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Inertia suppresses signatures of activity of active Brownian particles in a harmonic potential. Phys Rev E 2024; 109:034405. [PMID: 38632789 DOI: 10.1103/physreve.109.034405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/25/2024] [Indexed: 04/19/2024]
Abstract
A harmonically trapped active Brownian particle exhibits two types of positional distributions-one has a single peak and the other has a single well-that signify steady-state dynamics with low and high activity, respectively. Adding inertia to the translational motion preserves this strict classification of either single-peak or single-well densities but shifts the dividing boundary between the states in the parameter space. We characterize this shift for the dynamics in one spatial dimension using the static Fokker-Planck equation for the full joint distribution of the state space. We derive local results analytically with a perturbation method for a small rotational velocity and then extend them globally with a numerical approach.
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High-throughput fabrication of antimicrobial phage microgels and example applications in food decontamination. Nat Protoc 2024:10.1038/s41596-024-00964-6. [PMID: 38413781 DOI: 10.1038/s41596-024-00964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/14/2023] [Indexed: 02/29/2024]
Abstract
Engineered by nature, biological entities are exceptional building blocks for biomaterials. These entities can impart enhanced functionalities on the final material that are otherwise unattainable. However, preserving the bioactive functionalities of these building blocks during the material fabrication process remains a challenge. We describe a high-throughput protocol for the bottom-up self-assembly of highly concentrated phages into microgels while preserving and amplifying their inherent antimicrobial activity and biofunctionality. Each microgel is comprised of half a million cross-linked phages as the sole structural component, self-organized in aligned bundles. We discuss common pitfalls in the preparation procedure and describe optimization processes to ensure the preservation of the biofunctionality of the phage building blocks. This protocol enables the production of an antimicrobial spray containing the manufactured phage microgels, loaded with potent virulent phages that effectively reduced high loads of multidrug-resistant Escherichia coli O157:H7 on red meat and fresh produce. Compared with other microgel preparation methods, our protocol is particularly well suited to biological materials because it is free of organic solvents and heat. Bench-scale preparation of base materials, namely microporous films (the template for casting microgels) and pure concentrated phage suspension, requires 3.5 h and 5 d, respectively. A single production run, that yields over 1,750,000 microgels, ranges from 2 h to 2 d depending on the rate of cross-linking chemistry. We expect that this platform will address bottlenecks associated with shelf-stability, preservation and delivery of phage for antimicrobial applications, expanding the use of phage for prevention and control of bacterial infections and contaminants.
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Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment. PHYSICAL REVIEW LETTERS 2024; 132:065102. [PMID: 38394591 DOI: 10.1103/physrevlett.132.065102] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/03/2024] [Indexed: 02/25/2024]
Abstract
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.
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Dissociable Contributions of Basolateral Amygdala and Ventrolateral Orbitofrontal Cortex to Flexible Learning Under Uncertainty. J Neurosci 2024; 44:e0622232023. [PMID: 37968116 PMCID: PMC10860573 DOI: 10.1523/jneurosci.0622-23.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 11/17/2023] Open
Abstract
Reversal learning measures the ability to form flexible associations between choice outcomes with stimuli and actions that precede them. This type of learning is thought to rely on several cortical and subcortical areas, including the highly interconnected orbitofrontal cortex (OFC) and basolateral amygdala (BLA), and is often impaired in various neuropsychiatric and substance use disorders. However, the unique contributions of these regions to stimulus- and action-based reversal learning have not been systematically compared using a chemogenetic approach particularly before and after the first reversal that introduces new uncertainty. Here, we examined the roles of ventrolateral OFC (vlOFC) and BLA during reversal learning. Male and female rats were prepared with inhibitory designer receptors exclusively activated by designer drugs targeting projection neurons in these regions and tested on a series of deterministic and probabilistic reversals during which they learned about stimulus identity or side (left or right) associated with different reward probabilities. Using a counterbalanced within-subject design, we inhibited these regions prior to reversal sessions. We assessed initial and pre-/post-reversal changes in performance to measure learning and adjustments to reversals, respectively. We found that inhibition of the ventrolateral orbitofrontal cortex (vlOFC), but not BLA, eliminated adjustments to stimulus-based reversals. Inhibition of BLA, but not vlOFC, selectively impaired action-based probabilistic reversal learning, leaving deterministic reversal learning intact. vlOFC exhibited a sex-dependent role in early adjustment to action-based reversals, but not in overall learning. These results reveal dissociable roles for BLA and vlOFC in flexible learning and highlight a more crucial role for BLA in learning meaningful changes in the reward environment.
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Early disease intervention with guselkumab in psoriasis leads to a higher rate of stable complete skin clearance ('clinical super response'): Week 28 results from the ongoing phase IIIb randomized, double-blind, parallel-group, GUIDE study. J Eur Acad Dermatol Venereol 2023; 37:2016-2027. [PMID: 37262309 DOI: 10.1111/jdv.19236] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/25/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Guselkumab is an interleukin (IL)-23 inhibitor with demonstrated efficacy in patients with psoriasis. OBJECTIVES Evaluate the impact of early disease intervention on clinical responses following 28 weeks of guselkumab treatment in patients with moderate-to-severe plaque psoriasis. Correlate clinical response and disease duration data with serum biomarker data. METHODS GUIDE is a phase IIIb randomized, double-blind, parallel-group, multicentre study of adults with moderate-to-severe plaque psoriasis. In study part 1, patients with a short disease duration (SDD [≤2 years]) or a long disease duration (LDD [>2 years]) received guselkumab 100 mg at Week (W) 0, 4, 12, and 20. Those achieving complete skin clearance at W20 and W28 were defined as a super responder (SRe). A multivariable logistic regression analysed the association between baseline factors and the likelihood of becoming an SRe. The relationship between clinical response, disease duration and serum biomarker data was assessed at W0 and 4. RESULTS In total, 880 patients were enrolled (SDD/LDD = 40.6%/59.4% of patients). More SDD than LDD patients achieved absolute Psoriasis Area and Severity Index (PASI) = 0 at W28 (51.8% vs. 39.4%) and were SRes (43.7% vs. 28.1% [overall 34.4%]). SDD patients also achieved PASI = 0 quicker than LDD patients (median 141 vs. 200 days). Disease duration and prior biologic use had the greatest impact on becoming an SRe, with no strong association among these independent variables. At baseline, there were no significant differences in the serum biomarker levels of IL-17A, IL-17F, IL-22 and β-defensin 2 between SDD and LDD patients, or between SRe and non-SRe patients. Guselkumab rapidly decreased these markers of systemic inflammation across all patient groups analysed at W4. Guselkumab was well tolerated. CONCLUSIONS Guselkumab efficacy was consistent across subpopulations, on the skin and systemically. The proportion of SRes was higher in SDD than LDD patients, indicating early treatment intervention may improve clinical outcomes.
