Global Prevalence of Bronchopulmonary Dysplasia in Very Low Birth Weight Neonates: A Systematic Review and Meta-Analysis

Importance: Large-scale estimates of bronchopulmonary dysplasia (BPD) are warranted for adequate prevention and treatment. However, systematic approaches to ascertain global rates of BPD are lacking. Objective: To conduct a systematic review and meta-analysis to assess the prevalence of BPD in very low birth weight (≤1,500 grams) or very low gestational age (\u3c32 \u3eweeks) neonates. Data sources: A search of MEDLINE from January 1990 until September 2019 using search terms related to BPD and prevalence was performed. Study selection: Randomized controlled trials and observational studies evaluating rates of BPD in very low birth weight or very low gestational age were eligible. Included studies defined BPD as positive pressure ventilation or oxygen requirement at 28 days (BPD28) or at 36 weeks postmenstrual age (BPD36). Data extraction and synthesis: Two reviewers independently conducted all stages of the review. Random-effects meta-analysis was used to calculate the pooled prevalence. Subgroup analyses included gestational age group, birth weight group, setting, study period, continent, and gross domestic product. Meta-regression was performed to identify the impact of significant variables on study effect. Main outcomes and measures: Prevalence of BPD defined as BPD28, BPD36, AnyBPD (BPD 28 or BPD 36), and by subgroups. Results: A total of 82 articles and 696,881 patients were included in this review. The pooled prevalence was 23% (95% CI, 17%-30%) for BPD28 (n=29 studies, 101,848 neonates), 21% (95% CI, 17%-24%) for BPD36 (n=56 studies, 584,448 neonates), and 19% (95% CI, 16%-22%) for any BPD (n=70 studies, 607,653 neonates). In subgroup meta-analyses, birth weight was the strongest driver of the pooled prevalence of BPD. Conclusions and relevance: This study provides a global estimation of BPD prevalence in very low birth weight/low gestation neonates

Anti-Angiogenic Therapy Induces Integrin-Linked Kinase 1 Up-Regulation in a Mouse Model of Glioblastoma

BACKGROUND: In order to improve our understanding of the molecular pathways that mediate tumor proliferation and angiogenesis, and to evaluate the biological response to anti-angiogenic therapy, we analyzed the changes in the protein profile of glioblastoma in response to treatment with recombinant human Platelet Factor 4-DLR mutated protein (PF4-DLR), an inhibitor of angiogenesis. METHODOLOGY/PRINCIPAL FINDINGS: U87-derived experimental glioblastomas were grown in the brain of xenografted nude mice, treated with PF4-DLR, and processed for proteomic analysis. More than fifty proteins were differentially expressed in response to PF4-DLR treatment. Among them, integrin-linked kinase 1 (ILK1) signaling pathway was first down-regulated but then up-regulated after treatment for prolonged period. The activity of PF4-DLR can be increased by simultaneously treating mice orthotopically implanted with glioblastomas, with ILK1-specific siRNA. As ILK1 is related to malignant progression and a poor prognosis in various types of tumors, we measured ILK1 expression in human glioblastomas, astrocytomas and oligodendrogliomas, and found that it varied widely; however, a high level of ILK1 expression was correlated to a poor prognosis. CONCLUSIONS/SIGNIFICANCE: Our results suggest that identifying the molecular pathways induced by anti-angiogenic therapies may help the development of combinatorial treatment strategies that increase the therapeutic efficacy of angiogenesis inhibitors by association with specific agents that disrupt signaling in tumor cells

A metaheuristic method for joint task scheduling and virtual machine placement in cloud data centers

The virtual machine (VM) allocation problem is one of the main issues in the cloud data centers. This article proposes a new metaheuristic method to optimize joint task scheduling and VM placement in the cloud data center called JTSVMP. The JTSVMP problem composed of two parts, namely task scheduling and VM placement, is carried out by using metaheuristic optimization algorithms (MOAs). The proposed method aims to schedule task into the VM which has the least execution cost within deadline constraint and then place the selected VM on most utilized physical host (PH) within capacity constraint. To evaluate the performance of the proposed method, we compare the performance of task scheduling algorithms only with others that integrate both task scheduling and VM placement using MOAs, namely the basic glowworm swarm optimization (GSO), moth-flame glowworm swarm optimization (MFGSO) and genetic algorithm (GA). Simulation results show that optimizing joint task scheduling and VM placement algorithm leads to better overall results in terms of minimizing execution cost, makespan and degree of imbalance and maximizing PHs resource utilization

Сверхлегкие генераторные модули для КВЧ-терапии

Разработаны миниатюрные генераторные модули для КВЧ-терапии, лег-ко фиксируемые в любом месте тела пациента. Могут быть использованы не только в медицине

Be on Target: Strategies of Targeting Alternative and Lectin Pathway Components in Complement-Mediated Diseases

