Publications

Highlights What are the main findings? center dot The smartphone-based portable monitoring system enabled detection of previously undiagnosed sleep apnea among post-stroke patients undergoing rehabilitation. center dot Greater sleep-disordered respiratory events and nocturnal hypoxemia were associated with worse baseline disability and lower rehabilitation metrics. What are the implications of the main findings? center dot The portable system was easy to use, facilitating sleep apnea detection after stroke and supporting broader implementation in rehabilitation settings. center dot Routine screening for sleep-disordered breathing at admission may enable earlier diagnosis and management in patients with substantial hypoxemia/event burden that could slow functional recovery. Sleep-disordered breathing (SDB) is common after stroke and may negatively influence recovery, yet it is frequently underdiagnosed. Portable respiratory monitoring devices could facilitate early SDB screening in these patients. We estimated the prevalence of sleep apnea (SA) using a smartphone-based monitoring system in post-stroke patients and examined associations between respiratory indices, stroke severity and disability (NIHSS, mRS), and rehabilitation outcomes (motor and cognitive Functional Independence Measure; FIM). Consecutive patients admitted to inpatient rehabilitation within three months after a stroke underwent an overnight assessment with a smartphone-based respiratory monitoring device, which estimated the apnea-hypopnea index (AHI), mean and minimum SpO(2), time with SpO(2) < 94% and = 3% and >= 4%). Of the 104 screened patients, 59 were recruited, while 56 had valid recordings. Most patients (89%) had previously undiagnosed SA: 11% mild (AHI >= 5 and = 15 and = 30). Greater event burden and nocturnal hypoxemia were associated with older age, worse baseline disability (mRS), lower admission motor FIMs, and poorer rehabilitation metrics. Smartphone-based portable monitoring is an accessible, easy-to-use approach that may enable earlier identification of SA, particularly in individuals with substantial hypoxemia or respiratory event burden.

JTD Keywords: Apnea, Disturbance, Functional outcomes, Impact, Nocturnal hypoxemia, Portable device, Reliability, Risk, Sleep apnea, Sleep-disordered breathing, Stroke

The Boston Keratoprosthesis (BKPro) serves as a medical solution for restoring vision in complex cases of corneal blindness. Comprising a front plate made of polymethylmethacrylate (PMMA) and a back plate of titanium (Ti), this device utilizes the beneficial biomaterial properties of Ti. While BKPro demonstrates promising retention rates, infection emerges as a significant concern that impacts its long-term efficacy. However, limited research exists on enhancement of BKPros through intrinsic infection-preventing mechanisms. In this regard, metal ions, especially the well-known Ag+ ions, are a promising alternative to obtain implants with innate antibacterial properties. However, little information is available about the effects of Ag in corneal tissue, especially within human corneal keratocytes (HCKs). In this work, an electrodeposition treatment using a constant pulse is proposed to attach Ag complexes onto rough Ti surfaces, thus providing antibacterial properties without inducing cytotoxicity. Complete physicochemical characterization and ion release studies were carried out with both control and Ag-treated samples. The possible cytotoxic effects in the short and long term were evaluated in vitro with HCKs. Moreover, the antibacterial properties of the silver-treated surfaces were tested against the gram-negative bacterial strain Pseudomonas aeruginosa and the gram-positive strain Staphylococcus epidermidis, that are common contributors to infections in BKPros. Physicochemical characterization confirmed the presence of silver, predominantly in oxide form, with low release of Ag+ ions. Ag-treated surfaces demonstrated no cytotoxicity and promoted long-term proliferation of HCKs. Furthermore, the silver-treated surfaces exhibited a potent antibacterial effect, causing a reduction in bacterial adhesion and evident damage to the bacterial cell walls of P. aeruginosa and S. epidermidis. The low release of Ag+ ions suggested reactive oxygen species (ROS)-mediated oxidative stress imbalance as the bactericidal mechanism of the silver deposits. In conclusion, the proposed electrodeposition technique confers antibacterial protection to the Ti backplate of BKPro, mitigating implant-threatening infections while ensuring non-cytotoxicity within the corneal tissue.

JTD Keywords: Antibacterial properties, Biofilm, Boston keratoprosthesis (bkpro), Corneal blindness, Cytotoxicicity, Cytotoxicit, Electrodeposition, I keratoprosthesis, Infection, Infectious endophthalmitis, Ion, Long-term outcomes, Nanoparticles, Silver depositio, Surface, Titanium (ti)

Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer, with survival rates exceeding 85%. However, 15% of patients will relapse; consequently, their survival rates decrease to below 50%. Therefore, several research and innovation studies are focusing on pediatric relapsed or refractory ALL (R/R ALL). Driven by this context and following the European strategic plan to implement precision medicine equitably, the Relapsed ALL Network (ReALLNet) was launched under the umbrella of SEHOP in 2021, aiming to connect bedside patient care with expert groups in R/R ALL in an interdisciplinary and multicentric network. To achieve this objective, a board consisting of experts in diagnosis, management, preclinical research, and clinical trials has been established. The requirements of treatment centers have been evaluated, and the available oncogenomic and functional study resources have been assessed and organized. A shipping platform has been developed to process samples requiring study derivation, and an integrated diagnostic committee has been established to report results. These biological data, as well as patient outcomes, are collected in a national registry. Additionally, samples from all patients are stored in a biobank. This comprehensive repository of data and samples is expected to foster an environment where preclinical researchers and data scientists can seek to meet the complex needs of this challenging population. This proof of concept aims to demonstrate that a network-based organization, such as that embodied by ReALLNet, provides the ideal niche for the equitable and efficient implementation of "what's next" in the management of children with R/R ALL.© 2023 Velasco, Bautista, Rubio, Aguilar, Rives, Dapena, Pérez, Ramirez, Saiz-Ladera, Izquierdo, Escudero, Camós, Vega-Garcia, Ortega, Hidalgo-Gómez, Palacio, Menéndez, Bueno, Montero, Romecín, Zazo, Alvarez, Parras, Ortega-Sabater, Chulián, Rosa, Cirillo, García, García, Manzano-Muñoz, Minguela and Fuster.

JTD Keywords: artificial intelligence, cancer registry, children, discovery, functional assay, outcomes, precision medicine, risk-factors, Artificial intelligence, B-cell precursor, Cancer registry, Functional assay, Precision medicine, Relapsed acute lymphoblastic leukemia