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Effectiveness, safety and quality-of-life effects of guselkumab and ustekinumab in patients with psoriasis: Week 104 results from the non-interventional, prospective, German multicentre PERSIST study. J Eur Acad Dermatol Venereol 2023. [PMID: 37462295 DOI: 10.1111/jdv.19296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/03/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND PERSIST was a prospective, non-interventional, real-world study of guselkumab and ustekinumab in adult patients with moderate-to-severe plaque psoriasis in Germany. OBJECTIVES To examine effectiveness, safety and quality-of-life (QoL) outcomes to Week (W) 104 of treatment with guselkumab and ustekinumab in patients with moderate-to-severe plaque psoriasis. METHODS Patients (≥18 years of age) received guselkumab or ustekinumab as per routine clinical practice. Outcomes to W104 were examined separately in guselkumab and ustekinumab recipients. An ad hoc exploratory analysis of outcomes with guselkumab versus ustekinumab was also performed following propensity score matching. RESULTS Overall, 302 and 313 patients received guselkumab and ustekinumab, respectively. Patients in both cohorts experienced improvements in disease activity and QoL that were maintained to W104, with 64.7% and 63.6% of guselkumab- and 54.6% and 64.4% of ustekinumab-treated patients achieving a Psoriasis Area and Severity Index (PASI) 90 response and a Dermatology Life Quality Index (DLQI) 0/1 score, respectively. Propensity score matching yielded well-balanced baseline characteristics except for prior biologic use, which was higher in guselkumab versus ustekinumab recipients (51.7% vs. 32.0%). Achievement of PASI ≤1 at W104 was more common in guselkumab versus ustekinumab recipients (58.7% vs. 49.7%). The W104 PASI90 response rate was 65.6% with guselkumab and 56.0% with ustekinumab; corresponding rates for PASI100 were 44.3% and 28.5%. In guselkumab recipients, response rates were higher in biologic-naïve versus biologic-experienced patients (PASI90, 77.1% vs. 53.4%; PASI100, 55.0% vs. 33.0%). A high level of response for QoL outcomes was observed for both treatments. CONCLUSIONS Ustekinumab and guselkumab led to improvements in physician-assessed and patient-reported outcomes that were sustained for up to 2 years, with no new safety signals identified. Following propensity score matching, greater improvements in PASI outcomes were observed with guselkumab versus ustekinumab. Improvements with guselkumab were highest in biologic-naïve patients, highlighting the value of early treatment.
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Functionalization of 3D Printed Scaffolds Using Polydopamine and Silver Nanoparticles for Bone-Interfacing Applications. ACS APPLIED BIO MATERIALS 2023; 6:1161-1172. [PMID: 36881860 DOI: 10.1021/acsabm.2c00988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
The prevention of bacterial colonization and the stimulation of osseointegration are two major requirements for bone-interfacing materials to reduce the incidence of complications and promote the restoration of the patient's health. The present investigation developed an effective, two-step functionalization of 3D printed scaffolds intended for bone-interfacing applications using a simple polydopamine (PDA) dip-coating method followed by the formation of silver nanoparticles (AgNPs) after a second coating step in silver nitrate. 3D printed polymeric substrates coated with a ∼20 nm PDA layer and 70 nm diameter AgNPs proved effective in hindering Staphylococcus aureus biofilm formation, with a 3000-8000-fold reduction in the number of bacterial colonies formed. The implementation of porous geometries significantly accelerated osteoblast-like cell growth. Microscopy characterization further elucidated homogeneity, features, and penetration of the coating inside the scaffold. A proof-of-concept coating on titanium substrates attests to the transferability of the method to other materials, broadening the range of applications both in and outside the medical sector. The antibacterial efficiency of the coating is likely to lead to a decrease in the number of bacterial infections developed after surgery in the presence of these coatings on prosthetics, thus translating to a reduction in revision surgeries and improved health outcomes.
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Dalbavancin as sequential therapy for infective endocarditis due to Gram-positive organisms: a review. Int J Antimicrob Agents 2023; 61:106749. [PMID: 36758775 DOI: 10.1016/j.ijantimicag.2023.106749] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/25/2023] [Accepted: 02/02/2023] [Indexed: 02/10/2023]
Abstract
Dalbavancin is a parenteral lipoglycopeptide antibiotic derived from teicoplanin, an analogue of vancomycin. It is mainly used for skin and soft tissue infections. The sustained half-life of approximately 14 days makes dalbavancin a novel option for potential use as sequential treatment in infections such as infective endocarditis, which require prolonged antibiotic courses. However, only a few studies have been reported in the literature, and the use of dalbavancin remains limited. This article is a review of the currently available literature using dalbavancin for the treatment of infective endocarditis due to Gram-positive organisms. Almost all patients received dalbavancin as sequential therapy following standard-of-care antibiotics. The overall clinical efficacy of dalbavancin was approximately 90%, and it appeared to be well tolerated.
