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2.
J Prev Alzheimers Dis ; 11(5): 1418-1425, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39350389

RESUMEN

INTRODUCTION: Metrics of a participant's socioeconomic status (SES) are not routinely collected or standardized in clinical trials. This omission limits the ability to evaluate the generalizability of trial results and restricts clinicians from confidently interpreting the efficacy of new treatments across important sub-populations. METHODS: We adapted an SES measure of social disparity; the Hollingshead Two Factor Index of Social Position, which combines education and occupation into a single metric. We modernized the 1965 occupations to reflect the 2017 careers tabulated by the US Bureau of Labor Statistics. We currently use this adapted measure in Alzheimer's Clinical Trials Consortium studies. RESULTS: We present the revised table of occupations. We found that the collection of SES data using the modified Hollingshead was feasible in a multi-site clinical trial and scores were distributed across all SES strata. DISCUSSION: The modified Hollingshead provides a standardized method for collecting SES information, enabling data aggregation, monitoring, and reporting.


Asunto(s)
Enfermedad de Alzheimer , Clase Social , Humanos , Ensayos Clínicos como Asunto , Ocupaciones , Escolaridad , Femenino
3.
J Prev Alzheimers Dis ; 11(5): 1435-1444, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39350391

RESUMEN

BACKGROUND: Advances in plasma biomarkers to detect Alzheimer's disease (AD) biology allows researchers to improve the efficiency of participant recruitment into preclinical trials. Recently, protein levels of plasma amyloid-beta and tau proteins have been shown to be predictive of elevated amyloid in brain. Online registries, such as the Alzheimer's Prevention Trials (APT) Webstudy, include and follow participants using remote assessments to facilitate efficient screening and enrollment of large numbers of individuals who may be at higher risk for AD. OBJECTIVES: The AlzMatch Pilot Study investigated the feasibility of recruiting individuals from an online registry for blood sample collection at community-based phlebotomy centers and plasma biomarker quantification to assess an individual's eligibility for AD preclinical trials. DESIGN: Pilot feasibility study with co-primary outcomes. SETTING: This pilot feasibility study included participants from the APT Webstudy, the remote assessment arm of the Trial-ready cohort for Preclinical and Prodromal AD (TRC-PAD) Platform. Novel design included collection of electronic consent, use of community laboratories for plasma collection, mass spectrometry-based biomarker assay, and telephone communication of plasma biomarker screening eligibility. PARTICIPANTS: Participants invited to the AlzMatch pilot feasibility study were active in the APT Webstudy, 50 years of age or older, resided within 50 miles of both a Quest Diagnostics Patient Services Center (a national diagnostic laboratory with convenient locations for sample collection and processing) and one of six TRC-PAD vanguard clinical trial sites, had no self-reported dementia diagnosis, were able to communicate in English and engaged with the APT Webstudy within the prior 6 months. MEASUREMENTS: Primary feasibility outcomes were completion of electronic consent (e-consent) for invited participants and collection of usable blood samples. Additional feasibility outcomes included invitation response rate, plasma biomarker eligibility status (based on amyloid beta-42/40 [Aß42/40] concentration ratio), ApoE proteotype, and trial inclusion criterion), and completion of telephone contact to learn eligibility to screen for a study. RESULTS: 300 APT Webstudy participants were invited to consent to the AlzMatch study. The AlzMatch e-consent rate was 39% (n=117) (95% CI of 33.5%-44.5%) overall, which was higher than the expected rate of 25%. Similar consent rates were observed across participants based on self-defined sex (41% Female (n=75), 37% Male (n=42)) and race and ethnicity (37% from underrepresented groups (URG) (n=36), 40% not from URG (n=79)). Among those that consented (n=117), plasma was successfully collected from 74% (n=87) (95% CI of 66%-82%), with similar rates across sex (76% Female (n=57), 71% Male (n=30)) and race and ethnicity (75% URG (n=27) and 75% not from URG (n=59)). 60% (n=51) of participants with plasma biomarker results were eligible to screen for future preclinical AD trials. CONCLUSION: Electronic consent of participants through an online registry, blood sample collection at community-based centers, plasma biomarker quantification and reporting, and biomarker assessments for study eligibility were all feasible with similar engagement rates across demographic groups. Although this pilot was a small and selective sample, participants engaged and consented at higher than expected rates. We conclude that collecting blood at community laboratories for biomarker analyses may improve accessibility beyond research, and may facilitate broader access for clinical use of AD plasma biomarkers. Based on our results, an expanded version of the AlzMatch study is underway, which involves expanding invitations to additional APT Webstudy participants and clinical trial sites.


