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1.
Comput Softw Big Sci ; 8(1): 17, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39248308

RESUMO

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.

2.
Environ Manage ; 74(5): 870-885, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39210029

RESUMO

Anthropogenic and climatic changes are continuously altering the freshwater plankton, necessitating an evaluation of the complex structure of plankton communities to understand and mitigate these impacts. In this context, the present study focuses on evaluating the structure of plankton communities, specifically Phytoplankton Functional Groups (FGs) for assessing the environmental sensitivity of wetlands under changing scenario. These FGs are defined by shared adaptive features rather than taxonomic traits. Over the period from 2016 to 2018, two ecologically distinct wetlands were examined, analysing their phytoplankton FGs and their relationship with water quality parameters. Ecohydrological data revealed significant seasonal variations (p ≤ 0.05) in key parameters such as water depth, temperature, pH, electrical conductivity, dissolved oxygen, total alkalinity, total hardness, NO3-N, and PO4-P. Notably, there were no significant differences observed among the sampling stations within each wetland. A total of 125 phytoplankton genera/species were classified into 23 FGs in the open wetland and 22 FGs in the closed wetland. Spatial and seasonal analyses of dominant FGs suggested both wetlands were experiencing pollution pressures. This study highlights the powerful role of phytoplankton functional groups (FGs) as bioindicators of wetland health, uncovering pollution pressures. In open wetlands, 15 phytoplankton FGs with 36 key taxa (Indicator Value ≥ 40%) emerged as critical indicators, while in closed wetlands, only 10 FGs with 17 taxa were identified. To assess eutrophication, the occurrence of these indicator species was evaluated using BVSTEP function analysis. The study recommends pollution reduction in catchment areas and restoration of riverine connectivity to enhance FG diversity. Phytoplankton FG methodologies are deemed effective for assessing the environmental sensitivity of wetlands significantly impacted by human activities. This research offers a scientific foundation for the evaluation and restoration of wetland ecosystems.


Assuntos
Fitoplâncton , Áreas Alagadas , Monitoramento Ambiental/métodos , Qualidade da Água , Estações do Ano
3.
Phys Rev Lett ; 133(7): 071903, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39213583

RESUMO

Energy correlators that describe energy-weighted distances between two or three particles in a hadronic jet are measured using an event sample of sqrt[s]=13 TeV proton-proton collisions collected by the CMS experiment and corresponding to an integrated luminosity of 36.3 fb^{-1}. The measured distributions are consistent with the trends in the simulation that reveal two key features of the strong interaction: confinement and asymptotic freedom. By comparing the ratio of the measured three- and two-particle energy correlator distributions with theoretical calculations that resum collinear emissions at approximate next-to-next-to-leading-logarithmic accuracy matched to a next-to-leading-order calculation, the strong coupling is determined at the Z boson mass: α_{S}(m_{Z})=0.1229_{-0.0050}^{+0.0040}, the most precise α_{S}(m_{Z}) value obtained using jet substructure observables.

4.
Phys Rev Lett ; 132(24): 241802, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38949350

RESUMO

A search is presented for baryon number violating interactions in top quark production and decay. The analysis uses data from proton-proton collisions at a center-of-mass energy of 13 TeV, collected with the CMS detector at the LHC with an integrated luminosity of 138 fb^{-1}. Candidate events are selected by requiring two oppositely charged leptons (electrons or muons) and exactly one jet identified as originating from a bottom quark. Multivariate discriminants are used to separate the signal from the background. No significant deviation from the standard model prediction is observed. Upper limits are placed on the strength of baryon number violating couplings. For the first time the production of single top quarks via baryon number violating interactions is studied. This allows the search to set the most stringent constraints to date on the branching fraction of the top quark decay to a lepton, an up-type quark (u or c), and a down-type quark (d, s, or b). The results improve the previous bounds by 3 to 6 orders of magnitude based on the fermion flavor combination of the baryon number violating interactions.

