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1.
Res Integr Peer Rev ; 9(1): 2, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38360805

RESUMO

Journal editors have a large amount of power to advance open science in their respective fields by incentivising and mandating open policies and practices at their journals. The Data PASS Journal Editors Discussion Interface (JEDI, an online community for social science journal editors: www.dpjedi.org ) has collated several resources on embedding open science in journal editing ( www.dpjedi.org/resources ). However, it can be overwhelming as an editor new to open science practices to know where to start. For this reason, we created a guide for journal editors on how to get started with open science. The guide outlines steps that editors can take to implement open policies and practices within their journal, and goes through the what, why, how, and worries of each policy and practice. This manuscript introduces and summarizes the guide (full guide: https://doi.org/10.31219/osf.io/hstcx ).

2.
Clin Transplant ; 38(1): e15239, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-38289889

RESUMO

Infection and rejection outcomes were retrospectively analyzed in patients following liver transplant and separately following heart transplant with patients being stratified by their severity of immediate postoperative insulin resistance as measured by the peak insulin drip rate that was required to reduce glucose levels. For each group, these peak insulin drip rates were divided into quartiles (Q). In liver transplant patients (n = 207), those in Q4 (highest infusion rate) had significantly fewer infections up to 6 months post-transplant (42.3% vs. 60.0%, p = .036) and borderline fewer rejection episodes (25.0% vs. 40.0%, p = .066) compared to Q1-Q3 patients. To confirm these unexpected results, a subsequent similar analysis in heart transplant (n = 188) patients again showed that Q4 patients had significantly fewer infections up to 6 months (19.1% vs. 53.9%, p < .0001) compared to Q1-Q3 patients. Logistic regression in a subset of 103 cardiac transplant patients showed that the maximum glucose during surgery, prior MI, and hypertension were associated with severe insulin resistance (SIR) status, while the presence of pre-existing diabetes and BMI were not. We hypothesize that patients are who are able to mount a more robust counter-regulatory response that causes the insulin resistance may be healthier and thus able to mount a better response to infections.


Assuntos
Transplante de Coração , Resistência à Insulina , Insulinas , Humanos , Estudos Retrospectivos , Transplante de Coração/efeitos adversos , Glucose , Insulina/uso terapêutico
4.
R Soc Open Sci ; 10(5): 221255, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37206965

RESUMO

In recent years, the scientific community has called for improvements in the credibility, robustness and reproducibility of research, characterized by increased interest and promotion of open and transparent research practices. While progress has been positive, there is a lack of consideration about how this approach can be embedded into undergraduate and postgraduate research training. Specifically, a critical overview of the literature which investigates how integrating open and reproducible science may influence student outcomes is needed. In this paper, we provide the first critical review of literature surrounding the integration of open and reproducible scholarship into teaching and learning and its associated outcomes in students. Our review highlighted how embedding open and reproducible scholarship appears to be associated with (i) students' scientific literacies (i.e. students' understanding of open research, consumption of science and the development of transferable skills); (ii) student engagement (i.e. motivation and engagement with learning, collaboration and engagement in open research) and (iii) students' attitudes towards science (i.e. trust in science and confidence in research findings). However, our review also identified a need for more robust and rigorous methods within pedagogical research, including more interventional and experimental evaluations of teaching practice. We discuss implications for teaching and learning scholarship.

5.
R Soc Open Sci ; 10(2): 191375, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36756055

RESUMO

The low reproducibility rate in social sciences has produced hesitation among researchers in accepting published findings at their face value. Despite the advent of initiatives to increase transparency in research reporting, the field is still lacking tools to verify the credibility of research reports. In the present paper, we describe methodologies that let researchers craft highly credible research and allow their peers to verify this credibility. We demonstrate the application of these methods in a multi-laboratory replication of Bem's Experiment 1 (Bem 2011 J. Pers. Soc. Psychol. 100, 407-425. (doi:10.1037/a0021524)) on extrasensory perception (ESP), which was co-designed by a consensus panel including both proponents and opponents of Bem's original hypothesis. In the study we applied direct data deposition in combination with born-open data and real-time research reports to extend transparency to protocol delivery and data collection. We also used piloting, checklists, laboratory logs and video-documented trial sessions to ascertain as-intended protocol delivery, and external research auditors to monitor research integrity. We found 49.89% successful guesses, while Bem reported 53.07% success rate, with the chance level being 50%. Thus, Bem's findings were not replicated in our study. In the paper, we discuss the implementation, feasibility and perceived usefulness of the credibility-enhancing methodologies used throughout the project.

