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1.
Phys Rev Lett ; 132(6): 065102, 2024 Feb 09.
Artículo en Inglés | MEDLINE | ID: mdl-38394591

RESUMEN

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

2.
Med Vet Entomol ; 2024 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-39039827

RESUMEN

Among mammals, bats harbour the greatest taxonomic diversity of ectoparasitic arthropods. This is mainly due to their high mobility, wide distribution range and gregarious social behaviour. In Chile, 17 species of bats have been reported; however, their ectoparasitic arthropofauna has been little studied. There are currently 12 taxa recorded, belonging to two classes and associated with only four species of bats. This study aimed to investigate the diversity of parasitic flies associated with bats in three ecoregions: Atacama Desert, Chilean Matorral and Valdivian temperate forest. During 2021, using mist nets, bats were captured in Anzota caves (Atacama Desert ecoregion), Huelquén and Alto Jahuel (Chilean Matorral ecoregion), Cherquenco and San Patricio (Valdivian temperate forest). Each bat was carefully checked during a 15-min interval for the collection of ectoparasites. The arthropods were deposited in vials with 96% ethanol. A total of 26 bats corresponding to three species (Vespertilionidae: Histiotus magellanicus Philippi, 1866, Myotis arescens (Osgood, 1943); Phyllostomidae: Desmodus rotundus (Geoffroy, 1810)) were captured from which a total of 142 ectoparasitic arthropods were collected. Bat flies were separated/identified under a stereomicroscope. Additionally, from the fieldwork, we report the presence of other ectoparasites associated with Chilean bats. In our study, we report new host-parasite associations between Trichobius parasiticus Gervais, 1844 (Diptera: Streblidae) on D. rotundus, and Basilia silvae (Brèthes, 1913) (Diptera: Nycteribiidae) in M. arescens in Chile. Our study extended the latitudinal range of distribution for B. silvae to Araucanía region, and we report for first time T. parasiticus in the country. Additionally, partial sequences of the cytochrome c oxidase I gene were obtained from these specimens. Although there is slight morphological variation in the specimens of T. parasiticus, phylogenetic analyses suggest that they correspond to the same species. The sequences generated for B. silvae represent the first for the species. Authors recommend the use of an integrative approach in the identification of ectoparasites in poorly studied ecoregions and hosts. The integration of different markers is necessary to determine more precisely the phylogenetic relationships between South American populations and species of the genera Basilia and Trichobius.

3.
Int J Clin Pract ; 2024: 6219301, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38390376

RESUMEN

Background: Rates of major bleeding and intraprocedural thrombotic events (IPTE) in the setting of percutaneous coronary intervention (PCI) using weight-adjusted unfractionated heparin (UFH) without activated clotting time (ACT) monitoring are not known. Methods: We reviewed 2,748 consecutive patients who underwent coronary angiography at our tertiary care university hospital between January 2017 and December 2020. All patients who underwent PCI with weight-adjusted UFH without ACT guidance were considered for further analysis. Major bleeding complications occurring within 48 hours of PCI were collected from patients' medical records. IPTE were collected independently by two interventional cardiologists after review of coronary angiograms. Results: There were 718 patients included in the analysis (65.4 ± 12.2 years old; 81.3% male). In total, 45 patients (7.8%) experienced a major bleed or IPTE. The most common IPTE were slow/no reflow (1.5%) and coronary artery dissection with decreased flow (1.1%). Other IPTE occurred in <1% of cases. Major bleeding occurred in 11 patients (1.5%), of whom 8 required blood transfusion and 3 required vascular intervention. Bleeding complications were more common with femoral compared with radial access (6.6% vs. 0.2%, P < 0.001). Conclusion: Weight-adjusted UFH use during PCI without ACT monitoring was related to low rates of major bleeding or IPTE.


