233 results on '"Nicole Garcia"'
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2. Epidemiology and risk factors for recurrence in biliary source bloodstream infection episodes in oncological patients
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Ignacio Grafia, Mariana Chumbita, Elia Seguí, Celia Cardozo, Juan Carlos Laguna, Marta García de Herreros, Nicole Garcia-Pouton, Ana Villaescusa, Cristina Pitart, Verónica Rico-Caballero, Javier Marco-Hernández, Carles Zamora, Margarita Viladot, Joan Padrosa, Albert Tuca, Eric Mayor-Vázquez, Francesc Marco, Jose A. Martínez, Josep Mensa, Carolina Garcia-Vidal, Alex Soriano, and Pedro Puerta-Alcalde
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cholangitis ,biliary source bloodstream infection ,mortality ,empirical treatment ,recurrence ,Microbiology ,QR1-502 - Abstract
ABSTRACT We aimed to describe the characteristics and outcomes of biliary source bloodstream infections (BSIs) in oncological patients. Secondarily, we analyzed risk factors for recurrent BSI episodes. All episodes of biliary source BSIs in oncological patients were prospectively collected (2008–2019) and retrospectively analyzed. Logistic regression analyses were performed. A rule to stratify patients into risk groups for recurrent biliary source BSI was conducted. Four hundred biliary source BSIs were documented in 291 oncological patients. The most frequent causative agents were Escherichia coli (42%) and Klebsiella spp. (27%), and 86 (21.5%) episodes were caused by multidrug-resistant Gram-negative bacilli (MDR-GNB). The rates of MDR-GNB increased over time. Overall, 73 patients developed 118 recurrent BSI episodes. Independent risk factors for recurrent BSI episodes were prior antibiotic therapy (OR 3.781, 95% CI 1.906–7.503), biliary prosthesis (OR 2.232, 95% CI 1.157–4.305), prior admission due to suspected biliary source infection (OR 4.409, 95% CI 2.338–8.311), and BSI episode caused by an MDR-GNB (OR 2.857, 95% CI 1.389–5.874). With these variables, a score was generated that predicted recurrent biliary source BSI with an area under the receiver operating characteristic (ROC) curve of 0.819. Inappropriate empirical antibiotic treatment (IEAT) was administered in 23.8% of patients, and 30-d mortality was 19.5%. As a conclusion, biliary source BSI in oncological patients is mainly caused by GNB, with high and increasing MDR rates, frequent IEAT, and high mortality. Recurrent BSI episodes are frequent. A simple score to identify recurrent episodes was developed to potentially establish prophylactic strategies. IMPORTANCE This study shows that biliary source bloodstream infections (BSIs) in oncological patients are mainly caused by Gram-negative bacilli (GNB), with high and increasing rates of multidrug resistance. Importantly, recurrent biliary source BSI episodes were very frequent and associated with delays in chemotherapy, high rates of inappropriate empirical antibiotic therapy, and high 30-d mortality (19.5%). Using the variable independently associated with recurrent BSI episodes, a score was generated that predicted recurrent biliary source BSI with high accuracy. This score could be used to establish prophylactic strategies and lower the risk of relapsing episodes and the associated morbidity and mortality.
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- 2023
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3. Graft–Host Interaction and Its Effect on Wound Repair Using Mouse Models
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Nicole Garcia, Md Mostafizur Rahman, Carlos Luis Arellano, Ilia Banakh, Chen Yung-Chih, Karlheinz Peter, Heather Cleland, Cheng Hean Lo, and Shiva Akbarzadeh
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IL-6 ,TGF-β1 ,wound repair ,skin grafting ,myofibroblast ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Autologous skin grafting has been commonly used in clinics for decades to close large wounds, yet the cellular and molecular interactions between the wound bed and the graft that mediates the wound repair are not fully understood. The aim of this study was to better understand the molecular changes in the wound triggered by autologous and synthetic grafting. Defining the wound changes at the molecular level during grafting sets the basis to test other engineered skin grafts by design. In this study, a full-thickness skin graft (SKH-1 hairless) mouse model was established. An autologous full-thickness skin graft (FTSG) or an acellular fully synthetic Biodegradable Temporising Matrix (BTM) was grafted. The wound bed/grafts were analysed at histological, RNA, and protein levels during the inflammation (day 1), proliferation (day 5), and remodelling (day 21) phases of wound repair. The results showed that in this mouse model, similar to others, inflammatory marker levels, including Il-6, Cxcl-1, and Cxcl-5/6, were raised within a day post-wounding. Autologous grafting reduced the expression of these inflammatory markers. This was different from the wounds grafted with synthetic dermal grafts, in which Cxcl-1 and Cxcl-5/6 remained significantly high up to 21 days post-grafting. Autologous skin grafting reduced wound contraction compared to wounds that were left to spontaneously repair. Synthetic grafts contracted significantly more than FTSG by day 21. The observed wound contraction in synthetic grafts was most likely mediated at least partly by myofibroblasts. It is possible that high TGF-β1 levels in days 1–21 were the driving force behind myofibroblast abundance in synthetic grafts, although no evidence of TGF-β1-mediated Connective Tissue Growth Factor (CTGF) upregulation was observed.
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- 2023
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4. Bacterial co-infection at hospital admission in patients with COVID-19
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Estela Moreno-García, Pedro Puerta-Alcalde, Laura Letona, Fernanda Meira, Gerard Dueñas, Mariana Chumbita, Nicole Garcia-Pouton, Patricia Monzó, Carlos Lopera, Laia Serra, Celia Cardozo, Marta Hernandez-Meneses, Verónica Rico, Marta Bodro, Laura Morata, Mariana Fernandez-Pittol, Ignacio Grafia, Pedro Castro, Josep Mensa, José Antonio Martínez, Gemma Sanjuan, Mª Angeles Marcos, Alex Soriano, and Carolina Garcia-Vidal
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COVID-19 ,bacterial infection ,co-infection ,antibiotics ,SARS-CoV-2 ,Infectious and parasitic diseases ,RC109-216 - Abstract
ABSTRACT: Objectives: We described the current incidence and risk factors of bacterial co-infection in hospitalized patients with COVID-19. Methods: Observational cohort study was performed at the Hospital Clinic of Barcelona (February 2020–February 2021). All patients with COVID-19 who were admitted for >48 hours with microbiological sample collection and procalcitonin (PCT) determination within the first 48 hours were included. Results: A total of 1125 consecutive adults met inclusion criteria. Co-infections were microbiologically documented in 102 (9.1%) patients. Most frequent microorganisms were Streptococcus pneumoniae (79%), Staphylococcus aureus (6.8%), and Haemophilus influenzae (6.8%). Test positivity was 1% (8/803) for blood cultures, 10.1% (79/780) for pneumococcal urinary antigen test, and 11.4% (15/132) for sputum culture. Patients with PCT higher than 0.2, 0.5, 1, and 2 ng/mL had significantly more co-infections than those with lower levels (p=0.017, p=0.031, p94%.
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- 2022
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5. Data quality control considerations in multivariate environmental monitoring: experience of the French coastal network SOMLIT
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Elsa Breton, Nicolas Savoye, Peggy Rimmelin-Maury, Benoit Sautour, Eric Goberville, Arnaud Lheureux, Thierry Cariou, Sophie Ferreira, Hélène Agogué, Samir Alliouane, Fabien Aubert, Sébastien Aubin, Eric Berthebaud, Hadrien Blayac, Lucie Blondel, Cédric Boulart, Yann Bozec, Sarah Bureau, Arnaud Caillo, Arnaud Cauvin, Jean-Baptiste Cazes, Léo Chasselin, Pascal Claquin, Pascal Conan, Marie-Ange Cordier, Laurence Costes, Romain Crec’hriou, Olivier Crispi, Muriel Crouvoisier, Valérie David, Yolanda Del Amo, Hortense De Lary, Gaspard Delebecq, Jeremy Devesa, Aurélien Domeau, Maria Durozier, Claire Emery, Eric Feunteun, Juliette Fauchot, Valérie Gentilhomme, Sandrine Geslin, Mélanie Giraud, Karine Grangeré, Gerald Grégori, Emilie Grossteffan, Aurore Gueux, Julien Guillaudeau, Gael Guillou, Manon Harrewyn, Orianne Jolly, Florence Jude-Lemeilleur, Paul Labatut, Nathalie Labourdette, Nicolas Lachaussée, Michel Lafont, Veronique Lagadec, Christophe Lambert, Jezebel Lamoureux, Laurent Lanceleur, Benoit Lebreton, Eric Lecuyer, David Lemeille, Yann Leredde, Cédric Leroux, Aude Leynaert, Stéphane L’Helguen, Camilla Liénart, Eric Macé, Eric Maria, Barbara Marie, Dominique Marie, Sébastien Mas, Fabrice Mendes, Line Mornet, Behzad Mostajir, Laure Mousseau, Antoine Nowaczyk, Sandra Nunige, René Parra, Thomas Paulin, David Pecqueur, Franck Petit, Philippe Pineau, Patrick Raimbault, Fabienne Rigaut-Jalabert, Christophe Salmeron, Ian Salter, Pierre-Guy Sauriau, Laurent Seuront, Emmanuelle Sultan, Rémi Valdès, Vincent Vantrepotte, Francesca Vidussi, Florian Voron, Renaud Vuillemin, Laurent. Zudaire, and Nicole Garcia
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environmental monitoring network ,data quality control ,inter-laboratory comparison exercises ,measurement uncertainty ,analyst performance ,multivariate dataset ,Science ,General. Including nature conservation, geographical distribution ,QH1-199.5 - Abstract
IntroductionWhile crucial to ensuring the production of accurate and high-quality data—and to avoid erroneous conclusions—data quality control (QC) in environmental monitoring datasets is still poorly documented.MethodsWith a focus on annual inter-laboratory comparison (ILC) exercises performed in the context of the French coastal monitoring SOMLIT network, we share here a pragmatic approach to QC, which allows the calculation of systematic and random errors, measurement uncertainty, and individual performance. After an overview of the different QC actions applied to fulfill requirements for quality and competence, we report equipment, accommodation, design of the ILC exercises, and statistical methodology specially adapted to small environmental networks (
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- 2023
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6. C-reactive protein cut-off for early tocilizumab and dexamethasone prescription in hospitalized patients with COVID-19
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Ana M. Camon, Rodrigo Alonso, Francisco J. Muñoz, Celia Cardozo, Javier Bernal-Maurandi, Laia Albiach, Daiana Agüero, M. Angeles Marcos, Juan Ambrosioni, Marta Bodro, Mariana Chumbita, Lorena De la Mora, Nicole Garcia-Pouton, Gerard Dueñas, Marta Hernandez-Meneses, Alexy Inciarte, Genoveva Cuesta, Fernanda Meira, Laura Morata, Pedro Puerta-Alcalde, Verónica Rico, Sabina Herrera, Montse Tuset, Pedro Castro, Sergio Prieto-González, Alex Almuedo, José Muñoz, Josep Mensa, Gemma Sanjuan, J. M. Nicolas, Ana Del Rio, Jordi Vila, Felipe García, José Antonio Martínez, Carolina Garcia-Vidal, Alex Soriano, and Hospital Clinic of Barcelona COVID-19 Research Group
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Medicine ,Science - Abstract
Abstract Dexamethasone and tocilizumab have been associated with reduction in mortality, however, the beneficial effect is not for all patients and the impact on viral replication is not well defined. We hypostatized that C-reactive protein (CRP) could help in the identification of patients requiring anti-inflammatory therapy. Patients admitted for > 48 h in our hospital for a confirmed or suspected infection by SARS-CoV-2 from February 2020 to February 2021 were retrospectively evaluated. The primary outcome was mortality at 30 days. Demographics and the most relevant variables related with the outcome were included. CRP was stratified by percentiles. Univariate and multivariate analysis were performed. A total of 3218 patients were included with a median (IQR) age of 66 (74–78) years and 58.9% were males. The rate of intensive care unit admission was 24.4% and the 30-day mortality rate was 11.8%. Within the first 5 days from admission, 1018 (31.7%) patients received dexamethasone and 549 tocilizumab (17.1%). The crude analysis showed a mortality reduction in patients receiving dexamethasone when CRP was > 13.75 mg/dL and > 3.5 mg/dL for those receiving tocilizumab. Multivariate analysis identified the interaction of CRP > 13.75 mg/dL with dexamethasone (OR 0.57; CI 95% 0.37–0.89, P = 0014) and CRP > 3.5 mg/dL with tocilizumab (0.65; CI95%:0.44–0.95, P = 0.029) as independent predictors of mortality. Our results suggest that dexamethasone and tocilizumab are associated with a reduction in mortality when prescribed to patients with a certain inflammatory activity assessed by C-reactive protein.
