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Validation of the Asthma Impairment and Risk Questionnaire in Spain: A Useful Tool for Assessing Asthma Control in Adolescents and Adults. J Investig Allergol Clin Immunol 2023; 33:397-400. [PMID: 36520522 DOI: 10.18176/jiaci.0881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
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Platelet Function and Sildenafil Use During Left Ventricular Assist Device Support. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Mitigating Drug-Target-Drug Complexes in Patients With Paroxysmal Nocturnal Hemoglobinuria Who Switch C5 Inhibitors. Clin Pharmacol Ther 2023; 113:904-915. [PMID: 36660902 DOI: 10.1002/cpt.2851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/06/2023] [Indexed: 01/21/2023]
Abstract
Drug-target-drug complexes (DTDCs) are phenomena newly observed in patients who switch from the complement component 5 (C5) inhibitor eculizumab to crovalimab, a novel, anti-C5 antibody in development for paroxysmal nocturnal hemoglobinuria (PNH), because these agents bind to different C5 epitopes. In Part 3 of the four-part, phase I/II COMPOSER study, 19 patients with PNH switching from eculizumab received 1,000-mg crovalimab intravenously, then subcutaneous maintenance doses from Day 8 (680 mg every 4 weeks (q4w), 340 mg every 2 weeks, or 170 mg every week). Crovalimab exposure was transiently reduced, and size-exclusion chromatography and crovalimab-specific enzyme-linked immunosorbent assays revealed DTDCs in all 19 patients' sera. Additionally, self-limiting mild to moderate symptoms suggestive of type III hypersensitivity reactions occurred in two patients. Mathematical modeling simulations of DTDC kinetics and effects of dosing on DTDC size distribution using Part 3 data predicted that increased crovalimab concentrations could reduce the proportion of large, slow-clearing DTDCs in the blood. A simulation-guided, optimized crovalimab regimen (1,000 mg intravenously; four weekly, subcutaneous 340-mg doses; then 680 mg q4w from Day 29) was evaluated in Part 4. Confirming the model's predictions, mean proportions of large DTDCs in patients who switched from eculizumab to this optimized regimen decreased by > 50% by Day 22, and target crovalimab concentrations were maintained. No type III hypersensitivity reactions occurred in Part 4. Optimizing crovalimab dosing thus reduced the proportion of large DTDCs, ensured adequate complement inhibition, and may improve safety. Model-based dosing optimization to mitigate DTDC formation offers a useful strategy for patients switching to novel antibody treatments targeting soluble epitopes.
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On the melting behaviour of linear polyethylene single crystals in mixtures with homogeneous short chain branched polyolefins. POLYMER 2022. [DOI: 10.1016/j.polymer.2022.125256] [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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470 Investigating modifiers of cutaneous neurofibroma development in adults with neurofibromatosis type 1. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mental Health and economic effects: correlation between unemployment and psychoactive drugs. Eur Psychiatry 2022. [PMCID: PMC9567081 DOI: 10.1192/j.eurpsy.2022.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction
Mental Health is an invisible part of public health, and a determinant of it by affecting the human, social and economic capital of countries. Is one of the main causes of disability worldwide and, when left untreated, they can lead to increased costs and premature mortality. In 2019 they represented 22% of the disability burden in DALY in the European Union. Regarding the effects of economic recessions studies suggest that they have detrimental effects on mental health. And can became a reality in the current pandemic scenario. Objectives
To reflect on the studies carried out that debate the effects of previous economic crises on mental health, particularly the 2008-2013 crisis. It aims to list not only the possible intervention strategies in the area as well as the barriers to their implementation. Methods
Classic review of the topic through the international literature and the state of the art on available platforms. Establish a proxy between the unemployment rate and the number of packages (antidepressants and anxiolytics consumed) in homologous periods as a representative capacity of the impact of the crisis on mental health. Results The number of packages of antidepressants and anxiolytics behave differently. the antidepressants have greater consumption when unemployment decreases. Conclusions Several studies describe that the increase in the unemployment rate, indebtedness and social exclusion are empirically proven as consequences of the economic crises and predisposing factors for mental pathology. However, this does not translate into a proxy for the consumption of antidepressant packages with the increase in the unemployment rate. It may be due to the non-prioritization of mental health. Disclosure No significant relationships.
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Effect of Sperm Selection by Magnetic-Activated Cell Sorting in D-IUI: A Randomized Control Trial. Cells 2022; 11:cells11111794. [PMID: 35681488 PMCID: PMC9180176 DOI: 10.3390/cells11111794] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/20/2022] [Accepted: 05/27/2022] [Indexed: 02/05/2023] Open
Abstract
Clinical outcome in assisted reproduction techniques (ARTs) is mainly influenced by the quality of gametes used. It is known that a high percentage of sperm DNA fragmentation (DNAf) decreases the success of ART clinical results. Therefore, techniques such as magnetic-activated cell sorting (MACS) help to improve results in cases of patients with a high percentage of DNAf. Cryopreservation of sperm in donor intrauterine insemination (D-IUI) treatments increases sperm DNAf, so patients using these sperm samples can benefit from using this technique. This prospective randomized national multicenter study analyzed clinical outcomes of 181 D-IUI treatments. MACS was performed after density gradient centrifugation (DGC) in 90 thawed semen donor samples (MACSG), whereas only DGC was performed in 91 thawed semen donor samples (CG). To our knowledge, this is the first study analyzing the effect of MACS on D-IUI cycles. Our results show no significant differences in gestation, live birth, or miscarriage rates between the two groups. We believe that further studies with a larger sample size are needed to evaluate the application of MACS in combination with standard IUI donor sperm preparations in fertility clinics.
