The use of viscoelastic haemostatic assays in non-cardiac surgical settings. a systematic review and meta-analysis

Background: Thrombelastography (TEG) and rotational thromboelastometry (ROTEM) are viscoelastic haemostatic assays (VHA) which exploit the elastic properties of clotting blood. The aim of this systematic review and meta-analysis was to evaluate the usefulness of these tests in bleeding patients outside the cardiac surgical setting. Materials and methods: We searched the Cochrane Library, MEDLINE, EMBASE and SCOPUS. We also searched clinical trial registries for ongoing and unpublished studies, and checked reference lists to identify additional studies. Results: We found 4 randomised controlled trials (RCTs) that met our inclusion criteria with a total of 229 participants. The sample size was small (from 28 to 111 patients) and the follow-up periods very heterogenous (from 4 weeks to 3 years). Pooled data from the 3 trials reporting on mortality (199 participants) do not show any effect of the use of TEG on mortality as compared to standard monitoring (based on the average treatment effect from a fixed-effects model): Risk Ratio (RR) 0.71; 95% Confidence Interval (CI): 0.43 to 1.16. Likewise, the use of VHA does not reduce the need for red blood cells (mean difference -0.64; 95% CI: -1.51 to 0.23), platelet concentrates (mean difference -1.12; 95% CI: -3.25 to 1.02), and fresh frozen plasma (mean difference -0.91; 95% CI: -2.02 to 0.19) transfusion. The evidence on mortality and other outcomes was uncertain (very low-certainty evidence, down-graded due to risk of biases, imprecision, and inconsistency). Conclusions: Overall, the certainty of the evidence provided by the trials was too low for us to be certain of the benefits and harms of viscoelastic haemostatic assay in non-cardiac surgical settings. More, larger, and better-designed RCTs should be carried out in this area

What PLS can still do for Imaging Genetics in Alzheimer's disease

In this work we exploited Partial Least Squares (PLS) model for analyzing the genetic underpinning of grey matter atrophy in Alzheimer's Disease (AD). To this end, 42 features derived from T1-weighted Magnetic Resonance Imaging, including cortical thicknesses and subcortical volumes were considered to describe the imaging phenotype, while the genotype information consisted of 14 recently proposed AD related Polygenic Risk Scores (PRS), calculated by including Single Nucleotide Polymorphism passing different significance thresholds. The PLS model was applied on a large study cohort obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database including both healthy individuals and AD patients, and validated on an independent ADNI Mild Cognitive Impairment (MCI) cohort, including Early (EMCI) and Late MCI (LMCI). The experimental results confirm the existence of a joint dynamics between brain atrophy and genotype data in AD, while providing important generalization results when tested on a clinically heterogeneous cohort. In particular, less AD specific PRS scores were negatively correlated with cortical thicknesses, while highly AD specific PRSs showed a peculiar correlation pattern among specific subcortical volumes and cortical thicknesses. While the first outcome is in line with the well known neurodegeneration process in AD, the second could be revealing of different AD subtypes

Impact of a synbiotic food on the gut microbial ecology and metabolic profiles

<p>Abstract</p> <p>Background</p> <p>The human gut harbors a diverse community of microorganisms which serve numerous important functions for the host wellbeing. Functional foods are commonly used to modulate the composition of the gut microbiota contributing to the maintenance of the host health or prevention of disease. In the present study, we characterized the impact of one month intake of a synbiotic food, containing fructooligosaccharides and the probiotic strains <it>Lactobacillus helveticus </it>Bar13 and <it>Bifidobacterium longum </it>Bar33, on the gut microbiota composition and metabolic profiles of 20 healthy subjects.</p> <p>Results</p> <p>The synbiotic food did not modify the overall structure of the gut microbiome, as indicated by Polymerase Chain Reaction-Denaturing Gradient Gel Electrophoresis (PCR-DGGE). The ability of the probiotic <it>L. helveticus </it>and <it>B. longum </it>strains to pass through the gastrointestinal tract was hypothesized on the basis of real-time PCR data. In spite of a stable microbiota, the intake of the synbiotic food resulted in a shift of the fecal metabolic profiles, highlighted by the Gas Chromatography Mass Spectrometry Solid Phase Micro-Extraction (GC-MS/SPME) analysis. The extent of short chain fatty acids (SCFA), ketones, carbon disulfide and methyl acetate was significantly affected by the synbiotic food consumption. Furthermore, the Canonical discriminant Analysis of Principal coordinates (CAP) of GC-MS/SPME profiles allowed a separation of the stool samples recovered before and after the consumption of the functional food.</p> <p>Conclusion</p> <p>In this study we investigated the global impact of a dietary intervention on the gut ecology and metabolism in healthy humans. We demonstrated that the intake of a synbiotic food leads to a modulation of the gut metabolic activities with a maintenance of the gut biostructure. In particular, the significant increase of SCFA, ketones, carbon disulfide and methyl acetate following the feeding period suggests potential health promoting effects of the synbiotic food.</p