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- 2022
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7. High-titer rheumatoid factor seropositivity predicts mediastinal lymphadenopathy and mortality in rheumatoid arthritis-related interstitial lung disease
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Albina Tyker, Iazsmin Bauer Ventura, Cathryn T. Lee, Rachel Strykowski, Nicole Garcia, Robert Guzy, Renea Jablonski, Rekha Vij, Mary E. Strek, Jonathan H. Chung, and Ayodeji Adegunsoye
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Medicine ,Science - Abstract
Abstract Rheumatoid arthritis-related interstitial lung disease (RA-ILD) is a common connective tissue disease-related ILD (CTD-ILD) associated with high morbidity and mortality. Although rheumatoid factor (RF) seropositivity is a risk factor for developing RA-ILD, the relationship between RF seropositivity, mediastinal lymph node (MLN) features, and disease progression is unknown. We aimed to determine if high-titer RF seropositivity predicted MLN features, lung function impairment, and mortality in RA-ILD. In this retrospective cohort study, we identified patients in the University of Chicago ILD registry with RA-ILD. We compared demographic characteristics, serologic data, MLN size, count and location, and pulmonary function over 36 months among patients who had high-titer RF seropositivity (≥ 60 IU/ml) and those who did not. Survival analysis was performed using Cox regression modeling. Amongst 294 patients with CTD-ILD, available chest computed tomography (CT) imaging and serologic data, we identified 70 patients with RA-ILD. Compared to RA-ILD patients with low-titer RF, RA-ILD patients with high-titer RF had lower baseline forced vital capacity (71% vs. 63%; P = 0.045), elevated anti-cyclic citrullinated peptide titer (122 vs. 201; P = 0.001), CT honeycombing (50% vs. 80%; P = 0.008), and higher number of MLN ≥ 10 mm (36% vs. 76%; P = 0.005). Lung function decline over 36 months did not differ between groups. Primary outcomes of death or lung transplant occurred more frequently in the high-titer RF group (HR 2.8; 95% CI 1.1–6.8; P = 0.028). High-titer RF seropositivity was associated with MLN enlargement, CT honeycombing, and decreased transplant-free survival. RF titer may be a useful prognostic marker for stratifying patients by pulmonary disease activity and mortality risk.
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- 2021
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8. Multiple phytoplankton community responses to environmental change in a temperate coastal system: A trait-based approach
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Elsa Breton, Eric Goberville, Benoit Sautour, Anis Ouadi, Dimitra-Ioli Skouroliakou, Laurent Seuront, Gregory Beaugrand, Loïck Kléparski, Muriel Crouvoisier, David Pecqueur, Christophe Salmeron, Arnaud Cauvin, Adrien Poquet, Nicole Garcia, Francis Gohin, and Urania Christaki
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biodiversity ,community assembly ,diatoms ,environmental change ,functional traits ,Phaeocystis ,Science ,General. Including nature conservation, geographical distribution ,QH1-199.5 - Abstract
The effect of environmental change in structuring the phytoplankton communities of the coastal waters of the Eastern English Channel was investigated by applying a trait-based approach on two decades (1996-2019) of monitoring on diatoms and Phaeocystis. We show that phytoplankton species richness in an unbalanced nutrient supply context was influenced by wind-driven processes, ecological specialization for dissolved inorganic phosphorous, temporal niche differentiation, and a competition-defense and/or a growth-defense trade-off, a coexistence mechanism where weak competitors (i.e., slower growing) are better protected against predation. Under the influence of both environmental perturbations (e.g., wind-driven processes, freshwater influence, unbalanced nutrient levels) and biotic interactions (e.g., competition, predation, facilitation), phytoplankton species exhibited specific survival strategies such as investment on growth, adaptation and tolerance of species to environmental stresses, silicification and resource specialization. These strategies have led to more speciose communities, higher productivity, functional redundancy and stability in the last decade. Our results revealed that the unbalanced nutrient reduction facilitated Phaeocystis blooms and that anthropogenic climate warming and nitrate reduction may threaten the diatom communities of the eastern English Channel in a near future. Our results provide strong support for biogeographical historical and niche-based processes in structuring the phytoplankton community in this temperate region. The variety of species responses that we characterized in this region may help to better understand future changes in pelagic ecosystems, and can serve as a basis to consider functional approaches for future ecosystem management.
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- 2022
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9. Prolonged viral replication in patients with hematologic malignancies hospitalized with COVID-19
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Carolina Garcia-Vidal, Pedro Puerta-Alcalde, Aina Mateu, Genoveva Cuesta-Chasco, Fernanda Meira, Carlos Lopera, Patricia Monzo, Marta Santos-Bravo, Gerard Duenas, Mariana Chumbita, Nicole Garcia-Pouton, Anna Gaya, Marta Bodro, Sabina Herrera, Mar Mosquera, Francesc Fernandez-Aviles, Jose Antonio Martinez, Josep Mensa, Eva Gine, Maria Angeles Marcos, and Alex Soriano
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2022
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10. Emergence of Progressive Mutations in SARS-CoV-2 From a Hematologic Patient With Prolonged Viral Replication
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Carolina Garcia-Vidal, María Iglesias-Caballero, Pedro Puerta-Alcalde, Vicente Mas, Genoveva Cuesta-Chasco, Nicole Garcia-Pouton, Sarai Varona, Francisco Pozo, Sonia Vázquez-Morón, Maria Angeles Marcos, Alex Soriano, Inmaculada Casas, and HEMATOCOVID19-Researchers Group
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COVID-19 ,antivirals ,persistence ,mutations ,remdesivir ,immunosuppression ,Microbiology ,QR1-502 - Abstract
We documented a hematologic patient with prolonged SARS-CoV-2 viral replication in whom emergence of viral mutations was documented after the consecutive use of antivirals and convalescent plasma. The virus detected in the last of 12 clinical samples (day 237) had accumulated 22 changes in amino acids and 29 in nucleotides. Some of these changes, such as the E484Q, were mutations of concern as defined by WHO. This finding represents an enormous epidemiological threat and poses a major clinical challenge. Combined antiviral strategies, as well as specific strategies related to the diagnostic approach of prolonged infections for this specific population, may be needed.
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- 2022
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11. Trends in mortality of hospitalised COVID-19 patients: A single centre observational cohort study from Spain
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Carolina Garcia-Vidal, Alberto Cózar-Llistó, Fernanda Meira, Gerard Dueñas, Pedro Puerta-Alcalde, Catia Cilloniz, Nicole Garcia-Pouton, Mariana Chumbita, Celia Cardozo, Marta Hernández, Verónica Rico, Marta Bodro, Laura Morata, Pedro Castro, Alex Almuedo-Riera, Felipe García, Josep Mensa, José Antonio Martínez, Gemma Sanjuan, Antoni Torres, JM Nicolás, and Alex Soriano
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COVID-19 ,ICU admission ,Outcomes ,Mortality ,Public aspects of medicine ,RA1-1270 - Abstract
Background: We aimed to describe changes in characteristics and treatment strategies of hospitalised patients with COVID-19 and detail the mortality trend over time. Methods: Observational cohort study of all consecutive patients admitted ≥ 48 h to Hospital Clinic of Barcelona for COVID-19 (1 March–30 September 2020). Findings: A total of 1645 consecutive patients with COVID-19 were assessed over a 7-month period. Overall mortality (≤30 days) was 9.7% (159 patients), 7.7% in patients hospitalised in regular wards and 16.7 % in patients requiring ICU admission. Overall mortality decreased from 11.6% in the first month to 1.4% in the last month, reflecting a progressive, significant downward trend (p for trend 700 ng/mL (OR 2.3, CI 1.3–4.1), ferritin>489 ng/mL (OR 1.9; CI 1.5–3.2), C-RP>7 mg/dL (OR 2.6; CI 1.5–4.6), and shorter duration from symptom onset to hospital admission (OR 1.11; CI 1.04–1.17) were factors associated with 30-day mortality at hospital admission. Conversely, hospital admission in the last months (OR 0.80; CI 0.65–0.98) was significantly associated with lower mortality. Interpretation: In-hospital mortality has decreased in patients with COVID-19 over the last, few months, even though main patient characteristics remain similar. Several changes made when managing patients may explain this decreasing trend. Our study provides current data on mortality of patients hospitalised with COVID-19 that might be useful in establishing quality of standard of care. Funding: EIT Health, European Union´s Horizon 2020 Research and Innovation Programme), EDRD. PPA [CM18/00132], NGP [FI19/00133], and CGV [FIS PI18/01061], have received grants from Ministerio de Sanidad y Consumo, ISCIII. Resumen: Contexto: Nuestro objetivo es describir los cambios en las características y las estrategias de tratamiento de los pacientes hospitalizados por COVID-19, y detallar la tendencia de la mortalidad en el tiempo. Métodos: Estudio observacional de cohortes de todos los pacientes consecutivos, ingresados por COVID-19 durante más de 48 horas, en el Hospital Clínic de Barcelona (del 1 de marzo al 30 de septiembre de 2020). Resultados: Un total de 1645 pacientes consecutivos fueron evaluados durante un período de 7 meses. La mortalidad global (≤30 días) fue del 9.7% (159 pacientes): 7.7% en pacientes hospitalizados en salas convencionales, y 16.7% en pacientes que requirieron ingreso en UCI. La mortalidad global disminuyó del 11.6% en el primer mes al 1.4% en el último mes evaluado, reflejando una progresiva y significativa tendencia a la baja (p para la tendencia 700 ng/mL (OR 2.3; CI 1.3–4.1), ferritina>489 ng/mL (OR 1.9; CI 1.5–3.2), PCR>7 mg/dL (OR 2.6; CI 1.5–4.6), y una menor duración desde el inicio de síntomas a la hospitalización (OR 1.11; CI 1.04–1.17) fueron factores asociados a la mortalidad intrahospitalaria a 30 días. Por el contrario, el ingreso hospitalario previo en los últimos meses (OR 0.80; CI 0.65–0.98) se asoció significativamente a una menor mortalidad. Discusión: La mortalidad intrahospitalaria ha disminuido en los pacientes con COVID-19 durante los últimos meses, incluso siendo similares las características de los pacientes. Algunos cambios realizados en el manejo de estos pacientes podrían explicar esta tendencia decreciente. Nuestro estudio aporta datos actualizados en la mortalidad de los pacientes hospitalizados con COVID-19, que podrían ser útiles de cara a establecer unos cuidados estándar de calidad. Financiación: EIT Health, European Union´s Horizon 2020 Research and Innovation Programme, EDRD. PPA [CM18/00132], NGP [FI19/00133] y CGV [FIS PI18/01061], han recibido becas del Ministerio de Sanidad y Consumo, ISCIII.
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- 2021
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12. Late spring bloom development of pelagic diatoms in Baffin Bay
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Augustin Lafond, Karine Leblanc, Bernard Quéguiner, Brivaela Moriceau, Aude Leynaert, Véronique Cornet, Justine Legras, Joséphine Ras, Marie Parenteau, Nicole Garcia, Marcel Babin, and Jean-Eric Tremblay
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diatoms ,spring bloom ,sea ice ,community composition ,baffin bay ,arctic ,Environmental sciences ,GE1-350 - Abstract
The Arctic Ocean is particularly affected by climate change, with changes in sea ice cover expected to impact phytoplankton primary production. During the Green Edge expedition, the development of the late spring–early summer diatom bloom was studied in relation with the sea ice retreat by multiple transects across the marginal ice zone. Biogenic silica concentrations and uptake rates were measured. In addition, diatom assemblage structures and their associated carbon biomass were determined, along with taxon-specific contributions to total biogenic silica production using the fluorescent dye PDMPO. Results indicate that a diatom bloom developed in open waters close to the ice edge, following the alleviation of light limitation, and extended 20–30 km underneath the ice pack. This actively growing diatom bloom (up to 0.19 μmol Si L–1 d–1) was associated with high biogenic silica concentrations (up to 2.15 μmol L–1), and was dominated by colonial fast-growing centric ('Chaetoceros' spp. and 'Thalassiosira' spp.) and ribbon-forming pennate species ('Fragilariopsis' spp./'Fossula arctica'). The bloom remained concentrated over the shallow Greenland shelf and slope, in Atlantic-influenced waters, and weakened as it moved westwards toward ice-free Pacific-influenced waters. The development resulted in a near depletion of all nutrients eastwards of the bay, which probably induced the formation of resting spores of 'Melosira arctica'. In contrast, under the ice pack, nutrients had not yet been consumed. Biogenic silica and uptake rates were still low (respectively
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- 2019
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13. Can Artificial Intelligence Improve the Management of Pneumonia
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Mariana Chumbita, Catia Cillóniz, Pedro Puerta-Alcalde, Estela Moreno-García, Gemma Sanjuan, Nicole Garcia-Pouton, Alex Soriano, Antoni Torres, and Carolina Garcia-Vidal
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artificial intelligence ,pneumonia ,Medicine - Abstract
The use of artificial intelligence (AI) to support clinical medical decisions is a rather promising concept. There are two important factors that have driven these advances: the availability of data from electronic health records (EHR) and progress made in computational performance. These two concepts are interrelated with respect to complex mathematical functions such as machine learning (ML) or neural networks (NN). Indeed, some published articles have already demonstrated the potential of these approaches in medicine. When considering the diagnosis and management of pneumonia, the use of AI and chest X-ray (CXR) images primarily have been indicative of early diagnosis, prompt antimicrobial therapy, and ultimately, better prognosis. Coupled with this is the growing research involving empirical therapy and mortality prediction, too. Maximizing the power of NN, the majority of studies have reported high accuracy rates in their predictions. As AI can handle large amounts of data and execute mathematical functions such as machine learning and neural networks, AI can be revolutionary in supporting the clinical decision-making processes. In this review, we describe and discuss the most relevant studies of AI in pneumonia.
