Podcasts about objectives to

llc ab martinez copy behaviour residents aggressive reduction involvement testosterone dbs ht diwan deep brain stimulation giacobbe hypothalamic biorxiv objectives to

Play Episode Listen Later Mar 21, 2023

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.03.20.533520v1?rss=1 Authors: Gouveia, F. V., Diwan, M., Martinez, R. C., Giacobbe, P., Lipsman, N., Hamani, C. Abstract: Background: Aggressive behaviour (AB) may occur in patients with different neuropsychiatric disorders. Although most patients respond to conventional treatments, a small percentage continue to experience AB despite optimized pharmacological management and are considered to be treatment-refractory. For these patients, hypothalamic deep brain stimulation (pHyp-DBS) has been investigated. The hypothalamus is a key structure in the neurocircuitry of AB. An imbalance between serotonin (5-HT) and steroid hormones seems to exacerbate AB. Objectives: To test whether pHyp-DBS reduces aggressive behavior in mice through mechanisms involving testosterone and 5-HT. Methods: Male mice were housed with females for two weeks. These resident animals tend to become territorial and aggressive towards intruder mice placed in their cages. Residents had electrodes implanted in the pHyp. DBS was administered for 5h/day for 8 consecutive days prior to daily encounters with the intruder. After testing, blood and brain were recovered for measuring testosterone and 5-HT receptor density, respectively. In a second experiment, residents received WAY-100635 (5-HT1A antagonist) or saline injections prior to pHyp-DBS. After the first 4 encounters, the injection allocation was crossed, and animals received the alternative treatment during the next 4 days. Results: DBS-treated mice showed reduced AB that was correlated with testosterone levels and an increase in 5-HT1A receptor density in the orbitofrontal cortex and amygdala. Pre-treatment with WAY-100635 blocked the anti-aggressive effect of pHyp-DBS. Conclusions: This study shows that pHyp-DBS reduces AB in mice via changes in testosterone and 5-HT1A mechanisms. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

The Bionic Pancreas for Children: How Does it Work and What's Next?(Episode Includes Grand Rounds)

Pediatrics Now: Cases Updates and Discussions for the Busy Pediatric Practitioner

Play Episode Listen Later Dec 23, 2022 66:54

For CME Credit, click here: https://cmetracker.net/UTHSCSA/Publisher?page=pubOpen#/getCertificate/10092431 Presenter: Rabab Z. Jafri, MD Pediatric Endocrinologist Department of Pediatrics Texas Diabetes Institute UT Health San Antonio Overview: A Bionic Endocrine Pancreas for Automated Management of Glycemia in Diabetes Mellitus, grand rounds. Plus, Pediatrics Now Host Holly Wayment gets reaction from Dr. Jafri about the bionic pancreas study published in NEJM, plus soundbites from patients in the clinical trial. Objectives: To increase awareness and education for pediatric providers Financial Disclosures: Rabab Z. Jafri, MD has no financial relationships with ineligible companies to disclose. The Pediatric Grand Rounds Planning Committee (Deepak Kamat MD, PhD, Daniel Ranch, MD and Elizabeth Hanson, MD) has no financial relationships with ineligible companies to disclose. Planning Committee member Steven Seidner, MD has disclosed he receives funding from Draeger Medical for the Clinical Study to Evaluate the Safety and Effectiveness of the Infinity Acute Care System Workstation Neonatal Care Babylog VN500 Device in High-Frequency Oscillatory Ventilation (HFOV) Mode in Extremely Low Birth Weight (ELBW) Neonates for which he is a co-principal investigator. Our wonderful pediatric endocrinology team sees patients at University Hospital's Texas Diabetes Institute. Credits: AMA PRA Category 1 Credits™ (1.00 hour) Non-Physician Participation Credit (1.00 hour) MOC-2 credit (1.00 hour) Target Audience: Pediatric Community Doctors and Providers Faculty, residents, health care providers; medical students and trainees. Accreditation: The UT Health Science Center San Antonio is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Credit Designation: The UT Health Science Center San Antonio designates this live activity up to a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Nurses and other healthcare professionals will receive a Certificate of Attendance. For information on applicability and acceptance, please consult your professional licensing board.

Jennings Lectureship - "You Tell My Baby's Story for All the World to Hear" The Communal and Redemptive Act of Storytelling in Medicine

NGMC Continuing Medical Education

Play Episode Listen Later Nov 7, 2022 68:26

Enduring CME will expire on 11/7/2024. The presentation is originating from Northeast Georgia Medical Center Gainesville. Objectives: - To understand the importance of communication in caring for patients - To discern the importance of communal storytelling for provider wellness - To promote empathy for our patients and the journeys they are on Disclosures: - There is no commercial support for this activity - The speakers have disclosed that there are no relevant personal or financial relationships Accreditation and Designation: The Northeast Georgia Medical Center & Health System, Inc. is accredited by the Medical Association of Georgia to provide continuing medical education for physicians. The Northeast Georgia Medical Center & Health System, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s) TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

babies medicine storytelling credit physicians jennings tm health systems redemptive communal medical association lectureship ama pra category objectives to northeast georgia medical center

Umbilical cord blood-derived cell therapy for perinatal brain injury: A systematic review & meta-analysis of preclinical studies - Part B.

Play Episode Listen Later Oct 25, 2022

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.20.513105v1?rss=1 Authors: Purcell, E., Nguyen, T., Smith, M., Penny, T., Paton, M., Zhou, L., Jenkin, G., Miller, S., McDonald, C., Malhotra, A. Abstract: Introduction: We previously described preclinical literature, which supports umbilical cord blood-derived cell (UCBC) therapy use for perinatal brain injury. However, efficacy of UCBCs may be influenced by different patient populations and intervention characteristics. Objectives: To systematically review effects of UCBCs on brain outcomes in animal models of perinatal brain injury across subgroups to better understand contribution of model type (preterm versus term), brain injury type, UCB cell type, route of administration, timing of intervention, cell dosage and number of doses. Methods: A systematic search of MEDLINE and Embase databases was performed to identify studies using UCBC therapy in animal models of perinatal brain injury. Subgroup differences were measured by chi2 test where possible. Results: Differential benefits of UCBCs were seen in a number of subgroup analyses including intraventricular haemorrhage (IVH) vs. hypoxia ischaemia (HI) model (apoptosis white matter (WM): chi2=4.07; P=0.04, neuroinflammation-TNF-: chi2=5.99; P=0.01), UCB-derived mesenchymal stromal cells (MSCs) vs. UCB-derived mononuclear cells (MNCs) (oligodendrocyte WM: chi2=5.01; P=0.03, neuroinflammation-TNF-: chi2=3.93; P=0.05, apoptosis grey matter (GM), astrogliosis WM) and intraventricular/intrathecal vs. systemic routes of administration (microglial activation GM: chi2=7.51; P=0.02, astrogliosis WM: chi2=12.44; P=0.002). We identified a serious risk of bias and overall low certainty of evidence. Conclusions: Preclinical evidence suggests greater efficacy for UCBCs in IVH compared to HI injury model, use of UCB-MSCs compared to UCB-MNCs, and use of local administrative routes compared to systemic routes in animal models of perinatal brain injury. Further research is needed to improve certainty of evidence found and address knowledge gaps. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Umbilical cord blood-derived cell therapy for perinatal brain injury: A systematic review & meta-analysis of preclinical studies - Part A

friends mental health types objectives to

Play Episode Listen Later Oct 7, 2022

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.10.05.510916v1?rss=1 Authors: Nguyen, T., Purcell, E., Smith, M., Penny, T., Paton, M., Zhou, L., Jenkin, G., Miller, S., McDonald, C., Malhotra, A. Abstract: Introduction: Perinatal brain injury is a major contributor to long-term adverse neurodevelopment. There is mounting preclinical evidence for use of umbilical cord blood (UCB)-derived cell therapy as potential treatment. Objectives: To systematically review and analyse effects of UCB-derived cell therapy on brain outcomes in preclinical models of perinatal brain injury. Methods: MEDLINE and Embase databases were searched for relevant studies. Brain injury outcomes were extracted for meta-analysis to calculate standard mean difference (SMD) with 95% confidence interval (CI), using an inverse variance, random effects model. Outcomes were separated based on grey matter (GM) and white matter (WM) regions where applicable. Risk of bias was assessed using SYRCLE, and GRADE was used to summarise certainty of evidence. Results: Fifty-five eligible studies were included (7 large, 48 small animal models). UCB-derived cell therapy significantly improved outcomes across multiple domains, including decreased infarct size (SMD 0.53; 95%CI (0.32, 0.74), P less than 0.00001), apoptosis (WM, SMD 1.59; 95%CI (0.86, 2.32), P less than 0.0001), astrogliosis (GM, SMD 0.56; 95%CI (0.12, 1.01), P=0.01), microglial activation (WM, SMD 1.03; 95%CI (0.40, 1.66), P=0.001), neuroinflammation (TNF-, SMD 0.84; 95%CI (0.44, 1.25), P less than 0.0001); as well as improved neuron number (SMD 0.86; 95%CI (0.39, 1.33), P=0.0003), oligodendrocyte number (GM, SMD 3.35; 95%CI (1.00, 5.69), P=0.005) and motor function (cylinder test, SMD 0.49; 95%CI (0.23, 0.76), P=0.0003). Risk of bias was determined as serious, and overall certainty of evidence was low. Conclusions: UCB-derived cell therapy is an efficacious treatment in pre-clinical models of perinatal brain injury, however findings are limited by low certainty of evidence. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer

