Coronavirus disease 2019 (COVID-19) is a global pandemic that had affected more than eight million people worldwide by June 2020. Given the importance of the presence of diabetes mellitus (DM) for ...host immunity, we retrospectively evaluated the clinical characteristics and outcomes of moderate-to-severe COVID-19 in patients with diabetes.
We conducted a multi-center observational study of 1,082 adult inpatients (aged ≥18 years) who were admitted to one of five university hospitals in Daegu because of the severity of their COVID-19-related disease. The demographic, laboratory, and radiologic findings, and the mortality, prevalence of severe disease, and duration of quarantine were compared between patients with and without DM. In addition, 1:1 propensity score (PS)-matching was conducted with the DM group.
Compared with the non-DM group (
=847), patients with DM (
=235) were older, exhibited higher mortality, and required more intensive care. Even after PS-matching, patients with DM exhibited more severe disease, and DM remained a prognostic factor for higher mortality (hazard ratio, 2.40; 95% confidence interval, 1.38 to 4.15). Subgroup analysis revealed that the presence of DM was associated with higher mortality, especially in older people (≥70 years old). Prior use of a dipeptidyl peptidase-4 inhibitor or a renin-angiotensin system inhibitor did not affect mortality or the clinical severity of the disease.
DM is a significant risk factor for COVID-19 severity and mortality. Our findings imply that COVID-19 patients with DM, especially if elderly, require special attention and prompt intensive care.
Glioblastoma (GBM) is a devastating and incurable brain tumour, with a median overall survival of fifteen months
. Identifying the cell of origin that harbours mutations that drive GBM could provide ...a fundamental basis for understanding disease progression and developing new treatments. Given that the accumulation of somatic mutations has been implicated in gliomagenesis, studies have suggested that neural stem cells (NSCs), with their self-renewal and proliferative capacities, in the subventricular zone (SVZ) of the adult human brain may be the cells from which GBM originates
. However, there is a lack of direct genetic evidence from human patients with GBM
. Here we describe direct molecular genetic evidence from patient brain tissue and genome-edited mouse models that show astrocyte-like NSCs in the SVZ to be the cell of origin that contains the driver mutations of human GBM. First, we performed deep sequencing of triple-matched tissues, consisting of (i) normal SVZ tissue away from the tumour mass, (ii) tumour tissue, and (iii) normal cortical tissue (or blood), from 28 patients with isocitrate dehydrogenase (IDH) wild-type GBM or other types of brain tumour. We found that normal SVZ tissue away from the tumour in 56.3% of patients with wild-type IDH GBM contained low-level GBM driver mutations (down to approximately 1% of the mutational burden) that were observed at high levels in their matching tumours. Moreover, by single-cell sequencing and laser microdissection analysis of patient brain tissue and genome editing of a mouse model, we found that astrocyte-like NSCs that carry driver mutations migrate from the SVZ and lead to the development of high-grade malignant gliomas in distant brain regions. Together, our results show that NSCs in human SVZ tissue are the cells of origin that contain the driver mutations of GBM.
A flux pump is a kind of power source that energizes superconducting magnets usually embedded in the cryogenic system. Therefore, heat loss through current leads is eliminated, allowing for more ...efficient cooling design. A winding technique, the so-called "wind-and-flip," had been proposed by the authors to realize a jointless HTS coil for a perfect resistanceless closed loop, which may enable to induce a persistent current in an HTS coil wound with second-generation HTS tape. In this paper, we investigated charging/discharging characteristics and a possibility of persistent current operation of a jointless HTS coil with a flux pump. Results are discussed with regard to current capacity and temporal stability with a prototype jointless HTS coil.
