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1.
Proc Natl Acad Sci U S A ; 121(17): e2314772121, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38621122

RESUMO

Dynamic networks composed of constituents that break and reform bonds reversibly are ubiquitous in nature owing to their modular architectures that enable functions like energy dissipation, self-healing, and even activity. While bond breaking depends only on the current configuration of attachment in these networks, reattachment depends also on the proximity of constituents. Therefore, dynamic networks composed of macroscale constituents (not benefited by the secondary interactions cohering analogous networks composed of molecular-scale constituents) must rely on primary bonds for cohesion and self-repair. Toward understanding how such macroscale networks might adaptively achieve this, we explore the uniaxial tensile response of 2D rafts composed of interlinked fire ants (S. invicta). Through experiments and discrete numerical modeling, we find that ant rafts adaptively stabilize their bonded ant-to-ant interactions in response to tensile strains, indicating catch bond dynamics. Consequently, low-strain rates that should theoretically induce creep mechanics of these rafts instead induce elastic-like response. Our results suggest that this force-stabilization delays dissolution of the rafts and improves toughness. Nevertheless, above 35[Formula: see text] strain low cohesion and stress localization cause nucleation and growth of voids whose coalescence patterns result from force-stabilization. These voids mitigate structural repair until initial raft densities are restored and ants can reconnect across defects. However mechanical recovery of ant rafts during cyclic loading suggests that-even upon reinstatement of initial densities-ants exhibit slower repair kinetics if they were recently loaded at faster strain rates. These results exemplify fire ants' status as active agents capable of memory-driven, stimuli-response for potential inspiration of adaptive structural materials.


Assuntos
Formigas , Formigas Lava-Pés , Animais , Formigas/fisiologia , Física , Microdomínios da Membrana
2.
Nat Mater ; 23(2): 281-289, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38177377

RESUMO

Some animals form transient, responsive and solid-like ensembles through dynamic structural interactions. These ensembles demonstrate emergent responses such as spontaneous self-assembly, which are difficult to achieve in synthetic soft matter. Here we use shape-morphing units comprising responsive polymers to create solids that self-assemble, modulate their volume and disassemble on demand. The ensemble is composed of a responsive hydrogel, liquid crystal elastomer or semicrystalline polymer ribbons that reversibly bend or twist. The dispersions of these ribbons mechanically interlock, inducing reversible aggregation. The aggregated liquid crystal elastomer ribbons have a 12-fold increase in the yield stress compared with cooled dispersion and contract by 34% on heating. Ribbon type, concentration and shape dictate the aggregation and govern the global mechanical properties of the solid that forms. Coating liquid crystal elastomer ribbons with a liquid metal begets photoresponsive and electrically conductive aggregates, whereas seeding cells on hydrogel ribbons enables self-assembling three-dimensional scaffolds, providing a versatile platform for the design of dynamic materials.

3.
PLoS Pathog ; 19(5): e1011391, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-37228157

RESUMO

Coccidioidomycosis is a typically respiratory fungal disease that, in the United States, occurs primarily in Arizona and California. In California, most coccidioidomycosis cases occur in the San Joaquin Valley, a primarily agricultural region where the disease poses a risk for outdoor workers. We collected 710 soil samples and 265 settled dust samples from nine sites in the San Joaquin Valley and examined how Coccidioides detection varied by month, site, and the presence and abundance of other fungal species. We detected Coccidioides in 89 of 238 (37.4%) rodent burrow soil samples at five undeveloped sites and were unable to detect Coccidioides in any of 472 surface and subsurface soil samples at four agricultural sites. In what is the largest sampling effort undertaken on agricultural land, our results provide no evidence that agricultural soils in the San Joaquin Valley harbor Coccidioides. We found no clear association between Coccidioides and the greater soil fungal community, but we identified 19 fungal indicator species that were significantly associated with Coccidioides detection in burrows. We also did not find a seasonal pattern in Coccidioides detection in the rodent burrow soils we sampled. These findings suggest both the presence of a spore bank and that coccidioidomycosis incidence may be more strongly associated with Coccidioides dispersal than Coccidioides growth. Finally, we were able to detect Coccidioides in only five of our 265 near-surface settled dust samples, one from agricultural land, where Coccidioides was undetected in soils, and four from undeveloped land, where Coccidioides was common in the rodent burrow soils we sampled. Our ability to detect Coccidioides in few settled dust samples indicates that improved methods are likely needed moving forward, though raises questions regarding aerial dispersal in Coccidioides, whose key transmission event likely occurs over short distances in rodent burrows from soil to naïve rodent lungs.


