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Link between supercurrent diode and anomalous Josephson effect revealed by gate-controlled interferometry. Nat Commun 2024; 15:4413. [PMID: 38782910 PMCID: PMC11116472 DOI: 10.1038/s41467-024-48741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/07/2024] [Indexed: 05/25/2024] Open
Abstract
In Josephson diodes the asymmetry between positive and negative current branch of the current-phase relation leads to a polarity-dependent critical current and Josephson inductance. The supercurrent nonreciprocity can be described as a consequence of the anomalous Josephson effect -a φ0-shift of the current-phase relation- in multichannel ballistic junctions with strong spin-orbit interaction. In this work, we simultaneously investigate φ0-shift and supercurrent diode efficiency on the same Josephson junction by means of a superconducting quantum interferometer. By electrostatic gating, we reveal a direct link between φ0-shift and diode effect. Our findings show that spin-orbit interaction in combination with a Zeeman field plays an important role in determining the magnetochiral anisotropy and the supercurrent diode effect.
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Revised contraindications for the use of non-medical WB-electromyostimulation. Evidence-based German consensus recommendations. Front Sports Act Living 2024; 6:1371723. [PMID: 38689869 PMCID: PMC11058671 DOI: 10.3389/fspor.2024.1371723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/01/2024] [Indexed: 05/02/2024] Open
Abstract
Whole-body electromyostimulation has proven to be a highly effective alternative to conventional resistance-type exercise training. However, due to adverse effects in the past, very extensive contraindications have been put in place for the commercial, non-medical WB-EMS market. Considering recent positive innovations e.g., federal regulation, mandatory trainer education, revised guidelines, and new scientific studies on WB-EMS application, we believe that a careful revision of the very restrictive contraindications on WB-EMS is needed. This applies all the more because many cohorts with limited options for conventional exercise have so far been excluded. During a first meeting of an evidence-based consensus process, stakeholders from various backgrounds (e.g., research, education, application) set the priorities for revising the contraindications. We decided to focus on four categories of absolute contraindications: "Arteriosclerosis, arterial circulation disorders", "Diabetes mellitus" (DM), "Tumor and cancer" (TC), "Neurologic diseases, neuronal disorders, epilepsy". Based on scientific studies, quality criteria, safety aspects and benefit/risk assessment of the category, DM and TC were moved to the relative contraindication catalogue, while arteriosclerosis/arterial circulation disorders and neurologic diseases/neuronal disorders/epilepsy were still considered as absolute contraindications. While missing evidence suggests maintaining the status of neurologic diseases/neuronal disorders as an absolute contraindication, the risk/benefit-ratio does not support the application of WB-EMS in people with arteriosclerosis/arterial circulation diseases. Despite these very cautious modifications, countries with less restrictive structures for non-medical WB-EMS should consider our approach critically before implementing the present revisions. Considering further the largely increased amount of WB-EMS trials we advice regular updates of the present contraindication list.
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Genetic structure and ecological niche space of lentil's closest wild relative, Lens orientalis (Boiss.) Schmalh. PLANT BIOLOGY (STUTTGART, GERMANY) 2024; 26:232-244. [PMID: 38230798 DOI: 10.1111/plb.13615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
Crops arose from wild ancestors and to understand their domestication it is essential to compare the cultivated species with their crop wild relatives. These represent an important source of further crop improvement, in particular in relation to climate change. Although there are about 58,000 Lens accessions held in genebanks, only 1% are wild. We examined the geographic distribution and genetic diversity of the lentil's immediate progenitor L. orientalis. We used Genotyping by Sequencing (GBS) to identify and characterize differentiation among accessions held at germplasm collections. We then determined whether genetically distinct clusters of accessions had been collected from climatically distinct locations. Of the 195 genotyped accessions, 124 were genuine L. orientalis with four identified genetic groups. Although an environmental distance matrix was significantly correlated with geographic distance in a Mantel test, the four identified genetic clusters were not found to occupy significantly different environmental space. Maxent modelling gave a distinct predicted distribution pattern centred in the Fertile Crescent, with intermediate probabilities of occurrence in parts of Turkey, Greece, Cyprus, Morocco, and the south of the Iberian Peninsula with NW Africa. Future projections did not show any dramatic alterations in the distribution according to the climate change scenarios tested. We have found considerable diversity in L. orientalis, some of which track climatic variability. The results of the study showed the genetic diversity of wild lentil and indicate the importance of ongoing collections and in situ conservation for our future capacity to harness the genetic variation of the lentil progenitor.
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Sign reversal of the Josephson inductance magnetochiral anisotropy and 0-π-like transitions in supercurrent diodes. NATURE NANOTECHNOLOGY 2023; 18:1266-1272. [PMID: 37430040 DOI: 10.1038/s41565-023-01451-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/09/2023] [Indexed: 07/12/2023]
Abstract
The recent discovery of the intrinsic supercurrent diode effect, and its prompt observation in a rich variety of systems, has shown that non-reciprocal supercurrents naturally emerge when both space-inversion and time-inversion symmetries are broken. In Josephson junctions, non-reciprocal supercurrent can be conveniently described in terms of spin-split Andreev states. Here we demonstrate a sign reversal of the Josephson inductance magnetochiral anisotropy, a manifestation of the supercurrent diode effect. The asymmetry of the Josephson inductance as a function of the supercurrent allows us to probe the current-phase relation near equilibrium, and to probe jumps in the junction ground state. Using a minimal theoretical model, we can then link the sign reversal of the inductance magnetochiral anisotropy to the so-called 0-π-like transition, a predicted but still elusive feature of multichannel junctions. Our results demonstrate the potential of inductance measurements as sensitive probes of the fundamental properties of unconventional Josephson junctions.
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Development and usability testing of a fully immersive VR simulation for REBOA training. Int J Emerg Med 2023; 16:67. [PMID: 37803269 PMCID: PMC10559413 DOI: 10.1186/s12245-023-00545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potentially life-saving procedure for bleeding trauma patients. Being a rare and complex procedure performed in extreme situations, repetitive training of REBOA teams is critical. Evidence-based guidelines on how to train REBOA are missing, although simulation-based training has been shown to be effective but can be costly and complex. We aimed to determine the feasibility and acceptance of REBOA training using a fully immersive virtual reality (VR) REBOA simulation, as well as assess the confidence in conducting the REBOA procedure before and after the training. METHODS Prospective feasibility pilot study of prehospital emergency physicians and paramedics in Bern, Switzerland, from November 2020 until March 2021. Baseline characteristics of trainees, prior training and experience in REBOA and with VR, variables of media use (usability: system usability scale, immersion/presence: Slater-Usoh-Steed, workload: NASA-TLX, user satisfaction: USEQ) as well as confidence prior and after VR training were accessed. RESULTS REBOA training in VR was found to be feasible without relevant VR-specific side-effects. Usability (SUS median 77.5, IQR 71.3-85) and sense of presence and immersion (Slater-Usoh-Steed median 4.8, IQR 3.8-5.5) were good, the workload without under-nor overstraining (NASA-TLX median 39, IQR 32.8-50.2) and user satisfaction high (USEQ median 26, IQR 23-29). Confidence of trainees in conducting REBOA increased significantly after training (p < 0.001). CONCLUSIONS Procedural training of the REBOA procedure in immersive virtual reality is possible with a good acceptance and high usability. REBOA VR training can be an important part of a training curriculum, with the virtual reality-specific advantages of a time- and instructor-independent learning.
