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AIM: To evaluate the tolerability, safety and pharmacodynamics of different dose-escalation schemes of the oral small-molecule glucagon-like peptide-1 receptor (GLP-1R) agonist danuglipron. MATERIALS AND METHODS: This Phase 2a, double-blind, placebo-controlled, parallel-group study randomly assigned adults with type 2 diabetes (T2D) treated with metformin to placebo or danuglipron (low [5-mg] or high [10-mg] starting dose, with 1- or 2-week dose-escalation steps, to target doses of 80, 120 or 200 mg twice daily [BID]) and adults with obesity without diabetes to placebo or danuglipron 200 mg BID. RESULTS: Participants with T2D (n = 123, mean glycated haemoglobin [HbA1c] 8.19%) or obesity without diabetes (n = 28, mean body mass index 37.3 kg/m2 ) were randomly assigned and treated. Discontinuation from study medication occurred in 27.3% to 72.7% of participants across danuglipron groups versus 16.7% to 18.8% for placebo, most often due to adverse events. Nausea (20.0%-47.6% of participants across danuglipron groups vs. 12.5% for placebo) and vomiting (18.2%-40.9% danuglipron vs. 12.5% placebo, respectively) were most commonly reported in participants with T2D. Gastrointestinal adverse events were generally related to danuglipron target dose and were not substantially affected by starting dose. In participants with T2D, least squares mean changes from baseline in HbA1c (-1.04% to -1.57% across danuglipron groups vs. -0.32% for placebo), fasting plasma glucose (-23.34 mg/dL to -53.94 mg/dL danuglipron vs. -13.09 mg/dL placebo) and body weight (-1.93 to -5.38 kg danuglipron vs. -0.42 kg placebo) at Week 12 were generally statistically significant for danuglipron compared with placebo (P < 0.05). CONCLUSIONS: Danuglipron resulted in statistically significant reductions in HbA1c, FPG and body weight over 12 weeks, in the setting of higher discontinuation rates and incidence of gastrointestinal adverse events with higher target doses. CLINICALTRIALS: gov identifier: NCT04617275.
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Diabetes Mellitus Tipo 2 , Adulto , Humanos , Receptor del Péptido 1 Similar al Glucagón/agonistas , Hemoglobina Glucada , Hipoglucemiantes/efectos adversos , Peso Corporal , Obesidad/tratamiento farmacológico , Obesidad/inducido químicamente , Método Doble Ciego , Resultado del Tratamiento , GlucemiaRESUMEN
OBJECTIVE: To assess aerobic fitness of adolescents, using maximum aerobic speed (MAS). To test the relationship between MAS and other variables. To compare our 2019/21 data to similar data published in 1996. METHODS: A running application was used to measure MAS with the half-Cooper test. To test age, BMI, gender and school attended as possible predictors of MAS, multiple logistic regressions were performed. A series of t-tests and ANOVAs were performed to test differences between the variable means. t-tests were used to compare MAS, height and weight of our population to a similar population tested during the late 1990s. RESULTS: Our sample of 3368 adolescent students shows that age, BMI, gender and the school attended are predictors of MAS. MAS increases more significantly between 13 and 15 years of age, particularly in males. MAS is significantly greater in males compared to females at all ages between 12 and 18 years. When compared to a reference population in the 1990s, our data shows: significantly lower MAS at ages 14, 15, 16 and 17 for males and at 17 for females. Males' weight is significantly higher at each age between 12 and 17, but height only significantly higher at 12, 14 and 15 years of age. Females' weight is significantly higher in each age category between 14 and 17 years of age, but height only at 12 and 14 years old. CONCLUSIONS: The aerobic fitness in adolescent students was correlated to age, BMI, gender and school attended. After 12 years old, MAS evolved differently in males and females. Our data suggests a decline in MAS since the 1990s at as early as 14 years of age in males and 17 for females, and an increased weight, which is suggestive of a decline in health. The impact of MAS decline on mental health will be discussed.