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Stress Exposure of Evolved Bacteriophages under Laboratory versus Food Processing Conditions Highlights Challenges in Translatability. Viruses 2022; 15:113. [PMID: 36680153 PMCID: PMC9865000 DOI: 10.3390/v15010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/15/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023] Open
Abstract
Bacterial viruses, or bacteriophages, are highly potent, target-specific antimicrobials. Bacteriophages can be safely applied along the food production chain to aid control of foodborne pathogens. However, bacteriophages are often sensitive to the environments encountered in food matrices and under processing conditions, thus limiting their applicability. We sought to address this challenge by exposing commercially available Listeria monocytogenes bacteriophage, P100, to three stress conditions: desiccation, elevated temperature, and low pH, to select for stress-resistant bacteriophages. The stressed bacteriophage populations lost up to 5.1 log10 in infectivity; however, the surviving subpopulation retained their stress-resistant phenotype through five passages with a maximum of 2.0 log10 loss in infectivity when exposed to the same stressor. Sequencing identified key mutation regions but did not reveal a clear mechanism of resistance. The stress-selected bacteriophage populations effectively suppressed L. monocytogenes growth at a modest multiplicity of infection of 0.35-0.43, indicating no trade-off in lytic ability in return for improved survivability. The stressed subpopulations were tested for survival on food grade stainless steel, during milk pasteurization, and within acidic beverages. Interestingly, air drying on stainless steel and pasteurization in milk led to significantly less stress and titer loss in bacteriophage compared to similar stress under model lab conditions. This led to a diminished benefit for stress-selection, thus highlighting a major challenge in real-life translatability of bacteriophage adaptational evolution.
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083 Prolonged Q16W treatment interval of guselkumab is non-inferior to Q8W dosing for maintaining disease control in super responders: primary results from GUIDE at Week 68 in patients with psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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OC-069 EFECTIVENESS OF PROPHYLACTIC ONLAY MESH FOR PREVENTION OF TROCAR HERNIA: PRELIMINARY RESULTS OF A RANDOMIZED CLINICAL TRIAL. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
Trocar site hernia (TSH) incidence is a common complication of laparoscopic surgery. In the literature there is a lack of tools to prevent it. Our aim was to assess the effectiveness and safety of a prophylactic measure to decrease it.
Methods
A multicentric randomized clinical trial was performed in high-risk patients (diabetes mellitus and/or age ≥70 years and/or BMI ≥30 Kg/m2 and/or extended incision for specimen retrieval) who underwent laparoscopic cholecystectomy in an elective or emergency setting. Patients were allocated to prophylactic onlay polypropylene mesh fixation (intervention) or standard trocar closure (control). The main aim was to analyze the efficacy of the intervention, being TSH incidence the primary outcome. Clinical and radiological follow up was atleast 1 year after surgery. Secondary endpoints were technique-related complications.
Results
134 patients were included (70 and 62 to intervention and control arm, respectively). Groups were homogeneous. Mean [SD] age, 64.8 (17.3) years; 80 (60, 6%) women. The cumulative TSH incidence was lower in the intervention group although not reaching significant differences, either when were radiologically (16 [26.7%] vs 17 [37%], p = 0.294) or clinically assessed (9 [17.6%] vs 9 [24.3], p = 0.593). No differences in surgical site infection, hematoma or seroma were detected. Mean follow-up was 736 days (min. 365 – max. 1294).
Conclusions
Our preliminary results points out that the overall TSH incidence is extremely high when properly assessed. A polypropylene onlay mesh would not be an effective measure to decrease the TSH incidence. Radiological evaluation would show more accuracy.
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P.85 Analysis of Juvenile onset Pompe disease patients included in the Spanish Pompe Registry. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Real-world evidence from the non-interventional, prospective, German multicentre PERSIST study of patients with psoriasis after 1 year of treatment with guselkumab. J Eur Acad Dermatol Venereol 2022; 36:1568-1577. [PMID: 35569014 DOI: 10.1111/jdv.18218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/21/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND PERSIST was a prospective, non-interventional, long-term, German multicentre study of patients with moderate-to-severe psoriasis receiving guselkumab, an approved monoclonal antibody that binds to the p19 subunit of interleukin (IL)-23, in a real-world setting. OBJECTIVES Evaluation of the efficacy and safety of guselkumab, and its effect on health-related quality of life (HRQoL), in patients with moderate-to-severe psoriasis who have received 52 weeks of treatment. METHODS Patients (≥18 years old) were prescribed guselkumab as per routine clinical practice. End points assessed include Psoriasis Area and Severity Index (PASI), Physician's Global Assessment (PGA), target Nail Psoriasis Severity Index (NAPSI), and the Dermatology Life Quality Index (DLQI). RESULTS Overall, 303 patients were enrolled and treated with guselkumab. Mean disease duration was 21.0 years, and 77.2% and 51.2% of patients had received ≥1 prior conventional systemic or ≥1 prior biologic therapy, respectively. Mean PASI score decreased from 16.4 at baseline to 3.0 by Week (W) 28, and further decreased to 2.4 by W52, while the proportion of patients achieving an absolute PASI score of ≤1 increased from 1.3% at baseline, to 50.8% at W28 and to 58.4% by W52. PASI90 and PASI100 responses also showed marked improvements between W28 and W52, regardless of biologic treatment history. Clearance of psoriatic skin was observed in difficult-to-treat areas, with the percentage of patients achieving a PGA score ≤1 increasing between W28 and W52. Guselkumab improved HRQoL; mean DLQI score decreased from 13.7 at baseline to 2.8 by W28, and further decreased to 2.4 by W52. At W52, 64.6% of patients achieved a DLQI score ≤1. The cumulative probability of drug survival was 92.4% at W52. CONCLUSIONS Guselkumab is efficacious and well tolerated regardless of previous biologic therapies, comorbidities or psoriasis manifestation in difficult-to-treat areas. No new safety signals were observed.
