Diabetes is associated with increased risk for in-hospital mortality in patients with COVID-19: a systematic review and meta-analysis comprising 18,506 patients

© 2020, Hellenic Endocrine Society. Purpose: Infectious diseases are more frequent and can be associated with worse outcomes in patients with diabetes. The aim of this study was to systematically review and conduct a meta-analysis of the available observational studies reporting the effect of diabetes on mortality among hospitalized patients with COVID-19. Methods: The Medline, Embase, Google Scholar, and medRxiv databases were reviewed for identification of eligible studies. A random effects model meta-analysis was used, and I2 was utilized to assess the heterogeneity. In-hospital mortality was defined as the endpoint. Sensitivity, subgroup, and meta-regression analyses were performed. Results: A total of 18,506 patients were included in this meta-analysis (3713 diabetics and 14,793 non-diabetics). Patients with diabetes were associated with a higher risk of death compared with patients without diabetes (OR 1.65; 95% CI 1.35–1.96; I2 77.4%). The heterogeneity was high. A study-level meta-regression analysis was performed for all the important covariates, and no significant interactions were found between the covariates and the outcome of mortality. Conclusion: This meta-analysis shows that that the likelihood of death seems to be higher in diabetic patients hospitalized with COVID-19 compared with non-diabetic patients. Further studies are needed to assess whether this association is independent or not, as well as to investigate the role of adequate glycemic control prior to infection with COVID-19

Management of venous thromboembolism in pregnancy

Venous thromboembolism (VTE) in pregnancy, consisting of deep venous thrombosis (DVT) and pulmonary embolism (PE), is a major factor of maternal mortality. Several patient-specific risk factors along with the physiologic changes of pregnancy promote a state of hypercoagulability in pregnant women. Detailed assessment of all pregnant women can establish a risk profile that would guide clinical decisions, and balance potential therapeutic benefits with side effects. Differentiating between physiologic changes of pregnancy and symptoms of VTE can be challenging and warrants meticulous clinical evaluation. Timely and accurate diagnosis of VTE with proper imaging is essential for its management, and systemic anticoagulation remains the cornerstone of VTE prevention and therapy. Furthermore, advanced invasive treatment options such as inferior vena cava filters and thrombectomy can be considered for complex cases. Importantly, the risk of systemic anticoagulation should be balanced against the risk of VTE-associated morbidity and mortality for mother and fetus, and an informed decision should be made. In this review, we present an up-to-date overview of VTE management in pregnancy and the postpartum period. Keywords: Anticoagulants; Deep venous thrombosis; Pregnancy; Pulmonary embolism; Venous thromboembolism

Revascularization approaches in patients with radiation-induced carotid stenosis: an updated systematic review and meta-analysis

Background: Ionizing radiation remains a well-known risk factor of carotid artery stenosis. The survival rates of head and neck cancer patients undergoing radiotherapy have risen owing to medical advancements in the field. As a consequence, the incidence of carotid artery stenosis in these high-risk patients has increased.Aims: In this study we sought to compare the outcomes of carotid endarterectomy (CEA) vs carotid artery stenting (CAS) for radiation-induced carotid artery stenosis.Methods: This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Eligible studies were identified through a comprehensive search of PubMed, Scopus and Cochrane Central until July 2020. A random-effects model meta-analysis was conducted, and odds ratios (ORs) were calculated. The I-square statistic was used to assess for heterogeneity.Results: Seven studies and 201 patients were included. Periprocedural stroke, myocardial infarction (MI), and death rates were similar between the two revascularization approaches. However, the risk for cranial nerve (CN) injury was higher in the CEA group (OR, 7.40; 95% CI, 1.58–34.59; I2 = 0%). Analysis revealed no significant difference in terms of long-term mortality (OR, 0.41; 95% CI, 0.14–1.16; I2 = 0%) and restenosis rates (OR, 0.69; 95% CI, 0.29–1.66; I2 = 0%) between CEA and CAS after a mean follow-up of 40.5 months.Conclusions: CAS and CEA appear to have a similar safety and efficacy profile in patients with radiation-induced carotid artery stenosis. Patients treated with CEA have a higher risk for periprocedural CN injuries. Future prospective studies are warranted to validate these results

Becoming invisible: The ethics and politics of imperceptibility

This speculative essay examines ‘invisible’ social identities and the processes by which they are manifested and occasionally sought. Using various literary and academic sources, and loosely informed by an unlikely combination of Stoic philosophy and post-structuralist politics, we argue that invisibility is conventionally viewed as undesirable or ‘suffered’ by individuals or groups that are disadvantaged or marginalised within society. Whilst appreciating this possibility, we argue that social invisibility can also be the result of strategies carefully conceived and consciously pursued. We suggest that forms of social invisibility can be acquired by ethically informed personal action as well as by politically informed collective action. In this context, invisibility can be seen as a strategy of escaping from institutionalised and organisational judgements and which presents a challenge to common notions of voice and identity

At What Stage of Neural Processing Does Cocaine Act to Boost Pursuit of Rewards?

