Visceral Leishmaniasis (VL) is the most severe form of leishmaniasis because it can lead to death. In the Americas, 96% of cases are in Brazil, and despite efforts, the fatality rate has increased in ...the past years. We analyzed deaths associated to VL in Brazil and investigated the factors that could influence on the timeliness of fatal outcome with emphasis on time (tStoD).
The registered deaths by VL were sourced from the Brazilian National Notification System from 2007-2014. Through a retrospective cohort study, univariate and multivariable Cox proportional hazards model analysis were performed and investigated the factors that could influence the time (tStoD). These factors were analyzed through survival models.
Out of the 1,589 reported deaths, the median for onset of the symptoms and the case notification date (tStoN) is 25 days (10-61), and for date of case notification and death (tNotD) is 9 days (4-17). The time (tStoN) to event investigation for HIV non-infected individuals was 1.4 (1.16-1.68) greater than the HIV positive group. At the same time peri-urban and urban area were 0.83 (0.47-1.44) and 1.33 (1.16-1.52), respectively. The explorations revealed apparent differences between the time to event investigation (both for tStoN and tNotD) and the age at the onset of the symptoms. According to the tStoN the rate of notification is 1.73 times greater in patients under 5 years old at the onset of the clinical symptoms compared to older patients.
VL patients under 5 years old were diagnosed earlier and had shorter survival. It could mean that in younger population, although properly diagnosed, the fatality pattern might be related to the severity of the disease. Main host characteristics were evaluated, and age and co-infections seem to have an impact in the disease progression.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Activated carbons obtained by chemical activation of kraft lignin with H
3PO
4 were used as supports for the preparation of Pd catalysts. The catalysts activities were evaluated on the Suzuki–Miyaura ...cross-coupling reaction and in the hydrogenation of some selected double bonds. For both reactions the catalyst shows a high activity and selectivity as well as a high stability and reproducibility.
Mesoporous activated carbons obtained by chemical activation of kraft lignin with H
3PO
4 were used as supports for the preparation of low loading (0.5%) Pd catalysts. Thermal treatment up to 900
°C, performed on activated carbon, in inert atmosphere before the Pd-deposition was analyzed. The catalyst systems obtained showed highly developed porous structures with a large contribution of mesoporosity. The activation process also yielded catalysts supports with a significant amount of surface phosphorus, in form of C–O–P, C–P–O and C
3P groups, as shown by the XPS analyses. The presence of phosphorus groups on the carbons surface, especially C
3P groups, avoids the need of using triphenylphosphine as ligand in the Suzuki–Miyaura reactions. TEM analyses confirmed the presence of well-dispersed Pd particles (around 5
nm in size). The high dispersion and the low particle size could be due to the high amount of surface oxygen and phosphorus groups and to the high mesopores surface of the carbon supports. The activities of the catalysts were evaluated on the Suzuki–Miyaura cross-coupling reaction and in the hydrogenation of some selected double bonds. For both reactions the catalysts show high activity and selectivity as well as a high stability and reproducibility.
The effect of derivatization and temperature on the photoluminescence of 1–2 nm size silicon particles of different origin is investigated in an attempt to understand the effect of surface on the ...particles’ photoluminescence. To this purpose, silicon nanoparticles were synthesized by electrochemical (top-down) and wet chemical (bottom-up) procedures. Further derivatization by silylation or sylanization yielded particles with SiC, SiOSi, and SiOC groups at the interface. A detailed analysis of the corresponding excitation–emission matrices strongly indicates that different surface atomic arrangements contribute to the energy gap. In particular, particles with SiOSi groups at the interface show photoluminescence independent of the crystalline structure and on their further surface derivatization with different organic molecules. The lifetime and spectrum shape of all synthesized particles are invariable to changes in temperature in the range 270–330 K despite a significant reduction in the photoluminescence intensity being observed with increasing temperature; such behavior supports a thermal equilibrium between dark and bright conformations of the particles. The observed results are of importance for optimizing the use of silicon nanoparticles as optical sensors and therapeutic agents in biological systems.
Abstract
Aims
Most heterozygous familial hypercholesterolaemia (FH) patients require intensive lipid-lowering therapy (LLT) including PCSK9 inhibitors (PCSK9is) to reach current low-density ...lipoprotein cholesterol (LDL-C) goals. Persistence with chronic treatment is important to reduce the burden of atherosclerotic cardiovascular disease. We analysed persistence, efficacy, and impact on quality of life (QoL) of PCSK9i in FH patients in clinical practice setting.
