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1.
Cir Esp (Engl Ed) ; 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35667609

RESUMO

This article summarizes the clinical guidelines for the diagnosis and treatment of malignant pleural effusion (MPE) sponsored by the Spanish Society of Thoracic Surgery (SECT). Ten clinical controversies were elaborated under the methodology of PICO (Patient, Intervention, Comparison, Outcome) questions and the quality of the evidence and grading of the strength of the recommendations was based on the GRADE system. Immunocytochemical and molecular analyses of pleural fluid may avoid further invasive diagnostic procedures. Currently, the definitive control of MPE can be achieved either by pleurodesis (talc poudrage or slurry) or the insertion of a tunneled pleural catheter (TPC). It is likely that the combination of both techniques (i.e., thoracoscopy with talc poudrage and insertion of a TPC, or instillation of talc slurry through a TPC) will have a predominant role in the future therapeutic management.

2.
Cancers (Basel) ; 14(11)2022 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-35681751

RESUMO

The most appropriate duration of anticoagulant treatment for cancer-associated venous thromboembolism (CAT) remains unclear. We have conducted a prospective multicenter study in CAT patients with more than 6 months of anticoagulant treatment to predict the risk of venous thromboembolism (VTE) recurrence after anticoagulation discontinuation. Blood samples were obtained when patients stopped the anticoagulation, at 21 days and at 90 days. In each sample we assessed different coagulation-related biomarkers: D-dimer (DD), high-sensitivity C-reactive protein (hs-CRP), P-selectin (PS), phospholipids, soluble tissue factor, factor VIII and the thrombin generation test. It was evaluated 325 CAT patients and 166 patients were included in the study, mean age 64 ± 17 years. VTE recurrence until 6 months after stopping anticoagulation treatment was 9.87% [95% confidence interval (CI): 6-15]. The biomarkers sub-distribution hazard ratios were 6.32 for ratio DD basal/DD 21 days > 2 (95% CI: 1.82-21.90), 6.36 for hs-CRP > 4.5 (95% CI: 1.73-23.40) and 5.58 for PS > 40 (95% CI: 1.46-21.30) after 21 days of stopping anticoagulation. This is the first study that has identified the DD ratio, hs-CRP and PS as potential biomarkers of VTE recurrence in cancer patients after the discontinuation of anticoagulation treatment. A risk-adapted strategy may allow the identification of the optimal time to withdraw the anticoagulation in each CAT patient.

3.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35688688

RESUMO

INTRODUCTION AND OBJECTIVES: Equal opportunities to access technical advances with recognized clinical value should be a priority of the publicly-funded health system. We analyzed variability among all the Spanish autonomous communities in the use of cardiovascular techniques with an established indication and its relationship with economic indicators, burden of disease, and hospital mortality. METHODS: The activity registries of various Associations of the Spanish Society of Cardiology from 2011 to 2019 were analyzed for coronary angiography, overall percutaneous coronary intervention (PCI), primary PCI, implantable cardioverter-defibrillators (ICD), cardiac resynchronization therapy, and transcatheter aortic valve replacement (TAVR). Economic indices (gross domestic product and per capita health care expenditure) were obtained from public sources and data on attendance rates and mortality from the Resources and Quality in Cardiology (RECALCAR) reports of the Spanish Society of Cardiology. We analyzed the coefficient of variation for activity and the correlation of activity with regional economic indices, attendance rates, and risk-adjusted rates of in-hospital mortality. RESULTS: We identified wide variability in the use of technologies, especially for primary PCI (18%), ICD (22%), cardiac resynchronization therapy (36%), and TAVR (42%). A certain correlation with attendance rates was seen only for overall PCI and ICD. In general, no significant correlation was found between the use of the techniques and the economic indices of wealth and expenditure. The correlation with in-hospital mortality showed no significant results, although this was the analysis with the greatest limitations because the impact of these techniques on survival is exerted more in the mid- and long-term. CONCLUSIONS: The results of this study, despite its inherent limitations, show marked variability between autonomous communities in the use of cardiovascular technologies, which is not explained by economic differences or by hospital attendance rates due to the corresponding diseases.

