Several studies in mild chronic obstructive pulmonary disease (COPD) have shown a higher than normal ventilatory equivalent for carbon dioxide (Formula: see texte/Formula: see textco2) during ...exercise. Our objective was to examine pulmonary gas exchange abnormalities and the mechanisms of high Formula: see texte/Formula: see textco2 in mild COPD and its impact on dyspnea and exercise intolerance.
Twenty-two subjects (11 patients with GOLD Global Initiative for Chronic Obstructive Lung Disease grade 1B COPD, 11 age-matched healthy control subjects) undertook physiological testing and a symptom-limited incremental cycle exercise test with arterial blood gas collection.
Patients (post-bronchodilator FEV1: 94 ± 10% predicted; mean ± SD) had evidence of peripheral airway dysfunction and reduced peak oxygen uptake compared with control subjects (80 ± 18 vs. 113 ± 24% predicted; P<0.05). Arterial blood gases were within the normal range and effective alveolar ventilation was not significantly different from control subjects throughout exercise. The alveolar-arterial O2 tension gradient was elevated at rest and throughout exercise in COPD (P<0.05). Formula: see texte/Formula: see textco2, dead space to tidal volume ratio (Vd/Vt), and arterial to end-tidal CO2 difference were all higher (P<0.05) in patients with COPD than in control subjects during exercise. In patients with COPD versus control subjects, there was significant dynamic hyperinflation and greater tidal volume constraints (P<0.05). Standardized dyspnea intensity ratings were also higher (P<0.05) in patients with COPD versus control subjects in association with higher ventilatory requirements. Within all subjects, Vd/Vt correlated with the Formula: see texte/Formula: see textco2 ratio during submaximal exercise (r=0.780, P<0.001).
High Vd/Vt was the most consistent gas exchange abnormality in smokers with only mild spirometric abnormalities. Compensatory increases in minute ventilation during exercise maintained alveolar ventilation and arterial blood gas homeostasis but at the expense of earlier dynamic mechanical constraints, greater dyspnea, and exercise intolerance in mild COPD.
The concept of personalized therapy has been proven to be a promising approach. A popular technique is to utilize gold nanoparticles (AuNPs) as drug delivery vectors for cytotoxic drugs and small ...molecule inhibitors to target and eradicate oral cancer cells in vitro and in vivo. Both drug and nanocarrier designs play important roles in the treatment efficacy. In our study, we standardized the nanosystem regarding NPs type, size, surface ligands and coverage percentage leaving only the drugs mode of action as the confounding variable. We propose that similarly constructed nanoparticles (NPs) can selectively leverage different conjugated drugs irrelevant to their original mode of action. If proven, AuNPs may have a secondary role beyond bypassing cancer cell membrane and delivering their loaded drugs.
We conjugated 5- fluorouracil (5Fu), camptothecin (CPT), and a fibroblast growth factor receptor1-inhibitor (FGFR1i) to gold nanospheres (AuNSs). We followed their trajectories in Syrian hamsters with chemically induced buccal carcinomas.
Flow cytometry and cell cycle data shows that 5Fu- and CPT- induced a similar ratio of S-phase cell cycle arrest as nanoconjugates and in their free forms. On the other hand, FGFR1i-AuNSs induced significant sub-G1 cell population compared with its free form. Despite cell cycle dynamics variability, there was no significant difference in tumor cells' proliferation rate between CPT-, 5Fu- and FGFR1i- AuNSs treated groups. In our in vivo model, FGFR1i-AuNSs induced the highest tumor reduction rates followed by 5Fu- AuNSs. CPT-AuNSs induced significantly lower tumor reduction rates compared with the 5Fu- and FGFR1i- AuNSs despite showing similar proliferative rates in tumor cells.
