The prevention and treatment of venous thromboembolism with LMWHs and new anticoagulants

As the risk factors for thrombosis are becoming better understood, so is the need for anticoagulation. The inherent difficulties with warfarin are such that a low-molecular-weight heparin (LMWH) is often the key therapeutic. However, there are several different species of LMWH available to the practitioner, which leads to the need for an objective guide. New agents are coming onto the marketplace, and these may supersede both warfarin and the heparins. The current report will review the biochemistry and pharmacology of different LWMHs and identify which are more suitable for the different presentations of venous thromboembolism. It will conclude with a brief synopsis of new agents which may supersede warfarin and heparin

Prevalence and determinants of anxiety and depression in end stage renal disease (ESRD). A comparison between ESRD patients with and without coexisting diabetes mellitus

Objective: To compare anxiety and/or depressive symptoms between patients with end-stage renal disease with and without comorbid diabetes and identify factors associated with symptoms of distress in this population. Methods: Data from two studies (conducted between 2010 and 2014) were pooled. A total of 526 patients on hemodialysis (68.8% with diabetes) completed the Hospital Anxiety and Depression Scale (HADS). Elevated symptoms were defined as HADS-Anxiety or HADS-Depression ≥ 8. Univariate and multivariate logistic regressions were used to estimate associations between diabetic status, and other socio-demographic and clinical factors with baseline clinical anxiety and depression. Results: A total of 233 (45.4%) reported elevated anxiety symptoms and 256 (49.9%) reported elevated depressive symptoms sufficient for caseness. Rates were not different between patients with and without diabetes. Risk for clinical depression was higher in patients who were single/unpartnered (OR = 1.828), Chinese vs. Malay (OR = 2.05), or had lower albumin levels (OR = 0.932). None of the parameters were associated with anxiety caseness. Conclusion: Sociocultural factors rather than comorbid burden may help identify patients at risk for depression. The high rates of anxiety and depression underlie the importance for monitoring and intervention in dialysis care

An Expected Average Run Length (EARL) Performance Comparison of the SSGR and EWMA Control Charts

The acceleration use of control charts in industrial processes has led to the effectiveness in their evaluation by quality practitioners. This is crucial, as it influences their decisions on the choice of which control charts to employ. This study aims to explore and compare the performance of the side sensitive group runs (SSGR) and exponentially weighted moving average (EWMA) control charts. In general, the average run length (ARL) characteristics were used to evaluate the performance of these control charts. The ARL, which considers the exact shift size in the process, is restricted in the case when the practitioner cannot identify the process shift size (unknown shift size). In this situation, the expected average run length (EARL) is an alternative performance criterion. Upon comparison of the findings obtained, the EWMA chart has superior performance when (δmin, δmax) = (0.1, 0.4). In contrast, the SSGR chart overtakes the EWMA chart when (δmin, δmax) = (0.5, 0.8) and (δmin, δmax) = (0.9, 1.2), except when the sample size n = 3 for (δmin, δmax) = (0.5, 0.8). For this particular combination, the EWMA chart performs slightly better than the SSGR chart. The outcome of this study is expected to contribute to practitioners in identifying suitable control charts in process monitoring and implementation

An Expected Average Run Length (EARL) Performance Comparison of the SSGR and EWMA Control Charts

The acceleration use of control charts in industrial processes has led to the effectiveness in their evaluation by quality practitioners. This is crucial, as it influences their decisions on the choice of which control charts to employ. This study aims to explore and compare the performance of the side sensitive group runs (SSGR) and exponentially weighted moving average (EWMA) control charts. In general, the average run length (ARL) characteristics were used to evaluate the performance of these control charts. The ARL, which considers the exact shift size in the process, is restricted in the case when the practitioner cannot identify the process shift size (unknown shift size). In this situation, the expected average run length (EARL) is an alternative performance criterion. Upon comparison of the findings obtained, the EWMA chart has superior performance when (δmin, δmax) = (0.1, 0.4). In contrast, the SSGR chart overtakes the EWMA chart when (δmin, δmax) = (0.5, 0.8) and (δmin, δmax) = (0.9, 1.2), except when the sample size n = 3 for (δmin, δmax) = (0.5, 0.8). For this particular combination, the EWMA chart performs slightly better than the SSGR chart. The outcome of this study is expected to contribute to practitioners in identifying suitable control charts in process monitoring and implementation