4.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35691552

RESUMO

INTRODUCTION AND OBJECTIVES: Transfemoral access is the most frequently used vascular approach in chronic total occlusion percutaneous coronary interventions (CTO-PCI). The aim of this study was to evaluate the safety and feasibility of a transradial access CTO-PCI program and its impact on angiographic and clinical results and length of hospital stay. METHODS: Retrospective multicenter cohort study including 2550 consecutive CTO-PCI procedures included in a multicenter registry with accurate information on vascular access. A total of 896 procedures were performed as radial-only access while 1654 were performed through at least 1 femoral puncture. Clinical and angiographic data were collected. RESULTS: The mean age was 66.3 ± 11.4 years. The mean Japan-chronic total occlusion score (2.7 ± 0.3) was similar in the 2 groups. Successful revascularization was achieved in 2009 (79.6%) cases, 78.2% and 82.1% in the femoral and radial access cohorts, respectively (P = .002). Periprocedural in-hospital complications were observed in 5.1% and 2.3% (P = .02), with fewer access site-dependant vascular complications in the transradial cohort (2.3% vs 0.2%; P = .009). The mean length of hospital stay was significantly shorter in the transradial access group (0.89 ± 1.4 vs 2.2 ± 3.2 days, P < .001). CONCLUSION: A transradial program for CTO-PCI is safe and effective in most CTO lesions. The transradial strategy has fewer vascular complications and shorter length of hospital stay without compromising the success rate.

5.
Ecology ; : e3775, 2022 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-35661139

RESUMO

Managing wildlife populations in the face of global change requires regular data on the abundance and distribution of wild animals but acquiring these over appropriate spatial scales in a sustainable way has proven challenging. Here we present the data from Snapshot USA 2020, a second annual national mammal survey of the United States of America. This project involved 152 scientists setting camera traps in a standardized protocol at 1485 locations across 103 arrays in 43 states for a total of 52,710 trap-nights of survey effort. Most (58) of these arrays were also sampled during the same months (September and October) in 2019, providing a direct comparison of animal populations in two years that include data from both during and before the COVID-19 pandemic. All data were managed by the eMammal system, with all species identifications checked by at least two reviewers. In total we recorded 117,415 detections of 78 species of wild mammals, 9236 detections of at least 43 species of birds, 15,851 detections of six domestic animals and 23,825 detections of humans or their vehicles. Spatial differences across arrays explained more variation in the relative abundance than temporal variation across years for all 38 species modeled, although there are examples of significant site-level differences between years for many species. Temporal results show how species allocate their time and can be used to study species interactions, including between humans and wildlife. These data provide a snapshot of the mammal community of the USA for 2020 and will be useful for exploring the drivers of spatial and temporal changes in relative abundance and distribution, and the impacts of species interactions on daily activity patterns. There are no copyright restrictions, and please cite this paper when using these data, or a subset of these data, for publication.

6.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35557083

RESUMO

Annexins are a well-characterized multigene family of phospholipid-binding and membrane-bound proteins that are Ca2+-regulated. ANXA1 expression is variable in tumor cells, ranging from high levels to none, which is why it is helpful to know the staining potential of various antibodies against the protein. Our research aims to evaluate the specificity of five antibodies used to detect ANXA1 expression in selecting different types of cancer and normal tissue and the differential specificity between the two groups. We examined a data set composed of 2177 samples from The Human Protein Atlas (HPA) as mentioned, cancer patients:1904 samples, and healthy persons: 273 samples. We examined the specificity of five different antibody types of detecting ANXA1 expression (HPA011271, HPA011272, CAB013023, CAB035987, and CAB058693). The specificity of each antibody against ANXA1 protein was evaluated using a staining scale of 0 - 3.00, where 0 indicates no staining, 0.01-1.0 low staining, 1.01 - 2.0 medium staining, and 2.01 - 3.00 high staining. RESULTS: CAB013023 had the highest staining values for both cancer and healthy samples; thyroid cancer and endometrial cancer had the highest staining values (2.75 and 2.80, respectively). Breast, head and neck, and bladder normal tissues stained the most intensely in healthy samples (3.00 in all three cases). The antibody's specificity for identifying ANXA1 expression suggests that this may be used as a prognosis and treatment marker in cancer.