HOW FRIENDS CAN CONTRIBUTE TO YOUR MENTAL HEALTH

Think Big Win Big

Play Episode Listen Later Aug 10, 2022 27:44

Objectives: To make you know who friends are. To make you know why friends aren't needed but wanted. How friends can contribute both positively and negatively to your mental-health Types of friends. Where do you find friends? How to determine your kind of friends. How to retain good friendships that add value to your life. My goal is to make sure you can identify different kind of friends that can positively impact in your life and mental health, for you to make the best decision when choosing a friend or friends. In order words, Friends can contribute to your mental health positively or negatively as long as you spend quality time with them. They either will make you or break you. Be conscious of friends you surround yourself with daily. Who are friends? Friends are our loved ones. Friends are people we tend to trust and are our companions. We chat with them, spend a lot of quality time with them. Friends could be in a form of mother, father, wife, husband, children, colleagues at work, class mates, business partners, clients, pets and so on. What kind of friends do we need? Friends are nor needed, they are wanted (in my opinion) though having good friends do have a lot of benefits. Like the saying goes, "No man is an island". We want friends that are out chattok buddy. Friends we can trust with our lives and secrets if any. Good friends that are there for us to give positive and good advises when needed. Friends who are not only there when you are happy but also there when you are sad or unhappy. We live in a world where the next day is an adventure, the unexpected could happen. You can plan and make outlines on how you want your next day activities to play out but an unexpected incident can occur and you'll need to forgo all that outline and live the days struggle, while carrying out that activity that one person who you can express how you feel and can give you that listening ears with some encouraging words are those types of friends you want or need in your situation. Why do we need friends? Listen to my podcast. My book "Grace Found Me" pre-ordering is on-going on Amazon - Link: https://amzn.to/3PYrHHk Follow @iamjudithonuwa on instagram for updates.

Development of self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Process evaluation

development kenya selfhelp groups evaluation caregivers children with disabilities kilifi objectives to

Play Episode Listen Later Jul 22, 2022

Objectives: To conduct a process evaluation on the development of self-help groups during a 10-month set-up period, focusing on implementation and mechanisms associated with their functional status.

The value of a short practical training course for newly qualified therapists working with children with cerebral palsy in South Africa

children south africa practical therapists south africans qualified cp cerebral palsy training courses objectives to

Play Episode Listen Later Jul 12, 2022

Background: Cerebral palsy (CP) is the most common and most complex disabling disorder in children. Newly qualified therapists are expected to manage CP despite feeling inexperienced and inadequately prepared. Short postgraduate practical training courses could potentially help bridge this readiness gap. However, the value of these short courses in addressing the knowledge and experience gap is unknown. Objectives: To establish the value of a short practical training course on the self-perceived readiness of newly qualified South African trained therapists to work with children with CP.

Barriers experienced by people with disabilities participating in income-generating activities. A case of a sheltered workshop in Bloemfontein, South Africa

south africa workshop income barriers activities experienced generating participating people with disabilities sheltered bloemfontein igas objectives to

Play Episode Listen Later Jul 9, 2022

Background: People with disabilities often participate in income-generating activities (IGAs) in sheltered workshop in South Africa. However, they face many barriers that limit their ability to participate effectively in economic activities hosted by the workshops. Objectives: To illustrate the barriers that limit the participation of people with disabilities in IGAs in a sheltered workshop.

#216: Graham Brown & Jonathan Bowman-Perks

Inspiring Leadership with Jonathan Bowman-Perks MBE

Play Episode Listen Later Jun 28, 2022 80:44

PurposeTo stimulate the audience to raise their game, develop their leadership talent and be stimulated by the insights and playful “banter” between two passionate Broadcasters, in order that they can make a positive impact on their businesses, their own work and their lives. Objectives:To have fun, spar and have a healthy competition with a pair of hostsTo listen to each other with heart and soulTo have deeply authentic, open, vulnerable and courageous conversationsTo stimulate each other to share insights on leadership and lifeTo do our homework and bring new insights on leaders in the news and booksTo help individuals and organisations globallyTo be of such added value that we make our audiences hungry for the next episode OUR TOP INSPIRING LEADERSHIP ROLE MODELSGraham: Robert F Kennedy - a man who changed his views and embraced diversity and yet was serially unfaithful MLK - the power of storytelling, the “mountain top” etc Greta Thunberg - the 20 year old climate change “activist”Jacinda Ardern NZ PMSteven SpielbergMalala YousafaziSouichiro HondaBill Gates - Gates foundation from Microsoft (Melinda)Tim Cook Angela Merkel Jack Ma?Jonathan:Oprah WinfreyFlorence NightingaleSir Ernest Shackleton General the Lord Dannatt The Emperor Marcus Aurelius General Colin PowellAmelia EarhartRosa ParksMother TheresaThomas EdisonWarren BuffetINSPIRING BOOKSWhat's your favourite book on leadership and life and what would we learn from it?Jonathan: It worked for me: In Leadership & Life by General Colin Powell TUNE IN NEXT MONTHNext month we look forward and discuss MQ - Morals Integrity Values Principles & BeliefsOUR ASKWe ask YOU the audience to send questions in to our 2 websites Jonathanperks.com or Pikkal.com See acast.com/privacy for privacy and opt-out information.

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Lived experiences of caregivers of children with autism spectrum disorder in Kenya

children experiences kenya disorders lived caregivers asd autism spectrum disorder lived experiences objectives to

Play Episode Listen Later Mar 16, 2022

Objectives: To explore the perspectives of caregivers who are responsible for caring for both family and children living with ASD and to highlight the needs of children with ASD as well as the needs of their caregivers.

Episode 9 - Unemployment

unemployment objectives to

Play Episode Listen Later Nov 28, 2021 19:18

Objectives: - To introduce the concept of unemployment- To understand the way we calculate the unemployment rate

Episode 10 - Types of Unemployment

types unemployment objectives to

Play Episode Listen Later Nov 28, 2021 12:01

Objectives: - To introduce the three types of employment- To introduce the natural rate of unemployment

Episode 6- Nominal Versus Real GDP

nominal real gdp objectives to

Play Episode Listen Later Nov 10, 2021 13:49

Objectives: -To differentiate between the two concepts (Nominal vs Real)-To know when to use each concept

Exploring communication and interaction skills at work among participants in individual placement and support

research skills swedish individual interaction placement ips objectives to

Play Episode Listen Later Nov 5, 2021

Background: Not all people with severe mental illness who attend Individual Placement and Support (IPS) gain and keep their jobs or work full time. Research has indicated a relationship between social disabilities and work performance in this group, and that support provided is often directed towards the social work environment. However, relationships between social skills performed in an authentic work setting and vocational outcomes have not been explored. Objectives: To explore relationships between social communication and interaction skills and vocational outcomes among IPS-service users in a Swedish context.