6.
J Cereb Blood Flow Metab ; 43(1): 59-71, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36071616

RESUMO

During sleep, reduced brain energy demands provide an opportunity for biosynthetic processes like protein synthesis. Sleep is required for some forms of memory consolidation which requires de novo protein synthesis. We measured regional cerebral protein synthesis rates (rCPS) in human subjects to ascertain how rCPS is affected during sleep. Subjects underwent three consecutive L-[1-11C]leucine PET scans with simultaneous polysomnography: 1. rested awake, 2. sleep-deprived awake, 3. sleep. Measured rCPS were similar across the three conditions. Variations in sleep stage times during sleep scans were used to estimate rCPS in sleep stages under the assumption that measured rCPS is the weighted sum of rCPS in each stage, with weights reflecting time and availability of [11C]leucine in that stage. During sleep scans, subjects spent most of the time in N2, N3, and awake and very little time in N1 and REM; rCPS in N1 and REM could not be reliably estimated. When stages N1 and N2 were combined [N1,N2], estimates of rCPS were more robust. In selective regions, estimated rCPS were statistically significantly higher (30-39%) in [N1,N2] compared with N3; estimated rCPS in N3 were similar to values measured in sleep-deprived awake scans. Results indicate increased rates of protein synthesis linked to [N1,N2] sleep.


Assuntos
Sujeitos da Pesquisa , Sono , Humanos , Leucina , Encéfalo/diagnóstico por imagem , Tomografia por Emissão de Pósitrons
7.
Atten Percept Psychophys ; 85(1): 1-8, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36123500

RESUMO

A growing literature posits attention as a core component of working memory (Baddeley, European Psychologist, 7(2), 85-97, 2002), yet research exploring this relationship is scarce in the temporal attention domain. The present research provided further evidence that the magnitude of the attentional blink (AB) can be influenced by working memory load (WML; Akyürek et al., Memory & Cognition 35, 621-627, 2007). Additionally, we behaviorally tested Akyürek and colleagues' (Psychophysiology, 47(6), 1134-1141, 2010) conclusion that working memory influences attention at an early stage by systematically manipulating the timing of the first target in relation to the stimuli preceding and following it. In two experiments, we demonstrated that the AB effect increases as the temporal interval between the first target and the stimulus following it decreases. Importantly, this effect was observed only when WML was low, indicating that WM influences attending to a second target at an early stage of attentional processing.


Assuntos
Intermitência na Atenção Visual , Memória de Curto Prazo , Humanos , Memória de Curto Prazo/fisiologia , Intermitência na Atenção Visual/fisiologia , Cognição , Tempo de Reação , Psicofisiologia
8.
PLoS One ; 17(11): e0276970, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36441720

RESUMO

Voluntary isolation is one of the most effective methods for individuals to help prevent the transmission of diseases such as COVID-19. Understanding why people leave their homes when advised not to do so and identifying what contextual factors predict this non-compliant behavior is essential for policymakers and public health officials. To provide insight on these factors, we collected data from 42,169 individuals across 16 countries. Participants responded to items inquiring about their socio-cultural environment, such as the adherence of fellow citizens, as well as their mental states, such as their level of loneliness and boredom. We trained random forest models to predict whether someone had left their home during a one week period during which they were asked to voluntarily isolate themselves. The analyses indicated that overall, an increase in the feeling of being caged leads to an increased probability of leaving home. In addition, an increased feeling of responsibility and an increased fear of getting infected decreased the probability of leaving home. The models predicted compliance behavior with between 54% and 91% accuracy within each country's sample. In addition, we modeled factors leading to risky behavior in the pandemic context. We observed an increased probability of visiting risky places as both the anticipated number of people and the importance of the activity increased. Conversely, the probability of visiting risky places increased as the perceived putative effectiveness of social distancing decreased. The variance explained in our models predicting risk ranged from < .01 to .54 by country. Together, our findings can inform behavioral interventions to increase adherence to lockdown recommendations in pandemic conditions.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias , Controle de Doenças Transmissíveis , Aprendizado de Máquina , Distanciamento Físico
9.
Gerontol Geriatr Med ; 8: 23337214221130157, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36275411

RESUMO

We used principal component analysis (PCA) to examine the component structure of a neuropsychological test battery administered to 943 cognitively-normal adults enrolled in the Southern Illinois University (SIU) Longitudinal Cognitive Aging Study (LCAS). Four components explaining the most variance (63.9%) in the dataset were identified: speed/cognitive flexibility, visuospatial skills, word-list learning/memory, and story memory. Regression analyses confirmed that increased age was associated with decreased component scores after controlling for gender and education. Our identified components differ slightly from previous studies using PCA on similar test batteries. Factors such as the demographic characteristics of the study sample, the inclusion of mixed patient and control samples, the inclusion of different test measures in previous studies, and the fact that many neuropsychological test measures assess multiple cognitive processes simultaneously, may help to explain these inconsistencies.