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Escherichia coli Meningitis in a Patient With Urinary Tract Infection: A Case Report. Cureus 2023; 15:e41312. [PMID: 37539405 PMCID: PMC10395550 DOI: 10.7759/cureus.41312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 08/05/2023] Open
Abstract
This article discusses a case of Escherichia coli (E. coli) meningitis resulting in altered mental status in a patient with multiple pre-existing comorbidities. The case highlights the underestimated risk of community-acquired gram-negative meningitis in adults, which can have a high mortality rate, particularly in elderly patients with sepsis and urinary tract infections. Diagnosis of E. coli meningitis was confirmed by analyzing cerebrospinal fluid obtained through the lumbar puncture and blood cultures. Treatment involved prompt administration of antibiotics and supportive care. However, the emergence of antibiotic resistance, such as extended-spectrum beta-lactamase production, in community-acquired E. coli meningitis is an increasing concern. Therefore, early recognition and appropriate management are crucial in the diagnosis and treatment of this life-threatening condition.
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ICARUS at the Fermilab Short-Baseline Neutrino program: initial operation. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2023; 83:467. [PMID: 37303462 PMCID: PMC10239613 DOI: 10.1140/epjc/s10052-023-11610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023]
Abstract
The ICARUS collaboration employed the 760-ton T600 detector in a successful 3-year physics run at the underground LNGS laboratory, performing a sensitive search for LSND-like anomalous ν e appearance in the CERN Neutrino to Gran Sasso beam, which contributed to the constraints on the allowed neutrino oscillation parameters to a narrow region around 1 eV2 . After a significant overhaul at CERN, the T600 detector has been installed at Fermilab. In 2020 the cryogenic commissioning began with detector cool down, liquid argon filling and recirculation. ICARUS then started its operations collecting the first neutrino events from the booster neutrino beam (BNB) and the Neutrinos at the Main Injector (NuMI) beam off-axis, which were used to test the ICARUS event selection, reconstruction and analysis algorithms. ICARUS successfully completed its commissioning phase in June 2022. The first goal of the ICARUS data taking will be a study to either confirm or refute the claim by Neutrino-4 short-baseline reactor experiment. ICARUS will also perform measurement of neutrino cross sections with the NuMI beam and several Beyond Standard Model searches. After the first year of operations, ICARUS will search for evidence of sterile neutrinos jointly with the Short-Baseline Near Detector, within the Short-Baseline Neutrino program. In this paper, the main activities carried out during the overhauling and installation phases are highlighted. Preliminary technical results from the ICARUS commissioning data with the BNB and NuMI beams are presented both in terms of performance of all ICARUS subsystems and of capability to select and reconstruct neutrino events.
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Frailty as an indicator of postoperative complications following surgical excision of non-melanoma skin cancer on the head and neck. Ann R Coll Surg Engl 2023; 105:342-347. [PMID: 35950511 PMCID: PMC10066642 DOI: 10.1308/rcsann.2022.0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Non-melanoma skin cancer (NMSC) predominantly affects those aged over 90 years, with 85% of lesions arising on the head and neck, where surgical excision remains the treatment of choice. Frailty is a measure of physiologic age and can be used as a predictor of adverse treatment outcomes. The aim of this study was to determine if the Rockwood Frailty Index is predictive of complications following excision of NMSC. METHODS Data were collected prospectively for patients who underwent an excision of a suspected NMSC from the head or neck across a two-month period. Details of the patient, lesion and procedure were recorded alongside ASA grade and Rockwood's Frailty score. Postoperative complications were recorded four weeks later. RESULTS There was a total of 125 patients: 74 (60%) male, 51 (40%) female; mean age was 78 (±9.8) years. Of the excised sites, 61% were closed primarily, 26% with a full thickness skin graft (FTSG), 13% with a local flap. Frailty ranged from 1 to 7 (median = 4). ASA ranged from 1 to 4 (median = 3). A total of 21 (17%) patients reported postoperative complications. Within this group, the median frailty and ASA grades were 5 and 3. Both frailty and ASA were positively significantly associated with age (p ≤ 0.001). There was no significant difference between the frailty or ASA grades of patients that experienced complications and those who did not. Patients who had a FTSG were significantly more likely to experience complications (p ≤ 0.05). CONCLUSIONS Frailty is not predictive of postoperative complications following excision of NMSC on the head and neck. Postoperative complications are significantly more associated with FTSG.
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Etiologies of Extreme Leukocytosis. Cureus 2023; 15:e38062. [PMID: 37228523 PMCID: PMC10208012 DOI: 10.7759/cureus.38062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/02/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE The objective of this study was to determine the etiologies and co-morbidities associated with extreme leukocytosis, which is characterized by a white blood cell (WBC) count ≥ 35 × 109 leukocytes/L. Method: Retrospective chart review was conducted for all patients, aged 18 years and older, admitted to the internal medicine department between 2015 and 2021 with an elevated WBC count ≥ 35 × 109 leukocytes/L within the first 24 hours of admission. Results: Eighty patients were identified to have WBC count ≥ 35 × 109 leukocytes/L. The overall mortality was 16% and increased to 30% in those presenting with shock. Mortality increased from 2.8% in patients with WBC count in the range of 35-39.9 × 109 leukocytes/L to 33% in those with WBC count in the range of 40-50 × 109 leukocytes/L. There was no correlation with underlying co-morbidities or age. Pneumonia was the most common infection (38%), followed by UTI or pyelonephritis (28%) and abscesses (10%). There was no predominant organism responsible for these infections. The most common etiology for WBC count between 35-39.9 × 109 leukocytes/L and 40-50 × 109 leukocytes/L was infections, while malignancies (especially chronic lymphocytic leukemia) were more common with WBC count > 50 × 109 leukocytes/L. Conclusion: For WBC counts in the range of 35-50 × 109 leukocytes/L, infections were the main reason for admission to the internal medicine department. Mortality increased from 2.8% to 33% as WBC counts increased from 35-39.9 × 109 leukocytes/L to 40-50 × 109 leukocytes/L. Overall, mortality for all WBC counts ≥ 35 × 109 leukocytes/L was 16%. The most common infections were pneumonia, followed by UTI or pyelonephritis and abscesses. The underlying risk factors did not correlate with WBC counts or mortality.
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Donor Derived Cell Free DNA is Correlated with DSA and Rejection in Pediatric Heart Transplant Recipients. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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A Challenging Diagnosis of Febrile Pancytopenia in a Patient With a History of Autoimmune Disease. Cureus 2023; 15:e35956. [PMID: 37038578 PMCID: PMC10082673 DOI: 10.7759/cureus.35956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/09/2023] [Indexed: 03/11/2023] Open
Abstract
Pancytopenia is a hematologic condition characterized by a decrease in all three peripheral blood cell lines. There are many causes of pancytopenia, and the proper approach is required for accurate diagnosis. Brucellosis and systemic lupus erythematosus (SLE) are both diseases that can initially present as pancytopenia, both of which require a targeted workup to diagnose. Due to the immune system's complexity, many distinct diseases may have similar symptomatology. Furthermore, infections and rheumatological diseases can stimulate the same molecular pathways and trigger T and B cells. This creates a cross-reactivity between microbial peptides and self-peptides, allowing the spread of microbial-specific T cells that can also respond to self-peptides. Brucellosis has broad clinical manifestations, often mimicking many other diseases, such as rheumatoid arthritis, sarcoidosis, and SLE. In addition, brucellosis-induced autoantibody production has been described as a triggering factor for immunologic reactions, elevating rheumatological markers by a poorly understood mechanism. Finally, SLE is a well-known medical condition that can mimic several medical conditions, including brucellosis. We present a case of a young patient who was admitted with febrile pancytopenia. The patient also had IgM antibodies positive for brucellosis and high immune markers for SLE. She was treated for both diseases, and afterward, in retrospect, it was confirmed that the patient did not have acute brucellosis.
