147 research outputs found
Field Notes: Bursting Their Bubble: How to Have Difficult Conversations with Your Staff
At the summer 2017 Florida Association of Collegiate Registrars and Admissions Officers (FACRAO) Regional Conference, the authors shared an interactive session entitled, “Bursting their Bubble: How to Say Difficult Things to your Staff,” in which they discussed the importance of proactively addressing workplace behaviors by sharing stories, experiences and insights
Field Notes: Visions, Missions, and Strategic Plans 101
This article revolves around the importance of strategic planning within academic offices and divisions, and how difficult it is to balance day to day work load with long-term strategic planning
5G-SMART D1.5 Evaluation of radio network deployment options
This deliverable results from the work on the radio network performance
analysis of the identified use cases and deployment options. Covered topics
include latency reduction and mobility features of the 5G NR itself, as well as
detailed analysis of the radio network KPIs, such as latency, reliability,
throughput, spectral efficiency and capacity. Corresponding trade-offs for the
identified deployment options and industrial use cases are quantified with an
extensive set of technical results. Also, this deliverable is looking into
co-channel coexistence performance analyzed through a real-life measurement
campaign and considers performance optimization in presence of a special
micro-exclusion zone within a factory.Comment: Deliverable D1.5 of the project 5G For Smart Manufacturing (5G-SMART
Impact of dapagliflozin on cardiac remodelling in patients with chronic heart failure: The DAPA-MODA study.
AIMS
Dapagliflozin improves the prognosis of patients with heart failure (HF), regardless of left ventricular ejection fraction (LVEF). However, its effect on cardiac remodelling parameters, specifically left atrial (LA) remodelling, is not well established.
METHODS AND RESULTS
The DAPA-MODA trial (NCT04707352) is a multicentre, single-arm, open-label, prospective and interventional study that aimed to evaluate the effect of dapagliflozin on cardiac remodelling parameters over 6 months. Patients with stable chronic HF receiving optimized guideline-directed therapy, except for any sodium-glucose cotransporter 2 inhibitor, were included. Echocardiography was performed at baseline, 30 and 180 days, and analysed by a central core-lab in a blinded manner to both patient and time. The primary endpoint was the change in maximal LA volume index (LAVI). A total of 162 patients (64.2% men, 70.5 ± 10.6 years, 52% LVEF >40%) were included in the study. At baseline, LA dilatation was observed (LAVI 48.1 ± 22.6 ml/m2 ) and LA parameters were similar between LVEF-based phenotypes (≤40% vs. >40%). LAVI showed a significant reduction at 180 days (-6.6% [95% confidence interval -11.1, -1.8], p = 0.008), primarily due to a decrease in reservoir volume (-13.8% [95% confidence interval -22.5, -4], p = 0.007). Left ventricular geometry improved with significant reductions in left ventricular mass index (-13.9% [95% confidence interval -18.7, -8.7], p < 0.001), end-diastolic volume (-8.0% [95% confidence interval -11.6, -4.2], p < 0.001) and end-systolic volume (-11.9% [95% confidence interval -16.7, -6.8], p < 0.001) at 180 days. N-terminal pro-B-type natriuretic peptide (NT-proBNP) showed a significant reduction at 180 days (-18.2% [95% confidence interval -27.1, -8.2], p < 0.001), without changes in filling Doppler measures.
CONCLUSION
Dapagliflozin administration in stable out-setting patients with chronic HF and optimized therapy results in global reverse remodelling of cardiac structure, including reductions in LA volumes and improvement in left ventricular geometry and NT-proBNP concentrations.This study has been sponsored by Sociedad Española de CardiologĂa
and has received funding by a non-conditional investigational grant from
AstraZeneca Farmacéutica Spain.S
Decreased Expression Of apM1 in Omental and Subcutaneous Adipose Tissue of Humans With Type 2 Diabetes
We have screened a subtracted cDNA library in
order to identify differentially expressed genes in
omental adipose tissue of human patients with
Type 2 diabetes. One clone (#1738) showed a marked
reduction in omental adipose tissue from patients
with Type 2 diabetes. Sequencing and BLAST analysis
revealed clone #1738 was the adipocyte-specific
secreted protein gene apM1 (synonyms ACRP30,
AdipoQ, GBP28). Consistent with the murine orthologue,
apM1 mRNA was expressed in cultured
human adipocytes and not in preadipocytes.
Using RT-PCR we confirmed that apM1 mRNA
levels were significantly reduced in omental adipose
tissue of obese patients with Type 2 diabetes compared
with lean and obese normoglycemic subjects.
Although less pronounced, apM1 mRNA levels
were reduced in subcutaneous adipose tissue of
Type 2 diabetic patients. Whereas the biological
function of apM1 is presently unknown, the tissue
specific expression, structural similarities to TNFα
and the dysregulated expression observed in obese
Type 2 diabetic patients suggest that this factor
may play a role in the pathogenesis of insulin resistance
and Type 2 diabetes
Is type II diabetes mellitus (NIDDM) a surgical disease?