Our data indicates that the cellular biological events do not predict the outcome seen in our in vivo model. Furthermore, our results suggest that AuNSs selectively enhance the therapeutic effect of small molecule inhibitors such as FGFR1i than potent anticancer drugs. Future studies are required to better understand the underlying mechanism.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Smokers without airflow obstruction have reduced exercise capacity, but the underlying physiological mechanisms are not fully understood. We aimed to compare quadriceps function assessed using ...nonvolitional measures and ventilatory requirements during exercise, between smokers without airway obstruction and never-smoker controls. Adult smokers (
= 20) and never-smoker controls (
= 16) aged 25-50 yr with normal spirometry, underwent incremental cycle cardiopulmonary exercise testing to exhaustion with measurement of symptoms and dynamic lung volumes. Quadriceps strength and endurance were assessed nonvolitionally using single and repetitive magnetic stimulation. Quadriceps bulk was assessed using ultrasound, as rectus-femoris cross-sectional area. Physical activity level was quantified using the SenseWear armband worn for 5 days. Smokers had lower peak exercise workload, peak oxygen consumption, and anaerobic threshold than controls (170 ± 46 vs. 256 ± 57 W, 2.20 ± 0.56 vs. 3.18 ± 0.72 L/min, 1.38 ± 0.33 vs. 2.09 ± 0.7 L/min, respectively;
< 0.01 for all). Quadriceps endurance was lower in smokers (Δforce-time integral 54.9% ± 14.7% vs. 40.4% ± 14.7%;
= 0.007), but physical activity, quadriceps strength, and bulk were similar between groups. Smokers displayed higher ventilation (120 W: 52.6 ± 11.8 vs. 40.7 ± 6.0 L/min;
< 0.001), decreased ventilatory efficiency (higher V̇e/V̇co
), and were more breathless with greater leg fatigue at iso-workloads and iso-ventilation levels compared with never-smoker controls. Smokers showed no mechanical constraints on tidal volume expansion during exercise or ventilatory limitation at peak exercise. Adult smokers without airflow obstruction have reduced skeletal muscle endurance and ventilatory efficiency compared with never-smoker controls, despite similar daily physical activity levels, which contributed to reduced peak exercise capacity.
In adult smokers without airflow obstruction, the contributions of pulmonary and skeletal muscle functions to reduced exercise capacity are unclear. We found that non-COPD smokers had decreased exercise capacity and muscle endurance although strength was preserved compared with never-smoking controls. Exercise endurance was associated with quadriceps endurance and CO transfer factor. Despite similar physical activity levels, smokers developed leg fatigue, breathlessness, and displayed increased ventilation with reduced ventilatory efficiency at lower workloads, without exhibiting ventilatory constraint.
Background Diagnosis of pulmonary tuberculosis (PTB) is usually problematic regarding time and accuracy.
Aim To compare between the microscopic observation drug susceptibility (MODS) and MTB/RIF Gene ...Xpert in sputum samples of PTB-suspect patients regarding sensitivity, specificity, timing to positivity, and drug susceptibility compared with the gold standard Löwenstein-Jensen (LJ) mycobacterial culture.
Patients and methods This is a retrospective clinical study. Records of patients who were PTB suspect and who presented to El Maamoura Chest Hospital, Alexandria, Egypt, were reviewed between May 2016 and March 2018.
Results MODS showed variable significance in prognostic performance compared with Gene Xpert regarding sensitivity (71.7 vs. 80.0%, respectively) and specificity (93.33 vs. 64.44%, respectively) compared with LJ culture. After exclusion of 29 patients who were at risk of having dead bacilli in their sputa, results showed near-similar prognostic performance between MODS and Gene Xpert regarding specificity (90.32% for both techniques) and sensitivity (72.88 vs. 79.66%, respectively). Gene Xpert showed overall superiority in time to positivity (within 3 h). MODS showed significant difference than LJ medium with timing to positivity from 7 to 22 days with mean±SD of 19.11±4.0 days.
Conclusion For diagnosis of PTB, MODS was found to be more specific and relatively less sensitive compared with MTB/RIF Gene Xpert. With exclusion of sputum samples from patients who are at risk of having dead bacilli in their sputa, no significant difference was found between both techniques regarding sensitivity and specificity. MTB/RIF Gene Xpert has superiority in timing to positivity.
Hypoxemia is associated with more severe lung disease and worse outcomes. In some patients with chronic obstructive lung diseases who desaturate on exertion, supplemental oxygen improves exercise ...capacity. The clinical significance of this exercise response to oxygen supplementation is not known.
We identified chronic obstructive lung disease patients at our center who underwent a 6-minute walking test (6MWT) for ambulatory oxygen assessment and who desaturated breathing air and therefore had an additional walk test on supplemental oxygen, between August 2006 and June 2016. Responders were defined as walking ≥26 m further with oxygen. Survival was determined up to February 1, 2017. We compared survival in oxygen responders and nonresponders in patients with obstructive lung diseases.
One hundred and seventy-four patients were included in the study, median age 70 years. Seventy-seven (44.3%) of the patients were oxygen responders. Borg dyspnea score improved by 1.4 (±1.4) units (
<0.0005) on oxygen. Median survival was 66 months with death occurring in 84 (48.2%) patients. Kaplan-Meier analysis revealed no survival difference between both responders and nonresponders (
=0.571). Cox regression analysis showed that more 6MWT desaturation, lower 6-minute walking distance on room air, male gender, lower hemoglobin, and body mass index were associated with higher mortality risk.