Assuntos
Coccidioidomicose , Micobioma , Animais , Coccidioides , Coccidioidomicose/diagnóstico , Coccidioidomicose/epidemiologia , Coccidioidomicose/etiologia , Solo , Poeira , Roedores
4.
Am J Gastroenterol ; 2024 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-39162745

RESUMO

INTRODUCTION: Recent associative studies have linked intrapancreatic fat deposition (IPFD) with risk of pancreatitis, but the causal relationship remains unclear. METHODS: Using Mendelian randomization, we evaluated the causal association between genetically predicted IPFD and pancreatitis. This approach used genetic variants from genomewide association studies of IPFD (n = 25,617), acute pancreatitis (n = 6,787 cases/361,641 controls), and chronic pancreatitis (n = 3,875 cases/361,641 controls). RESULTS: Genetically predicted IPFD was significantly associated with acute pancreatitis (odds ratio per 1-SD increase: 1.40 [95% CI: 1.12-1.76], P = 0.0032) and chronic pancreatitis (odds ratio: 1.64 [95% CI: 1.13-2.39], P = 0.0097). DISCUSSION: Our findings support a causal role of IPFD in pancreatitis, suggesting that reducing IPFD could lower the risk of pancreatitis.

5.
Cardiovasc Diabetol ; 23(1): 306, 2024 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-39175055

RESUMO

BACKGROUND: Metabolic clusters can stratify subgroups of individuals at risk for type 2 diabetes mellitus and related complications. Since obesity and insulin resistance are closely linked to alterations in hemostasis, we investigated the association between plasmatic coagulation and metabolic clusters including the impact on survival. METHODS: Utilizing data from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, we assigned 917 participants without diabetes to prediabetes clusters, using oGTT-derived glucose and insulin, high-density lipoprotein cholesterol, triglycerides, and anthropometric data. We performed a comprehensive analysis of plasmatic coagulation parameters and analyzed their associations with mortality using proportional hazards models. Mediation analysis was performed to assess the effect of coagulation factors on all-cause mortality in prediabetes clusters. RESULTS: Prediabetes clusters were assigned using published tools, and grouped into low-risk (clusters 1,2,4; n = 643) and high-risk (clusters 3,5,6; n = 274) clusters. Individuals in the high-risk clusters had a significantly increased risk of death (HR = 1.30; CI: 1.01 to 1.67) and showed significantly elevated levels of procoagulant factors (fibrinogen, FVII/VIII/IX), D-dimers, von-Willebrand factor, and PAI-1, compared to individuals in the low-risk clusters. In proportional hazards models adjusted for relevant confounders, elevated levels of fibrinogen, D-dimers, FVIII, and vWF were found to be associated with an increased risk of death. Multiple mediation analysis indicated that vWF significantly mediates the cluster-specific risk of death. CONCLUSIONS: High-risk prediabetes clusters are associated with prothrombotic changes in the coagulation system that likely contribute to the increased mortality in those individuals at cardiometabolic risk. The hypercoagulable state observed in the high-risk clusters indicates an increased risk for cardiovascular and thrombotic diseases that should be considered in future risk stratification and therapeutic strategies.


Assuntos
Biomarcadores , Fatores de Coagulação Sanguínea , Coagulação Sanguínea , Causas de Morte , Angiografia Coronária , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/sangue , Estado Pré-Diabético/mortalidade , Estado Pré-Diabético/diagnóstico , Masculino , Pessoa de Meia-Idade , Feminino , Medição de Risco , Idoso , Biomarcadores/sangue , Fatores de Coagulação Sanguínea/metabolismo , Fatores de Coagulação Sanguínea/análise , Prognóstico , Doença da Artéria Coronariana/mortalidade , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico por imagem , Glicemia/metabolismo , Fatores de Risco , Análise de Mediação , Valor Preditivo dos Testes , Diabetes Mellitus Tipo 2/mortalidade , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico
6.
Liver Int ; 44(1): 27-38, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37697960

