927 research outputs found

    2010 Annual Evidence Update on Critical Illness Rehabilitation

    Get PDF
    For this annual evidence update a detailed literature review was undertaken to retrieve any evidence published subsequent to the literature search which formed the basis for the NICE guideline. A total of 29 articles were selected for review and appraisal by a team of critical care practitioners. In this context it has to be noted that the evidence base on the subject is still relatively small. For the original guideline only 12 articles were selected as evidence which addressed the review questions. This evidence update intends to give an indication of encouraging trends within critical illness rehabilitation

    A direct comparison, and prioritisation, of the antigens expressed in adult and paediatric acute myeloid leukaemia: a systematic review and meta-analysis

    Get PDF
    Acute myeloid leukaemia (AML) is characterized by impaired myeloid differentiation resulting in an accumulation of immature blasts in the bone marrow and peripheral blood. Although AML can occur at any age, the incidence peaks at age 65. The pathobiology of AML also varies with age with associated differences in incidence, as well as the frequency of cytogenetic change and somatic mutations. In addition, 5-year survival rates in paediatrics are 60–75% but fall to 5–15% in older AML patients. This systematic review aimed to determine whether the altered genes in AML affect the same molecular pathways, indifferent of patient age, and, therefore, whether patients could benefit from the repurposing drugs or the use of the same immunotherapeutic strategies across age boundaries to prevent relapse. Using a PICO framework and PRISMA-P checklist, relevant publications were identified using five literature databases and assessed against an inclusion criteria, leaving 36 articles, and 71 targets for therapy, for further analysis. QUADAS-2 was used to determine the risk of bias and perform a quality control step. We then priority-ranked the list of cancer antigens based on predefined and pre-weighted objective criteria as part of an analytical hierarchy process used for dealing with complex decisions. This organized the antigens according to their potential to act as targets for the immunotherapy of AML, a treatment that offers an opportunity to remove residual leukaemia cells at first remission and improve survival rates. It was found that 80% of the top 20 antigens identified in paediatric AML were also within the 20 highest scoring immunotherapy targets in adult AML. To analyse the relationships between the targets and their link to different molecular pathways, PANTHER and STRING analyses were performed on the 20 highest scoring immunotherapy targets for both adult and paediatric AML. There were many similarities in the PANTHER and STRING results, including the most prominent pathways being angiogenesis and inflammation mediated by chemokine and cytokine signalling pathways. The coincidence of targets suggests that the repurposing of immunotherapy drugs across age boundaries could benefit AML patients, especially when used in combination with conventional therapies. However, due to cost implications, we would recommend that efforts are focused on ways to target the highest scoring antigens, such as WT1, NRAS, IDH1 and TP53, although in the future other candidates may prove successful

    Intracortical myelin in individuals with alcohol use disorder: An initial proof-of-concept study

    Get PDF
    Introduction Disruption of cortical gray matter and white matter tracts are well-established markers of alcohol use disorder (AUD), but less is known about whether similar differences are present in intracortical myelin (ICM, i.e., highly myelinated gray matter in deeper cortical layers). The goal of this study was to provide initial proof-of-concept for using an optimized structural magnetic resonance imaging (MRI) sequence to detect differences in ICM in individuals with AUD compared to control participants reporting drinking within recommended guidelines. Methods This study used an optimized 3T MRI sequence for high intracortical contrast to examine ICM-related MRI signal in 30 individuals with AUD and 33 healthy social drinkers. Surface-based analytic techniques were used to quantify ICM-related MRI signal in 20 bilateral a priori regions of interest based on prior cortical thickness studies, and exploratory vertex-wise analyses were examined using Cohen's d effect size. Results The global distribution of ICM-related signal was largely comparable between groups. Region of interest analysis indicated that AUD group exhibited greater ICM-related MRI signal in precuneus, ventromedial prefrontal cortex, posterior cingulate, middle anterior cingulate, middle/posterior insula, and dorsolateral prefrontal cortex (Cohen's ds = 0.50–0.75). Four regions (right precuneus, ventromedial prefrontal cortex, posterior cingulate and left dorsolateral prefrontal cortex) remained significant (p < .05) after covarying for smoking status. Conclusion These findings provide initial evidence of ICM differences in a moderately sized sample of individuals with AUD compared to controls, although the inflation of type 1 error rate necessitates caution in drawing conclusions. Robustly establishing these differences in larger samples is necessary. The cross-sectional design cannot address whether the observed differences predate AUD or are consequences of heavy alcohol consumption

    Sodium naphthalene-2,6-dicarboxylate : an anode for sodium batteries

    Get PDF
    We thank the EPSRC (EP/K025112/1) and the Leverhulme Trust (RPG-2016-323) for funding and Diamond Light Source for rapid access to synchrotron radiation facilities.The conjugated dicarboxylate, sodium naphthalene-2,6-dicarboxylate (Na2NDC), has been prepared by a low energy consumption reflux method and its performance as a negative electrode for sodium-ion batteries evaluated in electrochemical cells. The structure of Na2NDC was solved for the first time (monoclinic P21/c) from powder X-ray diffraction data and consists of π-stacked naphthalene units separated by sodium-oxygen layers. Through an appropriate choice of binder and conducting carbon additive Na2NDC exhibits a reversible two electron sodium insertion at around 0.4 V vs. Na+/Na with remarkably stable capacities of ca. 200 mA h g-1 at a rate of C/2 and good rate capability (~133 mA h g-1 at 5C). In parallel the high thermal stability of the material is demonstrated by HT-X-ray diffraction, the framework remaining intact to above 500 °C.PostprintPeer reviewe