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Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment. PHYSICAL REVIEW LETTERS 2022; 129:075001. [PMID: 36018710 DOI: 10.1103/physrevlett.129.075001] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/24/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
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.
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Spray Drying and Particle Engineering in Dosage Form Design for Global Vaccines. J Aerosol Med Pulm Drug Deliv 2022; 35:121-138. [PMID: 35172104 DOI: 10.1089/jamp.2021.0056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Vaccines are a very important tool in the effort to reduce the global burden of infectious diseases. Modern vaccines can be formulated in several ways to induce specific immunity, including through the use of live bacteria, subunit antigens, and even genetic material. However, vaccines typically need to be transported and stored under controlled refrigerated or frozen conditions to maintain potency. This strict temperature control is incompatible with the available infrastructure in many developing countries. One method of improving the thermostability of a vaccine is through drying of a liquid presentation into a dry dosage form. In addition to enhancing the capability for distribution in resource-poor settings, these dry vaccine forms are more suitable for long-term stockpiling. Spray drying is a drying method that has been successfully used to stabilize many experimental vaccines into a dry form for storage above refrigerated temperatures. Additionally, the use of spray drying allows for the production of engineered particles suitable for respiratory administration. These particles can be further designed for increased out-of-package robustness against high humidity. Furthermore, there are already commercial dry powder delivery devices available that can be used to safely deliver vaccines to the respiratory system. The research in this field demonstrates that the resources to develop highly stable vaccines in flexible dosage forms are available and that these presentations offer many advantages for global vaccination campaigns.
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Abstract
We discovered a highly virulent variant of subtype-B HIV-1 in the Netherlands. One hundred nine individuals with this variant had a 0.54 to 0.74 log10 increase (i.e., a ~3.5-fold to 5.5-fold increase) in viral load compared with, and exhibited CD4 cell decline twice as fast as, 6604 individuals with other subtype-B strains. Without treatment, advanced HIV-CD4 cell counts below 350 cells per cubic millimeter, with long-term clinical consequences-is expected to be reached, on average, 9 months after diagnosis for individuals in their thirties with this variant. Age, sex, suspected mode of transmission, and place of birth for the aforementioned 109 individuals were typical for HIV-positive people in the Netherlands, which suggests that the increased virulence is attributable to the viral strain. Genetic sequence analysis suggests that this variant arose in the 1990s from de novo mutation, not recombination, with increased transmissibility and an unfamiliar molecular mechanism of virulence.
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Development and Testing of a Spray-Dried Tuberculosis Vaccine Candidate in a Mouse Model. Front Pharmacol 2022; 12:799034. [PMID: 35126135 PMCID: PMC8814656 DOI: 10.3389/fphar.2021.799034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/27/2021] [Indexed: 11/15/2022] Open
Abstract
Converting a vaccine into a thermostable dry powder is advantageous as it reduces the resource burden linked with the cold chain and provides flexibility in dosage and administration through different routes. Such a dry powder presentation may be especially useful in the development of a vaccine towards the respiratory infectious disease tuberculosis (TB). This study assesses the immunogenicity and protective efficacy of spray-dried ID93+GLA-SE, a promising TB vaccine candidate, against Mycobacterium tuberculosis (Mtb) in a murine model when administered via different routes. Four administration routes for the spray-dried ID93+GLA-SE were evaluated along with relevant controls—1) reconstitution and intramuscular injection, 2) reconstitution and intranasal delivery, 3) nasal dry powder delivery via inhalation, and 4) pulmonary dry powder delivery via inhalation. Dry powder intranasal and pulmonary delivery was achieved using a custom nose-only inhalation device, and optimization using representative vaccine-free powder demonstrated that approximately 10 and 44% of the maximum possible delivered dose would be delivered for intranasal delivery and pulmonary delivery, respectively. Spray-dried powder was engineered according to the different administration routes including maintaining approximately equivalent delivered doses of ID93 and GLA. Vaccine properties of the different spray-dried lots were assessed for quality control in terms of nanoemulsion droplet diameter, polydispersity index, adjuvant content, and antigen content. Our results using the Mtb mouse challenge model show that both intranasal reconstituted vaccine delivery as well as pulmonary dry powder vaccine delivery resulted in Mtb control in infected mice comparable to traditional intramuscular delivery. Improved protection in these two vaccinated groups over their respective control groups coincided with the presence of cytokine-producing T cell responses. In summary, our results provide novel vaccine formulations and delivery routes that can be harnessed to provide protection against Mtb infection.
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P–039 Sperm chromatin integrity in relation to clinical pregnancy rate in an egg donation program. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is DNA Fragmentation Index (DFI) determinant in clinical pregnancy rate (CPR) after ICSI?
Summary answer
DFI is determinant in CPR after ICSI
What is known already
Male fertility evaluation often leaves the clinician in uncertainty. Semen analysis is a basic examination, but insufficient. Sperm DNA is in a compact state, and its integrity is observed to be related to reproductive capacity
Study design, size, duration
A retrospective, single center study, in 65 couples underwent egg donation, ICSI and blastocyst transfer, evaluating DFI and its effect on CPR. This study was carried out since September 2017 to March 2020
Participants/materials, setting, methods
DFI was evaluated using Sperm Chromatin Dispersion test (SCD) and considering 20% or below as normal. We performed ICSI in donated eggs, cultured until blastocyst stage and transferred 1 to 3 embryos. CPR was defined as the number of patient with fetal heart beats presents in relation with the number of patients with embryo transfer. We determined CPR in both groups with normal and abnormal DFI. Fisher exact test was used to analyze the differences.