RESUMO

BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) has been linked to type 2 diabetes (T2D), but also to hypothyroidism. Nevertheless, the relationship between thyroid function and NAFLD in diabetes is less clear. This study investigated associations between free thyroxine (fT4) or thyroid-stimulating hormone (TSH) and NAFLD in recent-onset diabetes. METHODS: Participants with recent-onset type 1 diabetes (T1D, n = 358), T2D (n = 596) or without diabetes (CON, n = 175) of the German Diabetes Study (GDS), a prospective longitudinal cohort study, underwent Botnia clamp tests and assessment of fT4, TSH, fatty liver index (FLI) and in a representative subcohort 1 H-magnetic resonance spectroscopy. RESULTS: First, fT4 levels were similar between T1D and T2D (p = .55), but higher than in CON (T1D: p < .01; T2D: p < .001), while TSH concentrations were not different between all groups. Next, fT4 correlated negatively with FLI and positively with insulin sensitivity only in T2D (ß = -.110, p < .01; ß = .126, p < .05), specifically in males (ß = -.117, p < .05; ß = .162; p < .01) upon adjustments for age, sex and BMI. However, correlations between fT4 and FLI lost statistical significance after adjustment for insulin sensitivity (T2D: ß = -.021, p = 0.67; males with T2D: ß = -.033; p = .56). TSH was associated positively with FLI only in male T2D before (ß = .116, p < .05), but not after adjustments for age and BMI (ß = .052; p = .30). CONCLUSIONS: Steatosis risk correlates with lower thyroid function in T2D, which is mediated by insulin resistance and body mass, specifically in men, whereas no such relationship is present in T1D.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Resistência à Insulina , Hepatopatia Gordurosa não Alcoólica , Glândula Tireoide , Humanos , Masculino , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Estudos Longitudinais , Hepatopatia Gordurosa não Alcoólica/complicações , Estudos Prospectivos , Glândula Tireoide/fisiologia , Tireotropina
7.
Diabetes Obes Metab ; 26(1): 339-350, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37869933

RESUMO

AIMS: Exercise training induces white adipose tissue (WAT) beiging and improves glucose homeostasis and mitochondrial function in rodents. This could be relevant for type 2 diabetes in humans, but the effect of physical fitness on beiging of subcutaneous WAT (scWAT) remains unclear. This translational study investigates if beiging of scWAT associates with physical fitness in healthy humans and recent-onset type 2 diabetes and if a voluntary running wheel intervention is sufficient to induce beiging in mice. MATERIALS AND METHODS: Gene expression levels of established beiging markers were measured in scWAT biopsies of humans with (n = 28) or without type 2 diabetes (n = 28), stratified by spiroergometry into low (L-FIT; n = 14 each) and high physical fitness (H-FIT; n = 14 each). High-fat diet-fed FVB/N mice underwent voluntary wheel running, treadmill training or no training (n = 8 each group). Following the training intervention, mitochondrial respiration and content of scWAT were assessed by high-resolution respirometry and citrate synthase activity, respectively. RESULTS: Secreted CD137 antigen (Tnfrsf9/Cd137) expression was three-fold higher in glucose-tolerant H-FIT than in L-FIT, but not different between H-FIT and L-FIT with type 2 diabetes. In mice, both training modalities increased Cd137 expression and enhanced mitochondrial content without changing respiration in scWAT. Treadmill but not voluntary wheel running led to improved whole-body insulin sensitivity. CONCLUSIONS: Higher physical fitness and different exercise interventions associated with higher gene expression levels of the beiging marker CD137 in healthy humans and mice on a high-fat diet. Humans with recent-onset type 2 diabetes show an impaired adipose tissue-specific response to physical activity.


Assuntos
Diabetes Mellitus Tipo 2 , Dieta Hiperlipídica , Humanos , Camundongos , Animais , Atividade Motora , Diabetes Mellitus Tipo 2/metabolismo , Gordura Subcutânea/metabolismo , Tecido Adiposo Branco/metabolismo , Tecido Adiposo , Aptidão Física , Glucose/metabolismo
8.
Diabetes Obes Metab ; 26(10): 4281-4292, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39010284

RESUMO

AIM: To investigate the associations of the Dietary Approaches to Stop Hypertension (DASH) score with subcutaneous (SAT) and visceral (VAT) adipose tissue volume and hepatic lipid content (HLC) in people with diabetes and to examine whether changes in the DASH diet were associated with changes in these outcomes. METHODS: In total, 335 participants with recent-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) from the German Diabetes Study were included in the cross-sectional analysis, and 111 participants in the analysis of changes during the 5-year follow-up. Associations between the DASH score and VAT, SAT and HLC and their changes were investigated using multivariable linear regression models by diabetes type. The proportion mediated by changes in potential mediators was determined using mediation analysis. RESULTS: A higher baseline DASH score was associated with lower HLC, especially in people with T2D (per 5 points: -1.5% [-2.7%; -0.3%]). Over 5 years, a 5-point increase in the DASH score was associated with decreased VAT in people with T2D (-514 [-800; -228] cm3). Similar, but imprecise, associations were observed for VAT changes in people with T1D (-403 [-861; 55] cm3) and for HLC in people with T2D (-1.3% [-2.8%; 0.3%]). Body mass index and waist circumference changes explained 8%-48% of the associations between DASH and VAT changes in both groups. In people with T2D, adipose tissue insulin resistance index (Adipo-IR) changes explained 47% of the association between DASH and HLC changes. CONCLUSIONS: A shift to a DASH-like diet was associated with favourable VAT and HLC changes, which were partly explained by changes in anthropometric measures and Adipo-IR.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Abordagens Dietéticas para Conter a Hipertensão , Gordura Intra-Abdominal , Fígado , Humanos , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/metabolismo , Masculino , Feminino , Gordura Intra-Abdominal/metabolismo , Diabetes Mellitus Tipo 1/dietoterapia , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/complicações , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Abordagens Dietéticas para Conter a Hipertensão/métodos , Fígado/metabolismo , Alemanha/epidemiologia , Cooperação do Paciente/estatística & dados numéricos , Seguimentos , Metabolismo dos Lipídeos/fisiologia , Gordura Subcutânea/metabolismo
9.
Clin Chem Lab Med ; 62(4): 762-769, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-37870928