Selective dinitrogen binding to transition metal ions mainly covers two strategic domains: biological nitrogen fixation catalysed by metalloenzyme nitrogenases, and adsorptive purification of natural ...gas and air. Many transition metal-dinitrogen complexes have been envisaged for biomimetic nitrogen fixation to produce ammonia. Inspired by this concept, here we report mesoporous metal-organic framework materials containing accessible Cr(III) sites, able to thermodynamically capture N
over CH
and O
. This fundamental study integrating advanced experimental and computational tools confirmed that the separation mechanism for both N
/CH
and N
/O
gas mixtures is driven by the presence of these unsaturated Cr(III) sites that allows a much stronger binding of N
over the two other gases. Besides the potential breakthrough in adsorption-based technologies, this proof of concept could open new horizons to address several challenges in chemistry, including the design of heterogeneous biomimetic catalysts through nitrogen fixation.
Increased grain yield will be critical to meet the growing demand for food, and could be achieved by delaying crop senescence. Here, via quantitative trait locus (QTL) mapping, we uncover the genetic ...basis underlying distinct life cycles and senescence patterns of two rice subspecies, indica and japonica. Promoter variations in the Stay-Green (OsSGR) gene encoding the chlorophyll-degrading Mg
-dechelatase were found to trigger higher and earlier induction of OsSGR in indica, which accelerated senescence of indica rice cultivars. The indica-type promoter is present in a progenitor subspecies O. nivara and thus was acquired early during the evolution of rapid cycling trait in rice subspecies. Japonica OsSGR alleles introgressed into indica-type cultivars in Korean rice fields lead to delayed senescence, with increased grain yield and enhanced photosynthetic competence. Taken together, these data establish that naturally occurring OsSGR promoter and related lifespan variations can be exploited in breeding programs to augment rice yield.
Aim
To examine the relationships among nurse staffing, nurses prioritization of nursing activities, missed care, quality of nursing care, and nurse outcomes.
Background
Inadequate staffing is ...associated with increased missed care, which threatens the quality of care and nurse outcomes.
Methods
The study sample included 2114 staff nurses from 156 medical or surgical units of 49 general hospitals who had participated in a cross‐sectional survey conducted in 2015. Nurse staffing was measured using the patient‐to‐nurse ratio and perceived staffing adequacy. The Missed Nursing Care Survey was used to measure how frequently nurses had missed each of 24 activities. Multilevel regression analyses were employed to examine the relationships among variables.
Results
The prevalence of missed care differed by nursing activity. Poorer staffing was associated with an increased number of missed activities. A higher number of missed activities and poorer staffing were associated with poorer patient safety, quality of nursing care and job satisfaction, and a higher intent to leave. Nurses gave the highest priority to focused patient reassessments, timely medications, and patient teaching, under hypothetical conditions of improved staffing.
Conclusion
Adequate staffing is required to reduce missed care and to improve quality of care and nurse outcomes.
SUMMARY STATEMENT
What is already known about this topic?
Low nurse staffing is associated with a high prevalence of missed care, which has negative effects on patient and nurse outcomes.
Nurses are known to prioritize their nursing tasks in the face of time scarcity. However, insufficient studies have investigated how nurses prioritize nursing care and, further, how their prioritization would be modified if nurse staffing were to improve.
What is already known about this topic?
Poorer perceptions of staffing adequacy and the patient‐to‐RN ratio had a significant association with a higher number of missed nursing activities.
Nurses gave the highest priority to focused reassessments, timely medications, and patient teaching, which were less frequently missed than basic care (eg, mouth care, bathing, and ambulation), even under hypothetical conditions of improved staffing.
The implications of this paper:
Adequate staffing is required to meet patients needs and to improve patient and nurse outcomes.
Nurses perceptions and reports of missed care appear to be influenced by their health care system and culture (eg, family caregiving).
Based on the base module of Universal Robotics, this paper deals with a 16-pole, 18-slot fractional-slot concentrated-winding permanent magnet synchronous machine (PMSM) for articulated robot ...applications considering several pole-slot combinations and using an optimum design. The selected PMSM considering the pole-slot combination is optimized and compared both analytically and experimentally. The experimental results confirmed that the proposed PMSM can achieve improved performance at the rated state. Repeatability test results of the proposed smart actuator with a link-attached sphere-mounted retroreflector sensor met the goal of within <inline-formula> <tex-math notation="LaTeX">100~\mu \text{m} </tex-math></inline-formula> according to a laser tracker. The analysis results are in good agreement with the experimental results within the maximum 2.5% error in terms of the efficiency. The design, analysis, and experiment with the PMSM for articulated robot applications were conducted successfully.