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The role of adjuvant treatment for early-stage uterine clear cell carcinomas. Gynecol Oncol 2023; 170:77-83. [PMID: 36641903 DOI: 10.1016/j.ygyno.2022.12.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/29/2022] [Accepted: 12/31/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Uterine clear cell carcinoma is a rare and aggressive subtype of endometrial carcinoma. Prospective clinical trials have not been feasible for this rare tumor, and data regarding the optimal adjuvant treatment regimen for early-stage uterine clear cell carcinomas is limited. Our study's objective was to determine if adjuvant chemotherapy or radiation therapy improves patients' outcomes in stage I and II uterine clear cell carcinoma. METHODS Patients with stage I and II uterine clear cell carcinoma were identified at a single institution. All cases were reviewed by a gynecologic pathologist. Both pure and mixed non-serous uterine clear cell carcinomas were included. Primary outcomes were recurrence free survival and overall survival. RESULTS A total of 71 patients were identified including 39 (55%) pure and 32 (45%) mixed clear cell carcinoma. Most patients were FIGO stage IA (77.5%). Most patients (n = 58, 82%) received adjuvant therapy, including 43 (61%) receiving chemotherapy, 50 (70%) receiving radiation therapy, and 35 (49%) receiving both. Recurrence free survival was not significantly different among patients receiving no or <6 cycles of chemotherapy versus patients receiving 6 cycles of chemotherapy (p = 0.39). However, median OS was significantly different among patients receiving no or <6 cycles of chemotherapy versus 6 cycles of chemotherapy (p = 0.004). On univariable analysis, 6 cycles of chemotherapy was significantly associated with improved OS (HR 0.1, 95% CI 0.01-0.07). Presence of LVSI, mutated p53, number of pelvic and para-aortic lymph nodes assessed, adjuvant chemotherapy (any number of cycles), and >2 medical co-morbidities were not significant predictors of OS on univariable analysis. On multivariable analysis, 6 cycles of adjuvant chemotherapy remained a significant predictor of improved OS (HR 0.1, 95% CI 0.01-0.8). CONCLUSIONS In this study, administration of 6 cycles of chemotherapy appears to significantly improve OS. This finding suggests consideration of 6 cycles of adjuvant chemotherapy in patients with early-stage uterine clear cell carcinoma, however clinical trials are needed to confirm these findings.
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Erector spinae plane blocks for analgesia after percutaneous nephrolithotomy: A pathway to reduce opiates. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00986-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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AN ATYPICAL PRESENTATION OF LIPOPOLYSACCHARIDE-RESPONSIVE BEIGE-LIKE ANCHOR PROTEIN DEFICIENCY. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Is there an inter-manufacturer difference in generic clopidogrel response? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Differences in platelet aggregation response to generic clopidogrel by manufacturer has not been investigated.
Purpose
Compare rates of clopidogrel response among patients receiving medication produced by two different manufacturers after acute coronary syndrome and/or percutaneous coronary intervention.
Methods
This quality improvement project included 515 adult patients receiving clopidogrel for acute coronary syndrome or ischemic heart disease and referred for coronary angiography/percutaneous coronary intervention at a large, public hospital. The project was divided into two phases: 1. retrospective collection of baseline data; 2. two 12-week, prospective phases in which all clopidogrel in the hospital was restricted to a single manufacturer at a time. The primary outcome was clopidogrel response measured by platelet function testing defined as ADP response <40% on light transmission aggregometry between two manufacturer groups. Aspirin response defined as arachidonic acid response <20% was also measured.
Results
Of 515 total patients included in both phases (mean [SD] age, 64.5 [11.4] years; 351 [68.2%] men; 450 [87.4%] ACS), 52% were found to be clopidogrel responders based on results of platelet function testing (Table 1 – select variables). Among 135 patients in the prospective phase, there was a significantly lower proportion of patients who were clopidogrel responders in the Manufacturer 1 group compared to the Manufacturer 2 group (34.8% vs. 55.1%, p=0.03) (Table 2 – select variables). After adjustment for age, sex, BMI, aspirin response, therapeutic hypothermia, LHC indication, clopidogrel loading dose, time between loading dose and lab measurement, and manufacturer, aspirin response (OR [95% CI]: 0.96 [0.95–0.97], p<0.001) and manufacturer (OR [95% CI]: 2.45 [1.18–5.22], p=0.02) were associated with clopidogrel response.
Conclusions
In a large public hospital, we observed that pharmacodynamic response to clopidogrel varied by drug manufacturer. Further investigation and/or regulation is needed to minimize inter-manufacturer variability.
Funding Acknowledgement
Type of funding sources: None.
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Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2022; 82:618. [PMID: 35859696 PMCID: PMC9288420 DOI: 10.1140/epjc/s10052-022-10549-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/24/2022] [Indexed: 06/15/2023]
Abstract
DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6 × 6 × 6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.
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POS0130 NEAR INFRARED FLUORESCENCE OPTICAL IMAGING (NIR-FOI) CAN SUPPORT THE DIFFERENTIAL DIAGNOSES OF CONNECTIVE TISSUE DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundDifferentiation between degenerative osteoarthritis (OA) and autoimmune caused connective tissue diseases (CTD), or rheumatoid arthritis (RA) is important for effective therapy. Anamnesis, clinical examination, and analysis of laboratory parameters are helpful for diagnosis, but do not always lead to clear results. One problem is that patients often show overlapping symptoms. Particularly, imaging techniques as NIR-based fluorescence optical imaging (FOI) are playing an increasingly role as quantifiable and sensitive diagnostic methods. After injection of a fluorescent dye, changes in the microcirculation caused by inflammation can be detected due to altered blood flow and accumulation in anatomical structures of the hands. Analyses of enrichment features can be used to identify pathological changes and to support the diagnosis of degenerative and autoimmune diseases.ObjectivesThe present work investigates the potential of NIR-FOI feature assessment to differentiate between various rheumatic diseases, which are accompanied by pathological changes in connective tissues.MethodsNIR fluorescence imaging comprised 360 images/6 min. after injection of the dye. Analyses of patients with the clinical diagnosis of OA (n = 236) were compared with RA patients (n = 235), and patients diagnosed with autoimmune CTD (collagenoses) (n = 149). 