10.
Proc Natl Acad Sci U S A ; 119(40): e2116924119, 2022 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-36161932

RESUMO

People sometimes prefer groups to which they do not belong (outgroups) over their own groups (ingroups). Many long-standing theoretical perspectives assume that this outgroup favorability bias primarily reflects negative ingroup evaluations rather than positive outgroup evaluations. To examine the contributions of negative ingroup versus positive outgroup evaluations to outgroup bias, we examined participants' data (total n > 879,000) from Implicit Association Tests [A. G. Greenwald, D. E. McGhee, J. L. K. Schwartz, J. Pers. Soc. Psychol. 74, 1464-1480 (1998)] measuring intergroup attitudes across four social domains in exploratory and preregistered confirmatory analyses. Process modeling [F. R. Conrey, J. W. Sherman, B. Gawronski, K. Hugenberg, C. J. Groom, J. Pers. Soc. Psychol. 89, 469-487 (2005)] was applied to the responses of participants who demonstrated implicit outgroup bias to separately estimate the contributions of negative ingroup and positive outgroup evaluations. The outgroup biases of lower-status group members (i.e., Asian, Black, gay and lesbian, and older people) consistently reflected greater contributions of positive outgroup evaluations than negative ingroup evaluations. In contrast, the outgroup biases of higher-status group members (i.e., White, straight, and younger people) reflected a more varied pattern of evaluations. We replicated this pattern of results using explicitly measured intergroup evaluations. Taking these data together, the present research demonstrates a positive-negative asymmetry effect of outgroup bias, primarily among members of lower-status groups.


Assuntos
Atitude , Viés Implícito , Idoso , Viés , Feminino , Processos Grupais , Humanos
11.
J Cereb Blood Flow Metab ; 42(9): 1666-1675, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35350914

RESUMO

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability. Fragile X mental retardation protein, a putative translation suppressor, is significantly reduced in FXS. The prevailing hypothesis is that rates of cerebral protein synthesis (rCPS) are increased by the absence of this regulatory protein. We have previously reported increased rCPS in the Fmr1 knockout mouse model of FXS. To address the hypothesis in human subjects, we measured rCPS in young men with FXS with L-[1-11C]leucine PET. In previous studies we had used sedation during imaging, and we did not find increases in rCPS as had been seen in the mouse model. Since mouse measurements were conducted in awake animals, we considered the possibility that sedation may have confounded our results. In the present study we used a modified and validated PET protocol that made it easier for participants with FXS to undergo the study awake. We compared rCPS in 10 fragile X participants and 16 healthy controls all studied while awake. Contrary to the prevailing hypothesis and findings in Fmr1 knockout mice, results indicate that rCPS in awake participants with FXS are decreased in whole brain and most brain regions by 13-21% compared to healthy controls.


Assuntos
Cérebro , Síndrome do Cromossomo X Frágil , Biossíntese de Proteínas , Animais , Cérebro/metabolismo , Modelos Animais de Doenças , Proteína do X Frágil da Deficiência Intelectual/genética , Proteína do X Frágil da Deficiência Intelectual/metabolismo , Síndrome do Cromossomo X Frágil/diagnóstico por imagem , Síndrome do Cromossomo X Frágil/metabolismo , Humanos , Leucina/metabolismo , Masculino , Camundongos , Camundongos Knockout , Tomografia por Emissão de Pósitrons , Adulto Jovem
12.
Pers Soc Psychol Bull ; 47(2): 185-200, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32493120

RESUMO

This meta-analysis evaluated theoretical predictions from balanced identity theory (BIT) and evaluated the validity of zero points of Implicit Association Test (IAT) and self-report measures used to test these predictions. Twenty-one researchers contributed individual subject data from 36 experiments (total N = 12,773) that used both explicit and implicit measures of the social-cognitive constructs. The meta-analysis confirmed predictions of BIT's balance-congruity principle and simultaneously validated interpretation of the IAT's zero point as indicating absence of preference between two attitude objects. Statistical power afforded by the sample size enabled the first confirmations of balance-congruity predictions with self-report measures. Beyond these empirical results, the meta-analysis introduced a within-study statistical test of the balance-congruity principle, finding that it had greater efficiency than the previous best method. The meta-analysis's full data set has been publicly archived to enable further studies of interrelations among attitudes, stereotypes, and identities.