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Salud Mental , Carrera , Adolescente , Bélgica/epidemiología , Niño , Depresión , Femenino , Humanos , Masculino , Padres , Aptitud FísicaRESUMEN
BACKGROUND: In March 2020, the Belgian population was exposed to a confinement situation that it had never experienced before associated with the collapse in access to psychiatric care. Initially, only emergencies and constrained care continued to operate. In these specific circumstances, where both the overall population and the psychiatric population, was exposed to unique stress factors, what was the role of forced psychiatric internments in the treatment of mood disorders? SUBJECTS AND METHODS: We have measured the number of detentions for observation with and without suicide attempt over the two years prior to the pandemic in order to obtain theoretical reference values. We have compared these values with the measures over the 12 months following the start of the confinement period, which constitute the Crisis values. The continuation of measures, with an equal number of observation measures, constituted the Post-Crisis values. For these same cases, we compared in suicide attempt cases, whether the criteria for Severe Major Depressive Disorder were met or not. Lastly we compared the number of observation measures that were lifted, or not, within ten days of patient care. RESULTS: There was no significant increase in Detentions for Observation following a suicide attempt during the Crisis period. However a significant increase was observed during the Post-Crisis period. As regards cases of attempted suicide during the Crisis period, the number of patients suffering from Major Depressive Disorders reduced significantly in terms of statistics. This confirms our impression of a change in population. The Post-Crisis values dropped to the Theoric values. The number of Observation measures lifted increased quite significantly during the Crisis period, while there was a return to values in terms of statistics similar to the Theoric values during the Post-Crisis period. CONCLUSIONS: Although the population, both the healthy population and those suffering from a psychiatric condition, was subject to stress that it had never before experienced coinciding with a collapse of healthcare provision, there was no increase in patients meeting the criteria to benefit from constrained care during the Crisis period. On the other hand, there was a significant change in statistical terms in the population of patients who attempted suicide. We have seen a collapse in the number of patients suffering from depressive disorders and an equivalent increase in the number of patients with personality disorders or adjustment disorders. The number of Observation measures lifted during the Crisis period also grew quite significantly. Constrained care was available to help manage reactive suicide attempts. All other things being equal, they indirectly showed a reduction in Major Depressive Disorders requiring constrained care in the population.
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COVID-19 , Trastorno Depresivo Mayor , Trastorno Depresivo Mayor/epidemiología , Trastorno Depresivo Mayor/terapia , Humanos , Trastornos del Humor/epidemiología , Trastornos del Humor/terapia , Pandemias , Intento de Suicidio/prevención & controlRESUMEN
BACKGROUND: Hantavirus cardiopulmonary syndrome (HCPS) has a high lethality. Severe cases may be rescued by venoarterial extracorporeal membrane oxygenation (VA ECMO), alongside substantial complications. High volume hemofiltration (HVHF) is a depurative technique that provides homeostatic balance allowing hemodynamic stabilization in some critically ill patients. METHODS: We implemented HVHF before VA ECMO consideration in the last five severe HCPS patients requiring mechanical ventilation and vasoactive drugs admitted to our intensive care unit. Patients were considered HVHF-responders if VA ECMO was avoided and HVHF-nonresponders if VA ECMO support was needed despite HVHF. A targeted-HVHF strategy compounded by aggressive hyperoncotic albumin, sodium bicarbonate, and calcium supplementation plus ultrafiltration to avoid fluid overload was implemented on three patients. RESULTS: Patients had maximum serum lactate of 8.8 (8.7-12.8) mmol/L and a lowest cardiac index of 1.8 (1.8-1.9) L/min/m2 . The first two required VA ECMO. They were connected later to HVHF, displayed progressive tachycardia and declining stroke volume. The opposite was true for HVHF-responders who received targeted-HVHF. All patients survived, but one of the VA ECMO patients suffered a vascular complication. CONCLUSION: HVHF may contribute to support severe HCPS patients avoiding the need for VA ECMO in some. Early connection and targeted-HVHF may increase the chance of success.