Asunto(s)
Intervención Coronaria Percutánea , Trombosis , Humanos , Masculino , Persona de Mediana Edad , Anciano , Femenino , Heparina/efectos adversos , Intervención Coronaria Percutánea/efectos adversos , Resultado del Tratamiento , Hemorragia/inducido químicamente , Anticoagulantes/efectos adversos
4.
Chem Biodivers ; 21(4): e202301794, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38356385

RESUMEN

A large-scale quantity of copper oxalate nanoparticles were successfully obtained via a facile and green solid-state chemical reaction. Copper oxalate nanoparticles were obtained by ball-milling between copper chloride, Liquorice (Glycyrrhiza glabra), and ascorbic acid at ambient conditions. The size and morphology of copper oxalate nanoparticles powder were studied by transmission and scanning electron microscopy. The prepared nanoparticles were semi-spherical in shape and ranged from 5 to 15 nm in size. UV/Vis spectroscopy, Fourier transforms infrared spectroscopy, and X-ray photoelectron spectroscopy measurements were carried out to characterize the prepared samples. Copper oxalate nanoparticles were evaluated as a catalyst in the catalytic degradation of 4-nitrophenol, bromophenol blue, reactive yellow, and a mixture of the three pollutants. The present study combined solid-state reaction and green requirements for the mass production of nanomaterials. The proposed reaction is performed in simple steps, inexpensive, low energy consuming, solvent-free, and minimizes the emission of secondary wastes.


Asunto(s)
Glycyrrhiza , Nanopartículas , Cobre/química , Nanopartículas/química , Ácido Ascórbico , Oxalatos , Espectroscopía Infrarroja por Transformada de Fourier
5.
Can J Neurol Sci ; 50(2): 268-273, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-35272725

RESUMEN

The variable rate of infarct progression in acute ischemic stroke as assessed by various thresholds excludes a substantial proportion of patients due to time or core constraints. We evaluated 106 patients with any-type occlusion to compare these thresholds and assessed performance of hypoperfusion index (HI) for fast and slow rate of infarct progression. Seven (12.5%) were classified fast progressors and 23 (46%), 25 (50%), 12 (24%), and 33 (66%) slow progressors using different core and time criteria. In comparison, HI categorized 100% (n = 106) of cohort with optimal cutoff 0.5 for any-type occlusion (slow progressors: HI ≤ 0.5), sensitivity/specificity 100%/91%, AUC 0.94, and indicative of eligibility for reperfusion and clinical outcomes (median 90-day modified Rankin Scale; 2 for HI ≤ 0.5 versus 5). Estimation of progressors by HI seems comprehensive but needs external validation.


Asunto(s)
Isquemia Encefálica , Accidente Cerebrovascular Isquémico , Accidente Cerebrovascular , Humanos , Accidente Cerebrovascular/diagnóstico por imagen , Isquemia Encefálica/complicaciones , Isquemia Encefálica/diagnóstico por imagen , Accidente Cerebrovascular Isquémico/diagnóstico por imagen , Progresión de la Enfermedad , Infarto
6.
Oral Dis ; 29(7): 2938-2943, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36165852

RESUMEN

OBJECTIVE: To evaluate the prevalence of medial vascular calcifications in the oral and maxillofacial region and their association with systemic diseases. MATERIALS AND METHODS: The study included 211 consecutive patients with systemic diseases (January 2015-May 2016). Medical history and radiographic images were evaluated. Univariate analysis (t-test) was performed for continuous variables (age). The Chi square test was applied for the categorical variables (Mönckeberg medial arteriosclerosis [MMA], gender). RESULTS: There was a 6.2% prevalence of MMA. The mean age of patients with MMA was 65.46 ± 13.38. The prevalence of kidney disease in patients with MMA was significantly higher than in those without MMA (p < 0.001). This finding was maintained even after adjusting for other systemic diseases (OR = 31.84 [8.63-136.78]). CONCLUSION: A significant prevalence of MMA in kidney disease patients was observed in this pilot study.


Asunto(s)
Arteriosclerosis , Esclerosis Calcificante de la Media de Monckeberg , Humanos , Proyectos Piloto , Esclerosis Calcificante de la Media de Monckeberg/complicaciones , Arteriosclerosis/diagnóstico por imagen , Arteriosclerosis/epidemiología , Arteriosclerosis/complicaciones
7.
BMC Palliat Care ; 22(1): 135, 2023 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-37697339

RESUMEN

BACKGROUND: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya. OBJECTIVES: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC providers and leaders. METHODS: Focus groups (FGs) were conducted in November and December of 2018 using a semi-structured interview guide. FGs were audio-recorded, transcribed, and analyzed using a thematic content analysis approach. RESULTS: Three FGs were conducted (n = 22 participants). Ten themes related to PC research emerged, including research on: 1) beliefs about death, disease, and treatment to inform PC; 2) awareness about PC, 3) integration of PC within the health system; 4) understanding caregiver experiences and needs; 5) community health volunteers (CHVs) and volunteer programs; 6) evaluation of costs and benefits of PC; 7) treatment approaches, including complementary and alternative medicine (CAM) and advanced diagnostics at end of life; 8) other suggestions for research, 9) populations in need of PC research; and 10) resources for enabling research. CONCLUSIONS: Kenyan PC providers and leaders identified key areas requiring increased scientific inquiry and critical resources needed to enable this research. These findings can help to focus future PC research in Kenya and encourage funding agencies to prioritize the issues identified.