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- 2020
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14. Alcohol–salt interaction
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Leong, Hui Yi, primary, Chang, Chih-Kai, additional, Aung, Krisya Nicole Garcia, additional, Lin, Dong-Qiang, additional, and Show, Pau Loke, additional
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- 2023
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15. Contributors
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Ang, Zhi Ting, primary, Arshad, Zatul Iffah Mohd, additional, Aung, Krisya Nicole Garcia, additional, Bong, Kien Xiang, additional, Chai, Sophie Jing Nee, additional, Chai, Wai Siong, additional, Chang, Chih-Kai, additional, Cheah, Wai Yan, additional, Cheng, Chin Kui, additional, Rong Chew, Kah, additional, Chew, Kit Wayne, additional, Chia, Shir Reen, additional, Chia, Wen Yi, additional, Chong, Jun Wei Roy, additional, Devadas, Vishno Vardhan, additional, Duc, Nguyen Minh, additional, Fu, Xiao-Qian, additional, Hong, Teoh Rui, additional, Khoo, Kuan Shiong, additional, Koyande, Apurav Krishna, additional, Kuan, Wang Sze, additional, Lai, Shuet Fen, additional, Leong, Hui Yi, additional, Leong, Yoong Kit, additional, Lin, Dong-Qiang, additional, Liu, Xuwei, additional, Loo, Jia Rhen, additional, Shin Low, Sze, additional, Chee Lu, Hock, additional, Sie Ming, Jasmine Tiong, additional, Ng, Yan Jer, additional, Nomanbhay, Saifuddin, additional, Quah, Heam Boon, additional, Raguraman, Sridaran, additional, Sankaran, Revathy, additional, Show, Pau Loke, additional, Siau, Mei Yuen, additional, Tang, Malcom S.Y., additional, and Wan You, Kho, additional
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- 2023
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16. MANEJO CLÍNICO DE PACIENTES COM QUEIMADURAS
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SILVA FILHO, DANIEL RODRIGUES, primary, MONTEIRO, YURI ARAÚJO, additional, MORAES, NATHÁLIA VIEIRA DA SILVA, additional, FREITAS, PEDRO IVO PALÁCIOS, additional, BRANDÃO, NICOLE GARCIA, additional, BORGES, ISABELA LUCENA LISBOA, additional, BORGES, PYETRA SILVA, additional, ANDRADE, JOÃO VITOR PÍCOLI DE, additional, LUCAS, LUISA MELO, additional, FONTANELLA, FRANCIELLY, additional, KOOS, GABRIELA BASSO, additional, PROCÓPIO, DANIELA PEREIRA, additional, and LEITE, MARINALDO SOARES, additional
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- 2022
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17. FUNDAMENTOS E PRÁTICAS PEDIÁTRICAS E NEONATAIS
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VILAÇA, JHEMILY LOPES LIMA, primary, Ferreira, Vitória de Araújo, additional, Andrade, Fabianne Gomes de, additional, Santos, Vinicius de Oliveira, additional, Diniz, Isabella Hayashi, additional, Cunha, Lara Pontes, additional, Araújo, Hannah Áurea Girão dos Santos, additional, Nascimento, Lourdes Maria Pereira Marques, additional, Mota, Renata Cardoso Pelegrine, additional, Almeida, Isadora Alfenas, additional, Dantas, Veridiana Célia Bezerra, additional, Lima, Letícia Bastos, additional, SILVA, GABRIEL SOUZA SANTOS DA, additional, Moraes, Brenda Cariolita Japiassu, additional, Pacheco, Letícia Mesquita, additional, Severiano, Marina Oliveira, additional, Locarno, Camila Salles, additional, Santana, Rhayssa Gomes de, additional, Parente, Ariana Ximenes, additional, Magalhães, Camila Holanda, additional, Araújo, Italo Magalhães de, additional, Escóssia, Lara Nogueira da, additional, Freitas, Bianca Batista Diniz, additional, Sousa, Cristiane Rodrigues de, additional, Lima, Isabelle Girão De Oliveira, additional, Mendes, Karen Soares, additional, Guimarães, Maria de Fátima de Menezes, additional, Pacheco, Beatriz Carvalho Costa Saunders, additional, Paiva, Vitor Sauwen, additional, Vasconcelos, Rafael Barroso, additional, Pinheiro, Murilo Magalhães Couto, additional, Gomes, Maria Eduarda Felicio Philomeno, additional, Vargas, Larissa Jardim, additional, Lucena, Talytta Marinho de, additional, Damasceno, Rachel Pinto, additional, Pinheiro, Maria Jéssica Alves, additional, Pacheco, Fernanda Vidal, additional, Pires, Maria Eugênia de Paula, additional, Rôlo, Brunno, additional, Leite, Fernanda Moema Mendes, additional, Coelho, Ricardo Soares, additional, Quintairos, Midia Quaresma, additional, Maia, Juliane Tayse Ribeiro, additional, Passos, Ana Letícia Leite Sena, additional, Alves, Dennis Ramos, additional, Silva, Juliana da Silva e, additional, Dias, Sheila Mara, additional, Teles, José Ricardo Silvestre, additional, Calisto, Sarah de Pádua, additional, Gomes, Amanda Maria Silva, additional, Tenório, Jordão Lima, additional, Santos, Maria Eugênia Cavalcante Ferreira, additional, Almeida, Maria Júlia Souza De, additional, Praxedes, Marianne Aguiar Vitório, additional, Lessa, Millena Medeiros Maux, additional, Oliveira, José João Felipe Costa De, additional, Monteiro, Beatriz Torres, additional, Monteiro, Pablo Felipe dos Santos, additional, Leite, Sarah Edwarda Silva, additional, Herrmann, Délia Maria de Moura Lima, additional, Nogueira, Janaína da Silva, additional, Souza, Natasha Kelly de, additional, Oliveira, Thayná Barbosa de, additional, Rezende, Sophia Oliveira, additional, Lacerda, Alessandra Silvestrini, additional, Pereira, Fabianny de Lima, additional, Fernandes, Rafaelle de Lima, additional, Montenegro, Raylson Araújo, additional, Fin, Lucas Grangeiro, additional, Pereira, Kallen Rayane, additional, Souza, Dhara Martins de, additional, Gomes, Gabriela Moraes, additional, Resende, Joana de Sousa, additional, Carneiro, Lucas, additional, Ferreira, Ana Iara Costa, additional, Nakashima, Fabiana, additional, Lins, Cynthia Dantas, additional, Martins, Antônio Carlos Sansevero, additional, Costa, Bianca Jorge Sequeira, additional, Briglia, Charlote Aguiar Buffi, additional, Ribeiro, Leila Braga, additional, Prudente, Ana Luiza Naves, additional, Luiz, Victória Carolinne Alves, additional, Garrote, Celso Henrique Denófrio, additional, Andrade, Gabriela Couto, additional, Reis, Isabella França dos, additional, Alves, Jéssica Caroline de Deus, additional, Nogueira, Lyandra Yuri Katsuyama, additional, Sampaio, Luiza Caroline Felicianno, additional, Rios, Mateus Felipe Batista, additional, Silvério, Natália Ribeiro, additional, Gomes, Sayonara Caetano de Almeida, additional, Perillo, Valentina Machado, additional, Musmanno, Luiz Henrique Fernandes, additional, Nogueira, Aline Araújo, additional, Leal, Maria Carolina Bezerra Di Medeiros, additional, Silva, Gabriella Damares Sousa, additional, Paula, Ana Cecília Nunes de, additional, Cassilhas, Amanda Bonzi, additional, Oliveira, Giovanna Viana Pereira de, additional, Lobato, Júlia Lacerda, additional, Silva, Matheus Felipe de Abreu, additional, Souza, Nathália Carvalho de, additional, Dias, Isabela Karina Silva, additional, Ribeiro, Sarah Carvalho, additional, Silva, Ana Carla Ferreira Lana e, additional, Dias, Anna Beatriz Soares, additional, Maciel, Ana Luísa dos Santos, additional, Vaz, Lucas Fahel, additional, Castelani, Laura Mendes Ferreira, additional, Pedrosa, Yago Ricardo, additional, Leite, Larissa Cruvinel, additional, Sperancini, Larissa Fontes Cal, additional, Santos, Bruno Cassiano dos, additional, Lopes, Lais de Almeida Fraga, additional, Campos, Lucas Bernardes Cerqueira, additional, Moreira, Silvia de Andrade Toscano Mendes, additional, OLIVEIRA, MARCELA MARINHO DE, additional, Pinheiro, Elisama Pereira, additional, Santos, Jehovahnna Anttonioni, additional, Campos, Orotides Silvestre, additional, Borges, Polliane, additional, Moral, Lorena Ramos, additional, Rego, Maria Eduarda Carvalho, additional, Oliveira, Beatriz Dias, additional, SPÓSITO, LAVÍNIA ARRUDA, additional, GOMES, CLARA DE SOUSA, additional, Belke, Giovana, additional, Goetten, Áquila Jasmile de Moraes, additional, lisboa, Débora DAgostini Jorge, additional, Rodrigues, Marina Machado, additional, Rottenfusser, Robson, additional, Belke, Larissa, additional, Pinheiro, Ana Carolina Sardo de Oliveira, additional, Lopes, Andrea Marcela dos Santos, additional, Leitão, Camilla Cristina Pereira, additional, Machado, Carla Leonor Melo Vinagre, additional, Barletta, César Augusto Barata, additional, Albuquerque, Fernanda Cristina de Oliveira, additional, Pereira, Giovana Duarte, additional, Carneiro, João Vítor Tavares, additional, Moura, Larissa Victória Barra De, additional, Gonçalves, Lorena Oliveira, additional, Pantoja, Marla Cavalca, additional, Ferreira, Thayane Thais Pantoja, additional, Souza, Vilma Francisca Hutim Gondim de, additional, Santos, Yasmin A, additional, Defeo, Sarah Furtado, additional, Mendes, Rafaella Yasmin Ribeiro, additional, Moreira, Saulo Guimarães, additional, Amaral, Bernardo Merrighi de Figueiredo, additional, Santos, Lucas Siqueira dos, additional, Diniz, Ana Carollina Simão, additional, Moraes, Luzia Reis Rabelo de, additional, Morais, Vanessa Maria Oliveira, additional, Vitral, Gabriela Luiza Nogueira, additional, Drumond, Ana Beatriz Carvalho, additional, Nasser, Arthur Kalil Santana, additional, Estácio, Rayssa Carolinne Costa Mota, additional, Albuquerque, Aglaé Travassos, additional, Teixeira, Amanda Monteiro, additional, Oliveira, Amanda Távora, additional, Souza, Anelise Marques Feitosa de, additional, Morais, Bruna Almeida de Souza, additional, Andrade, Gabrielle Barbosa Lima de, additional, Cunha, Isadora Valentina dos Santos, additional, Matias, Laís Costa, additional, Costa, Lara Letycia Araujo, additional, Farias, Mariana Guimarães Nolasco, additional, Graças, Thallita Vasconcelos das, additional, Lopes, Izailza Matos Dantas, additional, Fonseca, Fabiana Soares, additional, Baptista, Mauricio Da Costa, additional, Lima, Messilane Cavalcante, additional, Cardoso, Paula Thaís Sousa de Oliveira, additional, Silva, Victor Menezes, additional, Cardoso, Clarisse Angelim Soares, additional, Santos, Camila de Oliveira, additional, Silva, Gabriel Felipe SantAna, additional, Folgado, Gustavo Reis, additional, Gomes, Izabella Caroline Prado, additional, Santos, Lorena Ferreira, additional, Porto, Sofia Sturzeneker, additional, Nogueira, Janaina da Silva, additional, Moraes, Victória Eduarda Cavalcanti de, additional, Galdino, Ana Carolina Brito, additional, Monte, Elaine Cristina Barros Rocha Do, additional, Costa, Larissa Barbosa Caldas, additional, Cerqueira, Maria Layane De Oliveira, additional, Barros, Matheus