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Crovalimab for treatment of patients with paroxysmal nocturnal haemoglobinuria and complement C5 polymorphism: Subanalysis of the phase 1/2 COMPOSER study. Br J Haematol 2022; 198:e46-e50. [PMID: 35608260 DOI: 10.1111/bjh.18274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022]
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Aktualisierte Ergebnisse von Tucatinib versus Placebo in Kombination
mit Trastuzumab und Capecitabin bei Patienten mit vorbehandeltem, metastasierten
HER2-positiven Brustkrebs mit ZNS-Metastasen (HER2CLIMB). Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1746156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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FLASH Modalities Track (Oral Presentations) 3D HIGH SPEED RF BEAM SCANNER FOR HADRON THERAPY OF CANCER. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01532-0] [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: 10/19/2022] Open
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Understanding caregiver acceptance of screening for family substance use in pediatric clinics serving economically disadvantaged children. Subst Abus 2022; 43:282-288. [PMID: 34214411 PMCID: PMC9901192 DOI: 10.1080/08897077.2021.1941510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Children of parents with substance use disorders are at greater risk for mental and physical health co-morbidities. Despite guidelines, pediatricians rarely screen for substance use in the family/household, citing fear of offending parents. The objectives of this study were to examine (1) caregiver acceptance of pediatricians screening for family/household substance use during well-child visits, (2) prevalence of family/household substance use, and (3) the association between family/household substance use and trust in their child's pediatrician. Methods: This cross-sectional study surveyed adult caregivers presenting a child for medical care at two urban pediatric outpatient clinics using a brief anonymous computer-based survey. The primary outcome measured the acceptability of pediatrician screening for family/household substance use. Substance use and concerns about use in the family/household were also assessed. Results: Adult caregivers (n = 271) surveyed were mean age 35 years, 73% mothers, 90% African American, and 85% on Medicaid. Over half (51%) of caregivers reported substance use by someone in the family/household, most commonly cigarettes (38%), followed by alcohol (19%) and marijuana (10%). Sixty-one percent of caregivers who reported family substance use expressed concern about the use of this substance. The majority (87%) agreed it is appropriate for pediatricians to ask caregivers about family/household substance use. No differences were found between caregivers who did and did not report substance use in their family/household. Caregivers with concerning substance use in their family/household were less likely to trust their pediatrician [OR = 0.21, 95%CI: 0.05, 0.85] Conclusions: Caregivers endorsed acceptance of universal screening for substance use, including illicit substances, and substance use disorders in the family/household during well-child visits. Pediatricians are trusted professionals with expertise in communicating with parents to maximize the health of their patients; assessing family history of substance use and substance use disorders is a natural extension of their role.
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The effect of frequency modulation on the FSR of a Fabry-Perot cavity using an Optical Spectrum Analyser. EPJ WEB OF CONFERENCES 2022. [DOI: 10.1051/epjconf/202226613027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
It is presented a study of the dependence between the free spectral range (FSR) and the cavity length in Fabry-Perot interferometers. Furthermore, the effect of frequency modulation on the FSR is studied when an optical spectrum analyser (OSA) is used as an interrogator. For low frequency range it is possible to observe this behaviour in the OSA and using an appropriate processing signal it is possible to use the white light interferometry technique.
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Effects of blood flow restriction and neuromuscular electrical stimulation on muscle hypertrophy in adults: a meta-analysis. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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14
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The relationship between cardiorespiratory fitness and chronic pelvic pain in women with endometriosis: a preliminary cross-sectional analysis. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cannabis and Alcohol Co-Use and Condomless Anal Sex Among Men Who have Sex with Men Living with HIV: An Event-Level Analysis. AIDS Behav 2021; 25:3770-3781. [PMID: 33733310 DOI: 10.1007/s10461-021-03228-6] [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] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
Men who have sex with men (MSM) account for more than two thirds of new HIV diagnoses annually. Sexual behavior that increases risk for onward transmission of HIV is associated with both alcohol and cannabis use. However, little is known about the influence of cannabis and alcohol co-use on engagement in condomless anal sex (CAS). The current study explored daily associations between substance use and CAS among HIV-positive MSM using a 42-day timeline followback interview (N = 101). Generalized estimating equation (GEE) logistic regression models were used to examine the association between cannabis and alcohol co-use and CAS at the sexual event while controlling for study site, condition, adherence to antiretroviral therapy, sex-related alcohol expectancies, and partner type. Participants provided data for 1052 sexual activity days, 60.7% of which involved CAS. Of 638 CAS days, 9.1% involved no substances, 72.0% involved either cannabis or alcohol use, and 18.9% involved cannabis and alcohol co-use. Results indicated that the odds of engaging in CAS were higher for sexual events in which cannabis and alcohol co-use occurred (aOR 2.98; 95% CI 1.27, 6.97) compared to events in which no substance use occurred (p = 0.012), but this relationship was no longer significant when cannabis and alcohol co-use was compared to single substance use (aOR 1.57; 95% CI 0.85, 2.90; p = 0.15). Future research should identify specific substance use (e.g., quantity) and partner characteristics (e.g., level of intoxication) that may uniquely influence the relationship between cannabis and alcohol co-use and condomless sex.