RESUMO

OBJECTIVES: Estimates of glucose concentrations vary among types of blood samples, which impact on the assessment of diabetes prevalence. Guidelines recommend a conversion factor to calculate plasma glucose from measurements of glucose in whole blood. The American Diabetes Association recommends the use of blood drawing tubes containing sodium fluoride (NaF) and citrate, which have not yet been evaluated regarding possible differences in glucose concentration and conversion factors. Thus, we compared glucose measurements in NaF-citrate plasma and venous whole blood and estimated the impact of differences on diabetes and prediabetes prevalence. METHODS: Glucose differences were calculated by Bland-Altman analysis with pairwise comparison of glucose measurements from whole blood and NaF-citrate plasma (n=578) in clinical studies of the German Diabetes Center. Subsequently, we computed the impact of the glucose difference on diabetes and prediabetes prevalence in the population-based National Health and Nutrition Examination Survey (NHANES). RESULTS: Even upon conversion of whole blood to plasma glucose concentrations using the recommended conversion factor, mean glucose concentration difference remained 4.72 % higher in NaF-citrate plasma. Applying the higher glucose estimates, increases the population-based diabetes and prediabetes prevalence by 13.67 and 33.97 % or more than 7.2 and 13 million people in NHANES, respectively. Additional economic burden could be about 20 $ billion per year due to undiagnosed diabetes. CONCLUSIONS: The recommended conversion factor is not valid for NaF-citrate plasma. Systematic bias of glucose measurements due to sampling type leads to clinically relevant higher estimates of diabetes and prediabetes prevalence.


Assuntos
Diabetes Mellitus , Estado Pré-Diabético , Humanos , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologia , Ácido Cítrico , Fluoreto de Sódio , Citrato de Sódio , Inquéritos Nutricionais , Glicemia/análise , Fluoretos , Prevalência , Glicólise , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Citratos
10.
Nutr Metab Cardiovasc Dis ; 34(4): 911-924, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38418350

RESUMO

BACKGROUND AND AIMS: Differences of dietary pattern adherence across the novel diabetes endotypes are unknown. This study assessed adherence to pre-specified dietary patterns and their associations with cardiovascular risk factors, kidney function, and neuropathy among diabetes endotypes. METHODS AND RESULTS: The cross-sectional analysis included 765 individuals with recent-onset (67 %) and prevalent diabetes (33 %) from the German Diabetes Study (GDS) allocated into severe autoimmune diabetes (SAID, 35 %), severe insulin-deficient diabetes (SIDD, 3 %), severe insulin-resistant diabetes (SIRD, 5 %), mild obesity-related diabetes (MOD, 28 %), and mild age-related diabetes (MARD, 29 %). Adherence to a Mediterranean diet score (MDS), Dietary Approaches to Stop Hypertension (DASH) score, overall plant-based diet (PDI), healthful (hPDI) and unhealthful plant-based diet index (uPDI) was derived from a food frequency questionnaire and associated with cardiovascular risk factors, kidney function, and neuropathy using multivariable linear regression analysis. Differences in dietary pattern adherence between endotypes were assessed using generalized mixed models. People with MARD showed the highest, those with SIDD and MOD the lowest adherence to the hPDI. Adherence to the MDS, DASH, overall PDI, and hPDI was inversely associated with high-sensitivity C-reactive protein (hsCRP) among people with MARD (ß (95%CI): -9.18 % (-15.61; -2.26); -13.61 % (-24.17; -1.58); -19.15 % (-34.28; -0.53); -16.10 % (-28.81; -1.12), respectively). Adherence to the PDIs was associated with LDL cholesterol among people with SAID, SIRD, and MOD. CONCLUSIONS: Minor differences in dietary pattern adherence (in particular for hPDI) and associations with markers of diabetes-related complications (e.g. hsCRP) were observed between endotypes. So far, evidence is insufficient to derive endotype-specific dietary recommendations. TRIAL REGISTRATION: Clinicaltrials.gov: NCT01055093.