Asunto(s)
Enfermería de Cuidados Paliativos al Final de la Vida , Cuidados Paliativos , Humanos , Kenia , Calidad de Vida , Grupos Focales
8.
Anim Biotechnol ; 34(2): 166-182, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-34319853

RESUMEN

The study planned to estimate biological parameters linked to rheumatoid arthritis (RA) patients, detecting the influence of MTX and biotherapy treatments on these parameters and synthesizing methotrexate bovine serum albumin nanoparticles linked to folate (FA-MTX-BSA NPs) to reduce the overwhelming expression of inflammatory cytokines. Inflammatory parameters showed significant increases in newly diagnosed and MTX-receiving groups while no changes were observed in the biotherapy-maintained group. MTX-loaded BSA nanoparticles were fabricated by the desolvation method and further linked to activated folic acid to obtain FA-MTX-BSA NPs. FA-MTX-BSA NPs were successfully characterized within the nanoscale range using different screening techniques. FA-MTX-BSA NPs showed an in vitro release in a sustained manner. The potential of MTX, MTX-BSA NPs, and FA-MTX-BSA NPs in inducing cytokine level reduction was detected. Significant decreases in interleukin- 1 beta (IL-1ß), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) levels were obtained in cultures treated with FA-MTX-BSA NPs compared to the untreated culture in a dose-dependent pattern. Furthermore, FA-MTX-BSA NPs comparing with MTX and MTX-BSA NPs exhibited a significant advanced effect in decreasing cytokines levels. Accordingly, the conjunction of BSA NPs and MTX linked to folate potentially reduced cytokines manifestation in RA.


Asunto(s)
Artritis Reumatoide , Nanopartículas , Animales , Metotrexato/uso terapéutico , Ácido Fólico/uso terapéutico , Albúmina Sérica Bovina/uso terapéutico , Citocinas , Sistemas de Liberación de Medicamentos , Artritis Reumatoide/tratamiento farmacológico
9.
Reumatismo ; 75(4)2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-38115775

RESUMEN

Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease that affects multiple organs and causes inflammation, necrosis, and vasculitis in small blood vessels. Treatment for GPA involves achieving and maintaining remission. In recent studies, cyclophosphamide-based regimens have been linked to comorbidity hazards, including an increased risk of malignancies, especially hematological ones. Acute myeloid leukemia is the main hematologic malignancy that can complicate GPA. In this context, we report the case of a middle-aged woman with GPA who developed acute promyelocytic leukemia (APL) during maintenance with cyclophosphamide. She was treated with all-trans retinoic acid at 50 mg/day and arsenic trioxide at 10 mg/day, along with steroids. This case highlights the unique emergence of APL in a GPA patient during cyclophosphamide therapy. A single case has previously been reported on the development of APL in a patient with GPA while using azathioprine monotherapy for 2 years.


Asunto(s)
Granulomatosis con Poliangitis , Leucemia Promielocítica Aguda , Persona de Mediana Edad , Femenino , Humanos , Leucemia Promielocítica Aguda/complicaciones , Leucemia Promielocítica Aguda/tratamiento farmacológico , Granulomatosis con Poliangitis/complicaciones , Granulomatosis con Poliangitis/tratamiento farmacológico , Ciclofosfamida/efectos adversos , Trióxido de Arsénico , Azatioprina
10.
Phys Rev Lett ; 129(7): 075001, 2022 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-36018710