5.
Mymensingh Med J ; 32(4): 959-967, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37777887

RESUMO

Cervical cancer is the fourth most common cancer in women in the world and is the second leading malignancy among Bangladeshi women. Persistent infection with high risk human papillomavirus (HPV) is an important cause of development of cervical intraepithelial neoplasia (CIN) followed by cancer. Bacterial vaginosis (BV), a common treatable vaginal infection which can disrupt the balanced vaginal ecosystem and its innate protective mechanisms against infection, can play an essential role in the acquisition and persistence of high risk human papillomavirus (HR-HPV) infection. This cross sectional study was conducted to detect the HR-HPV (HPV-16 and HPV-18) infection among bacterial vaginosis positive patient in the Department of Microbiology, Mymensingh Medical College (MMC), Bangladesh, from March 2018 to February 2019. A total of 300 endocervical swabs and high vaginal swabs were collected from the VIA (Visual inspection with acetic acid) outdoor clinic of Obstetrics and Gynaecology Department of Mymensingh Medical college Hospital. HPV DNA was tested among all 300 cases by nested PCR. Typing of HPV 16 and HPV 18 was done among HPV DNA positive cases with BV and intermediate flora by multiplex PCR. BV was diagnosed according to Nugent criteria by using the gram stained smear of high vaginal swab. A total of 57/300 (19.0%) samples were positive for HPV DNA by nested PCR. Of the total 300 cases 78(26.0%) had BV, 38(13.0%) had intermediate flora and 184(61.0%) had normal vaginal flora. HPV DNA was more positive in patients having intermediate flora 08/38 (21.05%) followed by the patients having normal vaginal flora 37/184 (20.11%) and BV 12/78 (15.38%). Among the 12 BV patients who were also HPV DNA positive (83.33%) were belong to high risk HPV (type 16 and 18) group and among them 08(66.67%) were HPV-16 and 02(16.67%) were HPV-18. But among 08 HPV DNA positive intermediate flora containing patients only 01(12.5%) were belong to HR-HPV (type 16 and no type 18 was detected).


Assuntos
Infecções por Papillomavirus , Neoplasias do Colo do Útero , Vaginose Bacteriana , Feminino , Humanos , Gravidez , Estudos Transversais , Papillomavirus Humano 16/genética , Papillomavirus Humano 18/genética , Papillomavirus Humano , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Centros de Atenção Terciária , Neoplasias do Colo do Útero/diagnóstico
6.
Anim Biotechnol ; 34(1): 25-38, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34106815

RESUMO

In addition to the transmission of paternal genome, spermatozoa also carry coding as well as noncoding microRNAs (miRNAs) into the female oocyte during the process of biological fertilization. Based on RNA deep sequencing, a total 28 number of differentially expressed miRNAs were cataloged in categorized FrieswalTM crossbred (Holstein Friesian X Sahiwal) bull semen on the basis of conception rate (CR) in field progeny testing program. Validation of selected miRNAs viz. bta-mir-182, bta-let-7b, bta-mir-34c and bta-mir-20a revealed that, superior bull semen having comparatively (p < .05) lower level of all the miRNAs in contrast to inferior bull semen. Additionally, it was illustrated that, bta-mir-20a and bta-mir-34c miRNAs are negatively (p < .01) correlated with seminal plasma catalase (CAT) activity and glutathione peroxidase (GPx) level. Interactome studies identified that bta-mir-140, bta-mir-342, bta-mir-1306 and bta-mir-217 can target few of the important solute carrier (SLC) proteins viz. SLC30A3, SLC39A9, SLC31A1 and SLC38A2, respectively. Interestingly, it was noticed that all the SLCs were significantly (p < .05) expressed at higher level in superior quality bull semen and they are negatively correlated (p < .01) with their corresponding miRNAs as mentioned. This study may reflect the role of miRNAs in regulating few of the candidate genes and thus may influence the bull semen quality traits.