Ramos De, additional, Silva, Paulo Henrique Alves Da, additional, Duarte, Rafaela Maria Bezerra, additional, Sirqueira, Sarah Valões Tenorio, additional, Varjão, Stephany Abdias, additional, Silva, Vitória Viana, additional, Lima, Zuíla Caroline Olegário, additional, MOREIRA, EMANUELLE ALVES, additional, Silva, Arthur Nunes, additional, Almeida, Anne Caroline Araújo, additional, Santos, Lislayle Silva, additional, Santos, Fernanda Marques da Silva, additional, Araújo, Anastácia Santiago, additional, REIS, FERNANDA FONTES PRADO, additional, Campos, Silvia Sayonara Silveira, additional, Faro, Caroliny Biasuz, additional, Teixeira, Giovanna de Jesus, additional, MOREIRA, GABRIELLE DOS SANTOS, additional, Oliveira, Isadora Ribeiro, additional, Oliveira, Halley Ferraro, additional, melo, Amélia soares de, additional, Coutinho, Camila Hostalacio Duarte, additional, Tolentino, Carolina Carvalho, additional, Alvarenga, Carolina Diniz, additional, Araújo, Carolina Muzzi Lamounier, additional, Santos, Clara Chagas Barbosa, additional, Bernardes, Clara Manoel, additional, Pimenta, Clara Rubião, additional, Lage, Fernanda Duarte Oliveira, additional, Murad, Gabriela Abreu, additional, Campos, Julia Pinheiro, additional, Sousa, Lara Oliveira, additional, Ferreira, João Vítor Gonçalves, additional, Meneses, Gustavo Henrique Rodrigues, additional, Ferreira, Thaize Prates, additional, Alves, Lucas Ferreira, additional, Gonçalves, Gleisy Kelly Neves, additional, Araújo, Allana Moura de, additional, Azevedo, Ana Carla Costa, additional, Silva, Arilson Lima da, additional, Andrade, Bianca Evelyn Piedade, additional, Reis, Giovana Silva Correa, additional, Kato, Jéssika Sayuri Campelo, additional, Castro, Lucas Matheus da Silva, additional, Santos, Mainã C S, additional, Fernandes, Maria Suely Bezerra, additional, Gonçalves, Paula Gabriela Nascimento, additional, Loureiro, Amanda Guimarães, additional, Moura, Ana L G, additional, Junqueira, Beatriz Guimarães, additional, Farias, Brenda P, additional, Kadosaki, Danilo Jun, additional, Gonçalves, Isabella Rocha, additional, Sousa, Karina Rodrigues de, additional, Rojas, Marcia de Fátima Maciel de, additional, Lourenço, Maria Fernanda, additional, Lira, Renata Barros, additional, Lobo, Giulli Catarini Cei Ribeiro, additional, Cardoso, Keise Bastos, additional, Silva, Ianka A, additional, Góes, Nicole Garcia dos Santos, additional, Andrade, Carla Hineida da Silva de, additional, Souza, Marilia Vitoria Santos de, additional, Santos, Mainã Cristina Santos dos, additional, Neves, Marcela Daun E Lorena Saraty, additional, Marques, Bruna Cristina Ribeiro, additional, Monteiro, Gabriel Felipe Perdigão Barros, additional, Carneiro, João Vitor Tavares, additional, Oliveira, Cláudia Maria Maciel de, additional, Corradi, Analaura, additional, Louzada, Cibelle Ferreira, additional, Oliveira, Déborah Luiza Vilela de, additional, Santos, Estevan Rodrigues dos, additional, Fernandes, Igor Cardoso, additional, Cruz, Olívia Maria Carvalho Lopes da, additional, Fernandes, Jairo Vinícius Cota, additional, Alves, Rayssa Stephanie Batista, additional, Oliveira, Pauline Pereira de, additional, Cruz, Karenn Santos Souza, additional, Santos, Áleff Edrei Gomes, additional, Silva, Francisca Roberta Oliveira, additional, Silva, Loranny Santana, additional, Trindade, Yasmin Tourinho Delmondes, additional, Silveira, Danilo José de Andrade Santos, additional, Bomfim, Raul, additional, Vieira, Arthur Sobral, additional, Araujo, Ângelo Marcel Santana Duarte, additional, Ferreira, Isabella Lisboa, additional, Santos, Eduarda Lavínia Carneiro, additional, Moreira, João Victor Aguiar, additional, Lima, Caio Augusto de, additional, Martins, Marcos Vinicius Teixeira, additional, Brito, Veronica Perius de, additional, Alves, Caroline Coutinho Horácio, additional, Coelho, Larissa Mariano, additional, Satokata, Alessandra Akemi Cury, additional, Ferro, Mateus da Silva, additional, Tavares, Eduardo Fellipe Capini de Almeida, additional, Henriques, Gustavo de Souza, additional, Canella, Douglas Alves Da Costa, additional, Lima, Monnyka Castro, additional, Calegari, Tatiany, additional, Campos, Carolina Calafiori de, additional, Yun, Chen Qi, additional, Ferreira, Gabrielly Gomes, additional, Ticianeli, Giovanna França, additional, Freitas, Isabella Gomes de, additional, Fonseca, Júlia Lana, additional, Cavalcanti, Isabela Lins, additional, Cavalcanti, Isabela de Farias, additional, Melo, Izabel rocha de, additional, Lemos, Letícia, additional, Soledade, Sarah Luanna Ferreira, additional, Souza, Renata Da Silva, additional, Gondim, Alice Batista, additional, Filetti, Benjamin Martinuzo, additional, Sousa, Débora Ferreira de, additional, Borges, Luan Machado, additional, Montenegro, Mariana Fonseca dos Santos, additional, Carvalho, Mateus de Souza Oliveira, additional, Serrano, Matheus Sampaio, additional, Oliveira, Pedro Henrique Duarte, additional, Ferreira, Phablo Fernandes José Oliveira, additional, Aragão, Rômulo Nunes, additional, Macedo, Tifany Cerqueira, additional, Santos, Vanessa Oliveira, additional, Raskin, Ana Pudles, additional, Fridman, Ana Flávia Wolff, additional, Nascimento, Eduarda Faria do, additional, BINKOWSKI, LUDMILA LIMPIAS TERRAZAS, additional, FULBER, JADE GUIMARÃES, additional, MANSUR, ISABELA MARTINS FERREIRA, additional, Fulber, Jade Guimarães, additional, Mansur, Isabela Martins Ferreira, additional, Binkowski, Ludmila Limpias Terrazas, additional, Leon, Cristiano do Amaral de, additional, Faccioli, Manoela Sauer, additional, Iglesias, Carolina da Mota, additional, Krug, Bruna Reis, additional, Dallapicola, Giovanni Reveilleau, additional, Severo, Bernardo Riveira Fernandes, additional, Tannhauser, Pedro Henrique Andreolio, additional, Bonamigo, Eduarda Rodrigues, additional, Goldmann, Ignacio Salonia, additional, Busin, Isabella Montemaggiore, additional, Marchese, Isabella Salzano, additional, Zanella, Alana, additional, Thofehrn, Stefano, additional, Zampieri, Giulia Parmeggiani, additional, Zanatta, Stefanie Flach, additional, Leon, Cristiano do A de, additional, Santos, Mariana Silva dos, additional, Moraes, Emanuela Caroline, additional, Seroiska, Gabriel, additional, Bischoff, Helena Marcon, additional, Schemkel, João Marcelo Libardoni, additional, Rosa, Rafael Fabiano Machado, additional, Rezende, Raíssa Queiroz, additional, Martins, Juliana Bezerra, additional, Rafael, Ana Luísa Bonfim, additional, Pontes, Nayanne Hardy Lima, additional, Fechine, José Ueides, additional, Melo, Amélia Soares de, additional, Coutinho, Camila Hostalácio Duarte, additional, Silveira, Nícolas Semaan, additional, Dayrell, Sophia Perrupato, additional, Ferreira, Rachel Myrrha, additional, Vasconcelos, Júlia Cunha, additional, Pereira, Juliana Monção Nippes, additional, Farnetti, Laura Normando, additional, Diniz, Letícia Tanure, additional, Ribeiro, Pedro Heleno Valente, additional, Faria, Regina Bicalho Gomes de, additional, Cruz, Victor Fonseca Alves da, additional, Fagundes, Eleonora Druve Tavares, additional, Resende, Paula Valladares Guerra, additional, Gontijo, Mariana Scapellato, additional, Pacheco, Gustavo G, additional, Almeida, Mileny C, additional, Melo, Luíza Alves, additional, Silva, Graciele Aparecida Bachião da, additional, Bernabé, Heloisa Cervantes, additional, Teixeira, Maria Laura Verissimo, additional, Silva, Grazielle lima, additional, Oliveira, Phablo Fernandes José, additional, Brito, Inácio Gomes de, additional, Albuquerque, Leonardo Siqueira, additional, Matos, Estela Mares Santos Salmito, additional, Andrade, Maria Denise Fernandes Carvalho de, additional, Bachur, Tatiana Paschoalette Rodrigues, additional, Leite, Alice Cristovão Delatorri, additional, Silva, Lucas Bagundes da, additional, Melo, Waldomauro Ferreira de, additional, Dias, Cláudio Gellis de Mattos, additional, Fecury, Amanda Alves, additional, Gonçalves, Ana Carolina Miranda, additional, Oliveira, Lara Carvalho de, additional, Gomes, Laura Vitória Melo, additional, Vital, Mabio Vigilato, additional, Silva, Marina Blanco, additional, Vasconcelos, Rafael Barroso de, additional, Silva, Fernanda Lacerda Santos, additional, Silva, Iara, additional, Messias, Beatriz Chiari, additional, Clemente, Alice França, additional, Rodrigues, Alícia Zeferino, additional, Lima, Messilene Cavalcanti, additional, Gusmão, Maria Brennda Ferreira de, additional, Leite, Débora Cristina Fontes, additional, Rodrigues, Letycia Santos, additional, and Ferreira, Nathálya Menezes de Menezes, additional
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- 2021
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18. Building a Theory of Teacher Learning, Together.
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Ilana Horn, Catherine Lewis, Shelley Friedkin, Brette Garner, Nadav Ehrenfeld, Janet F. Carlson, Hilda Borko, Alissa Fong, Meghan Shaughnessy, and Nicole Garcia
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- 2020
19. Understanding the mechanisms of spontaneous and skin-grafted wound repair: the path to engineered skin grafts
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Nicole Garcia, Lachlan Dat Wah Lau, Cheng Hean Lo, Heather Cleland, and Shiva Akbarzadeh
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Nursing (miscellaneous) ,Fundamentals and skills - Abstract
Spontaneous wound repair is a complex process that involves overlapping phases of inflammation, proliferation and remodelling, co-ordinated by growth factors and proteases. In extensive wounds such as burns, the repair process would not be achieved in a timely fashion unless grafted. Although spontaneous wound repair has been extensively described, the processes by which wound repair mechanisms mediate graft take are yet to be fully explored. This review describes engraftment stages and summarises current understanding of molecular mechanisms which regulate autologous skin graft healing, with the goal of directing innovation in permanent wound closure with skin substitutes. Graftability and vascularisation of various skin substitutes that are either in the market or in development phase are discussed. In doing so, we cast a spotlight on the paucity of scientific information available as to how skin grafts (both autologous and engineered) heal a wound bed. Better understanding of these processes may assist in developing novel methods of wound management and treatments.
