Prescription patterns and appropriateness of NSAID therapy according to gastrointestinal risk and cardiovascular history in patients with diagnoses of osteoarthritis

<p>Abstract</p> <p>Background</p> <p>Prescription of non-steroidal anti-inflammatory drugs (NSAIDs) should be based on the assessment of both gastrointestinal (GI) and cardiovascular (CV) risk for the individual patient. We aimed to assess the GI/CV risk profile and the pharmacological management of patients with osteoarthritis (OA) in clinical practice.</p> <p>Methods</p> <p>We conducted a cross-sectional, multicentre, observational study of consecutive OA patients that visited 1,760 doctors throughout the Spanish National Health System (NHS) in a single day. The presence of GI risk factors, CV histories, hypertension and current pharmacological treatments was recorded.</p> <p>Results</p> <p>Of the 60,868 patients, 17,105 had a diagnosis of OA and were evaluable. The majority (93.4%) had more than one GI risk factor and 60.3% were defined to be at high-GI risk. Thirty-two percent had a history of CV events, 57.6% were treated with anti-hypertensive therapy and 22.6% had uncontrolled hypertension. One-fifth of patients were treated with non-NSAID therapies, whereas the remaining patients received NSAIDs. Non-selective NSAIDs (nsNSAID) plus proton pump inhibitor (PPI) or cyclooxigenase-2 (COX-2)-selective NSAIDs alone were more frequently prescribed in patients at increased GI risk. Patients with a positive CV history received nsNSAIDs or COX-2-selective NSAIDs in 41.3% and 31.7% of cases, respectively. When both the GI and CV histories were combined, 51% of the overall population was being prescribed drugs that were either not recommended or contraindicated.</p> <p>Conclusions</p> <p>Over 90% of patients with OA are at increased GI and/or CV risk. In over half of these patients, the prescription of NSAIDs was not in accordance with current guidelines or recommendations made by regulatory agencies.</p

White Paper for Research Beyond 5G

The documents considers both research in the scope of evolutions of the 5G systems (for the period around 2025) and some alternative/longer term views (with later outcomes, or leading to substantial different design choices). This document reflects on four main system areas: fundamental theory and technology, radio and spectrum management; system design; and alternative concepts. The result of this exercise can be broken in two different strands: one focused in the evolution of technologies that are already ongoing development for 5G systems, but that will remain research areas in the future (with “more challenging” requirements and specifications); the other, highlighting technologies that are not really considered for deployment today, or that will be essential for addressing problems that are currently non-existing, but will become apparent when 5G systems begin their widespread deployment

Deep Learning-aided Robust Integrated Sensing and Communications with OTFS and Superimposed Training

One of the most awaited services promised by the sixth generation (6G) of mobile communication technologies is integrated sensing and communications (ISAC), which will offer a wealth of new benefits and applications. One of the most widely used waveforms for this purpose is orthogonal time-frequency space (OTFS), which together with superimposed training (ST) allows communication and target localization in the delay-Doppler (DD) domain with zero overhead. The conventional technique uses a threshold for the possible detection of a target. However, the optimal choice of this threshold requires statistical analysis of the received signal and prior knowledge of the channel, which is initially unknown. To address this problem, this paper proposes a target detection technique based on deep learning (DL), which is able to assist in the detection of targets without the need of a prior computation of any statistical parameter. The proposed deep neural network (DNN) outperforms the conventional threshold decision method and approaches the ideal performance

Decreased metalloproteinase production as a response to mechanical pressure in human cartilage: a mechanism for homeostatic regulation

