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Fracture risk prediction in postmenopausal women from GO Study: the comparison between FRAX, Garvan, and POL-RISK algorithms. Arch Osteoporos 2024; 19:39. [PMID: 38755326 PMCID: PMC11098877 DOI: 10.1007/s11657-024-01392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/21/2024] [Indexed: 05/18/2024]
Abstract
In the longitudinal, retrospective study, the ability of the FRAX, Garvan, and POL-RISK algorithms to predict osteoporotic fractures was compared in a group of 457 women. Using the rigid threshold of 10% showed a significant discrepancy in sensitivity and specificity of all tools. New thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds allow for improving the diagnostic accuracy of all three calculators. INTRODUCTION The aim of the longitudinal, retrospective study was to compare three tools designed to assess fracture risk: FRAX, Garvan, and POL-RISK in their prediction of fracture incidence. MATERIAL The study group consisted of 457 postmenopausal women with a mean age of 64.21 ± 5.94 years from the Gliwice Osteoporosis (GO) Study. Comprehensive data on clinical factors related to fractures were collected for all participants. Bone densitometry was performed at the proximal femur using the Prodigy device (GE, USA). Fracture risk was established using the FRAX, Garvan, and POL-RISK algorithms. Data on the incidence of osteoporotic fractures were collected over the last 10 years. RESULTS During the period of observation 72, osteoporotic fractures occurred in 63 subjects. For a preliminary comparison of the predictive value of analyzed diagnostic tools, the fracture risk threshold of 10% was used. For FRAX, the fracture probability exceeding 10% was observed only in 11 subjects who experienced fractures; thus, the fracture was properly predicted only in 22.9% of women. For Garvan, the respective value was 90.5%, and for POL-RISK, it was 98.4%. That gave a very low true positive value for FRAX and a very high false positive value for Garvan and POL-RISK. Based on ROC curves, new thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds improve the diagnostic accuracy of all compared fracture prediction tools. CONCLUSION The current study showed that different fracture risk assessment tools, although having similar clinical purposes, require different cut-off thresholds for making therapeutic decisions. Better identification of patients requiring therapy based on such an approach may help reduce the number of new fractures.
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Optimal fracture prediction thresholds for therapy onset, established from FRAX and Garvan algorithms: a longitudinal observation of the population representative female cohort from the RAC-OST-POL Study. Arch Osteoporos 2023; 18:136. [PMID: 37973685 PMCID: PMC10654207 DOI: 10.1007/s11657-023-01346-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 11/02/2023] [Indexed: 11/19/2023]
Abstract
The study shows that the use of unified cutoff thresholds to identify high fracture risks by two popular calculators-FRAX and Garvan-leads to a significant discrepancy between the prediction of fractures and their actual prevalence over the period of 10 years. On the basis of the ROC analyses, a proposal of differentiated thresholds is presented. They were established at 6% for FRAX major fracture risk, 1.4% for FRAX hip fracture risk, 14.4% for Garvan any fracture risk, and 8.8% for Garvan hip fracture risk. PURPOSE/INTRODUCTION The aim of the study was to verify how much were the tools, designed to predict fracture risks, precise vs. the actual fracture incidence values over a prospective observation. METHODS The study group consisted of a population-based postmenopausal sample from the RAC-OST-POL Study. At baseline, there were 978 subjects at the mean age of 66.4 ± 7.8 years and, after a 10-year follow-up, 640 women remained at the mean age of 75.0 ± 6.95 years. At baseline, the fracture risk was established by the FRAX and Garvan tools. RESULTS During the observation period, 190 osteoporotic fractures were identified in 129 subjects. When high-risk fracture cutoff thresholds (of 10% for major/any and 3% for hip fractures) were employed, only 19.59% of major fractures and 50% of hip fractures were identified in the high-risk group. For the Garvan tool, the percentage of correctly predicted fractures for any and hip fractures was 86.05% and 71.43%, respectively. Nevertheless, the fracture prediction by the Garvan tool was associated with the qualification of numerous subjects to the high-risk group, who subsequently did not experience a fracture in the 10-year follow-up period (false-positive prediction). Based on the ROC analyses, new high-risk thresholds were proposed individually for each calculator, improving the sensitivity, specificity, and diagnostic accuracy of these tools. They were established at 6% for FRAX major fracture risk, 1.4% for FRAX hip fracture risk, 14.4% for Garvan any fracture risk, and 8.8% for Garvan hip fracture risk. CONCLUSIONS The current prospective study enabled to establish new, optimal thresholds for therapy initiation. Such a modified approach may enable a more accurate identification of treatment requiring patients and, in consequence, reduce the number of new fractures.