RESUMEN

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

11.
Clin Exp Dermatol ; 47(1): 24-29, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34459019

RESUMEN

The term 'pemphigus' refers to chronic autoimmune skin disorders that cause blistering erosions on the skin and oral mucosa. The two major clinical forms are pemphigus vulgaris and pemphigus foliaceus. Although rare, they confer a stark symptomatic burden upon patients that significantly impacts daily life. Comorbid mental health issues are not routinely screened for in patients with pemphigus, and current UK guidance provides no formal provision for the identification and treatment of psychological issues. This review is the first of its kind, to our knowledge, to systematically examine the available evidence on mental health issues in pemphigus. Published work suggests that the incidence of anxiety and depression is much higher in patients with pemphigus compared with both the general population and with patients having other chronic skin disorders. Disease severity appears to be closely linked to mental health, with worsening of pemphigus associated with deteriorations in psychological wellbeing. Corticosteroids, which are associated with depression in chronic use, are the current first-line therapy for pemphigus and have been identified as a potential confounder and independent risk factor for mental health comorbidity in pemphigus. Current evidence is unclear whether a bidirectional relationship exists between mental health and pemphigus severity, and more thorough research is required to develop understanding of this issue. In conclusion, we have identified a high incidence of mental health comorbidity in pemphigus, and recommend routine screening of patients with pemphigus for mental health issues and signposting toward mental health services as an initial measure to address this.


Asunto(s)
Trastornos Mentales/etiología , Pénfigo/complicaciones , Pénfigo/psicología , Humanos
12.
J Eur Acad Dermatol Venereol ; 36(12): 2406-2413, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35796157

RESUMEN

BACKGROUND: Atopic dermatitis (AD) and asthma often co-occur in the same patient, and healthcare utilization is related to disease severity of these diseases. OBJECTIVE: The objective of the study was to investigate differences in healthcare utilization in adults with concomitant AD and asthma compared to patients with asthma or AD only. METHODS: All Danish adults with a hospital diagnosis of AD, asthma or concomitant AD, and asthma recorded in national registries were included. Healthcare utilization data were obtained in 3-month intervals from 2 years prior to index date (the date of the first hospital diagnosis) and to 5 years after. RESULTS: A total of 12 409 patients with AD were included (11 590 with AD only and 819 with concomitant AD and asthma), and 65 539 with asthma only. Adults with concomitant AD and asthma had higher risk of hospitalization for AD (OR 1.38, 95% CI (1.15-1.67), P = 0.001) and asthma (OR 1.16, 95% CI (1.00-1.35), P = 0.047) compared to patients with only AD and asthma, respectively. These patients also had fewer visits in outpatient clinics for AD (OR 0.10, 95% CI (0.08-0.12), P < 0.001) and asthma (OR 0.34, 95% CI (0.29-0.39), P < 0.001) compared to patients with only AD or asthma. Outpatient clinic visits for rhinitis were more frequent among patients with concomitant AD and asthma compared to patients with only AD or asthma. CONCLUSION: Adults with concomitant AD and asthma had different patterns of healthcare utilization compared to adults with AD or asthma alone, suggesting that improvements in management and monitoring may reduce unscheduled healthcare visits and lower healthcare costs.


Asunto(s)
Asma , Dermatitis Atópica , Adulto , Humanos , Dermatitis Atópica/complicaciones , Dermatitis Atópica/epidemiología , Dermatitis Atópica/terapia , Estudios de Cohortes , Estudios de Seguimiento , Asma/complicaciones , Asma/epidemiología , Asma/terapia , Aceptación de la Atención de Salud
13.
J Clin Monit Comput ; 36(1): 147-159, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-33606187

RESUMEN

Analysis of peripheral venous pressure (PVP) waveforms is a novel method of monitoring intravascular volume. Two pediatric cohorts were studied to test the effect of anesthetic agents on the PVP waveform and cross-talk between peripheral veins and arteries: (1) dehydration setting in a pyloromyotomy using the infused anesthetic propofol and (2) hemorrhage setting during elective surgery for craniosynostosis with the inhaled anesthetic isoflurane. PVP waveforms were collected from 39 patients that received propofol and 9 that received isoflurane. A multiple analysis of variance test determined if anesthetics influence the PVP waveform. A prediction system was built using k-nearest neighbor (k-NN) to distinguish between: (1) PVP waveforms with and without propofol and (2) different minimum alveolar concentration (MAC) groups of isoflurane. 52 porcine, 5 propofol, and 7 isoflurane subjects were used to determine the cross-talk between veins and arteries at the heart and respiratory rate frequency during: (a) during and after bleeding with constant anesthesia, (b) before and after propofol, and (c) at each MAC value. PVP waveforms are influenced by anesthetics, determined by MANOVA: p value < 0.01, η2 = 0.478 for hypovolemic, and η2 = 0.388 for euvolemic conditions. The k-NN prediction models had 82% and 77% accuracy for detecting propofol and MAC, respectively. The cross-talk relationship at each stage was: (a) ρ = 0.95, (b) ρ = 0.96, and (c) could not be evaluated using this cohort. Future research should consider anesthetic agents when analyzing PVP waveforms developing future clinical monitoring technology that uses PVP.