Episode 1- What is Economics

Play Episode Listen Later Oct 28, 2021 21:32

Objectives: -To know what is economics-Why we need to study economics-Introduce the two branches of Economics

economics objectives to

Amyloid β Impacts Future Freezing of Gait in Parkinson's Disease Via White Matter Hyperintensities

Play Episode Listen Later Oct 29, 2020

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.29.360552v1?rss=1 Authors: Dadar, M., Miyasaki, J., Duchesne, S., Camicioli, R. Abstract: Background: Freezing of gait (FOG) is a common symptom in Parkinsons Disease (PD) patients. Previous studies have reported relationships between FOG, substantia nigra (SN) degeneration, dopamine transporter (DAT) concentration, as well as amyloid {beta} deposition. However, there is a paucity of research on the concurrent impact of white matter damage. Objectives: To assess the inter-relationships between these different co-morbidities, their impact on future FOG and whether they act independently of each other. Methods: We used baseline MRI and longitudinal gait data from the Parkinson's Progression Markers Initiative (PPMI). We used deformation based morphometry (DBM) from T1-weighted MRI to measure SN atrophy, and segmentation of white matter hyperintensities (WMH) as a measure of WM pathological load. Putamen and caudate DAT levels from SPECT as well as cerebrospinal fluid (CSF) amyloid {beta} were obtained directly from the PPMI. Following correlation analyses, we investigated whether WMH burden mediates the impact of amyloid {beta} on future FOG. Results: SN DBM, WMH load, putamen and caudate DAT activity and CSF amyloid {beta} levels were significantly different between PD patients with and without future FOG (p < 0.008). Mediation analysis demonstrated an effect of CSF amyloid {beta} levels on future FOG via WMH load, independent of SN atrophy and striatal DAT activity levels. Conclusions: Amyloid {beta} might impact future FOG in PD patients through an increase in WMH burden, in a pathway independent of Lewy body pathology. Copy rights belong to original authors. Visit the link for more info

impacts parkinson previous copy mri mediation pd fog wm freezing sn t1 gait parkinson's disease lewy csf spect amyloid duchesne dbm biorxiv white matter wmh objectives to

Interfaith Leadership Forum Inaugural Event

Rumi Forum Podcast

Play Episode Listen Later Oct 26, 2020 121:27

On October 25, the inaugural event of the new Interfaith Leadership Forum explored how to deepen interfaith work in religious communities, professional life, and our culture. Leaders from all segments of society, and those who want to become leaders, joined us for this virtual event. The ILF aims to promote pluralism by convening leaders of various religious, ethnic, racial, cultural, and gender backgrounds to exchange ideas and generate action-oriented agenda. It provides a venue where a diverse group of community leaders, scholars, clergy, and public officials can engage in in-depth discussions on shared values and explore ways to harness them for social action. ILF is open to all individuals who are interested in advancing their interfaith literacy and serving the community as interfaith mobilizers in their professional or individual capacities. Objectives: * To strengthen interfaith relationships, literacy, and leadership by: • Equipping one another with various models of dialogue with distinct ends. • Experiencing deeper levels of interfaith encounter and dialogue • Strengthening literacy about other’s faiths and about one’s own • Overcoming prejudices and misconceptions about other faiths • Elicit social action through interfaith engagement Topics and workshops for the event include: Stories of Interfaith Dialogue Tackling Prejudices Learning from Differences Engaging a Racialized America, and The Life Cycle of Dialogue Presenters at the Forum will include: Ibrahim A. Anli, Executive Director, The Rumi Forum Ann Delorey, Program Director, Interfaith Council of Metropolitan Washington Dr. Beverly Goines, Assistant Pastor, National City Christian Church (Disciples of Christ), Washington, D.C.; Associate Director, Disciples Center for Public Witness; Adjunct Professor, Dept. of Theology & Religious Studies, Georgetown University Dr. Ori Soltes, Professor, Edmund A. Walsh School of Foreign Service, Georgetown University Dr. Pim (Wilhelmus) Valkenberg, Ordinary Professor of Religion and Culture, The Catholic University of America Moderator: Dr. Larry Golemon, Executive Director, Washington Theological Consortium Special thanks to the following for their sponsorship of the event: The Rumi Forum The Washington Theological Consortium The Interfaith Council of Metropolitan Washington Washington, D.C. Mayor’s Office of Religious Affairs

Does pericentral mu-rhythm power corticomotor excitability? A matter of EEG perspective

Play Episode Listen Later Sep 14, 2020

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.11.292789v1?rss=1 Authors: Karabanov, A. N., Madsen, K. H., Krohne, L., Siebner, H. R. Abstract: Background: Electroencephalography (EEG) and single-pulse transcranial magnetic stimulation (spTMS) of the primary motor hand area (M1-HAND) have been combined to explore whether the instantaneous expression of pericentral mu-rhythm drives fluctuations in corticomotor excitability, but this line of research has yielded diverging results. Objectives: To re-assess the relationship between the mu-rhythm power expressed in left pericentral cortex and the amplitude of motor potentials (MEP) evoked with spTMS in left M1-HAND. Methods: 15 non-preselected healthy young participants received spTMS to the motor hot spot of left M1-HAND. Regional expression of mu-rhythm was estimated online based on a radial source at motor hotspot and informed the timing of spTMS which was applied either during epochs belonging to the highest or lowest quartile of regionally expressed mu-power. Using MEP amplitude as dependent variable, we computed a linear mixed-effects model, which included mu-power and mu-phase at the time of stimulation and the inter-stimulus interval (ISI) as fixed effects and subject as a random effect. Mu-phase was estimated by post-hoc sorting of trials into four discrete phase bins. We performed a follow-up analysis on the same EEG-triggered MEP data set in which we isolated mu-power at the sensor level using a Laplacian montage centered on the electrode above the M1-HAND. Results: Pericentral mu-power traced as radial source at motor hot spot did not significantly modulate the MEP, but mu-power determined by the surface Laplacian did, showing a positive relation between mu-power and MEP amplitude. In neither case, there was an effect of mu-phase on MEP amplitude. Copy rights belong to original authors. Visit the link for more info

rhythm regional methods copy mu eeg madsen isi mep biorxiv laplacian objectives to

Investigating motor preparatory processes and conscious volition using machine learning

cnn twenty conscious morris previous copy machine learning processes motor investigating eeg volition preparatory biorxiv heever libet objectives to

Play Episode Listen Later Sep 9, 2020

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.09.07.286351v1?rss=1 Authors: Hall, S. M., van den Heever, D., Vinding, M. C., Morris, L. D. Abstract: Background: Conscious volition is a broad term and is difficult to reduce to a single empirical paradigm. It encompasses many areas of cognition, including decision-making and empirical studies can be done on these components. This work follows on the seminal work of Libet et al. (1983) which focused on brain activity preceding motor activity and conscious awareness of the intention to move. Previous results have subsequently faced criticism, particularly methods used to average out EEG data over all the trials and the readiness potential not being present on an individual trial basis. This following study aims to address these criticisms. Objectives: To use machine learning to investigate brain activity preceding left/right hand movements with relation to conscious intent and motor action. Methodology: The data collection involved the recreation of the Libet experiment, with electroencephalography (EEG) data being collected. An addition made in this study was the choice between 'left' and 'right' while observing the Libet clock to subjectively mark the moment of conscious awareness. Twenty-one participants were included (four females, all right-handed). A deep (machine) learning model known as a convolutional neural network (CNN) was used for the EEG data analysis. Results: Subjectively reported conscious intent preceded the action by 108 ms. The CNN model was able to predict the decision 'left' or 'right' as early as 4.45 seconds before the action with a test accuracy of 98%. Conclusion: This study has shown motor preparatory processes start up to 4.45 seconds before conscious awareness of a decision to move. Copy rights belong to original authors. Visit the link for more info

Microstructural integrity of the major nuclei of the thalamus in Parkinson's disease

Play Episode Listen Later May 25, 2020

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.05.21.109660v1?rss=1 Authors: Borlase, N., Myall, D., Melzer, T. R., Livingston, L., Watts, R., Keenan, R. J., MacAskill, M., Anderson, T., Dalrymple-Alford, J. C. Abstract: Background: Previous research has shown an association between thalamus and cognition in Parkinson's disease (PD). Objectives: To investigate the microstructural integrity of the nuclei of the thalamus and relationship with cognition. Methods: Level II Movement Disorder Society Task Force Criteria characterised patients with Parkinson's disease as cognitively normal (PDN, n=51); with mild cognitive impairment (PD-MCI, n=16) or with dementia (PDD, n=15). Twenty-three healthy control subjects were included for comparison. A k-means clustering approach segmented the thalamus into regions representing nine major nuclei. Volume, fractional anisotropy and mean diffusivity of nuclei were compared between cognitive groups and the relationship with cognitive domain z-scores investigated using hierarchical Bayesian regression models. Results: There was an overall progressive increase in mean diffusivity as cognition deteriorated (PDN: 1.4 m2/s (95% uncertainty interval [0.2, 2.7]), PDMCI: 2.4 m2/s [0.8,4.0], PDD: 4.5 m2/s [2.8, 6.3]). The largest increase was in the lateral dorsal nucleus (PDN: 0.3 m2/s [-6.7, 7.2], PDMCI: 5.4 m2/s [-4.7, 16.1], PDD: 14.8 m2/s [5.0, 25.0]). Fractional anisotropy showed minimal change between cognitive groups (PDN: 0.001 [-0.005, 0,007], PDMCI: -0.005 [-0.013, 0.003], PDD: -0.005 [-0.014, 0.003]). Increase in mean diffusivity of the thalamus is associated with a global decline in cognition, the magnitude of the effect was greatest in lateral dorsal nucleus. Fractional anisotropy only showed evidence of a relationship with cognitive domain scores in the lateral dorsal nucleus. Conclusions: The relationship between lateral dorsal nucleus integrity and cognitive changes is likely due to its primary connectivity with frontal and temporal regions. Copy rights belong to original authors. Visit the link for more info

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A randomized, controlled pilot study of the effects of vitamin D supplementation on balance in Parkinson's disease: Does age matter?