    Comparison between four published definitions of hyposmia in Parkinson's disease

    Get PDF
    Objectives Hyposmia is a common feature of Parkinson's disease (PD), yet there is no standard method to define it. A comparison of four published methods was performed to explore and highlight differences. Materials and methods Olfactory testing was performed in 2097 cases of early PD in two prospective studies. Olfaction was assessed using various cut-offs, usually corrected by age and/or gender. Control data were simulated based on the age and gender structure of the PD cases and published normal ranges. Association with age, gender, and disease duration was explored by method and study cohort. Prevalence of hyposmia was compared with the age and gender-matched simulated controls. Between method agreement was measured using Cohen's kappa and Gwet's AC1. Results Hyposmia was present in between 69.1% and 97.9% of cases in Tracking Parkinson's cases, and between 62.2% and 90.8% of cases in the Parkinson's Progression Marker Initiative, depending on the method. Between-method agreement varied (kappa 0.09–0.80, AC1 0.55–0.86). The absolute difference between PD cases and simulated controls was similar for men and women across methods. Age and male gender were positively associated with hyposmia (p &lt; .001, all methods). Odds of having hyposmia increased with advancing age (OR:1.06, 95% CI:1.03, 1.10, p &lt; .001). Longer disease duration had a negative impact on overall olfactory performance. Conclusions Different definitions of hyposmia give different results using the same dataset. A standardized definition of hyposmia in PD is required, adjusting for age and gender, to account for the background decline in olfactory performance with ageing, especially in men

    Delay Discounting as a Transdiagnostic Process in Psychiatric Disorders: A Meta-analysis

    Get PDF
    Importance Delay discounting is a behavioral economic index of impulsive preferences for smaller-immediate or larger-delayed rewards that is argued to be a transdiagnostic process across health conditions. Studies suggest some psychiatric disorders are associated with differences in discounting compared with controls, but null findings have also been reported. Objective To conduct a meta-analysis of the published literature on delay discounting in people with psychiatric disorders. Data Sources PubMed, MEDLINE, PsycInfo, Embase, and Web of Science databases were searched through December 10, 2018. The psychiatric keywords used were based on DSM-IV or DSM-5 diagnostic categories. Collected data were analyzed from December 10, 2018, through June 1, 2019. Study Selection Following a preregistered Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol, 2 independent raters reviewed titles, abstracts, and full-text articles. English-language articles comparing monetary delay discounting between participants with psychiatric disorders and controls were included. Data Extraction and Synthesis Hedges g effect sizes were computed and random-effects models were used for all analyses. Heterogeneity statistics, one-study-removed analyses, and publication bias indices were also examined. Main Outcomes and Measures Categorical comparisons of delay discounting between a psychiatric group and a control group. Results The sample included 57 effect sizes from 43 studies across 8 diagnostic categories. Significantly steeper discounting for individuals with a psychiatric disorder compared with controls was observed for major depressive disorder (Hedges g = 0.37; P = .002; k = 7), schizophrenia (Hedges g = 0.46; P = .004; k = 12), borderline personality disorder (Hedges g = 0.60; P < .001; k = 8), bipolar disorder (Hedges g = 0.68; P < .001; k = 4), bulimia nervosa (Hedges g = 0.41; P = .001; k = 4), and binge-eating disorder (Hedges g = 0.34; P = .001; k = 7). In contrast, anorexia nervosa exhibited statistically significantly shallower discounting (Hedges g = –0.30; P < .001; k = 10). Modest evidence of publication bias was indicated by a statistically significant Egger test for schizophrenia and at the aggregate level across studies. Conclusions and Relevance Results of this study appear to provide empirical support for delay discounting as a transdiagnostic process across most of the psychiatric disorders examined; the literature search also revealed limited studies in some disorders, notably posttraumatic stress disorder, which is a priority area for research

    The statement that folate supraphysiological levels in uremic patients do not cause harm should not go unchallenged

    Get PDF
    Diversity within the major histocompatibility complex (MHC) reflects the immunological fitness of a population. MHC-linked microsatellite markers provide a simple and inexpensive method for studying MHC diversity in large scale studies. We have developed six MHC-linked microsatellite markers in the domestic cat and used these, in conjunction with five neutral microsatellites, to assess MHC diversity in domestic mixed breed (n = 129) and purebred Burmese (n = 61) cat populations in Australia. The MHC of outbred Australian cats is polymorphic (average allelic richness = 8.52) while the Burmese population has much significantly lower MHC diversity (average allelic richness = 6.81; P<0.01). The MHC-linked microsatellites along with MHC cloning and sequencing demonstrated moderate MHC diversity in cheetahs (n = 13) and extremely low diversity in Gir lions (n = 13). Our MHC-linked microsatellite markers have potential future use in diversity and disease studies in other populations and breeds of cats as well as in wild felid species
    • …
    corecore