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Increasingly, the model driven engineering (MDE) community is paying more attention to the techniques offered by the machine learning (ML) community. This has led to the application ofML techniques to MDE related tasks in hope of increasing the current benefits of MDE.Nevertheless, there is a lack of empirical experiments that evaluate the benefits that ML brings to MDE. In this work, we evaluate the benefits of empowering model engineers of model-driven development (MDD) with an ML classifier. To do this, we tackled how to embed the ML classifier as part of the MDD. Then, this was evaluated using two different real industrial cases. Our results show that despite the ML part takes an extra effort, the use of theML classifier pays off in terms of the quality results, the perceived usefulness, and intention to use.

Improving the reliability of quantification in lipidomic analyses is crucial for its successful application in the discovery of new biomarkers or in clinical practice. In this study, we propose a workflow to improve the accuracy and precision of lipidomic results issued by the laboratory. Lipid species from 11 classes were analyzed by a targeted RPLC-MRM/MS method. The peak areas of species were used to estimate concentrations by an internal standard calibration approach (IS-calibration) and by an alternative normalization signal calibration schema (NS-calibration). The latter uses a long-term reference plasma material as a matrix-matched external calibrator whose accuracy was compared to the NIST SRM-1950 mean consensus values reported by the Interlaboratory Lipidomics Comparison Exercise. The bias of lipid concentrations showed a good accuracy for 69 of 89 quantified lipids. The quantitation of species by the NS-calibration schema improved the within- and between-batch reproducibility in quality control samples, in comparison to the usual IS-calibration approach. Moreover, the NS-calibration workflow improved the robustness of the lipidomics measurements reducing the between-batch variability (relative standard deviation

The safety of non-selective β-blockers (NSBBs) has been questioned in refractory ascites (RA). We studied the effects of NSBBs on cardiac systolic function, systemic hemodynamics, and renal perfusion pressure (RPP) and function in patients with diuretic-responsive ascites (DRA) and RA.We performed a prospective pre-post repeated-measures study in cirrhotic patients, 18 with DRA and 20 with RA on NSBBs for variceal bleeding prophylaxis. Systolic function (by ejection intraventricular pressure difference [EIVPD]), hepatic venous pressure gradient (HVPG), cardiopulmonary pressures, RPP, and sympathetic activation were measured at baseline and after 4 weeks of propranolol.EIVPD was elevated at baseline (RA 4.5 [2.8-5.7] and DRA 4.2 [3.1-5.7] mmHg; normal 2.4-3.6 mmHg) and directly related to the severity of vasodilation and sympathetic activation. NSBBs led to similar reductions in heart rate and HVPG in both groups. NSBBs reduced EIPVD in RA but not in DRA (-20% vs. -2%, p0.01). In RA, the NSBB-induced reduction in EIPVD correlated with the severity of vasodilation and with higher plasma nitric oxide, norepinephrine and IL-6 (r0.40, all p 0.05). NSBBs reduced RPP in both groups, but impaired renal function only in patients with RA. Reduced EIPVD correlated with decreases in RPP and estimated glomerular filtration rate (r 0.40, all p0.01). After NSBB treatment, RPP dropped below the threshold of renal flow autoregulation in 11 of the 20 (55%) patients with RA, including the 4 fulfilling the criteria for HRS-AKI.Renal perfusion and function depend critically on systolic function and sympathetic hyperactivation in RA. NSBBs blunt the sympathetic overdrive, hamper cardiac output, lower RPP below the critical threshold and impair renal function. β-blockade should be used cautiously or even avoided in patients with RA.We have identified the mechanisms by which non-selective beta-blockers could impair survival in patients with refractory ascites. We show that peripheral vasodilation and sympathetic activation lead to increased left ventricle systolic function in patients with cirrhosis and ascites, which acts as an adaptive mechanism to maintain renal perfusion. When ascites becomes refractory, this compensatory cardiac response to vasodilation is critically dependent on sympathetic hyperactivation and is hardly able to maintain renal perfusion. In this setting, β-blockade blunts the sympathetic overdrive of cardiac function, hampers cardiac output, lowers renal perfusion pressure below the critical threshold and impairs renal function.