The complement system has moved into the focus of drug development efforts in the last decade, since its inappropriate or uncontrolled activation has been recognized in many diseases. Some of them are primarily complement-mediated rare diseases, such as paroxysmal nocturnal hemoglobinuria, C3 glomerulonephritis, and atypical hemolytic uremic syndrome. Complement also plays a role in various multifactorial diseases that affect millions of people worldwide, such as ischemia reperfusion injury (myocardial infarction, stroke), age-related macular degeneration, and several neurodegenerative disorders. In this review, we summarize the potential advantages of targeting various complement proteins with special emphasis on the components of the lectin (LP) and the alternative pathways (AP). The serine proteases (MASP-1/2/3, factor D, factor B), which are responsible for the activation of the cascade, are straightforward targets of inhibition, but the pattern recognition molecules (mannose-binding lectin, other collectins, and ficolins), the regulatory components (factor H, factor I, properdin), and C3 are also subjects of drug development. Recent discoveries about cross-talks between the LP and AP offer new approaches for clinical intervention. Mannan-binding lectin-associated serine proteases (MASPs) are not just responsible for LP activation, but they are also indispensable for efficient AP activation. Activated MASP-3 has recently been shown to be the enzyme that continuously supplies factor D (FD) for the AP by cleaving pro-factor D (pro-FD). In this aspect, MASP-3 emerges as a novel feasible target for the regulation of AP activity. MASP-1 was shown to be required for AP activity on various surfaces, first of all on LPS of Gram-negative bacteria

Is it necessary to check outcomes to improve quality of care? The example of anemia management

International Conference on Survival is not Enough - Quality of Life in CKD -- MAR 07-08, 2007 -- Naples, ITALYWOS: 000269100100027PubMed ID: 18446749The aim of this study was to verify the importance of continuously monitoring the level of adherence to the anemia guideline recommendations in order to improve not only quality of care but also patient safety. Data presented in this investigation were gained through the FME database EuCliD (R) which contains the clinical data of over 24,000 prevalent patients under treatment at the time of the analysis in 344 dialysis centres in 15 countries. Patient data from 4 countries (United Kingdom, Turkey, Italy, Portugal) was used for this study. The parameter selected was anemia control. The level of hemoglobin (Hb) was considered as the quality indicator for anemia, the target being an Hb level > 11 g/dL, for UK centres the target was > 10 g/dL. All new patients commencing hemodialysis between October 2003 and September 30, 2004 with the previous follow-up of less than one month and without previous blood transfusion were considered. A total of 902 patients were enrolled. The study showed that 4 to 6% of the Italian, Portuguese and British patients treated in FME clinics received a blood transfusion during the first year of follow-up. This is consistent with reports by USRDS that only 3.3% of ESRD patients received at least 1 transfusion per quarter in 1992 after erythropoietin became available and was prescribed to 88% of patients. About 18% Turkish patients, required blood transfusions during the first year of follow-up on hemodialysis, which is more comparable with USRDS data reported in 1989, when 16% of patients needed at least 1 transfusion quarterly. In conclusion, the practice of blood transfusion for hemodialysis patients is still frequent especially in elderly patients.Italian Soc Nephrol, Int Federat Kidney Fdn, European Renal Nephrol, Campania Reg, Natl Comm Bioeth, Italian Govt, Council Minist, Branch Presidenc

Plasma spectroscopy analysis technique based on optimization algorithms and spectral synthesis for arc-welding quality assurance

A new plasma spectroscopy analysis technique based on the generation of synthetic spectra by means of optimization processes is presented in this paper. The technique has been developed for its application in arc-welding quality assurance. The new approach has been checked through several experimental tests, yielding results in reasonably good agreement with the ones offered by the traditional spectroscopic analysis technique

Respiratory Training Late After Fontan Intervention: Impact on Cardiorespiratory Performance

Fontan palliation allows patients with â\u80\u9csingle ventricleâ\u80\u9d circulation to reach adulthood with an acceptable quality of life, although exercise tolerance is significantly reduced. To assess whether controlled respiratory training (CRT) increases cardiorespiratory performance. 16 Adolescent Fontan patients (age 17. 5 ± 3.8 years) were enrolled. Patients were divided into CRT group (n = 10) and control group (C group, n = 6). Maximal cardiopulmonary test (CPT) was repeated at the end of CRT in the CRT group and after an average time of 3 months in the C group. In the CRT group a CPT endurance was also performed before and after CRT. In the CRT group there was a significant improvement in cardiovascular and respiratory response to exercise after CRT. Actually, after accounting for baseline values, the CRT group had decreased breathing respiratory reserve (â\u88\u92 15, 95% CI â\u88\u9222.3 to â\u88\u92 8.0, p = 0.001) and increased RR peak (+ 4.8, 95% CI 0.7â\u80\u938.9, p = 0.03), VE peak (+ 13.7, 95% CI 5.6â\u80\u9321.7, p = 0.004), VO2of predicted (+ 8.5, 95% CI 0.1â\u80\u9317.0, p = 0.05), VO2peak (+ 4.3, 95% CI 0.3 to 8.2, p = 0.04), and VO2workslope (+ 1.7, 95% CI 0.3â\u80\u933.1, p = 0.02) as compared to the control group. Moreover, exercise endurance time increased from 8.45 to 17.7 min (p = 0.01). CRT improves cardiorespiratory performance in post-Fontan patients leading to a better aerobic capacity