Assuntos
Atitude , Modelos Psicológicos , Estereotipagem , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Autoimagem , Autorrelato , Identificação Social , Estatística como Assunto
13.
Neurobiol Dis ; 143: 104978, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32569795

RESUMO

Fragile X syndrome (FXS) is the most common inherited cause of intellectual disability. Fragile X mental retardation protein (FMRP), a putative translation suppressor, is absent or significantly reduced in FXS. One prevailing hypothesis is that rates of protein synthesis are increased by the absence of this regulatory protein. In accord with this hypothesis, we have previously reported increased rates of cerebral protein synthesis (rCPS) in the Fmr1 knockout mouse model of FXS and others have reported similar effects in hippocampal slices. To address the hypothesis in human subjects, we applied the L[1-11C]leucine PET method to measure rCPS in adults with FXS and healthy controls. All subjects were males between the ages of 18 and 24 years and free of psychotropic medication. As most fragile X participants were not able to undergo the PET study awake, we used dexmedetomidine for sedation during the imaging studies. We found no differences between rCPS measured during dexmedetomidine-sedation and the awake state in ten healthy controls. In the comparison of rCPS in dexmedetomidine-sedated fragile X participants (n = 9) and healthy controls (n = 14) we found no statistically significant differences. Our results from in vivo measurements in human brain do not support the hypothesis that rCPS are elevated due to the absence of FMRP. This hypothesis is based on findings in animal models and in vitro measurements in human peripheral cells. The absence of a translation suppressor may produce a more complex response in pathways regulating translation than previously thought. We may need to revise our working hypotheses regarding FXS and our thinking about potential therapeutics.


Assuntos
Encéfalo/metabolismo , Síndrome do Cromossomo X Frágil/metabolismo , Biossíntese de Proteínas/fisiologia , Adolescente , Encéfalo/efeitos dos fármacos , Radioisótopos de Carbono , Dexmedetomidina/farmacologia , Humanos , Hipnóticos e Sedativos/farmacologia , Leucina , Masculino , Tomografia por Emissão de Pósitrons/métodos , Biossíntese de Proteínas/efeitos dos fármacos , Adulto Jovem
14.
J Cereb Blood Flow Metab ; 39(9): 1849-1863, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-29664322

RESUMO

We developed and validated a method to estimate input functions for determination of regional rates of cerebral protein synthesis (rCPS) with L-[1-11C]leucine PET without arterial sampling. The method is based on a population-derived input function (PDIF) approach, with venous samples for calibration. Population input functions were constructed from arterial blood data measured in 25 healthy 18-24-year-old males who underwent L-[1-11C]leucine PET scans while awake. To validate the approach, three additional groups of 18-27-year-old males underwent L-[1-11C]leucine PET scans with both arterial and venous blood sampling: 13 awake healthy volunteers, 10 sedated healthy volunteers, and 5 sedated subjects with fragile X syndrome. Rate constants of the L-[1-11C]leucine kinetic model were estimated voxel-wise with measured arterial input functions and with venous-calibrated PDIFs. Venous plasma leucine measurements were used with venous-calibrated PDIFs for rCPS computation. rCPS determined with PDIFs calibrated with 30-60 min venous samples had small errors (RMSE: 4-9%), and no statistically significant differences were found in any group when compared to rCPS determined with arterial input functions. We conclude that in young adult males, PDIFs calibrated with 30-60 min venous samples can be used in place of arterial input functions for determination of rCPS with L-[1-11C]leucine PET.