BackgroundDihydrosphingolipids are lipid molecules biosynthetically related to ceramides. An increase in ceramides is associated with enhanced fat storage in the liver and inhibition of their synthesis is reported to prevent the appearance of steatosis in animal models. However, the precise association of dihydrosphingolipids with non-alcoholic fatty liver disease (NAFLD) is yet to be established. We employed a diet-induced NAFLD mouse model to study the association between this class of compounds and disease progression.MethodsMice were fed a high-fat diet enriched in cholesterol and supplemented with glucose and fructose up to 40 weeks. A mouse subgroup was treated with carbon tetrachloride to accelerate fibrosis development. Animals were sacrificed at different time-points to reproduce the full spectrum of histological damage found in human disease, including steatosis (NAFL) and steatohepatitis (NASH) with and without significant fibrosis. Blood and liver tissue samples were obtained from patients (n=195) whose NAFLD severity was assessed histologically. Lipidomic analysis was performed using liquid chromatography-tandem mass spectrometry.ResultsTriglyceride, cholesterol ester and dihydrosphingolipid levels were increased in the liver of model mice in association with the degree of steatosis. Dihydroceramide concentrations increased with the histological severity of the disease in liver samples of mice (0.024 ± 0.003 vs 0.049 ± 0.005, non-NAFLD vs NASH-fibrosis, pConclusionsDihydrosphingolipids accumulate in the liver in response to increased free fatty acid overload and are correlated with progressive histological damage in NAFLD. The increase in dihydrosphingolipids is related to upregulation of hepatic expression of enzymes involved in de novo synthesis of ceramides.HIGHLIGHTSNeutral lipids and dihydrosphingolipids accumulate in liver in correlation with the histological severity of NAFLD in both mice and humans.The ceramide pathway is stimulated to alleviate the free fatty acid excess in liver of NAFLD models.Appearance of significant fibrosis is associated with reduced concentrations of neutral lipids but not dihydrosphingolipids in a mouse model of NAFLD.

Nephrotoxicity is a major complication of cisplatin-based chemotherapy, leading to acute kidney injury in ca. 30% of patients, with no preventive intervention or treatment available for clinical use. Cilastatin has proved to exert a nephroprotective effect for cisplatin therapies in in vitro and in vivo models, having recently entered clinical trials. A deeper understanding at the molecular level of cisplatin-induced renal damage and the effect of potential protective agents could be key to develop successful nephroprotective therapies and to establish new biomarkers of renal damage and nephroprotection. A targeted lipidomics approach, using LC-MS/MS, was employed for the quantification of 108 lipid species (comprising phospholipids, sphingolipids, and free and esterified cholesterol) in kidney cortex and medulla extracts from rats treated with cisplatin and/or cilastatin. Up to 56 and 63 lipid species were found to be altered in the cortex and medulla, respectively, after cisplatin treatment. Co-treatment with cilastatin attenuated many of these lipid changes, either totally or partially with respect to control levels. Multivariate analysis revealed that lipid species can be used to discriminate renal damage and nephroprotection, with cholesterol esters being the most discriminating species, along with sulfatides and phospholipids. Potential diagnostic biomarkers of cisplatin-induced renal damage and cilastatin nephroprotection were also found.

In cirrhosis, intestinal dysbiosis, intestinal barrier impairment, and systemic immune system abnormalities lead to gut bacterial translocation (GBT) and bacterial infection. However, intestinal immune system dysfunction and its contribution to barrier damage are poorly understood. This study correlates immune system dysregulation in the intestines of rats at different stages of CCl4 -induced cirrhosis with barrier function and pathogenic microbiota. The following variables were addressed in the small intestine: intraepithelial lymphocyte (IEL) and lamina propria lymphocyte (LPL) activation status and cytokine production (flow cytometry), cytokine mRNA and protein expression (quantitative real-time PCR and immunofluorescence), microbiota composition of ileum content (16S recombinant DNA massive sequencing), permeability (fecal albumin loss), and epithelial junctions (immunohistochemistry and immunofluorescence). The intestinal mucosa in rats with cirrhosis showed a proinflammatory pattern of immune dysregulation in IELs and LPLs, which featured the expansion of activated lymphocytes, switch to a T helper 1 (Th1) regulatory pattern, and Th17 reduction. In rats with cirrhosis with ascites, this state was associated with epithelial junction protein disruption, fecal albumin loss, and GBT. Direct correlations (P < 0.01) were observed between elevated interferon gamma (IFNγ)-expressing T cytotoxic LPLs and fecal albumin and between inflammatory taxa abundance and IFNγ-producing immune cells in the ileum. Bowel decontamination led to redistributed microbiota composition, reduced proinflammatory activation of mucosal immune cells, normalized fecal albumin levels, and diminished GBT; but there were no modifications in Th17 depletion. Conclusion: The intestinal mucosa of rats with cirrhosis acquires a proinflammatory profile of immune dysregulation that parallels the severity of cirrhosis; this impaired intestinal immune response is driven by gut dysbiosis and leads to disrupted barrier function, promoting GBT.