7.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35557263

RESUMO

Annexin A1 (ANXA1) is the first member of the Lipocortin family, a calcium-dependent phospholipid-binding protein with potent immunomodulatory activity. ANXA1 is related to cellular proliferation, apoptosis, progression, and metastasis in cancer, and its expression is variable depending on the tumor type. Our research will compare the expression of ANXA1 in various forms of cancer and establish if the protein is up-or down-regulated. METHODS: We analyzed 1904 immunohistochemistry datasets from The Human Protein Atlas (HPA). The samples represent 20 different forms of cancer from 455 patients. The expression of ANXA1 was compared to the same in tissue samples from 137 healthy subjects, which meant the tissues of origins of primary tumors. The levels of ANXA1 expression were quantified using a visual grading method based on staining intensity (I) and cell fraction stained (F). The Q score (combination of stained cell fraction and staining intensity) was obtained by the product of (F)*(I). RESULTS: 9 of 20 cancer types showed increased protein expression (up-regulation) comparison to their healthy counterparts. Eight cancer types showed decreased protein expression (down-regulation). Three types of cancer showed no significant differences. CONCLUSION: ANXA1 expression may serve as an important diagnostic marker for such a variety of different cancer types.

8.
EFSA J ; 20(Suppl 1): e200417, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35634547

RESUMO

Keeping food safe is a challenge that needs continuous surveillance for the sake of consumers' health. The main issue when a food-borne pathogen outbreak occurs is represented by the identification of the source(s) of contamination. Delivering this information in a timely manner helps to control the problem, with positive outcomes for everyone, especially for the consumers, whose health is in this way preserved, and for the stakeholders involved in food production and distribution, who could face enormous economic losses if recalls or legal issues occur. Whole genome sequencing (WGS) is a tool recently implemented for the characterisation of isolates and the study of outbreaks because of its higher efficiency and faster results, when compared to traditional typing methods. Lower sequencing costs and the development of many bioinformatic tools helped its spread, and much more attention has been given to its use for outbreak investigation. It is important to reach a certain level of standardisation, though, for ensuring result reproducibility and interoperability. Moreover, nowadays it is possible, if not mandatory for Open Science Practices, to share WGS data in publicly available databases, where raw reads, assembled genomes and their corresponding metadata can be easily found and downloaded. The scope of this Fellowship was to provide the Fellow all the training necessary for successfully integrating genomics to surveillance and risk assessment of food-borne pathogens from farm to fork.

9.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35554424

RESUMO

Annexin A1 (ANXA1) is a Ca2+-regulated phospholipid-binding protein involved in several physiological functions. Further research has shown that this protein might have various roles in cancer development and operate at different levels. This is partially related to the placement of ANXA1 in distinct cellular compartments. ANXA1 is maybe nuclear, cytoplasmic, and membrane-associated. The goal of this study has been to analyze ANXA1 subcellular localization and expression in different types of cancer. METHODS: We examined 1295 data sets available in The Human Protein Atlas (HPA) (HPA). The research examined the ANXA1 expression in tissue from 1130 cancer and 165 normal samples. A visual categorization method based on staining intensity (I), the proportion of stained cells (F) (F). ANXA1 expression levels as a function of subcellular localization. Q Score (product of E*I) was calculated by the fraction of stained cells (F) and the intensity (I) (I) RESULTS: In cancer patients, the predominant subcellular localization was cytoplasmic membranous (53.3 %), whereas, in healthy individuals, the principal was cytoplasmic membranous and nuclear (57.0 %). In terms of staining intensity (Q Score), the highest values were found at the cytoplasmic membranous and nuclear levels (Q Score=5.69). In contrast, the highest Q Score values were found in standard samples at the nuclear level (Q Score=6.0). CONCLUSION: The subcellular localization of ANXA1 expression may be a helpful diagnostic marker in various cancer types.