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Antimicrobial treatment of ENT infections. Infect Dis Now 2023; 53:104785. [PMID: 37730165 DOI: 10.1016/j.idnow.2023.104785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/22/2023]
Abstract
Ear, nose and throat (ENT) or upper respiratory tract infections (URTI) are the most common infections in children and the leading causes of antibiotic prescriptions. In most cases, these infections are due to (or are triggered by) viruses and even when bacterial species are implicated, recovery is usually spontaneous. The first imperative is to refrain from prescribing antibiotics in a large number of URTIs: common cold, most cases of sore throat, laryngitis, congestive otitis, and otitis media with effusion. On the contrary, a decision to treat sore throats with antibiotics is based primarily on the positivity of the Group A Streptococcus (GAS) rapid antigen diagnostic tests. For ear infections, only (a) purulent acute otitis media in children under 2 years of age and (b) complicated or symptomatic forms of purulent acute otitis media (PAOM) in older children should be treated with antibiotics. Amoxicillin is the first-line treatment in the most cases of ambulatory ENT justifying antibiotics. Severe ENT infections (mastoiditis, epiglottitis, retro- and parapharyngeal abscesses, ethmoiditis) are therapeutic emergencies necessitating hospitalization and initial intravenous antibiotic therapy.
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Pediatric ambulatory pertussis epidemiology in France, recent updates. Infect Dis Now 2023; 53:104727. [PMID: 37268040 DOI: 10.1016/j.idnow.2023.104727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/11/2023] [Accepted: 05/24/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Following various changes in the vaccine strategy in 2013 and the mandatory vaccination in 2018, we aimed to analyze the vaccination status, age, and source of contamination of pertussis and parapertussis cases in outpatient surveillance. PATIENTS AND METHODS Confirmed pertussis and parapertussis cases were enrolled by 35 pediatricians. RESULTS From 2014 to 2022, 73 confirmed cases of pertussis (n = 65) and parapertussis (n = 8) were reported. For children below 6 years of age, the number of cases with a 2 + 1 schedule (n = 22) was higher than that of those with a 3 + 1 schedule (n = 7). The age of cases with a 3 + 1 or a 2 + 1 schedule was not significantly different (3.8y ± 1.4 vs 4.2y ± 1.5). The main source of contamination was either adults or adolescents. CONCLUSION Vaccination status and source of contamination are crucial to study the impact of vaccination recommendations.
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Therapeutic inertia during isotretinoin treatment of juvenile acne by dermatologists, paediatricians and general practitioners. Ann Dermatol Venereol 2023; 150:39-45. [PMID: 36642678 DOI: 10.1016/j.annder.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Isotretinoin is an effective treatment for severe juvenile acne, but it appears to be underused in relation to the recommendations. Therapeutic inertia is defined as a failure to initiate or intensify treatment even when warranted by the recommendations. The aim of this study was to investigate therapeutic inertia among dermatologists (D), paediatricians (P), and general practitioners (GPs) in initiating isotretinoin for moderate-to-very severe juvenile acne. METHODS Data were collected using a questionnaire distributed to French physicians through medical societies via Internet. The questions explored the role in inertia of factors related to physicians, patients, parents, and the healthcare system, and evaluated barriers and facilitators to prescribing isotretinoin. RESULTS In all, 768 physicians responded to the survey (528 D, 178P, and 61 GPs; mean age: 51 years; women: 78 %). Their responses revealed that 99 % of dermatologists felt comfortable prescribing isotretinoin, compared with 8 % and 15 % of paediatricians and GPs (p < 0.05); 93 % of dermatologists were aware of the current guidelines compared with 37 % of paediatricians and GPs. Under 50 % of the physicians had received training on acne in the previous 3 years, regardless of specialty. The most frequently identified factors for inertia were concerns over the psychological consequences of the treatment in adolescents, exclusive requests from parents, and patient unavailability. Paediatricians reported having insufficient knowledge of current recommendations, a lack of training, and a tendency to anticipate poor compliance. Paediatricians and GPs considered that access to first-time prescriptions and peer-to-peer exchanges would constitute facilitating factors in their use of isotretinoin. DISCUSSION Concerns over the psychiatric consequences of isotretinoin in adolescents, the need for frequent follow-up, and lack of continuing medical education were identified as factors favouring inertia in the initiation of isotretinoin treatment in patients with moderate-to-very severe juvenile acne, particularly among paediatricians and GPs. Potential strategies to overcome these barriers include regular training, simplified recommendations in French, and access to first-time prescription for paediatricians and GPs.
