319 research outputs found

    Response to pulmonary arterial hypertension drug therapies in patients with pulmonary arterial hypertension and cardiovascular risk factors.

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    The age at diagnosis of pulmonary arterial hypertension (PAH) and the prevalence of cardiovascular (CV) risk factors are increasing. We sought to determine whether the response to drug therapy was influenced by CV risk factors in PAH patients. We studied consecutive incident PAH patients (n = 146) between January 1, 2008, and July 15, 2011. Patients were divided into two groups: the PAH-No CV group included patients with no CV risk factors (obesity, systemic hypertension, type 2 diabetes mellitus, permanent atrial fibrillation, mitral and/or aortic valve disease, and coronary artery disease), and the PAH-CV group included patients with at least one. The response to PAH treatment was analyzed in all the patients who received PAH drug therapy. The PAH-No CV group included 43 patients, and the PAH-CV group included 69 patients. Patients in the PAH-No CV group were younger than those in the PAH-CV group (P < 0.0001). In the PAH-No CV group, 16 patients (37%) improved on treatment and 27 (63%) did not improve, compared with 11 (16%) and 58 (84%) in the PAH-CV group, respectively (P = 0.027 after adjustment for age). There was no difference in survival at 30 months (P = 0.218). In conclusion, in addition to older age, CV risk factors may predict a reduced response to PAH drug therapy in patients with PAH

    Longest common substring made fully dynamic

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    Given two strings S and T, each of length at most n, the longest common substring (LCS) problem is to find a longest substring common to S and T. This is a classical problem in computer science with an O(n)-time solution. In the fully dynamic setting, edit operations are allowed in either of the two strings, and the problem is to find an LCS after each edit. We present the first solution to this problem requiring sublinear time in n per edit operation. In particular, we show how to find an LCS after each edit operation in Õ(n2/3) time, after Õ(n)-time and space preprocessing. 1 This line of research has been recently initiated in a somewhat restricted dynamic variant by Amir et al. [SPIRE 2017]. More specifically, they presented an Õ(n)-sized data structure that returns an LCS of the two strings after a single edit operation (that is reverted afterwards) in Õ(1) time. At CPM 2018, three papers (Abedin et al., Funakoshi et al., and Urabe et al.) studied analogously restricted dynamic variants of problems on strings. We show that the techniques we develop can be applied to obtain fully dynamic algorithms for all of these variants. The only previously known sublinear-time dynamic algorithms for problems on strings were for maintaining a dynamic collection of strings for comparison queries and for pattern matching, with the most recent advances made by Gawrychowski et al. [SODA 2018] and by Clifford et al. [STACS 2018]. As an intermediate problem we consider computing the solution for a string with a given set of k edits, which leads us, in particular, to answering internal queries on a string. The input to such a query is specified by a substring (or substrings) of a given string. Data structures for answering internal string queries that were proposed by Kociumaka et al. [SODA 2015] and by Gagie et al. [CCCG 2013] are used, along with new ones, based on ingredients such as the suffix tree, heavy-path decomposition, orthogonal range queries, difference covers, and string periodicity

    Probiotic microcarrier: a continuous folate producer

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    The recommended daily intake of folate (B-complex vitamin) for an adult varies between 200-400 ”g, being the intake of folate inefficient due its extremely unstable chemical forms. The aim of this work is the creation of model to folate in situ production using probiotics. However, three main issues need to be overcome: (a) probiotic bacteria should be protected towards the gastric medium (encapsulation); (b) microcarriers size should be smaller than 100 ”m, to avoid modifying food texture; and (c) microcarriers should adhere to gut epithelium in order to increase bacteria residence time. Lactococcus lactis cremoris was grown in milk (30ÂșC). Alginate-based microcarriers were produced and three layers were built using the layer-by-layer technique in that worder: poly-L-lysine; sodium alginate; chitosan. Confocal microscopy was used to confirm the consequent adhesion of the layers (poly-L-lysine/FITC; chitosan/rhodamine). After production the microcarriers where put into a 10 mL solution of KCl-HCl (pH 2 - 1 hour), at 100 rpm and then into a PBS solution (pH 7.2 - 3 hours) in order to mimic the passage through the gastrointestinal tract. The utilization of free bacteria (LLC) in milk showed an increase of folate content in 4.73 ”g/L after 6 h. The average size of the microcarriers from 21.01 ± 0.49 ”m to 39.84 ± 0.79 ”m when the pH increased from 2 to 7.2. The size averages obtained were smaller than 100 ”m and showed a swelling capacity (particles duplicate their size upon passing from pH 2 to pH 7.2), being confirmed by confocal microscopy images the correct adhesion of the different layers after this experiment and the stability of the microcarriers. Microcarriers produced through LbL showed great potential for encapsulation of probiotics, allowing their protection against harsh gastrointestinal conditions, predicting their use as a microcarrier for in situ folate production

    Clinical predictors of all‐cause mortality in patients presenting to specialist heart failure clinic with raised NT‐proBNP and no heart failure

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    Aims Clinical outcomes for patients suspected of having heart failure (HF) who do not meet the diagnostic criteria of any type of HF by echocardiography remain unknown. The aim of this study was to investigate the clinical predictors of all‐cause mortality in patients with suspected HF, a raised N‐terminal pro‐b‐type natriuretic peptide (NTproBNP) and who do not meet the diagnostic criteria of any type of HF by echocardiography. Methods and results Relevant data were taken from the S heffield HEA rt F ailure (SHEAF) registry (222349P4). The inclusion criteria were presence of symptoms raising suspicion of HF, NTproBNP > 400 pg/mL, and preserved left ventricular function. Exclusion criteria were any type of HF by echocardiography. The outcome was defined as all‐cause mortality. Cox proportional‐hazards regression model was used to investigate the association between the survival time of patients and clinical variables; 1031 patients were identified with NTproBNP > 400 pg/mL but who did not have echocardiographic evidence of HF. All‐cause mortality was 21.5% (222 deaths) over the mean follow‐up (FU) period of 6 ± 2 years. NTproBNP was similar in patients who were alive or dead (P = 0.96). However, age (HR 1, P 627 pg/mL, NYHA class predicted death (II, 19.6%; III, 27.4%; IV, 66.7%; P < 0.01). Conclusions Patients with no HF on echocardiography but raised NTproBNP suffer excess mortality particularly in the presence of certain clinical variables. Age, male gender, worsening CKD stage, presence of COPD, and dementia are independently associated with all‐cause mortality in these patients. An NTproBNP > 627 pg/mL coupled with NYHA class could identify patients at greatest risk of death
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