1,776 research outputs found
Establishing a pragmatic framework to optimise health outcomes in heart failure and multimorbidity (ARISE-HF): A multidisciplinary position statement
What are effective program characteristics of self-management interventions in patients with heart failure? An individual patient data meta-analysis
Coupling and pathway control of coenzyme Q redox state and respiration in isolated mitochondria
Redox states of the mitochondrial coenzyme Q pool, which reacts with the electron transfer system, reflect the balance between (1) reducing capacities of electron flow from fuel substrates converging at the Q-junction, (2) oxidative capacities downstream of Q to O2, and (3) the load on the OXPHOS system utilizing or dissipating the protonmotive force.
A three-electrode sensor (Rich 1988; Moore et al 1988) was implemented into the NextGen-O2k to monitor continuously the redox state of CoQ2 added as a Q-mimetic simultaneously with O2 consumption. The Q-Module was optimized for high signal-to-noise ratio, minimum drift, and minimum oxygen diffusion. CoQ2 equilibrates in the same manner as Q at Complexes CI, CII and CIII. The CoQ2 redox state is monitored amperometrically with the working electrode, which is poised at CoQ2 redox peak potentials determined by cyclic voltammetry. The voltammogram also provides quality control of the Q-sensor and reveals chemical interferences.
The CoQ2 redox state and O2 consumption were measured simultaneously in isolated mouse cardiac and brain mitochondria. CoQ2 ― and by implication mitochondrial Q ― was more oxidized when O2 flux was stimulated by coupling control: when energy demand increased from LEAK to OXPHOS and electron transfer capacities in the succinate pathway. In contrast, CoQ2 was more reduced when O2 flux was stimulated by pathway-control of electron input capacities, increasing from the NADH (N)- to succinate (S)-linked pathway which converge at the Q-junction, with CI-Q-CIII and CII-Q-CIII segments, respectively. N- and S- respiratory pathway capacities were not completely additive, compatible with partitioning of Q intermediary between the solid-state and liquid-state models of supercomplex organization. The direct proportionality of CoQ2 reduction and electron input capacities through the CI-Q-CIII and CII-Q-CIII segments suggests that CoQ2 is accurately mimicking mitochondrial Q-redox changes
Transition of free convection flow inside an inclined parallel walled channel: effects of inclination angle and width of the channel
Transition of free convection flow in an inclined parallel walled channel has been investigated numerically by employing k–ɛ turbulent model. Particular attention is paid on how the inclination angle and width of the channel affect the transition process of the flow developing in the channel. The upper plate of the channel is heated isothermally and facing downward, while the lower one is kept under the adiabatic condition. The inclination angle of the channel is varied from 0° to 85° with respect to its vertical position while the distance separating the two plates is systematically reduced from 0.45 to 0.06 m. Distributions of velocity, turbulent kinetic energy and local heat flux are presented to examine the critical distance and the results obtained show good agreement with experimental data available in the literature
Small-cell lung cancer in England: trends in survival and chemotherapy using the National Lung Cancer Audit
Background: The purpose of this study was to identify trends in survival and chemotherapy use for individuals with smallcell lung cancer (SCLC) in England using the National Lung Cancer Audit (NLCA).
Methods: We used data from the NLCA database to identify people with histologically proven SCLC from 2004–2011. We
calculated the median survival by stage and assessed whether patient characteristics changed over time. We also assessed whether the proportion of patients with records of chemotherapy and/or radiotherapy changed over time.
Results: 18,513 patients were diagnosed with SCLC in our cohort. The median survival was 6 months for all patients, 1 year for those with limited stage and 4 months for extensive stage. 69% received chemotherapy and this proportion changed very slightly over time (test for trends p = 0.055). Age and performance status of patients remained stable over the study period, but the proportion of patients staged increased (p-value,0.001), mainly because of improved data completeness. There has been an increase in the proportion of patients that had a record of receiving both chemotherapy and radiotherapy each year (from 19% to 40% in limited and from 9% to 21% in extensive stage from 2004 to 2011). Patients who received chemotherapy with radiotherapy had better survival compared with any other treatment (HR 0.24, 95% CI 0.23–0.25).
