Platelet-rich plasma for regeneration of neural feedback pathways around dental implants: a concise review and outlook on future possibilities

published_or_final_versio

Cardiovascular control and stabilization via inclination and mobilization during bed rest

Cardiovascular deconditioning has long been recognized as a characteristic of the physiological adaptation to long-term bed rest in patients. The process is thought to contribute to orthostatic intolerance and enhance secondary complications in a significant way. Mobilization is a cost-effective and simple method to maintain the cardiovascular parameters (i.e., blood pressure, heart rate) stable, counter orthostatic intolerance and reduce the risk of secondary problems in patients during long-term immobilization. The aim of this project is to control the cardiovascular parameters such as heart rate and blood pressure of bed rest patients via automated leg mobilization and body tilting. In a first step, a nonlinear model predictive control strategy was designed and evaluated on five healthy subjects and 11 bed rest patients. In a next step, a clinically feasible study was conducted on two patients. The mean values differed on average less than 1 bpm from the predetermined heart rate and less than 2.5 mmHg from the desired blood pressure values. These results of the feasibility study are promising, although heterogeneous disease etiologies and individual medication strongly influence the mechanically induced reactions. The long-term goal is an automation of the control of physiological signals and the mobilization of bed rest patients in an early phase of the rehabilitation process. Therefore, this new approach could help to strengthen the cardiovascular system and prevent secondary health problems arising from long-term bed rest

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Improved access to information for development

DraftThe project was implemented using a participatory action research methodology. Farmers’ access to information was achieved through establishment of two telecentres and six village information centres (VICEs). Telecentres were each equipped with computer, printer, photocopier, and telephone. In addition, the district level telecentre could access the Internet. Village information centres were equipped with solar charged telephone sets and a library of information. The project developed an effective strategy for service providers to respond to farmers’ information needs with a sustainable system of demand-driven information delivery between farmers and information providers

Determinants of farm-level adoption of water systems innovations in dryland areas: The case of Makanya watershed in Pangani river basin, Tanzania

Water system innovations such as rainwater harvesting involve abstraction of water in the upper catchments. Increasing adoption of rainwater harvesting in the riparian catchments could have hydrological impacts on downstream flows in the river basin, but it is assumed to have overall gains and synergies when efficient use of rainwater is optimized at farm-level. This paper examines the main determinants of adoption of water system innovations with specific emphasis on the intensity of adoption and adoption lag, using a cross-sectional sample of 234 farmers in the Makanya watershed. Censored Tobit models were used to estimate the coefficients of intensity of adoption and adoption lag of water system innovations. Group networking, years spent in formal education, age of respondent, location and agricultural information pathways were found to be major determinants of intensity of adoption at farm-level. It was also found that intensity of adoption and frequency of attendance to collective action are strong determinants of adoption lag of water system innovation in Makanya watershed. Empirical knowledge of the determinants of adoption of water system innovations is critical for an effective scaling out of best practices of water harvesting in the Basin

Age specific prevalence of impairment and disability relating to hemiplegic stroke in the Hai District of northern Tanzania

OBJECTIVES—To determine the age specific prevalence of impairment and disability relating to hemiplegic stroke in one rural area of Tanzania.
METHODS—During the yearly house to house census of the study population of 148 135 (85 152 aged 15 and over) in August 1994, specific questions were asked to identify those who might be disabled from stroke. People thus identified were subsequently interviewed and examined by one investigator. In those in whom the clinical diagnosis of stroke was confirmed a more detailed interview and examination relating to risk factors and recovery was carried out.
RESULTS—One hundred and eight patients, 61 men and 47 women, were identified with a median age of 70 (range 18-100). Median age at first stroke was 65 years. The age specific rates in this study were lower than previous studies in developed countries. All were cared for at home although 23 (21%) were bedbound.
CONCLUSIONS—Although prevalence of impairment and disability related to stroke in this population as a whole was low this is mainly explained by the age structure, with less than 6% being aged 65 and over. Age standardised rates for stroke with residual disability were about half those found in previous studies in developed countries. Death from stroke in Africa may be higher but data are limited. With the demographic transition stroke is likely to become a more important cause of disability in sub-Saharan Africa.