Outcomes and Cost Ef-fectiveness of a Respiratory Coordinated Care Program in Patients with Severe or Very Severe COPD

Abstract Multidisciplinary community coordinated care programs are widely adopted to optimise care of chronic disease patients, but there is a need for further evaluation in the setting of COPD. This observational study evaluated 147 patients with severe or very severe COPD who were enrolled in a multidisciplinary community respiratory coordinated care progra

Forgotten electrical accidents and the birth of shockproof X-ray systems

OBJECTIVES: To commemorate victims of electrical accidents that occurred in the first decades of radiology and relate these accidents to the evolution of the X-ray apparatus. METHODS: Digitised newspapers, scientific journals, books and reports of legal procedures were searched for electrical accidents involving X-ray systems. Information on the historical systems was retrieved from the scientific literature and brochures from manufacturers. RESULTS: We found 51 fatal and 62 non-fatal but serious electrical accidents. Most of them occurred between 1920 and 1940 and involved transformers that provided output currents well above the threshold for the induction of ventricular fibrillation. The accidents led to recommendations and regulations to improve safety for operators and patients, and spurred manufacturers to technical developments that culminated in fully electrically shockproof systems by 1935. CONCLUSIONS: Although largely forgotten, the development of the shockproof X-ray systems we take for granted today lasted about 4 decades and was associated with considerable human suffering. The complete solution of the problem is a success story of engineering realised by contributions from all parties involved. MAIN MESSAGES: • The development of electrically shockproof X-ray systems took about 4 decades (1895-1935). • Between 1896 and 1920 electrical shocks from X-ray systems were common, but their consequences limited. • After 1920, transformers killed by delivering currents above the ventricular fibrillation threshold. • Inductors, static generators and high-frequency coils were generally low-current systems and safe. • We found 51 fatal and 62 serious non-fatal electrical accidents, most occurring from 1920 to 1940

Defining the temporal evolution of gut dysbiosis and inflammatory responses leading to hepatocellular carcinoma in Mdr2 -/- mouse model.

BACKGROUND: Emerging evidence implicates the gut microbiome in liver inflammation and hepatocellular carcinoma (HCC) development. We aimed to characterize the temporal evolution of gut dysbiosis, in relation to the phenotype of systemic and hepatic inflammatory responses leading to HCC development. In the present study, Mdr2 -/- mice were used as a model of inflammation-based HCC. Gut microbiome composition and function, in addition to serum LPS, serum cytokines/chemokines and intrahepatic inflammatory genes were measured throughout the course of liver injury until HCC development. RESULTS: Early stages of liver injury, inflammation and cirrhosis, were characterized by dysbiosis. Microbiome functional pathways pertaining to gut barrier dysfunction were enriched during the initial phase of liver inflammation and cirrhosis, whilst those supporting lipopolysaccharide (LPS) biosynthesis increased as cirrhosis and HCC ensued. In parallel, serum LPS progressively increased during the course of liver injury, corresponding to a shift towards a systemic Th1/Th17 proinflammatory phenotype. Alongside, the intrahepatic inflammatory gene profile transitioned from a proinflammatory phenotype in the initial phases of liver injury to an immunosuppressed one in HCC. In established HCC, a switch in microbiome function from carbohydrate to amino acid metabolism occurred. CONCLUSION: In Mdr2 -/- mice, dysbiosis precedes HCC development, with temporal evolution of microbiome function to support gut barrier dysfunction, LPS biosynthesis, and redirection of energy source utilization. A corresponding shift in systemic and intrahepatic inflammatory responses occurred supporting HCC development. These findings support the notion that gut based therapeutic interventions could be beneficial early in the course of liver disease to halt HCC development

Roux-en-Y Gastric Bypass Increases Glycemic Variability and Time in Hypoglycemia in Patients With Obesity and Prediabetes or Type 2 Diabetes: A Prospective Cohort Study

OBJECTIVE: Roux-en-Y gastric bypass (RYGB) is an established treatment for type 2 diabetes and obesity. The study objective was to establish RYGB's effects on glycemic variability (GV) and hypoglycemia. RESEARCH DESIGN AND METHODS: This was a prospective observational study of 10 participants with obesity and prediabetes or type 2 diabetes who underwent RYGB. Patients were studied before RYGB (Pre) and 1 month, 1 year, and 2 years postsurgery with continuous glucose measurement (CGM). A mixed-meal test (MMT) was conducted at Pre, 1 month, and 1 year. RESULTS: After RYGB, mean CGM decreased (at 1 month, 1 year, and 2 years), and GV increased (at 1 year and 2 years). Five of the 10 participants had a percent time in range (%TIR) <3.0 mmol/L (54 mg/dL) greater than the international consensus target of 1% at 1 or 2 years. Peak glucagon-like peptide-1 (GLP-1) and glucagon area under the curve during MMT were positively and negatively associated, respectively, with contemporaneous %TIR <3.0 mmol/L. CONCLUSIONS: Patients undergoing RYGB are at risk for development of postbariatric hypoglycemia due to a combination of reduced mean glucose, increased GV, and increased GLP-1 response

The CLAS12 Forward Tagger

This document presents the technical layout and the performance of the CLAS12 Forward Tagger (FT). The FT, composed of an electromagnetic calorimeter based on PbWO4 crystals (FT-Cal), a scintillation hodoscope (FT-Hodo), and several layers of Micromegas trackers (FT-Trk), has been designed to detect electrons and photons scattered at polar angles from 2∘ to 5∘ and to meet the physics goals of the hadron spectroscopy program and other experiments running with the CLAS12 spectrometer in Hall B

Over elektrocutie in de vroege radiologie en de ontwikkeling van elektrisch veilige röntgentoestellen (About electrocution in early radiology and the development of electrically safe X-ray machines)

The development of electrically safe X-ray machines took about four decades, from 1895-1935. Between 1895 and 1920, electric shocks were common, but they rarely had serious consequences. This low risk was due to the small current that electrifying machines and Ruhmkorff inductors could supply. After 1920, transformers, which could supply currents above the induction threshold for ventricular fibrillation, were responsible for fatal accidents. We found information on 51 fatal and 62 serious electrical accidents, almost all of which occurred between 1920 and 1940

Apunts. Educació física i esports

Resumen tomado del autor. Contiene gráficas y tablas de datos y resultadosSe realiza un estudio del ritmo con la finalidad de validar una batería de pruebas de ritmo. Esta batería se ha aplicado a tres muestras que presentan diferentes tipos y niveles de experiencia respecto de la capacidad rítmica. Grupo 1: nula o escasa experiencia; grupo 2: profesores de música; grupo 3: gimnastas de gimnasia rítmica. Como conclusiones más destacables del estudio se expone que, en primer lugar, el 'tempo' de las pruebas condiciona el ajuste temporal. En segundo lugar, se constata que existen diferencias significativas entre el Grupo 2 -músicos- y el resto de los grupos en algunas pruebas rápidas (estructuras ternaria y cuaternaria), lentas (estructuras ternaria y cuaternaria) y muy lentas (todas las estructuras). En tercer lugar, se destaca que las pruebas de estructura simple presentan mejores resultados que las de estructura ternaria y éstas mejores resultados que las de estructura cuaternaria.CataluñaUniversitat de les Illes Balears. Redined Balears; Edifici Guillem Cifre de Colonya. Ctra. de Valldemossa, Km 7,5; 07122 Palma; +34971172792; +34971173190; [email protected]