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463 Implications of the ds-RNA stress response in melanoma cell lines and patient samples. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.477] [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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Sleep Reactivity and Poor Sleep in Adolescents: A Longitudinal Investigation. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.377] [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: 11/17/2022]
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343 Endogenous double-stranded RNA is a potential target for psoriasis therapy. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.356] [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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Qualitative Evaluation of Cooking and Gardening Sessions with Elementary School Children. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.08.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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305 Managing Low and Intermediate Risk Transient Ischemic Attacks in the Time of a Pandemic. Ann Emerg Med 2022. [DOI: 10.1016/j.annemergmed.2022.08.333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Sustainable production of a natural colorant by exploiting the fermentation of the basidiomycota
Laetiporus sulphureus. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255351] [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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Mycelium‐based construction materials for the post‐oil era. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255061] [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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l-citrulline ameliorates pathophysiology in a rat model of superimposed preeclampsia. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.923] [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: 11/02/2022]
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The association of depression and all-cause mortality: Explanatory factors and the influence of gender. J Affect Disord 2022; 303:315-322. [PMID: 35176339 DOI: 10.1016/j.jad.2022.02.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association of depression with mortality and the significance of explanatory factors, in particularly gender, have remained an issue of debate. We therefore aimed to estimate the effect of depression on all-cause mortality, to examine potential explanatory factors and to assess effect modification by gender. METHODS We used Cox regression models to estimate the effect of depression on mortality based on data from the Gutenberg Health Study, which is a prospective cohort study of the adult population in the districts of Mainz and Mainz-Bingen, Germany. Baseline assessment was between 2007 and 2012. Effect modification by gender was measured on both additive and multiplicative scales. RESULTS Out of 14,653 participants, 7.7% were depressed according to Patient Health Questionnaire 9 (PHQ-9), and 1,059 (7.2%) died during a median follow-up of 10.7 years. Depression elevated the risk of mortality in men and women in age-adjusted models (HR: 1.41, 95%-CI: 1.03-1.92; resp. HR: 1.96, 95%-CI: 1.43-2.69). Adjustment for social status, physical health and lifestyle covariates attenuated the effect and in the fully-adjusted model the hazard ratio was 0.96 (95%-CI: 0.69-1.33) in men and 1.53 (95%-CI: 1.10-2.12) in women. For effect modification by gender, the measure on multiplicative interaction was 0.68 (95%-CI 0.44-1.07) and on additive interaction was RERI=-0.47 (95%-CI -1.24-0.30). LIMITATIONS The PHQ-9 is a single self-report measure of depression reflecting symptoms of the past two weeks, limiting a more detailed assessment of depression and course of symptoms, which likely affects the association with mortality. CONCLUSIONS Depression elevates mortality by multifactorial pathways, which should be taken into account in the biopsychosocially informed treatment of depression. Effect modification by gender was not statistically significant.
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Abstract
Abstract
Background
Left ventricular (LV) strain rate (SR) during isovolumic relaxation (SRIVR) and early diastolic filling (SRe) has previously been shown to correlate with the invasive gold standard for LV diastolic function (i.e. the time constant of LV pressure decay tau). However, the translation of these biomarkers to the clinic has been hampered by technical limitations. Indeed, conventional speckle tracking (STE) is limited by its temporal resolution, whereas tissue Doppler imaging (TDI) is angle-dependent, labor-intensive and thus rarely used clinically nowadays.
Purpose
The aim of this study was to show that these limitations could be overcome by using a recently proposed STE algorithm operating on high frame rate (HFR) imaging data.