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The inter-individual heart rate variability triangular index response to different exercise doses in adults with metabolic syndrome: a randomised trial. J Sci Med Sport 2021. [DOI: 10.1016/j.jsams.2021.09.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Diagnostic Accuracy Study Comparing Hysterosalpingo-Foam Sonography and Hysterosalpingography for Fallopian Tube Patency Assessment. J Clin Med 2021; 10:jcm10184169. [PMID: 34575278 PMCID: PMC8466769 DOI: 10.3390/jcm10184169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/03/2021] [Accepted: 09/10/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: Simplified ultrasound-based infertility protocols that appear to provide enough information to plan effective management have been described. Thus, the objective of this study is to compare the diagnostic accuracy of the hysterosalpingo-foam sonography (HyFoSy) in tubal patency testing with the traditional hysterosalpngography (HSG) for establishing a new diagnostic strategy in infertility. Material and Methods: Prospective observational diagnostic accuracy was performed in a private fertility clinic in which 106 women undergoing a preconceptionally visit were recruited. All of them had low risk for tubal disease, had performed an HSG and were negative for Chlamydia trachomatis antibody. Main outcome measures were tubal patency and pain grade. Results: Evaluation of tubal patency by HyFoSy showed a total concordance with the results of the previous HSG in 72.6% (n = 77), and a total discordance for 4.7% (n = 6), with the inter-test agreement Kappa equal to 0.57, which means moderate concordance. Among the patients, 59.1% did not report pain during the procedure, while the remaining 48.1% indicated pain in different degrees; patients usually report less pain and only 6.6% described more pain with HyFoSy than with HSG (OR 6.57 (CI 95% 3.11–13.89)). Clinical outcomes after performing HyFoSy were not affected. Conclusions: HyFoSy is in concordance with HSG regarding tubal patency results and it is a less painful technique than HSG. HyFoSy is more economical and can be performed in an exam room only equipped with an ultrasound scanner. Based on these results, HyFoSy could be the first-choice diagnostic option to assess tubal patency in patients with low risk of tubal disease.
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O-122 ICSI in a box: development of a successful automated sperm injection robot with external supervision and minimal manual intervention. Hum Reprod 2021. [DOI: 10.1093/humrep/deab126.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is it possible to automate the way sperm is injected in an oocyte and improve ICSI consistency between embryologists?
Summary answer
The developed ICSI robot demonstrated a high degree of consistency and operator skill independence, allowing human supervision and external control, but minimal manual intervention.
What is known already
ICSI is a clinical procedure that is currently performed worldwide in most IVF centers and its use will only increase with more utilization of egg freezing. Since its implementation, the technique has been conducted manually by highly skilled embryologists. However, success rates can vary significantly depending on the experience of the operator. We leverage our experience in robotics, AI algorithms and embryology to develop an automated ICSI robot that requires minimal manual intervention with the aim to standardize the consistency of the procedure and, ultimately, improve overall results maintaining embryologist oversight.
Study design, size, duration
The ICSI robot was developed to have supervised automated control on critical steps of the injection procedure, including injection pipette advancement, zona pellucida and oolemma penetration with piezo-pulses, and pipette removal after injection. Manual intervention is required only for immobilization and capture of spermatozoa with a joystick gamepad and to release the sperm in the ooplasm, without the need for micromanipulation skills. In parallel, piezo-ICSI was performed in a conventional micromanipulation station as a control.
Participants/materials, setting, methods
Hamster and mouse oocytes were collected from superovulated females. For testing the efficiency of the automated system, hamster oocytes were injected with human donor sperm, as historically used in manual ICSI training programs, and survival rates evaluated after overnight culture. Mouse oocytes were injected with mouse sperm heads and subsequently cultured in vitro for five days. Blastocysts obtained were vitrified and embryo transfers are ongoing to evaluate term developmental rates.
Main results and the role of chance
The technical components of the ICSI robot were engineered to integrate AI algorithms, optics, cell microinjectors and mechatronics. AI algorithms were developed to identify the morphological structures of MII oocytes, including the zona pellucida, perivitelline space and polar body, both in the hamster and mouse models. The system detects and analyzes both the pipette and the oocyte and chooses the best area and plane for injection, allowing automated control of the subsequent injection steps. Using the hamster oocyte-human sperm model, a survival rate of 91% (n = 110) was achieved with the robot, which was statistically similar (p = 0.335) to the results obtained in the controls injected manually (96%, n = 28). The average time spent in each injection cycle, which includes scanning of the oocyte and injection pipette, and injection of the sperm into the oocyte, was approximately two minutes per ICSI operation. This time was comparable to the time required by highly experienced operators with manual piezo-injection. In the mouse, 91% (n = 53) of the oocytes injected survived the procedure, of which, 92% developed to two-cells and 87% to the blastocyst stage. No statistical differences were found when compared these efficiencies with manual controls (n = 40, 98%, 97% and 92%, respectively).