17 features known to occur in FOI images were analyzed in both hands in three time periods (P1-3) after injection in two independent passes. In some cases, Prima Vista images (PVI), representing the sum of images 1-240 were also analyzed (n = 45, 33, 33 for OA, RA, CTD). Signals compared to the background were assessed as positive or negative (Figure 1). The data were analyzed statistically.Figure 1.Examples of significantly different features in NIR-FOI images of patients with clinically diagnosed OA, RA, or CTD. Top: the whole hands, also with nail bed injuries in phase 1 (P1) for a CTD patient (right), bottom: increased intensity in muscle-tendon junction in the forearm in phase 2 (P2) for an OA patient, increased intensity in MCP joint in phase 1 (P1) for an RA patient and a secondary Raynaud syndrome for a CTD patient in PVI.ResultsComparing the analyses of all phases of the OA cohort with those of the RA cohort, 14 of 51 features were identified as significantly different (p<0.05). The dye accumulation in metacarpophalangeal joints (MCP) has high specificity and diagnostic odds ratio (DOR) for RA patients (91%, 4.32). Patients in the OA cohort showed an increase in the signal at the muscle-tendon junction in the forearm (80% specificity, DOR 3.11). A comparison of the RA and CTD cohorts revealed 24 significant differences, most prominent changes in the nail bed in P1 (100% specificity, DOR 8.27) and a punctate accumulation pattern in P2 (98% specificity, DOR 2.61) for the CTD cohort. Comparing the RA and CTD cohorts, 22 features were significantly different. The strongest differences were found in the PIP joints of RA patients (78% sensitivity, DOR 2.97) and in the nail bed of CTD patients (100 % specificity, DOR 8.18). In the cumulative PV images a high specificity for a secondary Raynaud’s syndrome in CTD patients was found as compared to RA (97%, DOR 17.7) and OA (91%, DOR 5.9). Further, DIP signals for OA comparing to CTD show significant differences (76 % sensitivity, DOR 2,73).ConclusionThe present work demonstrates the detection and localization of specific, significant features in NIR-FOI of patients with different rheumatic diseases and can thus make an important contribution to diagnosis and optimization of therapy. In future, multivariate analysis and artificial intelligence algorithms can combine these features to further improve the diagnostic value.AcknowledgementsFunded by the Federal Ministry of Education and Research (grant nb.; 13GW0341A)Disclosure of InterestsDenise Kiesel Employee of: Xiralite GmbH, Jörn Berger Employee of: Xiralite GmbH, Egbert Gedat Employee of: Xiralite GmbH, Sarah Ohrndorf: None declared, Andreas Briel Shareholder of: Xiralite GmbH, Employee of: Xiralite Gmbh, Vieri Failli Employee of: nanoPET GmbH, Pia Welker Employee of: nanoPET GmbH
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AB1363 IMAGE PATTERN ANALYSIS IN FLUORESCENCE OPTICAL IMAGING FOR DIFFERENTIAL DIAGNOSIS IN RHEUMATIC JOINT DISEASES. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundAs outlined in previous studies, different rheumatic joint diseases present specific characteristic patterns and features in fluorescence optical imaging (FOI) (1-4).ObjectivesWe tested different features in FOI for their ability to differentiate various rheumatic joint diseases such as rheumatoid arthritis (RA), osteoarthritis (OA) and psoriatic arthritis (PsA) with the aim to identify clear FOI criteria for the diseases.MethodsFOI images from patients with RA, OA, PsA and healthy volunteers were evaluated by two readers blinded for diagnosis and calibrated against each other, using the prima vista mode (PVM) and the 5-phase model. For the latter, the overall time course of FOI in each hand was divided into 5 phases with a computational algorithm. Phases 1 and 2 describe the inflow (start to 15% and 15%-90% on rising edge), phase 3 is the peak phase and phases 4 and 5 comprise the outflow (90%-36.8% and 36.8% to end on falling edge). Twenty-six different features were defined by an atlas, for example the streaky pattern feature (T) as a signal enhancement around the PIP area that appears streaky, whereby the stripes are orthogonal to the finger axis (Figure 1a). The cloudy pattern (W) is visible during the inflow on the back of the hand (Figure 1b). The enthesis feature (E) depicts a V shaped and filled pattern between nail and DIP (Figure 1c). The feature frequency in each patient and phase (PVM, 5-phase) was counted and statistically analysed.Figure 1.Examples for FOI patterns and features: a) (T) Streaky pattern in PVM image (OA); b) (W) Cloudy pattern on the back of the hand in phase 1 (PsA); c) (E) Enthesis pattern in phase 3.ResultsIn total, 128 patients (RA (age mean 54.2; SD 10.6; median 52.4), OA (58.0; 14.3; 60.1), and PsA (47.9; 12.7; 46.8)) and healthy volunteers (32 in each group) were included in the feature reading. In our analysis, OA can be differentiated from RA on the basis of the feature T. Feature T is found in phase 3 (χ2: 4.61; diagnostic odds ratio (DOR): 7.49; sensitivity (TPR) 0.11; specificity (TNR): 0.98; positive predictive value (PPV): 0.87; negative predictive value (NPV): 0.52), phase 5 (χ2: 18.5; DOR: 5.60; TPR 0.55; TNR: 0.82; PPV: 0.76; NPV: 0.64 and PVM (28.3; 12.1; 52%; 92% 87%; 65%). By means of the feature E, a distinction between RA and PsA is only limited possible (χ2: 9.58; DOR: 3.65; TPR 0.40; TNR: 0.84; PPV: 0.71; NPV: 0.59). But PsA can well be distinguished from RA by the appearance of pattern W in phase 1 (χ2: 7.68; DOR: 6.92; TPR 0.19; TNR: 0.97; PPV: 0.86; NPV: 0.54).Other significant features yield high specificity (70%-98%) while having low sensitivity (12%-52%).ConclusionThis work demonstrates that FOI feature analysis has the potential for differential diagnosis with FOI, which could optimize the (early) diagnostic process of rheumatic joint diseases. A majority of features yield high specificity, but only low sensitivity. The combination of different features using artificial intelligence might lead to improved diagnostic accuracy.References[1]Werner SG, et al. Inflammation assessment in patients with arthritis using a novel in vivo fluorescence optical imaging technology. Ann Rheum Dis. 2012; 71(4):504-510.[2]Glimm AM, et al. Analysis of distribution and severity of inflammation in patients with osteoarthitis compared to rheumatoid arthritis by ICG-enhanced fluorescence optical imaging and musculoskeletal ultrasound: a pilot study. Ann Rheum Dis. 2016; 75(3):566-570.[3]Wiemann O, et al. The “green nail” phenomenon in ICG-enhanced fluorescence optical imaging - a potential tool for the differential diagnosis of psoriatic arthritis. J Dtsch Dermatol Ges. 2019;17(2):138-147.[4]Schmidt A, et al. Detection of subclinical skin manifestation in patients with psoriasis and psoriatic arthritis by fluorescence optical imaging. Arthritis Res Ther. 2020; 22(1):192.Disclosure of InterestsNone declared
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PD-0913 Is substantial LVSI prognostic in patients with pathological lymph node-negative endometrial cancer? Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02992-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Treatment outcome of atypical EGFR mutations in the German National Network Genomic Medicine Lung Cancer (nNGM). Ann Oncol 2022; 33:602-615. [PMID: 35263633 DOI: 10.1016/j.annonc.2022.02.225] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Atypical EGFR mutations occur in 10-30% of NSCLC patients with EGFR mutations and their sensitivity to classical EGFR-tyrosine kinase inhibitors (TKI) is highly heterogeneous. Patients harboring one group of uncommon, recurrent EGFR mutations (G719X, S768I, L861Q) respond to EGFR-TKI. Exon 20 insertions are mostly insensitive to EGFR-TKI but display sensitivity to exon 20 inhibitors. Clinical outcome data of patients with very rare point and compound mutations upon systemic treatments are still sparse to date. PATIENTS AND METHODS In this retrospective, multi-center study of the national Network Genomic Medicine (nNGM) in Germany, 856 NSCLC cases with atypical EGFR mutations including co-occuring mutations were reported from 12 centers. Clinical follow-up data after treatment with different EGFR-TKI, chemotherapy and immune checkpoint inhibitors were available from 260 patients. Response to treatment was analyzed in three major groups: (1) uncommon mutations (G719X, S7681, L861Q and combinations), (2) exon 20 insertions and (3) very rare EGFR mutations (very rare single point mutations, compound mutations, exon 18 deletions, exon 19 insertions). RESULTS Our study comprises the largest thus far reported real-world cohort of very rare EGFR single point and compound mutations treated with different systemic treatments. We validated higher efficacy of EGFR-TKI in comparison to chemotherapy in group 1 (uncommon), while most exon 20 insertions (group 2) were not EGFR-TKI responsive. In addition, we found TKI sensitivity of very rare point mutations (group 3) and of complex EGFR mutations containing exon 19 deletions or L858R mutations independent of the combination partner. Notably, treatment responses in group 3 (very rare) were highly heterogeneous. Co-occurring TP53 mutations exerted a non-significant trend for a detrimental effect on outcome in EGFR-TKI treated patients in groups 2 and 3 but not in group 1. CONCLUSIONS Based on our findings we propose a novel nNGM classification of uncommon EGFR mutations.