Conclusion: Since 2004, when the NLCA was established, the proportion of patients with SCLC having chemotherapy has remained static. We have found an upward trend in the proportion of patients receiving both chemotherapy and radiotherapy which corresponded to a better survival in this group, but as it only applied for a small proportion of patients, it was not enough to change the overall survival
Characterization and validation of an intra-fraction motion management system for masked-based radiosurgery
Treatment decisions and survival for people with small-cell lung cancer
Background: Chemotherapy improves survival for many patients with SCLC, and hence it is important to understand variations in practice and outcomes for this treatment strategy.
Methods: We used the National Lung Cancer Audit and Hospital Episodes Statistics to determine the proportion of patients who received chemotherapy for SCLC, and assess the effects of patient and organisational factors on the odds of receiving chemotherapy and of completing four cycles. We calculated median survival and used Cox regression to determine factors that predicted survival.
Results: Of 15 091 cases of SCLC, 70% received at least one cycle of chemotherapy. More deprived people were less likely to receive chemotherapy, but patients were more likely to receive chemotherapy, and to complete Xfour cycles, if they were referred to the lung cancer team by their GP. Median survival for those treated with chemotherapy was 12.9 months for limited and 7.3 months for extensive stage disease.
Conclusions: The Linked NLCA and HES data provide real-life measures of survival in people treated with chemotherapy and
show how this is influenced by patient and tumour characteristics. These data show the characteristics of patients who are less likely to complete a full course of treatment, an adverse predictor of survival
Factors Underlying the Early Limb Muscle Weakness in Acute Quadriplegic Myopathy Using an Experimental ICU Porcine Model
The basic mechanisms underlying acquired generalized muscle weakness and paralysis in critically ill patients remain poorly understood and may be related to prolonged mechanical ventilation/immobilization (MV) or to other triggering factors such as sepsis, systemic corticosteroid (CS) treatment and administration of neuromuscular blocking agents (NMBA). The present study aims at exploring the relative importance of these factors by using a unique porcine model. Piglets were all exposed to MV together with different combinations of endotoxin-induced sepsis, CS and NMBA for five days. Peroneal motor nerve conduction velocity and amplitude of the compound muscle action potential (CMAP) as well as biceps femoris muscle biopsy specimens were obtained immediately after anesthesia on the first day and at the end of the 5-day experimental period. Results showed that peroneal nerve motor conduction velocity is unaffected whereas the size of the CMAP decreases independently of the type of intervention, in all groups after 5 days. Otherwise, despite a preserved size, muscle fibre specific force (maximum force normalized to cross-sectional area) decreased dramatically for animals exposed to MV in combination with CS or/and sepsis. These results suggest that the rapid declines in CMAP amplitude and in force generation capacity are triggered by independent mechanisms with significant clinical and therapeutic implications
Integrated multimodal airport operations for efficient passenger flow management: Two case studies
Predictive models and decision support tools allow information sharing, common situational awareness and real-time collaborative decision-making between airports and ground transport stakeholders. To support this general goal, IMHOTEP has developed a set of models able to anticipate the evolution of an airport’s passenger flows within the day of operations. This is to assess the operational impact of different management measures on the airport processes and the ground transport system. Two models covering the passenger flows inside the terminal and of passengers accessing and egressing the airport have been integrated to provide a holistic view of the passenger journey from door-to-gate and vice versa. This paper describes IMHOTEP’s application at two case study airports, Palma de Mallorca (PMI) and London City (LCY), at Proof of Concept (PoC-level) assessing impact and service improvements for passengers, airport operators and other key stakeholders. For the first time one measurable process is created to open up opportunities for better communication across all associated stakeholders. Ultimately the successful implementation will lead to a reduction of the carbon footprint of the passenger journey by better use of existing facilities and surface transport services, and the delay or omission of additional airport facility capacities
- …