Asunto(s)
Anestésicos por Inhalación , Anestésicos , Isoflurano , Propofol , Anestésicos/farmacología , Animales , Presión Arterial , Niño , Humanos , Porcinos , Presión Venosa
14.
Acute Med ; 21(3): 139-145, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36427212

RESUMEN

High quality discharge information communication has been linked to a reduction in the incidence of adverse events, decreasing the risk of prescription errors and lost follow up. In this paper we describe how our trust-wide quality improvement project, led by acute physicians, successfully improved discharge documentation. We demonstrate how we identified obstacles to continued success, and the interventions we implemented. We recommend how discharge summary quality can be optimised through training of junior doctors, recruitment of local champions, and use of novel methods to preserve engagement, such as gamification.


Asunto(s)
Comunicación , Alta del Paciente , Humanos , Documentación , Gamificación , Cuerpo Médico de Hospitales
15.
J Surg Res ; 266: 222-229, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34023578

RESUMEN

INTRODUCTION: Trauma is the leading cause of death among young people. These patients have a high incidence of kidney injury, which independently increases the risk of mortality. As valproic acid (VPA) treatment has been shown to improve survival in animal models of lethal trauma, we hypothesized that it would also attenuate the degree of acute kidney injury. METHODS: We analyzed data from two separate experiments where swine were subjected to lethal insults.  Model 1: hemorrhage (50% blood volume hemorrhage followed by 72-h damage control resuscitation). Model 2: polytrauma (traumatic brain injury, 40% blood volume hemorrhage, femur fracture, rectus crush and grade V liver laceration). Animals were resuscitated with normal saline (NS) +/- VPA 150 mg/kg after a 1-h shock phase in both models (n = 5-6/group). Serum samples were analyzed for creatinine (Cr) using colorimetry on a Liasys 330 chemistry analyzer. Proteomic analysis was performed on kidney tissue sampled at the time of necropsy. RESULTS: VPA treatment significantly (P < 0.05) improved survival in both models. (Model 1: 80% vs 20%; Model 2: 83% vs. 17%). Model 1 (Hemorrhage alone): Cr increased from a baseline of 1.2 to 3.0 in NS control animals (P < 0.0001) 8 h after hemorrhage, whereas it rose only to 2.1 in VPA treated animals (P = 0.004). Model 2 (Polytrauma): Cr levels increased from baseline of 1.3 to 2.5 mg/dL (P = 0.01) in NS control animals 4 h after injury but rose to only 1.8 in VPA treated animals (P = 0.02). Proteomic analysis of kidney tissue identified metabolic pathways were most affected by VPA treatment. CONCLUSIONS: A single dose of VPA (150 mg/kg) offers significant protection against acute kidney injury in swine models of polytrauma and hemorrhagic shock.


Asunto(s)
Lesión Renal Aguda/prevención & control , Hemorragia/complicaciones , Inhibidores de Histona Desacetilasas/uso terapéutico , Traumatismo Múltiple/complicaciones , Ácido Valproico/uso terapéutico , Lesión Renal Aguda/sangre , Lesión Renal Aguda/etiología , Animales , Creatinina/sangre , Evaluación Preclínica de Medicamentos , Hemorragia/sangre , Hemorragia/mortalidad , Inhibidores de Histona Desacetilasas/farmacología , Riñón/efectos de los fármacos , Riñón/metabolismo , Lipocalina 2/sangre , Traumatismo Múltiple/sangre , Traumatismo Múltiple/mortalidad , Proteoma/efectos de los fármacos , Porcinos , Ácido Valproico/farmacología
16.
Arthroscopy ; 37(5): 1599-1609, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33453346