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979. Getting Candid with Candida auris: Evaluation of Isolates at SBH Health System. Open Forum Infect Dis 2021. [DOI: 10.1093/ofid/ofab466.1173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Candida auris is a multidrug resistant yeast that was originally isolated in the external ear of a patient in Japan in 2009. Since then, it has rapidly spread throughout the world. C. auris is inherently a multidrug resistant organism, making echinocandins the drugs of choice. C. auris was first isolated in SBH in a wound culture in 2018, and it has become a major health concern. Our objectives were to evaluate our clinical C. auris isolates, identify potential risk factors for infection, and assess our susceptibilities to determine the most appropriate treatment option.
Methods
This was a retrospective chart review of all clinical isolates of C. auris from July 2018 – April 2021. Data collection included location prior to admission, SBH hospitalization within 90 days, hospital vs community acquired, new vs recurrent, specimen type, susceptibilities, and lines at the time of culture.
Results
A total of 121 clinical isolates were evaluated from 74 patients. Although initially clinical isolates were rare, prevalence increased in subsequent years, with 97 clinical isolates identified in 2020. Isolates were identified in various specimen types, with the majority in urine, respiratory samples, or blood cultures. 64% of the isolates were hospital onset. Among patients who tested positive for C. auris colonization through surveillance testing, 22% proceeded to develop clinical infections. Most of the patients with positive blood cultures had either one or multiple IV access points, which may be a risk factor for candidemia. All isolates were resistant to fluconazole, 87% were susceptible to amphotericin B, and susceptibility to echinocandins ranged from 98-99%.
Susceptibilities
Susceptibilities for the Candida auris clinical isolates received from the NYS Department of Health
Specimen Type
IV Access in Positive Blood Cultures
Access points that were present at the time of candidemia
Conclusion
Candida auris is a persistent fungus that is highly contagious that has been increasing in prevalence. Infection control measures remain the most proven method to decrease the development of clinical infections. Our study has some limitations, such as the retrospective design, the lack of a control group, lack of clinical outcomes, and limited surveillance testing capabilities. C. auris remains a major cause of concern for nosocomial infections, particularly in patients with various indwelling catheters. Our susceptibilities confirmed echinocandins as the class of choice for treatment of C. auris infections.
Disclosures
Judith Berger, MD, Nothing to disclose
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Vestibular testing in children - The suppression head impulse (SHIMP) test. Int J Pediatr Otorhinolaryngol 2021; 151:110921. [PMID: 34537549 DOI: 10.1016/j.ijporl.2021.110921] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/07/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The incidence of vestibular disorders and vertigo during childhood is increasing and pediatric clinicians have become more sensitive to children's balance disorders; thus, there is a need for appropriate detection test procedures for peripheral vestibular hypofunction. In order to ensure a reliable diagnosis and minimize misdiagnosis, a standardized clinical procedure via careful history and clinical examination is recommended. However, children, especially, are often unable to verbalize "vertigo" in a concrete manner, which often necessitates a consultation with a pediatrician holding nonspecific symptoms. The so-called suppression of the head impulse test (SHIMPs) represents a modification of the video head impulse test (HIMP) and is used for a more sensitive assessment of residual vestibular functions. In adults, SHIMPs are already an established diagnostic method. Nevertheless, to date, nothing is known about the applicability and standard values in childhood. MATERIAL AND METHODS In this monocentric, prospective study, we investigated whether SHIMPs enable a sensitive functional analysis of the vestibular system in healthy children of different ages. For this purpose, SHIMPs were performed in 40 children aged 3-18 years. RESULTS In this study, we demonstrated that SHIMPs can be easily performed in children (3-18 years). It is vital that the test be appropriately explained for children to ensure sufficient test tolerance and compliance. CONCLUSION SHIMPs are a helpful supplement to clinically established vestibular tests such as the HIMP in pediatric vestibular balance disorder diagnostics and can be integrated into the clinical routine, especially in children who have minimal verbal abilities or understanding of the instructions for HIMP. Similar to the HIMP, SHIMPs are characterized by a short test duration and a high tolerance.
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Cost-effectiveness analysis of tumor molecular classification in high-risk early-stage endometrial cancer. Gynecol Oncol 2021; 164:129-135. [PMID: 34740462 DOI: 10.1016/j.ygyno.2021.10.071] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/04/2021] [Accepted: 10/10/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Tumor molecular analyses in endometrial cancer (EC) includes 4 distinct subtypes: (1) POLE-mutated, (2) mismatch repair protein (MMR) deficient, (3) p53 mutant, and (4) no specific molecular profile. Recently, a sub-analysis of PORTEC-3 demonstrated notable differences in treatment response between molecular classification (MC) groups. Cost of testing is one barrier to widespread adoption of MC. Therefore, we sought to determine the cost-effectiveness of MC in patients with stage I and II high-risk EC. METHODS A Markov decision model was developed to compare tumor molecular classification (TMC) vs. no testing (NT). A healthcare payor's perspective and 5-year time horizon were used. Base case data were abstracted from PORTEC-3 and the molecular sub-analysis. Cost and utility data were derived from public databases, peer-reviewed literature, and expert input. Strategies were compared using the incremental cost-effectiveness ratio (ICER) with effectiveness in quality-adjusted life years (QALYs) and evaluated with a willingness-to-pay threshold of $100,000 per QALY gained. Sensitivity analyses were performed to test model robustness. RESULTS When compared to NT, TMC was cost effective with an ICER of $25,578 per QALY gained; incremental cost was $1780 and incremental effectiveness was 0.070 QALYs. In one-way sensitivity analyses, results were most sensitive to the cost of POLE testing, but TMC remained cost-effective over all parameter ranges. CONCLUSIONS TMC in early-stage high-risk EC is cost-effective, and the model results were robust over a range of parameters. Given that MC can be used to guide adjuvant treatment decisions, these findings support adoption of TMC into routine practice.
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Erratum: Azimuthal Anisotropy of K_{S}^{0} and Λ+Λ[over ¯] Production at Midrapidity from Au+Au Collisions at sqrt[s]_{NN}=130 GeV [Phys. Rev. Lett. 89, 132301 (2002)]. PHYSICAL REVIEW LETTERS 2021; 127:089901. [PMID: 34477449 DOI: 10.1103/physrevlett.127.089901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.89.132301.
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Erratum: Azimuthal Anisotropy at the Relativistic Heavy Ion Collider: The First and Fourth Harmonics [Phys. Rev. Lett. 92, 062301 (2004)]. PHYSICAL REVIEW LETTERS 2021; 127:069901. [PMID: 34420354 DOI: 10.1103/physrevlett.127.069901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Indexed: 06/13/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.92.062301.