Science Says

Play Episode Listen Later Jul 24, 2019

Objectives: To explore if short term, high dose vitamin D supplementation is safe and improves balance in persons with Parkinson's disease (PD). Methods: A pilot randomized, double-blind intervention trial to measure the effects of 16 weeks of high dose vitamin D (10,000 IU/day) on balance as well as other motor and non-motor features of PD. We measured balance, gait, strength, falls, cognition, mood, PD severity, and quality of life before and after 16 weeks of high dose vitamin D supplementation or placebo. All participants also received 1000 mg calcium once daily. Results: Fifty-one randomized participants completed sixteen weeks of high dose vitamin D supplementation or placebo. The intervention resulted in a rise in serum concentrations of vitamin D (25-OH) (30.2 ng/ml to 61.1 ng/ml) and was well tolerated with no serious adverse events. Serum vitamin D (25-OH) levels rose steadily and did not suggest a leveling off at the end of the 16 weeks. There was not an improvement in the primary endpoint, balance as measured by the Sensory Organization Test (p = 0.43). A post hoc analysis examining treatment effects in younger (ages 52–66) versus older (ages 67–86) participants found a significant improvement in the SOT of 10.6 points in the younger half of the cohort (p = 0.012). Conclusions: Short term, high dose vitamin D supplementation appears safe in persons with PD, but did not significantly improve balance as measured with the Sensory Organization Test in this pilot study population. A post hoc analysis suggests that vitamin D may have potential for improving balance in a younger population with PD. High dose vitamin D supplementation in PD needs further study especially in light of new research suggesting that mega doses and even moderate doses (as low as 4000IU a day) may increase falls in an older populations. Hiller AL, Murchison CF, Lobb BM, O'Connor S, O'Connor M, Quinn JF. A randomized, controlled pilot study of the effects of vitamin D supplementation on balance in Parkinson's disease: Does age matter?. PLoS One. 2018;13(9):e0203637. Published 2018 Sep 26. doi:10.1371/journal.pone.0203637. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157857/

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Understanding the consequences of education inequality on cardiovascular disease: mendelian randomisation study

Science Says

Play Episode Listen Later Jun 12, 2019

Objectives: To investigate the role of body mass index (BMI), systolic blood pressure, and smoking behaviour in explaining the effect of education on the risk of cardiovascular disease outcomes. Design: Mendelian randomisation study. Setting: UK Biobank and international genome-wide association study data. Participants: Predominantly participants of European ancestry. Exposure: Educational attainment, BMI, systolic blood pressure, and smoking behaviour in observational analysis, and randomly allocated genetic variants to instrument these traits in mendelian randomisation. Main outcomes measure: The risk of coronary heart disease, stroke, myocardial infarction, and cardiovascular disease (all subtypes; all measured in odds ratio), and the degree to which this is mediated through BMI, systolic blood pressure, and smoking behaviour respectively. Results: Each additional standard deviation of education (3.6 years) was associated with a 13% lower risk of coronary heart disease (odds ratio 0.86, 95% confidence interval 0.84 to 0.89) in observational analysis and a 37% lower risk (0.63, 0.60 to 0.67) in mendelian randomisation analysis. As a proportion of the total risk reduction, BMI was estimated to mediate 15% (95% confidence interval 13% to 17%) and 18% (14% to 23%) in the observational and mendelian randomisation estimates, respectively. Corresponding estimates were 11% (9% to 13%) and 21% (15% to 27%) for systolic blood pressure and 19% (15% to 22%) and 34% (17% to 50%) for smoking behaviour. All three risk factors combined were estimated to mediate 42% (36% to 48%) and 36% (5% to 68%) of the effect of education on coronary heart disease in observational and mendelian randomisation analyses, respectively. Similar results were obtained when investigating the risk of stroke, myocardial infarction, and cardiovascular disease. Conclusions: BMI, systolic blood pressure, and smoking behaviour mediate a substantial proportion of the protective effect of education on the risk of cardiovascular outcomes and intervening on these would lead to reductions in cases of cardiovascular disease attributable to lower levels of education. However, more than half of the protective effect of education remains unexplained and requires further investigation. Carter AR, Gill D, Davies NM, et al. Understanding the consequences of education inequality on cardiovascular disease: mendelian randomisation study. BMJ. 2019;365:l1855. Published 2019 May 22. doi:10.1136/bmj.l1855 This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529852/

education european study consequences similar published inequality bmi abstract sections cardiovascular diseases open access bmj mendelian objectives to randomisation

Journal of Cystic Fibrosis: Efficacy and Safety of Levofloxacin Inhalation Solution (APT-1026) in Stable Cystic Fibrosis Patients

Cystic Fibrosis in Focus

Play Episode Listen Later Aug 1, 2016

A phase 3, multi-center, multinational, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of levofloxacin inhalation solution (APT-1026) in stable cystic fibrosis patients. Flume PA, VanDevanter DR, Morgan EE, Dudley MN, Loutit JS, Bell SC, Kerem E, Fischer R, Smyth AR, Aaron SD, Conrad D, Geller DE,Elborn JS. J Cyst Fibros. 2016 Jul;15(4):495-502. doi: 10.1016/j.jcf.2015.12.004. Epub 2016 Feb 4. Abstract RATIONALE: For patients with cystic fibrosis (CF), the use of inhaled antibiotics has become standard of care to suppress chronic Pseudomonas airways infection. There are limited antibiotic options formulated and approved for inhaled use and antibiotic efficacies attenuate over time, making additional inhaled antibiotic classes desirable. APT-1026 (levofloxacin inhalation solution, LIS) is a fluoroquinolone in development for management of chronic P. aeruginosa airways infection in patients with CF. OBJECTIVES: To compare the safety and efficacy of a 28-day course of treatment with LIS 240mg or placebo BID in persons ≥12years old with CF and chronic P. aeruginosa infection. METHODS: A multinational, randomized (2:1), double-blinded study of LIS and placebo over 28days in CF patients ≥12years with chronic P. aeruginosa infection. Time to exacerbation was the primary endpoint. FEV1 (% predicted) and patient-reported ...

time safety patients journal solution stable infectious diseases cf efficacy lis bid epub cystic fibrosis apt rmd inhalation clinical pharmacology pseudomonas pulmonary medicine reachmd general medicine and primary care fev1 hiv/aids and infectious disease poisoning and drug reference objectives to audioabstracts prova education cystic fibrosis in focus

Journal of Cystic Fibrosis: Efficacy and Safety of Levofloxacin Inhalation Solution (APT-1026) in Stable Cystic Fibrosis Patients

Play Episode Listen Later Aug 1, 2016

A phase 3, multi-center, multinational, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of levofloxacin inhalation solution (APT-1026) in stable cystic fibrosis patients. Flume PA, VanDevanter DR, Morgan EE, Dudley MN, Loutit JS, Bell SC, Kerem E, Fischer R, Smyth AR, Aaron SD, Conrad D, Geller DE,Elborn JS. J Cyst Fibros. 2016 Jul;15(4):495-502. doi: 10.1016/j.jcf.2015.12.004. Epub 2016 Feb 4. Abstract RATIONALE: For patients with cystic fibrosis (CF), the use of inhaled antibiotics has become standard of care to suppress chronic Pseudomonas airways infection. There are limited antibiotic options formulated and approved for inhaled use and antibiotic efficacies attenuate over time, making additional inhaled antibiotic classes desirable. APT-1026 (levofloxacin inhalation solution, LIS) is a fluoroquinolone in development for management of chronic P. aeruginosa airways infection in patients with CF. OBJECTIVES: To compare the safety and efficacy of a 28-day course of treatment with LIS 240mg or placebo BID in persons ≥12years old with CF and chronic P. aeruginosa infection. METHODS: A multinational, randomized (2:1), double-blinded study of LIS and placebo over 28days in CF patients ≥12years with chronic P. aeruginosa infection. Time to exacerbation was the primary endpoint. FEV1 (% predicted) and patient-reported ...

