Physical activity (PA) helps prevention and aftercare of sporadic breast cancer (BC), cardiopulmonary fitness (CPF) being an age-independent predictor of tumor-specific mortality. Therefore, we ...wanted to identify predictors of CPF (represented by peak oxygen uptake: VO
) in BRCA1/2 mutation carriers whose risk of developing BC is high. We used cross-sectional data from 68 BRCA1/2 germline mutation carrying women participating in the randomized, prospective, controlled clinical study LIBRE-1. Assessments included cardiopulmonary exercise testing, medical and lifestyle history plus socioeconomic status. Additionally, the participants completed a psychological questionnaire regarding their attitude, subjective norms, perceived behavior control and intention towards PA. A multivariate logistic regression model was used to identify predictors for participants reaching their age- and sex-adjusted VO
reference values. 22 participants (median age: 40 years, interquartile range (IQR) 33-46) were cancer-unaffected and 46 cancer-affected (median age: 44 years, IQR 35-50). The strongest predictor for reaching the reference VO
value was attitude towards PA (Odds Ratio 3.0; 95% Confidence Interval 1.3-8.4; p = 0.021). None of the other predictors showed a significant association. A positive attitude towards PA seems to be associated with VO
, which should be considered in developing therapeutic and preventive strategies.Trial registrations: NCT02087592; DRKS00005736.
Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation ...(rSO
2
) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO
2
and processed EEG monitor. The response of the monitors during carotid artery clamping and shunting were assessed and compared between monitors and bilaterally within each monitor. Sixty-nine patients were included in the study. At clamping the surgical-side and contralateral-side rSO
2
dropped significantly below the baseline incision value (−17.6 and −9.4 % respectively). After shunting, the contralateral-side rSO
2
returned to baseline while the surgical-side rSO
2
remained significantly below baseline (−9.0 %) until the shunt was removed following surgery. At clamping the surgical-side and contralateral-side processed EEG also dropped below baseline (−19.9 and −20.6 % respectively). However, following shunt activation, the processed EEG returned bilaterally to baseline. During the course of this research, we found the rSO
2
monitor to be clinically more robust (4.4 % failure rate) than the processed EEG monitor (20.0 % failure rate). There was no correlation between the rSO
2
or processed EEG changes that occurred immediately after clamping and the degree of surgical side stenosis measured pre-operatively. Both rSO
2
and processed EEG respond to clamping and shunting during CEA. Cerebral oximetry discriminates between the surgical and contralateral side during surgery. The rSO
2
monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these monitors that can predict clamping-induced cerebral ischemia during CEA in order to decide whether carotid artery shunting is worth the associated risks. From the practical point of view, the rSO
2
monitor may be the better monitor for this purpose.
Abstract Study Objective To evaluate three evening insulin glargine dosing strategies for achievement of target (100–179 mg/dL; 5.5 - 9.8 mmol/L) and widened (80–249 mg/dL; 4.4 - 13.7 mmol/L) ...preoperative fasting blood glucose (FBG) ranges on the day of surgery. Design Prospective, randomized, open trial. Setting Preoperative units at two sites of a suburban hospital system. Patients 401 adult, ASA physical status 3 and 4 patients with type 1 and type 2 diabetes, undergoing elective noncardiac surgery. Interventions Patients were divided into two groups according to absence of daily rapid-acting/short-acting insulin (insulin glargine-only group) or presence of daily rapid-acting/short-acting insulin (insulin glargine plus bolus group). Subjects were then randomized to three evening insulin glargine dosing strategies: (a) take 80% of usual dose, (b) call physician for dose, or (c) refer to dosing table, based on self-reported usual FBG and insulin regimen. In the prehospital setting, patients administered the instructed insulin glargine dose on the evening before surgery. Measurements Venous blood glucose values were recorded in the preoperative holding area on the day of surgery. Main Results No significant differences in target preoperative FBG achievement were detected among strategies in the insulin glargine-only group (n = 174) or the insulin glargine plus bolus group (n = 227). In widened preoperative FBG achievement, no significant difference was noted among strategies in the insulin glargine-only group. In the insulin glargine plus bolus group, fewer subjects following the dosing table had FBG > 249 mg/dL (> 13.7 mmol/L; P = 0.031). Conclusions Target preoperative FBG achievement was similar among strategies in both insulin glargine groups. An insulin glargine adjustment strategy based on usual glycemic control may better prevent severe preoperative hyperglycemia in patients receiving basal/bolus regimens.