Methods and results
Spanish Familial Hypercholesterolaemia Cohort Study (SAFEHEART) is an open, prospective study in genetically defined FH patients in Spain. Patients ≥18 years of age (n = 696, 46% females) on stable LLT treated with PCSK9i were analysed. Median LDL-C at starting PCSK9i was 145 mg/dL interquartile range (IQR), 123–177, 3.8 mmol/L (IQR 3.2–4.6). After a median follow up of 3.7 years (IQR 2.3–4.8), 27 patients (4%) discontinued PCSK9i treatment: 5 temporarily (0.7%) and 22 permanently (3.2%). Persistence with PCSK9i was 96.1% in the whole period. Median LDL-C levels and % LDL-C reduction attained after 1 year of treatment and in the last follow-up visit were 63 mg/dL (IQR 43–88), 1.6 mmol/L (IQR 1.1–2.23); 61 mg/dL (IQR 44–82), 1.6 mmol/L (IQR 1.1–2.1); 57.6% (IQR 39.5–69); and 58% (IQR 44–68), respectively. 2016 and 2019 ESC/EAS LDL-C goals were attained by 77 and 48% of patients, respectively, at the last follow-up visit (P < 0.001). Mean QoL score increased slightly in the first year and remained stable.
Conclusion
Long-term persistence with PCSK9i in FH patients is very high, with a good QoL. Effectiveness in LDL-C reduction and LDL-C goal achievement dramatically improved with PCSK9i in this high-risk population in clinical practice setting.
Trial registration
ClinicalTrials.gov number NCT02693548.
Graphical Abstract
Graphical Abstract
Persistence with long-term PCSK9 inhibitors treatment and its effectiveness in familial hypercholesterolaemia.
► Organic wastes from different origins were bioconverted into four vermicomposts. ► Vermicomposts’ chemical features and microbial functional diversity were explored. ► Response of the ...vermicomposts’ microbiota to three pesticides was investigated. ► The vermicompost’ chemical features affected its microbial functional diversity. ► Functional diversity of the microbiota was related with its response to pesticides.
The relationships between vermicompost chemical features, enzyme activities, community-level physiological profiles (CLPPs), fungal community structures, and its microbial respiratory response to pesticides were investigated. Fungal community structure of vermicomposts produced from damaged tomato fruits (DT), winery wastes (WW), olive-mill waste and biosolids (OB), and cattle manure (CM) were determined by denaturing gradient gel electrophoresis of 18S rDNA. MicroResp™ was used for assessing vermicompost CLPPs and testing the microbial response to metalaxyl, imidacloprid, and diuron. Vermicompost enzyme activities and CLPPs indicated that WW, OB, and DT had higher microbial functional diversity than CM. The microbiota of the former tolerated all three pesticides whereas microbial respiration in CM was negatively affected by metalaxyl and imidacloprid. The response of vermicompost microbiota to the fungicide metalaxyl was correlated to its fungal community structure. The results suggest that vermicomposts with higher microbial functional diversity can be useful for the management of pesticide pollution in agriculture.
To determine if there is an optimal grip span for determining the maximum handgrip strength in male and female teenagers, and if the optimal grip span was related to hand span. If they are related ...then the second aim was to derive a mathematic equation relating hand span and optimal grip span.
One hundred healthy teenage boys (15.1 ± 1.1 y) and 106 girls (15.4 ± 1.3 y) were evaluated (age range, 13–18 y). Each hand was randomly tested on 10 occasions using 5 different grip spans, allowing a 1-minute rest between attempts. The hand span was measured from the tip of the thumb to the tip of the small finger with the hand opened as wide as possible.
The results showed that an optimal grip span to determine the maximum handgrip strength was identified for both genders, and the optimal grip span and hand span correlated in both genders.
The results suggest that there is an optimal grip span to which the dynamometer should be adjusted when measuring handgrip strength in teenagers. The optimal grip span was influenced by hand span in both genders. For males the optimal grip span can be derived from the equation y = x/7.2 + 3.1 cm, and for females from the equation y = x/4 + 1.1 cm. where y is the optimal grip span and x is the hand-span. These equations may improve the reliability and accuracy of the results and may guide clinicians and researchers in selecting the optimal grip span on the hand dynamometer when measuring handgrip strength in teenagers.