time safety patients journal solution stable infectious diseases cf efficacy lis bid epub cystic fibrosis apt rmd inhalation clinical pharmacology pseudomonas pulmonary medicine reachmd general medicine and primary care fev1 hiv/aids and infectious disease poisoning and drug reference objectives to audioabstracts prova education cystic fibrosis in focus

Journal of Cystic Fibrosis: Efficacy and Safety of Levofloxacin Inhalation Solution (APT-1026) in Stable Cystic Fibrosis Patients

Cystic Fibrosis in Focus

Play Episode Listen Later Jul 31, 2016

A phase 3, multi-center, multinational, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of levofloxacin inhalation solution (APT-1026) in stable cystic fibrosis patients. Flume PA, VanDevanter DR, Morgan EE, Dudley MN, Loutit JS, Bell SC, Kerem E, Fischer R, Smyth AR, Aaron SD, Conrad D, Geller DE,Elborn JS. J Cyst Fibros. 2016 Jul;15(4):495-502. doi: 10.1016/j.jcf.2015.12.004. Epub 2016 Feb 4. Abstract RATIONALE: For patients with cystic fibrosis (CF), the use of inhaled antibiotics has become standard of care to suppress chronic Pseudomonas airways infection. There are limited antibiotic options formulated and approved for inhaled use and antibiotic efficacies attenuate over time, making additional inhaled antibiotic classes desirable. APT-1026 (levofloxacin inhalation solution, LIS) is a fluoroquinolone in development for management of chronic P. aeruginosa airways infection in patients with CF. OBJECTIVES: To compare the safety and efficacy of a 28-day course of treatment with LIS 240mg or placebo BID in persons ≥12years old with CF and chronic P. aeruginosa infection. METHODS: A multinational, randomized (2:1), double-blinded study of LIS and placebo over 28days in CF patients ≥12years with chronic P. aeruginosa infection. Time to exacerbation was the primary endpoint. FEV1 (% predicted) and patient-reported ...

time safety patients journal solution stable infectious diseases cf efficacy lis bid epub cystic fibrosis apt rmd inhalation clinical pharmacology pseudomonas pulmonary medicine reachmd general medicine and primary care fev1 hiv/aids and infectious disease poisoning and drug reference objectives to audioabstracts prova education cystic fibrosis in focus

Journal of Cystic Fibrosis: Efficacy and Safety of Levofloxacin Inhalation Solution (APT-1026) in Stable Cystic Fibrosis Patients

Play Episode Listen Later Jul 31, 2016

A phase 3, multi-center, multinational, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of levofloxacin inhalation solution (APT-1026) in stable cystic fibrosis patients. Flume PA, VanDevanter DR, Morgan EE, Dudley MN, Loutit JS, Bell SC, Kerem E, Fischer R, Smyth AR, Aaron SD, Conrad D, Geller DE,Elborn JS. J Cyst Fibros. 2016 Jul;15(4):495-502. doi: 10.1016/j.jcf.2015.12.004. Epub 2016 Feb 4. Abstract RATIONALE: For patients with cystic fibrosis (CF), the use of inhaled antibiotics has become standard of care to suppress chronic Pseudomonas airways infection. There are limited antibiotic options formulated and approved for inhaled use and antibiotic efficacies attenuate over time, making additional inhaled antibiotic classes desirable. APT-1026 (levofloxacin inhalation solution, LIS) is a fluoroquinolone in development for management of chronic P. aeruginosa airways infection in patients with CF. OBJECTIVES: To compare the safety and efficacy of a 28-day course of treatment with LIS 240mg or placebo BID in persons ≥12years old with CF and chronic P. aeruginosa infection. METHODS: A multinational, randomized (2:1), double-blinded study of LIS and placebo over 28days in CF patients ≥12years with chronic P. aeruginosa infection. Time to exacerbation was the primary endpoint. FEV1 (% predicted) and patient-reported ...

time safety patients journal solution stable infectious diseases cf efficacy lis bid epub cystic fibrosis apt rmd inhalation clinical pharmacology pseudomonas pulmonary medicine reachmd general medicine and primary care fev1 hiv/aids and infectious disease poisoning and drug reference objectives to audioabstracts prova education cystic fibrosis in focus

Individual Detection of 14 High-risk HPV Genotypes by the PapType Test for the Prediction of High-grade Cervical Lesions

Play Episode Listen Later Jul 29, 2016

Individual detection of 14 high risk human papilloma virus genotypes by the PapType test for the prediction of high grade cervical lesions. Cuzick J, Ho L, Terry G, Kleeman M, Giddings M, Austin J, Cadman L, Ashdown-Barr L, Costa MJ, Szarewski A. J Clin Virol. 2014 May;60(1):44-9. doi: 10.1016/j.jcv.2014.02.002. Epub 2014 Feb 14. Abstract BACKGROUND: HR HPV genotypes when assayed collectively, achieve high sensitivity but low specificity for the prediction of CIN2+. Knowledge of the specific genotypes in an infection may facilitate the use of HR HPV detection in routine clinical practice. OBJECTIVES: To compare the rate of HR HPV detection and the accuracy of CIN2+ prediction between PapType test (Genera Biosystems) and other commercially available HR HPV assays, and to examine the value of full HPV genotyping. STUDY DESIGN: PreservCyt samples from 1099 women referred for abnormal cervical cytology were used. CIN2+ was chosen as the primary end-point but CIN3+ was also evaluated. A hierarchy of HR HPV genotypes was created using PPV and this was used to create 3 groups of genotypes with potentially different ...

predictions individual genetics ppv detection hpv high risk epub cervical rmd lesions highgrade reachmd general medicine and primary care objectives to audioabstracts cin3 omnia education

Individual Detection of 14 High-risk HPV Genotypes by the PapType Test for the Prediction of High-grade Cervical Lesions

mandela pan african unisa winnie mandela youth of today objectives to

Play Episode Listen Later Jul 28, 2016

Individual detection of 14 high risk human papilloma virus genotypes by the PapType test for the prediction of high grade cervical lesions. Cuzick J, Ho L, Terry G, Kleeman M, Giddings M, Austin J, Cadman L, Ashdown-Barr L, Costa MJ, Szarewski A. J Clin Virol. 2014 May;60(1):44-9. doi: 10.1016/j.jcv.2014.02.002. Epub 2014 Feb 14. Abstract BACKGROUND: HR HPV genotypes when assayed collectively, achieve high sensitivity but low specificity for the prediction of CIN2+. Knowledge of the specific genotypes in an infection may facilitate the use of HR HPV detection in routine clinical practice. OBJECTIVES: To compare the rate of HR HPV detection and the accuracy of CIN2+ prediction between PapType test (Genera Biosystems) and other commercially available HR HPV assays, and to examine the value of full HPV genotyping. STUDY DESIGN: PreservCyt samples from 1099 women referred for abnormal cervical cytology were used. CIN2+ was chosen as the primary end-point but CIN3+ was also evaluated. A hierarchy of HR HPV genotypes was created using PPV and this was used to create 3 groups of genotypes with potentially different ...

predictions individual genetics ppv detection hpv high risk epub cervical rmd lesions highgrade reachmd general medicine and primary care ob/gyn and women's health objectives to audioabstracts cin3 omnia education

WHAT IS THE JUNE 16 OF THE YOUTH OF TODAY?