Limitations, reasons for caution
The developed ICSI robot has shown highly consistent results, independently of operator skills, both in hamster and mouse oocytes. However, additional validations should be performed to enlarge the sample size of injected oocytes and to evaluate the efficiency of the system in other oocyte species, including translational studies to humans.
Wider implications of the findings
The combination of multidisciplinary teams allows the development of automated processes that can reduce variability in certain IVF procedures, while supervised and assisted by experienced embryologists. It is expected that other laboratory procedures can be automated in the field of assisted reproductive treatments in a near future.
Trial registration number
N/A
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P-179 Complications of the rescue esophagectomy in advanced esophageal cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gastrointestinal: Olmesartan-induced enterocolopathy: A new presentation of a known entity. J Gastroenterol Hepatol 2021; 36:1150. [PMID: 33305434 DOI: 10.1111/jgh.15332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 10/07/2020] [Accepted: 11/03/2020] [Indexed: 12/09/2022]
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Revisiting Polymer-Particle Interaction in PEO Solutions. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2021; 37:3808-3816. [PMID: 33764765 PMCID: PMC9132384 DOI: 10.1021/acs.langmuir.0c02715] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/17/2021] [Indexed: 06/12/2023]
Abstract
We have measured the electrophoretic mobility and diffusion coefficient of carboxylate-modified and sulfate-modified polystyrene latex particles in poly(ethylene oxide) aqueous solutions. Carboxylate-modified polystyrene particles have shown a bound polymeric layer as the surface net charge vanishes even at very low poly(ethylene oxide) concentration. The polymeric layer causes a lower electrophoretic mobility and slower Brownian diffusion than that corresponding to the bare particles. We show that the diffusion is the result of a significantly increased effective particle size 2rheff = 30 nm. This bound layer is not present in sulfate-modified polystyrene latex particles. The interaction between the carboxylate-modified particle surface and the macromolecules has been confirmed by means of atomistic computer simulations. The grafted acrylate copolymers, which come from the preparation procedure of the latex particles, confer more hydrophobic surface ready to interact with the polymer. The simulations suggest that the interaction is modulated not only by the nature of the acrylic acid monomer but also by the length of the grafted copolymer. Our results have important implications for particle selection in microrheology experiments.
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Therapeutic interventions for PTSD – current evidence on the the role of psychedelics. Eur Psychiatry 2021. [PMCID: PMC9475922 DOI: 10.1192/j.eurpsy.2021.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionPost-traumatic stress disorder (PTSD) is often a chronic condition, despite the existence of evidence-based treatment options. Psychotherapy is the designated first line treatment for PTSD, although high rates of psychiatric and medical comorbidity are observed among patients who have undergone treatment. The psychoactive properties of psychedelics may be of particular interest within a substance-assisted psychotherapy approach, offering new treatment opportunities for this debilitating disorder.ObjectivesReview current evidence, therapeutic context, and possible mechanisms of action of different types of psychedelics in the treatment of PTSD.MethodsLiterature review using Medline database.Results3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy appears to be a potentially safe, effective, and durable treatment for individuals with treatment-refractory PTSD. Based on a small number of studies, ketamine administration appears to result in temporary symptom relief and may, in combination with psychotherapy, lead to lasting reductions in PTSD symptoms. Although these have not yet been investigated in controlled studies, it is known that psilocybin and LSD induce psychoactive effects that could as well contribute to the psychotherapeutic treatment of PTSD.ConclusionsThe use of psychedelic compounds within a substance-assisted psychotherapy framework offers a novel method for pharmacotherapy-psychotherapy integration, although there is still much to learn from both a clinical and neurobiological perspective. It is necessary to generate more data regarding the safety and efficacy of psychedelics, in addition to research on cost-effectiveness, its use in mental health care infrastructure and also regarding the training of specialized therapists.
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Colorectal cancer liver metastases: management and five-year survival in a South African patient cohort. S AFR J SURG 2021; 59:2-6. [PMID: 33779097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Approximately 25% of patients with colorectal cancer (CRC) will be diagnosed with CRC liver metastases (CRCLM) during the course of their disease. No data regarding CRCLM presentation, management and survival outcomes has been published from either the private or public health care sectors in South Africa. This study aimed to address this deficit, reporting on a private sector cohort. METHODS A retrospective review of a private health care funder's database from 1 January 2008 to 31 December 2015 was performed. ICD-10 diagnosis codes were used to identify CRC and CRCLM. Procedure codes assigned to hospital admissions were used to identify the type of surgical treatment. Chemotherapy was identified by the WHO Anatomical Therapeutic Chemical classification system of medicines. Treatment patterns were assessed and five-year overall survival (OS) was calculated. Survival was estimated using the Kaplan-Meier method, and Cox proportional-hazards regression was used for between group survival comparisons. RESULTS Six hundred and one (601) of 3 412 patients presenting with CRC (17.6%) were diagnosed with CRCLM at presentation or during the follow-up period. Sixty patients with CRCLM (10.0%) underwent resection of the primary CRC and liver resection for metastases, 281 (46.8%) underwent CRC resection only, 180 (30%) received chemotherapy only, and 47 (7.8%) received no treatment. Five-year OS for these groups were 57.3%, 15.6%, 9.8% and 0% respectively. CONCLUSION Five-year OS of the various CRCLM treatment pathways in a South African private sector population compares to results published in international series. However, a smaller proportion of patients with CRCLM underwent liver resection, compared to international studies.