Assuntos
MicroRNAs , Sêmen , Bovinos , Animais , Masculino , Feminino , MicroRNAs/genética , Análise do Sêmen , Espermatozoides/metabolismo , Hibridização Genética
7.
Environ Monit Assess ; 194(9): 643, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35930070

RESUMO

The present study demonstrates the spatial analysis and mapping of fish and different measures of environmental parameters and fish diversity of Pong reservoir, Himachal Pradesh, using Kriging spatial interpolation methods for geographical information system mapping. Seasonal data on environmental parameters, potential fish habitat and fish diversity was collected from lentic (dam), lentic (reservoir), transitional and lotic zone of the reservoir.. Important environmental parameters like water temperature, dissolved oxygen, electrical conductivity, water depth and transparency showed variations across the different zones of the reservoir. The sediment of the reservoir was sandy clay loam in nature as per texture analysis. Fish species richness, Shannon index and evenness index showed a similarity of the lotic and lentic (reservoir) zones of the reservoir. Six potential fish breeding grounds were identified in the reservoir indicating high conservation significance. The analysis of data showed a declining trend in fish production from 456.9 tonnes during the decade 1976-1987 to 347.91 tonnes during 2009-2020. The factors like anthropogenic climate change, predation of a stocked fish juvenile by water birds, undersized fish stocking and unscientific management are the probable reasons for the decreasing fish production. The spatial variation pattern of the water spread area, environmental parameters, fish catch and potential fish breeding grounds depicted in the GIS platform can be used as an important information base by the policy makers for fisheries management. The stocking of large size fish as a stocking material and adequate protection of the potential fish breeding grounds are the key advisories for the sustainable enhancement of fisheries as well as conservation.


Assuntos
Biodiversidade , Sistemas de Informação Geográfica , Animais , Ecossistema , Monitoramento Ambiental , Peixes , Água
8.
Transfus Apher Sci ; 61(5): 103442, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35450806

RESUMO

OBJECTIVE: Transfusion transmitted infection (TTI) is a major hazard for blood transfusion. The present retrospective chart review was undertaken to study the demographic profile and TTI trends among blood donors to see impact of interventions on blood safety. METHODS: Data of donors and TTI screening results from 2010 to 2019 were analyzed. Degree of significance was determined by Chi square test. RESULTS: Out of 1,68,570 donors, 33,227 (19.7%) were voluntary and 1,35,343 (80.3%) were replacement with 2.8% females and 54% belonging to the age group 18-29 years. Voluntary donation increased by only 3% in ten years and total reactivity rate was 1.6%. The reactive rate for all infections was 0.8% in volunteer donors and 1.95% in replacement donors (p-value < 0.001). The prevalence of HBsAg, HCV, HIV and syphilis showed a significant decline from 2010 to 2014. Of the donors who were reactive for HBV, 8.7% were missed by ELISA but detected by NAT. Donor reactivity for malaria remained the same in this period. CONCLUSION: Newer strategies and effort to increase voluntary donation helping the general public adopt a healthy lifestyle is urgently needed in India. Higher prevalence of TTI among replacement donors is substantiated by this study. Role of counseling of donors cannot be overemphasized. Utility of malaria screening for blood donors needs to be reexamined by evaluating evidences from other blood banks. A rational policy approach, based on a careful assessment of epidemiological data, cost effectiveness analysis, and opinion of stakeholders is necessary for universal adoption of NAT.