Asunto(s)
Enfermedad de Alzheimer , Péptidos beta-Amiloides , Biomarcadores , Estudios de Factibilidad , Humanos , Enfermedad de Alzheimer/sangre , Enfermedad de Alzheimer/diagnóstico , Proyectos Piloto , Biomarcadores/sangre , Femenino , Masculino , Anciano , Péptidos beta-Amiloides/sangre , Proteínas tau/sangre , Recolección de Muestras de Sangre/métodos , Selección de Paciente , Síntomas Prodrómicos , Persona de Mediana Edad , Sistema de Registros , Ensayos Clínicos como Asunto
4.
Lab Anim ; 58(5): 419-426, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39365005

RESUMEN

Blinding and randomisation are important methods for increasing the robustness of pre-clinical studies, as incomplete or improper implementation thereof is recognised as a source of bias. Randomisation ensures that any known and unknown covariates introducing bias are randomly distributed over the experimental groups. Thereby, differences between the experimental groups that might otherwise have contributed to false positive or -negative results are diminished. Methods for randomisation range from simple randomisation (e.g. rolling a dice) to advanced randomisation strategies involving the use of specialised software. Blinding on the other hand ensures that researchers are unaware of group allocation during the preparation, execution and acquisition and/or the analysis of the data. This minimises the risk of unintentional influences resulting in bias. Methods for blinding require strong protocols and a team approach. In this review, we outline methods for randomisation and blinding and give practical tips on how to implement them, with a focus on animal studies.


Asunto(s)
Experimentación Animal , Distribución Aleatoria , Proyectos de Investigación , Animales , Experimentación Animal/normas , Sesgo
5.
Int J Biol Macromol ; : 136190, 2024 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-39366605

RESUMEN

Current study provides insight on the feasibility of polylactic acid (PLA) integrated with (1:1 ratio) of essential oils belonging to Ocimum gratissimum (OG) and Mentha spicata (MS) for prevention of major stored insect pests (Sitophilus oryzae and Oryzophilus surinamensis) in Sorghum and Pearl millet. A combination of OG and MS essential oils (1:1) was incorporated into the PLA polymer matrix. Further, SPME analysis of synthesized PLA showed the presence of volatiles corresponding to carvone (6.44 %) and thymol (6.22 %). Synthesized PLA composites were tested against S. oryzae and O. surinamensis using Sorghum and Pearl millets, and insect mortality was equivalent to commercial super bags (CSB). The head space oxygen decreased significantly in CSB and slightly in PLA bags. Thickness of EO blended PLA composite was increased (99 µm), tensile strength (23.94 MPa), WVTR (1.42 g/m2.hr) analysis, significant folding ability, and swelling capacity (0.24 %) showed slight reduction in composite film. TGA showed good thermal stability (334˚C) and XRD displayed the increased crystallinity (38.35 %) in PLAOM films, SEM and FTIR analysis of the synthesized composite films revealed complete homogenization of EO and PLA matrix. In addition, SEM analysis of insects (control & treated) revealed less topology changes in the elytra. Biodegradability study confirmed the weight loss in PLA films. Hence, current approach of using composite EO's with PLA offers sustainable solution for prevention of infestation during storage of millets.