Assuntos
Diabetes Mellitus Tipo 1 , Dieta Mediterrânea , Insulinas , Humanos , Padrões Dietéticos , Proteína C-Reativa , Estudos Transversais , Dieta , Dieta Vegetariana
11.
Cardiol Young ; 34(6): 1312-1324, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38287708

RESUMO

BACKGROUND: Complex CHDs are life threatening, and surgical treatment is needed for survival. Fontan palliation led to a significant increase in survival rates during the last decades. Consequently, quality of life became more essential. While a reduced quality of life compared to healthy children has been reported, detailed knowledge about individual quality of life and particular areas is lacking. Furthermore, the effect of different risk factors on quality of life is only rarely evaluated. METHOD AND RESULTS: Database of the department for pediatric cardiology, Heart Center Leipzig, was screened for children after total cavopulmonary connection palliation. n = 39 patients were included in the study, the outcome after total cavopulmonary connection was analysed in detail and quality of life data were collected and analysed using the standardised questionnaire "Pediatric quality of life inventory", version 4.0. We compared the total health score of our patients to the mean score of healthy children in the literature. The mean follow-up time was 6.4 ± 3.2 years, the overall survival was 100% after maximal follow-up time of 11.1 years. We could not find any age or gender dependence, nor an influence of age at total cavopulmonary connection on the later quality of life. Yet, patients with three-staged surgery exhibited a worse quality of life than patients with two-staged palliation. Late complications might influence quality of life, but patient number is too small, to find universal results. CONCLUSION: The total cavopulmonary connection palliation affects physical and psychological quality of life as well as cardiac health independently from age and gender. More patients and longer observation should be examined to confirm the results.


Assuntos
Técnica de Fontan , Cardiopatias Congênitas , Cuidados Paliativos , Qualidade de Vida , Humanos , Masculino , Feminino , Técnica de Fontan/métodos , Seguimentos , Criança , Pré-Escolar , Cardiopatias Congênitas/cirurgia , Cardiopatias Congênitas/psicologia , Cuidados Paliativos/métodos , Inquéritos e Questionários , Adolescente , Estudos Retrospectivos , Lactente , Alemanha/epidemiologia , Taxa de Sobrevida/tendências , Resultado do Tratamento , Fatores de Risco
12.
Arch Orthop Trauma Surg ; 144(8): 3237-3245, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38967783

RESUMO

INTRODUCTION: Treatment for complex olecranon fractures with metaphyseal comminution can be challenging. To improve reduction maneuvers and augment stability, we apply a small medial and/or lateral locking compression plate (LCP) prior to placing a posterior contoured 3.5 mm-2.7 mm LCP. The aim is to describe our technique and outcomes of this "orthogonal" plating technique. MATERIAL AND METHODS: 26 patients were treated with orthogonal plating. Clinical outcome variables were available for all patients at a median of 27 months (IQR 6-54), and patient-reported outcomes (Q-DASH and MEPS) for 23 patients at 38 months (IQR 18-71). RESULTS: All fractures healed at a median of 2.0 months (IQR 1.5-3.8). The median elbow flexion was 120°, extension-deficit 15°, pronation 88°, and supination 85°. The median Q-DASH was 9 (IQR 0-22) and the median MEPS was 90 (IQR 80-100). Hardware was electively removed in seven patients. One patient had a late superficial infection that resolved with hardware removal and antibiotics, and one patient had two consecutive re-fractures after two hardware removals; and healed after the second revision surgery. CONCLUSION: Orthogonal plating with a posterior LCP and a small medial and/or lateral LCP is a safe technique that leads to excellent healing rates, and good clinical and patient-reported outcomes.