Atypical or second-generation antipsychotics are used in the treatment of psychosis and behavioral problems in older persons with dementia. However, these pharmaceutical drugs are associated with an increased risk of stroke in such patients. In this study, we evaluated the effects of risperidone treatment on phospholipid and sphingolipid composition and lipid raft function in peripheral blood mononuclear cells (PBMCs) of older patients (mean age &gt, 88 years). The results showed that the levels of dihydroceramides, very-long-chain ceramides, and lysophosphatidylcholines decreased in PBMCs of the risperidone-treated group compared with untreated controls. These findings were confirmed by in vitro assays using human THP-1 monocytes. The reduction in the levels of very-long-chain ceramides and dihydroceramides could be due to the decrease in the expression of fatty acid elongase 3, as observed in THP-1 monocytes. Moreover, risperidone disrupted lipid raft domains in the plasma membrane of PBMCs. These results indicated that risperidone alters phospholipid and sphingolipid composition and lipid raft domains in PBMCs of older patients, potentially affecting multiple signaling pathways associated with these membrane domains.

espanolAntecedentes: En la historia reciente de la investigacion en la actividad fisica para la salud, se ha demostrado que la utilizacion de las propiedades del medio acuatico (presion hidrostatica, hipogravidez y termorregulacion) reporta numerosos beneficios para la poblacion de mujeres en periodo de gestacion, siendo este muy adecuado con muchas ventajas para el momento del parto y postparto, tanto para la madre como para el bebe. Objetivos: Realizar una revision bibliografica de los estudios donde se analicen la integridad del suelo pelvico y las episiotomias durante la labor del parto tras participar en programas de actividad fisica en el medio acuatico. Metodo: Tras la busqueda inicial teniendo en cuenta la estrategia de la misma, el resultado obtenido fue de 88 publicaciones provenientes de PubMed, Scielo, etc., que tras descartar duplicados y analizar los criterios de inclusion quedaron 3 articulos, siendo 2 de ellos protocolos de estudio, y 1 articulo de investigacion. Resultados: Dichas publicaciones resaltaron el seguimiento de las pautas propuestas por el American College of Sports Medicine (ACSM) para dicha poblacion de 3 sesiones semanales de 60’ a una intensidad moderada (12-14 Escala de Borg). Conclusiones: Gracias al ejercicio desarrollado en el medio acuatico, con ejercicios de fuerza-resistencia implicando los grupos musculares suelo pelvico, se consigue aumentar significativamente la tasa de integridad del perineo, mejorando las labores del parto y reduciendo la recuperacion postparto. EnglishBackground: In the recent history of research in physical activity for health, it has been shown that the use of the properties of the aquatic environment (hydrostatic pressure, hypogravity and thermoregulation) provides numerous benefits for the population of women in pregnancy, this being very suitable with many advantages for the time of delivery and postpartum, both for the mother and the baby. Objectives: Carry out a bibliographic review of the studies that analyze the integrity of the pelvic floor and episiotomies during the labor of delivery after participating in physical activity programs in the aquatic environment. Method: After the initial search, taking into account its strategy, the result obtained was 88 publications from PubMed, Scielo, etc., which after discarding duplicates and analyzing the inclusion criteria, 3 articles remained, 2 of which were study protocols, and 1 research article. Results: Said publications highlighted the following of the guidelines proposed by the American College of Sports Medicine (ACSM) for this population of 3 weekly sessions of 60 'at a moderate intensity (12-14 Borg Scale). Conclusions: Thanks to the exercise developed in the aquatic environment, with strength-resistance exercises involving the pelvic floor muscle groups, it is possible to significantly increase the rate of integrity of the perineum, improving labor and reducing postpartum recovery. portuguesIntroducao: Na historia recente das pesquisas em atividade fisica para a saude, tem-se mostrado que a utilizacao das propriedades do meio aquatico (pressao hidrostatica, hipogravidade e termorregulacao) proporciona inumeros beneficios para a populacao de mulheres gravidas, sendo muito adequada com muitas vantagens para a hora do parto e puerperio, tanto para a mae quanto para o bebe. Objetivos: Realizar revisao bibliografica dos estudos que analisam a integridade do assoalho pelvico e episiotomias durante o trabalho de parto apos participacao em programas de atividade fisica no meio aquatico. Metodo: Apos a busca inicial, levando em consideracao sua estrategia, obteve-se o resultado de 88 publicacoes no PubMed, Scielo, etc., que apos o descarte das duplicatas e analise dos criterios de inclusao, restaram 3 artigos, sendo 2 protocolos de estudo e 1 artigo de pesquisa. Resultados: Essas publicacoes destacaram o cumprimento das diretrizes propostas pelo American College of Sports Medicine (ACSM) para essa populacao de 3 sessoes semanais de 60 'em intensidade moderada (Escala de Borg 12-14). Conclusoes: Gracas aos exercicios desenvolvidos no meio aquatico, com exercicios de forca-resistencia envolvendo os grupos musculares do assoalho pelvico, e possivel aumentar significativamente o indice de integridade do perineo, melhorando o trabalho de parto e reduzindo a recuperacao pos-parto.

