Survival after acute hemodialysis in Pennsylvania, 2005-2007: A retrospective cohort study

Background: Little is known about acute hemodialysis in the US. Here we describe predictors of receipt of acute hemodialysis in one state and estimate the marginal impact of acute hemodialysis on survival after accounting for confounding due to illness severity. Materials and Methods: This is a retrospective cohort study of acute-care hospitalizations in Pennsylvania from October 2005 to December 2007 using data from the Pennsylvania Health Care Cost Containment Council. Exposure variable is acute hemodialysis; dependent variable is survival following acute hemodialysis. We used multivariable logistic regression to determine propensity to receive acute hemodialysis and then, for a Cox proportional hazards model, matched acute hemodialysis and non-acute hemodialysis patients 1:5 on this propensity. Results: In 2,131,248 admissions of adults without end-stage renal disease, there were 6,657 instances of acute hemodialysis. In analyses adjusted for predicted probability of death upon admission plus other covariates and stratified on age, being male, black, and insured were independent predictors of receipt of acute hemodialysis. One-year post-admission mortality was 43% for those receiving acute hemodialysis, compared to 13% among those not receiving acute hemodialysis. After matching on propensity to receive acute hemodialysis and adjusting for predicted probability of death upon admission, patients who received acute hemodialysis had a higher risk of death than patients who did not over at least 1 year of follow-up (hazard ratio 1.82, 95% confidence interval 1.68-1.97). Conclusions: In a populous US state, receipt of acute hemodialysis varied by age, sex, race, and insurance status even after adjustment for illness severity. In a comparison of patients with similar propensity to receive acute hemodialysis, those who did receive it were less likely to survive than those who did not. These findings raise questions about reasons for lack of benefit. © 2014 Ramer et al

Reduction in Hepatic Apoptosis Modulated by Garlic Derived S-Allylmercaptocysteine (SAMC) in Non-Alcoholic Fatty Liver Disease Rat Model Through P53-Dependent Pathways

Poster PresentationPurpose Previous study demonstrated that administration of garlic-derived antioxidant S-allylmercaptocysteine (SAMC) ameliorated hepatic injury in a non-alcoholic fatty liver disease (NAFLD) rat model. In the present study, we investigated the effect and mechanism of SAMC on NAFLD-induced cellular apoptosis in the liver. Methods Adult Sprague-Dawley female rats were fed with a diet comprising of highly unsaturated fat diet (30% fish oil) for 8 weeks to develop NAFLD with or without intraperitoneal injection of 200 mg/kg SAMC three times per week. After chemical euthanasia, liver samples were collected for histological, biochemical and molecular analyses. Results During NAFLD development, increased apoptotic cells were observed in the liver. Hepatic apoptosis was accompanied by activated intrinsic apoptotic pathway as shown by expressional changes of cytochrome c and Bcl-2 family genes. Extrinsic apoptotic pathway was also activated as shown by expressional changes of Fas, TRAIL, FADD and cleaved caspase-8. Increased activity of caspase-3 further confirmed the activation of apoptosis. In addition, reduced activity of LKB1/AMPK and PI3K/Akt pathways could be observed with increased expression of pro-apoptotic regulator p53 in NAFLD rats. Administration of SAMC reduced the number of apoptotic cells through down-regulation of both intrinsic and extrinsic apoptotic mechanisms. Phosphorylation status of LKB1, AMPK, PI3K, and Akt were also restored by SAMC co-treatment, leading to the reduction of p53 expression. Conclusion Administration of SAMC during NAFLD development in rats protects liver from apoptosis through p53-dependent intrinsic and extrinsic apoptotic pathways.published_or_final_versio

Life expectancy at birth and all-cause mortality among people with personality disorder

Objective: It is well established that serious mental illness is associated with raised mortality, yet few studies have looked at the life expectancy of people with personality disorder (PD). This study aims to examine the life expectancy and relative mortality in people with PD within secondary mental health care. Methods: We set out to examine this using a large psychiatric case register in southeast London, UK. Mortality was obtained through national mortality tracing procedures. In a cohort of patients with a primary diagnosis of PD (n = 1836), standardised mortality ratios (SMRs) and life expectancies at birth were calculated, using general population mortality statistics as the comparator. Results: Life expectancy at birth was 63.3 years for women and 59.1 years for men with PD—18.7 years and 17.7 years shorter than females and males respectively in the general population in England and Wales. The SMR was 4.2 (95% CI: 3.03–5.64) overall; 5.0 (95% CI: 3.15–7.45) for females and 3.5 (95% CI: 2.17–5.47) for males. The highest SMRs were found in the younger age groups for both genders. Conclusion: People with PD using mental health services have a substantially reduced life expectancy, highlighting the significant public health burden of the disorder

Role of mitogen-activated protein kinase in Zn-BC-AM PDT-induced apoptosis in nasopharyngeal carcinoma cells

Photodynamic therapy (PDT) with a recently developed photosensitizer Zn-BC-AM was found to effectively induce apoptosis in a welldifferentiated nasopharyngeal carcinoma (NPC) HK-1 cell line. Sustained activation of p38 mitogen-activated protein kinase (MAPK) and cjun N-terminal kinase (JNK) as well as a transient increase in activation of extracellular signal-regulated kinase (ERK) were observed immediately after Zn-BC-AM PDT. A commonly used p38 MAPK/JNK pharmacological inhibitor PD169316 was found to reduce PDTinduced apoptosis of HK-1 cells. PD169316 also prevented the loss of Bcl-2 and Bcl-xL in PDT-treated HK-1 cells. However, inhibition of JNK with SP600125 had no effect on Zn-BC-AM PDT-induced apoptosis while inhibition of ERK with PD98059 or p38 MAPK with SB203580 significantly increased Zn-BC-AM PDT-induced apoptosis. Further study showed that knockdown of the p38b isoform with siRNA also increased Zn-BC-AM PDT-induced apoptosis, indicating that the anti-apoptotic effect of PD169316 in PDT-treated HK-1 cells was probably independent of p38 MAPK or JNK activation. Taken together, the results suggest that inhibition of p38b and ERK may enhance the therapeutic efficacy of Zn-BC-AM PDTon NPC cells. It should be noted that data only based on the use of PD169316 should be interpreted in caution. Copyright © 2010 John Wiley & Sons, Ltd.postprin