Assuntos
Placas Ósseas , Fixação Interna de Fraturas , Olécrano , Medidas de Resultados Relatados pelo Paciente , Fraturas da Ulna , Humanos , Olécrano/lesões , Olécrano/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Feminino , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/instrumentação , Fraturas da Ulna/cirurgia , Idoso , Adulto , Articulação do Cotovelo/cirurgia , Fraturas Cominutivas/cirurgia , Fratura do Olécrano
13.
Arch Orthop Trauma Surg ; 144(2): 701-721, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38006438

RESUMO

INTRODUCTION: In pre-operatively presumed aseptic nonunions, the definitive diagnosis of infection relies on intraoperative cultures. Our primary objective was to determine (1) the rate of surprise positive intraoperative cultures in presumed aseptic long-bone nonunion (surprise positive culture nonunion), and (2) the rate of surprise positive cultures that represent infection vs. contamination. Secondary objectives were to determine the healing and secondary surgery rates and to identify cultured micro-organisms. MATERIALS AND METHODS: We performed a systematic literature search of PubMed, Embase and Cochrane Libraries from 1980 until December 2021. We included studies reporting on ≥ 10 adult patients with a presumed aseptic long-bone nonunion, treated with a single-stage surgical protocol, of which intraoperative cultures were reported. We performed a meta-analysis for: (1) the rates of surprise positive culture nonunion, surprise infected nonunion, and contaminated culture nonunion, and (2) healing and (3) secondary surgery rates for each culture result. Risk of bias was assessed using the QUADAS-2 tool. RESULTS: 21 studies with 2,397 patients with a presumed aseptic nonunion were included. The rate of surprise positive culture nonunion was 16% (95%CI: 10-22%), of surprise infected nonunion 10% (95%CI: 5-16%), and of contaminated culture nonunion 3% (95%CI: 1-5%). The secondary surgery rate for surprise positive culture nonunion was 22% (95%CI: 9-38%), for surprise infected nonunion 14% (95%CI 6-22%), for contaminated culture nonunion 4% (95%CI: 0-19%), and for negative culture nonunion 6% (95CI: 1-13%). The final healing rate was 98% to 100% for all culture results. Coagulase-negative staphylococci accounted for 59% of cultured micro-organisms. CONCLUSION: These results suggest that surprise positive cultures play a role in the clinical course of a nonunion and that culturing is important in determining the etiology of nonunion, even if the pre-operative suspicion for infection is low. High healing rates can be achieved in presumed aseptic nonunions, regardless of the definitive intraoperative culture result.


Assuntos
Fixação Interna de Fraturas , Fraturas não Consolidadas , Adulto , Humanos , Estudos Retrospectivos , Fixação Interna de Fraturas/métodos , Staphylococcus , Fraturas não Consolidadas/cirurgia , Consolidação da Fratura , Resultado do Tratamento
14.
Cardiovasc Diabetol ; 22(1): 211, 2023 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-37592260

RESUMO

BACKGROUND: Heterogeneous metabolic clusters have been identified in diabetic and prediabetic states. It is not known whether such pathophysiologic clusters impact survival in at-risk persons being evaluated for coronary heart disease. METHODS: The LURIC Study recruited patients referred for coronary angiography at a median age of 63 (IQR 56-70) with a follow-up of 16.1 (IQR 9.6, 17.7) years. Clustering of 1269 subjects without diabetes was performed with oGTT-derived glucose and insulin; fasting triglyceride, high-density lipoprotein, BMI, waist and hip circumference. Patients with T2D (n = 794) were clustered using age, BMI, glycemia, homeostasis model assessment, and islet autoantibodies. Associations of clusters with mortality were analysed using Cox regression. RESULTS: Individuals without diabetes were classified into six subphenotypes, with 884 assigned to subjects at low-risk (cluster 1,2,4) and 385 at high-risk (cluster 3,5,6) for diabetes. We found significantly increased mortality in clusters 3 (hazard ratio (HR)1.42), 5 (HR 1.43), and 6 (HR 1.46) after adjusting for age, BMI, HbA1c and sex. In the T2D group, 508 were assigned to mild age-related diabetes (MARD), 183 to severe insulin-resistant diabetes (SIRD), 84 to mild obesity-related diabetes (MOD), 19 to severe insulin-deficient diabetes (SIDD). Compared to the low-risk non-diabetes group, crude mortality was not different in MOD. Increased mortality was found for MARD (HR 2.2), SIRD (HR 2.2), and SIDD (HR 2.5). CONCLUSIONS: Metabolic clustering successfully stratifies survival even among persons undergoing invasive coronary diagnostics. Novel clustering approaches based on glucose metabolism can identify persons who require special attention as they are at risk of increased mortality.