Assuntos
Infecções por HIV , Malária , Reação Transfusional , Feminino , Humanos , Adolescente , Adulto Jovem , Adulto , Masculino , Doadores de Sangue , Antígenos de Superfície da Hepatite B , Estudos Retrospectivos , Estudos Soroepidemiológicos , Infecções por HIV/epidemiologia , Índia/epidemiologia , Reação Transfusional/epidemiologia , Biomarcadores
9.
Sci Rep ; 11(1): 22890, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819593

RESUMO

The polycrystalline CoFe2O4 (CFO) film on cantilever substrate of silicon was grown using pulsed laser deposition (PLD) method and investigated its in-plane and out-of-plane magnetostrictive strain at room temperature (300 K) using the indigenous optical Cantilever Beam Magnetometer (CBM). The film shows a high compressive magnetostrictive strain of ‒ 387 ppm and ‒ 708 ppm for in-plane and out-of-plane configurations, respectively. Considerably, the magnetostrictive strain loops (λ‒H) possess a certain degree of hysteresis with a symmetric butterfly shape. The origin of large compressive magnetostriction of CFO film is attributed to the non-180° domain wall motion followed by 90° domain rotation. The large values of saturation magnetostrictive strain make CFO film a suitable candidate in sensor design for different purposes.

10.
J Assoc Physicians India ; 69(4): 11-12, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34470191

RESUMO

The concept of SGLT2-inhibition, once regarded as a non-physiological approach to glycemia control, now finds a foundational relevance in risk-modification for cardiovascular, kidney, and metabolic outcomes, spanning beyond type-2 diabetes. Major studies have proven meaningful improvements in various clinical outcomes, with different SGLT2-i agents. Apart from glycosuria, SGLT2-inhibition is associated with several patho-physiological effects, which may contribute to the clinical benefits seen with these agents. This narrative review is an attempt to appraise the different patho-physiological effects mediated by SGLT2-inhibition, based on contemporary evidence. The review classifies these effects in the acronym of EUPHORIA, and grades the possible relevance of each effect, in improving clinical outcomes.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Inibidores do Transportador 2 de Sódio-Glicose , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/tratamento farmacológico , Euforia , Homeostase , Humanos , Hipoglicemiantes , Transportador 2 de Glucose-Sódio
11.
J Environ Manage ; 292: 112816, 2021 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-34030019

RESUMO

Mangroves can play a crucial part in climate change mitigation policies due to their high carbon-storing capacity. However, the carbon sequestration potential of Indian mangroves generally remained unexplored to date. In this study, multi-temporal Sentinel-1 and 2 data-derived variables were used to estimate the AGB of a tropical carbon-rich mangrove forest of India. Ensemble prediction of multiple machine learning algorithms, including Random Forest (RF), Gradient Boosted Model (GBM), and Extreme Gradient Boosting (XGB), were used for AGB prediction. The multi-temporal dataset was used in two different ways to find the most suitable method of using them. The results of the analysis showed that the modeling field measured AGB with individual date data values results in estimates with root mean square errors (RMSE) ranging from 149.242 t/ha for XGB to 151.149 t/ha for the RF. Modeling AGB with the average and percentile metrics of the multi-temporal image stack improves the prediction accuracy of AGB, with RMSE ranging from 81.882 t/ha for the XGB to 74.493 t/ha for the RF. The AGB modeling using ensemble prediction showed further improvement in accuracy with an RMSE of 72.864 t/ha and normalized RMSE of 11.38%. In this study, the intra-seasonal variation of Sentinel-1 and 2 data for mangrove ecosystems was explored for the first time. The variations in remotely sensed variables could be attributed mainly to soil moisture availability and rainfall in the mangrove ecosystem. The efficiency of Sentinel-1 and 2 data-derived variables and ensemble prediction of machine learning models for Indian mangroves were also explored for the first time. The methodologies established in this study can be used in the future for accurate prediction and repeated monitoring of AGB for mangrove ecosystems.