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POS1401 ASSESSMENT OF INTERREADER RELIABILITY IN SCORING PATIENTS WITH HAND OSTEOARTHRITIS AND PSORIATIC ARTHRITIS BY FLUORESCENCE OPTICAL IMAGING. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Fluorescence Optical Imaging (FOI) utilises the fluorophore indocyanine green (ICG) to reflect enhanced microcirculation in hand and finger joints due to inflammation.Objectives:We wanted to assess the interreader reliability of FOI enhancement in patients with hand osteoarthritis (OA) and psoriatic arthritis (PsA). Furthermore, predefined typical morphologic patterns were included to determine the ability of FOI to discriminate between both diagnoses.Methods:An atlas with example images of grade 0-3 in different joint groups and typical morphologic patterns (‘streaky signals’[1], ‘green/blue nail sign’[2], ‘Werner sign’[3,4], and ‘Bishop’s crozier sign’) of PsA and hand OA was created. Two readers scored all joints in both hands (30 in total) of 20 cases with hand OA and PsA. The cases were randomly mixed and both readers were blinded to diagnosis. Each joint was rated on a semiquantitative scale from 0 to 3 in five different images (PrimaVista Mode (PVM), phase 1, 2 (first and middle image), and 3) during the FOI sequence according to the scoring method FOIAS (fluorescence optical imaging activity score)[1,3]. Interreader reliability on scoring joint enhancement was calculated using linear weighted Cohen’s kappa (κ). Agreement on diagnosis (hand OA vs. PsA) and different morphologic patterns was assessed by calculating (regular) Cohen’s kappa.Results:Overall agreement on scoring joint enhancement (all phases) was substantial (κ = 0.75), with greatest consensus in phase 2 first (κ = 0.75) and lowest agreement in phase 1 (κ = 0.46). Reliability varied in different joint groups (wrist, MCP, (P)IP, DIP), with almost perfect overall agreement on PIP joint affection (κ = 0.81), substantial agreement on wrist (κ = 0.69) and DIP joint affection (κ = 0.63), and moderate agreement on MCP joint affection (κ = 0.49) across all phases. Consensus on morphologic patterns showed overall fair agreement (κ = 0.37) with a similar kappa value on the ability to discriminate between both diagnoses (κ = 0.3).Conclusion:Joint enhancement in FOI can be reliably assessed using a predefined scoring method. The ability of FOI to differentiate between hand OA and PsA seems to be limited. Clearer definition and more training might be needed to better agree on morphologic patterns in FOI.References:[1] Glimm AM, Werner SG, Burmester GR, et al. Ann Rheum Dis. 2016 Mar;75(3):566-570[2] Wiemann O, Werner SG, Langer HE, et al. J Dtsch Dermatol Ges. 2019 Feb;17(2):138-148[3] Werner SG, Langer HE, Ohrndorf S, et al. Ann Rheum Dis. 2012 Apr;71(4):504-510[4] Zeidler H 2019. Fluoreszenzoptische Bildgebung. In: Zeidler H, Michel BA. Differenzialdiagnose rheumatischer Erkrankungen 5. Aufl. Springer, Heidelberg, S. 88-89Disclosure of Interests:Benedict Drude: None declared, Øystein Maugesten: None declared, Stephanie Gabriele Werner: None declared, Gerd Rüdiger Burmester: None declared, Jörn Berger Employee of: Xiralite GmbH, Ida K. Haugen: None declared, Sarah Ohrndorf: None declared
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ASSESSING THE ROLE OF TRANSESOPHAGEAL ECHO IN PATIENTS WITH STAPHYLOCOCCUS AUREUS BACTEREMIA IN ADESIGNATED MEDICALLY UNDERSERVED AREA. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02748-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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PO-0178 Feasibility and Outcomes for Cervical Cancer Patients Treated with Hybrid Brachytherapy Applicators. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06337-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2021; 81:322. [PMID: 34720713 PMCID: PMC8550327 DOI: 10.1140/epjc/s10052-021-09007-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/23/2021] [Indexed: 06/13/2023]
Abstract
The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.
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Grants
- MR/T019530/1 Medical Research Council
- MR/T041323/1 Medical Research Council
- MSMT, Czech Republic
- NRF, South Korea
- Canadian Network for Research and Innovation in Machining Technology, Natural Sciences and Engineering Research Council of Canada
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- SERI, Switzerland
- Fundação de Amparo à Pesquisa do Estado de São Paulo
- U.S. Department of Energy
- CERN
- Türkiye Bilimsel ve Teknolojik Arastirma Kurumu
- The Royal Society, United Kingdom
- Canada Foundation for Innovation
- U.S. NSF
- FCT, Portugal
- CEA, France
- CNRS/IN2P3, France
- European Regional Development Fund
- Science and Technology Facilities Council
- H2020-EU, European Union
- IPP, Canada
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro
- CAM, Spain
- MSCA, European Union
- Instituto Nazionale di Fisica Nucleare
- Fundacção de Amparo à Pesquisa do Estado de Goiás
- Ministerio de Ciencia e Innovación
- Fundacion “La Caixa” Spain
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Three-dimensional microscale hanging drop arrays with geometric control for drug screening and live tissue imaging. SCIENCE ADVANCES 2021; 7:7/17/eabc1323. [PMID: 33893093 PMCID: PMC8064630 DOI: 10.1126/sciadv.abc1323] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 03/05/2021] [Indexed: 05/09/2023]
Abstract
Existing three-dimensional (3D) culture techniques are limited by trade-offs between throughput, capacity for high-resolution imaging in living state, and geometric control. Here, we introduce a modular microscale hanging drop culture where simple design elements allow high replicates for drug screening, direct on-chip real-time or high-resolution confocal microscopy, and geometric control in 3D. Thousands of spheroids can be formed on our microchip in a single step and without any selective pressure from specific matrices. Microchip cultures from human LN229 glioblastoma and patient-derived mouse xenograft cells retained genomic alterations of originating tumors based on mate pair sequencing. We measured response to drugs over time with real-time microscopy on-chip. Last, by engineering droplets to form predetermined geometric shapes, we were able to manipulate the geometry of cultured cell masses. These outcomes can enable broad applications in advancing personalized medicine for cancer and drug discovery, tissue engineering, and stem cell research.
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369. Clinical Characteristics of the First 177 Patients Admitted with COVID-19 at a Bronx Community Hospital. Open Forum Infect Dis 2020. [PMCID: PMC7776415 DOI: 10.1093/ofid/ofaa439.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The first case of COVID-19 was admitted on March 15th 2020 to our community based hospital in the Bronx, NY. The aim of this study is to describe the clinical characteristics and outcome of these first COVID-19 patients.
Patient Characteristics and Outcome
Methods
IRB approved retrospective chart review study of all COVID-19 patients admitted during March 2020 focusing on patient characteristics, co-morbidities, clinical manifestations and outcome.
Results
A total of 177 patients were admitted during March 2020: 57% African American 23.1% Hispanic and 16.9% White. 44.9% female, average age 60 years, and 90% had at least one comorbidity. Outcome was available on all patients except for one who was transferred to another institution for ECMO. Overall mortality was 33%.
Clinical presentation: 69.4% presented with cough or shortness of breath, 15.8% with diarrhea, nausea, vomiting or abdominal pain, and 14.6% with myalgia, dizziness or altered mental status. 6.2% presented only with fever. However 59.8% of patients presented with fever and respiratory or gastrointestinal symptoms.
Mortality
The table compares patients who died vs discharged (either home or to a short term facility). Those that were 65 years or older, hypertensive or presented to the ER with an oxygen saturation of 94% or lower, were more likely to die.
Ventilated patients: 31.6% of patients were intubated with a mortality rate of 77%. 22% of these patients were intubated in the first 24 hours. Compared to non-intubated patients, there was no difference in BMI, diabetes, hypertension, COPD/Asthma, use of statins, aspirin or calcium channel blockers. Intubated patients older than 64 years had significantly higher mortality rates (p=0.0001).
Conclusion
This cohort of COVID-19 patients is unique as almost all received Hydroxychloroquine and Azithromycin. Only 9% received steroids and even fewer received an interleukin-6 inhibitor, convalescent plasma or Remdesivir. African Americans and Hispanics accounted for 80% of patients. Greater than 90% received Medicaid. Overall mortality was 33%. The most common presentation was respiratory followed by gastrointestinal symptoms. The overall mortality was 33% but increased to 77% in intubated patients. Age, hypertension, and ER oxygen saturation correlated with mortality.