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Oxigenación por Membrana Extracorpórea/métodos , Infecciones por Hantavirus/complicaciones , Cardiopatías/virología , Hemofiltración/métodos , Enfermedades Pulmonares/virología , Adolescente , Femenino , Orthohantavirus/patogenicidad , Corazón/virología , Cardiopatías/terapia , Hemofiltración/normas , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Enfermedades Pulmonares/terapia , Masculino , Estudios Prospectivos , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto JovenRESUMEN
BACKGROUND: Effective treatments for managing suboptimal clinical responses to current therapy for schizophrenia remain a critical unmet need. Phosphodiesterase 10A (PDE10A) inhibition represents a mechanistically novel approach to the treatment of schizophrenia, with preclinical studies suggesting improvements in partially responsive symptoms could be achieved via adjunctive use of the PDE10A inhibitor PF-02545920. Therefore, the adjunctive safety, tolerability, pharmacokinetics, and efficacy of multiple repeat doses of PF-02545920 were investigated in a phase 1b study and subsequent phase 2 study. METHODS: The phase 1b study randomized 37 adult patients with stable symptomatology and stable antipsychotic regimens within 3 cohorts. Study participants received ascending doses of PF-02545920 or placebo for 10 to 18 days. The phase 2 study randomized 240 outpatients with stable symptomatology but suboptimal response to current antipsychotic regimens 1:1:1 to PF-02545920 5 mg, PF-02545920 15 mg, or placebo every 12 hours for 12 weeks. The primary efficacy end point of the phase 2 study was change in the Positive and Negative Syndrome Scale total score from baseline to week 12, with changes in other clinical assessments as secondary end points. RESULTS: Treatment was well tolerated, and observed PF-02545920 exposures were within the range predicted to be adequate for demonstrating efficacy. However, no significant differences in the prespecified efficacy end points between the 2 PF-02545920 treatment arms and placebo were observed. CONCLUSIONS: Current data and results of a prior monotherapy study in which PF-02545920 failed to differentiate from placebo refute the hypothesis that PDE10A inhibitors have use as antipsychotic agents for schizophrenia.
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Inhibidores de Fosfodiesterasa/uso terapéutico , Pirazoles/uso terapéutico , Quinolinas/uso terapéutico , Esquizofrenia/tratamiento farmacológico , Adulto , Antipsicóticos/uso terapéutico , Método Doble Ciego , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración PsiquiátricaRESUMEN
Colloidal quantum dot (CQD) solar cells have attracted tremendous attention mostly due to their wide absorption spectrum window and potentially low processability cost. The ultimate efficiency of CQD solar cells is highly limited by their high trap state density. Here we show that the overall device power conversion efficiency could be improved by employing photonic structures that enhance both charge generation and collection efficiencies. By employing a two-dimensional numerical model, we have calculated the characteristics of patterned CQD solar cells based of a simple grating structure. Our calculation predicts a power conversion efficiency as high as 11.2%, with a short circuit current density of 35.2 mA/cm2, a value nearly 1.5 times larger than the conventional flat design, showing the great potential value of patterned quantum dot solar cells.
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Colloidal quantum dot (CQD) solar cells have attracted tremendous attention because of their tunable absorption spectrum window and potentially low processing cost. Recently reported quantum junction solar cells represent a promising approach to building a rectifying photovoltaic device that employs CQD layers on each side of the p-n junction. However, the ultimate efficiency of CQD solar cells is still highly limited by their high trap state density in both p- and n-type CQDs. By modeling photonic structures to enhance the light absorption within the carrier transport length and by ensuring that the carrier generation and collection efficiencies were both augmented, our work shows that overall device current density could be improved. We utilized a two-dimensional numerical model to calculate the characteristics of patterned CQD solar cells based on a simple grating structure. Our calculation predicts a short circuit current density as high as 31 mA/cm2, a value nearly 1.5 times larger than that of the conventional flat design, showing the great potential value of patterned quantum junction solar cells.