6.
Indian J Nephrol ; 34(5): 482-486, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39372630

RESUMEN

Background: Neural epidermal-like growth factor-like 1 (NELL-1) is a protein kinase C binding protein expressed in osteoblasts and renal tubules. It is expressed in 5%-25% glomerular cells at the mRNA level. Membranous Nephropathy (MN) is characterized by the presence of antibodies against certain types of antigens on the glomerular basement membrane. The most common one implicated in primary MN is an antibody against PLA2R. Many newer antigens have been discovered in the recent past, which are proven to cause secondary MN, one of which is NELL-1. NELL-1 has been associated with malignancy-associated MN and also recently associated with traditional indigenous medications containing mercury. In this study, we study the expression of NELL-1 in mercury-associated MN. Materials and Methods: Records of ten cases of Mercury -associated MN were retrieved from the Institute medical archives and NELL-1 Immunohistochemistry was performed in all ten cases. Results: NELL-1 was found to be positive in 50% of the cases of Mercury associated MN. In addition, mass spectrometric studies was performed, which revealed the common Mercuric compound associated to be 'Swaskalpa', 'Sudarshana Melugu' and 'Rasagandhi Mezhugu'. Conclusion: This study highlights why it is important to diagnose mercury-associated MN by a pathologist by picking up the finer histopathological clues and by using NELL-1 immunohistochemistry, especially in PLA2R-negative patients. The former is true as most of the time a history of mercuric compound intake is missed out.

8.
Public Health ; 237: 1-6, 2024 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-39316850

RESUMEN

OBJECTIVE: In the United States, cancer mortality rates continue to decline, yet geographic and racial disparities persist and are particularly evident in the Delta region, characterized by high economic distress and disease burden. We examined cancer mortality patterns by demographic groups across geographic region (Delta vs non-Delta) and investigated the influence of macro-level social determinants of health (SDoH) in cancer death. STUDY DESIGN AND METHODS: This observational study included cancer death records of individuals aged ≥20 years from 2018 to 2021 in the United States. County-level characteristics were ascertained through the linkage of multiple national administrative and community surveys. We estimated age-standardized mortality rates (ASR) and rate ratios. We calculated the adjusted relative risks by county-level SDoH (geographic region, rurality, household income, income inequality, health insurance, and education) and other factors using age-adjusted multivariate quasi-Poisson regression. RESULTS: In 2018-2021, approximately 2.4 million cancer deaths occurred in the United States. We observed important declines in the Black-White disparities, from 16.6% in 2018 (ASR = 289.9 vs 248.6 per 100,000) to 12.1% in 2021 (281.1 vs 250.8) in the Delta region and from 15.9% (254.9 vs 219.9) to 10.7% (240.6 vs 217.3) in the non-Delta region, though Black men in the Delta region remained the highest rate (ASR2021 = 346.9 per 100,000). County-level analyses provided strong evidence of geographic inequality and the role of SDoH, particularly education and income inequality. CONCLUSIONS: Unfavorable SDoH are associated with increased cancer death risk. Region-specific health policies and interventions in the Delta region are essential to advance cancer health equity.

9.
Braz J Biol ; 84: e282609, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39319927

RESUMEN

Candida albicans is often associated with oral candidiasis, and drug-resistance profiles have contributed to an increase in morbidity and mortality. It is known that Lactobacillus spp. acts by competing for adhesion to the epithelium, absorption of nutrients and modulation of the human microbiota. Therefore, they are important to assist in the host's microbiological balance and reduce the growth of Candida spp. Until now, there have been no reports in the literature of reviews correlating to the use of Lactobacillus spp. in the treatment of oral candidiasis. Thus, this review aims to highlight the mechanisms of action of Lactobacillus spp. and methods that can be used in the treatment of oral candidiasis. This is a study carried out through the databases PubMed Central and Scientific Electronic Library Online, using the following keywords: Oral Candidiasis and Lactobacillus. Original articles about oral candidiasis were included, with both in vitro and in vivo analyses, and published from 2012 to 2022. Lactobacillus rhamnosus was the most common microorganism used in the experiments against Candida, acting mainly in the reduction of biofilm, filamentation, and competing for adhesion sites of Candida spp. Among in vivo studies, most researchers used immunosuppressed mouse modelsof Candida infection. The studies showed that Lactobacillus has a great potential as a probiotic, acting mainly in the prevention and treatment of mucosal diseases. Thus, the use of Lactobacillus may be a good strategy for the treatment of oral candidiasis.