10.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35554434

RESUMO

Tumor radioresistance, or the lack of control of certain tumors with this treatment, can result in locoregional recurrence; therefore, there is great interest in understanding the underlying biology and developing strategies to overcome this problem. MicroRNAs (miRNAs, miRs) are small non-coding RNAs that regulate gene expression at the post-transcriptional level and participate in cancer invasion, progression, metastasis, and therapeutic resistance. Emerging evidence indicates that miRNAs play a critical role in modulating key cellular pathways that mediate response to radiation, influencing radiosensitivity of cancer cells through interaction with other biological processes such as cell cycle checkpoints, apoptosis, autophagy, epithelialmesenchymal transition, and cancer stem cells. Today, most studies on patient data report different, results on the miRNAs evaluated for each tumor type, highlighting miR-106b whose overexpression can determine radioresistance both in vitro and in vivo by inhibiting apoptosis and promotion of cell proliferation. The objective of this study was to find the signaling pathways involved with miR-106b-mediated radioresistance. METHODS: CRC gene expression data sets were collected from the public database, The Cancer Genome Atlas (TCGA). In addition, web-based tools were used to explore TCGA data, specifically that developed by the Memorial Sloan Kettering Cancer Center (MSK) cBioPortal for Cancer Genomics. The public site cBioPortal is hosted at the MSK Molecular Oncology Center, in which the term "colorectal cancer" was searched and 12 studies were selected, creating a single combined study which has 4341 patients and 4488 samples, within which the search for miR-106b was carried out and the signaling pathways involved with the expression mediated by this miRNA were obtained. RESULTS: The following signaling pathways involved with miR-106b were obtained: WNT, TP53, TGF-Beta, RTK-RAS, PI3K, NRF2, NOTCH, MYC, HIPPO, and its influence on the cell cycle was also noted. CONCLUSION: miRNAs have been shown to play an important role in the regulation of CRC radio resistance, by controlling various signaling pathways, including cell cycle, proliferation, apoptosis, and DNA damage repair. Furthermore, these results are consistent with recent data that have shown that selective modulation of miRNA activity can improve the response to radiotherapy, providing an innovative antitumor approach based on miRNA-related gene therapy. Therefore, miRNAs could also serve as targets for the development of new therapeutic strategies to overcome radiation resistance in CRC.