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On-demand drug delivery holds great promise to optimize pharmaceutical efficacy while minimizing the side effects. However, existing on-demand drug delivery systems often require complicated manufacturing processes that preclude their wide implementation of a broad range of drugs. In this work, we demonstrate the introduction of MXene-coated microneedles (MNs) into bioelectronics for digitally controllable gate-valve drug delivery. MXenes, featuring high electronic conductivity, excellent biocompatibility, and solution processibility, enable low-cost scalability for printable bioelectronics. In an electrolytic state (e.g., body fluid), the coated MXene is oxidized and desorbed due to redox reactions caused by electrical bias, allowing the underlying drug to be controllably released. The MXene-incorporated drug delivery system not only demonstrates excellent biocompatibility and operational stability, but also features low-cost construction and sustainable usage. Besides, these MXene-coated MNs allow both on-demand transformation and local-region customization, further increasing the structural versatility and capability of multidrug delivery systems.
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Sistemas de Liberación de Medicamentos , Conductividad Eléctrica , Sistemas de Liberación de Medicamentos/instrumentación , Agua/química , Humanos , Diseño de EquipoRESUMEN
Hantaviruses, members of the Bunyaviridae family, can cause two patterns of disease in humans, hantavirus hemorrhagic fever with renal syndrome (HFRS) and cardiopulmonary syndrome (HCPS), being the latter hegemonic on the American continent. Andesvirus is one of the strains that can cause HCPS and is endemic in Chile. Its transmission occurs through direct or indirect contact with infected rodents' urine, saliva, or feces and inhalation of aerosol particles containing the virus. HCPS rapidly evolves into acute but reversible multiorgan dysfunction. The hemodynamic pattern of HCPS is not identical to that of cardiogenic or septic shock, being characterized by hypovolemia, systolic dysfunction, and pulmonary edema secondary to increased permeability. Given the lack of specific effective therapies to treat this viral infection, the focus of treatment lies in the timely provision of intensive care, specifically hemodynamic and respiratory support, which often requires veno-arterial extracorporeal membrane oxygenation (VA-ECMO). This narrative review aims to provide insights into specific ICU management of HCPS based on the available evidence and gathered experience in Chile and South America including perspectives of pathophysiology, organ dysfunction kinetics, timely life support provision, safe patient transportation, and key challenges for the future.
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Pyrethroid resistance in Aedes aegypti has become widespread after almost two decades of frequent applications to reduce the transmission of mosquito-borne diseases. Because few insecticide classes are available for public health use, insecticide resistance management (IRM) is proposed as a strategy to retain their use. A key hypothesis of IRM assumes that negative fitness is associated with resistance, and when insecticides are removed from use, susceptibility is restored. In Tapachula, Mexico, pyrethroids (PYRs) were used exclusively by dengue control programs for 15 years, thereby contributing to selection for high PYR resistance in mosquitoes and failure in dengue control. In 2013, PYRs were replaced by organophosphates-insecticides from a class with a different mode of action. To test the hypothesis that PYR resistance is reversed in the absence of PYRs, we monitored Ae. aegypti's PYR resistance from 2016 to 2021 in Tapachula. We observed significant declining rates in the lethal concentration 50 (LC50), for permethrin and deltamethrin. For each month following the discontinuation of PYR use by vector control programs, we observed increases in the odds of mosquitoes dying by 1.5% and 8.4% for permethrin and deltamethrin, respectively. Also, knockdown-resistance mutations (kdr) in the voltage-gated sodium channel explained the variation in the permethrin LC50s, whereas variation in the deltamethrin LC50s was only explained by time. This trend was rapidly offset by application of a mixture of neonicotinoid and PYRs by vector control programs. Our results suggest that IRM strategies can be used to reverse PYR resistance in Ae. aegypti; however, long-term commitment by operational and community programs will be required for success.