Asunto(s)
Candidiasis Bucal , Lactobacillus , Probióticos , Candidiasis Bucal/microbiología , Candidiasis Bucal/terapia , Candidiasis Bucal/tratamiento farmacológico , Humanos , Probióticos/uso terapéutico , Lactobacillus/fisiología , Animales , Biopelículas/efectos de los fármacos , Ratones , Candida albicans/fisiología
10.
Obes Surg ; 2024 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-39320627

RESUMEN

The 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) updated the indications for Metabolic and Bariatric Surgery (MBS), replacing the previous guidelines established by the NIH over 30 years ago. The evidence supporting these updated guidelines has been strengthened to assist metabolic and bariatric surgeons, nutritionists, and other members of multidisciplinary teams, as well as patients. This study aims to assess the level of evidence and the strength of recommendations compared to the previously published criteria.

11.
ACS Mater Lett ; 6(9): 4158-4167, 2024 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-39309214

RESUMEN

This work develops the first laser-induced graphene (LIG)-based electrochemical sensor with a superhydrophobic fluorous membrane for a flexible acetylcholine (ACh) sensor. ACh regulates several physiological functions, including synaptic transmission and glandular secretion. The ACh sensing membrane is doped with a fluorophilic cation-exchanger that can selectively measure ACh based on the inherent selectivity of the fluorous phase for hydrophobic ions, such as ACh. The fluorous-phase sensor improves the selectivity for ACh over Na+ and K+ by 2 orders of magnitude (compared to traditional lipophilic membranes), thus lowering the detection limit in artificial cerebrospinal fluid (aCSF) from 331 to 0.38 µ M, thereby allowing measurement in physiologically relevant ranges of ACh. Engraving LIG under argon creates a hydrophobic surface with a 133.7° contact angle, which minimizes the formation of a water layer. The flexible solid-contact LIG fluorous sensor exhibited a slope of 59.3 mV/decade in aCSF and retained function after 20 bending cycles, thereby paving the way for studying ACh's role in memory and neurodegenerative diseases.

12.
Photochem Photobiol Sci ; 23(9): 1757-1769, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39242437

RESUMEN

Porphyrazines (Pzs) are porphyrin derivatives that show potential application as photosensitizers for photodynamic therapy (PDT), but are still far less explored in the literature. In this work, we evaluate how the photophysics and phototoxicity of the octakis(trifluoromethylphenyl)porphyrazine (H2Pz) against tumor cells can be modulated by coordination with Mg(II), Zn(II), Cu(II) and Co(II) ions. Fluorescence and singlet oxygen quantum yields for the Pzs were measured in organic solvents and in soy phosphatidylcholine (PC) liposomes suspended in water. While H2Pz and the respective complexes with Cu(II) and Co(II) showed very low efficiency to fluoresce and to produce 1O2, the Mg(II) and Zn(II) complexes showed significantly higher quantum yields in organic solvents. The fluorescence of these two Pzs in the liposomes was sensitive to the fluidity of the membrane, showing potential use as viscosity markers. The cytotoxicity of the compounds was tested in HaCaT (normal) and A431 (tumor) cells using soy PC liposomes as drug carriers. Despite the low 1O2 quantum yields in water, the Mg(II) and Zn(II) complexes showed IC50 values against A431 cells in the nanomolar range when activated with low doses of red LED light. Their phototoxicity was ca. three times higher for the tumor cells compared to the normal ones, showing promising application as photosensitizers for PDT protocols. Considering that H2Pz and the respective Co(II) and Cu(II) complexes were practically non-phototoxic to the cells, we demonstrate the importance of the central metal ion in the modulation of the photodynamic activity of porphyrazines.