We measured serum concentrations of trace elements and evaluated their clinical significance in relation to treatment outcomes of critically ill patients. A total of 167 participants (105 men and 62 ...women; average age, 61.4 years; age range, 18–90 years) were enrolled. Arterial blood concentrations of the trace elements zinc, copper, selenium, and manganese were measured every 14 days. At the time of intensive care unit (ICU) admission, serum concentrations of zinc, selenium, copper, and manganese were lower than the normal values in 75.1, 1.8, 37.8, and 2.1% of patients, respectively. Serum trace element concentrations measured on day 14 of ICU stay were higher than those measured at the time of ICU admission for zinc (53.3 → 80.7 μg/L) and copper (87.1 → 102.3 μg/L). Increased serum zinc and copper concentrations during ICU care were associated with a significantly lower mortality compared to decreased concentrations of zinc (15.6 vs. 83.3%,
p
= 0.003) and copper (5.6 vs. 50.0%,
p
= 0.013). At the time of ICU admission, low serum levels of zinc and copper were observed. Patients with increased serum concentrations of zinc and copper had significantly lower mortality.
The low-density-lipoprotein receptor (LDLr) removes low-density lipoprotein (LDL), an endovascular transporter that carries cholesterol from the bloodstream to peripheral tissues. The maintenance of ...cholesterol content in the brain, which is important to protect brain function, is affected by LDLr. LDLr co-localizes with the insulin receptor and complements the internalization of LDL. In LDLr deficiency, LDL blood levels and insulin resistance increase, leading to abnormal cholesterol control and cognitive deficits in atherosclerosis. Defects in brain cholesterol metabolism lead to neuroinflammation and blood–brain-barrier (BBB) degradation. Moreover, interactions between endoplasmic reticulum stress (ER stress) and mitochondria are induced by ox-LDL accumulation, apolipoprotein E (ApoE) regulates the levels of amyloid beta (Aβ) in the brain, and hypoxia is induced by apoptosis induced by the LDLr defect. This review summarizes the association between neurodegenerative brain disease and typical cognitive deficits.
CCL2/CCR2 signaling is believed to play an important role in kidney diseases. Several studies have demonstrated that blocking of CCR2 has a therapeutic effect on kidney diseases. However, the effects ...of CCR2 knockout on obesity-induced kidney injury remain unclear. We investigated the therapeutic effects and the mechanism of CCL2/CCR2 signaling in obesity-induced kidney injury. We used C57BL/6-CCR2 wild type and C57BL/6-CCR2 knockout mice: Regular diet wild type (RD WT), RD CCR2 knockout (RD KO), High-fat diet WT (HFD WT), HFD CCR2 KO (HFD KO). Body weight of WT mice was significantly increased after HFD. However, the body weight of HFD KO mice was not decreased compared to HFD WT mice. Food intake and calorie showed no significant differences between HFD WT and HFD KO mice. Glucose, insulin, total cholesterol, and triglycerides levels increased in HFD WT mice were decreased in HFD KO mice. Insulin resistance, increased insulin secretion, and lipid accumulation showed in HFD WT mice were improved in HFD KO mice. Increased desmin expression, macrophage infiltration, and TNF-α in HFD mice were reduced in HFD KO mice. HFD-induced albuminuria, glomerular hypertrophy, glomerular basement membrane thickening, and podocyte effacement were restored by CCR2 depletion. HFD-induced elevated expressions of xBP1, Bip, and Nox4 at RNA and protein levels were significantly decreased in HFD KO. Therefore, blockade of CCL2/CCR2 signaling by CCR2 depletion might ameliorate obesity-induced albuminuria through blocking oxidative stress, ER stress, and lipid accumulation.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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