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Aedes , Dengue , Insecticidas , Nitrilos , Piretrinas , Animales , Humanos , Insecticidas/farmacología , Permetrina , Aedes/genética , México , Estudios Longitudinales , Mosquitos Vectores/genética , Mutación , Piretrinas/farmacología , Resistencia a los Insecticidas/genética , Dengue/prevención & controlRESUMEN
Importance: There is an urgent need to identify treatments for postacute sequelae of SARS-CoV-2 infection (PASC). Objective: To assess the efficacy of a 15-day course of nirmatrelvir-ritonavir in reducing the severity of select PASC symptoms. Design, Setting, and Participants: This was a 15-week blinded, placebo-controlled, randomized clinical trial conducted from November 2022 to September 2023 at Stanford University (California). The participants were adults with moderate to severe PASC symptoms of 3 months or longer duration. Interventions: Participants were randomized 2:1 to treatment with oral nirmatrelvir-ritonavir (NMV/r, 300 mg and 100 mg) or with placebo-ritonavir (PBO/r) twice daily for 15 days. Main Outcomes and Measures: Primary outcome was a pooled severity of 6 PASC symptoms (fatigue, brain fog, shortness of breath, body aches, gastrointestinal symptoms, and cardiovascular symptoms) based on a Likert scale score at 10 weeks. Secondary outcomes included symptom severity at different time points, symptom burden and relief, patient global measures, Patient-Reported Outcomes Measurement Information System (PROMIS) measures, orthostatic vital signs, and sit-to-stand test change from baseline. Results: Of the 155 participants (median [IQR] age, 43 [34-54] years; 92 [59%] females), 102 were randomized to the NMV/r group and 53 to the PBO/r group. Nearly all participants (n = 153) had received the primary series for COVID-19 vaccination. Mean (SD) time between index SARS-CoV-2 infection and randomization was 17.5 (9.1) months. There was no statistically significant difference in the model-derived severity outcome pooled across the 6 core symptoms at 10 weeks between the NMV/r and PBO/r groups. No statistically significant between-group differences were found at 10 weeks in the Patient Global Impression of Severity or Patient Global Impression of Change scores, summative symptom scores, and change from baseline to 10 weeks in PROMIS fatigue, dyspnea, cognitive function, and physical function measures. Adverse event rates were similar in NMV/r and PBO/r groups and mostly of low grade. Conclusions and Relevance: The results of this randomized clinical trial showed that a 15-day course of NMV/r in a population of patients with PASC was generally safe but did not demonstrate a significant benefit for improving select PASC symptoms in a mostly vaccinated cohort with protracted symptom duration. Further studies are needed to determine the role of antivirals in the treatment of PASC. Trial Registration: ClinicalTrials.gov Identifier: NCT05576662.
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Thin film nanostructured photovoltaic cells are increasing in efficiency and decreasing the cost of solar energy. FDTD modeling of branched nanowire 'forests' are shown to have improved optical absorption in the visible and near-IR spectra over nanowire arrays alone, with a factor of 5 enhancement available at 1000 nm. Alternate BNW tree configurations are presented, achieving a maximum absorption of over 95% at 500 nm.
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Tantalum nitride (Ta3N5) has gained significant attention as a potential photoanode material, yet it has been challenged by material quality issues. Defect-induced trap states are detrimental to the performance of any semiconductor material. Beyond influencing the performance of Ta3N5 films, defects can also accelerate the degradation in water during desired electrochemical applications. Defect passivation has provided an enormous boost to the development of many semiconductor materials but is currently in its infancy for Ta3N5. This is in part due to a lack of experimental understanding regarding the spatial and energetic distribution of trap states throughout Ta3N5 thin films. Here, we employ drive-level capacitance profiling (DLCP) to experimentally resolve the spatial and energetic distribution of trap states throughout Ta3N5 thin films. The density of deeper energetic traps is found to reach â¼2.5 to 6 × 1022 cm-3 at the interfaces of neat Ta3N5 thin films, over an order of magnitude greater than the bulk. In addition to the spatial profile of deep trap states, we report neat Ta3N5 thin films to be highly n-type in nature, owning a free carrier density of â¼9.74 × 1017 cm-3. This information, coupled with the present understanding of native oxide layers on Ta3N5, has facilitated the rational design of a targeted passivation strategy that simultaneously provides a means for catalyst immobilization. Loading catalyst via silatrane moieties suppresses the density of defects at the surface of Ta3N5 thin films by two orders of magnitude, while also reducing the free carrier density of films by over one order of magnitude, effectively dedoping the films to â¼2.40 × 1016 cm-3. The surface passivation of Ta3N5 films translates to suppressed defect-induced trapping and recombination of photoexcited carriers, as determined through absorption, photoluminescence, and transient photovoltage. This illustrates how developing a deeper understanding of the distribution and influence of defects in Ta3N5 thin films has the potential to guide future works and ultimately accelerate the integration and development of high-performance Ta3N5 thin film devices.