Asunto(s)
Liposomas , Fármacos Fotosensibilizantes , Porfirinas , Humanos , Fármacos Fotosensibilizantes/farmacología , Fármacos Fotosensibilizantes/química , Porfirinas/química , Porfirinas/farmacología , Liposomas/química , Fotoquimioterapia , Oxígeno Singlete/metabolismo , Oxígeno Singlete/química , Complejos de Coordinación/farmacología , Complejos de Coordinación/química , Complejos de Coordinación/síntesis química , Antineoplásicos/farmacología , Antineoplásicos/química , Antineoplásicos/síntesis química , Zinc/química , Zinc/farmacología , Línea Celular Tumoral , Supervivencia Celular/efectos de los fármacos , Ensayos de Selección de Medicamentos Antitumorales , Iones/química
13.
Sci Rep ; 14(1): 22178, 2024 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-39333150

RESUMEN

Precipitation variations in the tropical Indian Ocean region result from changes in the Indian Summer Monsoon (ISM), as well as convective and cyclonic rainfall. The relative roles of such forcing can be elucidated by constructing robust paleoclimate records, which help to better predict future variability in precipitation due to rising greenhouse gases. This study was carried out using a suite of paleoclimate proxies on a combination of marine and terrestrial sediment cores from Sri Lanka. The sites receive differing amounts of precipitation from the ISM versus convective and cyclone-driven intermonsoon rainfall and allow differentiation of precipitation sources through time. The constructed 80000-year-long precipitation record for the ISM-dominant regions of Sri Lanka shows strong sensitivity to orbital scale insolation variations as well as to millennial-scale events in the North Atlantic region. This precipitation response to external and internal forcings is a result of the combined effects of ISM and Intermonsoon intensity either of which dominated periodically. The strong positive correlation between different periods in the precipitation record and different monthly insolation curves shows that changes in solar insolation due to precession decide the dominant rainfall mechanism in the region, suggesting the ISM dominated after 13 ka (MIS1) while the first intermonsoon dominated between 29 and 13 ka (MIS2) and the second intermonsoon dominated period between 77 and 40 ka.

14.
Drug Metab Rev ; : 1-32, 2024 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-39340261

RESUMEN

Synthesis and illicit use of designer benzodiazepines are growing concerns, withthese newpsychoactive substances (NPS) posing serious health consequences and new hurdles for toxicologists. Consumption marker identification and characterization is paramount in confirming their use. The benzodiazepine core structure is a fusion of benzene and a seven-membered heterocycle with two nitrogen atoms forming the diazepine ring. Minor variations on the core structure produce different classes of benzodiazepines with marked differences in physiological effects.The present review provides a comprehensive designer benzodiazepines metabolismoverview and suggestssuitable human consumptionbiomarkers for toxicology casework. A systematic literature search of PubMed®, ScopusTM, Web of ScienceTM, and Cochranedatabaseswas conducted independently by two coauthorsadhering to PRISMA guidelines. Data from 30in vitro and in vivo models of designer benzodiazepines metabolism from January 2007 to February 2023 were included. 1,4-benzodiazepines (n = 10), 2,3-benzodiazepines (n = 1), triazolo-benzodiazepines (n = 9), and thieno-triazolo-benzodiazepines (n = 3) study design, sample pretreatment, analytical techniques and major metabolites detected in various matrices are addressed. Metabolites following hydroxylation and phase II glucuronide conjugation were the most prevalent analytes. N-Glucuronidation of parent azole-fused benzodiazepines, andnitro-reduced and N-acetylated metabolites of nitro-containing designer benzodiazepines were also common. From these data, we propose a generic metabolic pathwayfor designer benzodiazepines. The sporadic illicit market presents challenges in toxicological casework and necessitates comprehensive biomarker investigations, especially in cases with legal implications. There are fewmetabolismdata for many designer benzodiazepines, emphasizing the need for research focusing on closing these gaps.