Characterization of essential habitat for sharks is a key requirement for effective conservation of shark populations. In Cuba, shark essential habitat is largely undocumented. Here we present the ...first study of a shark nursery area in Cuban waters, for the lemon shark. Nursery areas for lemon sharks are typically surrounded by mangroves and contain sandy substrate where the young can feed, grow, move, and eventually disperse from the area. We conducted our study in Cuba’s La Salina Wildlife Refuge during 2015–2019, to understand the role this refuge might play as a lemon shark nursery area, by documenting the distribution and length structure of juveniles. Our results indicate that juvenile lemon sharks are present throughout much of the refuge with no clear pattern of aggregation by size. The size range of all juveniles captured was 39.8–108.0 cm precaudal length (PCL) with a mode in length-class 70.0–75.0 cm PCL. The mean size and weight of all individuals during the study period was 75.8 cm PCL and 5.5 kg, respectively. We infrequently observed neonates in May, June, and September with size range 39.8–55.5 cm PCL. Enforcement of management regulations, difficult access to the refuge for fishers and other user groups, and isolation from human settlements are factors that help maintain nearly pristine conditions in La Salina Wildlife Refuge. The size/age structure of lemon sharks likely represents a population unaltered by human influence. We recommend our study be expanded to contribute to shark conservation and management as outlined in Cuba’s National Plan of Action for sharks.
•BDNF and NGF plasma levels cannot serve as biomarkers of a second relapse in FES.•BDNF and NGF cannot be considered reliable biomarkers of state changes in schizophrenia.•There are significant ...correlations between BDNF and NGF and symptom severity.•BDNF and NGF serve as biomarkers of the underlying illness trait in later phases after a FES.
Neurotrophins have been proposed to be involved in biological mechanisms which might underlie different clinical outcomes in schizophrenia. The aims of the present study were to examine the BDNF/NGF plasma levels in a cohort of first-episode schizophrenia (FES) patients in remission as potential biological predictors of relapse; to study the associations between these neurotrophins and the symptomatology severity through different stages after a FES in two independent cohorts. 2EPs-Cohort: 69 first-episode in clinical remission were included. BDNF/NGF plasma levels and symptom severity were measured at enrollment and at 3-year or at the time of the second episode/relapse. FLAMM-PEPs-Cohort: 65 first-episodes were also included. BDNF/NGF and symptom severity were obtained at enrollment and 2-year follow-up. Symptomatology was assessed with the Marder-PANSS-Factor scores. Plasma neurotrophins did not differ significantly over time and neither BDNF/NGF were predictors of relapse. Besides, in remission stages, baseline BDNF levels showed significant correlations with both positive and negative symptoms (p<0.05); NGF, with negative symptomatology (p<0.01). Similarly, in the FLAMM-PEPs-Cohort, baseline BDNF/NGF levels showed significant correlations with negative symptoms (and not positive symptomatology) at follow-up (p<0.05). In both cohorts, lower levels correlated with higher symptom severity. Findings did not support a role for BDNF/NGF plasma levels as biomarkers of relapse in FES patients. Nevertheless, baseline BDNF/NGF may lead to be considered potentially useful biomarkers of long-term severity in schizophrenia and of the underlying illness traits, specially of negative symptomatology severity. More longitudinal studies in FES samples and adding a control group are warranted to replicate these findings.
Knowledge of the features of patients with familial hypercholesterolaemia (FH) who are protected from atherosclerotic cardiovascular disease (ASCVD) is important for the clinical and prognostic care ...of this apparently high-risk condition. Our aim was to investigate the determinant and characteristics of patients with FH who are protected from ASCVD and have normal life expectancy, so-called 'resilient' FH (R-FH).
Spanish Familial Hypercholesterolaemia cohort study (SAFEHEART) is an open, multicentre, nation-wide, long-term prospective cohort study in genetically defined patients with heterozygous FH in Spain. Patients in the registry who at the time of analysis were at least 65 years or those who would have reached that age had they not died from an ASCVD event were analysed as a case-control study. Resilient FH was defined as the presence of a pathogenic mutation causative of FH in a patient aged ≥65 years without clinical ASCVD. Nine hundred and thirty registrants with FH met the study criteria. A defective low-density lipoprotein (LDL)-receptor mutation, higher plasma level of high-density lipoprotein cholesterol (HDL-C), younger age, female gender, absence of hypertension, and lower plasma lipoprotein (a) Lp(a) concentration were independently predictive of R-FH. In a second model, higher levels of HDL-C and lower 10-year score in SAFEHEART-RE were also independently predictive of R-FH.
Resilient FH may be typified as being female and having a defective LDL-receptor mutation, higher levels of plasma HDL-C, lower levels of Lp(a), and an absence of hypertension. The implications of this type of FH for clinical practice guidelines and the value for service design and optional care of FH remains to be established.
ClinicalTrials.gov number NCT02693548.
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