Methods
37 subjects (age: 64±12, 81% male) were included in the study; 16 had cardiac amyloidosis, 12 were undergoing clinically indicated left and/or right heart cardiac catheterization and 9 were healthy volunteers. Since the sequence of left ventricular activation and thus the repolarization process (i.e. relaxation) starts at mid septum, we measured SRIVR and SRe in the mid septal segment in an apical 4 chamber view using a commercially available clinical system with: (1) TDI (frame rate (FR) ∼142 Hz); (2) STE (FR ∼65 Hz). Moreover, subjects were scanned with HD-PULSE, an experimental high frame ultrasound scanner (FR ∼915 Hz) and then a manually placed contour was tracked during the cardiac cycle by a custom-made 2D HFR STE algorithm, to compute and extract SRIVR and SRe from the mid septum. Since TDI is considered the reference method to assess SR, conventional as well as HFR STE values were correlated against the TDI SR values.
Results
In 3 subjects, SRIVR could not be reliably assessed with the clinical STE approach, which we attributed to the relatively low temporal resolution of the images; all other measurements could be made in all subjects. For both biomarkers, HFR STE values correlated better with the TDI reference measurements than the clinical STE estimates (Fig.1). The latter estimates showed a systematic underestimation (bias −0.19 1/s (p<0.01) and −0.46 1/s (p<0.01) for SRIVR and SRe respectively) while no significant bias was observed for the HFR STE values. Similarly, the limits of agreement of the HFR STE values were narrower (−0.45 to +0.54 1/s and −0.94 to +0.86 1/s) than those of the clinical STE measurements (−0.85 to +0.48 1/s and −1.32 to +0.41 1/s).
Conclusions
These results show that HFR STE offers a reliable way to assess novel biomarkers of diastolic function in a user-friendly manner and can therefore facilitate their incorporation to the clinical practice.
Funding Acknowledgement
Type of funding sources: None.
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The influence of hemodialysis-induced preload changes on the propagation speed of natural shear waves. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.145] [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: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Research Foundation - Flanders (FWO)
Background
Shear wave elastography (SWE) is a novel ultrasound technique based on the detection of transverse waves travelling through the myocardium using high frame rate echocardiography. The propagation speed of these shear waves is dependent on the stiffness of the myocardium. Previous studies have shown the potential of SWE for the non-invasive assessment of myocardial stiffness. It is unclear, however, if preload changes lead to measurable changes in the shear wave propagation speed in the left ventricle. In patients undergoing hemodialysis, the volume status is acutely changed. In this way, the effect of preload changes on shear wave speed can be assessed.
Purpose
The aim of this study was to explore the influence of preload changes on end-diastolic shear wave propagation speed.
Methods
Until now, 6 patients (age: 80[53-85] years; female: n = 2) receiving hemodialysis treatment were included. Echocardiographic images were taken before and every hour during a 4 hour hemodialysis session. Left ventricular parasternal long-axis views were acquired with an experimental high frame rate ultrasound scanner (average frame rate: 1016[941-1310] Hz). Standard echocardiography was performed with a conventional ultrasound machine. Shear waves were visualized on tissue acceleration maps by drawing an M-mode line along the interventricular septum. Shear wave propagation speed after mitral valve closure (MVC) was calculated by measuring the slope of the wave pattern on the acceleration maps (Figure A).
Results
Over the course of hemodialysis, the systolic (141[135-156] mmHg vs. 165[105-176] mmHg; p = 0.35 among groups) and diastolic blood pressure (70[66-75] mmHg vs. 82[63-84] mmHg; p = 0.21 among groups), heart rate (56[54-73] bmp vs. 57[50-67] bpm; p = 0.76 among groups), E/A ratio (1.6[0.7-1.8] vs. 1.2[0.6-1.4]; p = 0.43 among groups) and E/e’ (14[9-15] vs. 9[8-13]; p = 0.24 among groups ) remained the same. The ultra-filtrated volumes are shown in Figure B. The shear wave propagation speed after MVC gradually decreased during hemodialysis (6.7[5.4-9.7] m/s vs. 4.4[3.6-9.0] m/s; p = 0.04 among groups) (Figure C). There was a moderate negative correlation between shear wave speed and the ultra-filtrated volume (r=-0.63; p < 0.01) (Figure D).