Update@Noon

Play Episode Listen Later Jun 13, 2016 52:33

Objectives: _- To understand what the youth of 1976 stood and fought for? -To establish what the youth of today are fighting for? Guest: Ntombizikhona Valela is doing her MA on the intellectual work and value of Winnie Mandela. She is framing Mandela as a vernacular intellectual Guest: Mikaela Erskog is doing her MA on some of the most influential Pan African figures such as Miriam Tlali, Bessie Head and Noni Jabavu Guest: Prof Teffo Letsiba - He is attached with UNISA

CT stress perfusion imaging for detection of haemodynamically relevant coronary stenosis as defined by FFR

Medizin - Open Access LMU - Teil 21/22

Play Episode Listen Later Jul 1, 2013

Objectives: To evaluate the diagnostic accuracy (DA) of CT-myocardial perfusion imaging (CT-MPI) and a combined approach with CT angiography (CTA) for the detection of haemodynamically relevant coronary stenoses in patients with both suspected and known coronary artery disease. Design: Prospective, non-randomised, diagnostic study. Setting: Academic hospital-based study. Patients: 65 patients (42 men age 70.4 +/- 9) with typical or atypical chest pain. Interventions: CTA and CT-MPI with adenosine stress using a fast dual-source CT system. At subsequent invasive angiography, FFR measurement was performed in coronary arteries to define haemodynamic relevance of stenosis. Main outcome measures: We tried to correlate haemodynamically relevant stenosis (FFR

stress positive patients relevant defined ppv medizin imaging detection cta coronary stenosis perfusion npv ffr mbf objectives to design prospective

Sample size determinations in original research protocols for randomised clinical trials submitted to UK research ethics committees: review

Medizin - Open Access LMU - Teil 21/22

Play Episode Listen Later Mar 1, 2013

Objectives To assess the completeness of reporting of sample size determinations in unpublished research protocols and to develop guidance for research ethics committees and for statisticians advising these committees. Design Review of original research protocols. Study selection Unpublished research protocols for phase IIb, III, and IV randomised clinical trials of investigational medicinal products submitted to research ethics committees in the United Kingdom during 1 January to 31 December 2009. Main outcome measures Completeness of reporting of the sample size determination, including the justification of design assumptions, and disagreement between reported and recalculated sample size. Results 446 study protocols were reviewed. Of these, 190 (43%) justified the treatment effect and 213 (48%) justified the population variability or survival experience. Only 55 (12%) discussed the clinical importance of the treatment effect sought. Few protocols provided a reasoned explanation as to why the design assumptions were plausible for the planned study. Sensitivity analyses investigating how the sample size changed under different design assumptions were lacking; six (1%) protocols included a re-estimation of the sample size in the study design. Overall, 188 (42%) protocols reported all of the information to accurately recalculate the sample size; the assumed withdrawal or dropout rate was not given in 177 (40%) studies. Only 134 of the 446 (30%) sample size calculations could be accurately reproduced. Study size tended to be over-estimated rather than under-estimated. Studies with non-commercial sponsors justified the design assumptions used in the calculation more often than studies with commercial sponsors but less often reported all the components needed to reproduce the sample size calculation. Sample sizes for studies with non-commercial sponsors were less often reproduced. Conclusions Most research protocols did not contain sufficient information to allow the sample size to be reproduced or the plausibility of the design assumptions to be assessed. Greater transparency in the reporting of the determination of the sample size and more focus on study design during the ethical review process would allow deficiencies to be resolved early, before the trial begins. Guidance for research ethics committees and statisticians advising these committees is needed.

Math 10, Sequences Unit, Lesson 6

MYP Mathematics 10

Play Episode Listen Later Oct 11, 2011 21:59

Objectives: To model real world situations and solve problems using geometric and arithmetic sequences.

lesson math sequences objectives to

Are There Options to Prevent Early Occurring Deaths in Acute Myocardial Infarction: Prospective Evaluation of All < 24 h In-Hospital Deaths, 2004-2006-The MONICA/KORA Augsburg Infarction Registry

Medizin - Open Access LMU - Teil 16/22

Play Episode Listen Later Jan 1, 2010

Objectives: To provide valid clinical data of early in-hospital deaths with presumed acute myocardial infarction (AMI) who are often not included in clinical trials or registries. Methods: From August 2004 to August 2006 all patients (age 25-84 years) dying within 24 h after hospitalization in a large tertiary care academic teaching hospital were screened regarding an underlying cardiovascular cause of death. Results: After validation, 79 out of 1,352 patients remained with a final diagnosis of AMI. Sixty-six percent of these experienced prehospital cardiac arrest or shock. In 37% no resuscitation attempts were performed in-hospital, the most common reason being multimorbidity. Only 23% could be transferred to coronary angiography for revascularisation attempts. An independent panel of clinicians judged that only in one patient would another management strategy have been promising. Of interest, 33% of the deceased patients had typical or atypical chest pain the days before the lethal event. Conclusion: A large percentage of AMI patients who died soon after hospitalization were in critical circulatory state directly before hospitalization. In 37%, in-hospital resuscitation attempts were omitted for understandable reasons. Options for improvement in acute care in the investigated setting were not found. However, in one third of the cases earlier preventive measures might have been reasonable. Copyright (C) 2010 S. Karger AG, Basel

hospitals options prevent deaths evaluation medizin sixty acute basel prospective augsburg registry occurring myocardial infarction copyright c objectives to results after karger ag

Rac1-mediated signaling plays a central role in secretion-dependent platelet aggregation in human blood stimulated by atherosclerotic plaque

Medizin - Open Access LMU - Teil 17/22

Play Episode Listen Later Jan 1, 2010

Background: Platelet activation requires rapid remodeling of the actin cytoskeleton which is regulated by small GTP-binding proteins. By using the Rac1-specific inhibitor NSC23766, we have recently found that Rac1 is a central component of a signaling pathway that regulates dephosphorylation and activation of the actin-dynamising protein cofilin, dense and alpha granule secretion, and subsequent aggregation of thrombin-stimulated washed platelets. Objectives: To study whether NSC23766 inhibits stimulus-induced platelet secretion and aggregation in blood. Methods: Human platelet aggregation and ATP-secretion were measured in hirudin-anticoagulated blood and platelet-rich plasma (PRP) by using multiple electrode aggregometry and the Lumi-aggregometer. Platelet P-selectin expression was quantified by flow cytometry. Results: NSC23766 (300 mu M) inhibited TRAP-, collagen-, atherosclerotic plaque-, and ADP-induced platelet aggregation in blood by 95.1%, 93.4%, 92.6%, and 70%, respectively. The IC50 values for inhibition of TRAP-, collagen-, and atherosclerotic plaque-, were 50 +/- 18 mu M, 64 +/- 35 mu M, and 50 +/- 30 mu M NSC23766 (mean +/- SD, n = 3-7), respectively. In blood containing RGDS to block integrin alpha(IIb)beta(3)-mediated platelet aggregation, NSC23766 (300 mu M) completely inhibited P-selectin expression and reduced ATP-secretion after TRAP and collagen stimulation by 73% and 85%, respectively. In ADP-stimulated PRP, NSC23766 almost completely inhibited P-selectin expression, in contrast to aspirin, which was ineffective. Moreover, NSC23766 (300 mu M) decreased plaque-stimulated platelet adhesion/aggregate formation under arterial flow conditions (1500s(-1)) by 72%. Conclusions: Rac1-mediated signaling plays a central role in secretion-dependent platelet aggregation in blood stimulated by a wide array of platelet agonists including atherosclerotic plaque. By specifically inhibiting platelet secretion, the pharmacological targeting of Rac1 could be an interesting approach in the development of future antiplatelet drugs.

Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children: Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC)

Medizin - Open Access LMU - Teil 17/22

Play Episode Listen Later Jan 1, 2010

Objectives: To investigate the effect of ambient particulate matter on variation in childhood prevalence of asthma, rhinoconjunctivitis and eczema. Methods: Prevalences of asthma, rhinoconjunctivitis and eczema obtained in Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC) were matched with city-level estimates of residential PM10 obtained from a World Bank model. Associations were investigated using binomial regression adjusting for GNP per capita and for clustering within country. For countries with more than one centre, a two stage meta-analysis was carried out. The results were compared with a meta-analysis of published multi-centre studies. Results: Annual concentrations of PM₁₀ at city level were obtained for 105 ISAAC centres in 51 countries. After controlling for GNP per capita, there was a weak negative association between PM₁₀ and various outcomes. For severe wheeze in 13-14-year-olds, the OR for a 10 μg/m³ increase in PM₁₀ was 0.92 (95 CI 0.84 to 1.00). In 24 countries with more than one centre, most summary estimates for within-country associations were weakly positive. For severe wheeze in 13-14-year-olds, the summary OR for a 10 μg/m³ increase in PM₁₀ was 1.01 (0.92 to 1.10). This result was close to a summary OR of 0.99 (0.91 to 1.06) obtained from published multi-centre studies. Conclusions: Modelled estimates of particulate matter at city level are imprecise and incomplete estimates of personal exposure to ambient air pollutants. Nevertheless, our results together with those of previous multi-centre studies, suggest that urban background PM₁₀ has little or no association with the prevalence of childhood asthma, rhinoconjunctivitis or eczema either within or between countries.