Acute exercise response to supplemental oxygen is not associated with long-term survival in patients with obstructive lung disease. This supports the use of ambulatory oxygen treatment for symptomatic purposes only.
Bipolar Complex Fuzzy Soft Sets and Their Application Alqaraleh, Sahar M; Alkouri, Abd Ulazeez M. J. S; Massa'deh, Mourad Oqla ...
International journal of fuzzy system applications,
12/2021, Letnik:
11, Številka:
1
Journal Article
Recenzirano
We introduce a new computational model to solve efficient problems. This research generalizes the concept of bipolar fuzzy soft sets (BFSS) to the realm of complex numbers. However, the ranges of ...positive and negative values membership BFSS functions are extended to unit disk instead of 0, 1 and -1, 0 respectively. The main benefit of bipolar complex fuzzy soft sets BCFSSs appears in the ability to transfer bipolar fuzzy soft information to a mathematical formula without losing the full meaning of information that may appear from different phases. Some basic operations and theorems on BCFSS are defined with numerical examples. This research has extended to illustrate the utilization of BCFSS in decision making problems by generalizing the applications and algorithms.
Background Urinary lipoarabinomannan (LAM) detection is a promising approach for the rapid diagnosis of active tuberculosis (TB).
Objective to assess the diagnostic accuracy of quantitative urine ...Lipoarabinomannan (LAM) test in the diagnosis of pulmonary tuberculosis and evaluate its efficacy as a follow up test after 3 months of the first line of antituberculous therapy.
Methods This study was carried out on 40 patients (32 male and 8 female) with active tubercular infection LAM level was measured in urine by enzyme-linked immunosorbant assay (ELISA).
Results Patients with smear positive specimens had higher urine LAM level: grade 1+ (mean ± SD of 1.47 ± 0.85 ng/ml), grade 2+ (1.63 ± 1.05 ng/ml), grade 3+ (4.32 ± 2.56 ng/ml) than that of smear negative (1.42 ± 0.50 ng/ml) (P < 0.001). Quantitative urine LAM test results positively correlate with the degree of bacillary burden. Lipoarabinomannan level before treatment (2.74 ± 2.25ng/ml) decreased significantly after 3 months of anti tuberculous treatment (1.28 ± 1.65ng/ml) (p<0.001FNx01).
Conclusion Our finding showed that the urine LAM test is simple, rapid, and reliable diagnostic modality for active pulmonary tuberculosis. Quantitative LAM detection results increased progressively with bacillary burden. Urine LAM testing may be an accessible method to monitor response to anti-TB therapy among active pulmonary tuberculosis patients.
The first stage of four different species belonging to three families of the super family; Coccoidea were described and illustrated by using the scanning electron microscope. These species: ...Mycetaspis personata (Comstock) and Fiorinia fioriniae (Targioni Tozzetti), pertaining to the family Diaspididae; Pulvinaria psidii (Maskell) (Family: Coccidae) and lcerya seychellarum seychellarum (Westw.) of the family Margarodidae. The dimensions of the first stage (crawler), as well as some taxonomical aspects were examined and discussed. The obtained data showed that the first instar of the mealybug, I. seychellarum seychellarum gave the largest diameter of 299.33 +/- 0.94 pm in length and 183.44 +/- 0.17 microm in width followed by the diaspidid species, F. fioriniae recorded 208.1 +/- 0.78 microm in length and 178.96 +/- 2.34 pm in width; while the coccid species, P. psidii measured 119.17 +/- 0.85 microm in length and 74.83 +/- 1.03 microm in width and the smallest first stage crawler was for the diaspidid, M. personata measured 85.50 +/- 0.41 microm in length and 63.88 +/- 0.27 microm in width. The modes of assigned insects in protecting their eggs were also discussed briefly.
The present study was initiated to perform a comparative measurements of egg dimension and structure of four different species pertaining to three families of the super family: Coccoidea. These ...species were: Mycetaspis personata (Comstock) (Diaspididae), Ceroplastes floridensis (Comstock) (Coccidae), Pulvinaria psidii (Maskell) (Coccidae), and Icerya seychellarum seychellarum (Westw.) (Margarodidae). The studied species differed in their means of egg laying and chorion structure, which may explain the mode of insect protection. The dimensions of chorion shell, as well as the ultra structure of the egg shell of each species were examined and discussed.
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