Atrial thrombus as a complication of SLE and APS in an 8-year-old child

xlomafota.13 shared this article with you from Inoreader Atrial thrombus as a complication of SLE and APS in an 8-year-old child Via Latest Results for Pediatric Rheumatology Abstract Background Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple systems with various clinical manifestations. Renal involvement is common, but intracardiac thrombus is rarely reported as a complication of antiphospholipid syndrome (APS, also known as anticardiolipin syndrome). Anticoagulant therapy is the first-line treatment, and surgery is performed in severe cases. We report a case to improve clinicians' understanding of disease diagnosis. Case presentation An 8-year-old girl was admitted to our hospital because of left costal pain, hematuria and fever. She had obvious edema occult blood 3+, urinary protein 3.2 g/24 h, albumin 17.6 g/L, and total cholesterol 7.21 mmol/L, consistent with a diagnosis of nephrotic syndrome. We continued to track the etiology of nephrotic syndrome and performed a renal biopsy, showing dsDNA 1:10 positivity, low C3, low platelets and hemoglobin, anticardiolipin IgM 12 U/ml, anti-β2-glycoprotein I (β2GPI) 223 U/ml; renal pathology suggested lupus nephritis (LN), and the patient was ultimately diagnosed with SLE, secondary APS and LN. The patient was treated with hormones and immunosuppressants. Sixteen weeks later, her urinary protein was 1+, and the quantity of urine protein was less than 0.5 g/d. Echocardiography showed that the mass in the right atrium was thrombotic. Heparin anticoagulant therapy was effective. Conclusion SLE can involve multiple systems and various complications. Thrombus in the right atrium is a rare complication of APS. Early diagnosis and treatment are key to improving the prognosis of children. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Temporal Variation of Road Dust Load and Its Size Distribution—a Comparative Study of a Porous and a Dense Pavement

xlomafota.13 shared this article with you from Inoreader Temporal Variation of Road Dust Load and Its Size Distribution—a Comparative Study of a Porous and a Dense Pavement Via Latest Results for Water, Air, & Soil Pollution Abstract Resuspension of road dust contributes to air quality issues with resulting health impacts. Limited studies imply that porous pavements can initially mitigate PM10 emissions by acting as a dust trap, but the abrasion wear generates road dust and thus accelerates the clogging processes. In addition, knowledge regarding the impact of pavement types on road dust load dynamics is limited. Road traffic noise can be mitigated using porous pavements, but the use of studded tyres increases the abrasion wear of the pavement as well as increasing the noise emission. Due to this durability problem, porous pavements are rarely used in the Nordic countries where, instead, dense pavements which are abrasion resistant are more common. Linköping municipality, in Sweden, constructed a porous pavement to mitigate road traffic noise. This led to the opportunity to investigate the temporal variation of the dust load dynamics and inherent size distributions over the wint er and spring in comparison to those of an adjacent dense pavement. Results, when using the wet dust sampler (WDS) method, showed similar dust load dynamics for the dense and porous pavements. The results were also compared to previous studies using the same method on different dense pavements in Stockholm, Sweden. All locations showed a seasonal variation with higher dust loads during winter and early spring and declining loads towards summer. The size distributions were more complex for the wheel tracks at the porous pavement, having primarily properties of a mixture model compared to the simple size distributions for the dense pavement. On the other hand, the dust load and size distribution were more similar between the porous and dense pavements regarding loads and shapes, indicating a less pronounced but similar behaviour between the surfaces outside of the wheel tracks. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perceived and Preferred Social Support in Patients Experiencing Weight Regain After Bariatric Surgery—a Qualitative Study

xlomafota.13 shared this article with you from Inoreader Perceived and Preferred Social Support in Patients Experiencing Weight Regain After Bariatric Surgery—a Qualitative Study Via Latest Results for Obesity Surgery Abstract Purpose While bariatric surgery generally shows successful weight loss outcomes in patients with obesity, weight regain exists. The aim of this qualitative study was to improve understanding of how patients with substantial weight regain after bariatric surgery experienced the support from family, friends, and healthcare providers, and what kind of support they had preferred. Materials and Methods Qualitative data were collected from semi-structured interviews with 16 participants. Mean weight regain from surgery to interview was 36%. The transcribed interviews were analyzed with thematic analysis. Results Two main themes and seven sub-themes were formulated. The theme, A lonely struggle, illustrates patients' feelings of abandonment and struggle during weight regain due to lack of support or unfavorable treatment. Participants commonly blamed themselves for re-gaining weight, and shame made them reluctant to engage in social activities or seek medical care. The theme, Others as sources of compassion and control, covers what support they desired, as well as had perceived to be helpful. Exercising or eating healthy with others was appreciated and felt supportive. Pro-active healthcare support and access to dietitians, physiotherapists, and psychological support were desired. Conclusion To optimize the effect of bariatric surgery, support may need to be individualized and lifelong. Since shame and self-blame in patients with weight regain may hinder seeking professional help, care providers may need to initiate follow-up visits. Empathetic and non-judgmental support, access to multidisciplinary healthcare team, as well as peer-support groups may be beneficial to counteract weight regain post-bariatric surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Sex differences in the physiological adaptations to heat acclimation: a state-of-the-art review