Assuntos
Carbono , Ecossistema , Biomassa , Carbono/análise , Sequestro de Carbono , Índia
12.
Sci Rep ; 11(1): 10845, 2021 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-34035326

RESUMO

High density planting system i.e. accommodating a higher number of plants than routine in a given area is an innovative agro-technology to increase yield and thereby early net returns. Due to conventional wide spacing plantation in Nagpur mandarin (Citrus reticulata Blanco), the land remains unutilized as the plant canopy gradually increases over the years. In the present study, Nagpur mandarin (Citrus reticulata Blanco) budded on Rangpur lime rootstock was evaluated under six different planting spacings. It was observed that the organic carbon (1.10-1.82%) and major nutrients viz. N (309-430 kg ha-1), P (20-54 kg ha-1) and K (291-810 kg ha-1) increased vis-à-vis plant density and was highest under 2 × 2 m spacing. Plants were tallest at 2 × 2 m spacing with the higher PAR interception (88.2) and the lowest leaf area index (1.09). Fruit yield on area basis, under 2 × 2 m spacing was 26, 7.1, 4.6 times more as compared to conventional plantation during the first, second and third year, respectively. At fifth year of crop harvest, the highest B:C ratio (6.36) was recorded in 6 × 3 m followed by 4 × 2 m and 2 × 2 m.

13.
Diabetes Metab Syndr Obes ; 14: 1703-1728, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33889005

RESUMO

Diabetes and obesity are both increasing at a fast pace and giving rise to a new epidemic called diabesity. Lifestyle interventions including diet play a major role in the treatment of diabetes, obesity and diabesity. There are many guidelines on dietary management of diabetes or obesity globally and also from South Asia. However, there are no global or South Asian guidelines on the non-pharmacological management of diabesity. South Asia differs from the rest of the world as South Asians have different phenotype, cooking practices, food resources and exposure, medical nutrition therapy (MNT) practices, and availability of trained specialists. Therefore, South Asia needs its own guidelines for non-pharmacological management of diabesity in adults. The aim of the Consensus on Medical Nutrition Therapy for Diabesity (CoMeND) in Adults: A South Asian Perspective is to recommend therapeutic and preventive MNT in the South-Asians with diabesity.

14.
J Pak Med Assoc ; 70(6): 1094-1098, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32810116

RESUMO

Cardiovascular disease (CVD) is a major cause of morbidity and mortality across the globe. Prevention and management of the CVD pandemic calls for concerted action on part of all health care professionals, as well as other concerned stakeholders. We call for cardiovigilance in healthcare and define it as "the action or state of keeping careful watch, to prevent, screen, diagnose and manage cardiovascular disease (CVD) in a timely and appropriate manner". We expand upon the concept of cardiovigilance, describe its utility, and suggest various taxonomic rubrics to simplify its practice.


Assuntos
Doenças Cardiovasculares , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Humanos , Fatores de Risco
15.
J Phys Condens Matter ; 32(41): 415606, 2020 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-32575089

RESUMO

Density functional theory calculations within the generalized gradient approximation are employed to study the ground state of Co2FeAl. Various magnetic configurations are considered to find out its most stable phase. The ferromagnetic ground state of the Co2FeAl is energetically observed with an optimized lattice constant of 5.70 Å. After that, the system was subjected under uniform and non-uniform strains, to see their effects on spin polarization (P) and half-metallicity. The effect of spin-orbit coupling is considered in the present study. Half-metallicity (and 100% P) is retained only under uniform strains started from 0 to +4%, and dropped rapidly from 90% to 16% for the negative strains started from -1% to -6%. We find that the present system is much sensitive under tetragonal distortions as half-metallicity (and 100% P) is preserved only for the cubic case. The main reason for the loss of half-metallicity is due to the shift of the bands with respect to the Fermi level (E F). We also discuss the influence of these results on spintronics devices.

16.
J Phys Condens Matter ; 32(38): 385802, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32438352

RESUMO

CaBaCo4O7 (CBCO) cobaltite shows a giant spin driven pyroelectric polarization below its ferrimagnetic transition temperature at 64 K. In the present study, we have investigated the structural, magnetic and electric polarization properties of light nonmagnetic Zn doped polycrystalline CaBaCo3.97Zn0.03O7 (CBCZO) cobaltite. Neutron powder diffraction studies on the CBCZO show that the Zn occupies the Co2 sites which lowers the strength of the magnetic interactions between the bitetrahedral cobalt c-axis chains. Further, we show that these chains act as magnetic clusters and causes the switching of the electric polarization. This study specifies that the ferrimagnetic-pyroelectric ground state of CBCO is very sensitive to the light non-magnetic doping and the results can be used to further understand the pyroelectric polarization switching properties of CBCO.