Laser beam filamentation in fractal aggregates

We investigate filamentation of a cw laser beam in soft matter such as colloidal suspensions and fractal gels. The process, driven by electrostriction, is strongly affected by material properties, which are taken into account via the static structure factor, and have impact on the statistics of the light filaments.Comment: 4 pages, 5 figures. Revised version with corrected figure 5. To be published in Phys. Rev. Let

Effect of different drying methods and solvent ratios on biological activities of Phyllanthus acidus extracts

The main purpose of this study was to evaluate the antioxidant and α-glucosidase inhibitory activities of Phyllanthus acidus. The P. acidus fruits were dried using three different methods, namely oven (OD), air (AD) and freeze (FD) dryings and extracted with ethanol at different ratios (50 and 100%). The proximate analysis and total phenolic content (TPC) as well as free radical scavenging and α-glucosidase inhibitory activities were determined. The proximate analysis of P. acidus fruit indicated that all the dried samples contained potential nutrient contents. The highest TPC value, α-glucosidase inhibitory and antioxidant activities were observed for 50% ethanolic extract from OD method with TPC value of 28.39 mg GAE/g dried extract, IC50 value of 12.394 μg/mL and 64.17% inhibition, respectively. The study revealed that phenolic compounds could be the main contributors to the antioxidant and α-glucosidase inhibitory activities based on the Pearson correlation coefficients with R values of 95.0 and 73.8%, respectively. The study could provide scientific evidence for some folk uses in the treatment of diseases related to the production of reactive oxygen species and oxidative stress

Potential role of doravirine for the treatment of HIV-1-infected persons with transmitted drug resistance

Background: Doravirine has a unique resistance profile but how this profile might increase its usefulness beyond first-line therapy in persons with susceptible viruses has not been well studied. We sought to determine scenarios in which doravirine would retain activity against isolates from ART-naïve persons with transmitted drug resistance (TDR) and to identify gaps in available doravirine susceptibility data. Methods: We analyzed published in vitro doravirine susceptibility data and applied the results to 42,535 RT sequences from ART-naïve persons published between 2017 and 2021. NNRTI drug resistance mutations (DRMs) were defined as those with a Stanford HIV Drug Resistance Database doravirine penalty score either alone or in combination with other mutations. Results: V106A, Y188L, F227C/L, M230L, and Y318F were associated with the greatest reductions in doravirine susceptibility. However, several NNRTI DRMs and DRM combinations lacking these canonical resistance mutations had > tenfold reduced susceptibility including G190E, one isolate with G190S, three isolates with L100I + K103N, one isolate with K103N + P225H, and isolates with L100I + K103N + V108I and K101E + Y181C + G190A. Of the 42,535 ART-naïve sequences, 3,374 (7.9%) contained a NNRTI DRM of which 2,788 (82.6%) contained 1 DRM (n = 33 distinct mutations), 426 (12.6%) contained 2 DRMs (79 distinct pairs of mutations), and 143 (4.2%) contained ≥ 3 DRMs (86 distinct mutation patterns). Among the 2,788 sequences with one DRM, 112 (4.0%) were associated with ≥ 3.0-fold reduced doravirine susceptibility while 2,625 (94.2%) were associated with < 3.0-fold reduced susceptibility. Data were not available for individual NNRTI DRMs in 51 sequences (1.8%). Among the 426 sequences with two NNRTI DRMs, 180 (42.3%) were associated with ≥ 3.0 fold reduced doravirine susceptibility while just 32 (7.5%) had < 3.0 fold reduced susceptibility. Data were not available for 214 (50.2%) sequences containing two NNRTI DRMs. Conclusions: First-line therapy containing doravirine plus two NRTIs is expected to be effective in treating most persons with TDR as more than 80% of TDR sequences had a single NNRTI DRM and as more than 90% with a single DRM were expected to be susceptible to doravirine. However, caution is required for the use of doravirine in persons with more than one NNRTI DRM even if none of the DRMs are canonical doravirine-resistance mutations. © 2023, The Author(s)