59 research outputs found

    Strategy for the management of diabetic macular edema: the European Vitreo-Retinal Society macular edema study

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    Objective. To compare the efficacy of different therapies in the treatment of diabetic macular edema (DME). Design. Nonrandomized, multicenter clinical study. Participants. 86 retina specialists from 29 countries provided clinical information on 2,603 patients with macular edema including 870 patients with DME. Methods. Reported data included the type and number of treatment(s) performed, the pre-and posttreatment visual acuities, and other clinical findings.The results were analyzed by the French INSEE (National Institute of Statistics and Economic Studies). Main Outcome Measures. Mean change of visual acuity and mean number of treatments performed. Results.The change in visual acuity over time in response to each treatment was plotted in second order polynomial regression trend lines. Intravitreal triamcinolone monotherapy resulted in some improvement in vision. Treatmentwith threshold or subthreshold grid laser also resulted in minimal vision gain. Anti-VEGF therapy resulted in more significant visual improvement. Treatment with pars plana vitrectomy and internal limiting membrane (ILM) peeling alone resulted in an improvement in vision greater than that observed with anti-VEGF injection alone. In our DME study, treatment with vitrectomy and ILM peeling alone resulted in the better visual improvement compared to other therapies

    The 13th Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the SDSS-IV Survey Mapping Nearby Galaxies at Apache Point Observatory

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    The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) began observations in July 2014. It pursues three core programs: APOGEE-2,MaNGA, and eBOSS. In addition, eBOSS contains two major subprograms: TDSS and SPIDERS. This paper describes the first data release from SDSS-IV, Data Release 13 (DR13), which contains new data, reanalysis of existing data sets and, like all SDSS data releases, is inclusive of previously released data. DR13 makes publicly available 1390 spatially resolved integral field unit observations of nearby galaxies from MaNGA,the first data released from this survey. It includes new observations from eBOSS, completing SEQUELS. In addition to targeting galaxies and quasars, SEQUELS also targeted variability-selected objects from TDSS and X-ray selected objects from SPIDERS. DR13 includes new reductions ofthe SDSS-III BOSS data, improving the spectrophotometric calibration and redshift classification. DR13 releases new reductions of the APOGEE-1data from SDSS-III, with abundances of elements not previously included and improved stellar parameters for dwarf stars and cooler stars. For the SDSS imaging data, DR13 provides new, more robust and precise photometric calibrations. Several value-added catalogs are being released in tandem with DR13, in particular target catalogs relevant for eBOSS, TDSS, and SPIDERS, and an updated red-clump catalog for APOGEE.This paper describes the location and format of the data now publicly available, as well as providing references to the important technical papers that describe the targeting, observing, and data reduction. The SDSS website, http://www.sdss.org, provides links to the data, tutorials and examples of data access, and extensive documentation of the reduction and analysis procedures. DR13 is the first of a scheduled set that will contain new data and analyses from the planned ~6-year operations of SDSS-IV.PostprintPeer reviewe

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    SynthÚse et évaluation de la cytotoxicité de carbolines, indoloquinolines et pyridocarbazoles à potentialité anticancéreuse

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    En progression constante, le cancer est un défi médical majeur. Au vu de la potentialité anticancéreuse des composés polycicliques azotés comme la cryptolépine, l'ellipticine,la murrayaquinone A et l'amarorine, la synthÚse par voie photochimique d'analogues de ces substances a été envisagée. Les squelettes carboline, indoloquinoléine, et pyridocarbazole sont obtenus en deux ou trois étapes à partir d'énaminones issues d'aminopyridines ou d'aminoquinoléines et de cyclohexanedione : synthÚse de l'énaminone, éventuelle N-alkylation, photocyclisation. Le squelette pyridopyrroloquinoléine est obtenu à partir d'aminoquinoléine et de cyclopentanedione, par une synthÚse incluant deux étapes clés : une photocyclisation et une transposition de Beckmann. Les tests de cytotoxicité in vitro des dérivés d'aminoquinoléines ont révélé les composés les plus actifs, les premiÚres relations structure-activité et l'absence de sensibilité de ces composés à la résistance MDR.MONTPELLIER-BU Pharmacie (341722105) / SudocPARIS-BIUP (751062107) / SudocSudocFranceF