15.
Artículo en Inglés | MEDLINE | ID: mdl-39341693

RESUMEN

Artificial Intelligence (AI) can enhance the precision and efficiency of diagnostics and treatments in oral and maxillofacial surgery (OMS), leveraging advanced computational technologies to mimic intelligent human behaviors. The study aimed to examine the current state of AI in the OMS literature and highlight the urgent need for further research to optimize AI integration in clinical practice and enhance patient outcomes. A scoping review of journals related to OMS focused on OMS-related applications. PubMed was searched using terms "artificial intelligence", "convolutional networks", "neural networks", "machine learning", "deep learning", and "automation". Ninety articles were analyzed and classified into the following subcategories: pathology, orthognathic surgery, facial trauma, temporomandibular joint disorders, dentoalveolar surgery, dental implants, craniofacial deformities, reconstructive surgery, aesthetic surgery, and complications. There was a significant increase in AI-related studies published after 2019, 95.6% of the total reviewed. This surge in research reflects growing interest in AI and its potential in OMS. Among the studies, the primary uses of AI in OMS were in pathology (e.g., lesion detection, lymph node metastasis detection) and orthognathic surgery (e.g., surgical planning through facial bone segmentation). The studies predominantly employed convolutional neural networks (CNNs) and artificial neural networks (ANNs) for classification tasks, potentially improving clinical outcomes.

16.
Expert Rev Cardiovasc Ther ; 22(8): 353-366, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39258965

RESUMEN

INTRODUCTION: Lipoprotein(a) [Lp(a)] is linked to higher risks of atherosclerotic cardiovascular disease (ASCVD). Current guideline recommendations are quite liberal on measuring Lp(a) (Class IIa, Level C), and may lead to underuse among (interventional) cardiologists. AREAS COVERED: This case-based narrative review outlines four clinical cases of patients with elevated Lp(a) to illustrate its pathophysiological impact on coronary artery disease (CAD). The expert consensus statements from the American Heart Association (AHA) and European Atherosclerosis Society (EAS) served as the basis of this review. More recent publications, from 2023 to 2024, were accessed through the MEDLINE online library. EXPERT OPINION: We highlighted the importance of routine Lp(a) measurement in identifying patients at high risk for atherosclerosis, necessitating potent risk mitigation. Measuring Lp(a) helps clinicians identify which patients are at highest residual risk, who require potent pharmacological treatment and special attention during catheter interventions. As noninvasive and advanced intravascular imaging modalities evolve, future catheterization laboratories will integrate advanced imaging, diagnostics, and treatment, facilitating tailored patient care. Knowing Lp(a) levels is crucial in this context. While Lp(a)-lowering drugs are currently investigated in clinical trials, it is of paramount importance to know Lp(a) levels and strive toward aggressive management of other modifiable risk factors in patients with elevated Lp(a) and established symptomatic CAD being diagnosed or treated in catheterization laboratories.


Asunto(s)
Enfermedad de la Arteria Coronaria , Lipoproteína(a) , Humanos , Aterosclerosis/sangre , Aterosclerosis/diagnóstico , Biomarcadores/sangre , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico , Lipoproteína(a)/sangre , Guías de Práctica Clínica como Asunto , Recurrencia , Medición de Riesgo/métodos , Medición de Riesgo/normas
17.
Lancet ; 404(10457): 1019-1028, 2024 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-39236726

