóde TV3(grant number 369/C/2016)and by the funding from Idilia Foods(FBG 311240)+6 种基金Support was also provided by the Ministerio de Ciencia,Innovación y Universidades(PID2020-114022RB-I00)CIBEROBN from the Instituto de Salud Carlos III,ISCIII from the Ministerio de Ciencia,Innovación y Universidades,(AEI/FEDER,UE)Generalitat de Catalunya.J.Martínez-Gómez is a postgraduate fellow of the Ministerio de Ciencia e Innovación of Spain at the Residencia de Estudiantes(2020–ongoing)R.F-J is a recipient of grant PI19/01704 funded by the Fondo de Investigación Sanitaria-Instituto de Salud Carlos III(ISCIII)co-funded by the European Regional Development Fund/European Social Fund“A way to make Europe”/“Investing in your future”.The CNIC is supported by the ISCIII,the Ministerio de Ciencia e Innovación(MCIN)and the Pro CNIC Foundation,and is a Severo Ochoa Center of Excellence(CEX2020-001041-S funded by MICIN/AEI/10.13039/501100011033)G.Santos-Beneit is the recipient of grant LCF/PR/MS19/12220001 funded by“la Caixa”Foundation(ID 100010434)A.Tresserra-Rimbau is a Serra Húnter Fellow.E.P.Laveriano-Santos is a FI-SDUR(EMC/503/2021)fellow from the Generalitat de Catalunya.
文摘The protective role of(poly)phenols against metabolic disorders has been extensively studied in adults but not in adolescents.To assess associations of dietary(poly)phenols and their subclasses with cardiometabolic health parameters in adolescents.A cross-sectional study was conducted in 944 individuals aged 11–14 years enrolled in the SI!Program for Secondary Schools trial(NCT03504059).(Poly)phenol intake was assessed using semiquantitative food frequency questionnaires and the Phenol-Explorer database.The measured cardiometabolic parameters were waist circumference(WC)age-sex Z-score,blood pressure(BP)age-sex Z-score,blood glucose(BG),triglycerides(TG),and high-density lipoprotein cholesterol(HDL-c).Multilevel mixedeffect linear regression models were applied to examine the association between(poly)phenol quintiles and cardiometabolic health parameters.Compared to the lowest quintile,adolescents in the highest quintile of total(poly)phenol intake had lower WC Z-scores,mean arterial pressure Z-scores,and HDL-c after multivariable adjustment.The WC Z-scores and HDL-c were lower in the highest quintile of flavonoid intake compared to the lowest quintile.The highest quintile of phenolic acid intake was associated with a lower WC Z-score and TG levels,and the highest quintile of stilbene intake with lower BG and TG,and with higher HDL-c compared to the lowest quintile.A higher intake of(poly)phenols,especially flavonoids,phenolic acids,and stilbenes,was associated with better cardiometabolic parameters in adolescents.
文摘Objectives To assess the effects of an exercise training program combining power-oriented resistance training(RT)and high-intensity interval training(HIIT)on metabolic syndrome(MetS)markers in older people with COPD.Methods Twenty-nine older people(66–90 years old)with COPD were randomly assigned to 12 weeks of exercise training(ET;power-oriented RT+HIIT)or a control group(CON).Waist circumference,diastolic(DBP)and systolic blood pressure(SBP),and serum fasting glucose,triglycerides and HDL cholesterol levels were assessed at baseline and after 12 weeks.Linear mixed-effects models were used to assess the effects of the intervention,and data were reported as mean and 95%confidence interval values.Results Waist circumference increased in the CT group,but not in the ET group(2.0[0.2,3.7]vs.1.0[−1.3,3.2]cm,respectively).No changes in fasting glucose(−4.1[−10.3,2.1]vs.−1.0[−8.7,6.7]mg dL−1),triglycerides(3.9[−13.4,21.3]vs.−13.9[−35.6,7.7]mg dL−1)or HDL cholesterol(1.0[−3.4,5.4]vs.2.9[−2.6,8.4]mg dL−1)were found in the CT or ET group,respectively.The ET group exhibited decreased DBP(−5.2[−9.5,−0.8]mmHg)and SBP(−2.7[−22.7,−2.7]mmHg),while no changes were found in the CT group(0.3[−3.2,3.7]and−3.5[−11.4,4.5]mmHg).MetS z-score declined in ET but remained unchanged in CT(−0.88[−1.74,−0.03]vs.0.07[−0.62,0.76],respectively).Conclusions A 12-week exercise training program led to a reduction in blood pressure and MetS z-score in older people with COPD.
基金supported by the CICYT(AGL2016-75329-R PID2020-114022RB-I00)CIBEROBN from the Instituto de Salud Carlos III,ISCIII from the Ministerio de Ciencia,Innovación y Universidades(AEI/FEDER,UE)Generalitat de Catalunya(GC)(2017SGR 196).