Purpose: Epidemiological studies and clinical trials support the association of nut consumption with a lower risk of prevalent non-communicable diseases, particularly cardiovascular disease. However, the molecular mechanisms underlying nut benefits remain to be fully described. MicroRNAs (miRNAs) are post-transcriptional regulators of gene expression and play a pivotal role in health and disease. Exosomes are extracellular vesicles released from cells and mediate intercellular communication. Whether nut consumption modulates circulating miRNAs (c-miRNAs) transported in exosomes is poorly described. Methods: Cognitively healthy elderly subjects were randomized to either control (n = 110, abstaining from walnuts) or daily supplementation with walnuts (15% of their total energy, ≈30–60 g/day, n = 101) for 1-year. C-miRNAs were screened in exosomes isolated from 10 samples, before and after supplementation, and identified c-miRNA candidates were validated in the whole cohort. In addition, nanoparticle tracking analysis and lipidomics were assessed in pooled exosomes from the whole cohort. Results: Exosomal hsa-miR-32-5p and hsa-miR-29b-3p were consistently induced by walnut consumption. No major changes in exosomal lipids, nanoparticle concentration or size were found. Conclusion: Our results provide novel evidence that certain c-miRNAs transported in exosomes are modulated by walnut consumption. The extent to which this finding contributes to the benefits of walnuts deserves further research., Fundacion Ramon Areces (CIVP18A3888) Madrid, Spain; the Instituto de Salud Carlos III-Fondo de Investigacion Sanitaria–Fondo Europeo de Desarrollo Regional (grant PI15/01014 and PI18/01152), and the Spanish Agencia Estatal de Investigacion and European Feder Funds (AGL2016-78922-R, PID2019-109369RB-I00, RTI2018-093873-A-I00 and BIO2017-86500-R). AS-V is recipient of the Instituto de Salud Carlos III Miguel Servet II fellowship (grant CP II 17/00029)

Background and aims. The molecular mechanisms by which the liver develops steatotic disease still remain unclear. Previous studies using nutritional and genetic models of hepatic steatosis in mice showed that liver synaptotagmin 1 (Syt1) expression was associated with lipid droplet area. Hepatic Syt1 overexpression was used as a tool to explore its effect on hepatic and plasma lipids. Methods and results To find out a cause-effect, hepatic mouse Syt1 mRNA was cloned into a vector driving hepatocyte-specific expression and administered by hydrodynamic injection to male Apoe-deficient mice fed on a Western diet, the latter as a model of rapid spontaneous steatosis development. Hepatic microsomal, large vesicle, lysosomal and plasma membrane fractions were enriched in SYT1 protein following gene overexpression. In these conditions, very low density lipoprotein esterified cholesterol increased. Likewise, the transgene caused an alteration in lipid droplet surface and a positive correlation between Syt1 expression and hepatic total cholesterol content. A lipidomic approach evidenced a decrease in lysophosphatidylcholine, phosphatidylcholine and triglycerides in isolated plasma membrane fraction. Expressions of genes involved in biosynthesis of bile acids, fatty acid metabolism, lipoprotein dynamics and vesicular transport were modified by the increased SYT1 expression. Conclusions These results indicate that this protein is involved in hepatic management of lipids and in the regulation of genes involved in lipid metabolism.