xlomafota.13 shared this article with you from Inoreader Sex differences in the physiological adaptations to heat acclimation: a state-of-the-art review Via Latest Results for European Journal of Applied Physiology Abstract Over the last few decades, females have significantly increased their participation in athletic competitions and occupations (e.g. military, firefighters) in hot and thermally challenging environments. Heat acclimation, which involves repeated passive or active heat exposures that lead to physiological adaptations, is a tool commonly used to optimize performance in the heat. However, the scientific community's understanding of adaptations to heat acclimation are largely based on male data, complicating the generalizability to female populations. Though limited, current evidence suggests that females may require a greater number of heat acclimation sessions or greater thermal stress to achieve the same magnitude of physiological adaptations as males. The underlying mechanisms explaining the temporal sex differences in the physiological adaptations to heat acclimation are currently unclear. Therefore, the aims of this state-of-the-art review are to: (i) present a brief yet comprehensive synthesis of the current female and sex difference literature, (ii) highlight sex-dependent (e.g. anthropometric, menstrual cycle) and sex-independent factors (e.g. environmental conditions, fitness) influencing the physiological and performance adaptations to heat acclimation, and (iii) address key avenues for future research. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Exact solutions of a quantum system placed in a Kratzer potential and under a uniform magnetic field

xlomafota.13 shared this article with you from Inoreader Exact solutions of a quantum system placed in a Kratzer potential and under a uniform magnetic field Via Latest Results for Pramana Abstract We propose Whittaker function approach as a theoretical method for finding exact solutions of a quantum mechanical system placed in the Kratzer potential. We then show that the effect of an external uniform magnetic field on this system can be satisfactorily determined using variational method. By following the one-step treatment suggested in this study, we increase the reliability and the accuracy of the solutions of Schrödinger equation for a quantum mechanical system placed in potential energy and perturbed by a uniform magnetic field that proves to be useful in modelling physical phenomena. We find that the achieved numerical and analytical results agree very well with those already published and those calculated using the Numerov method. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pharmacological Interactions between the Dual Orexin Receptor Antagonist Daridorexant and Ethanol in a Double-Blind, Randomized, Placebo-Controlled, Double-Dummy, Four-Way Crossover Phase I Study in Healthy Subjects

xlomafota.13 shared this article with you from Inoreader Pharmacological Interactions between the Dual Orexin Receptor Antagonist Daridorexant and Ethanol in a Double-Blind, Randomized, Placebo-Controlled, Double-Dummy, Four-Way Crossover Phase I Study in Healthy Subjects Via Latest Results for CNS Drugs Abstract Background Daridorexant (ACT-541468) is a potent dual orexin receptor antagonist under development for the treatment of sleep disorders. Concomitant intake of ethanol and hypnotics has been shown to result in additive/supra-additive depression of the central nervous system, resulting in pronounced sedation. Objective The aim of this study was to evaluate the pharmacokinetic (PK) and pharmacodynamic (PD) interactions between ethanol and daridorexant. Method This was a single-center, double-blind, placebo-controlled, randomized, four-way crossover study conducted in 19 healthy male/female subjects. Subjects received the following four treatments: ethanol with daridorexant, daridorexant alone, ethanol alone, and placebo. Daridorexant 50 mg and the matching placebo were administered as single oral tablets. Ethanol was infused intravenously and clamped at a level of 0.6 g/L for 5 h. The PK of ethanol and daridorexant were assessed and a battery of PD tests performed. Results Concomitant administration of ethanol prolonged the time to reach maximum plasma concentrations (tmax) of daridorexant (median difference 1.25 h). No other relevant PK interactions were observed. Coadministration with ethanol produced a numerically greater impairment on saccadic peak velocity, body sway, visual analog scale (VAS) alertness, VAS alcohol intoxication, smooth pursuit, and adaptive tracking compared with daridorexant alone. All treatments were generally well tolerated without serious adverse events (AEs). The most commonly reported treatment-emergent AEs following coadministration of daridorexant and ethanol included somnolence, headache, fatigue, sudden onset of sleep, and dizziness. Conclusions Apart from a shift in tmax, no relevant changes in PK parameters were observed following coadministration of daridorexant and ethanol. The coadministration led to reinforced drug actions that were, at most, indicative of infra-additive effects on certain PD markers. Patients will be advised not to consume ethanol with daridorexant. Clinical Trials Registration number: NCT03609775 (ClinicalTrials.gov Identifier) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