Assuntos
Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Humanos , Pessoa de Meia-Idade , Idoso , Estado Pré-Diabético/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Insulina , Autoanticorpos , Angiografia Coronária
15.
PLoS Comput Biol ; 18(2): e1009869, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35176019

RESUMO

Collective living systems regularly achieve cooperative emergent functions that individual organisms could not accomplish alone. The rafts of fire ants (Solenopsis invicta) are often studied in this context for their ability to create aggregated structures comprised entirely of their own bodies, including tether-like protrusions that facilitate exploration of and escape from flooded environments. While similar protrusions are observed in cytoskeletons and cellular aggregates, they are generally dependent on morphogens or external gradients leaving the isolated role of local interactions poorly understood. Here we demonstrate through an ant-inspired, agent-based numerical model how protrusions in ant rafts may emerge spontaneously due to local interactions. The model is comprised of a condensed structural network of agents that represents the monolayer of interconnected worker ants, which floats on the water and gives ant rafts their form. Experimentally, this layer perpetually contracts, which we capture through the pairwise contraction of all neighboring structural agents at a strain rate of [Formula: see text]. On top of the structural layer, we model a dispersed, on-lattice layer of motile agents that represents free ants, which walk on top of the floating network. Experimentally, these self-propelled free ants walk with some mean persistence length and speed that we capture through an ant-inspired phenomenological model. Local interactions occur between neighboring free ants within some radius of detection, R, and the persistence length of freely active agents is tuned through a noise parameter, η as introduced by the Vicsek model. Both R and η where fixed to match the experimental trajectories of free ants. Treadmilling of the raft occurs as agents transition between the structural and free layers in accordance with experimental observations. Ultimately, we demonstrate how phases of exploratory protrusion growth may be induced by increased ant activity as characterized by a dimensionless parameter, [Formula: see text]. These results provide an example in which functional morphogenesis of a living system may emerge purely from local interactions at the constituent length scale, thereby providing a source of inspiration for the development of decentralized, autonomous active matter and swarm robotics.


Assuntos
Formigas , Animais , Microdomínios da Membrana , Água
16.
Faraday Discuss ; 245(0): 467-487, 2023 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-37341061

RESUMO

Ice is a major component of astrophysical environments - from interstellar molecular clouds through protoplanetary disks to evolved solar systems. Ice and complex organic matter coexist in these environments as well, and it is thought primordial ice brought the molecules of life to Earth four billion years ago, which could have kickstarted the origin of life on Earth. To understand the journey of ice and organics from their origins to becoming a part of evolved planetary systems, it is important to complement high spatial and spectral resolution telescopes such as JWST with laboratory experimental studies that provide deeper insight into the processes that occur in these astrophysical environments. Our laboratory studies are aimed at providing this knowledge. In this article we present simultaneous mass spectrometric and infrared spectroscopic investigation on how molecular ice mixtures behave at different temperatures and how this information is critical to interpret observational data from protoplanetary disks as well as comets. We find that amorphous to crystalline water ice transformation is the most critical phenomenon that differentiates between outgassing of trapped volatiles such as CO2vs. outgassing of pure molecular ice domains of the same in a mixed molecular ice. Crystalline water ice is found to trap only a small fraction of other volatiles (<5%), indicating ice grain composition in astrophysical and planetary environments must be different depending on whether the ice is in amorphous phase or transformed into crystalline phase, even if the crystalline ice undergoes radiation-induced amorphization subsequently. Crystallization of water ice is a key differentiator for many ices in astronomical environments as well as in our Solar System.

17.
Soft Matter ; 19(15): 2716-2725, 2023 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-36974710

RESUMO

Dynamic networks containing multiple bond types within a continuous network grant engineers another design parameter - relative bond fraction - by which to tune storage and dissipation of mechanical energy. However, the mechanisms governing emergent properties are difficult to deduce experimentally. Therefore, we here employ a network model with prescribed fractions of dynamic and stable bonds to predict relaxation characteristics of hybrid networks. We find that during stress relaxation, predominantly dynamic networks can exhibit long-term moduli through conformationally inhibited relaxation of stable bonds due to exclusion interactions with neighboring chains. Meanwhile, predominantly stable networks exhibit minor relaxation through non-affine reconfiguration of dynamic bonds. Given this, we introduce a single fitting parameter, ξ, to Transient Network Theory via a coupled rule of mixture, that characterizes the extent of stable bond relaxation. Treating ξ as a fitting parameter, the coupled rule of mixture's predicted stress response not only agrees with the network model's, but also unveils likely micromechanical traits of gels hosting multiple bond dissociation timescales.