RESUMEN

BACKGROUND: Percutaneous active mechanical circulatory support (MCS) devices are being increasingly used in the treatment of acute myocardial infarction-related cardiogenic shock (AMICS) despite conflicting evidence regarding their effect on mortality. We aimed to ascertain the effect of early routine active percutaneous MCS versus control treatment on 6-month all-cause mortality in patients with AMICS. METHODS: In this individual patient data meta-analysis, randomised controlled trials of potential interest were identified, without language restriction, by querying the electronic databases MEDLINE via PubMed, Cochrane Central Register of Controlled Trials, and Embase, as well as ClinicalTrials.gov, up to Jan 26, 2024. All randomised trials with 6-month mortality data comparing early routine active MCS (directly in the catheterisation laboratory after randomisation) versus control in patients with AMICS were included. The primary outcome was 6-month all-cause mortality in patients with AMICS treated with early routine active percutaneous MCS versus control, with a focus on device type (loading, such as venoarterial extracorporeal membrane oxygenation [VA-ECMO] vs unloading) and patient selection. Hazard ratios (HRs) of the primary outcome measure were calculated using Cox regression models. This study is registered with PROSPERO, CRD42024504295. FINDINGS: Nine reports of randomised controlled trials (n=1114 patients) were evaluated in detail. Overall, four randomised controlled trials (n=611 patients) compared VA-ECMO with a control treatment and five randomised controlled trials (n=503 patients) compared left ventricular unloading devices with a control treatment. Two randomised controlled trials also included patients who did not have AMICS, who were excluded (55 patients [44 who were treated with VA-ECMO and 11 who were treated with a left ventricular unloading device]). The median patient age was 65 years (IQR 57-73); 845 (79·9%) of 1058 patients with data were male and 213 (20·1%) were female. No significant benefit of early unselected MCS use on 6-month mortality was noted (HR 0·87 [95% CI 0·74-1·03]; p=0·10). No significant differences were observed for left ventricular unloading devices versus control (0·80 [0·62-1·02]; p=0·075), and loading devices also had no effect on mortality (0·93 [0·75-1·17]; p=0·55). Patients with ST-elevation cardiogenic shock without risk of hypoxic brain injury had a reduction in mortality with MCS use (0·77 [0·61-0·97]; p=0·024). Major bleeding (odds ratio 2·64 [95% CI 1·91-3·65]) and vascular complications (4·43 [2·37-8·26]) were more frequent with MCS use than with control. INTERPRETATION: The use of active MCS devices in patients with AMICS did not reduce 6-month mortality (regardless of the device used) and increased major bleeding and vascular complications. However, patients with ST-elevation cardiogenic shock without risk of hypoxic brain injury had a reduction in mortality after MCS use. Therefore, the use of MCS should be restricted to certain patients only. FUNDING: The Heart Center Leipzig at Leipzig University and the Foundation Institut für Herzinfarktforschung.


Asunto(s)
Oxigenación por Membrana Extracorpórea , Corazón Auxiliar , Infarto del Miocardio , Choque Cardiogénico , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oxigenación por Membrana Extracorpórea/métodos , Estudios de Seguimiento , Infarto del Miocardio/mortalidad , Infarto del Miocardio/complicaciones , Ensayos Clínicos Controlados Aleatorios como Asunto , Choque Cardiogénico/terapia , Choque Cardiogénico/mortalidad , Choque Cardiogénico/etiología , Resultado del Tratamiento
18.
F1000Res ; 13: 578, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39290846

RESUMEN

Background: The purpose of the study was to compare the effectiveness of yoga as a form of Vestibular Rehabilitation (VR) to standard VR for managing patients with symptoms such as dizziness, disequilibrium and gait instability. Methods: 150 participants based on 18-point difference in the DHI score were randomly assigned to group 1- Yoga, group 2- VR and group 3- control group using block randomization. The intervention was provided for 12 weeks. The participants were assessed for Dizziness Handicap Inventory (DHI) at baseline, 4 th, 8 th and 12 th week. Results: The mean DHI for group 1(41.12±7.13) group 2 (42.96±10.54) group 3 (50.84±10.78), p<0.001 decreased significantly in group 1 and 2 when compared to baseline. There was no statistically significant difference in overall Dizziness Handicap Inventory (DHI) scores between the Yoga and Physiotherapy groups after one month; however, both groups resulted in a significant decrease in scores when compared to the control group. Similarly, by the end of the second and third months, there was no significant distinction between the Yoga and Physiotherapy groups, even though both had a considerable decrease in DHI scores when compared to the control group. Furthermore, an examination of the functional, emotional, and physical components of DHI demonstrated persistent trends of significant improvement in both the Yoga and Physiotherapy groups as compared to the control group over a three-month period. Conclusions: In addition to VR, Yoga and medications administered concurrently can provide effective therapeutic effects. Yoga has an advantage over VR since it offers a customized cure for giddiness in addition to symptom relief. Yoga might be a great alternative to the conventional VR because along with enhancing overall body relaxation, it is affordable and is easy to learn.