Background Cystic fibrosis (CF) patients have an alteration in fatty acid (FA) metabolism, associated with increased omega-6 and low omega-3 FA. Previous studies on supplementation with omega-3 FA in CF had contradictory results, and to date there is no evidence to recommend routine use of omega-3 supplements in CF patients. We hypothesized that long-term supplementation with docosahexaenoic acid (DHA) will have beneficial effects in these patients, by reducing pulmonary, systemic and intestinal inflammation. Methods This was a randomized, double-blind, parallel, placebo-controlled trial. CF patients (age >2 months) were randomized to receive a seaweed DHA oil solution (50 mg/Kg/day) or matching placebo for 48 weeks. Primary outcomes were pulmonary (interleukin [IL]-8), systemic (IL-8) and intestinal (calprotectin) inflammatory biomarkers. Secondary outcomes included other pulmonary (IL-1β, IL-6, neutrophil elastase, lactate and calprotectin) and systemic (serum-IL-1β, IL-6) inflammatory biomarkers, as well as clinical outcomes (FEV1, pulmonary exacerbations, antibiotic use, nutritional status and quality of life). Results Ninety six CF patients, 44 female, age 14.6±11.9 years (48 DHA and 48 placebo) were included. At trial completion, there were no differences in all primary outcomes [serum-IL-8 (p=0.909), respiratory-IL-8 (p=0.384) or fecal calprotectin (p=0.948)], all secondary inflammatory biomarkers, or in any of the clinical outcomes evaluated. There were few adverse events, with similar incidence in both study groups. Conclusion In this study, long-term DHA supplementation in CF patients was safe, but did not offer any benefit on inflammatory biomarkers, or in clinical outcomes compared with placebo. (NCT01783613)

[Background] Non-alcoholic steatohepatitis (NASH) is present in a high percentage of obese patients undergoing bariatric surgery. A significant proportion of patients still present NASH even after considerable weight loss and metabolic improvements after surgery., [Objective] To determine whether the changes in the serum lipidome after sleeve gastrectomy could be used to discriminate obese patients with NASH patients to those with non-alcoholic fatty liver (NAFL)., [Methods] This study involved 24 patients with grade 3 obesity diagnosed with either NAFL (n = 8) or NASH (n = 16) using the non-invasive OWLiver assay. All patients suffering from NASH were re-evaluated 6 months after bariatric surgery using the OWLiver test to confirm NASH resolution. Serum lipid extracts were assessed at baseline and 6 months post surgery and were analyzed in an ultra-performance liquid chromatography/time-of-flight mass spectrometry (UPLC-TOF-MS)-based platform., [Results] Lipidomic analysis revealed a differential sphingomyelin profile in patients with NASH resolution after sleeve gastrectomy. Certain serum sphingomyelin species were significantly higher at baseline in NASH patients in comparison to those with NAFL. Sphingomyelin profile of subjects with NASH resolution was similar to that for obese subjects with NAFL before bariatric surgery., [Conclusion] Our study indicates that the serum sphingomyelin levels could be related to the status of non-alcoholic fatty liver disease and that certain sphingomyelin species may be used for the follow-up of obese patients with NASH after sleeve gastrectomy., This study was supported by the “Centros de Investigación Biomédica en Red” (CIBER) of the “Instituto de Salud Carlos III” (ISCIII) (CB06/03/0018), and research grants from ISCIII (PIE14/00031, PI14/00082, and PI15/01114), and co-financed by the European Regional Development Fund (ERDF). DCC was a recipient of a FPU predoctoral fellowship from Ministry of Education, Spain (13/04211). BRM was a recipient of a Sara Borrell postdoctoral fellowship, ISCIII, Spain (CD16/0003). FC was a recipient of the Nicolas Monardes Programme from SAS (C-0032-2016).

Background Bariatric surgery (BS) is the most effective treatment for severe obesity. Our group and others have previously reported that the type of BS (restrictive vs malabsorptive) can lead to different effects on the lipid profile and glucose homeostasis in morbidly obese patients. Furthermore, BS exerts significant changes in lipid metabolism, which are not yet fully understood and that might be dependent of surgical technique. Objective The objective of this study was to evaluate the differential changes in the serum lipidomic profile of morbidly obese subjects who underwent two different BS techniques: sleeve gastrectomy (SG) (restrictive) and biliopancreatic diversion (BPD) (malabsorptive). Methods This study included 37 morbidly obese patients (body mass index ≥ 40 kg/m2) who underwent either SG (n = 25) or BPD (n = 12). Serum lipid extracts were assessed at baseline and 6 months after BS and were analyzed in a ultra-high performance liquid chromatography time-of-flight mass spectrometry–based platform. Results SG not only restores the circulating levels of fatty acids and glycerolipids to similar levels to those observed in nonobese subjects but also results in a consistent increase of phospholipid and sphingolipid species, ranging from antioxidant plasmalogens to lipotoxic ceramides. BPD, however, leads to an overall reduction in circulating fatty acids, glycerolipids, phospholipids and sphingolipids, and a substantial increase of bile acids. Conclusion Our lipidomic analysis suggests that the differential metabolic effects typically observed after restrictive vs malabsorptive BS procedures could be explained, at least partially, to BS-specific lipid changes and provides novel aspects of lipid remodeling in obesity during weight loss.