18.
Nutr Metab Cardiovasc Dis ; 33(9): 1785-1796, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37495452

RESUMO

BACKGROUND AND AIMS: Increased hepatocellular lipid content (HCL) is linked to insulin resistance, risk of type 2 diabetes and related complications. Conversely, a single-nucleotide polymorphism (TM6SF2EK; rs58542926) in the transmembrane 6 superfamily member 2-gene has been associated with nonalcoholic fatty liver disease (NAFLD), but lower cardiovascular risk. This case-control study tested the role of this polymorphism for tissue-specific insulin sensitivity during early course of diabetes. METHODS AND RESULTS: Males with recent-onset type 2 diabetes with (TM6SF2EK: n = 16) or without (TM6SF2EE: n = 16) the heterozygous TM6SF2-polymorphism of similar age and body mass index, underwent Botnia-clamps with [6,6-2H2]glucose to measure whole-body-, hepatic- and adipose tissue-insulin sensitivity. HCL was assessed with 1H-magnetic-resonance-spectroscopy. A subset of both groups (n = 24) was re-evaluated after 5 years. Despite doubled HCL, TM6SF2EK had similar hepatic- and adipose tissue-insulin sensitivity and 27% higher whole-body-insulin sensitivity than TM6SF2EE. After 5 years, whole-body-insulin sensitivity, HCL were similar between groups, while adipose tissue-insulin sensitivity decreased by 87% and 55% within both groups and circulating triacylglycerol increased in TM6SF2EE only. CONCLUSIONS: The TM6SF2-polymorphism rs58542926 dissociates HCL from insulin resistance in recent-onset type 2 diabetes, which is attenuated by disease duration. This suggests that diabetes-related metabolic alterations dominate over effects of the TM6SF2-polymorphism during early course of diabetes and NAFLD.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Neoplasias Hepáticas , Hepatopatia Gordurosa não Alcoólica , Humanos , Masculino , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/complicações , Resistência à Insulina/genética , Fígado/metabolismo , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Hepatopatia Gordurosa não Alcoólica/genética , Hepatopatia Gordurosa não Alcoólica/complicações , Polimorfismo de Nucleotídeo Único , Triglicerídeos/metabolismo
19.
Int J Sports Med ; 44(4): 247-257, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36174660

RESUMO

The objective of this systematic review was to identify potential risk factors for injury in CrossFit participants. Embase, Medline, Web of Science, Cochrane, CINAHL, Google Scholar, and SportDiscuss databases were all searched up to June 2021. Cohort studies that investigated risk factors for CrossFit injuries requiring medical attention or leading to time loss in sports were included. A best-evidence synthesis was performed combining all the outcomes from prospective cohort studies. From 9,452 publications identified, we included three prospective cohort studies from which two had a low risk of bias and one a high risk of bias. The studies examined 691 participants of whom 172 sustained an injury. There was limited evidence that switching between prescribed and scaled loads during training is associated with increased injury risk and that increased duration of participation is a protective factor for injury. This could mean that novice CrossFit athletes and those increasing their training load should have closer supervision by CrossFit coaches. These risk factors should be considered when developing preventive interventions.


Assuntos
Traumatismos em Atletas , Esportes , Humanos , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Estudos Prospectivos , Fatores de Risco , Atletas
20.
J Appl Clin Med Phys ; 24(1): e13828, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36347052

RESUMO

PURPOSE: Quantitative measurements of activity in SPECT are important for radioisotope therapy planning and disease diagnosis. The aim of this manuscript is to develop a robust method to quantify the total activity in a volume-of-interest (VOI) of different quantitative SPECT reconstructions and validate the estimation accuracy. METHODS: We customized an IEC body phantom using 3D printing technology and made six sphere inserts of 1-6 cm in diameter with at least 3 cm separation. The activity concentration within the spheres was in the range of patient lesion/organ activity. The background activity was then increased from zero to a sphere/background activity concentration of 8:1, 4:1, and 2:1. SPECT data were acquired with Philips Brightview and GE Discovery 670 SPECT/computed tomography (CT) systems under clinical acquisition protocols. Quantitative SPECT images were reconstructed with Hermes SUV-SPECT (both Philips and GE data) and GE Q.Metrix (GE data only). The quantitative SPECT reconstructions are iterative with scatter, CT attenuation correction, and resolution recovery. We quantified the total activity by expanding the sphere VOI to include a spill-out region. Background correction was applied by sampling a region outside the spill-out region. The true fractions (TFs) (total activity/true activity) were measured for all six spheres for all SPECT acquisitions. RESULTS: The TF is close to 100% for 2-6 cm spheres for zero background, 8:1 and 4:1 sphere/background activity ratios. The TF was found to be unreliable for the 1-cm sphere because of the limit of phantom design. TF accuracy for 2:1 sphere/background ratio was degraded due to significantly large background, inadequate scatter correction and detector count loss. CONCLUSIONS: The results demonstrated that the proposed quantification method is accurate for objects of different sizes in currently clinical quantitative reconstruction and has the potential for improving the accuracy for therapeutic treatment planning or radiation dosimetry calculations.


Assuntos
Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , Humanos , Tomógrafos Computadorizados , Imagens de Fantasmas , Impressão Tridimensional
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