Perioperatively, insulin to treat hyperglycemia is administered judiciously to minimize the risk of hypoglycemia. In patients with diabetes in whom preoperative blood glucose levels are on the low ...end of normal, hypoglycemia risk may be underestimated. This retrospective study enrolled subjects with presenting preoperative blood glucose values in these ranges: 70 to 89 mg/dL (low normal group) and above 249 mg/dL (hyperglycemia-treated group). These groups were compared for subsequent perioperative hypoglycemia development. Subjects in the low normal group (n = 308) were older (P < .001), had increased incidence of renal disease (P = .02), and more prevalent beta-blocker use (P = .02) than the hyperglycemia-treated subjects (n = 279). Accounting for differences between groups, the incidence of perioperative blood glucose levels below 70 mg/dL was greater in the low normal group than the hyperglycemia-treated group (17.2% vs 3.6%, P < .001). Of subjects whose blood glucose levels fell below 70 mg/dL, blood glucose levels dropped below 50 mg/dL in 40% of hyperglycemia-treated subjects and 4% of low normal subjects. Perioperative hypoglycemia was likelier to develop in patients with diabetes who presented preoperatively with low normal blood glucose values than in patients treated with insulin for presenting hyperglycemia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Shukla and Dukatz explore the current state of quantum computing and its potential impact on various industries. They emphasize that quantum computing is not just a futuristic concept but a ...technology that is already being used to optimize key performance indicators in different sectors. They also highlight the potential benefits of quantum computing, such as discovering transformative drugs and combating climate change.
Accurate solutions to the electronic Schr\"odinger equation can provide valuable insight for electron interactions within molecular systems, accelerating the molecular design and discovery processes ...in many different applications. However, the availability of such accurate solutions are limited to small molecular systems due to both the extremely high computational complexity and the challenge of operating and executing these workloads on high-performance compute clusters. This work presents a massively scalable cloud-based quantum chemistry platform by implementing a highly parallelizable quantum chemistry method that provides a polynomial-scaling approximation to full configuration interaction (FCI). Our platform orchestrates more than one million virtual CPUs on the cloud to analyze the bond-breaking behaviour of carbon-fluoride bonds of per- and polyfluoroalkyl substances (PFAS) with near-exact accuracy within the chosen basis set. This is the first quantum chemistry calculation utilizing more than one million virtual CPUs on the cloud and is the most accurate electronic structure computation of PFAS bond breaking to date.
Under normal hydro-meteorological conditions, lagoons cover up to 2,000,000 of the Pampas territory (Argentina), distributed in more than 2,000 permanent lacunar bodies. They contribute significantly ...to the life quality of their inhabitants and they constitute a potential source of environmental, economic and recreational resources. Several studies in different lagoons in different temporal periods have been developed in the province of Buenos Aires (Argentina). They responded in an optimum way to the original goals, but they are barely valid when looking for dynamic spatial and temporal patterns in the lagoons, involving the use of the support basin. The use of remote sensors has proved effective in collecting the information needed to evaluate the quality of water bodies, to allow the search of temporal and spatial patterns, and to link lagoon water quality data with the characteristics of land use. A procedure for previously normalized satellite image analysis that will allow a classification of the lagoons based on their optical properties, conditioned by the contents of suspended inorganic solid matter and algal biomass, is proposed. The results will be compared to samples in the field and spatially extrapolated and will be used to propose alternative management methods jointly with some local decision makers.
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