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Colorectal cancer liver metastases: management and five-year survival in a South African patient cohort. S AFR J SURG 2021. [DOI: 10.17159/2078-5151/2021/v59n1a2707] [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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PAINEL DIAGNÓSTICO FILMARRAY GASTROINTESTINAL EM PORTADORES DE NEOPLASIAS HEMATOLÓGICOS E SUBMETIDOS A TMO ALOGÊNICO COM DIARRÉIA: CONTRIBUIÇÃO NO DIAGNÓSTICO E NA ADEQUAÇÃO TERAPÊUTICA. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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275O Impact of tucatinib on health-related quality of life (HRQoL) in patients with HER2+ metastatic breast cancer (MBC) with and without brain metastases (BM). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.377] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Modeling the Transport of Human Rotavirus and Norovirus in Standardized and in Natural Soil Matrix-Water Systems. FOOD AND ENVIRONMENTAL VIROLOGY 2020; 12:58-67. [PMID: 31721078 DOI: 10.1007/s12560-019-09414-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/31/2019] [Indexed: 05/24/2023]
Abstract
We modeled Group A Rotavirus (RVA) and Norovirus genogroup II (GII NoV) transport experiments in standardized (crystal quartz sand and deionized water with adjusted pH and ionic strength) and natural soil matrix-water systems (MWS). On the one hand, in the standardized MWS, Rotavirus and Norovirus showed very similar breakthrough curves (BTCs), showing a removal rate of 2 and 1.7 log10, respectively. From the numerical modeling of the experiment, transport parameters of the same order of magnitude were obtained for both viruses. On the other hand, in the natural MWS, the two viruses show very different BTCs. The Norovirus transport model showed significant changes; BTC showed a removal rate of 4 log10, while Rotavirus showed a removal rate of 2.6 log10 similar to the 2 log10 observed on the standardized MWS. One possible explanation for this differential behavior is the difference in the isoelectric point value of these two viruses and the increase of the ionic strength on the natural MWS.
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P727 Unexpected ventricular aneurysm: further ischemic aetiology. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.399] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Ventricular aneurysm is an infrequent complication of myocardial infarction. In absence of an ischemic event, alternative aetiologies include: thoracic trauma, hypertrophic cardiomyopathy, myocarditis, Chagas disease, cardiac sarcoidosis or arrythmogenic cardiomyopathy. In the absence of any of the previous, congenital aneurysm diagnosis is made.
Case
We present the case of 57-year-old man referred to cardiology department because a new onset of atrial fibrillation with left bundle branch block. Past medical history included high blood pressure and dyslipidaemia without any history or smoking, alcohol consumption or any other toxic abuse. No chest pain, shortness of breath or other significant symptoms were reported. Physical examination was unremarkable except for an arrhythmic pulse at 85-90 bpm.
Echocardiogram showed moderate dilated left ventricle with mild-moderate LV dysfunction (EF 40% ) with a septal aneurysm of 2.4x1cm (Picture A). A coronary CT was performed that ruled out coronary heart disease and confirmed the presence of the septal aneurysm (Picture B). To better characterize this image, a cardiac magnetic resonance (CMR) was performed. Moderate dilated LV with significant dysfunction (EF 31%) was reported. A septal aneurysm of 13 x 22 x 33 mm composed of a 2.8 m thin wall of true myocardial tissue was documented (picture C and D-late gadolinium enhance). No myocardial delayed enhancement was detected in any area of the LV. Moreover, no signs of myocardial non compaction, arrythmogenic cardiomyopathy, hypertrophic cardiomyopathy or myocarditis were seen. Chagas serology as well as sarcoidosis diagnosis work up were negative. Patient denied any thoracic traumatism. Congenital aneurysm diagnosis was finally established.
Electrical cardioversion was performed after 1 month of correct oral anticoagulation and heart failure treatment was started. Case was presented in the Heart Team session and a conservative management was decided based on asymptomatic status and absence of ventricular arrhythmias. After 3 years of clinical follow up, the patients is in good status, asymptomatic and in sinus rhythm. Discussion: Congenital ventricular aneurysm is a rare cardiac malformation that arises during the fourth embryonic week. Most frequently, left ventricular aneurysms are found in the apex and the perivalvular area, being the septal location an atypical one. Most patients are asymptomatic but when symptoms occur, they are mostly related to the presence of ventricular arrhythmias. Aneurysm rupture incidence is variable, ranging from 3.7% to 12 % according to the different series. For this reason, surgery is recommended in symptomatic patients. However, management of asymptomatic patients is not clear since prognosis studies are lacking.