17.
Indian Heart J ; 72(1): 7-13, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32423565

RESUMO

AIM: The primary objective of this review is to develop practice-based expert group opinions on the cardiovascular (CV) safety and utility of modern sulfonylureas (SUs) in cardiovascular outcome trials (CVOTs). BACKGROUND: The United States Food and Drug Administration issued new guidance to the pharmaceutical industry in 2008 regarding the development of new antihyperglycemic drugs. The guidance expanded the scope for the approval of novel antihyperglycemic drugs by mandating CVOTs for safety. A few long-term CVOTs on dipeptidyl peptidase 4 inhibitors, glucagon-like peptide 1 receptor agonists, and sodium-glucose cotransporter 2 inhibitors have been completed, while others are ongoing. SUs, which constitute one of the key antihyperglycemic agents used for the management of type 2 diabetes mellitus (T2DM), have been used as comparator agents in several CVOTs. However, the need for CVOTs on modern SUs remains debatable. In this context, a multinational group of endocrinologists convened for a meeting and discussed the need for CVOTs of modern SUs to evaluate their utility in the management of patients with T2DM. At the meeting, CVOTs of modern SUs conducted to date and the hypotheses derived from the results of these trials were discussed. REVIEW RESULTS: The expert group analyzed the key trials emphasizing the CV safety of modern SUs and also reviewed the results of various CVOTs in which modern SUs were used as comparators. Based on literature evidence and individual clinical insights, the expert group opined that modern SUs are cardiosafe and that since they have been used as comparators in other CVOTs, CVOTs of SUs are not required. CONCLUSION: Modern SUs can be considered a cardiosafe option for the management of patients with diabetes mellitus and CV disease; thus CVOTs among individuals with T2DM are not required.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Prova Pericial , Compostos de Sulfonilureia/uso terapêutico , Humanos , Resultado do Tratamento
18.
Diabetes Ther ; 11(2): 411-422, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31916214

RESUMO

AIM: The primary objective of this review is to develop a practice-based expert group opinion on the role of precision medicine with a specific focus on sulfonylureas (SUs) in diabetes management. BACKGROUND: The clinical etiology, presentation and complications of diabetes vary from one patient to another, making the management of the disease challenging. The pre-eminent feature of diabetes mellitus (DM) are chronically elevated blood glucose concentrations; however, in clinical practice, the exclusion of autoimmunity, pregnancy, pancreatic disease or injury and rare genetic forms of diabetes is crucial. Within this framework, precision medicine provides unique insights into the risk factors and natural history of DM. Precision medicine goes beyond genomics and encompasses patient-centered care, molecular technologies and data sharing. Precision medicine has evolved in the field of diabetology. It has helped improve the efficacy of SUs, a class of drugs, which have been effectively used in the management of diabetes mellitus for decades, and it has enabled the expansion of SUs use in diabetes patients with genetic mutations. REVIEW RESULTS: After due discussions, the expert group analyzed studies that focused on the use of SUs in diabetes patients with genomic variations and rare mutations. The expert group opined that SUs are important glucose-lowering drugs and that precision medicine helps in improving the efficacy of SUs by matching them to those patients who will benefit most. CONCLUSION: Precision medicine opens new vistas for the effective use of SUs in unexpected patient populations, such as those with genetic mutations.