11.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35554881

RESUMO

Colorectal cancer (CRC) is the third leading cause of cancer-related mortality globally. MicroRNAs (miRNAs, miRs), a class of small non-coding RNA molecules, have demonstrated important roles in carcinogenesis and its progression through the regulation of the epithelialmesenchymal transition (EMT), oncogenic signaling pathways, and metastasis. Despite the increase in miRNA studies and extensive analyzes of their expression, the role and function of many individual miRNAs in CRC remains poorly understood. The aim of this study was to identify miRNA targets in CRC through data sequencing, which could be a solid prognostic prediction tool and help clinical strategy. METHODS: CRC gene expression data sets were collected from the public database, The Cancer Genome Atlas (TCGA). In addition, web-based tools were used to explore TCGA data, specifically the one developed by the Broad Institute TCGA GDAC Firehose, which provides data sets, algorithms, and analysis results standardized for TCGA. This pipeline has the following steps: The CLR (Context Likelihood of Relatedness) approach is applied to infer putative miRNA regulatory connections: gene; miRNA filtering: gene pairs based on Pearson's correlation (<= -0.3); and miRNA filtering: gene pairs based on predicted interactions in three sequence prediction databases (Miranda, Pictar, Targetscan). The CLR algorithm was applied on 617 miRs and 18012 mRNAs across 220 samples. After 2 filtering steps, the number of 9 miR:genes pairs were detected. RESULTS: The initial search with the term "Colorectal adenocarcinoma", "COADREAD" yielded 631 cases. After the analysis of these samples, data on the significance miR:gene pairs were obtained and Table 1 shows the results of miR:gene pairs with corr < -0.30 and predicted interactions in three sequence prediction databases. About the miRNA connections, Table 2 shows all miRNA hubs with their associated genes in the putative direct target network. Finally, about gene connections, Table 3 shows all gene hubs with their associated miRNAs in the putative direct target network. CONCLUSION: The use of miRNAs as biomarkers for CRC could provide a new and less invasive technique to detect CRC and help determine prognosis. These miRNAs and their targets require further evaluation for a better understanding of their associations, ultimately, with the potential to develop new therapeutic targets. Therefore, it is proposed to develop a screening panel that should consist of multiple miRNAs that would provide a more accurate and efficient screening tool for CRC.

12.
Comput Biol Med ; 146: 105575, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35533462

RESUMO

SARS-CoV-2, the causal agent of COVID-19, is primarily a pulmonary virus that can directly or indirectly infect several organs. Despite many studies carried out during the current COVID-19 pandemic, some pathological features of SARS-CoV-2 have remained unclear. It has been recently attempted to address the current knowledge gaps on the viral pathogenicity and pathological mechanisms via cellular-level tropism of SARS-CoV-2 using human proteomics, visualization of virus-host protein-protein interactions (PPIs), and enrichment analysis of experimental results. The synergistic use of models and methods that rely on graph theory has enabled the visualization and analysis of the molecular context of virus/host PPIs. We review current knowledge on the SARS-COV-2/host interactome cascade involved in the viral pathogenicity through the graph theory concept and highlight the hub proteins in the intra-viral network that create a subnet with a small number of host central proteins, leading to cell disintegration and infectivity. Then we discuss the putative principle of the "gene-for-gene and "network for network" concepts as platforms for future directions toward designing efficient anti-viral therapies.


Assuntos
COVID-19 , SARS-CoV-2 , Antivirais/farmacologia , Antivirais/uso terapêutico , COVID-19/tratamento farmacológico , Humanos , Pandemias , Proteínas/metabolismo
13.
Stoch Environ Res Risk Assess ; : 1-17, 2022 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-35599987

RESUMO

Pro-environmental behaviors towards climate change can be measured and evaluated in different fields. Typically, surveys are the standard tool for extracting personal information regarding this phenomenon. However, statistical modeling for these surveys is not straightforward, as the response variable is often not explicit. Hence, we propose a set of methodological procedures to deal with pro-environmental behavior data. First, validity evidence through a factorial analysis. Second, indexes are created from factor scores, where one of the latent factors summarizes a target variable. Third, a Beta regression is used to model the index of interest. Fourth, the inferential process is performed from a Bayesian perspective, in which posterior probabilities are used to sort and select the relevant variables. Finally, suitable models are obtained, and conclusions can be drawn from them. As a motivation, we used data from two Chilean surveys to illustrate our methodology as well as interpret and discuss the results.