Main results and the role of chance
From these 65 couples, in 29 male partners had normal DFI and 36 abnormal. CPR was 68.97% in the first group and 41.67% in the second (p = 0.0448)
Limitations, reasons for caution
The small number of patients is a limitation
Wider implications of the findings: The results permit us to know more male patients, to consider DFI as an important variable and to prepare better our patients for procedures.
Trial registration number
00012
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Evaluation of the stability of a spray-dried tuberculosis vaccine candidate designed for dry powder respiratory delivery. Vaccine 2021; 39:5025-5036. [PMID: 34256969 DOI: 10.1016/j.vaccine.2021.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022]
Abstract
Particle engineering via spray drying was used to develop a dry powder presentation of an adjuvanted tuberculosis vaccine candidate. This presentation utilizing a trileucine-trehalose excipient system was designed to be both thermostable and suitable for respiratory delivery. The stability of the spray-dried vaccine powder was assessed over one year at various storage temperatures (-20, 5, 25, 40, 50 °C) in terms of powder stability, adjuvant stability, and antigen stability. A formulation without trileucine was included as a control. The results showed that the interior particle structure and exterior particle morphology of the powder was maintained for one year at 40 °C, while the control case exhibited a small extent of particle fusing under the same storage conditions. Moisture content was maintained, and powder solid state remained amorphous for all storage temperatures. Aerosol performance was assessed with a commercial dry powder inhaler in combination with a human mouth-throat model. The emitted dose and lung dose were maintained for all samples after one year at temperatures up to 40 °C. Nanoemulsion size and oil content of the adjuvant system were maintained after one year at temperatures up to 40 °C, and the agonist content was maintained after one year at temperatures up to 25 °C. The antigen was completely degraded in the control formulation at seven months of storage at 40 °C; by contrast, 45% of the antigen was still present in the trehalose-trileucine formulation after one year of storage at 50 °C. Comparatively, the antigen was completely degraded in a liquid sample of the vaccine candidate after only one month of storage at 37 °C. The spray-dried trehalose-trileucine vaccine powder clearly maintained its inhalable properties after one year's storage at high temperatures and improved overall thermostability of the vaccine.
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Microparticle encapsulation of a tuberculosis subunit vaccine candidate containing a nanoemulsion adjuvant via spray drying. Eur J Pharm Biopharm 2021; 163:23-37. [PMID: 33753213 PMCID: PMC8096719 DOI: 10.1016/j.ejpb.2021.03.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/10/2021] [Accepted: 03/13/2021] [Indexed: 12/20/2022]
Abstract
Spray drying is a technique that can be used to stabilize biopharmaceuticals, such as vaccines, within dry particles. Compared to liquid pharmaceutical products, dry powder has the potential to reduce costs associated with refrigerated storage and transportation. In this study, spray drying was investigated for processing an adjuvanted tuberculosis subunit vaccine, formulated as an oil-in-water nanoemulsion, into a dry powder composed of microparticles. Applying in-silico approaches to the development of formulation and processing conditions, successful encapsulation of the adjuvanted vaccine within amorphous microparticles was achieved in only one iteration, with high retention (>90%) of both the antigen and adjuvant system. Moisture-controlled stability studies on the powder were conducted over 26 months at temperatures up to 40 °C. Results showed that the powder was physically stable after 26 months of storage for all tested temperatures. Adjuvant system integrity was maintained at temperatures up to 25 °C after 26 months and after one month of storage at 40 °C. The spray-dried product demonstrated improved antigen thermostability when stored above refrigerated temperatures as compared to the liquid product. These results demonstrate the feasibility of spray drying as a method of encapsulating and stabilizing an adjuvanted vaccine.
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Development of a formulation platform for a spray-dried, inhalable tuberculosis vaccine candidate. Int J Pharm 2021; 593:120121. [PMID: 33278492 PMCID: PMC7790949 DOI: 10.1016/j.ijpharm.2020.120121] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/17/2020] [Accepted: 11/22/2020] [Indexed: 12/24/2022]
Abstract
Protection against primarily respiratory infectious diseases, such as tuberculosis (TB), can likely be enhanced through mucosal immunization induced by direct delivery of vaccines to the nose or lungs. A thermostable inhalable dry powder vaccine offers further advantages, such as independence from the cold chain. In this study, we investigate the formulation for a stable, inhalable dry powder version of ID93 + GLA-SE, an adjuvanted subunit TB vaccine candidate, containing recombinant fusion protein ID93 and glucopyranosyl lipid A (GLA) in a squalene emulsion (SE) as an adjuvant system, via spray drying. The addition of leucine (20% w/w), pullulan (10%, 20% w/w), and trileucine (3%, 6% w/w) as dispersibility enhancers was investigated with trehalose as a stabilizing agent. Particle morphology and solid state, nanoemulsion droplet size, squalene and GLA content, ID93 presence, and aerosol performance were assessed for each formulation. The results showed that the addition of leucine improved aerosol performance, but increased aggregation of the emulsion droplets was demonstrated on reconstitution. Addition of pullulan preserved emulsion droplet size; however, the antigen could not be detected after reconstitution. The trehalose-trileucine excipient formulations successfully stabilized the adjuvant system, with evidence indicating retention of the antigen, in an inhalable dry powder format suitable for lung delivery.