19.
J Visc Surg ; 157(1): 3-11, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31427102

RESUMO

AIM OF THE STUDY: Bile duct injury (BDI) after cholecystectomy is a serious complication. It often requires surgical repair. The aim of this study was to report on the short and long-term outcomes of surgery for post-cholecystectomy BDI. PATIENTS AND METHODS: All the patients, who underwent surgery for post-cholecystectomy BDI between August 2007 and September 2017, were retrospectively reviewed. McDonald grading system was used to assess the long-term outcome. The risk factors for unsatisfactory long-term outcome were analyzed by univariate and multivatiate logistic regression analysis. RESULTS: In total, 228 patients had a Roux-en-Y hepaticojejunostomy. Open cholecystectomy was the major cause of BDI (61%). The median time from injury to definitive repair was 6 months. The types of BDI were as follows: E1 in 13 (5.7%), E2 in 68 (29.82%), E3 in 108 (47.36%), E4 in 28 (12.28%), and E5 in 11 (4.82%) patients respectively. Postoperative morbidity and mortality were 25% and 1.31% respectively. After a median follow-up of 58 months, 90% patients had excellent to good outcome. Recurrent stricture developed in 6 (3%) patients. On multivariate analysis, long injury-repair interval and previous attempt at repair were independent predictors for unsatisfactory long-term outcome. CONCLUSION: Surgical reconstruction affords excellent to good results for majority of the patients with post-cholecystectomy BDI. As longer delay in definitive repair and previous attempt at repair were associated with unsatisfactory long-term outcome, early referral to a specialized hepatobiliary surgery unit is recommended.


Assuntos
Ductos Biliares/lesões , Ductos Biliares/cirurgia , Colecistectomia , Complicações Pós-Operatórias/cirurgia , Adolescente , Adulto , Idoso , Anastomose em-Y de Roux , Criança , Feminino , Humanos , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária
20.
Diabet Med ; 37(5): 885-892, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31691356

RESUMO

AIM: India contributes towards a large part of the worldwide epidemic of diabetes and its associated complications. However, there are limited longitudinal studies available in India to understand the occurrence of diabetes complications over time. This pan-India longitudinal study was initiated to assess the real-world outcomes of diabetes across the country. METHODS: The LANDMARC study is the first prospective, multicentre, longitudinal, observational study investigating a large cohort of people with type 2 diabetes mellitus across India over a period of 3 years. The primary objective of this ongoing study is to determine the proportion of people developing macrovascular diabetes complications over the duration of the study (36 months ± 45 days) distributed over seven visits; the secondary objective is to evaluate microvascular diabetes complications, glycaemic control and time-to-treatment adaptation or intensification. Overall, 6300 participants (aged 25-60 years) diagnosed with type 2 diabetes for at least 2 years will be included from 450 centres across India. Data will be recorded for baseline demographics, comorbidities, glycaemic measurements, use of anti-hyperglycaemic medications and any cardiovascular or other diabetes-related events occurring during the observational study period. CONCLUSIONS: The LANDMARC study is expected to reveal the trends in complications associated with diabetes, treatment strategies used by physicians, and correlation among treatment, control and complications of diabetes within the Indian context. The findings of this study will help to identify the disease burden, emergence of early-onset complications and dose titration patterns, and eventually develop person-centred care and facilitate public health agencies to invest appropriate resources in the management of diabetes. (Trial Registration No: CTRI/2017/05/008452).


Assuntos
Diabetes Mellitus Tipo 2/terapia , Angiopatias Diabéticas/epidemiologia , Hipoglicemiantes/uso terapêutico , Adulto , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Angiopatias Diabéticas/etiologia , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Neuropatias Diabéticas/epidemiologia , Neuropatias Diabéticas/etiologia , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/etiologia , Feminino , Hemoglobinas Glicadas/metabolismo , Controle Glicêmico , Humanos , Índia/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/etiologia , Estudos Observacionais como Assunto , Doenças Vasculares Periféricas/epidemiologia , Doenças Vasculares Periféricas/etiologia , Estudos Prospectivos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia
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