children worldwide world bank pollution allergies medizin asthma associations international studies prevalence eczema phase one gnp objectives to childhood isaac

Outpatient alcoholism treatment-24-month outcome and predictors of outcome

Medizin - Open Access LMU - Teil 16/22

Play Episode Listen Later Jan 1, 2009

Objectives: To study the value of demographic and alcohol-related variables for predicting 24-month treatment outcome in an outpatient setting. Methods: Prospective observational study with 92 alcohol-dependent patients. Assessments were made by personal interviews at the beginning and end of therapy, and at the 24-month follow-up. Univariate and logistic regression analyses were performed. Results: The mean age was 46.0 (SD = 9.9) years. There were 58 males (65.2%) and 31 females (34.8%). Of the 67 patients interviewed at 2-year follow-up, 58% were abstinent and 79% improved. Differences between abstainers and non-abstainers were found for number of previous detoxifications, and number of patients attempted suicides. In addition, female gender and a higher number of prior treatments predicted negative treatment outcome. Conclusion: Matching patients to different types of treatment by means of empirically based characteristics may help to improve outcome but research has failed to establish reliable predictors in that area. Data from this follow-up study confirm the role of certain clinical outcome predictors. Additionally, results give further evidence for outpatient treatment as an effective setting for alcohol-dependent patients as indicated by a favourable retention rate (84%) and outcome (minimum abstinence rate 44%).

data treatments differences outcome sd alcoholism medizin assessments predictors outpatient objectives to univariate

Influence of peptidylarginine deiminase type 4 genotype and shared epitope on clinical characteristics and autoantibody profile of rheumatoid arthritis.

Play Episode Listen Later Jan 1, 2009

Background: Recent evidence suggests that distinction of subsets of rheumatoid arthritis (RA) depending on anticyclic citrullinated peptide antibody (anti-CCP) status may be helpful in distinguishing distinct aetiopathologies and in predicting the course of disease. HLA-DRB1 shared epitope (SE) and peptidylarginine deiminase type 4 (PADI4) genotype, both of which have been implicated in anti-CCP generation, are assumed to be associated with RA. Objectives: To elucidate whether PADI4 affects the clinical characteristics of RA, and whether it would modulate the effect of anti-CCPs on clinical course. The combined effect of SE and PADI4 on autoantibody profile was also analysed. Methods: 373 patients with RA were studied. SE, padi4_94C.T, rheumatoid factor, anti-CCPs and antinuclear antibodies (ANAs) were determined. Disease severity was characterised by cumulative therapy intensity classified into ordinal categories (CTI-1 to CTI-3) and by Steinbrocker score. Results: CTI was significantly associated with disease duration, erosive disease, disease activity score (DAS) 28 and anti-CCPs. The association of anti-CCPs with CTI was considerably influenced by padi4_94C.T genotype (C/C: ORadj=0.93, padj=0.92; C/T: ORadj=2.92, padj=0.093; T/T: ORadj=15.3, padj=0.002). Carriage of padi4_94T exhibited a significant trend towards higher Steinbrocker scores in univariate and multivariate analyses. An association of padi4_94C.T with ANAs was observed, with noteworthy differences depending on SE status (SE2: ORadj=6.20, padj,0.04; SE+: ORadj=0.36, padj=0.02) and significant heterogeneity between the two SE strata (p=0.006). Conclusions: PADI4 genotype in combination with anti- CCPs and SE modulates clinical and serological characteristics of RA.

influence disease ra methods shared profile characteristics clinical cc medizin ccp anas rheumatoid arthritis carriage cti genotype epitope objectives to hla drb1 background recent

Responsiveness of the International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis

Play Episode Listen Later Jan 1, 2009

Background: The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the ICF, representing relevant aspects in the functioning of patients with RA. Objectives: To study the responsiveness of the ICF Core Set for RA in rheumatological practice. Methods: A total of 46 patients with RA (72% women, mean (SD) age 53.6 (12.6) years, disease duration 6.3 (8.0) years) were interviewed at baseline and again after 6 months treatment with a disease-modifying antirheumatic drug (DMARD), applying the ICF Core Set for RA with qualifiers for problems on a modified three-point scale (no problem, mild/moderate, severe/complete). Patient-reported outcomes included Modified Health Assessment Questionnaire (MHAQ) and Short-Form 36 (SF-36) health survey, and disease activity was calculated. Responsiveness was measured as change in qualifiers in ICF categories, and was also compared with change in patient-reported outcomes. Results: After 6 months of DMARD treatment, improvement by at least one qualifier was seen in 20% of patients (averaged across all ICF categories), 71% experienced no change and 9% experienced worsening symptoms. Findings were similar across the different aspects of functioning. Mainly moderate effect sizes were seen for 6-month changes in the ICF Core Set for RA, especially in patients with improved health status, with similar effect size for disease activity. The components in the ICF Core Set for RA were only weakly associated with patient-reported outcomes and disease activity. Conclusions: The ICF Core Set for RA demonstrated moderate responsiveness in this real-life setting of patients where minor changes occurred during treatment with DMARDs.

international patients ra disability sf sd medizin findings classification icf functioning rheumatoid arthritis short form responsiveness core set international classification dmards objectives to health icf results after icf core set

The protective effect of farm animal exposure on childhood allergy is modified by NPSR1 polymorphisms

Play Episode Listen Later Jan 1, 2009

Background: Little is known about the asthma candidate gene neuropeptide S receptor 1 (NPSR1) in relation to environmental exposures, but recent evidences suggest its role as an effect modifier.Objectives: To explore the interaction between NPSR1 polymorphisms and environmental exposures related to farming lifestyle and to study the in vitro effects of lipopolysaccharide (LPS) stimulation on NPSR1 expression levels.Methods: We studied 3113 children from PARSIFAL, a European cross-sectional study on environmental/lifestyle factors and childhood allergy, partly focused on children brought up on a farm. Information on exposures and outcomes was primarily obtained from parental questionnaires. Seven tagging polymorphisms were analysed in a conserved haplotype block of NPSR1. Multivariate logistic regression was used to evaluate a multiplicative model of interaction. NPSR1 protein and messenger RNA (mRNA) levels in monocytes were measured after LPS stimulation by fluorescence activated cell sorting (FACS) and quantitative real-time polymerase chain reaction (PCR).Results: A strong interaction was seen between current regular contact to farm animals and several NPSR1 polymorphisms, particularly rs323922 and rs324377 (p

european childhood animal farm exposure medizin pcr allergy protective lps modified facs parsifal polymorphism multivariate rna mrna objectives to background little

Information and participation in decision-making about treatment: a qualitative study of the perceptions and preferences of patients with rheumatoid arthritis.

study patients treatments decision making participation perceptions medizin preferences rheumatoid arthritis qualitative objectives to

Play Episode Listen Later Jan 1, 2008

Objectives: To elicit the perceptions and preferences of patients with rheumatoid arthritis regarding information and participation in treatment decision-making. To analyse the patients’ narratives on the background of the ethical discourse on various approaches to treatment decisionmaking. Design: In-depth interviews with themes identified using principles of grounded theory. Participants: 22 patients with long-standing rheumatoid arthritis. Main outcome measures: Qualitative data on patients’ perceptions and preferences regarding information and participation in decision-making about treatment. Results: Decision-making about treatment has been described by the patients as a process consisting of different stages with shifting loci of control and responsibility. Patients initially received one treatment recommendation and were not aware of alternative treatment options. Those participants in this study who wanted information about negative effects of a treatment cited ‘‘interest in one’s own health’’ and the potential ‘‘use of information’’ as reasons for their preference. The physicians’ expert knowledge and clinical experience regarding the effects of medication were cited as arguments by patients for a treatment recommendation. Conclusions: The patients’ accounts of decision-making about treatment differ from models of physician–patient relationship that have been put forward in ethical discourse. These differences may be relevant with respect to the starting point of an ethical analysis of treatment decision-making. Patients’ accounts with respect to a lack of information on treatment alternatives point to ethically relevant challenges regarding treatment decision-making in clinical practice.