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Perovskite photovoltaics offer a highly efficient and low-cost solar energy harvesting technology. However, the presence of lead (Pb) cations in photovoltaic halide perovskite (HaPs) materials is concerning, and quantifying the environmental hazard of accidental Pb2+ leaching into the soil is crucial for assessing the sustainability of this technology. Pb2+ from inorganic salts was previously found to remain in the upper soil layers due to adsorption. However, Pb-HaPs contain additional organic and inorganic cations, and competitive cation adsorption may affect Pb2+ retention in soils. Therefore, we measured, analyzed by simulations and report the depths to which Pb2+ from HaPs penetrates into 3 types of agricultural soil. Most of the HaP-leached Pb2+ is found to be retained already in the first cm of the soil columns, and subsequent rain events do not induce Pb2+ penetration below the first few cm of soil surface. Surprisingly, organic co-cations from the dissolved HaP are found to enhance the Pb2+ adsorption capacity in clay-rich soil, compared to non-HaP-based Pb2+ sources. Our results imply that installation over soil types with improved Pb2+ adsorption, and removal of only the contaminated topsoil, are sufficient means to prevent ground water contamination by HaP-leached Pb2+.
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Hantavirus cardiopulmonary syndrome (HCPS) is a severe respiratory illness primarily associated with microvascular endothelial changes, particularly in the lungs. However, the role of the pulmonary epithelium in HCPS pathogenesis remains unclear. This study explores the potential of soluble Receptors for Advanced Glycation End-products (sRAGE) as a biomarker for assessing pulmonary epithelial damage in severe HCPS, challenging the prevailing view that endothelial dysfunction is the sole driver of this syndrome. We conducted a cross-sectional study on critically ill HCPS patients, categorizing them into mild HCPS, severe HCPS, and negative control groups. Plasma sRAGE levels were measured, revealing significant differences between the severe HCPS group and controls. Our findings suggest that sRAGE holds promise as an indicator of pulmonary epithelial injury in HCPS and may aid in tracking disease progression and guiding therapeutic strategies. This study brings clarity on the importance of investigating the pulmonary epithelium's role in HCPS pathogenesis, offering potential avenues for enhanced diagnostic precision and support in this critical public health concern.
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Enfermedades Transmisibles , Infecciones por Hantavirus , Síndrome Pulmonar por Hantavirus , Lesión Pulmonar , Orthohantavirus , Humanos , Receptor para Productos Finales de Glicación Avanzada , Endotelio Vascular , Estudios Transversales , Pulmón/patología , Biomarcadores , Lesión Pulmonar/patología , Síndrome Pulmonar por Hantavirus/diagnósticoRESUMEN
Hantavirus infections are part of the broad group of viral haemorrhagic fevers. They are also recognised as a distinct model of an emergent zoonotic infection with a global distribution. Many factors influence their epidemiology and transmission, such as climate, environment, social development, ecology of rodent hosts, and human behaviour in endemic regions. Transmission to humans occurs by exposure to infected rodents in endemic areas; however, Andes hantavirus is unique in that it can be transmitted from person to person. As hantaviruses target endothelial cells, they can affect diverse organ systems; increased vascular permeability is central to pathogenesis. The main clinical syndromes associated with hantaviruses are haemorrhagic fever with renal syndrome (HFRS), which is endemic in Europe and Asia, and hantavirus cardiopulmonary syndrome (HCPS), which is endemic in the Americas. HCPS and HFRS are separate clinical entities, but they share several features and have many overlapping symptoms, signs, and pathogenic alterations. For HCPS in particular, clinical outcomes are highly associated with early clinical suspicion, access to rapid diagnostic testing or algorithms for presumptive diagnosis, and prompt transfer to a facility with critical care units. No specific effective antiviral treatment is available.