Abstract P727 Figure. A.Echo B.-CT C.-CMR. D.-CMR gadolinium
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26 Intensity modulated therapy on breast: Dosimetric and clinical results. Phys Med 2019. [DOI: 10.1016/j.ejmp.2019.09.107] [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: 11/30/2022] Open
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Prevalence, environmental risk factors and heritability of body condition in Pura Raza Español horses. Livest Sci 2019. [DOI: 10.1016/j.livsci.2019.103851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Low Golimumab Trough Levels at Week 6 Are Associated With Poor Clinical, Endoscopic and Histological Outcomes in Ulcerative Colitis Patients: Pharmacokinetic and Pharmacodynamic Sub-analysis of the Evolution Study. J Crohns Colitis 2019; 13:1387-1393. [PMID: 30989180 DOI: 10.1093/ecco-jcc/jjz071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Golimumab has an established exposure-response relationship in patients with ulcerative colitis [UC]. However, the association of serum golimumab trough levels [TL] with objective markers of disease activity, such as endoscopic and histological activity scores and concentrations of biomarkers, remains less understood. This report describes the relationship of serum golimumab TL at the end of the induction period [Week 6] with clinical, endoscopic, histological, and biomarker parameters. METHODS This was an open-label, uncontrolled, prospective and interventional study. Moderate to severely active UC patients naïve to biologic therapy were treated with golimumab. Serum golimumab TL and faecal calprotectin levels were measured at baseline [Week 0 of induction] and Week 6. RESULTS A total of 34 patients completed the induction phase [Week 6] and were included in this analysis. Overall, 47.1% and 14.7% of patients achieved clinical response and remission with significantly higher serum golimumab TL in patients with early response or remission [3.7 μg/mL vs 1.3 μg/mL, p = 0.0013; and 3.1 μg/mL vs 1.7 μg/mL, p = 0.0164, respectively]. In addition, golimumab TL were significantly higher in patients achieving histological remission [4.2 μg/mL vs 1.7 μg/mL, p = 0.0049]. Week 6 golimumab TL were inversely correlated with the total Mayo score [rs = -0.546; p = 0.0008], the Mayo endoscopic subscore [rs = -0.381; p = 0.0262], the Geboes histological activity score [rs = -0.464; p = 0.0057], and faecal calprotectin levels [rs = -0.497; p = 0.0044]. CONCLUSIONS A higher early exposure to golimumab is associated with a better objective response in active UC patients and appears to drive the outcome at Week 6.
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P102 Shunting slit ventricles: a comparison of the parieto-occipital vs frontal approach. J Neurol Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesSlit ventricles can be a challenging target during shunt catheter insertion. Traditionally, the frontal approach has been considered optimal. At this centre, routine use of electromagnetic (EM) stereotatic guidance (StealthTM, Medtronic) has enabled a parieto-occipital burr hole approach to the frontal horns. We compare shunt placement and revisions required for patients with slit ventricles who had shunts inserted via a parieto-occipital (P-O) approach vs. frontal shunt.DesignRetrospective cohort.SubjectsPatients with slit ventricles and a ventricular shunt inserted using EM guidance between 2012–2018.MethodsSlit ventricles were defined as <3 mm (widest). Outcome measures included placement accuary and survival using Kaplan-Meier curve.Results82 patients (77F:5M) aged 34.9±10.8 years (mean ±SD) had shunts inserted for IIH (n=63), chiari/syrinx (n=8), congenital hydrocephalus (n=10), pseudomeningocoele (n=1). 35 had primary P-O shunts and 46 had frontal shunts. Overall, 94% of cases had the catheter tip sitting in the frontal horn. The P-O approach was just as accurate as the frontal approach. Eight P-O shunts and 9 frontal shunts required revision over a 60 month periods. There was no significant different in shunt survival between the two approaches (p=0.99).ConclusionsEM guided placement has enabled the P-O approach to be as safe and with equivalent survival to frontal approach. The accuracy of shunt placement between the two approaches was equivocal.
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TM3-3 Correlation of lumbar puncture opening pressure with 24 hours intraparenchymal ICP monitoring: the effects of position on ICP. Journal of Neurology, Neurosurgery and Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
ObjectivesLumbar Puncture opening pressure in lateral decubitus has been considered the gold standard method of intracranial pressure (ICP) measurement for many years. The use of continuous intraparenchymal ICP monitoring is more recent and there is no consensus regarding what can be considered normal ICP with this method of measurement. A conversion factor between lumbar puncture opening pressure and 24 hours ICP monitoring could provide a better insight on the interpretation of ICP. This study investigates the differences between 24 hours ICP and ICP in lumbar puncture position.DesignSingle centre prospective observational study.SubjectsFifty-four patients (42F:12M, mean age 38±12 years) were included.MethodsPatients investigated with 24 hours ICP monitoring who underwent a short exercise battery during the monitoring period were included. The exercise battery was standardised; patients were asked to stay in a supine, sitting, standing and lumbar puncture position for 2 min each.Mean ICP and pulse amplitude were calculated for each position.ResultsThe mean 24 hours ICP was 4.9 mmHg (±6.9 SD) and the mean ICP in lumbar puncture position was 14.1 mmHg (±8.9 SD). The average increase in lumbar puncture position was 9.1 mmHg (±5.9 SD). Patients with normal lumbar puncture position ICP (<12 mmHg) had an average 24 hours ICP of 1.4 mmHg (±2.81 SD).ConclusionsOur results suggest that ICP measured in lumbar puncture position is on average 9.1 mmHg higher than 24 hours ICP results. Larger studies will be needed to confirm these findings.