14.
Prev Med Rep ; 28: 101822, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35620050

RESUMO

Differences in cannabis use patterns among racial, ethnic and sexual minoritized identity subgroups have been attributed to marginalized identity stressors. However, associations at the intersection of these minoritized identities remain underexplored in a changing medical cannabis law (MCL) context. We estimated medical cannabis and daily cannabis use, and cannabis use disorder (CUD) by intersecting racial, ethnic and sexual minoritized identity subgroups. We included 189,800 adults in the 2015-2019 National Survey on Drug Use and Health identifying as non-Hispanic white, non-Hispanic Black, or Hispanic and self-reported heterosexual, gay/lesbian, or bisexual sexual identity. We estimated the adjusted odds of past-year: (a) any medical cannabis, (b) daily cannabis use (i.e., 300 + days/year), and (c) DSM-5-proxy CUD by sexual identity, stratified by race and ethnicity. Cannabis measures were higher among sexual minoritized groups than heterosexual adults across racial and ethnic subgroups. Bisexual adults had higher odds of any medical cannabis use than their heterosexual counterparts: non-Hispanic white (6.4% vs. 1.8%; aOR = 2.6, 95% CI = [2.5-3.5]), non-Hispanic Black (4.1% vs. 1.7%; aOR = 2.7, 95% CI = [1.6-4.5]), and Hispanic adults (5.3% vs. 1.8 %; aOR = 2.6, 95% CI = [1.9-3.3]). We found heterogeneous associations with state MCL status across subgroups stratified by race and ethnicity. Bisexual adults in MCL states had higher odds of any medical cannabis use among non-Hispanic white (aOR = 2.0, 95% CI = [1.4-2.9]) and Hispanic (aOR = 3.6, 95% CI = [1.2-10.2]) adults compared to their non-MCL counterparts, but this was marginal among non-Hispanic Black bisexual adults (aOR = 1.6, 95% CI = [1.0-2.6]). Studies should assess intended and unintended cannabis policy effects among racial, ethnic, and sexual identity subgroups.

15.
FASEB J ; 36 Suppl 12022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35560647

RESUMO

Based on the CREST (Connecting Researchers, Educators, and STudents) model undergraduate students at Nova Southeastern University (NSU) cooperated in teams through a specially designed Honors Seminar Course titled, "Introduction to Protein Modeling". This Course-based Undergraduate Research Experience (CURE) brought together groups of undergraduate students early in their studies to have authentic research and presentation experiences. This course was open to all students in NSU's Farquhar Honors College regardless of their major, academic level or previous college level experience with science or protein modeling. Out of 15 registered students, seven of them were first semester freshmen, one was a sophomore, three were juniors, and four were seniors. Most of the students were Biology or Behavioral Neuroscience Majors. However, there was one of each of the following four majors: Dance, Exercise and Sport Science, Marine Biology, and Pre-Nursing. The students were divided into five groups of three, each consisting of a mix of freshmen and upper-level students. Here we present the design and results of a course that provided students with early access to a course-based research experience using various protein bioinformatics tools (Jmol, Pymol, Autodoc Vina, and the Protein Data Bank). Students were shown previously completed projects as part of the CREST Program available on the Program's website: https://cbm.msoe.edu/crest/new9_2021.php. To support CURE sustainability, we used an interdisciplinary team-teaching approach, with distributed leadership and the support of the University's Honors College in the development of this course. Students worked collaboratively during class meetings to identify a protein molecular story that they wanted to research and describe using molecular modeling tools, including the development of a 3-D model. At the midterm, the student groups shared their progress and received feedback from the faculty and their peers. Students continued to revise their modeling projects and received additional feedback one month later. At the end of the semester each team presented their final projects with components that included a protein model description sheet, poster, and oral presentations. Student projects included molecular stories related to MMP 12, cystic fibrosis transmembrane regulator, marine bacterial laminarinase, sickle cell anemia, and iron acquisition in E. coli related to TonB/TonBox binding. Through interacting with the primary literature, course materials, and using protein modeling tools, students gained an introduction to the scientific process and applied it to better understand molecular mechanisms. During this process, students also learned to explain these processes to themselves and others through constructing presentations and model descriptions. Student learning gains were documented by using the RISC (Research on the Integrated Science Curriculum) Survey.