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PD-0299: Changes in PET/CT uptake between pre/ and post-treatment might predict response in esophageal cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00323-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Beta3-adrenergic stimulation restores endothelial mitochondrial dynamics and prevents pulmonary arterial hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Endothelial dysfunction is one of the most important hallmarks of pulmonary arterial hypertension (PAH). This leads to anomalous production of vasoactive mediators that are responsible for a higher vascular tone and a subsequent increase in pulmonary artery pressure (PAP), and to an increased vascular permeability that favors perivascular inflammation and remodeling, thus worsening the disease. Therefore, preservation of the endothelial barrier could become a relevant therapeutic strategy.
Purpose
In previous studies, others and we have suggested the pharmacological activation of the β3-adrenergic receptor (AR) as a potential therapeutic strategy for pulmonary hypertension (PH) due to left heart disease. However, its potential use in other forms of PH remain unclear. The aim of the present study was to elucidate whether the β3-AR agonist mirabegron could preserve pulmonary endothelium function and be a potential new therapy in PAH.
Methods
For this purpose, we have evaluated the effect of mirabegron (2 and 10 mg/kg·day) in different animal models, including the monocrotaline and the hypoxia-induced PAH models in rats and mice, respectively. Additionally, we have used a transgenic mouse model with endothelial overexpression of human β3-AR in a knockout background, and performed in vitro experiments with human pulmonary artery endothelial cells (HPAECs) for mechanistic experiments.
Results
Our results show a dose dependent effect of mirabegron in reducing mean PAP and Right Ventricular Systolic Pressure in both mice and rats. In addition, the use of transgenic mice has allowed us to determine that pulmonary endothelial cells are key mediators of the beneficial role of β3-AR pathway in ameliorating PAH. Mechanistically, we have shown in vitro that activation of β3-AR with mirabegron protects HPAECs from hypoxia-induced ROS production and mitochondrial fragmentation by restoring mitochondrial fission/fusion dynamics.
Conclusions
This protective effect of mirabegron would lead to endothelium integrity and preserved pulmonary endothelial function, which are necessary for a correct vasodilation, avoiding increased permeability and remodeling. Altogether, the current study demonstrates a beneficial effect of the β3-AR agonist mirabegron that could open new therapeutic avenues in PAH.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Programa de Atracciόn de Talento, Comunidad de Madrid
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Skin Stretch Enhances Illusory Movement in Persons with Lower-Limb Amputation. IEEE Int Conf Rehabil Robot 2020; 2019:1233-1238. [PMID: 31374798 DOI: 10.1109/icorr.2019.8779477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Performance of lower limb prostheses is related not only to the mechanical design and the control scheme, but also to the feedback provided to the user. Proprioceptive feedback, which is the sense of position and movement of one's body parts, can improve the utility as well as facilitate the embodiment of the prosthetic device. Recent studies have shown that proprioceptive kinesthetic (movement) sense can be elicited when non-invasively vibrating a muscle tendon proximal to the targeted joint. However, consistency and quality of the elicited sensation depend on several parameters and muscle tendons after lower limb amputation may not always be accessible. In this study, we developed an experimental protocol to quantitatively and qualitatively assess the elicited proprioceptive kinesthetic illusion when non-invasively vibrating a muscle belly. Furthermore, we explored ways to improve consistency and strength of the illusion by integrating another non-invasive feedback method, namely cutaneous information manipulation via skin stretch. Our preliminary results from tests conducted with a person with transtibial (below knee) amputation show that stretching skin while vibrating a muscle belly on the residual limb provided a stronger and more consistent kinesthetic illusion (90%) than only vibrating the muscle (50%). In addition, we found that stretching skin enhances the range (1.5 times) and speed (3.5 times) of the illusory movement triggered by muscle vibration. These findings may enable the development of mechanisms for controlling feedback parameters in closing the control loop for various walking routines, which may improve performance of lower limb prostheses.
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3070Caloric restriction increases lifespan in dilated cardiomyopathy mice by enhancing mitochondrial quality control. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Dilated cardiomyopathy (DCM) is a leading cause of heart failure (HF) in young and middle aged individuals worldwide. Alterations in mitochondrial dynamics (fusion/fission) and quality control (mitophagy) are critical for normal cardiac function. Imbalanced mitochondrial dynamics towards fission has been shown to contribute to DCM development in mice with ablation of the mitochondrial protease YME1L, which results in altered OPA1 processing precluding mitochondrial fusion. In these mice, the DCM phenotype includes a metabolic reprogramming of cardiomyocytes, shifting from fatty acid (FA) oxidation towards glucose. High fat diet (HFD) in these mice results in reversal of this metabolic reprogramming and rescue from DCM despite the genetic defect (lack of YME1) still present. These results opened a new venue for dietary approaches as a therapeutic strategy in HF. To understand whether the fat itself contained in the HFD was responsible of HF rescue, we studied the trajectories of cardiac function in mice with altered mitochondrial dynamics under HFD, caloric restriction and control chow.
Methods
Cardiomyocyte-specific Yme1l knock-out (cYKO) male mice (N=10–15) known to develop DCM phenotype at 20–25 weeks of age were randomized to 3 different diets (1: HFD containing >30% crude fat; 2: non-fat diet containing <0.5% crude fat, and 3: control diet containing 10% crude fat) at 10 weeks of age. Every 10 weeks, cardiac function was tested by echocardiography. At 30 weeks, animals underwent a multitracer microPET/CT (glucose and FA uptake) to evaluate myocardial substrate utilization. At the end of the study, animals were sacrificed and hearts were harvested for histological and further tissue analyses.