Conclusion
The shear wave propagation speed at MVC significantly decreased over the course of hemodialysis and correlated to the ultra-filtrated volume. These results indicate that alterations in left ventricular preload affect the speed of shear waves at end-diastole. End-diastolic shear wave speed might therefore be a potential novel parameter for the evaluation of the left ventricular filling state. More patients will be included in the future to further explore these findings.
Abstract Figure.
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Cost-effectiveness of Lutetium [ 177Lu] oxodotreotide versus best supportive care with octreotide in patients with midgut neuroendocrine tumors in France. J Med Econ 2020; 23:1534-1541. [PMID: 32990484 DOI: 10.1080/13696998.2020.1830286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIMS In France, there are approximately 2,400 new cases of neuroendocrine tumors (NETs) annually. Peptide receptor radionuclide therapy with 177Lu-Dotatate plus long-acting repeatable [LAR] octreotide 30 mg has been shown to significantly improve progression-free survival and overall survival relative to high-dose octreotide LAR 60 mg in patients with unresectable or metastatic progressive midgut NETs. A long-term cost-effectiveness analysis was performed to assess whether 177Lu-Dotatate is a cost-effective option versus octreotide 60 mg for patients with unresectable/metastatic progressive midgut NETs from the perspective of French healthcare payer. METHODS The analysis was performed using a three-state partitioned survival model. In the base case analysis 177Lu-Dotatate plus octreotide LAR 30 mg was compared with high-dose octreotide LAR 60 mg in patients with midgut NETs. Survival data were obtained from the phase III NETTER-1 trial in patients with metastatic midgut NETs. Future costs and clinical outcomes were discounted at 4% per annum. One-way deterministic and probabilistic sensitivity analyses were performed. RESULTS In the base case analysis, for patients with midgut NETs, 177Lu-Dotatate treatment improved quality-adjusted life expectancy by 1.21 quality-adjusted life years (QALYs) relative to octreotide LAR 60 mg and the lifetime treatment costs were EUR 50,784 higher with 177Lu-Dotatate resulting in an incremental cost-effectiveness ratio (ICER) of EUR 42,106 per QALY gained versus octreotide LAR 60 mg. When compared with everolimus, 177Lu-Dotatate was associated with an ICER of EUR 59,769 per QALY gained. Sensitivity analyses showed that the results were sensitive to methods used to extrapolate survival data. CONCLUSIONS For patients with advanced progressive midgut NETs 177Lu-Dotatate is likely to be considered a cost-effective option versus octreotide 60 mg from the perspective of the French healthcare payer.
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PO-0973: Axillary lymph node dissection after neoadjuvant chemotherapy for node-positive breast cancer. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00991-9] [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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The sense of smell is not strongly affected by ambient temperature and humidity: a prospective study in a controlled environment. Eur Arch Otorhinolaryngol 2020; 278:1465-1469. [PMID: 33094385 DOI: 10.1007/s00405-020-06436-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The sense of smell is dependent on environmental conditions. In this study, we analysed the effect of temperature and humidity on the ability to smell. METHODS Using the controlled setting of a hypobaric climate chamber 50 healthy participants (40 men, 10 women; mean age of 33 years) completed repeated testing in 4 different settings-cold/dry, cold/humid, warm/dry, warm/humid. The temperatures were 20-35 °C, respectively, and the humidity was set at 30-75%. Testing was performed using the "Sniffin' Sticks" test battery (odour threshold, discrimination and identification) in a semi-randomised order and in controlled atmospheric pressure conditions. RESULTS The analysis showed that neither temperature nor humidity had a significant effect on olfactory test results. This indicates that olfactory functions in healthy, young subjects with an excellent sense of smell are not strongly affected by temporary changes in environmental conditions.
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Post-feeding behavior in crayfish (Procambarus clarkii): Description of an invertebrate behavioral satiety sequence. Physiol Behav 2019; 213:112720. [PMID: 31639378 DOI: 10.1016/j.physbeh.2019.112720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/01/2019] [Accepted: 10/18/2019] [Indexed: 11/19/2022]
Abstract
Previous studies have demonstrated that food consumption induces the behavioral satiety sequence (BSS) in some animals, a characteristic series of activities which include exploration, grooming, and resting. The BSS, while valuable in assessing the effects of drugs on food intake, has not been widely studied in non-mammalian species. Our experiment examined post-feeding behavior in crayfish using continuous recording of five behaviors: feeding, walking, grooming, leg wave, and quiescence. We found that food intake, but not sham feeding, significantly decreased feeding behavior, increased leg wave, and increased quiescence. Walking and grooming were not significantly altered by food intake. These findings indicate that post-feeding behaviors in crayfish share some characteristics with the mammalian BSS. Detailed descriptions of post-ingestive behavior in invertebrates may contribute to the development of drugs targeting feeding behaviors in medically and economically important species.