Assuntos
Encéfalo/metabolismo , Leucina/metabolismo , Tomografia por Emissão de Pósitrons/métodos , Biossíntese de Proteínas , Adolescente , Adulto , Encéfalo/irrigação sanguínea , Radioisótopos de Carbono/análise , Radioisótopos de Carbono/metabolismo , Feminino , Humanos , Leucina/análise , Masculino , Adulto Jovem
15.
J Endocr Soc ; 2(11): 1314-1319, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30430145

RESUMO

OBJECTIVE: To characterize the types of hyperglycemia that occur up to 1 year following liver transplant and to clarify the nomenclature for posttransplant hyperglycemia. DESIGN: We analyzed 1-year glycemic follow-up data in 164 patients who underwent liver transplant and who had been enrolled in a randomized controlled trial comparing moderate to intensive insulin therapy to determine if patients had preexisting known diabetes, transient hyperglycemia, persistent hyperglycemia, or new-onset diabetes after transplantation (NODAT). RESULTS: Of 119 patients with posttransplant hyperglycemia following hospital discharge, 49 had preexisting diabetes, 5 had insufficient data for analysis, 48 had transient hyperglycemia (16 resolved within 30 days and 32 resolved between 30 days and 1 year), 13 remained persistently hyperglycemic out to 1 year and most likely had preexisting diabetes that had not been diagnosed or insulin resistance/insulinopenia prior to transplant, and 4 had NODAT (i.e., patients with transient hyperglycemia after transplant that resolved but then later truly developed sustained hyperglycemia, meeting criteria for diabetes). CONCLUSIONS: Distinct categories of patients with hyperglycemia following organ transplant include known preexisting diabetes, persistent hyperglycemia (most likely unknown preexisting diabetes or insulin resistance/insulinopenia), transient hyperglycemia, and NODAT. Those with preexisting diabetes for many years prior to transplant may well have very different long-term outcomes compared with those with true NODAT. Therefore, it would be prudent to classify patients more carefully. Long-term outcome studies are needed to determine if patients with true NODAT have the same poor prognosis as patients with preexisting diabetes (diagnosed and undiagnosed) undergoing transplant.

16.
Sleep ; 41(7)2018 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-29771362

RESUMO

If protein synthesis during sleep is required for sleep-dependent memory consolidation, we might expect rates of cerebral protein synthesis (rCPS) to increase during sleep in the local brain circuits that support performance on a particular task following training on that task. To measure circuit-specific brain protein synthesis during a daytime nap opportunity, we used the L-[1-(11)C]leucine positron emission tomography (PET) method with simultaneous polysomnography. We trained subjects on the visual texture discrimination task (TDT). This was followed by a nap opportunity during the PET scan, and we retested them later in the day after the scan. The TDT is considered retinotopically specific, so we hypothesized that higher rCPS in primary visual cortex would be observed in the trained hemisphere compared to the untrained hemisphere in subjects who were randomized to a sleep condition. Our results indicate that the changes in rCPS in primary visual cortex depended on whether subjects were in the wakefulness or sleep condition but were independent of the side of the visual field trained. That is, only in the subjects randomized to sleep, rCPS in the right primary visual cortex was higher than the left regardless of side trained. Other brain regions examined were not so affected. In the subjects who slept, performance on the TDT improved similarly regardless of the side trained. Results indicate a regionally selective and sleep-dependent effect that occurs with improved performance on the TDT.


Assuntos
Consolidação da Memória/fisiologia , Biossíntese de Proteínas/fisiologia , Sono/fisiologia , Córtex Visual/metabolismo , Vigília/fisiologia , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Radioisótopos de Carbono , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Polissonografia , Tomografia por Emissão de Pósitrons/métodos , Córtex Visual/diagnóstico por imagem , Percepção Visual , Adulto Jovem
18.
PLoS One ; 13(4): e0195580, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29659612

RESUMO

To examine effects of scan duration on estimates of regional rates of cerebral protein synthesis (rCPS), we reanalyzed data from thirty-nine previously reported L-[1-11C]leucine PET studies. Subjects consisted of 12 healthy volunteers studied twice, awake and under propofol sedation, and 15 subjects with fragile X syndrome (FXS) studied once under propofol sedation. All scans were acquired on a high resolution scanner. We used a basis function method for voxelwise estimation of parameters of the kinetic model of L-[1-11C]leucine and rCPS over the interval beginning at the time of tracer injection and ending 30, 45, 60, 75 or 90 min later. For each study and scan interval, regional estimates in nine regions and whole brain were obtained by averaging voxelwise estimates over all voxels in the region. In all three groups rCPS was only slightly affected by scan interval length and was very stable between 60 and 90 min. Furthermore, statistical comparisons of rCPS between awake and sedated healthy volunteers provided almost identical results when they were based on 60 min scan data as when they were based on data from the full 90 min interval. Statistical comparisons between sedated healthy volunteers and sedated subjects with FXS also yielded almost identical results when based on 60 and 90 min scan intervals. We conclude that, under the conditions of our studies, scan duration can be shortened to 60 min without loss of precision.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Radioisótopos de Carbono , Leucina , Tomografia por Emissão de Pósitrons , Biossíntese de Proteínas , Adolescente , Humanos , Cinética , Masculino , Modelos Biológicos , Adulto Jovem
19.
Sci Rep ; 8(1): 931, 2018 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-29343731