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- 2023
20. Qualitative Subgenomic RNA to Monitor the Response to Remdesivir in Hospitalized Patients With Coronavirus Disease 2019: Impact on the Length of Hospital Stay and Mortality
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Rodrigo Alonso-Navarro, Genoveva Cuesta, Marta Santos, Celia Cardozo, Verónica Rico, Nicole Garcia-Pouton, Montse Tuset, Marta Bodro, Laura Morata, Pedro Puerta-Alcalde, Sabina Herrera, Dafne Soria, Marta Aldea, Josep Mensa, José Antonio Martínez, Ana del Rio, Jordi Vila, Felipe Garcia, Carolina Garcia-Vidal, M Angeles Marcos, and Alex Soriano
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Microbiology (medical) ,Infectious Diseases - Abstract
Background There is no reliable microbiological marker to guide the indication and the response to antiviral treatment in patients with coronavirus disease 2019 (COVID-19). We aimed to evaluate the dynamics of subgenomic RNA (sgRNA) in patients with COVID-19 before and after receiving treatment with remdesivir. Methods We included consecutive patients admitted for COVID-19 who received remdesivir according to our institutional protocol and accepted to participate in the study. A nasopharyngeal swab for quantitative reverse transcriptase–polymerase chain reaction (qRT-PCR) was collected at baseline and after 3 and 5 days of treatment with remdesivir. Genomic and sgRNA were analyzed in those samples and main comorbidities and evolution were collected for the analyses. The main outcomes were early discharge (≤10 days) and 30-day mortality. Results A total of 117 patients were included in the study, of whom 24 had a negative sgRNA at baseline, with 62.5% (15/24) receiving early discharge (≤10 days) and no deaths in this group. From the 93 remaining patients, 62 had a negative sgRNA at day 5 with 37/62 (59.6%) with early discharge and a mortality rate of 4.8% (3/62). In the subgroup of 31 patients with positive sgRNA after 5 days of remdesivir, the early discharge rate was 29% (9/31) and the mortality rate was 16.1% (5/31). In multivariable analyses, the variables associated with early discharge were negative sgRNA at day 3 and not needing treatment with corticosteroids or intensive care unit admission. Conclusions Qualitative sgRNA could help in monitoring the virological response in patients who receive remdesivir. Further studies are needed to confirm these findings.
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- 2022
21. CPFE Supplement
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Dylan Douglas, Layne Keating, Rachel Strykowski, Cathryn T Lee, Nicole Garcia, Kavitha Selvan, Neha Kaushik, Iazsmin Bauer Ventura, Renea Jabolonski, Rekha Vij, Jonathan H. Chung, Shashi Bellam, Mary E. Strek, and Ayodeji Adegunsoye
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Supplemental Figures and Tables
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- 2023
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22. Contamination of planktonic food webs in the Mediterranean Sea: Setting the frame for the MERITE-HIPPOCAMPE oceanographic cruise (spring 2019)
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Marc Tedetti, Jacek Tronczynski, François Carlotti, Marc Pagano, Sana Ben Ismail, Cherif Sammari, Malika Bel Hassen, Karine Desboeufs, Charlotte Poindron, Sandrine Chifflet, Amel Bellaaj Zouari, Moufida Abdennadher, Sirine Amri, Daniela Bănaru, Lotfi Ben Abdallah, Nagib Bhairy, Ismail Boudriga, Aude Bourin, Christophe Brach-Papa, Nicolas Briant, Léa Cabrol, Cristele Chevalier, Lassaad Chouba, Sylvain Coudray, Mohamed Nejib Daly Yahia, Thibault de Garidel-Thoron, Aurélie Dufour, Jean-Claude Dutay, Boris Espinasse, Pamela Fierro-González, Michel Fornier, Nicole Garcia, Franck Giner, Catherine Guigue, Loïc Guilloux, Asma Hamza, Lars-Eric Heimbürger-Boavida, Stéphanie Jacquet, Joel Knoery, Rim Lajnef, Nouha Makhlouf Belkahia, Deny Malengros, Pauline L. Martinot, Anthony Bosse, Jean-Charles Mazur, Marouan Meddeb, Benjamin Misson, Olivier Pringault, Marianne Quéméneur, Olivier Radakovitch, Patrick Raimbault, Christophe Ravel, Vincent Rossi, Chaimaa Rwawi, Asma Sakka Hlaili, Javier Angel Tesán-Onrubia, Bastien Thomas, Melilotus Thyssen, Noureddine Zaaboub, Cédric Garnier, Institut méditerranéen d'océanologie (MIO), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut national des sciences de l'Univers (INSU - CNRS)-Université de Toulon (UTLN)-Centre National de la Recherche Scientifique (CNRS), Institut Français de Recherche pour l'Exploitation de la Mer (IFREMER), Institut National des Sciences et Technologies de la Mer [Salammbô] (INSTM), Laboratoire Interuniversitaire des Systèmes Atmosphériques (LISA (UMR_7583)), Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Ecole nationale supérieure Mines-Télécom Lille Douai (IMT Nord Europe), Institut Mines-Télécom [Paris] (IMT), Qatar University, Centre européen de recherche et d'enseignement des géosciences de l'environnement (CEREGE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Collège de France (CdF (institution))-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire des Sciences du Climat et de l'Environnement [Gif-sur-Yvette] (LSCE), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), Modélisation du climat (CLIM), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris-Saclay-Centre National de la Recherche Scientifique (CNRS), The Arctic University of Norway [Tromsø, Norway] (UiT), Laboratoire de recherche sur les transferts des radionucléides dans les écosystèmes aquatiques (IRSN/PSE-ENV/SRTE/LRTA), Service de recherche sur les transferts et les effets des radionucléides sur les écosystèmes (IRSN/PSE-ENV/SRTE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN)-Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Faculté des Sciences de Bizerte [Université de Carthage], Université de Carthage - University of Carthage, Institut de Recherche pour le Développement (IRD)-Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Collège de France (CdF (institution))-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), ANR-19-CE34-0001,CONTAMPUMP,Plancton: pompe biologique de contaminants dans les écosystèmes marins (CONTAMPUMP)?(2019), ANR-11-LABX-0005,Cappa,Physiques et Chimie de l'Environnement Atmosphérique(2011), and Institut de Recherche pour le Développement (IRD)
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bioaccumulation ,atmospheric deposition ,plankton ,size fractions ,[SDE]Environmental Sciences ,Mediterranean Sea ,contaminants ,Aquatic Science ,Oceanography ,Pollution - Abstract
International audience; This paper looks at experiential feedback and the technical and scientific challenges tied to the MERITE-HIPPOCAMPE cruise that took place in the Mediterranean Sea in spring 2019. This cruise proposes an innovative approach to investigate the accumulation and transfer of inorganic and organic contaminants within the planktonic food webs. We present detailed information on how the cruise worked, including 1) the cruise track and sampling stations, 2) the overall strategy, based mainly on the collection of plankton, suspended particles and water at the deep chlorophyll maximum, and the separation of these particles and planktonic organisms into various size fractions, as well as the collection of atmospheric deposition, 3) the operations performed and material used at each station, and 4) the sequence of operations and main parameters analysed. The paper also provides the main environmental conditions that were prevailing during the campaign. Lastly, we present the types of articles produced based on work completed by the cruise that are part of this special issue.
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- 2023
23. Aspergillosis by cryptic Aspergillus species: A case series and review of the literature
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Mariana Fernandez-Pittol, Izaskun Alejo-Cancho, Elisa Rubio-García, Celia Cardozo, Pedro Puerta-Alcalde, Estela Moreno-García, Nicole Garcia-Pouton, Miriam Garrido, Miriam Villanueva, Ana Alastruey-Izquierdo, Cristina Pitart, Carolina Garcia-Vidal, and Francesc Marco
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Antifungal Agents ,Aspergillus ,Infectious Diseases ,Amphotericin B ,Aspergillosis ,Humans ,Microbial Sensitivity Tests ,Microbiology ,Retrospective Studies - Abstract
The cryptic Aspegillus species are rare, these microorganisms are usually more resistant to common antifungal therapies. Therefore, a correct identification is important when evaluating the impact of such species in aspergillosis.We aimed to describe the frequency, clinical and microbiological characteristics, and the outcomes of those cases of aspergillosis caused by cryptic species in a tertiary hospital.We retrospectively identified all microbiologically documented cases of aspergillosis between January 2013 and December 2018. Definitive species identification of clinically significant isolates was achieved via sequencing methods. The polymerase chain reaction (PCR) products were sequenced, and the results obtained were compared to sequences deposited in GenBank. Antifungal susceptibility testing was performed using the Sensititre® YeastOne® panel.A total of 679 Aspergillus isolates were recovered from 489 patients, of which 109 were clinically relevant. Ten (9.2%) isolates were identified as cryptic species: Aspergillus arcoverdensis (2), Aspergillus lentulus (2), Aspergillus ellipticus (2), Aspergillus alliaceus (1), Aspergillus nomius (1), Aspergillus tubingensis (1) and Aspergillus montevidensis (1). Most patients already suffered some type of immunosuppression. Half of these patients had required intensive care before the infection showed up, and most of them had a pulmonary infection. Mortality at the 100-day follow-up was 40%. Antifungal susceptibility testing was performed on three of the isolates (A. arcoverdensis, A. tubingensis and A. nomius), which showed high minimum inhibitory concentrations (MIC) for azoles and amphotericin B.The frequency of cryptic species in our centre was 9.2%. Most patients had some degree of immunosuppression, and the mortality rate was 40%.
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- 2022
24. Where to Draw the Line for Intracranial Hypertension; Opening Pressures and Mortality
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Jacob D. Edwards, Seth A. Quinn, Seth Saylors, Katherine McBride, Stephanie Scott, William Irish, Nicole Garcia, and Eric Toschlog
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Adult ,Injury Severity Score ,Intracranial Pressure ,Humans ,Hospital Mortality ,General Medicine ,Intracranial Hypertension ,Monitoring, Physiologic - Abstract
Background Intracranial pressure (ICP) monitoring and treatment is a mainstay of severe TBI management but the relationship between intracranial opening pressure (OP) and outcomes has not been well established. The purpose of our study was to assess the relationship between OP and outcomes in severe TBI patients, with a focus on in-hospital mortality. Methods Adult blunt TBI patients with ICP monitoring between 2007 and 2017 were evaluated using sequential multivariable binary logistic modeling. Generalized additive model (GAM) was used to evaluate the relationship between OP and death. Odds ratio (OR) and 95% confidence interval (CI) were calculated for measures of strength of association and precision. Results A total of 182 patients were identified, with 61 (33.5%) having OP >20 mmHG (overall mean ± OP = 19.4 ± 17.8 mmHG). Forty-eight percent, 9% and 8% of patients were discharged to rehabilitation, skilled nursing institution, and home, respectively. Thirty-five percent died in the hospital. A linear relationship was found between OP and log-odds of mortality. OP (OR = 1.07; 95% CI = 1.04-1.11), age (OR = 1.05;95%CI = 1.02-1.07), and injury severity score (ISS) (OR = 1.06; 95% CI = 1.02-1.10) were independently associated with increased odds of death while adjusting for sex, race, and year. Discussion Elevated opening pressure is strongly predictive of death in severe TBI. Age and ISS are independent predictors of mortality regardless of OP. These results suggest that maintaining low levels of ICP should result in decreased mortality in severe TBI patients. The patient’s age and ISS should be considered in the decision-making processes related to ICP utilization and management.
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- 2022
25. Alcohol–salt interaction
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Hui Yi Leong, Chih-Kai Chang, Krisya Nicole Garcia Aung, Dong-Qiang Lin, and Pau Loke Show
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- 2023
26. Contributors
- Author
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Zhi Ting Ang, Zatul Iffah Mohd Arshad, Krisya Nicole Garcia Aung, Kien Xiang Bong, Sophie Jing Nee Chai, Wai Siong Chai, Chih-Kai Chang, Wai Yan Cheah, Chin Kui Cheng, Kah Rong Chew, Kit Wayne Chew, Shir Reen Chia, Wen Yi Chia, Jun Wei Roy Chong, Vishno Vardhan Devadas, Nguyen Minh Duc, Xiao-Qian Fu, Teoh Rui Hong, Kuan Shiong Khoo, Apurav Krishna Koyande, Wang Sze Kuan, Shuet Fen Lai, Hui Yi Leong, Yoong Kit Leong, Dong-Qiang Lin, Xuwei Liu, Jia Rhen Loo, Sze Shin Low, Hock Chee Lu, Jasmine Tiong Sie Ming, Yan Jer Ng, Saifuddin Nomanbhay, Heam Boon Quah, Sridaran Raguraman, Revathy Sankaran, Pau Loke Show, Mei Yuen Siau, Malcom S.Y. Tang, and Kho Wan You
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- 2023
27. Recording Student Thinking in a Mathematics Discussion
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Nicole Garcia
- Abstract
Representing and recording student thinking in public spaces during mathematics discussions is challenging work. We share principles for recording student thinking in the moment and share an activity for improving your recording practice.