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[Radium-223 for the treatment of metastatic castration-resistant prostate cancer (mCRPC) : The androgen receptor-independent active agent in the therapeutic sequence]. Urologe A 2019; 59:53-64. [PMID: 31598745 DOI: 10.1007/s00120-019-01052-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Radium-223 improves overall survival and preserves quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC) and symptomatic bone metastases and no known visceral metastases. Radium-223 can be used in combination with a luteinizing hormone releasing hormone (LHRH) analogue and as part of a sequential treatment scheme if disease progresses after at least two prior lines of systemic mCRPC therapies or if no other available systemic treatment is eligible. OBJECTIVES Today physicians are faced with a previously unknown multitude and complexity of options for the treatment of mCRPC. An increasing number of clinical trials contribute to the dynamics of the therapeutic landscape. Radium-223 was approved for mCRPC treatment in 2013. Up to now the recommendations of use have been adjusted several times. Highlighting recent clinical trials and practice, this paper explores the position of radium-223 within the therapeutic sequence and outlines key elements for the interdisciplinary cooperation between uro-oncologists and nuclear medicine specialists. RESULTS The mode of action of radium-223 does not depend on the androgen receptor (AR) pathway. Thus, it is an option in the therapeutic sequence when the efficacy of other agents is reduced by resistance. Furthermore, the efficacy of prior or subsequent medications are neither reduced nor enhanced by radium-223. The opportunity of an AR-independent and survival-prolonging medication should be taken as soon as the indication criteria are met because the incidence of visceral metastases increases during disease progression. According to current mCRPC guidelines, the osteoprotective use of bisphosphonates or denosumab is recommended, before treatment with radium-223 is started or resumed.
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Pain evaluation in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) treated with radium-223 (Ra-223) in the PARABO observation study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz248.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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The new W7-X logbook – A software for effective experiment documentation and collaborative research at Wendelstein 7-X. FUSION ENGINEERING AND DESIGN 2019. [DOI: 10.1016/j.fusengdes.2019.02.052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
It was hypothesized that faster cardiorespiratory kinetics during exercise are associated with higher orthostatic tolerance. Cardiorespiratory kinetics of 14 healthy male subjects (30 ± 4 years, 179 ± 8 cm, 79 ± 8 kg) were tested on a cycle ergometer during exercise with changing work rates of 30 and 80 W. Pulmonary oxygen uptake ( ) was measured breath-by-breath and heart rate (HR), mean arterial blood pressure (MAP), and total peripheral resistance (TPR) were measured beat-to-beat. Muscular oxygen uptake ( ) was estimated from HR and . Kinetic parameters were determined by time-series analysis, using cross-correlation functions (CCFmax(x)) between the parameter and the work rate. Cardiovascular regulations of MAP, HR, and TPR during orthostatic stress were measured beat-to-beat on a tilt seat. Changes between the minima and maxima during the 6° head-down tilt and the 90° head-up tilt positions were calculated for each parameter (Δtilt-up). correlated significantly with ΔTPRtilt-up (r = 0.790, p ≤ 0.001). CCFmax(HR) was significantly correlated with ΔHRtilt-up (r = -0.705, p = 0.002) and the amplitude in HR from 30 to 80 W (rSP = -0.574, p = 0.016). The observed correlations between cardiorespiratory regulation in response to exercise and orthostatic stress during rest might allow for a more differential analysis of the underlying mechanisms of orthostatic intolerance in, for example, patient groups.