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The three prognostic factors associated with poor outcomes after pancreatico-duodenectomy for carcinoma of the head of the pancreas: a retrospective multi-centers study during the last 5-years. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Evaluation of Bacterial Contamination as an Indicator of Viral Contamination in a Sedimentary Aquifer in Uruguay. FOOD AND ENVIRONMENTAL VIROLOGY 2018; 10:305-315. [PMID: 29564721 DOI: 10.1007/s12560-018-9341-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 12/22/2017] [Indexed: 06/08/2023]
Abstract
In Uruguay, groundwater is frequently used for agricultural activities, as well as for human consumption in urban and rural areas. As in many countries worldwide, drinking water microbiological quality is evaluated only according to bacteriological standards and virological analyses are not mentioned in the legislation. In this work, the incidence of human viral (Rotavirus A, Norovirus GII, and human Adenovirus) and bacterial (total and thermotolerant coliform and Pseudomonas aeruginosa) contamination in groundwater in the Salto district, Uruguay, as well as the possible correlation between these groups of microorganisms, was studied. From a total of 134 groundwater samples, 42 (32.1%) were positive for Rotavirus, only 1 (0.7%) for both Rotavirus and Adenovirus, and 96 (72.6%) samples were positive for bacterial indicators. Results also show that Rotavirus presence was not associated with changes in chemical composition of the aquifer water. Bacteriological indicators were not adequate to predict the presence of viruses in individual groundwater samples (well scale), but a deeper spatial-temporal analysis showed that they are promising candidates to assess the viral contamination degree at aquifer scale, since from the number of wells with bacterial contamination the number of wells with viral contamination could be estimated.
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P897Sacubitril/valsartan: science-fiction, or current practice? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p897] [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: 11/14/2022] Open
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Colonic perforation associated with sodium polystyrene sulfonate (Kayexalate) use. Diagn Interv Imaging 2018; 99:507-509. [PMID: 29627281 DOI: 10.1016/j.diii.2018.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 02/09/2018] [Accepted: 02/16/2018] [Indexed: 01/19/2023]
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Double composante histologique au sein de lésions métastatiques d’un carcinome de Merkel. Ann Dermatol Venereol 2017. [DOI: 10.1016/j.annder.2017.09.237] [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]
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Right–left or midgut–hindgut? Ann Oncol 2017; 28:2618. [DOI: 10.1093/annonc/mdx282] [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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Ideal cardiovascular health (ICVH) in patients with a recent diagnosis of colorectal cancer (CRC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx388.058] [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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Optimisation of imaging protocols in interventional cardiology: impact on patient doses. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:684-696. [PMID: 28677594 DOI: 10.1088/1361-6498/aa7dae] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this work is to evaluate the impact of the imaging protocol as part of the optimisation of patient doses in interventional cardiology. This paper reports the results of an initial study to refine the existing fluoroscopy and cine settings, evaluates a new imaging protocol by measuring the image quality and phantom entrance air kerma values, and tests the clinical implementation of the new protocol in terms of the reduction in patient doses and the impact on clinical images. The initial study developed a new fluoroscopy mode using 7.5 frames s-1 (instead of the previous 15 frames s-1) with a similar dose/frame and a reduction of approximately 26% in dose/frame for the existing standard cine mode. For the new imaging protocol, the reduction in entrance air kerma was characterised for water depths of 16, 20, and 24 cm and the image quality was evaluated using a Leeds test object. A reduction in dose of around 50% was observed for the low fluoroscopy mode and an 18%-38% reduction was measured for cine. The image quality was unchanged in fluoroscopy mode and did not suffer noticeable alterations in cine mode. In the clinical implementation, cardiologists evaluated the new imaging protocol in clinical practice and cooperated with medical physicists to ensure full optimisation. The image quality criteria evaluated the ability to visualise the standard coronary arteries and small vessels (<2 mm), and the proper visualisation of the heart and diaphragm. A total of 1635 interventional cardiac procedures were assessed. The median kerma-area product exhibited a reduction of 37% for CA and 43% for PTCA examinations, and the quality of the clinical images was considered sufficient for standard clinical practice.
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Molecular and hydrodynamic properties of human epidermal growth factor receptor HER2 extracellular domain and its homodimer: Experiments and multi-scale simulations. Biochim Biophys Acta Gen Subj 2017. [PMID: 28642126 DOI: 10.1016/j.bbagen.2017.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND In a broad range of human carcinomas gene amplification leads to HER2 overexpression, which has been proposed to cause spontaneous dimerization and activation in the absence of ligand. This makes HER2 attractive as a therapeutic target. However, the HER2 homodimerization mechanism remains unexplored. It has been suggested that the "back-to-back" homodimer does not form in solution. Notwithstanding, very recently the crystal structure of the HER2 extracellular domain homodimer formed with a "back-to-head" interaction has been resolved. We intend to explore the existence of such interactions. METHODS A combination of experiments, molecular dynamics and hydrodynamic modeling were used to monitor the transport properties of HER2 in solution. RESULTS & CONCLUSIONS We have detected the HER2 extracellular domain homodimer in solution. The results show a high degree of molecular flexibility, which ultimately leads to quite higher values of the intrinsic viscosity and lower values of diffusion coefficient than those corresponding to globular proteins. This flexibility obeys to the open conformation of the receptor and to the large fluctuations of the different domains. We also report that for obtaining the correct hydrodynamic constants from the modeling one must consider the glycosylation of the systems. GENERAL SIGNIFICANCE Conformational features of epidermal growth factor receptors regulate their hydrodynamic properties and control their activity. It is essential to understand the dynamics of these systems and the role of the specific domains involved. To find biophysical correlations between dynamics and macroscopic transport properties is of general interest for researches working in this area. This article is part of a Special Issue entitled "Biochemistry of Synthetic Biology - Recent Developments" Guest Editor: Dr. Ilka Heinemann and Dr. Patrick O'Donoghue.