RESUMO

Functional quantification with PET is generally based on modeling that assumes tissue regions are kinetically homogeneous. Even in regions sufficiently small to approach homogeneity, spillover due to resolution limitations of PET scanners may introduce heterogeneous kinetics into measured data. Herein we consider effects of kinetic heterogeneity at the smallest volume accessible, the single image voxel. We used L-[1-11C]leucine PET and compared rates of cerebral protein synthesis (rCPS) estimated voxelwise with methods that do (Spectral Analysis Iterative Filter, SAIF) and do not (Basis Function Method, BFM) allow for kinetic heterogeneity. In high resolution PET data with good counting statistics BFM produced estimates of rCPS comparable to SAIF, but at lower computational cost; thus the simpler, less costly method can be applied. With poorer counting statistics (lower injected radiotracer doses), BFM estimates were more biased. In data smoothed to simulate lower resolution PET, BFM produced estimates of rCPS 9-14% higher than SAIF, overestimation consistent with applying a homogeneous tissue model to kinetically heterogeneous data. Hence with lower resolution data it is necessary to account for kinetic heterogeneity in the analysis. Kinetic heterogeneity may impact analyses of other tracers and scanning protocols differently; assessments should be made on a case by case basis.


Assuntos
Encéfalo/metabolismo , Radioisótopos de Carbono/metabolismo , Leucina/metabolismo , Biossíntese de Proteínas/fisiologia , Humanos , Cinética , Modelos Biológicos , Tomografia por Emissão de Pósitrons/métodos , Tomografia Computadorizada por Raios X/métodos
20.
J Clin Endocrinol Metab ; 102(2): 451-459, 2017 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-27875061

RESUMO

Context: Previous studies have shown a relationship between glycemic control and posttransplant morbidity. Objective: We conducted a prospective randomized controlled trial in postliver transplant patients to evaluate intensive inpatient glycemic control and effects on outcomes to 1 year. Research Design and Intervention: A total of 164 patients [blood glucose (BG) >180 mg/dL] were randomized into 2 target groups: 82 with a BG of 140 mg/dL and 82 with a BG of 180 mg/dL. Continuous insulin infusions were initiated and then converted to subcutaneous basal bolus insulin therapy by our glucose management service. Results: The inpatient mean BG level was significantly different (140 group, 151.4 ± 19.5 mg/dL vs 180 group, 172.6 ± 27.9 mg/dL; P < 0.001). Any infection within 1 year occurred in 35 of the 82 patients (42.7%) in the 140 group and 54 of 82 (65.9%) in the 180 group (P = 0.0046). In a time-to-first infection analysis, being in the 140 group resulted in a hazard ratio of 0.54 (95% confidence interval, 0.35 to 0.83; P = 0.004); the difference between the 2 groups was statistically significant at 1 month (P = 0.008). The number with adjudicated transplant rejection was similar between the 2 groups [17 of 82 (20.7%) and 20 of 82 (24.3%) in the 140 and 180 groups, respectively; P = not significant]. Severe hypoglycemia (BG ≤40 mg/dL) occurred in 3 patients (2 in the 140 group and 1 in the 180 group). However, more patients had moderate hypoglycemia (BG, 41 to 70 mg/dL) in the 140 group [27 of 82 (32.9%) vs 10 of 82 (12.2%) in the 180 group; P = 0.003]. Insulin-related hypoglycemia was not associated with the incidence of severe adverse outcomes. Conclusions: Glycemic control of 140 mg/dL safely resulted in a reduced incidence of infection after transplantation compared with 180 mg/dL, but with an increase in moderate hypoglycemia.


Assuntos
Glicemia/metabolismo , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Transplante de Fígado/efeitos adversos , Infecções Oportunistas/prevenção & controle , Idoso , Relação Dose-Resposta a Droga , Feminino , Humanos , Hospedeiro Imunocomprometido , Infusões Intravenosas , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Infecções Oportunistas/imunologia , Estudos Prospectivos
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