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Enfermedades Transmisibles , Infecciones por Hantavirus , Síndrome Pulmonar por Hantavirus , Fiebre Hemorrágica con Síndrome Renal , Orthohantavirus , Humanos , Fiebre Hemorrágica con Síndrome Renal/diagnóstico , Fiebre Hemorrágica con Síndrome Renal/epidemiología , Fiebre Hemorrágica con Síndrome Renal/terapia , Células Endoteliales/patología , Síndrome Pulmonar por Hantavirus/diagnóstico , Síndrome Pulmonar por Hantavirus/tratamiento farmacológico , Síndrome Pulmonar por Hantavirus/epidemiología , Infecciones por Hantavirus/diagnóstico , Infecciones por Hantavirus/epidemiología , Infecciones por Hantavirus/terapiaRESUMEN
PURPOSE: To determine whether VDPhys/VT is associated with coagulation activation and outcomes. MATERIALS AND METHODS: We enrolled patients with COVID-19 pneumonia who were supported by invasive mechanical ventilation and were monitored using volumetric capnography. Measurements were performed during the first 24 h of mechanical ventilation. The primary endpoint was the likelihood of being discharge alive on day 28. RESULTS: Sixty patients were enrolled, of which 25 (42%) had high VDPhys/VT (>57%). Patients with high vs. low VDPhys/VT had higher APACHE II (10[8-13] vs. 8[6-9] points, p = 0.002), lower static compliance of the respiratory system (35[24-46] mL/cmH2O vs. 42[37-45] mL/cmH2O, p = 0.005), and higher D-dimer levels (1246[1050-1594] ng FEU/mL vs. 792[538-1159] ng FEU/mL, p = 0.001), without differences in P/F ratio (157[112-226] vs. 168[136-226], p = 0.719). Additionally, D-dimer levels correlated with VDPhys/VT (r = 0.530, p < 0.001), but not with the P/F ratio (r = -0.103, p = 0.433). Patients with high VDPhys/VT were less likely to be discharged alive on day 28 (32% vs. 71%, aHR = 3.393[1.161-9.915], p = 0.026). CONCLUSIONS: In critically ill COVID-19 patients, increased VDPhys/VT was associated with high D-dimer levels and a lower likelihood of being discharged alive. Dichotomic VDPhys/VT could help identify a high-risk subgroup of patients neglected by the P/F ratio.
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COVID-19 , Síndrome de Dificultad Respiratoria , COVID-19/terapia , Capnografía , Humanos , Respiración Artificial , Espacio Muerto Respiratorio/fisiología , Síndrome de Dificultad Respiratoria/terapia , Volumen de Ventilación Pulmonar/fisiologíaRESUMEN
This work presents a mechanistic study of the electrochemical synthesis of magnetite nanoparticles (NPs) based on the analysis of the electrochemical impedance spectroscopy (EIS) technique. After a discussion of the mechanisms reported in the literature, three models are devised and a prediction of their EIS spectra is presented. The approach consisted of the simulation of EIS spectra as a tool for assessing model validity, as EIS allows to characterize the relaxation of adsorbed intermediates. The comparison between the simulated impedance spectra and the experimental results shows that the mechanisms proposed to date do not explain all of the experimental results. Thus, a new model is proposed, in which up to three adsorbed intermediate species are involved. This model accounts for the number of loops found in experimental impedance data. The closest approximation of the features found in the experimental spectra by this proposed model suggests a better representation of the reaction mechanism within the evaluated potential range.
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In this Letter we provide experimental verification of the interparticle distance dependence of the SERS enhancement factor in 1 µm gold gapped nanorods. Au dimers are fabricated from electrochemically grown heterogeneous Au-Ag-Au nanorods and deposited on a stretchable elastomer film which allows active and reversible tuning of the interparticle gap on the sub-5-nm level. Significantly, this technique allows the distance dependence to be tracked using a single dimer, thereby avoiding enhancement factor reproducibility issues arising from morphological differences in disparate nanoparticle pairs.