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Timeliness of routine immunization in non-preterm children less than 2 years old using electronic data capture in an ambulatory setting in France in the context of vaccine hesitancy. Arch Pediatr 2019; 26:56-64. [DOI: 10.1016/j.arcped.2018.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/19/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
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Symptomatic skeletal event (SSE) dynamics in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) treated with radium-223 (Ra-223): An interim review of a prospective, non-interventional study (PARABO). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy284.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Comparison of wear between occlusal splint materials and resin composite materials. J Oral Rehabil 2018; 45:539-544. [DOI: 10.1111/joor.12636] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2018] [Indexed: 01/13/2023]
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One last Who am I! Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:153-154. [PMID: 29653721 DOI: 10.1016/j.anorl.2018.04.001] [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]
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Risk Factors for Fractures Identified in the Algorithm Developed in 5-Year Follow-Up of Postmenopausal Women From RAC-OST-POL Study. J Clin Densitom 2018; 21:213-219. [PMID: 28826886 DOI: 10.1016/j.jocd.2017.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/07/2017] [Accepted: 07/21/2017] [Indexed: 11/21/2022]
Abstract
The aim of the study was to establish factors with an impact on fracture risk and to develop an algorithm to predict osteoporotic fracture. A total of 978 postmenopausal women from the epidemiological, population-based RAC-OST-POL study with a mean age of 65.7 ± 7.3 years were enrolled. At baseline, bone mineral density at hip and clinical risk factors for fracture were collected. Afterward, each person was asked annually on fracture incidence in the 5-year follow-up. Finally, data for complete 5-year observation were gathered for the group of 802 patients. During the follow-up, 92 osteoporotic fractures occurred in 78 women. The most common fracture site was the forearm (n = 45). The following baseline factors were found as significant for fracture incidence: femoral neck bone mineral density, prior fractures, steroid use, falls within previous 12 months, and height. Fracture risk was predicted by the following formula: Riskoffractureincidence=11+e-(-9.899+1.077∗STEROIDS+0.681∗PRIORFALLS+0.611∗PRIORFRACTURES-0.483∗FNTscore+0.042∗HEIGHT). In our current longitudinal study, an algorithm predicting fracture occurrence over a period of 5 years was developed. It may find application in daily medical practice.
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Archive WEB API: A web service for the experiment data archive of Wendelstein 7-X. FUSION ENGINEERING AND DESIGN 2017. [DOI: 10.1016/j.fusengdes.2017.02.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Significance of MHD Effects in Stellarator Confinement. FUSION SCIENCE AND TECHNOLOGY 2017. [DOI: 10.13182/fst06-a1231] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Numerical Studies on Radiative Heat Loads to Plasma-Facing Components for the W7-X Stellarator. FUSION SCIENCE AND TECHNOLOGY 2017. [DOI: 10.13182/fst08-a1733] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Divertors for Helical Devices: Concepts, Plans, Results, and Problems. FUSION SCIENCE AND TECHNOLOGY 2017. [DOI: 10.13182/fst04-a551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Optimization of the vaporization of flavour components during wort boiling in the brewery by implementing a rectification column. JOURNAL OF THE INSTITUTE OF BREWING 2017. [DOI: 10.1002/jib.419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Benefits, pitfalls and risks of phytotherapy in clinical practice in otorhinolaryngology. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:95-99. [DOI: 10.1016/j.anorl.2016.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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39
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The study of under- and over-sampling methods’ utility in analysis of highly imbalanced data on osteoporosis. Inf Sci (N Y) 2017. [DOI: 10.1016/j.ins.2016.09.038] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Synthesis of surfactant-free micro- and nanolatexes from Pickering emulsions stabilized by acetylated cellulose nanocrystals. Polym Chem 2017. [DOI: 10.1039/c7py01203a] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Surfactant-free micro- and nanolatexes from Pickering emulsions stabilized by acetylated cellulose nanocrystals (CNCs).