Dopamine-containing neurons have been implicated in reward and decision making. One element of the supporting evidence is that cocaine, like other drugs that increase dopaminergic neurotransmission, powerfully potentiates reward seeking. We analyze this phenomenon from a novel perspective, introducing a new conceptual framework and new methodology for determining the stage(s) of neural processing at which drugs, lesions and physiological manipulations act to influence reward-seeking behavior. Cocaine strongly boosts the proclivity of rats to work for rewarding electrical brain stimulation. We show that the conventional conceptual framework and methods do not distinguish between three conflicting accounts of how the drug produces this effect: increased sensitivity of brain reward circuitry, increased gain, or decreased subjective reward costs. Sensitivity determines the stimulation strength required to produce a reward of a given intensity (a measure analogous to the KM of an enzyme) whereas gain determines the maximum intensity attainable (a measure analogous to the vmax of an enzyme-catalyzed reaction). To distinguish sensitivity changes from the other determinants, we measured and modeled reward seeking as a function of both stimulation strength and opportunity cost. The principal effect of cocaine was a two-fourfold increase in willingness to pay for the electrical reward, an effect consistent with increased gain or decreased subjective cost. This finding challenges the long-standing view that cocaine increases the sensitivity of brain reward circuitry. We discuss the implications of the results and the analytic approach for theories of how dopaminergic neurons and other diffuse modulatory brain systems contribute to reward pursuit, and we explore the implications of the conceptual framework for the study of natural rewards, drug reward, and mood

Integration operators for generating RDF/OWL-based user defined mediator views in a grid environment

Research and development activities relating to the grid have generally focused on applications where data is stored in files. However, many scientific and commercial applications are highly dependent on Information Servers (ISs) for storage and organization of their data. A data-information system that supports operations on multiple information servers in a grid environment is referred to as an interoperable grid system. Different perceptions by end-users of interoperable systems in a grid environment may lead to different reasons for integrating data. Even the same user might want to integrate the same distributed data in various ways to suit different needs, roles or tasks. Therefore multiple mediator views are needed to support this diversity. This paper describes our approach to supporting semantic interoperability in a heterogeneous multi-information server grid environment. It is based on using Integration Operators for generating multiple semantically rich RDF/OWL-based user defined mediator views above the grid participating ISs. These views support different perceptions of the distributed and heterogeneous data available. A set of grid services are developed for the implementation of the mediator views

Organizing solidarity initiatives : a socio-spatial conceptualization of resistance

This paper offers a spatial conceptualization of resistance by focusing on the practices through which solidarity initiatives constitute new resistance socio-spatialities. We discuss two solidarity initiatives in Greece, WCNA and Vio.Me.SI, and explore how they institute distinctive local and translocal organizational practices that make the production of new forms of resistance possible. In particular, we adopt a productive and transformative view of resistance. First, we identify three local practices of organizing solidarity initiatives, namely, the organization of general assembly meetings, the constitution of resistance laboratories and the (re)articulation of socio-spatial relations in local sites. Then, we turn to flows, movements and translocal social formations, and examine the role of solidarity mobilizations, the material and symbolic co-production of resources and members’ mobility in the production of resistance. We conclude that new resistance socio-spatialities become constitutive of a broader reconfiguration of political agencies, a creative process that challenges existing relations and invites alternative ways of working and organizing

Contribution à la réduction polarographique de composés azobenzéniques dans le méthanol en présence de chlorure d’hydrogène

Le but de ce travail est l’étude polarographique de la réduction de l’azobenzène et de ses p-dérivés en solution dans le inéthanol et en présence d’un acide fort du chlorure d’hydrogène.Aussi, examine-t-on l’influence des inhibiteurs sur les vagues polarographiques de ces composés.On a constaté que les substituants, qui agissent comme accepteurs d’électrons, permettent la réduction des composés azobenzéniques en produits hydrazoïques. Par contre, avec ceux qui agissent comme donneurs d’électrons, la réduction lion conduit partiellement ou totalement aux amines correspondantes

Indexing views to route queries in a PDMS

P2P computing gains increasing attention lately, since it provides the means for realizing computing systems that scale to very large numbers of participating peers, while ensuring high autonomy and fault-tolerance. Peer Data Management Systems (PDMS) have been proposed to support sophisticated facilities in exchanging, querying and integrating (semi-)structured data hosted by peers. In this paper, we are interested in routing graph queries in a very large PDMS, where peers advertise their local bases using fragments of community RDF/S schemes (i.e., views). We introduce an original encoding for these fragments, in order to efficiently check whether a peer view is subsumed by a query. We rely on this encoding to design an RDF/S view lookup service featuring a statefull and a stateless execution over a DHT-based P2P infrastructure. We finally evaluate experimentally our system to demonstrate its scalability for very large P2P networks and arbitrary RDF/S schema fragments, and to estimate the number of routing hops required by the two versions of our lookup servic