16.
Foods ; 11(9)2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35564006

RESUMO

Faba bean is a potential ingredient due to its high protein yield and its possible cultivation in colder climate regions. In this study, meat analogues made from faba bean protein isolate (FPI) and concentrate (FPC) blends were produced using high moisture extrusion. The aim of this study was to investigate the effect of the FPI content (FPIc), feed water content (FWC), and temperature of the long cooling die (LT) during extrusion on the mechanical and physicochemical properties as well as on the structure of the meat analogues. Increased FPIc resulted in higher values in hardness, gumminess, chewiness, and cutting strengths as well as in darker colour and decreased water absorption capacity. The effect of increased FWC on these properties was weaker and the opposite. Images from microtomography revealed that higher FPIc led to a less organised fibrous structure. In conclusion, fibrous structures can be achieved by utilising a mixture of faba bean protein ingredients, and a higher FPC content seemed to promote fibre formation in the meat analogue.

17.
Nat Commun ; 13(1): 2613, 2022 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-35551183

RESUMO

Neuromodulators adapt sensory circuits to changes in the external world or the animal's internal state and synapses are key control sites for such plasticity. Less clear is how neuromodulation alters the amount of information transmitted through the circuit. We investigated this question in the context of the diurnal regulation of visual processing in the retina of zebrafish, focusing on ribbon synapses of bipolar cells. We demonstrate that contrast-sensitivity peaks in the afternoon accompanied by a four-fold increase in the average Shannon information transmitted from an active zone. This increase reflects higher synaptic gain, lower spontaneous "noise" and reduced variability of evoked responses. Simultaneously, an increase in the probability of multivesicular events with larger information content increases the efficiency of transmission (bits per vesicle) by factors of 1.5-2.7. This study demonstrates the multiplicity of mechanisms by which a neuromodulator can adjust the synaptic transfer of sensory information.


Assuntos
Transmissão Sináptica , Peixe-Zebra , Animais , Neurotransmissores , Retina/fisiologia , Sinapses/fisiologia , Transmissão Sináptica/fisiologia
18.
Artigo em Inglês | MEDLINE | ID: mdl-35561974

RESUMO

OBJECTIVE: Extended anticoagulation therapy should always be considered after standard treatment of an unprovoked episode of venous thromboembolism (VTE). It can also be considered for selected patients with provoked VTE. However, the evidence-based protocols suggested by some clinical guidelines and risk assessment tools to guide this practice are limited and ambiguous. The goal of the present survey research was to analyze current practices in applying extended anticoagulation therapy for patients with VTE among members of the American Venous Forum (AVF) and European Venous Forum (EVF). METHODS: An online survey was created by the AVF Research Committee. The survey consisted of 16 questions to identify the country of practice, specialty, experience of the participating physicians, and their clinical practice patterns in applying extended anticoagulation therapy for VTE patients. The survey was distributed via e-mail to the members of the AVF and EVF. RESULTS: A total of 144 practitioners, 48 AVF members (33%) and 96 EVF members (66%), participated in the survey. Most of the respondents identified themselves as vascular specialists with primary certification in vascular surgery (70%), vascular medicine or angiology (9%), and venous disease or phlebology (3%). Of the 144 respondents, 72% believed that the risk of VTE recurrence will generally overweigh the risk of bleeding for patients with unprovoked VTE. Extended anticoagulation therapy might be used by 97% of providers. Different patterns in real world clinical practice were identified. More than one half of the practitioners estimated the VTE recurrence and bleeding risk subjectively. The antithrombotic drugs most commonly used for secondary prophylaxis were rivaroxaban, apixaban, warfarin, dabigatran, and aspirin, in decreasing order of frequency. Among the reasons selected for not regularly considering extended anticoagulation therapy were the lack of specific clinical practice guidelines (24%), lack of reported evidence (9%), and absence of valid VTE and/or bleeding risk prediction calculators (8%). Twelve participants (8%) stated that extended anticoagulation therapy would not be beneficial for most patients with VTE. Ten participants (7%) indicated that prescribing extended anticoagulation therapy was outside the scope of their specialty. CONCLUSIONS: Different practice patterns exist regarding extending anticoagulation therapy beyond the standard treatment for patients with VTE. Major gaps in knowledge remain a serious challenge at least partially explaining the inaccuracy and inconsistency in long-term VTE management. Appropriately designed studies are needed to evaluate risk stratification tools when contemporary best medical therapy is used, accurately predict VTE recurrence and its long-term outcomes, and tailor safe and effective secondary prophylaxis.