Disclosures
All Authors: No reported disclosures
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56. Ertapenem Utilization: “CRE”ating Solutions for Improving Hospital Stay and Stewardship. Open Forum Infect Dis 2020. [PMCID: PMC7777173 DOI: 10.1093/ofid/ofaa439.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Ertapenem, a carbapenem offers advantages over other carbapenems. It is administered daily and can therefore facilitate home infusion discharges, it has a narrower spectrum of activity which could reduce resistance, and is more cost effective than meropenem. Our objectives were to determine whether ertapenem utilization decreased hospital length of stay and whether use had an impact on future meropenem resistance. Methods This was a retrospective chart review of ertapenem over 2 years for the following infections: urinary tract, skin and soft tissue (SSTI), and osteomyelitis. Evaluated pathogens, duration of inpatient therapy, discharged antimicrobials, length of discharged therapy, and positive cultures up to 90 days post treatment. Analyzed length of stay, and calculated the hospital days that were saved by discharging patients on ertapenem. Results 70 patients were analyzed, with indications and pathogens listed in Figure 1. Patients were initially placed on empiric therapies pending culture results. On average, patients received 2.9 days of empiric meropenem. Once cultures finalized, patients were switched to ertapenem. On average, patients received 6 days of inpatient ertapenem prior to discharge. 37 patients were discharged with ertapenem, totaling 937 days of discharged therapy. Of the 36 patients readmitted within 90 days, 20 had pathogens identified, of which 4 were meropenem-resistant (Figure 2). Infections, Pathogens, and Treatment Duration ![]()
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Conclusion In this pilot stewardship initiative, switching to and discharging patients on ertapenem saved 937 hospital days over the 2 years evaluated, with the greatest days of therapy saved in osteomyelitis and SSTIs. There were a total of 422 days of inpatient ertapenem, mostly in the SSTI and cystitis indications. Of the 20 pathogens identified on readmission, 4 (20%) were meropenem-resistant. All were Acinetobacter baumanii-often carbapenem-resistant; none of the cultures were the same pathogen as the originally identified, but this warrants further investigation. The indication associated with least days of therapy saved and the highest days of inpatient ertapenem was cystitis. 53% of the patients were discharged with ertapenem; future direction involved identifying barriers for speedy discharge across all indications. Disclosures All Authors: No reported disclosures
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525. Characteristics of HIV SARS-COV-2 Coinfection in a Highly HIV Seropositive Population in New York City. Open Forum Infect Dis 2020. [PMCID: PMC7776273 DOI: 10.1093/ofid/ofaa439.719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The HIV and COVID-19 co-infection prevalence has not been described extensively. Given the high prevalence of HIV positive patients in our population-our Designated AIDS Center (DAC) caters to approximately 600 patients-of which 68% are virally suppressed, this relationship is of great interest. The objectives of this analysis are to report the characteristics of HIV and COVID-19 patients, and to evaluate for any associations of HIV with COVID-19 outcomes.
Methods
Retrospective chart review of all patients admitted with both HIV and confirmed COVID-19. Collected demographics, past medical history, HIV history including therapy, compliance, viral loads, and CD4 counts, and COVID-19 disease course. Evaluate baseline clinical status utilizing the World Health Organization’s Ordinal Scale for Clinical Improvement, and note disease outcomes. Analyzed mortality and disease severity as compared to the general COVID-19 patient population.
Results
39 patients were identified with HIV and COVID-19 from March 15th –June 18th 2020. Baseline characteristics of these patients are listed in Figure 1. Of the available labs, 60% of patients were virally suppressed, and 87% had CD4+ counts above 200/µL. On admission, most patients either did not require oxygen support, or received support through noninvasive methods. In Figure 2 we see the final outcome of the patients, with 77% of the patients discharged, and a mortality rate of 18%. Of note, the only baseline characteristic that had a significant correlation with mortality among our patients was age > 60 (p = 0.03).
Baseline Characteristics of HIV COVID-19 Patients and Pertinent COVID-19 Admission Statistics
COVID-19 Outcomes
Conclusion
Mortality in our HIV COVID-19 population was 18%, significantly lower than the 33% in COVID-19 patients overall at our institution. 39 patients with HIV were admitted for confirmed COVID-19 infections, which only amounts to 6.5% of the DAC population, although it is possible that our patients were admitted to other facilities for COVID-19. In our patients, compliance, viral suppression, and CD4+ counts did not correlate with outcomes. Although our mortality was significantly lower than the overall hospital mortality, larger studies are needed to fully evaluate the mortality relationship and determine the protective effects of antiviral therapy and/or decreased immune response in HIV patients with COVID-19.
Disclosures
All Authors: No reported disclosures
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565. Tocilizumab Use in COVID-19: Act(emra) to Inhibit Intubation and Decompensation. Open Forum Infect Dis 2020. [PMCID: PMC7776800 DOI: 10.1093/ofid/ofaa439.759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Tocilizumab is an IL-6 receptor inhibitor that has been utilized for the prevention and treatment of the cytokine storm inflammatory reaction in COVID-19. The objectives of this analysis were to evaluate clinical outcomes of tocilizumab treatment in relation to respiratory status improvements and to analyze the association between initial inflammatory markers and treatment outcomes.
Methods
IRB approved retrospective chart review of adult patients with confirmed COVID-19 treated with tocilizumab from March- May 2020. Data collection focused on relevant past medical history, hematologic and inflammatory markers before and after tocilizumab administration, concomitant COVID-19 treatments, and disease outcomes such as mortality and discharge. Assessed baseline characteristics and treatment outcomes in patients who received tocilizumab prior to intubation versus after intubation, and evaluated for any significant markers of treatment success and failure.
Results
84 patients were evaluated. Baseline characteristics did not vary between intubated and not intubated patients (Figure 1). Overall mortality in patients who received an IL-6 inhibitor was 43%. Mortality in patients who received IL-6 inhibitor when intubated (63%) compared to patients who were not intubated (26%) was significantly higher (p = 0.005). Patients with BMI’s of 30 or above and patients with diabetes had a higher rate of treatment failure (p < 0.05) (Figure 2). Patients with IL-6 levels of 1000 or above had higher rates of treatment failure (p = 0.0001); however, given the small sample size larger studies are required for further analysis (Figure 3).
Baseline Characteristics by Respiratory Status Pre-Tocilizumab Administration
Subgroup Analysis
Outcome by Baseline IL-6 Levels
Conclusion
Overall mortality in our patients was 43%; however, our sample size was small and the study did not have a control group to fully assess treatment success or failure. Comorbidities such as diabetes and obesity, and elevated IL-6 levels were associated with significantly higher rates of treatment failure. Randomized control trials are needed to determine the true benefit of tocilizumab in COVID-19.