Study of the Synthetic Approach Influence in Ni/CeO2-Based Catalysts for Methane Dry Reforming

This study focuses on the synthetic approach influence in morphostructural features and catalytic performances for Ni/CeO2 catalysts. Incipient wetness impregnation, coprecipitation and nitrate combustion were studied as catalyst preparation approaches, and the materials were then tested at 700 C for methane dry reforming (MDR). The morphostructural properties of the materials were deeply studied using several techniques, such as temperature programmed reduction (TPR), to investigate reducibility and support-metal interaction, N2 physisorption to evaluate the porosity and the surface area, scanning electron microscopy (SEM) and X-ray diffraction (XRD) to estimate Ni dispersion, and temperature programmed oxidation (TPO) to identify the type and amount of coke formed on catalysts’ surface after reaction. From the data obtained, coprecipitation turned out to be the most suitable technique for this application because this catalyst was able to reach 70% of CO2 conversion and 30% methane conversion, with an H2 yield of 15% and 30% yield of CO at the end of the 30 h test. Moreover, it was also the catalyst with the highest metal dispersion, the strongest interaction with the support, and the lowest coke deposition

Definition of physical-dynamic parameters in circular kick in Muay Thai through latest generation inertial sensors with a critical review of the literature

In recent years, the study of movement analysis with the application of dedicated advanced technologies, such as inertial technologies, has also become essential in scientific research of sports disciplines such as martial arts and combat sports, to better define the real dynamics of technical components in order to adapt the training design. A great number of studies in the literature have focused on the kinematics of circular kick in combat sport and martial arts but a relatively small number have focused on the kinetic and kinematic analysis of Muay Thai and especially its circular kick technique. This study aims to highlight instrumentally the quality of circular kick gesture and through which segmental motor dynamics it achieves its greatest effectiveness, evaluating the accelerations and execution times of the different body segments involved in technical execution itself obviously in a performative sense. It is important to note that the inertial data shows that both knee and ankle have an increasing linear velocity greater than the hip in the preparation and execution phase, while for the angular velocity in the execution phase it is the hip that has higher acceleration than the knee and ankle. These results, therefore, highlight the basic importance of intra-articular and intramuscular coordination processes that allow or not linearity and fluidity of movements that are the basis to obtain maximum intersegmental performance in order to deliver maximum acceleration in the apical point of the shot and thus have the maximum effectiveness of hit and therefore the optimal performance

Microstructural MRI Correlates of Cognitive Impairment in Multiple Sclerosis: The Role of Deep Gray Matter

Although cognitive impairment (CI) is frequently observed in people with multiple sclerosis (pwMS), its pathogenesis is still controversial. Conflicting results emerged concerning the role of microstructural gray matter (GM) damage especially when involving the deep GM structures. In this study, we aimed at evaluating whether differences in cortical and deep GM structures between apparently cognitively normal (ACN) and CI pwMS (36 subjects in total) are present, using an extensive set of diffusion MRI (dMRI) indices and conventional morphometry measures. The results revealed increased anisotropy and restriction over several deep GM structures in CI compared with ACN pwMS, while no changes in volume were present in the same areas. Conversely, reduced anisotropy/restriction values were detected in cortical regions, mostly the pericalcarine cortex and precuneus, combined with reduced thickness of the superior frontal gyrus and insula. Most of the dMRI metrics but none of the morphometric indices correlated with the Symbol Digit Modality Test. These results suggest that deep GM microstructural damage can be a strong anatomical substrate of CI in pwMS and might allow identifying pwMS at higher risk of developing CI

Analysis of the human Y-chromosome haplogroup Q characterizes ancient population movements in Eurasia and the Americas

Background: Recent genome studies of modern and ancient samples have proposed that Native Americans derive from a subset of the Eurasian gene pool carried to America by an ancestral Beringian population, from which two well-differentiated components originated and subsequently mixed in different proportion during their spread in the Americas. To assess the timing, places of origin and extent of admixture between these components, we performed an analysis of the Y-chromosome haplogroup Q, which is the only Pan-American haplogroup and accounts for virtually all Native American Y chromosomes in Mesoamerica and South America. Results: Our analyses of 1.5 Mb of 152 Y chromosomes, 34 re-sequenced in this work, support a "coastal and inland routes scenario" for the first entrance of modern humans in North America. We show a major phase of male population growth in the Americas after 15 thousand years ago (kya), followed by a period of constant population size from 8 to 3 kya, after which a secondary sign of growth was registered. The estimated dates of the first expansion in Mesoamerica and the Isthmo-Colombian Area, mainly revealed by haplogroup Q-Z780, suggest an entrance in South America prior to 15 kya. During the global constant population size phase, local South American hints of growth were registered by different Q-M848 sub-clades. These expansion events, which started during the Holocene with the improvement of climatic conditions, can be ascribed to multiple cultural changes rather than a steady population growth and a single cohesive culture diffusion as it occurred in Europe. Conclusions: We established and dated a detailed haplogroup Q phylogeny that provides new insights into the geographic distribution of its Eurasian and American branches in modern and ancient samples