High-dose rocuronium-induced paralysis of the adductor pollicis muscle facilitates detection of the timing for tracheal intubation in elderly patients: a randomized double-blind study

xlomafota.13 shared this article with you from Inoreader High-dose rocuronium-induced paralysis of the adductor pollicis muscle facilitates detection of the timing for tracheal intubation in elderly patients: a randomized double-blind study Via Latest Results for Journal of Anesthesia Abstract Purpose To prevent coughing related to tracheal intubation and the resultant exposure of intubating staff to the patients' expiratory aerosols, the timing of tracheal intubation needs to be precisely predicted. The aim of this study was to evaluate the hypothesis that the timing for safe tracheal intubation in elderly patients can be determined by acceleromyographically monitoring paralysis of the adductor pollicis muscle when high-dose rocuronium, given to block the respiratory muscles, is administered. Methods Forty elderly (65–92 years) patients were enrolled in this study and randomly assigned to two groups, to receive rocuronium 0.6 mg/kg or 1 mg/kg. After induction of anesthesia and observing acceleromyographic train-of-four (TOF) responses of the adductor pollicis muscle to ulnar nerve stimulation, the patients randomly received either dose of rocuronium. The onset times from rocuronium administration to TOF counts of 0 were measured. Soon thereafter, a single anesthesiologist who was blinded to the allocated dose of rocuronium performed laryngoscopy and tracheal intubation, and assessed intubating conditions. Data were analyzed by the unpaired t-test and Chi-squared test. Results The averaged [SD] onset time of neuromuscular blockade was significantly shorter with 1 mg/kg than 0.6 mg/kg rocuronium (104.3 [30.1] s vs. 186.8 [37.5] s, p < 0.001). Patients who received 0.6 mg/kg rocuronium variously showed either poor (n = 9) or good (n = 11) intubating conditions. However, all patients who received 1 mg/kg rocuronium had excellent intubating conditions. Conclusions If 1 mg/kg rocuronium is administered, a TOF count of 0 acceleromyographically observed at the adductor pollicis muscle can reveal the adequate timing for tracheal intubation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of colloid and crystalloid using goal-directed fluid therapy protocol in non-cardiac surgery: a meta-analysis of randomized controlled trials

xlomafota.13 shared this article with you from Inoreader Comparison of colloid and crystalloid using goal-directed fluid therapy protocol in non-cardiac surgery: a meta-analysis of randomized controlled trials Via Latest Results for Journal of Anesthesia Abstract Purpose A few randomized controlled trials (RCTs) have compared crystalloid-based goal-directed fluid therapy (GDFT) with starch-based GDFT in patients undergoing major surgical procedures with conflicting results. In this meta-analysis, colloid-based GDFT was compared with crystalloid-based GDFT. Methods In this meta-analysis, RCTs comparing colloid- and crystalloid-based GDFT in patients undergoing non-cardiac surgery were included. Binary outcomes were reported as risk ratio (RR) and continuous outcomes were reported as mean difference (MD) with 95% confidence interval (95% CI). PubMed, PubMed central, The Cochrane Library database and EMBASE were searched for potentially eligible trials from inception to 28 February 2020. Results Data of 2392 patients from nine RCTs were included in this meta-analysis. Mortality at the longest available follow-up [RR (95% CI) 1.44 (0.88, 2.34); p = 0.15], postoperative kidney dysfunction [RR (95% CI) 1.07 (0.72, 1.60); p = 0.73], postoperative length of hospital stay [MD (95% CI)  – 0.29 ( – 1.25, 0.66) d; p = 0.55], cardiovascular complications [RR (95% CI) 1.20 (0.50, 2.88); p = 0.68], wound complications [RR (95% CI) 1.08 (0.76, 1.54); p = 0.66], pulmonary complications [RR (95% CI) 0.90 (0.71, 1.140); p = 0.40] and bleeding [RR (95% CI) 1.24 (0.77, 1.99); p = 0.37] were similar in both the groups. Postoperative major complications were also similar between patients who received colloid and crystalloid [RR (95% CI) 0.79 (0.48, 1.29); p = 0.34]. Conclusion Colloids in goal-directed fluid therapy protocol does not offer any benefit over crystalloid-based goal-directed fluid therapy protocol in patients undergoing major non-cardiac surgical procedure. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Associations of Maternal Trait Anger Expression and Lifetime Traumatic and Non-traumatic Experiences with Preterm Birth