文摘With increasing life expectancy,neurodegenerative diseases have become one of the leading causes of illhealth in the elderly.Preventive strategies include following healthy diets,such as the Mediterranean diet,which is particularly rich in polyphenols,bioactive compounds with neuroprotective properties.The aim of this study was to assess the association of microbial phenolic metabolites(MPM)with cognition.This cross-sectional analysis was performed with 200 participants of the PREDIMED trial(Barcelona-Clinic recruitment center).A novel method based on liquid chromatography coupled to mass spectrometry was used to identify urinary MPM(protocatechuic acid,enterodiol glucuronide,enterolactone glucuronide,urolithin B glucuronide,and vanillic acid glucuronide),and cognitive function was evaluated with neuropsychological tests.Multivariable-adjusted ordinary least squares regression was used to assess the associations between cognitive function and MPM,and a score was calculated as the weighted sum of MPM.A higher MPM score was associated with better frontal lobe function.Among individual metabolites,vanillic acid glucuronide was correlated with frontal cognitive performance.Participants with higher concentrations of vanillic acid glucuronide and urolithin B glucuronide obtained better scores in the Color Trail Test part 2.A higher score for urinary multiMPM was associated with better frontal cognitive performance in an older Mediterranean population.
基金funded by Instituto de Salud Carlos Ill(IsCll)and co-funded by the European Union(grants Pl16/00612 and PI20/01200 to MCS)Junta de Andalucia-Consejeria de Salud y Consumo(grant PIER-0468-2019 to MCS)+4 种基金MCS has been supported by ISCIII(JR15/00042)Junta de Andalucia-Consejeria de Salud y Consumo(B-0005-2017)JD has been supported by grants PID2020-117979RB-100 from the Spanish Ministry of Science and Innovation and IMP/00019 from the Instituto de Salud Carlos III(ISCIII)RC has been supported by Junta de Andalucia-Consejeria de Salud y Familias(RH-0052-2021)by the European Union,European Social Fund(FSE)2014-2020.
文摘In recent years,the number of known disease genes has exponentially grown due to the widespread adoption of cost-effective massive parallel sequencing.To identify new disease variants,especially in monogenic disorders,a frequency-based filtering approach has proved very useful(Dopazo et al.,2016).
文摘目的临床指南需要根据相关研究结果定期审查以确保其可靠性,但在更新临床指南的过程中仍然缺乏对于更新过程表述的优先报告条目。本文旨在介绍更新版指南报告清单(Checklist for the Reporting of Updated Guidelines,Check Up)及其制定过程。方法基于临床指南更新的研究证据的概述,指南研究与评价工具(Appraisal of Guidelines for Research and EvaluationⅡ,AGREEⅡ)和报告清单专家组(33位)的建议开发了初始清单的各条目。然后,使用多个步骤对本清单进行了完善,包括评估10个现有的更新版临床指南,对关键信息提供者进行访谈[应答率为54.2%(13/24)],清单制定专家组内部进行的一个三轮的德尔菲(Delphi)共识调查,以及来自于临床指南方法学专家[应答率为90%(53/59)]和指南使用者[应答率为55.6%(10/18)]的外部评审意见。结果清单最终包括16个条目,主要涉及:(1)更新版指南的呈现;(2)编辑独立性;(3)更新过程采用的方法。结论更新版指南的报告清单作为一个工具可用于评估更新版指南报告的完整性,并为指南制定者提供撰写报告的要求。
基金Supported by Grants from the Ministerio de Cienciae Innovacion,No.SAF2009-07408CIBER de Diabetesy Enfermedades Metabólicas Asociadas and Generaltitat de Catalunya,No. 2009SGR739
文摘Diabetic retinopathy(DR) has been classically considered to be a microcirculatory disease of the retina caused by the deleterious metabolic effects of hyperglycemia per se and the metabolic pathways triggered by hyperglycemia.However,retinal neurodegeneration is already present before any microcirculatory abnormalities can be detected in ophthalmoscopic examination.In other words,retinal neurodegeneration is an early event in the pathogenesis of DR which predates and participates in the microcirculatory abnormalities that occur in DR.Therefore,the study of the mechanisms that lead to neurodegeneration will be essential to identify new therapeutic targets in the early stages of DR.Elevated levels of glutamate and the overexpression of the renin-angiotensin-system play an essential role in the neurodegenerative process that occurs in diabetic retina.Among neuroprotective factors,pigment epithelial derived factor,somatostatin and erythropoietin seem to be the most relevant and these will be considered in this review.Nevertheless,it should be noted that the balance between neurotoxic and neuroprotective factors rather than levels of neurotoxic factors alone will determine the presence or absence of retinal neurodegeneration in the diabetic eye.New strategies,based on either the delivery of neuroprotective agents or the blockade of neurotoxic factors,are currently being tested in experimental models and in clinical pilot studies.Whether these novel therapies will eventually supplement or prevent the need for laser photocoagulation or vitrectomy awaits the results of additional clinical research.