Articular cartilage is optimised for bearing mechanical loads. Chondrocytes are the only cells present in mature cartilage and are responsible for the synthesis and integrity of the extracellular matrix. Appropriate joint loads stimulate chondrocytes to maintain healthy cartilage with a concrete protein composition according to loading demands. In contrast, inappropriate loads alter the composition of cartilage, leading to osteoarthritis (OA). Matrix metalloproteinases (MMPs) are involved in degradation of cartilage matrix components and have been implicated in OA, but their role in loading response is unclear. With this study, we aimed to elucidate the role of MMP-1 and MMP-3 in cartilage composition in response to mechanical load and to analyse the differences in aggrecan and type II collagen content in articular cartilage from maximum- and minimum-weight-bearing regions of human healthy and OA hips. In parallel, we analyse the apoptosis of chondrocytes in maximal and minimal load areas. Because human femoral heads are subjected to different loads at defined sites, both areas were obtained from the same hip and subsequently evaluated for differences in aggrecan, type II collagen, MMP-1, and MMP-3 content (enzyme-linked immunosorbent assay) and gene expression (real-time polymerase chain reaction) and for chondrocyte apoptosis (flow cytometry, bcl-2 Western blot, and mitochondrial membrane potential analysis). The results showed that the load reduced the MMP-1 and MMP-3 synthesis (p < 0.05) in healthy but not in OA cartilage. No significant differences between pressure areas were found for aggrecan and type II collagen gene expression levels. However, a trend toward significance, in the aggrecan/collagen II ratio, was found for healthy hips (p = 0.057) upon comparison of pressure areas (loaded areas > non-loaded areas). Moreover, compared with normal cartilage, OA cartilage showed a 10- to 20-fold lower ratio of aggrecan to type II collagen, suggesting that the balance between the major structural proteins is crucial to the integrity and function of the tissue. Alternatively, no differences in apoptosis levels between loading areas were found – evidence that mechanical load regulates cartilage matrix composition but does not affect chondrocyte viability. The results suggest that MMPs play a key role in regulating the balance of structural proteins of the articular cartilage matrix according to local mechanical demands

Electrochemical and bioelectrocatalytical properties of novel block-copolymers containing interacting ferrocenyl units

The electrochemical characterization of three different polystyrene-b-polybutadiene block copolymers functionalized with ferrocenyl units electronically communicated, PSm-PBn(HSiMeFc2)p where m=615, n=53, p=39 (1), m=375, n=92, p=76 (2) and m=455, n=204, p=170 (3), has been carried out both in solution and electrochemically deposited onto platinum electrodes. The bioelectrocatalytical properties of electrodes modified with the polymers in the nicotinamide dinucleotide (NADH) and glucose oxidase (GOx) oxidations have been investigated as a function of the constitution and structure of the polymers. The analytical properties of electrodes modified with these polymers as sensors of NADH and GOx are described. In addition, an amperometric biosensor for glucose, prepared by electrostatic immobilization of glucose oxidase onto a platinum electrode modified with one of the ferrocenyl block copolymers as an example, has been developed. The results confirm that electrodes modified with the examined copolymers act as efficient redox mediators for the electrocatalytic oxidation of both reduced nicotinamide dinucleotide cofactor and glucose oxidase. The reaction with NADH proceeds via formation of a charge-transfer intermediate before yielding the reaction products. This is a novel example of electrodes modified with ferrocene derivatives that can be applied to the determination of NADH without the use of diaphorase. The redox copolymers co-immobilized with glucose-oxidase have been successfully used as amperometric biosensors for glucose determinations. As expected these compounds allow using lower working potentials. The sensitivities and detection limits obtained are comparable or even better than those of other ferrocene-modified polymers mediator electrodes

Reference Scenarios and Key Performance Indicators for 5G Ultra-dense Networks

The so-called 5G will revolutionize the way we live, and work. In order to demonstrate the profound changes, we can expect to experience within the next 5 to 10 years, we present use cases for the planned research within the TeamUp5G project. Some use cases are strongly linked to the network layer and aim at developing solutions capable of optimizing the main promising benefits of 5G: extremely low latency and extremely high bandwidth (e.g., handle video streams, traffic congestion, user profiles), in the most efficient way possible. Other use cases focus on commercial applications that make use of middleware applications to enhance their performance. The latter fall into two main areas: real-time virtual reality and live video streaming, which are extremely demanding in terms of latency and bandwidth to provide an acceptable QoE/QoS to multiple users. The use cases presented are built assuming that 5G is essential for their support with appropriate QoE/QoS. Key performance indicators and their range of variation are also identified.info:eu-repo/semantics/acceptedVersio