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Occupational dose reduction in cardiac catheterisation laboratory: a randomised trial using a shield drape placed on the patient. RADIATION PROTECTION DOSIMETRY 2017; 174:255-261. [PMID: 27247448 DOI: 10.1093/rpd/ncw139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 05/11/2016] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the occupational radiation dose in interventional cardiology by using a shielding drape on the patient. A random study with and without the protective material was conducted. The following control parameters were registered: demographic data, number of stents, contrast media volume, fluoroscopy time, number of cine images, kerma-area product and cumulative air kerma. Occupational dose data were obtained by electronic active dosemeters. No statistically significant differences in the analysed control parameters were registered. The median dose value received by the interventional cardiologist was 50% lower in the group with a shielding drape with a statistically significant p-value <0.001. In addition, the median value of the maximum scatter radiation dose was 31% lower in this group with a statistically significant p-value <0.001. This study showed that a shielding drape is a useful tool for reducing the occupational radiation dose in a cardiac catheterisation laboratory.
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A Grassroots Student-Faculty Coalition on Curriculum Change. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:434. [PMID: 28350608 DOI: 10.1097/acm.0000000000001614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Introductory Learning of Inclusive Sexual History Taking: An E-Lecture, Standardized Patient Case, and Facilitated Debrief. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2016; 12:10520. [PMID: 30984862 PMCID: PMC6440490 DOI: 10.15766/mep_2374-8265.10520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION This student-driven curriculum intervention, implemented with first-year medical students, was guided by the Association of American Medical Colleges' standards for medical education on health care for sexual and gender minorities. Its goals are to describe the spectrum of sexual orientation and gender identity and sensitively and effectively elicit relevant information from patients about their sexual orientation and gender identity through inclusive sexual history taking. METHODS Developed through student-faculty collaboration, this three-part module includes a 14-minute e-lecture on taking an inclusive sexual history, a 35-minute formative standardized patient encounter in which students take a sexual history and receive feedback, and a 20-minute facilitated group debrief on the standardized patient activity. RESULTS Students completed a postmodule evaluation anonymously; the majority of respondents (92%) agreed that they felt more prepared to take a sexual history inclusive of sexual and gender minority patients. Most were more comfortable discussing sexual orientation (91%) and gender identity (83%) with patients after the module. Content analysis revealed an improved confidence in creating a safe space for sexual and gender minority patients and an increased awareness of biases about sexual and gender minority patients. DISCUSSION This curriculum serves as an early foundation for students to understand sexual and gender minority identities and develop confidence in their inclusive sexual history taking skills before they provide care for patients. In addition, the student-driven curriculum development process used can serve as a template for students at other institutions hoping to collaborate with faculty to develop comprehensive sexual and gender minority curricula.
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Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016. Crit Care 2016; 20:347. [PMID: 31268434 PMCID: PMC5078922 DOI: 10.1186/s13054-016-1358-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022] Open
Abstract
[This corrects the article DOI: 10.1186/s13054-016-1208-6.].
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Proactive therapeutic drug monitoring of infliximab: a comparative study of a new point-of-care quantitative test with two established ELISA assays. Aliment Pharmacol Ther 2016; 44:684-92. [PMID: 27507790 DOI: 10.1111/apt.13757] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 06/09/2016] [Accepted: 07/18/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Therapeutic drug monitoring is a powerful strategy known to improve the clinical outcomes and to optimise the healthcare resources in the treatment of autoimmune diseases. Currently, most of the methods commercially available for the quantification of infliximab (IFX) are ELISA-based, with a turnaround time of approximately 8 h, and delaying the target dosage adjustment to the following infusion. AIM To validate the first point-of-care IFX quantification device available in the market - the Quantum Blue Infliximab assay (Buhlmann, Schonenbuch, Switzerland) - by comparing it with two well-established methods. METHODS The three methods were used to assay the IFX concentration of spiked samples and of the serum of 299 inflammatory bowel diseases (IBD) patients undergoing IFX therapy. RESULTS The point-of-care assay had an average IFX recovery of 92%, being the most precise among the tested methods. The Intraclass Correlation Coefficients of the point-of-care IFX assay vs. the two ELISA-based established methods were 0.889 and 0.939. Moreover, the accuracy of the point-of-care IFX compared with each of the two reference methods was 77% and 83%, and the kappa statistics revealed a substantial agreement (0.648 and 0.738). CONCLUSIONS The Quantum Blue IFX assay can successfully replace the commonly used ELISA-based IFX quantification kits. This point-of-care IFX assay is able to deliver the results within 15 min makes it ideal for an immediate target concentration adjusted dosing. Moreover, it is a user-friendly desktop device that does not require specific laboratory facilities or highly specialised personnel.
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Cancer-related fatigue in breast cancer survivors: more evidence for a physiological substrate. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.64] [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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Antecedent variables of innovation behaviors in organizations: Differences between men and women. EUROPEAN REVIEW OF APPLIED PSYCHOLOGY 2016. [DOI: 10.1016/j.erap.2016.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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