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- 2021
28. COVID-19 in patients aged 80 years and over during the peaks of the first three pandemic waves at a Spanish tertiary hospital
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Gerad Dueñas, Antoni Torres, Pedro Puerta-Alcalde, Carolina Garcia-Vidal, Verónica Rico, Alex Soriano, Catia Cilloniz, Mariana Chumbita, Julia Gimeno-Miron, Nicole Garcia-Pouton, Albert Gabarrus, and Fernanda Meira
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Pulmonary and Respiratory Medicine ,Pediatrics ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Pandemic ,medicine ,In patient ,business - Published
- 2021
29. Supporting Students in Critiquing Math Arguments
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Meghan Shaughnessy, Nicole Garcia, and Darrius D. Robinson
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Mathematics education - Abstract
Using cases from early childhood, elementary, and secondary classrooms, we showcase the work that teachers do to support students in building a collective argument and critiquing an individual’s argument. We identify four areas of work central to teaching students to build and critique mathematical arguments.
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- 2021
30. Impact of remdesivir according to the pre-admission symptom duration in patients with COVID-19
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Carolina, Garcia-Vidal, Rodrigo, Alonso, Ana M, Camon, Celia, Cardozo, Laia, Albiach, Daiana, Agüero, M Angeles, Marcos, Juan, Ambrosioni, Marta, Bodro, Mariana, Chumbita, Lorena, de la Mora, Nicole, Garcia-Pouton, Gerard, Dueñas, Marta, Hernandez-Meneses, Alexy, Inciarte, Genoveva, Cuesta, Fernanda, Meira, Laura, Morata, Pedro, Puerta-Alcalde, Sabina, Herrera, Montse, Tuset, Pedro, Castro, Sergio, Prieto-Gonzalez, Alex, Almuedo-Riera, Josep, Mensa, José Antonio, Martínez, Gemma, Sanjuan, J M, Nicolas, A, Del Rio, José, Muñoz, Jordi, Vila, Felipe, Garcia, Alex, Soriano, and Y, Zboromyrska
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Male ,Microbiology (medical) ,medicine.medical_specialty ,Multivariate analysis ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Antiviral Agents ,law.invention ,law ,Internal medicine ,Symptom duration ,medicine ,Humans ,AcademicSubjects/MED00740 ,Pharmacology (medical) ,In patient ,Aged ,Retrospective Studies ,Original Research ,Pharmacology ,Mechanical ventilation ,Alanine ,SARS-CoV-2 ,business.industry ,Mortality rate ,Respiration, Artificial ,Intensive care unit ,Adenosine Monophosphate ,COVID-19 Drug Treatment ,AcademicSubjects/MED00290 ,Infectious Diseases ,AcademicSubjects/MED00230 ,business - Abstract
Background The use of remdesivir has demonstrated a significant reduction in the time to recovery in patients with COVID-19. However, the impact on mortality is still controversial. Therefore, it is necessary to evaluate whether there is a specific subgroup of patients in whom an active antiviral therapy also reduces the mortality. Methods Patients admitted for >48 h in our hospital for a SARS-CoV-2 confirmed or suspected infection from February 2020 to February 2021 were retrospectively analysed. The primary outcome of the study was mortality at 30 days. Univariate and multivariate analyses were performed to identify predictors of mortality. Results In total, 2607 patients (438 receiving remdesivir and 2169 not) were included with a median (IQR) age of 65 (54–77) years and 58% were male. Four hundred and seventy-six were admitted to the ICU (18.3%) and 264 required invasive mechanical ventilation (10.1%). The global 30 day mortality rate was 10.7%. Pre-admission symptom duration of 4–6 days and ≤3 days was associated with a 1.5- and 2.5-fold increase in the mortality rate, respectively, in comparison with >6 days and treatment with remdesivir was independently associated with a lower mortality rate (OR = 0.382, 95% CI = 0.218–0.671). The analysis showed that the major difference was among patients with shorter pre-admission symptom duration ( Conclusions Patients with ≤3 days and 4–6 days from symptom onset to admission are associated with a 2.5- and 1.5-fold higher risk of death, respectively. Remdesivir was associated with 62% reduced odds of death versus standard-of-care and its survival benefit increased with shorter duration of symptoms.
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- 2021
31. COVID-19 and fungal infections: Etiopathogenesis and therapeutic implications
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Carolina Garcia-Vidal, Pedro Puerta-Alcalde, Nicole Garcia-Pouton, and Mariana Chumbita
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Microbiology (medical) ,Pharmacology ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Aspergillus ,Coronavirus disease 2019 (COVID-19) ,biology ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,CAPA ,General Medicine ,biology.organism_classification ,Viral infection ,Update on the management of SARS-CoV-2 infection ,Intensive Care Units ,co-infection ,Mycoses ,Medicine ,Humans ,aspergillosis ,business ,Intensive care medicine - Abstract
Invasive fungal infection often complicates patients with severe viral infection, especially those admitted to critical care units. Severe SARS-CoV-2 infection has been no exception and a significant association with Aspergillus spp. has been documented, resulting in high patient mortality. In this summary we describe the clinical presentation, the underlying diseases most commonly linked with this association, radiological manifestations and therapeutic management of CAPA.
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- 2021
32. Explorando el mundo del habla y de los sonidos : /Un sonido, una palabra/ Si empiezas a escuchar, al mundo podrás hablar
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Romero, Nicole García and Romero, Nicole García
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- 2020
- Full Text
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33. Ultraphytoplankton community structure in subsurface waters along a North-South Mediterranean transect
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Ismail Boudriga, Melilotus Thyssen, Amel Zouari, Nicole Garcia, Marc Tedetti, Malika Bel Hassen, Institut National des Sciences et Technologies de la Mer [Salammbô] (INSTM), Institut méditerranéen d'océanologie (MIO), and Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut national des sciences de l'Univers (INSU - CNRS)-Université de Toulon (UTLN)-Centre National de la Recherche Scientifique (CNRS)
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Synechococcus ,[SDU.OCEAN]Sciences of the Universe [physics]/Ocean, Atmosphere ,Food Chain ,Seawater ,Biomass ,Aquatic Science ,Plankton ,Oceanography ,Pollution - Abstract
Here we assessed the subsurface ultraphytoplanktonic (10 μm) community along a North-South round-trip Mediterranean transect as part of a MERITE-HIPPOCAMPE cruise campaign in April-May 2019. Temperature, salinity, and nutrient concentrations in subsurface waters (2-5 m depth) were also measured along the transect. The subsurface ultraphytoplankton community structure was resolved with a spatial resolution of few kilometers and temporal resolution of 30-min intervals using automated pulse shape recording flow cytometry. The subsurface waters were clustered into seven areas based on temperature and salinity characteristics. Synechococcus were by far the most abundant group in all prospected zones, and nanoeukaryotes were the main biomass component, representing up to 51 % of ultraphytoplanktonic carbon biomass. Apparent net primary productivity (NPP) followed a decreasing gradient along the transect from north to south and was mostly sustained by Synechococcus in all zones. These findings are likely to have implications in terms of the trophic transfer of contaminants in planktonic food webs, as they highlight the potential role of nanoplankton in contaminants bioaccumulation processes and the potential role of Synechococcus in a likely transfer via grazing activities.
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- 2022
34. Encounters and Content Sharing in an Urban Village: Reading Texts Through an Archaeological Lens.
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Nicole Garcia, Marcus Foth, and Greg Hearn
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- 2010
- Full Text
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35. Chapter 3 - Alcohol–salt interaction
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Leong, Hui Yi, Chang, Chih-Kai, Aung, Krisya Nicole Garcia, Lin, Dong-Qiang, and Show, Pau Loke
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- 2023
- Full Text
- View/download PDF
36. Formatively assessing prospective teachers’ skills in leading mathematics discussions
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Sarah Kate Selling, Sabrina Bobsin Salazar, Meghan Shaughnessy, Michaela Krug O’Neill, Deborah Loewenberg Ball, Nicole Garcia, Amber T. Willis, and Charles E. Wilkes
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Teacher education ,General Mathematics ,05 social sciences ,Practice-based teacher education ,050301 education ,Assessment ,Article ,Education ,Formative assessment ,Prospective teachers ,0502 economics and business ,Mathematics discussion ,Mathematics education ,ComputingMilieux_COMPUTERSANDEDUCATION ,0503 education ,Discipline ,050203 business & management - Abstract
Mathematics discussions are important for helping students to develop conceptual understanding and to learn disciplinary norms and practices. In recent years, there has been increased attention to teaching prospective teachers to lead discussions with students. This paper examines the possibilities of designing a formative assessment that gathers information about prospective elementary teachers’ skills with leading problem-based mathematics discussions and makes sense of such information. A decomposition of the practice of leading discussions was developed and used to design the assessment. Nine first-year teachers who graduated from a range of different teacher education programs participated in the study. The findings reveal that our formative assessment works to gather information about teachers’ capabilities with leading discussions and that the associated tools support making sense of the information gathered. This suggests that such tools could be useful to support the formative assessment of the developing capabilities of prospective teachers.
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- 2021
37. THE DEVELOPMENT OF REACHING HAND-PRINTED READING MATERIALS (PREAM) FOR GRADE 2 LEARNERS
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Christine Nicole Garcia Bicomong
- Published
- 2022
38. Machine Learning to Assess the Risk of Multidrug-Resistant Gram-Negative Bacilli Infections in Febrile Neutropenic Hematological Patients
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Jordi Esteve, Miquel A. Orellana, Montserrat Rovira, Celia Cardozo, Carolina Garcia-Vidal, Jaime Lagunas, Gaston Besanson, Alex Soriano, Nicole Garcia-Pouton, Mariana Chumbita, Pedro Puerta-Alcalde, Ana del Río, Francesc Marco, Josep Mensa, and José Antonio Martínez
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0301 basic medicine ,Microbiology (medical) ,Multivariate analysis ,Isolation (health care) ,business.industry ,medicine.drug_class ,030106 microbiology ,Antibiotics ,Retrospective cohort study ,Neutropenia ,Logistic regression ,medicine.disease ,Machine learning ,computer.software_genre ,Multiple drug resistance ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,medicine ,030212 general & internal medicine ,Artificial intelligence ,business ,computer ,Febrile neutropenia - Abstract
We aimed to assess risk factors for multidrug-resistant Gram-negative bacilli (MDR-GNB) from a large amount of data retrieved from electronic health records (EHRs) and determine whether machine learning (ML) may be useful in assessing the risk of MDR-GNB infection at febrile neutropenia (FN) onset. Retrospective study of almost 7 million pieces of structured data from all consecutive episodes of FN in hematological patients in a tertiary hospital in Barcelona (January 2008–December 2017). Conventional multivariate analysis and ML algorithms (random forest, gradient boosting machine, XGBoost, and GLM) were done. A total of 3235 episodes of FN in 349 patients were documented; MDR-GNB caused 180 (5.6%) infections in 132 patients. The most frequent MDR-GNBs were MDR-Pseudomonas aeruginosa (53%) and extended-spectrum beta-lactamase-producing Enterobacterales (46%). According to conventional logistic regression analysis, independent factors associated with MDR-GNB infection were age older than 45 years (OR 2.07; 95% CI 1.31–3.24), prior antibiotics (2.62; 1.39–4.92), first-ever FN in this hospitalization (2.94; 1.33–6.52), prior hospitalizations for FN (1.72; 1.02–2.89); at least 15 prior hospital visits (2.65; 1.31–5.33), high-risk hematological diseases (3.62; 1.12–11.67), and hospitalization in a room formerly occupied by patients with MDR-GNB isolation (1.69; 1.20–2.38). ML algorithms achieved the following AUC and F1 score for MDR-GNB prediction: random forest, 0.79–0.9711; GMB, 0.79–0.9705; XGBoost, 0.79–0.9670; and GLM, 0.78–0.9716. Data generated in EHRs proved useful in assessing risk factors for MDR-GNB infections in patients with FN. The great number of analyzed variables allowed us to identify new factors related to MDR infection, as well as to train ML algorithms for infection predictions. This information may be used by clinicians to make better clinical decisions.