Clinical and functional characterisation of a novel TNFRSF1A c.605T > A/V173D cleavage site mutation associated with tumour necrosis factor receptor-associated periodic fever syndrome (TRAPS), cardiovascular complications and excellent response to etan

Play Episode Listen Later Jan 1, 2008

Objectives: To study the clinical outcome, treatment response, T-cell subsets and functional consequences of a novel tumour necrosis factor (TNF) receptor type 1 (TNFRSF1A) mutation affecting the receptor cleavage site. Methods: Patients with symptoms suggestive of tumour necrosis factor receptor-associated periodic syndrome (TRAPS) and 22 healthy controls (HC) were screened for mutations in the TNFRSF1A gene. Soluble TNFRSF1A and inflammatory cytokines were measured by ELISAs. TNFRSF1A shedding was examined by stimulation of peripheral blood mononuclear cells (PBMCs) with phorbol 12-myristate 13-acetate followed by flow cytometric analysis (FACS). Apoptosis of PBMCs was studied by stimulation with TNFa in the presence of cycloheximide and annexin V staining. T cell phenotypes were monitored by FACS. Results: TNFRSF1A sequencing disclosed a novel V173D/ p.Val202Asp substitution encoded by exon 6 in one family, the c.194–14G.A splice variant in another and the R92Q/p.Arg121Gln substitution in two families. Cardiovascular complications (lethal heart attack and peripheral arterial thrombosis) developed in two V173D patients. Subsequent etanercept treatment of the V173D carriers was highly effective over an 18-month follow-up period. Serum TNFRSF1A levels did not differ between TRAPS patients and HC, while TNFRSF1A cleavage from monocytes was significantly reduced in V173D and R92Q patients. TNFa-induced apoptosis of PBMCs and T-cell senescence were comparable between V173D patients and HC. Conclusions: The TNFRSF1A V173D cleavage site mutation may be associated with an increased risk for cardiovascular complications and shows a strong response to etanercept. T-cell senescence does not seem to have a pathogenetic role in affected patients.

Reliability of the ICF core set for rheumatoid arthritis

Play Episode Listen Later Jan 1, 2007

Background: The comprehensive ICF Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the International Classification of Functioning, Disability and Health (ICF), representing relevant aspects in the functioning of RA patients. Objectives: To study the reliability of the ICF Core Set for RA in rheumatological practice, and to explore the metric of the qualifiers’ scale. Methods: 25 RA patients from an outpatient department of rheumatology were interviewed using the ICF Core Set for RA (76% females, mean (SD) age 57.5 (12.5) years, disease duration 15.9 (14.6) years). Interviews were performed independently by both a physiotherapist and an occupational therapist on the same day and again after one week by one of them. The severity of the patients’ problems was quantified on a qualifier scale ranging from 0 (no problem) to 4 (complete problem). Analyses of intra-rater and inter-rater agreement, kappa statistics, and Rasch analyses were applied. Results: Mean intra-rater (inter-rater) complete agreement for all categories was seen in 59% (47%) of observations, ranging from 29% (0%) to 96% (80%) for individual categories. Weighted kappa statistics with value >0.4 showed reliability in 86% of categories within raters, and in 43% of categories between raters. Improved inter-rater and intra-rater reliability was observed with a reduced number of qualifiers for the categories. Conclusions: Inter-rater and intra-rater reliability of the ICF Core Set of RA was low to moderate. The metric of the qualifiers’ scale may be improved by reducing the number of qualifiers to three for all components.

interview ra disability methods improved sd medizin reliability functioning rheumatoid arthritis analyses weighted rasch results mean international classification objectives to health icf icf core set

Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohort of young children

Play Episode Listen Later Jan 1, 2007

Objectives: To estimate long-term exposure to traffic-related air pollutants on an individual basis and to assess adverse health effects using a combination of air pollution measurement data, data from geographical information systems (GIS) and questionnaire data.Methods: 40 measurement sites in the city of Munich, Germany were selected at which to collect particulate matter with a 50% cut-off aerodynamic diameter of 2.5 µm (PM2.5) and to measure PM2.5 absorbance and nitrogen dioxide (NO2). A pool of GIS variables (information about street length, household and population density and land use) was collected for the Munich metropolitan area and was used in multiple linear regression models to predict traffic-related air pollutants. These models were also applied to the birth addresses of two birth cohorts (German Infant Nutritional Intervention Study (GINI) and Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany (LISA)) in the Munich metropolitan area. Associations between air pollution concentrations at birth address and 1-year and 2-year incidences of respiratory symptoms were analysed.Results: The following means for the estimated exposures to PM2.5, PM2.5 absorbance and NO2 were obtained: 12.8 textgreekmg/m3, 1.7×10-5 m-1 and 35.3 textgreekmg/m3, respectively. Adjusted odds ratios (ORs) for wheezing, cough without infection, dry cough at night, bronchial asthma, bronchitis and respiratory infections indicated positive associations with traffic-related air pollutants. After controlling for individual confounders, significant associations were found between the pollutant PM2.5 and sneezing, runny/stuffed nose during the first year of life (OR 1.16, 95% confidence interval 1.01 to 1.34) Similar effects were observed for the second year of life. These findings are similar to those from our previous analysis that were restricted to a subcohort in Munich city. The extended study also showed significant effects for sneezing, running/stuffed nose. Additionally, significant associations were found between NO2 and dry cough at night (or bronchitis) during the first year of life. The variable ``living close to major roads'' (

The delay of contrast arrival in magnetic resonance first-pass perfusion imaging: a novel non-invasive parameter detecting collateral-dependent myocardium

Play Episode Listen Later Jan 1, 2007

Objectives: To establish the regional delay of contrast arrival in magnetic resonance perfusion imaging (MRPI) for the detection of collateral-dependent myocardium in patients with coronary artery disease. Design and Setting: observational study, case series; single center, university hospital. Patients: 30 patients with coronary artery disease and collateral-dependent myocardium and 17 healthy volunteers. Methods: Resting and hyperemic (adenosine) MRPI was used to determine delay time (Δtd) of contrast arrival between the left ventricle and collateral-dependent or antegradely-perfused myocardium, and myocardial perfusion (MP, ml/g/min). Results: In healthy volunteers Δtd at rest and during hyperemia were 0.8±0.4 and 0.3±0.3 sec., and MP was 1.14±0.21 and 4.23±1.12 ml/min/g. Δtd in antegradely-perfused vs. collateraldependent myocardium was 0.9±0.7 vs. 1.7±1.0 sec. at rest (p

design pass patients arrival delay mp contrast medizin roc dependent imaging invasive detecting collateral parameter auc perfusion magnetic resonance objectives to mrpi

Possible reasons for an increase in the proportion of genital ulcers due to herpes simplex virus from a cohort of female bar workers in Tanzania

Play Episode Listen Later Jan 1, 2007

Objectives: To determine trends in the prevalence and aetiological distribution of genital ulcer syndrome (GUS) in a cohort of female bar workers and to assess factors associated with these trends.Methods: An open cohort of 600 women at high risk of HIV and sexually transmitted infection (STI) was offered screening and treatment for STI at 3-month intervals. The prevalence of GUS and associated aetiological agents (Herpes simplex virus (HSV), Treponema pallidum and Haemophilus ducreyi) were monitored over 27 months through clinical examination, dry lesion swabbing and multiplex polymerase chain reaction. The effects of HIV status and other factors on the prevalence trends of STI were assessed.Results: A total of 753 women were recruited into the cohort over 10 examination rounds. At recruitment, the seroprevalence was 67% for HIV and 89% for HSV type 2 (HSV-2). During follow-up, 57% of ulcers had unknown aetiology, 37% were due to genital herpes and 6% to bacterial aetiologies, which disappeared completely in later rounds. The absolute prevalence of genital herpes remained stable at around 2%. The proportion of GUS caused by HSV increased from 22% to 58%, whereas bacterial causes declined. These trends were observed in both HIV-negative and HIV-positive women.Conclusions: The changes observed in the frequency and proportional distribution of GUS aetiologies suggest that regular STI screening and treatment over an extended period can effectively reduce bacterial STI and should therefore be sustained. However, in populations with a high prevalence of HSV-2, there remains a considerable burden of genital herpes, which soon becomes the predominant cause of GUS. Given the observed associations between genital herpes and HIV transmission, high priority should be given to the evaluation of potential interventions to control HSV-2 either through a vaccine or through episodic or suppressive antiviral therapy and primary prevention.

female workers hiv tanzania medizin herpes sti cohorts genitals hsv ulcers proportion herpes simplex virus haemophilus treponema objectives to

Segmental stabilizing exercises and low back pain: What is the evidence?