Disclosures
All Authors: No reported disclosures
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Risk factors for surgical management of bowel obstruction in patients with gynecological malignancy. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The role of ERAS in minimally invasive surgery: Impact on patient satisfaction and opiate use. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Novel Mandibular Full Arch Rehabilitation Using Standardized Prefabricated Hybrid Framework. J Oral Maxillofac Surg 2020. [DOI: 10.1016/j.joms.2020.07.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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AB0325 FLUORESCENCE OPTICAL IMAGING (FOI) AIDS DIFFERENTIAL DIAGNOSIS OF RHEUMATIC DISEASES AND INCREASES TREATMENT RESPONSE RATE IN RA THROUGH PATIENT STRATIFICATION. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In recent years, indocyanine green (ICG)-enhanced FOI has become clinically available as a novel tool for the early detection of rheumatic diseases, assessment of disease activity and monitoring of treatment response. The high sensitivity of this method allows visualization of slight changes in the microcirculation of the hands as a sign of inflammation. Different rheumatic diseases present characteristic signal enhancement patterns, which may facilitate differential diagnosis. Signal enhancement in metacarpophalangeal (MCP) joints, for example, can frequently be seen in patients with rheumatoid arthritis (RA).Objectives:We analyzed data of a multicentric clinical study (OPERA, n = 3300) including patients with different rheumatic diseases. Patients were divided into groups using clinical parameters followed by FOI examination to test the hypothesis that this method can improve the diagnosis.Methods:The present study involved 200 patients with RA (n=200), divided into groups according to Steinbrocker’s (STBR) staging system, patients that had degenerative osteoarthritis (OA, n=100), and a control group without clinical symptoms (n=40). RA patients were examined before and during treatment with biologicals, glucocorticoids (GK), or DMARDs. Clinical and laboratory assessments were made by analyses of DAS28, patient questionnaires, rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), erythrocyte sedimentation rate (ESR), and x-rays. FOI signal intensity (SI) was defined by ratio of areas with SI in patients and controls. Image sequences were analyzed visually, and MCP joints were judged as positive if in the early phase of ICG inflow, a higher SI in any MCP region was found in comparison to the control group.Results:Initially, serum factors typical for RA patients were analyzed in the different groups. In 23 % of OA patients RF and/or ACPA were detected in the serum. Surprisingly, in the STBR I group, only 35 % of patients were tested as serum-positive for RF and/or ACPA. After FOI, the patients were subdivided into two groups with and without ICG enrichment in MCPs. In the MCP-positive group, the percentage of RF/ACPA-positive STBRI patients increased to 83%, with only 25 % seropositive patients in the MCP-negative group. In STBRII-IV cohorts, the proportion of RF/ACPA-positive patients was initially higher as in the STBRI group, but also increased after FOI analysis of MCP positivity. In the group treated with biologicals (STBRI-IV), responders were identified both by clinical parameters and FOI. After treatment, 42 % of all analyzed patients were found to respond to treatment. Compared to all patients, the MCP-positive group showed a significantly increased response rate at 71%, while all patients (100%) in the MCP-negative group were identified as non-responders (Figure 1).Conclusion:The study indicates that FOI is highly effective for the diagnosis of RA, selection of the appropriate therapy, and for the monitoring of therapeutic success. Treatment response rate can be increased (from 42% to 71%) through patient stratification in terms of ICG enrichment in MCP.Figure.Disclosure of Interests:Mark Ferl: None declared, Sarah Ohrndorf: None declared, Jörn Berger Employee of: Xiralite GmbH, Andreas Briel Shareholder of: Xiralite GmbH, Pia Welker Employee of: Xiralite GmbH
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Rapid Isothermal Amplification and Portable Detection System for SARS-CoV-2. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2020:2020.05.21.108381. [PMID: 32511358 PMCID: PMC7263486 DOI: 10.1101/2020.05.21.108381] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
The COVID-19 pandemic provides an urgent example where a gap exists between availability of state-of-the-art diagnostics and current needs. As assay details and primer sequences become widely known, many laboratories could perform diagnostic tests using methods such as RT-PCR or isothermal RT-LAMP amplification. A key advantage of RT-LAMP based approaches compared to RT-PCR is that RT-LAMP is known to be robust in detecting targets from unprocessed samples. In addition, RT-LAMP assays are performed at a constant temperature enabling speed, simplicity, and point-of-use testing. Here, we provide the details of an RT-LAMP isothermal assay for the detection of SARS-CoV-2 virus with performance comparable to currently approved tests using RT-PCR. We characterize the assay by introducing swabs in virus spiked synthetic nasal fluids, moving the swab to viral transport medium (VTM), and using a volume of that VTM for performing the amplification without an RNA extraction kit. The assay has a Limit-of-Detection (LOD) of 50 RNA copies/μL in the VTM solution within 20 minutes, and LOD of 5000 RNA copies/μL in the nasal solution. Additionally, we show the utility of this assay for real-time point-of-use testing by demonstrating detection of SARS-CoV-2 virus in less than 40 minutes using an additively manufactured cartridge and a smartphone-based reader. Finally, we explore the speed and cost advantages by comparing the required resources and workflows with RT-PCR. This work could accelerate the development and availability of SARS-CoV-2 diagnostics by proving alternatives to conventional laboratory benchtop tests.
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Severe Lower Extremity Cellulitis Caused by an Unusual Pathogen: Haemophilus Influenzae Type F. Cureus 2020; 12:e7819. [PMID: 32467794 PMCID: PMC7249777 DOI: 10.7759/cureus.7819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We present a case of unusual cellulitis of the lower extremities caused by Haemophilus influenzae (HI). A 64-year-old female with human immunodeficiency virus (HIV) with a suppressed viral load on treatment, presented with severe, very painful cellulitis of her lower extremity. CT scan did not show any gas or collections; however, she was taken to the operating room for concern of necrotizing fasciitis but no evidence of deep tissue involvement was found. Blood culture and wound culture were positive forHI type F (HiF), a newly emergent pathogenic capsulatedHI that has emerged post-HI type B (HiB) vaccination.
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Recommended Contraindications for the Use of Non-Medical WB-Electromyostimulation. DEUTSCHE ZEITSCHRIFT FÜR SPORTMEDIZIN 2019. [DOI: 10.5960/dzsm.2019.401] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Retrospective Comparison of Outcomes in Patients Treated with Functionally Rigid Fixation plus Maxillomandibular Fixation Versus Patients Treated with Combined Rigid and Functionally Rigid Fixation. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ovarian tissue cryopreservation: A fertility preservation option for gynecologic oncology patients. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lymph node micrometastases in endometrial cancer: Treatment patterns and prognosis. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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What Approaches are Most Effective at Addressing Micronutrient Deficiency in Children 0-5 Years? A Review of Systematic Reviews. Matern Child Health J 2019; 23:4-17. [PMID: 29868936 PMCID: PMC6373288 DOI: 10.1007/s10995-018-2527-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Introduction Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status. This review therefore aims to summarize the evidence published in systematic reviews on intervention strategies that aim at improving micronutrient status in children under the age of five. Methods We searched the literature and included systematic reviews that reported on micronutrient status as a primary outcome for children of 0-5 years old, had a focus on low or middle income countries. Subsequently, papers were reviewed and selected by two authors. Results We included 4235 reviews in this systematic review. We found that (single or multiple) micronutrient deficiencies in pre-school children improved after providing (single or multiple) micronutrients. However home fortification did not always lead to significant increase in serum vitamin A, serum ferritin, hemoglobin or zinc. Commercial fortification did improve iron status. Cord clamping reduced the risk of anemia in infants up to 6 months and, in helminth endemic areas, anthelminthic treatment increased serum ferritin levels, hemoglobin and improved height for age z-scores. Anti-malaria treatment improved ferritin levels. Discussion Based on our results the clearest recommendations are: delayed cord clamping is an effective intervention for reducing anemia in early life. In helminth endemic areas iron status can be improved by anthelminthic treatment. Anti-malaria treatment can improve ferritin. In deficient populations, single iron, vitamin A and multimicronutrient supplementation can improve iron, vitamin A and multimicronutrient status respectively. While the impact of home-fortification on multimicronutrient status remains questionable, commercial iron fortification may improve iron status.
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Étude sur les séances collectives d’éducation nutritionnelle pour des patients diabétiques type II. Rev Epidemiol Sante Publique 2019; 67:98-105. [DOI: 10.1016/j.respe.2019.01.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 12/05/2018] [Accepted: 01/01/2019] [Indexed: 11/26/2022] Open
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Septic shock caused by the under-recognized bacterium Eggerthella lenta in a 61-year-old male with a periurethral abscess: a case report. Rev Soc Bras Med Trop 2019; 52:e20190081. [PMID: 31340368 DOI: 10.1590/0037-8682-0081-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/03/2019] [Indexed: 11/22/2022] Open
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Geburtsmodus bei extremer Frühgeburtlichkeit. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-018-0546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Micronutrient status of populations and preventive nutrition interventions in South East Asia. Matern Child Health J 2018; 23:29-45. [DOI: 10.1007/s10995-018-2639-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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