Since February 1, 1980, 515 morbidly obese patients have undergone
the Greenville gastric bypass (GGB) operation. Of these,
212 (41.2%) were euglycemic, 288 (55.9%) were either diabetic
or had glucose intolerance, and 15 (2.9%) were unable to complete
the evaluation. After the operation, only 30 (5.8%) patients remained
diabetic (and 20 of these improved), 457 (88.7%) became
and have remained euglycemic, and inadequate data prevented
classification of the other 28 (5.4%). The patients who failed to
return to normal glucose values were older and their diabetes
was of longer duration than those who did. The effect of the
GGB was not only limited to the correction of abnormal glucose
levels. The GGB also corrected the abnormal levels of fasting
insulin and glycosylated hemoglobin in a cohort of 52 consecutive
severely obese patients with non-insulin-dependent diabetes. The
GGB effectively controls weight. If morbid obesity is defined as
100 pounds over ideal body weight, 89% of the patients are no
longer "morbidly" obese within 2 years. In most patients, the
control of the weight has been well maintained during the 11
years of follow-up; most of the upward creep in weight of 20.8%
between 24 and 132 months was from the 49 (9.5%) patients
who had staple line breakdowns between the large and small
gastric pouches. Non-insulin-dependent diabetes, previously
considered a chronic unrelenting disease, can be controlled in
the severely obese by the gastric bypass. Whether the correction
of glucose metabolism affects the complications of diabetes is
unknown. Whether the gastric bypass should be considered for
patients with advanced non-insulin-dependent diabetes but who
are not severely obese deserves consideration. The GGB has an
unacceptably high rate of staple line failure. Accordingly, the
authors have recently changed their procedure to one that divides
the stomach rather than partitions it with staples. Originally published Annals of Surgery, Vol. 215, No. 6, June 199
Differences in response to antiretroviral therapy in HIV-positive patients being treated for tuberculosis in Eastern Europe, Western Europe and Latin America.
BACKGROUND: Efavirenz-based antiretroviral therapy (ART) regimens are preferred for treatment of adult HIV-positive patients co-infected with tuberculosis (HIV/TB). Few studies have compared outcomes among HIV/TB patients treated with efavirenz or non-efavirenz containing regimens. METHODS: HIV-positive patients aged ≥16 years with a diagnosis of tuberculosis recruited to the TB:HIV study between Jan 1, 2011, and Dec 31, 2013 in 19 countries in Eastern Europe (EE), Western Europe (WE), and Latin America (LA) who received ART concomitantly with TB treatment were included. Patients either received efavirenz-containing ART starting between 15 days prior to, during, or within 90 days after starting tuberculosis treatment, (efavirenz group), or other ART regimens (non-efavirenz group). Patients who started ART more than 90 days after initiation of TB treatment, or who experienced ART interruption of more than 15 days during TB treatment were excluded. We describe rates and factors associated with death, virological suppression, and loss to follow up at 12 months using univariate, multivariate Cox, and marginal structural models to compare the two groups of patients. RESULTS: Of 965 patients (647 receiving efavirenz-containing ART, and 318 a non-efavirenz regimen) 50% were from EE, 28% from WE, and 22% from LA. Among those not receiving efavirenz-containing ART, regimens mainly contained a ritonavir-boosted protease inhibitor (57%), or raltegravir (22%). At 12 months 1.4% of patients in WE had died, compared to 20% in EE: rates of virological suppression ranged from 21% in EE to 61% in WE. After adjusting for potential confounders, rates of death (adjusted Hazard Ratio; aHR, 95%CI: 1.13, 0.72-1.78), virological suppression (aHR, 95%CI: 0.97, 0.76-1.22), and loss to follow up (aHR, 95%CI: 1.17, 0.81-1.67), were similar in patients treated with efavirenz and non-efavirenz containing ART regimens. CONCLUSION: In this large, prospective cohort, the response to ART varied significantly across geographical regions, whereas the ART regimen (efavirenz or non-efavirenz containing) did not impact on the proportion of patients who were virologically-suppressed, lost to follow up or dead at 12 months
Association of Candidate Gene Polymorphisms With Chronic Kidney Disease: Results of a Case-Control Analysis in the Nefrona Cohort
Chronic kidney disease (CKD) is a major risk factor for end-stage renal disease, cardiovascular disease and premature death. Despite classical clinical risk factors for CKD and some genetic risk factors have been identified, the residual risk observed in prediction models is still high. Therefore, new risk factors need to be identified in order to better predict the risk of CKD in the population. Here, we analyzed the genetic association of 79 SNPs of proteins associated with mineral metabolism disturbances with CKD in a cohort that includes 2, 445 CKD cases and 559 controls. Genotyping was performed with matrix assisted laser desorption ionizationtime of flight mass spectrometry. We used logistic regression models considering different genetic inheritance models to assess the association of the SNPs with the prevalence of CKD, adjusting for known risk factors. Eight SNPs (rs1126616, rs35068180, rs2238135, rs1800247, rs385564, rs4236, rs2248359, and rs1564858) were associated with CKD even after adjusting by sex, age and race. A model containing five of these SNPs (rs1126616, rs35068180, rs1800247, rs4236, and rs2248359), diabetes and hypertension showed better performance than models considering only clinical risk factors, significantly increasing the area under the curve of the model without polymorphisms. Furthermore, one of the SNPs (the rs2248359) showed an interaction with hypertension, being the risk genotype affecting only hypertensive patients. We conclude that 5 SNPs related to proteins implicated in mineral metabolism disturbances (Osteopontin, osteocalcin, matrix gla protein, matrix metalloprotease 3 and 24 hydroxylase) are associated to an increased risk of suffering CKD
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