Results
As expected, HFD was associated with a better left ventricular ejection fraction (LVEF; %) at 30 weeks: 37.97±8.59 vs. 29.16±8.9 in control diet, p=0.04. This functional improvement was associated with an increase in FA uptake on microPET/CT. Non-fat diet was associated with even higher LVEF at 30 weeks: 44.94±11 vs. 29.16±8.9 in control diet, p=0.0001, as well as smaller LV diameter (mm): 3.58±0.29 vs. 4.3±0.39 in control diet, p<0.0001 (A). Lifespan of mice on non-fat diet was significantly prolonged (70% extension compared to control) (B). Enhanced mitochondrial clearance (mitophagy) mediated by Parkin, together with an increase in autophagy related protein as LC3B was identified in the non-fat diet group (C).
Conclusion
Different dietary approaches have been shown to be beneficial in the prevention of DCM in mice with altered mitochondrial dynamics. Caloric restriction (non-fat diet) is able to prevent DCM, reverse metabolic reprogramming, increase mitochondrial quality control and ultimately prolong lifespan in mice with genetic defect associated with altered mitochondrial dynamics. Interventions aiming at enhancing cardiac mitophagy might represent a new therapeutic option in DCM.
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MON-PO399: Nutritional Care Pathways of Patients with Malignant Bowel Obstruction: Preliminary Findings from 8 UK Centres. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32232-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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MON-PO400: Parenteral Nutrition in Patients with Malignant Bowel Obstruction: Preliminary Findings from 8 UK Centres: Are all Patients Referred Appropriately? Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Does the repetition over a short time of a microsurgical suture improve its reliability? HAND SURGERY & REHABILITATION 2019; 38:348-352. [PMID: 31473335 DOI: 10.1016/j.hansur.2019.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 11/25/2022]
Abstract
Our hypothesis was that immediate repetition of a microsurgery-suturing task will improve its execution and outcome. This was an experimental animal study. Ten surgeons were divided into two groups of five surgeons. Each performed two end-to-end carotid anastomoses on the same rat, one after the other. The anastomosis was evaluated by the surgeon and an instructor. The primary endpoint was permeability. The outcome was evaluated using an objective and subjective assessment grid yielding 1 to 3 points per item. The total scores for each of the 10 surgeons were used to compare the anastomosis of carotid 1 versus 2, using the ratings given by the surgeon and the instructor. Twenty anastomoses were performed, but 1 rat died intraoperatively, leaving 18 anastomoses for evaluation. No significant differences were found on the main endpoint of permeability, with all anastomoses being permeable. The surgeon's self-assessment was significantly better for the second carotid artery (P=0.05), but this was not confirmed by the proxy assessment (instructor). The analysis by subgroups-morning versus afternoon-found the second carotid anastomosis was significant better in the self-assessment and proxy assessment for the morning group (P<0.001, P=0.024). There was no significant difference in clamping times. The immediate repetition of a microsurgical procedure seems to favor its execution, which leads us to propose that the more difficult or important anastomosis should be done after an easier or less important one during complex surgeries. LEVEL OF EVIDENCE: 2B.
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OWE-17 Nutritional care pathways of patients with malignant bowel obstruction: preliminary findings from 8 UK Centres. Nutrition 2019. [DOI: 10.1136/gutjnl-2019-bsgabstracts.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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SP469STUDY OF BIOCOMPATIBILITY OF MEMBRANES IN HEMODIAFILTRACIÓN ON-LINE. Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz103.sp469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P2652Impact of transfemoral aortic valve implantation and surgical aortic valve replacement on right ventricular function up to six months of post-procedural phase. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rehabilitation team approach for the treatment in facial palsy in a multicentric clinical practice. Consensus guide. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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PO-170 Dissecting the role of IFITM1 in response to anticancer treatment. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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0551 A Combined Approach for Upper Airway Remodeling for Skeletal class III Malocclusion with Complex OSA. Sleep 2018. [DOI: 10.1093/sleep/zsy061.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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0553 Non-Surgical Osseous Remodeling and Myofunctional Therapy for Skeletal class III Malocclusion with Severe OSA. Sleep 2018. [DOI: 10.1093/sleep/zsy061.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brain Involvement in Myotonic Dystrophy Type 1: A Morphometric and Diffusion Tensor Imaging Study with Neuropsychological Correlation. Arch Clin Neuropsychol 2018; 32:401-412. [PMID: 28164212 DOI: 10.1093/arclin/acx008] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 01/13/2017] [Indexed: 11/12/2022] Open
Abstract
Objective Myotonic dystrophy type 1 (DM1), the most prevalent inherited neuromuscular disease in adults, is a genetic multisystem disorder with a well-established but not well-characterized cerebral involvement. The aim of this study was to evaluate the presence of white matter and gray matter abnormalities in DM1 patients and to investigate their relationship with neurocognitive dysfunction. Methods A total of 42 DM1 patients and 42 healthy controls were included in the study. Clinical, cognitive, and magnetic resonance imaging evaluations, including the use of structural and diffusion tensor imaging (DTI) techniques, were performed. White matter lesion (WML) load, volumetric analysis, and diffusivity changes were assessed and correlated with clinical and neuropsychological test findings. Results WMLs were significantly more frequent in DM1 patients (p < .001), and anterior temporal lobe lesions were only found in the patient group. Global and regional cortical volume loss and corpus callosum atrophy were found. Diffuse white matter DTI abnormalities, including fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity were observed with sparing of the internal capsule. Subcortical structures showed volume loss and increased median diffusivity. Neuropsychological evaluation showed significant impairment in several cognitive functions, but only visuospatial impairment was correlated with white matter abnormalities and cortical atrophy. Daytime sleepiness was associated with WML and ventral diencephalon and pallidum volume loss. Conclusion DM1 produces a widespread involvement of white matter and gray matter, including cortical and subcortical structures. These structural abnormalities are involved in the progressive neuropsychological functional impairment in these patients.