RESUMEN

PURPOSE: To examine the relationship between posterior tibial slope and lateral meniscal bone angle (LMBA) on anterior cruciate ligament (ACL) tear risk in a pediatric population. METHODS: In this case-control study, non-contact ACL-injured pediatric patients with no significant lateral meniscal lesions were matched by age and sex in a 1:1 ratio to a group of radiologically normal controls. Knee magnetic resonance imaging (MRI) studies were analyzed by 3 independent, blinded observers measuring the medial posterior tibial slope (MTS), lateral posterior tibial slope (LTS), and LMBA. Sagittal slope asymmetry was calculated as the absolute difference in degrees between slopes, and the relationship between LMBA and LTS was calculated as a ratio. Binary logistic regressions identified independent predictors of ACL injury. Receiver operator characteristics were performed to determine predictive accuracy. RESULTS: 20 study patients were compared with 20 sex- and age-matched controls (age 14.8 ± 2.42, mean ± standard deviation). LTS was significantly higher in the ACL-injured group (11.30° ± 3.52° versus 7.00° ± 2.63°, P = .0001), as were the absolute slope difference (7.10 ± 2.92° versus 3.14 ± 3.25°, P = .0002) and LTS:LMBA ratio (0.46 ± 0.17 versus 0.26 ± 0.12, P = .0001). No significant differences were observed for MTS or LMBA. Independent predictors were LTS (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.18 to 2.13, P = .002), LTS:LMBA ratio (OR 3.13, 95% CI 1.48 to 6.62, P = .003), and absolute slope difference (OR 1.65, 95% CI 1.17 to 2.32, P = .005). LTS:LMBA ratio was the strongest predictor variable (area under the curve 0.86). CONCLUSION: This study suggests that LTS, absolute slope difference, and LTS:LMBA ratio are significant pediatric ACL-injury risk factors. All 3 demonstrate good predictive accuracy; however, the relationship between steep LTS and shallow LMBA was the strongest predictor. LEVEL OF EVIDENCE: III, case-control study.


Asunto(s)
Lesiones del Ligamento Cruzado Anterior/diagnóstico , Meniscos Tibiales/patología , Tibia/patología , Adolescente , Adulto , Lesiones del Ligamento Cruzado Anterior/diagnóstico por imagen , Lesiones del Ligamento Cruzado Anterior/patología , Estudios de Casos y Controles , Niño , Femenino , Humanos , Rodilla/diagnóstico por imagen , Modelos Logísticos , Imagen por Resonancia Magnética , Masculino , Meniscos Tibiales/diagnóstico por imagen , Variaciones Dependientes del Observador , Oportunidad Relativa , Curva ROC , Reproducibilidad de los Resultados , Factores de Riesgo , Tibia/diagnóstico por imagen
17.
Int Orthop ; 45(1): 23-31, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32862265

RESUMEN

PURPOSE: Thirty-day mortality of patients with hip fracture is well researched and predictive; validated scoring tools have been developed (Nottingham Hip Fracture Score, NHFS). COVID-19 has significantly greater mortality in the elderly and comorbid patients which includes hip fracture patients. Non-operative treatment is not appropriate due to significantly higher mortality, and therefore, these patients are often exposed to COVID-19 in the peri-operative period. What is unclear is the effect of concomitant COVID-19 infection in these patients. METHODS: A multicentre prospective study across ten sites in the United Kingdom (responsible for 7% of hip fracture patients per annum in the UK). Demographic and background information were collected by independent chart review. Data on surgical factors included American Society of Anesthesiologists (ASA) score, time to theatre, Nottingham Hip fracture score (NHFS) and classification of fracture were also collected between 1st March 2020 and 30th April 2020 with a matched cohort from the same period in 2019. RESULTS: Actual and expected 30-day mortality was found to be significantly higher than expected for 2020 COVID-19 positive patients (RR 3.00 95% CI 1.57-5.75, p < 0.001), with 30 observed deaths compared against the 10 expected from NHFS risk stratification. CONCLUSION: COVID-19 infection appears to be an independent risk factor for increased mortality in hip fracture patients. Whilst non-operative management of these fractures is not suggested due to the documented increased risks and mortality, this study provides evidence to the emerging literature of the severity of COVID-19 infection in surgical patients and the potential impact of COVID-19 on elective surgical patients in the peri-operative period.