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- 2021
39. Clinical Characteristics and Outcome of Bloodstream Infections in HIV-Infected Patients with Cancer and Febrile Neutropenia: A Case–Control Study
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Juan Ambrosioni, Josep Mensa, Montserrat Rovira, Josep Mallolas, José Antonio Martínez, Francesc Marco, Celia Cardozo, Jordi Esteve, Estela Moreno-García, Marta Hernández-Meneses, Alex Soriano, Mariana Chumbita, Felipe García, Carolina Garcia-Vidal, Nicole Garcia-Pouton, Pedro Puerta-Alcalde, and José M. Miró
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Microbiology (medical) ,medicine.medical_specialty ,business.industry ,Cancer ,Neutropenia ,medicine.disease ,Chronic liver disease ,Regimen ,Infectious Diseases ,Internal medicine ,Bacteremia ,Epidemiology ,medicine ,business ,Viral load ,Febrile neutropenia - Abstract
We aimed to compare the clinical characteristics and outcomes of bloodstream infections (BSI) in cancer patients presenting febrile neutropenia with and without HIV infection, and analyze the prognostic factors for mortality. BSI episodes in febrile neutropenic patients following chemotherapy were prospectively collected (1997–2018). A case (HIV-infected)–control (non-HIV-infected) sub-analysis was performed (1:2 ratio), matching patients by age, gender, baseline disease, and etiological microorganism. From 1755 BSI episodes in neutropenic cancer patients, 60 (3.4%) occurred in those with HIV. HIV characteristics: 51.7% were men who have sex with men; 58.3% had
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- 2021
40. Real-life use of remdesivir in hospitalized patients with COVID-19
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Carolina Garcia-Vidal, Marta Bodro, Laura Morata, Ferran Segui, Josep Mensa, Nacho Grafia, Marta Hernández-Meneses, Juan Ambrosioni, Alex Soriano, Mariana Chumbita, Gemma Sanjuan, Carlos Lopera, Felipe García, José Antonio Martínez, Daiana Agüero, Verónica Rico, Pedro Puerta-Alcalde, Carlota Jordan, Fernanda Meira, Alberto Cózar-Llistó, Rodrigo Alonso-Navarro, Nicole Garcia-Pouton, Pedro Castro, Gerard Dueñas, and Celia Cardozo
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Male ,Microbiology (medical) ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Original ,Hospitalized patients ,medicine.medical_treatment ,resultados ,Anti-Inflammatory Agents ,remdesivir ,Antibodies, Monoclonal, Humanized ,Antiviral Agents ,Dexamethasone ,law.invention ,Cohort Studies ,law ,Humans ,Medicine ,Hospital Mortality ,Adverse effect ,Aged ,Pharmacology ,Mechanical ventilation ,Inpatients ,Alanine ,business.industry ,Mortality rate ,COVID-19 ,General Medicine ,Middle Aged ,Antivirals ,Respiration, Artificial ,Intensive care unit ,Adenosine Monophosphate ,COVID-19 Drug Treatment ,Discontinuation ,Intensive Care Units ,Treatment Outcome ,Spain ,Emergency medicine ,outcome ,Antivirales ,Female ,business ,Cohort study - Abstract
Objective. Controversial results on remdesivir efficacy have been reported. We aimed to report our real-life experience with the use of remdesivir from its availability in Spain. Methods. We performed a descriptive study of all patients admitted for ≥48 hours with confirmed COVID-19 who received remdesivir between the 1st of July and the 30th of September 2020. Results. A total of 123 patients out of 242 admitted with COVID-19 at our hospital (50.8%) received remdesivir. Median age was 58 years, 61% were males and 56.9 % received at least one anti-inflammatory treatment. No adverse events requiring remdesivir discontinuation were reported. The need of intensive care unit admission, mechanical ventilation and 30-days mortality were 19.5%, 7.3% and 4.1%, respectively. Conclusion. In our real-life experience, the use of remdesivir in hospitalized patients with COVID-19 was associated with a low mortality rate and good safety profile.
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- 2021
41. THE DEVELOPMENT OF REACHING HAND-PRINTED READING MATERIALS (PREAM) FOR GRADE 2 LEARNERS
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Nicole Garcia Bicomong, Christine, primary
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- 2022
- Full Text
- View/download PDF
42. Evaluation of Pulmonary Fibrosis Outcomes by Race and Ethnicity in US Adults
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Ayodeji Adegunsoye, Elizabeth Freiheit, Emily N. White, Bhavika Kaul, Chad A. Newton, Justin M. Oldham, Cathryn T. Lee, Jonathan Chung, Nicole Garcia, Sahand Ghodrati, Rekha Vij, Renea Jablonski, Kevin R. Flaherty, Paul J. Wolters, Christine Kim Garcia, and Mary E. Strek
- Subjects
General Medicine - Abstract
ImportancePulmonary fibrosis (PF) is characterized by progressive scarring of lung tissue and poor survival. Racial and ethnic minority populations face the greatest risk of morbidity and mortality from disparities impacting respiratory health, but the pattern of age at clinically relevant outcomes across diverse racial and ethnic populations with PF is unknown.ObjectiveTo compare the age at PF-related outcomes and the heterogeneity in survival patterns among Hispanic, non-Hispanic Black, and non-Hispanic White participants.Design, Setting, and ParticipantsThis cohort study included adult patients with a PF diagnosis and used data from prospective clinical registries: the Pulmonary Fibrosis Foundation Registry (PFFR) for the primary cohort and registries from 4 geographically distinct tertiary hospitals in the US for the external multicenter validation (EMV) cohort. Patients were followed between January 2003 and April 2021.ExposuresRace and ethnicity comparisons between Black, Hispanic, and White participants with PF.Main Outcomes and MeasuresAge and sex distribution of participants were measured at the time of study enrollment. All-cause mortality and age at PF diagnosis, hospitalization, lung transplant, and death were assessed in participants over 14 389 person-years. Differences between racial and ethnic groups were compared using Wilcoxon rank sum tests, Bartlett 1-way analysis of variance, and χ2 tests, and crude mortality rates and rate ratios were assessed across racial and ethnic categories using Cox proportional hazards regression models.ResultsIn total, 4792 participants with PF were assessed (mean [SD] age, 66.1 [11.2] years; 2779 [58.0%] male; 488 [10.2%] Black, 319 [6.7%] Hispanic, and 3985 [83.2%] White); 1904 were in the PFFR and 2888 in the EMV cohort. Black patients with PF were consistently younger than White patients (mean [SD] age at baseline, 57.9 [12.0] vs 68.6 [9.6] years; P P P P P Conclusions and RelevanceIn this cohort study of participants with PF, racial and ethnic disparities, especially among Black patients, were found in PF-related outcomes, including earlier onset of death. Further research is essential to identify and mitigate the underlying responsible factors.
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- 2023
43. Patterns of Platelet Mapping Thromboelastography Abnormalities in Trauma
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Seth A. Quinn, Stephen E. Gregg, Nicole Garcia, Yuanyuan Fu, William Irish, and Eric A. Toschlog
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General Medicine - Abstract
Objectives Platelet mapping thromboelastography (TEG-PM) to evaluate trauma induced coagulopathy has become more prevalent. The objective of this study was to evaluate associations between TEG-PM and outcomes in trauma patients, including patients with TBI. Methods A retrospective review was conducted utilizing the American College of Surgeons National Trauma Database. Chart review was conducted to obtain specific TEG-PM parameters. Patients were excluded if they were on anti-platelets, anticoagulation, or received blood products prior to arrival. TEG-PM values and their associations with outcomes were evaluated using generalized linear model and Cox cause-specific hazards model. Outcomes included in-hospital death, hospital and ICU length of stay (LOS). Relative risk (RR) and hazard ratio (HR) and their 95% confidence intervals (CIs) are provided. Results A total of 1066 patients were included, with 151 (14%) diagnosed with isolated TBI. ADP inhibition was associated with significant increase rate of hospital LOS and ICU LOS (RR per % increase = 1.002 and RR = 1.006 per % increase, respectively) while increased MA(AA) and MA(ADP) were significantly associated with decrease rate of hospital LOS and ICU LOS (RR = .993 per mm increase and RR = .989 per mm increase, respectively, and RR = .986 per mm increase and RR = .989 per mm increase). R (per minute increase) and LY30 (per % increase) were associated with increased risk of in-hospital mortality (HR = 1.567 and HR = 1.057, respectively). No TEG-PM values significantly correlated with ISS. Conclusion Specific TEG-PM abnormalities are associated with worse outcomes in trauma patients, including TBI patients. These results require further investigation to understand associations between traumatic injury and coagulopathy.
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- 2023
44. Incidence of co-infections and superinfections in hospitalized patients with COVID-19: a retrospective cohort study
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Carolina Garcia-Vidal, Gemma Sanjuan, Estela Moreno-García, Pedro Puerta-Alcalde, Nicole Garcia-Pouton, Mariana Chumbita, Mariana Fernandez-Pittol, Cristina Pitart, Alexy Inciarte, Marta Bodro, Laura Morata, Juan Ambrosioni, Ignacio Grafia, Fernanda Meira, Irene Macaya, Celia Cardozo, Climent Casals, Adrian Tellez, Pedro Castro, Francesc Marco, Felipe García, Josep Mensa, José Antonio Martínez, Alex Soriano, Verónica Rico, Marta Hernández-Meneses, Daiana Agüero, Berta Torres, Ana González, Lorena de la Mora, Jhon Rojas, Laura Linares, Berta Fidalgo, Natalia Rodriguez, David Nicolas, Laia Albiach, José Muñoz, Alex Almuedo, Daniel Camprubí, Ma Angeles Marcos, Catia Cilloniz, Sara Fernández, Jose M. Nicolas, and Antoni Torres
- Subjects
Male ,0301 basic medicine ,medicine.disease_cause ,0302 clinical medicine ,Pandemic ,Epidemiology ,030212 general & internal medicine ,Cross Infection ,Coinfection ,Incidence ,Incidence (epidemiology) ,Bacterial Infections ,General Medicine ,Middle Aged ,Hospitals ,Infeccions ,Anti-Bacterial Agents ,Bacterial Typing Techniques ,Community-Acquired Infections ,Hospitalization ,Infectious Diseases ,Virus Diseases ,Superinfection ,Female ,Original Article ,Superinfections ,Cohort study ,Microbiology (medical) ,medicine.medical_specialty ,030106 microbiology ,Infections ,03 medical and health sciences ,Internal medicine ,Streptococcus pneumoniae ,medicine ,Humans ,Mortality ,Aged ,Retrospective Studies ,Co-infections ,SARS-CoV-2 ,Pseudomonas aeruginosa ,business.industry ,Sputum ,COVID-19 ,Retrospective cohort study ,Survival Analysis ,Mycoses ,Blood Culture ,Spain ,business - Abstract
Objectives To describe the burden, epidemiology and outcomes of co-infections and superinfections occurring in hospitalized patients with coronavirus disease 2019 (COVID-19). Methods We performed an observational cohort study of all consecutive patients admitted for ≥48 hours to the Hospital Clinic of Barcelona for COVID-19 (28 February to 22 April 2020) who were discharged or dead. We describe demographic, epidemiologic, laboratory and microbiologic results, as well as outcome data retrieved from electronic health records. Results Of a total of 989 consecutive patients with COVID-19, 72 (7.2%) had 88 other microbiologically confirmed infections: 74 were bacterial, seven fungal and seven viral. Community-acquired co-infection at COVID-19 diagnosis was uncommon (31/989, 3.1%) and mainly caused by Streptococcus pneumoniae and Staphylococcus aureus. A total of 51 hospital-acquired bacterial superinfections, mostly caused by Pseudomonas aeruginosa and Escherichia coli, were diagnosed in 43 patients (4.7%), with a mean (SD) time from hospital admission to superinfection diagnosis of 10.6 (6.6) days. Overall mortality was 9.8% (97/989). Patients with community-acquired co-infections and hospital-acquired superinfections had worse outcomes. Conclusions Co-infection at COVID-19 diagnosis is uncommon. Few patients developed superinfections during hospitalization. These findings are different compared to those of other viral pandemics. As it relates to hospitalized patients with COVID-19, such findings could prove essential in defining the role of empiric antimicrobial therapy or stewardship strategies.
