400 research outputs found
Damage Assessment Method of Reinforcement Concrete Building By Fuzzy Theory
As reinforcement concrete building is composition material which reinforcement bar and concrete work together, effect factors concerned with its damage are countlessly much and interrelationship between them is also very complex and indefiniteness. Until now many researches about the damage assessment of a building has been performed but the problem accounting correctly damage of the reinforcement concrete building by connecting several of damage factors has not yet been solved. In research a method accounting damage of reinforcement concrete building in the fuzzy integral way in consideration of fuzzy property existing in the damage assessment system of it has been newly suggested
EVALUATION OF TREATMENTS FOR CORONARY ARTERY DISEASE UTILIZING CONTEMPORARY STATISTICAL METHODS
Cardiovascular disease is the leading cause of mortality worldwide, and approximately half of all cardiovascular deaths are attributed specifically to coronary artery disease (CAD). Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) procedures play a prominent role in managing the heavy burden of CAD. The purpose of this dissertation was to evaluate revascularization treatment in patients with multivessel coronary disease. Specifically, predictors of long-term prognosis and factors related to selection of revascularization strategy were investigated in the BARI and BARI 2D cohorts, respectively.In BARI, treatment with CABG was associated with a significantly lower risk of sudden cardiac death, but did not impact any other causes of mortality. Moreover, protection conferred by CABG was observed in patients regardless of diabetes status. Following successful initial PCI in BARI, male gender, proximal LAD disease, and incomplete revascularization were associated with an increased risk of a first subsequent revascularization event but not latter events. Diabetes and extensive CAD, on the other hand, demonstrated an incremental impact on the number of repeat procedures over 10 years of follow-up.Among patients with diabetes and stable CAD in BARI 2D, angiographic features associated with the extent and location of coronary disease greatly influenced the decision to perform CABG over PCI. Geographic region, independent of patient characteristics, was also a driving factor in treatment selection, with a greater propensity to recommend PCI in the US. In all countries of origin, we observed substantial variation across individual clinical sites in this decision-making process. Results in the BARI cohort may have clinical implications on guiding initial revascularization strategy and underscore the importance of intensive management of atherosclerotic risk factors in order to limit disease progression. Our investigation of BARI 2D demonstrate the need for rigorous evaluation of optimal CAD treatment approaches in diabetic patients and factors that guide this decision-making process in current practice. Overall, these findings may be useful for devising long-term treatment strategies that address the chronic, progressive, and systemic nature of coronary disease, which will be of great public health importance as medical advances continue to extend the lives of individuals with CAD
Rational strategies for enhancing mAb binding to SARS-CoV-2 variants through CDR diversification and antibody-escape prediction
Since the emergence of SARS-CoV-2, dozens of variants of interest and half a dozen variants of concern (VOCs) have been documented by the World Health Organization. The emergence of these VOCs due to the continuous evolution of the virus is a major concern for COVID-19 therapeutic antibodies and vaccines because they are designed to target prototype/previous strains and lose effectiveness against new VOCs. Therefore, there is a need for time- and cost-effective strategies to estimate the immune escape and redirect therapeutic antibodies against newly emerging variants. Here, we computationally predicted the neutralization escape of the SARS-CoV-2 Delta and Omicron variants against the mutational space of RBD-mAbs interfaces. Leveraging knowledge of the existing RBD-mAb interfaces and mutational space, we fine-tuned and redirected CT-p59 (Regdanvimab) and Etesevimab against the escaped variants through complementarity-determining regions (CDRs) diversification. We identified antibodies against the Omicron lineage BA.1 and BA.2 and Delta variants with comparable or better binding affinities to that of prototype Spike. This suggests that CDRs diversification by hotspot grafting, given an existing insight into the Ag-Abs interface, is an exquisite strategy to redirect antibodies against preselected epitopes and combat the neutralization escape of emerging SARS-CoV-2 variants
Mitochondrial DNA Copy Number in Peripheral Blood Is Independently Associated with Visceral Fat Accumulation in Healthy Young Adults