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Overview of diagnostic performance and results for the first operation phase in Wendelstein 7-X (invited). THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:11D304. [PMID: 27910389 DOI: 10.1063/1.4964376] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Wendelstein 7-X, a superconducting optimized stellarator built in Greifswald/Germany, started its first plasmas with the last closed flux surface (LCFS) defined by 5 uncooled graphite limiters in December 2015. At the end of the 10 weeks long experimental campaign (OP1.1) more than 20 independent diagnostic systems were in operation, allowing detailed studies of many interesting plasma phenomena. For example, fast neutral gas manometers supported by video cameras (including one fast-frame camera with frame rates of tens of kHz) as well as visible cameras with different interference filters, with field of views covering all ten half-modules of the stellarator, discovered a MARFE-like radiation zone on the inboard side of machine module 4. This structure is presumably triggered by an inadvertent plasma-wall interaction in module 4 resulting in a high impurity influx that terminates some discharges by radiation cooling. The main plasma parameters achieved in OP1.1 exceeded predicted values in discharges of a length reaching 6 s. Although OP1.1 is characterized by short pulses, many of the diagnostics are already designed for quasi-steady state operation of 30 min discharges heated at 10 MW of ECRH. An overview of diagnostic performance for OP1.1 is given, including some highlights from the physics campaigns.
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pH-abhängige Abtrennung von Indium und Germanium aus Laugungslösungen mit NF-Membranen. CHEM-ING-TECH 2016. [DOI: 10.1002/cite.201650193] [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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040 Updosing of non sedating antihistamines can improve the treatment of patients with cholinergic urticaria. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.057] [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]
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“Ubermedicine”: The return of home ENT visits? Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:227. [DOI: 10.1016/j.anorl.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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[Treatment pathways in the care of patients with schizophrenia and depression]. DER NERVENARZT 2016; 86:1358-70. [PMID: 26384106 DOI: 10.1007/s00115-015-4417-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND In mental healthcare the concept of pathways addresses diverse issues and problem areas, such as heterogeneous health service offers, the regional variability of treatment concepts and clear-cut guidelines on how and where to obtain treatment for a particular mental disorder. The ambiguous aspects of the concept require international and national definitions and consensus which must also cover quality criteria. METHODS This article gives an overview of currently available evidence for the analysis of clinical pathways and pathways to care in international mental healthcare, covering studies on schizophrenia and depression from 2010 to 2014. RESULTS AND DISCUSSION The ambiguity of the concept impedes the overview and does not provide unequivocal results. The development, implementation and analyses of guidelines or clear-cut clinical and pathways to care must consider individual, clinical and care system aspects as well as the interplay of these factors. Results suggest that system aspects tend to dominate over clinical factors of schizophrenia and depression. As a consequence, the definition, implementation and evaluation of clinical pathways or pathways to mental healthcare is first and foremost a responsibility of the respective national mental healthcare system and must be understood on that level, before findings are summarized internationally and models of best practice are debated.
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Development of Fourier transform mid-infrared calibrations to predict acetone, β-hydroxybutyrate, and citrate contents in bovine milk through a European dairy network. J Dairy Sci 2016; 99:4816-4825. [DOI: 10.3168/jds.2015-10477] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 02/12/2016] [Indexed: 11/19/2022]
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Das CADASIL-Syndrom als Differentialdiagnose eines postpartalen HELLP-Syndroms. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583563] [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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Abstract
Chondrocytes are the uniquely resident cells found in all types of cartilage and key to their function is the ability to respond to mechanical loads with changes of metabolic activity. This mechanotransduction property is, in part, mediated through the activity of a range of expressed transmembrane channels; ion channels, gap junction proteins, and porins. Appropriate expression of ion channels has been shown essential for production of extracellular matrix and differential expression of transmembrane channels is correlated to musculoskeletal diseases such as osteoarthritis and Albers-Schönberg. In this study we analyzed the consistency of gene expression between channelomes of chondrocytes from human articular and costal (teenage and fetal origin) cartilages. Notably, we found 14 ion channel genes commonly expressed between articular and both types of costal cartilage chondrocytes. There were several other ion channel genes expressed only in articular (6 genes) or costal chondrocytes (5 genes). Significant differences in expression of BEST1 and KCNJ2 (Kir2.1) were observed between fetal and teenage costal cartilage. Interestingly, the large Ca2+ activated potassium channel (BKα, or KCNMA1) was very highly expressed in all chondrocytes examined. Expression of the gap junction genes for Panx1, GJA1 (Cx43) and GJC1 (Cx45) was also observed in chondrocytes from all cartilage samples. Together, this data highlights similarities between chondrocyte membrane channel gene expressions in cells derived from different anatomical sites, and may imply that common electrophysiological signaling pathways underlie cellular control. The high expression of a range of mechanically and metabolically sensitive membrane channels suggest that chondrocyte mechanotransduction may be more complex than previously thought.
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