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- 2021
45. Retrospective evaluation of the effects and outcome of bromethalin ingestion: 192 Dogs (2010–2016)
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Alicia Thomas, Amy M. Koenigshof, Nyssa A Levy, Katherine Maria Scotti, Nicole Garcia, and Julie Pfeifer
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Male ,040301 veterinary sciences ,Anorexia ,0403 veterinary science ,03 medical and health sciences ,Lethargy ,chemistry.chemical_compound ,Dogs ,0302 clinical medicine ,Interquartile range ,Animals ,Medicine ,Ingestion ,Dog Diseases ,Retrospective Studies ,Aniline Compounds ,General Veterinary ,business.industry ,Poisoning ,Records ,Rodenticides ,030208 emergency & critical care medicine ,Retrospective cohort study ,04 agricultural and veterinary sciences ,Prognosis ,Bromethalin ,United States ,chemistry ,Private practice ,Anesthesia ,Vomiting ,Female ,medicine.symptom ,business - Abstract
Objective To evaluate the frequency of clinical signs, dose ingested, and outcome in a large group of dogs with bromethalin ingestion. Design Retrospective cohort study of dogs from 2010 to 2016. Setting Three university teaching hospitals and 1 private practice. Animals A total of 192 dogs with bromethalin ingestion. Measurements and main results Total 192 cases were identified, of which 25 dogs developed clinical signs. Five cases initially had severe neurological signs and were euthanized. A sum of 187 dogs survived to discharge. The total ingested dose was recorded in 59 dogs with a median (interquartile range) 0.2 mg/kg (0.28 mg/kg). The remaining 133 dogs had confirmed ingestion reported by owners (witnessed ingestion or colored feces) but the total dose could not be calculated. The median (interquartile range) time to presentation for all dogs was 2 hours (4.8 h). A majority of patients were treated on an outpatient basis (121/192) and 71 of 192 were treated as inpatients with 58 of 71 receiving fluid diuresis. Decontamination was performed in 179 dogs including emesis induction (14), activated charcoal administration (42), and both (123). Emesis was successful in 128 dogs and apomorphine was the most common emetic agent (121). Mild to severe clinical signs at admission were reported in 19 cases including vomiting (6), tremors (5), lethargy (4), ataxia (3), weakness (2), diarrhea (2), collapse (2), and and anorexia (2). One case developed ataxia and tremors within 72 hours of admission. Conclusions and clinical relevance Symptoms of bromethalin toxicosis are uncommon, and most ingested doses are well below the reported dose expected to cause clinical signs. In this patient population, prognosis was excellent unless severe clinical signs were noted, which carried a high euthanasia rate. Effects of treatment on outcome could not be evaluated due to the low number of patients that developed clinical signs.
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- 2020
46. The Green Edge cruise: Understanding the onset, life and fate of the Arctic phytoplankton spring bloom
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Flavienne Bruyant, Rémi Amiraux, Marie-Pier Amyot, Philippe Archambault, Lise Artigue, Lucas Bardedo de Freitas, Guislain Bécu, Simon Bélanger, Pascaline Bourgain, Annick Bricaud, Etienne Brouard, Camille Brunet, Tonya Burgers, Danielle Caleb, Katrine Chalut, Hervé Clautre, Véronique Cornet-Barthaux, Pierre Coupel, Marine Cusa, Fanny Cusset, Laeticia Dadaglio, Marty Davelaar, Gabriele Deslongchamps, Céline Dimier, Julie Dinasquet, Dany Dumont, Brent Else, Igor Eulaers, Joannie Ferland, Gabrielle Filteau, Marie-Hélène Forget, Jérome Fort, Louis Fortier, Martí Galí-Tapías, Morgane Gallinari, Svend-Erik Garbus, Nicole Garcia, Catherine Gérikas Ribeiro, Colline Gombault, Priscilla Gourvil, Clémence Goyens, Cindy Grant, Pierre-Luc Grondin, Pascal Guillot, Sandrine Hillion, Rachel Hussher, Fabien Joux, Hannah Joy-Warren, Gabriel Joyal, David Kieber, Augustin Lafond, José Lagunas, Patrick Lajeunesse, Catherine Lalande, Jade Larivière, Florence Le Gall, Karine Leblanc, Mathieu Leblanc, Justine Legras, Keith Levesque, Kate-Marie Lewis, Edouard Leymarie, Aude Leynaert, Thomas Linkowski, Martine Lizotte, Adriana Lopes dos Santos, Claudie Marec, Dominique Marie, Guillaume Massé, Philippe Massicotte, Atsushi Matsuoka, Lisa Miller, Sharif Mirshak, Nathalie Morata, Brivaela Moriceau, Philippe-Israël Morin, Simon Morisset, Anders Mosbech, Alfonso Mucci, Gabrielle Nadaï, Christian Nozais, Ingrid Obernosterer, Timothe Paire, Christos Panagiotopoulos, Marie Parenteau, Noémie Pelletier, Marc Picheral, Bernard Quéguiner, Patrick Raimbault, Joséphine Ras, Eric Rehm, Llúcia Ribot Lacosta, Jean-François Rontani, Blanche Saint-Béat, Julie Sansoulet, Noé Sardet, Catherine Schmechtig, Antoine Sciandra, Richard Sempéré, Caroline Sévigny, Jordan Toullec, Margot Tragin, Jean-Eric Tremblay, Annie-Pier Trottier, Daniel Vaulot, Anda Vladoiu, Lei Xue, Gustavo Yunda-Guarin, and Marcel Babin
- Abstract
The Green Edge project was designed to investigate the onset, life and fate of a phytoplankton spring bloom (PSB) in the Arctic Ocean. The lengthening of the ice-free period and the warming of seawater, amongst other factors, have induced major changes in arctic ocean biology over the last decades. Because the PSB is at the base of the Arctic Ocean food chain, it is crucial to understand how changes in the arctic environment will affect it. Green Edge was a large multidisciplinary collaborative project bringing researchers and technicians from 28 different institutions in seven countries, together aiming at understanding these changes and their impacts into the future. The fieldwork for the Green Edge project took place over two years (2015 and 2016) and was carried out from both an ice-camp and a research vessel in the Baffin Bay, canadian arctic. This paper describes the sampling strategy and the data set obtained from the research cruise, which took place aboard the Canadian Coast Guard Ship (CCGS) Amundsen in spring 2016. The dataset is available at https://doi.org/10.17882/59892 (Massicotte et al., 2019a).
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- 2022
47. Impact of Empirical Antibiotic Regimens on Mortality in Neutropenic Patients with Bloodstream Infection Presenting with Septic Shock
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Alex Soriano, Júlia Laporte-Amargós, Mariana Chumbita, Jordi Carratalà, Maria Condom, Carolina Garcia-Vidal, Andrea Ladino, María Suárez-Lledó, Carlota Gudiol, Francesc Marco, Enric Sastre, Ignacio Grafia, Josep Mensa, Alba Bergas, Cristina Helguera, José Antonio Martínez, Adaia Albasanz-Puig, Pedro Castro, Nicole Garcia-Pouton, Xavier Durà, Carlota Jordan, and Pedro Puerta-Alcalde
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medicine.medical_specialty ,Multivariate analysis ,Combination therapy ,medicine.drug_class ,Antibiotics ,Bacteremia ,Clinical Therapeutics ,Internal medicine ,Bloodstream infection ,Sepsis ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,Aged ,Retrospective Studies ,Pharmacology ,business.industry ,Septic shock ,Acute kidney injury ,Retrospective cohort study ,bacterial infections and mycoses ,medicine.disease ,Shock, Septic ,Anti-Bacterial Agents ,Infectious Diseases ,Amikacin ,business ,medicine.drug - Abstract
We analyzed risk factors for mortality in febrile neutropenic patients with bloodstream infections (BSI) presenting with septic shock and assessed the impact of empirical antibiotic regimens. A multicenter retrospective study (2010 to 2019) of two prospective cohorts compared BSI episodes in patients with or without septic shock. Multivariate analysis was performed to identify independent risk factors for mortality in episodes with septic shock. Of 1,563 patients with BSI, 257 (16%) presented with septic shock. Those patients with septic shock had higher mortality than those without septic shock (55% versus 15%, P 70 years (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.2 to 4.7), IEAT for Candida spp. or Gram-negative bacilli (OR, 3.8; 95% CI, 1.3 to 11.1), acute kidney injury (OR, 2.6; 95% CI, 1.4 to 4.9), and amikacin as the only active antibiotic (OR, 15.2; 95% CI, 1.7 to 134.5) were independent risk factors for mortality, while the combination of β-lactam and amikacin was protective (OR, 0.32; 95% CI, 0.18 to 0.57). Septic shock in febrile neutropenic patients with BSI is associated with extremely high mortality, especially when IEAT is administered. Combination therapy including an active β-lactam and amikacin results in the best outcomes.
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- 2022
48. Personalized Therapy Approach for Hospitalized Patients with Coronavirus Disease 2019
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Laura Linares, Pedro Castro, Jose Muñoz, Verónica Rico, Marta Hernández-Meneses, David Vidal, Carolina Garcia-Vidal, Celia Cardozo, José Antonio Martínez, Jose María Nicolás, Josep Mensa, Pedro Puerta-Alcalde, Estela Moreno-García, Nicole Garcia-Pouton, Alex Soriano, Mariana Chumbita, Felipe García, and Covid Researchers
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0301 basic medicine ,Microbiology (medical) ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Hospitalized patients ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,030106 microbiology ,Personalized treatment ,medicine.disease ,03 medical and health sciences ,Pneumonia ,0302 clinical medicine ,Infectious Diseases ,Internal medicine ,Medicine ,030212 general & internal medicine ,Personalized therapy ,business - Abstract
Hospitalized patients with coronavirus disease 2019 (COVID-19) experiencing respiratory symptoms have different complications (inflammatory, co-infection, and thrombotic) that are identifiable by analytics patterns. Personalized treatment decisions decreased early mortality (odds ratio [OR] .144; 95% confidence interval [CI] .03–.686; P = .015). Increasing age (OR 1.06; P = .038) and therapeutic effort limitation (OR 9.684; P
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- 2020
49. Up-to-Date Infection Control Practices for Febrile Neutropenic Patients
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Hugo Manuel Paz Morales, Alex Soriano, Mariana Chumbita, Pedro Puerta-Alcalde, Estela Moreno-García, Nicole Garcia-Pouton, Gemma Sanjuan-Gomez, and Carolina Garcia-Vidal
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0301 basic medicine ,Cultural Studies ,Linguistics and Language ,History ,medicine.medical_specialty ,medicine.medical_treatment ,media_common.quotation_subject ,030106 microbiology ,Population ,Neutropenia ,Language and Linguistics ,03 medical and health sciences ,0302 clinical medicine ,Hygiene ,Medicine ,Infection control ,030212 general & internal medicine ,Antibiotic prophylaxis ,education ,Intensive care medicine ,media_common ,education.field_of_study ,business.industry ,medicine.disease ,Anthropology ,Contact isolation ,business ,Central venous catheter - Abstract
Neutropenia and its related infections are still a significant challenge in the treatment of patients with onco-hematological diseases, impacting increased mortality and morbidity. In this review, we compiled up-to-date scientific evidence on infection control in neutropenic patients and discussed the potential role of new technologies Traditional measures such as hand hygiene (HH), patient’s skincare, central venous catheter care, environment protection, and contact isolation are the cornerstone of infection prevention in neutropenic patients while antibiotic prophylaxis is still a debated issue. Multidrug-resistant organisms (MDRO) are increasing as reported in this population, and new techniques such as decolonization and the use of predictive models for infection by MDRO could play a pivotal role. Well-established measures should always be enhanced and stimulated. New technological tools based on artificial intelligence algorithms could lead to personalized infection control practices and better outcomes. More studies are needed to evaluate these new tools in the real-world setting.
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- 2020
50. Dermatofitose disseminada em paciente de psoríase em uso dimunobiológico/Disseminated dermatophytosis in psoriasis patient using immunobiology
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Carneiro, Francisca Regina Oliveira, Góes, Nicole Garcia dos Santos, Savino, Beatriz Amaral Costa, Cruz, Matheus Ferreira Santos da, Cruz, Sergio Ferreira Santos da, Mafra, Eduarda Gabriel, Mafra, Bárbara Gabriel, Ribeiro, Samuel Soares, and Melo, Matheus Moreira de
- Subjects
Dermatofitose ,General Medicine ,Psoríase ,Imunomoduladores - Abstract
Introdução: A psoríase é uma doença inflamatória crônica que atinge cerca de 1% a 3% da população no mundo inteiro, sendo que seu tratamento envolve o uso de imunomoduladores biológicos Objetivo: Relatar um caso de dermatofitose disseminada em paciente em uso de imunobiológico devido Psoríase. Apresentação de Caso: Masculino, 55 anos, com queixa de surgimento de lesões avermelhadas em tronco, abdômen, membros superiores e inferiores. Referiu ser portador de Psoríase e Artrite Psoriásica em tratamento com Secuquinumabe subcutâneo há 3 meses. Ao exame dermatológico, placas eritematoescamosas circinadas, com vesículas e crostas na periferia e tendência de cura central, disseminadas pelo tronco MMSS e MMII com tamanho variando de 2 a 8 cm de diâmetro. Micológico direto revelando hifas hialinas septadas compatíveis com dermatófitos e cultura com Trychophyton rubrum. Conduta: troca da medicação imunobiológica e introdução de Griseofulvina. Conclusão: A ocorrência de efeitos colaterais decorrentes da utilização das medicações imunobiológicas, como o secuquinumabe, para Psoríase depreciam o sistema de defesa do paciente e propiciam a disseminação de microorganismos, sobretudo de fungos.
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- 2020
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