Asunto(s)
COVID-19 , Fracturas de Cadera/mortalidad , Anciano de 80 o más Años , Procedimientos Quirúrgicos Electivos , Femenino , Fracturas de Cadera/cirugía , Mortalidad Hospitalaria , Humanos , Masculino , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , SARS-CoV-2 , Reino Unido
18.
Opt Express ; 28(12): 17630-17642, 2020 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-32679968

RESUMEN

A novel technique for realization of configurable/one-time programmable (OTP) silicon photonic circuits is presented. Once the proposed photonic circuit is programmed, its signal routing is retained without the need for additional power consumption. This technology can potentially enable a multi-purpose design of photonic chips for a range of different applications and performance requirements, as it can be programmed for each specific application after chip fabrication. Therefore, the production costs per chip can be reduced because of the increase in production volume, and rapid prototyping of new photonic circuits is enabled. Essential building blocks for the configurable circuits in the form of erasable directional couplers (DCs) were designed and fabricated, using ion implanted waveguides. We demonstrate permanent switching of optical signals between the drop port and through the port of the DCs using a localized post-fabrication laser annealing process. Proof-of-principle demonstrators in the form of generic 1×4 and 2×2 programmable switching circuits were fabricated and subsequently programmed.

19.
Clin Exp Dermatol ; 45(1): 86-88, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31120587

RESUMEN

Squamous cell carcinomas (SCCs) have the potential for local tissue destruction and metastasis. The risk of complications increases if the lesion is not diagnosed and excised in a timely manner. Total body skin examination (TBSE) has been reported to increase melanoma detection; the objective of this study was to determine if it also increases SCC detection. Analysis of 469 SCCs diagnosed at a UK tertiary centre showed that 6.8% of these were detected incidentally and not from the index lesion that prompted referral. These incidentally detected SCCs tended to represent early disease, and therefore carried lower risk of complications. Our findings suggest that full skin checks may increase the number of SCCs detected, and at an earlier stage of disease. Therefore, we encourage the use of TBSE in all dermatology outpatient appointments, and make suggestions as to how to incorporate it into the limited time available in dermatology clinics.


Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Examen Físico/métodos , Neoplasias Cutáneas/diagnóstico , Anciano , Anciano de 80 o más Años , Atención Ambulatoria , Dermatología/métodos , Detección Precoz del Cáncer/métodos , Humanos , Hallazgos Incidentales , Estudios Retrospectivos , Reino Unido
20.
Int J Toxicol ; 39(5): 422-432, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32662347

RESUMEN

Gold nanoparticles (AuNPs) have been widely used in many applications. Their usage as drug delivery vehicles has also gained considerable attention due to their chemical and optical properties as well as their good biocompatibility. The present study was conducted to evaluate the efficiency of AuNPs in enhancing the cytotoxic and apoptotic induction activity of lantadene A (LA), separated from Lantana camara leaves, on the breast tumor cell line MCF-7 in vitro. By utilizing plant-mediated synthesis method of nanostructures, LA-loaded AuNPs (LA-AuNPs) were prepared and their formation was confirmed by means of ultraviolet-visible spectroscope, atomic force microscope, scanning electron microscope, and zeta potential. The cytotoxic effect of LA-AuNPs was analyzed using a methylthiazol tetrazolium assay and compared to free AuNPs and LA. The results indicated a significant increase in the reduction of MCF-7 cells viability after incubation with LA-AuNPs. As determined by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay, LA-AuNPs induced a greater ratio of DNA-fragmented cells compared to LA-treated and untreated cells. Also, by operating real-time polymerase chain reaction, LA-AuNPs-treated cells displayed an increased upregulation of p53 expression and downregulation of BCL-2 expression in addition to a significant reduction in the level of BCL-2-BAX ratio. No significant effect was shown on the expression of BAX. Collectively, our results indicate that LA-AuNPs showed promising cytotoxicity to MCF-7 cells as a novel nanoscale preparation, likely via induction of apoptotic genes and stimulation of DNA fragmentation.


Asunto(s)
Antineoplásicos Fitogénicos/toxicidad , Oro/toxicidad , Mutágenos/toxicidad , Nanopartículas/toxicidad , Ácido Oleanólico/análogos & derivados , Antineoplásicos Fitogénicos/química , Apoptosis/efectos de los fármacos , Apoptosis/genética , Supervivencia Celular/efectos de los fármacos , Daño del ADN , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Oro/química , Humanos , Lantana , Células MCF-7 , Mutágenos/química , Nanopartículas/química , Ácido Oleanólico/química , Ácido Oleanólico/toxicidad , Hojas de la Planta
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