19.
Int J Cardiol ; 362: 128-136, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35550389

RESUMO

BACKGROUND: High degree cardiac conduction disturbances (HDCD) remain a major complication after transcatheter aortic valve replacement (TAVR), especially with self-expandable valves (SEV). Our aim was to investigate peri-procedural and in-hospital modification of atrioventricular and intracardiac conduction associated to new generation SEV implantation, and the development of new HDCD resulting in permanent pacemaker implantation (PPM) in patients undergoing TAVR. METHODS AND RESULTS: Three-hundred forty-four consecutive patients with severe aortic stenosis who underwent TAVR with a new generation SEV [Evolut-R/Pro (n = 130), Acurate-neo (n = 79), Portico (n = 75) and Allegra (n = 60)] were included. An analysis of baseline, post-TAVR and pre-discharge ECG and procedural aspects were centrally performed. A significant increase in baseline PR interval (169.6 ± 28.2 ms) and QRS complex width (101.7 ± 25.9 ms) was noted immediately post-TAVR (188.04 ± 34.49; 129.55 ± 30.02 ms), with a partial in-hospital reversal (179.4 ± 30.1; 123.06 ± 30.94 ms), resulting in a net increase at hospital discharge of 12.6 ± 38.8 ms and 21.4 ± 31.6 ms (p < 0.001), respectively. The global incidence of new onset persistent HDCD at hospital discharge was 46.3%, with 17.7% of patients requiring PPM. Independent predictors of new onset HCDC at hospital discharge were valve recapture (OR: 2.8; 95% IC: 1.1-7.2, p = 0.033) and implantation depth ≥ 6 mm (OR: 1.9 05% IC 1.1-3.3, p = 0.015), while higher implantation (<3 mm (OR: 0.3, 95% IC 0.1-0.7, p = 0.014) and use of Acurate-Neo valve (OR: 0.4; 95% IC 0.2-0.8, p = 0.009) were protective factor. CONCLUSIONS: New generation self-expanding aortic valves were associated with a significant increase in PR and QRS interval at hospital discharge leading to a very high rate of HDCD. While valve recapture and implantation depth were independent predictors for the occurrence of HDCD, use of Accurate-Neo valve was a protective factor.


Assuntos
Estenose da Valva Aórtica , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Doença do Sistema de Condução Cardíaco/diagnóstico , Doença do Sistema de Condução Cardíaco/epidemiologia , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Desenho de Prótese , Fatores de Risco , Substituição da Valva Aórtica Transcateter/efeitos adversos , Resultado do Tratamento
20.
Am Surg ; : 31348221086821, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35387524

RESUMO

We investigated whether the COVID-19 pandemic affected rates of interpersonal violence (IV). A retrospective study was performed using city-wide crime data and the trauma registry at one high-volume trauma center pre-pandemic [PP] (March-October 2019) and during the pandemic [PA] (March-October 2020). The proportion of trauma admissions attributable to IV remained unchanged from PP to PA, but IV increased as a proportion of overall crime (34% to 41%, p<0.001). Assaults decreased, but there was a proportionate increase in penetrating trauma which was mostly attributable to firearms. Despite a reduction in admissions due to IV in the first 4 months of the pandemic, the rates of violence subsequently exceeded that of the same months in 2019. The cause of the observed increase of IV is multi-factorial. Future studies aimed at identifying the root causes are essential to mitigate violence during this ongoing health crisis.

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