Garlic-derived S-allylmercaptocysteine ameliorates nonalcoholic fatty liver disease in a rat model through inhibition of apoptosis and enhancing autophagy

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POCS-based reconstruction of multiplexed sensitivity encoded MRI (POCSMUSE): A general algorithm for reducing motion-related artifacts.

PURPOSE: A projection onto convex sets reconstruction of multiplexed sensitivity encoded MRI (POCSMUSE) is developed to reduce motion-related artifacts, including respiration artifacts in abdominal imaging and aliasing artifacts in interleaved diffusion-weighted imaging. THEORY: Images with reduced artifacts are reconstructed with an iterative projection onto convex sets (POCS) procedure that uses the coil sensitivity profile as a constraint. This method can be applied to data obtained with different pulse sequences and k-space trajectories. In addition, various constraints can be incorporated to stabilize the reconstruction of ill-conditioned matrices. METHODS: The POCSMUSE technique was applied to abdominal fast spin-echo imaging data, and its effectiveness in respiratory-triggered scans was evaluated. The POCSMUSE method was also applied to reduce aliasing artifacts due to shot-to-shot phase variations in interleaved diffusion-weighted imaging data corresponding to different k-space trajectories and matrix condition numbers. RESULTS: Experimental results show that the POCSMUSE technique can effectively reduce motion-related artifacts in data obtained with different pulse sequences, k-space trajectories and contrasts. CONCLUSION: POCSMUSE is a general post-processing algorithm for reduction of motion-related artifacts. It is compatible with different pulse sequences, and can also be used to further reduce residual artifacts in data produced by existing motion artifact reduction methods

The Early Bird Catches The Term: Combining Twitter and News Data For Event Detection and Situational Awareness

Twitter updates now represent an enormous stream of information originating from a wide variety of formal and informal sources, much of which is relevant to real-world events. In this paper we adapt existing bio-surveillance algorithms to detect localised spikes in Twitter activity corresponding to real events with a high level of confidence. We then develop a methodology to automatically summarise these events, both by providing the tweets which fully describe the event and by linking to highly relevant news articles. We apply our methods to outbreaks of illness and events strongly affecting sentiment. In both case studies we are able to detect events verifiable by third party sources and produce high quality summaries

Ultra-processed food consumption and risk of obesity: a prospective cohort study of UK Biobank

Objective: To examine the associations between ultra-processed food consumption and risk of obesity among UK adults. Methods: Participants aged 40-69 years at recruitment in the UK Biobank (2006-2019) with dietary intakes collected using 24-hour recall and repeated measures of adiposity - body mass index (BMI), waist circumference (WC) and percentage of body fat (% BF) - were included (N=22,659; median follow-up: 5 years). Ultra-processed foods were identified using the NOVA classification and their consumption was expressed as a percentage of total energy intake. Multivariable Cox proportional hazards regression models were used to estimate hazard ratios (HR) of several indicators of obesity according to ultra-processed food consumption. Models were adjusted for sociodemographic and lifestyle characteristics. Results: 947 incident cases of overall obesity (BMI≥30 kg/m2) and 1,900 incident cases of abdominal obesity (men: WC≥102cm, women: WC≥88cm) were identified during follow-up. Participants in the highest quartile of ultra-processed food consumption had significantly higher risk of developing overall obesity (HR: 1.79; 95%CI: 1.06─3.03) and abdominal obesity (HR: 1.30; 95%CI: 1.14─1.48). They had higher risk of experiencing a ≥5% increase in BMI (HR: 1.31; 95%CI: 1.20─1.43), WC (HR: 1.35; 95%CI: 1.25─1.45) and %BF (HR: 1.14; 95%CI: 1.03─1.25), than those in the lowest quartile of consumption. Conclusions: Our findings provide evidence that higher consumption of ultra-processed food is strongly associated with a higher risk of multiple indicators of obesity in the UK adult population. Policy makers should consider actions that promote consumption of fresh or minimally processed foods and reduce consumption of ultra-processed foods

Chapter 6: Assessing Applicability of Medical Test Studies in Systematic Reviews

Use of medical tests should be guided by research evidence about the accuracy and utility of those tests in clinical care settings. Systematic reviews of the literature about medical tests must address applicability to real-world decision-making. Challenges for reviews include: (1) lack of clarity in key questions about the intended applicability of the review, (2) numerous studies in many populations and settings, (3) publications that provide too little information to assess applicability, (4) secular trends in prevalence and the spectrum of the condition for which the test is done, and (5) changes in the technology of the test itself. We describe principles for crafting reviews that meet these challenges and capture the key elements from the literature necessary to understand applicability

Deep level defect in Si-implanted GaN n +-p junction

The results of deep level transient spectroscopy (DLTS) experiments on GaN junctions, fabricated by silicon implantation, were discussed. An unusual appearance of a minority peak in the majority carrier DLTS spectra within the interfacial region of the junctions was observed. The presence of this minority peak suggested a high concentration of a deep level defect within the interfacial region.published_or_final_versio