Aims. Visceral obesity is associated with an increased risk of cardiometabolic diseases and it is important to identify the underlying mechanisms. There is growing evidence that mitochondrial dysfunction is associated with metabolic disturbances related to visceral obesity. In addition, maintaining mitochondrial DNA (mtDNA) copy number is important for preserving mitochondrial function. Therefore, we investigated the relationship between mtDNA copy number and visceral fat in healthy young adults. Methods. A total of 94 healthy young subjects were studied. Biomarkers of metabolic risk factors were assessed along with body composition by computed tomography. mtDNA copy number was measured in peripheral leukocytes using real-time polymerase chain reaction (PCR) methods. Results. The mtDNA copy number correlated with BMI (r=-0.22, P=0.04), waist circumference (r=-0.23, P=0.03), visceral fat area (r=-0.28, P=-0.01), HDL-cholesterol levels (r=0.25, P=0.02), and hs-CRP (r=0.32, P=0.02) after adjusting for age and sex. Both stepwise and nonstepwise multiple regression analyses confirmed that visceral fat area was independently associated with mtDNA copy number (β=-0.33, P<0.01, β=0.32, and P=0.03, resp.). Conclusions. An independent association between mtDNA content and visceral adiposity was identified. These data suggest that mtDNA copy number is a potential predictive marker for metabolic disturbances. Further studies are required to understand the causality and clinical significance of our findings
Physician Compliance with Nutrition Support Team Recommendations: Effects on the Outcome of Treatment for Critically Ill Patients
Purpose Attending physicians in Korea are aware of the existence of the Nutrition Support Team (NST), but even when the NST are consulted, compliance with their recommendations may be low. This study was performed to identify physicians’ compliance with the NST advice and how this affected the outcome of treatment for critically ill patients. Methods This study was a retrospective observational study. Critically ill patients who were older than 18 years, younger than 90 years, and had been admitted and managed in the intensive care unit were selected for this study. Patients were assigned to either the compliance group or the non-compliance group according to physician compliance with the NST advice. Each group were compared using variables such as calorie supply, protein supply, laboratory findings, hospital stay, 30-day mortality, and survival rate. Results The compliance group (81% of cases) was supplied with a significantly higher energy (1,146.36 ± 473.45 kcal vs. 832.45 ± 364.28 kcal, p < 0.01) and a significantly higher protein (55.00 ± 22.30 g/day vs. 42.98 ± 24.46 g/day, p = 0.04) compared with the non-compliance group. There was no significant difference in the basic demographics between groups, although the compliance group had a better outcome in the 30-day mortality rate (8% vs. 26%, p = 0.02), and in survival beyond 1 year (Crude model, hazard ratio: 2.42, CI: 1.11–5.29). Conclusion Critically ill patients whose attending physician complied with the NST advice, received an increased energy intake and supply of protein which was positively associated with survival
Effect of additive calcium administration on FGF23 levels in patients with mild chronic kidney disease treated with calcitriol: a randomized, open-labeled clinical trial
Impact of Pneumocystis jirovecii pneumonia on kidney transplant outcome
Backgrounds
Pneumocystis jirovecii pneumonia (PCP) remains an important cause of morbidity and mortality in kidney transplant recipients. While the acute phase toxicity in patients with PCP is well-characterized, there is a lack of data on the effects of PCP on long-term graft outcome.
Method
This retrospective observational study analyzed 1502 adult patients who underwent kidney transplantation at Seoul National University Hospital between 2000 and 2017. After a propensity score matching was performed, the graft and survival outcomes were compared between PCP-negative and PCP-positive groups.
Results
A total of 68 patients (4.5%) developed PCP after transplantation. The multivariable Cox analysis showed that positivity for cytomegalovirus and lack of initial oral antibiotic prophylaxis were risk factors of post-transplant PCP. The PCP-positive group had higher hazard ratios of graft failure [adjusted hazard ratio (HR), 3.1 (1.14–8.26); P = 0.027] and mortality [adjusted HR, 11.0 (3.68–32.80); P < 0.001] than the PCP-negative group. However, the PCP event was not related with subsequent development of de novo donor-specific antibodies or pathologic findings, such as T-cell or antibody mediated rejection and interstitial fibrosis and tubular atrophy.
Conclusions
PCP is a risk factor of long-term graft failure and mortality, irrespective of rejection. Accordingly, appropriate prophylaxis and treatment is needed to avoid adverse transplant outcomes of PCP.This study was supported by the Young Investigator Research Grant from the Korean Society Nephrology (Kyowa Hakko Kirin 2017) and a grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF), which is funded by the Ministry of Education (NRF-2017R1D1A1B03031642). The grants had neither role in the study design, nor in data collection, analysis, interpretation and nor in manuscript writing
- …