Asunto(s)
Vértigo , Yoga , Humanos , Masculino , Femenino , Persona de Mediana Edad , Vértigo/rehabilitación , Vértigo/terapia , Resultado del Tratamiento , Adulto , Enfermedad Crónica , Mareo/rehabilitación , Mareo/terapia , Anciano , Vestíbulo del Laberinto/fisiopatología
19.
JDS Commun ; 5(4): 338-343, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39220852

RESUMEN

Mastitis is among the costliest diseases affecting dairy cows, partly due to the resulting permanent reduction in the quantity and quality of milk produced. Most mastitis cases involve pathogenic organisms entering the cow's mammary gland through the teat canal. The teat has natural defenses against these pathogens that can be disrupted during milk harvesting. These disruptions of the teat's circulatory system and tissue integrity can predispose them to mastitis. Traditionally, machine milking-induced changes in teat blood circulation and tissue integrity have been assessed by means of manual evaluation and ultrasonography. Infrared thermography has previously been shown to produce precise and consistent measurements of skin surface temperatures (SST) on cows' hind teats. Our objective was to describe the variability in the teat SST following machine milking. Describing the variability in teat SST before and after milking could be useful to guide further studies to elucidate the physiology of the effects of milking on teat defense mechanisms. In this observational study, thermographic images of both hind teats from 140 cows immediately pre- and postmachine milking were analyzed. The average SST were subsequently determined at the proximal, middle, and distal aspects of each hind teat using image analysis software. The LSM (95% CI) from general linear mixed models of the pre- and postmilking SST, respectively, were 33.6 (33.5-33.8)°C and 35.4 (35.3-35.5)°C at the proximal aspect, 33.2 (33.1-33.4)°C and 35.2 (35.1-35.3)°C at the middle aspect, and 32.3 (32.1-32.5)°C and 34.0 (33.9-34.1)°C at the distal aspect. The observed increase in SST from pre- to postmilking SST at all 3 aspects of the teat suggest that some of the variability in the SST can be attributed to the milking event. Future research is warranted to investigate the biological relevance of SST changes during machine milking and any potential change in teat defense mechanisms, risk of mastitis, or other pathologies.

20.
Comput Softw Big Sci ; 8(1): 17, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39248308

RESUMEN

Computing demands for large scientific experiments, such as the CMS experiment at the CERN LHC, will increase dramatically in the next decades. To complement the future performance increases of software running on central processing units (CPUs), explorations of coprocessor usage in data processing hold great potential and interest. Coprocessors are a class of computer processors that supplement CPUs, often improving the execution of certain functions due to architectural design choices. We explore the approach of Services for Optimized Network Inference on Coprocessors (SONIC) and study the deployment of this as-a-service approach in large-scale data processing. In the studies, we take a data processing workflow of the CMS experiment and run the main workflow on CPUs, while offloading several machine learning (ML) inference tasks onto either remote or local coprocessors, specifically graphics processing units (GPUs). With experiments performed at Google Cloud, the Purdue Tier-2 computing center, and combinations of the two, we demonstrate the acceleration of these ML algorithms individually on coprocessors and the corresponding throughput improvement for the entire workflow. This approach can be easily generalized to different types of coprocessors and deployed on local CPUs without decreasing the throughput performance. We emphasize that the SONIC approach enables high coprocessor usage and enables the portability to run workflows on different types of coprocessors.

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