xlomafota.13 shared this article with you from Inoreader Associations of Maternal Trait Anger Expression and Lifetime Traumatic and Non-traumatic Experiences with Preterm Birth Via Latest Results for Maternal and Child Health Journal Abstract Objectives Most studies examining psychosocial factors contributing to preterm birth (PTB) have focused on negative life events. Studies examining the influence of negative emotion, in particular maternal anger, remain sparse. We examined associations of maternal trait anger expression and lifetime traumatic and non-traumatic experiences with the risk of PTB. Methods Mother-newborn pairs were enrolled in the PRogramming of Intergenerational Stress Mechanisms pregnancy cohort based in Boston and New York City. Women completed the State-Trait Anger Expression Inventory-2 (STAXI-2), Life Stressor Checklist-Revised (LSC-R), and Childhood Trauma Questionnaire (CTQ) in pregnancy. We used modified Poisson regression to estimate the relative risk (RR) of PTB (1) in relation to continuous STAXI-2 Anger Expression-In (AX-I) and Anger Expression-Out (AX-O) subscales, (2) in relation to continuous LSC-R scores, and (3) between women who did versus did not experience childhood sexual, emotional, and/or physical abuse in six separate models. We also examined interactions between maternal anger expression and lifetime stress/childhood trauma. Results Younger, single, minority women had higher outward anger expression and inward anger suppression. AX-I and AX-O scores were higher among women who experienced abuse in childhood and who had higher lifetime stress. Maternal lifetime stress, outward anger expression, and inward anger suppression were associated with an increased risk of PTB in separate models; however, stress, trauma and anger did not interact to further increase the risk of PTB. Conclusions for Practice Higher anger expression and higher lifetime stress experiences were associated with an increased risk of PTB among a racially and ethnically diverse sample of pregnant women. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Assessing HIV Care Outcomes Among African-Born People Living with HIV in Seattle: An Analysis of the University of Washington Electronic Medical Record

xlomafota.13 shared this article with you from Inoreader Assessing HIV Care Outcomes Among African-Born People Living with HIV in Seattle: An Analysis of the University of Washington Electronic Medical Record Via Latest Results for Journal of Immigrant and Minority Health Abstract To examine the relationship between African birth and HIV outcomes and comorbidities among individuals accessing care at the University of Washington. Patients who received a diagnosis of HIV at the University of Washington from 1995 to 2018 were identified. African-born patients were defined as those with recorded birthplace or primary language belonging to an African country. This cohort was compared to all non-African-born patients for initial CD4 count < 200 cells/mL, time from diagnosis to viral suppression, and prevalence of comorbid conditions. We identified 357 African-born and 3710 non-African-born patients. Over the time period, African-born patients were more likely to present with initial CD4 counts < 200 cells/mL (31% vs 19%, p < 0.01), but had shorter time to viral suppression (HR 1.31, [95% CI: 1.14–1.56]). African-born patients had higher rates of hepatitis B and tuberculosis (12% vs. 7% p < 0.01 and 13% vs. 3% p < 0.01). African-born patients living in the Seattle area have better HIV outcomes, but low initial CD4 counts suggest that they are presenting to care late. Increased efforts to engage this population in HIV, hepatitis B, and tuberculosis screening are warranted. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Rodlike nanoparticle parameter measurement method based on improved Mask R-CNN segmentation

xlomafota.13 shared this article with you from Inoreader Rodlike nanoparticle parameter measurement method based on improved Mask R-CNN segmentation Via Latest Results for Signal, Image and Video Processing Abstract Parameter measurement of nanoparticle, which aims at evaluation of the quality of nanomaterials, is essential to nanotechnology and many applications. According to the nanoparticle images captured by transmission electron microscopy, this paper presents an automated procedure that can expedite the parameter measurement of the rodlike nanoparticles. Nanoparticle segmentation is the most important step in nanoparticle parameter measurement. The challenge of this task involves segmenting the adhesive nanoparticles and nanoparticles with weak contours. To accurately measure nanoparticle size and evaluate nanomaterial quality, firstly, according to the characteristics of agglomeration and adhesion of nanoparticle images, the Mask R-CNN network was selected to segment the nanoparticle images, and the network was optimized to improve the segmentation accuracy. Secondly, according to the particle segmentation result, the minimum circumscribed rectangle of the rodlike nan oparticle boundary is obtained. Finally, the size and shape parameters of the particles are measured based on the minimum circumscribed rectangle. The experimental results confirm the effectiveness of the proposed method for measuring the rodlike nanoparticle parameters. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.