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PNM-09 Meaning of Sexuality and Orgasm in Professional Women. J Sex Med 2017. [DOI: 10.1016/j.jsxm.2017.10.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Results of an allergy educational needs questionnaire for primary care. Allergy 2017; 72:1123-1128. [PMID: 28122131 DOI: 10.1111/all.13134] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2017] [Indexed: 12/19/2022]
Abstract
It is well recognized that knowledge of allergic conditions is suboptimal in primary care. The Primary Care Interest Group of the European Academy of Allergy and Clinical Immunology undertook an educational needs survey to better understand what they were and how best to meet them, in the primary care environment. An electronic questionnaire was devised and distributed as widely as possible. A total of 2226 people from 63 countries opened the e-questionnaire of which 692 provided evaluable responses. In total, 81% were medical doctors with 299 possessing additional qualifications. Self-declared gaps in knowledge were expressed for most manifestations of allergy with a correspondingly high self-expressed educational need. The preferred learning modalities were online guidelines (69.6%) and courses (68.8%) followed closely by workshops (68%), structured online modules (63.9%) and small local working groups (59.75%). Podcasts and webinars scored poorly with only 25% expressing these as preferred learning modes although there was an age gradient. The preferred electronic platform was the personal computer (82.6%). A better understanding of the needs of primary care should help guide the design of educational initiatives to meet those needs.
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A new combined operative technique using crossed inguinal lymphatic rescue for pediatric patients with mixed lymphatic and venous malformations. Lymphology 2017; 50:141-147. [PMID: 30234251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Truncular venous malformations and acquired functional or anatomical venous occlusions (or sub-occlusions) can be the cause of secondary lymphedema and even the cause of primary lymphedema when they are associated with lymphatic malformations (lymphangiodysplasia - LAD I, lymphadenodysplasia - LAD II, or a combination of both) in pediatric patients. This understanding recognizes the shared and successive embryogenesis of both systems. These conditions can exhibit hypertension in the venous pedicles intended for lymph-venous anastomosis, and this finding would be a formal contraindication to the procedure. However, this hypertension is a rarely considered condition and is not commonly identified. As a technique to solve this problem, we have combined Nielubowicz, Olszewski, Campisi, and Palma's proposals and created a lymph-venous anastomosis from the side with lymphedema and venous hypertension (lymphatic donor and venous recipient) with an internal suprapubic saphenous venous bridge (from the normal side to the lymphedematous side with venous hypertension) to enable a crossed inguinal lymphatic/venous rescue. We believe this newly synthesized approach will allow better clinical care of pediatric patients with complex and combined lymphatic-venous malformations and is worthy of further investigation.
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Nodular Regenerative Hyperplasia in HIV-positive patients : a case series and review of the literature. Acta Gastroenterol Belg 2017; 80:15-19. [PMID: 29364092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Nodular regenerative hyperplasia (NRH) is a well-described condition that leads to non-cirrhotic portal hypertension and is histologically characterised by a nodular transformation of the liver without fibrosis. It seems to be a consequence of obliterative portal venopathy of small hepatic veins. Its precise aetiology remains to be clearly determined. NRH was reported to occur in HIV-positive patients ten years ago. In this article, three consecutive clinical cases of HIV-related NRH were identified in a high volume reference centre of HIV positive patients and are presented. Clinical, diagnostic aspects and strategies for management of this under-diagnosed medical condition in the HIV population are also developed.
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Moderated Posters: Imaging of the right heart - What is new?P814Prognostic value of parameters of pulmonary artery stiffness in patients with pulmonary hypertension receiving specific vasodilator therapyP815Reconsidering of inferior vena cava parameters for estimating right atrial pressure: a comparative simultaneous ultrasound-catheterization studyP816Pulmonary hypertension is the main factor echocardiography to predicting mortality in medium and long term in a cohort of patients with heart failureP817Normal values for 3D-right atrial volumes : results from the SKIPOGH-II population studyP818Assessment of right ventricular function by free wall longitudinal strain in organic mitral regurgitationP819Importance of radial dysfunction to determine the impairment of right ventricular ejection fraction in patients with pulmonary hypertensionP820Influence of tricuspid regurgitation severity on non-invasive assessment of right heart hemodynamics: a simultaneous echocardiography-catheterization studyP821Right ventricular failure following ventricular assist device implant: systematic review and meta-analysis of clinical and echocardiographic predictors. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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An approach to vmat on radiation therapy treatments of pelvic and paraaortic lymph nodes. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Patient doses in a biplane angiography system. Phys Med 2016. [DOI: 10.1016/j.ejmp.2016.07.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract PR015. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492425.34530.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Midterm evaluation of health-provider alert functionality in a program of
automated telephone monitoring and self-care support for diabetic patients
in Colombia. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Llamada Saludable: Evaluation of patient engagement with a mobile health
program for improving self-management of diabetes in Medellin,
Colombia. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Collaborations between academic institutions and a Colombian health
insurance provider to implement a mobile health platform for chronic disease
management: Opportunities and obstacles. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Validación de la biopsia selectiva del ganglio centinela en mujeres con cáncer de mama N1-2 con respuesta axilar completa tras la neoadyuvancia. Estudio multicéntrico en la provincia de Tarragona. Rev Esp Med Nucl Imagen Mol 2016; 35:221-5. [DOI: 10.1016/j.remn.2015.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 12/14/2015] [Accepted: 12/19/2015] [Indexed: 02/06/2023]
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Intérêt de la vérification du positionnement des patients par tomographie conique quadridimensionnelle (Symmetry-Elekta) avant irradiation stéréotaxique de tumeurs pulmonaires. Cancer Radiother 2015. [DOI: 10.1016/j.canrad.2015.07.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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