    Improvement of Generic Attacks on the Rank Syndrome Decoding Problem

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    Rank metric code-based cryptography exists for several years. The security of many cryptosystems is based on the difficulty of decoding a random code. Any improvement in the complexity of the best decoding algorithms can have a big impact on the security of these schemes. In this article, we present an improvement on the recent GRS algorithm [1] and we obtain a complexity of O ((n − k)^ 3 m^3 q^( w (k+1)m/ n −m ))for decoding an error of weight w in an [n, k] F 2 m-linear code

    A New Algorithm for Solving the Rank Syndrome Decoding Problem

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    International audienceIn this paper, we propose an improvement of the attack on the Rank Syndrome Decoding (RSD) problem found in [1], usually the best attack considered for evaluating the security of rank based cryptosystems. For H a full-rank (n − k) × n matrix over Fqm and e ∈ F n q m of small norm r, the RSD problem consists in recovering e from s = He T. In our case, the norm of a vector over Fqm is defined by the dimension of the Fq-subspace generated by its coordinates. This problem is very similar to the Syndrome Decoding problem in the Hamming metric (only the metric and the field of the coefficients are different) and the security of several cryptosystems relies on its hardness, like McEliece-based PKE [2], [3] or IBE [4]. Our attack is in O (n − k) 3 m 3 q w (k+1)m n −m operations in Fq whereas the previous best attacks are in O (n − k) 3 m 3 q (w−1) min (k+1)m n ,k+1 [1], [5]. In particular in the case m ≀ n, our attack permits to obtain an exponential gain in q m(1−R) for R = k/n the rate of the code. We give examples of broken parameters for recently proposed cryptosystems based on LRPC codes or Gabidulin codes. Our attack does not fully break these cryptosystems but implies larger parameters for the same security levels

    A Photochemical Approach to Pyridopyrroloquinoline Derivatives as New Potential Anticancer Agents

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    International audienceIndoloquinoline alkaloid cryptolepine and pyridocarbazole alkaloid ellipticine are of great interest becausein vitro and in vivo studies revealed their good cytotoxic properties. In order to obtain some biologically activeanalogs of these compounds, we developped a synthesis based on the photocyclisation of tertiary N-methylatedenaminones derived from cyclopentane-1,3-dione and 3 or 6-aminoquinoline. The angular cyclised compoundsthus obtained were submitted to Beckmann rearrangement, preceded by the formation of a Z oxime. Finally, thed -lactame ring was oxidized using 10% palladium/carbon in diphenylether and pyridopyrroloquinolines wereobtained. These compounds and the intermediate lactams and cyclopentanopyrroloquinolines were tested in vitroon K 562 cells and A 2780 doxorubicine sensitive and resistant cells. All compounds were less effective than doxorubicine in sensitive cells but their activity wasn’t decreased by MDR resistance

    Predicting the extent of Maillard reactions in infant formula during sterilization by ohmic heating

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    International audienceThis study aimed at monitoring the biochemical reactions induced by an intense thermal treatment like sterilization of a liquid infant formula. The stake is the control of the nutritional quality of the product concerning undesirable newly formed compounds, most of them being Maillard reaction products. A fluorimetric method called FAST (Fluorescence of Advanced Maillard products and Soluble Tryptophan) was used for monitoring the accumulation of Maillard products along thermal treatment. UHT sterilization was achieved by ohmic heating in a lab scale reactor specially designed for this study. The reproducibility of the thermal treatment was characterized for the three phases of the sterilization: heating, holding and cooling. The extent of Maillard reaction was monitored under two types of conditions: (i) isothermal conditions at five holding temperatures (100, 110, 120, 130 and 140°C) and (ii) nonisothermal conditions at five heating rates (0.16 to 4.19 °C.s-1). A semi-empirical model was developed to predict product temperature history during a complete sterilization treatment with good adjustment. The extent of Maillard reaction was fitted with a kinetic model of pseudo-zero order and Arrhenius parameters were identified to model the temperature effect on the chemical reaction. The physical and the chemical models were coupled to predict the extent of Maillard reaction during ohmic treatment as a function of operating parameters (temperature and electrical conditions) and product parameters (electrical conductivity
); it was successfully adjusted to the experimental results
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