There is limited evidence whether being on fludrocortisone prevents vasovagal syncope.
The authors sought to determine whether treatment with fludrocortisone reduces the proportion of patients with ...recurrent vasovagal syncope by at least 40%, representing a pre-specified minimal clinically important relative risk reduction.
The multicenter POST 2 (Prevention of Syncope Trial 2) was a randomized, placebo-controlled, double-blind trial that assessed the effects of fludrocortisone in vasovagal syncope over a 1-year treatment period. All patients had >2 syncopal spells and a Calgary Syncope Symptom Score >-3. Patients received either fludrocortisone or matching placebo at highest tolerated doses from 0.05 mg to 0.2 mg daily. The main outcome measure was the first recurrence of syncope.
The authors randomized 210 patients (71% female, median age 30 years) with a median 15 syncopal spells over a median of 9 years equally to fludrocortisone or placebo. Of these, 96 patients had ≥1 syncope recurrences, and only 14 patients were lost to follow-up before syncope recurrence. There was a marginally nonsignificant reduction in syncope in the fludrocortisone group (hazard ratio HR: 0.69: 95% confidence interval CI: 0.46 to 1.03; p = 0.069). In a multivariable model, fludrocortisone significantly reduced the likelihood of syncope (HR: 0.63; 95% CI: 0.42 to 0.94; p = 0.024). When the analysis was restricted to outcomes after 2 weeks of dose stabilization, there was a significant benefit due to fludrocortisone (HR: 0.51; 95% CI: 0.28 to 0.89; p = 0.019).
The study did not meet its primary objective of demonstrating that fludrocortisone reduced the likelihood of vasovagal syncope by the specified risk reduction of 40%. The study demonstrated a significant effect after dose stabilization, and there were significant findings in post hoc multivariable and on-treatment analyses. (A randomised clinical trial of fludrocortisone for the prevention of vasovagal syncope; ISRCTN51802652; Prevention of Syncope Trial 2 POST 2; NCT00118482).
Early False-Belief Understanding Scott, Rose M; Baillargeon, Renée
Trends in cognitive sciences,
04/2017, Letnik:
21, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Intense controversy surrounds the question of when children first understand that others can hold false beliefs. Results from traditional tasks suggest that false-belief understanding does not emerge ...until about 4 years of age and constitutes a major developmental milestone in social cognition. By contrast, results from nontraditional tasks, which have steadily accumulated over the past 10 years, suggest that false-belief understanding is already present in infants (under age 2 years) and toddlers (age 2–3 years) and thus forms an integral part of social cognition from early in life. Here we first present an overview of the findings from nontraditional tasks. We then return to traditional tasks and argue that processing difficulties, rather than limitations in false-belief understanding, account for young children’s failure at these tasks.
Almost without exception, everything human beings undertake involves a choice. In recent years there has been a growing interest in the development and application of quantitative statistical methods ...to study choices made by individuals with the purpose of gaining a better understanding both of how choices are made and of forecasting future choice responses. In this primer the authors provide an unintimidating introduction to the main techniques of choice analysis and include detail on themes such as data collection and preparation, model estimation and interpretation and the design of choice experiments. A companion website to the book provides practice data sets and software to estimate the main discrete choice models such as multinomial logit, nested logit and mixed logit. This primer will be an invaluable resource to students as well as of immense value to consultants and professionals, researchers and anyone else interested in choice analysis and modelling.
The pattern of structural brain alterations associated with major depressive disorder (MDD) remains unresolved. This is in part due to small sample sizes of neuroimaging studies resulting in limited ...statistical power, disease heterogeneity and the complex interactions between clinical characteristics and brain morphology. To address this, we meta-analyzed three-dimensional brain magnetic resonance imaging data from 1728 MDD patients and 7199 controls from 15 research samples worldwide, to identify subcortical brain volumes that robustly discriminate MDD patients from healthy controls. Relative to controls, patients had significantly lower hippocampal volumes (Cohen's d=-0.14, % difference=-1.24). This effect was driven by patients with recurrent MDD (Cohen's d=-0.17, % difference=-1.44), and we detected no differences between first episode patients and controls. Age of onset ⩽21 was associated with a smaller hippocampus (Cohen's d=-0.20, % difference=-1.85) and a trend toward smaller amygdala (Cohen's d=-0.11, % difference=-1.23) and larger lateral ventricles (Cohen's d=0.12, % difference=5.11). Symptom severity at study inclusion was not associated with any regional brain volumes. Sample characteristics such as mean age, proportion of antidepressant users and proportion of remitted patients, and methodological characteristics did not significantly moderate alterations in brain volumes in MDD. Samples with a higher proportion of antipsychotic medication users showed larger caudate volumes in MDD patients compared with controls. This currently largest worldwide effort to identify subcortical brain alterations showed robust smaller hippocampal volumes in MDD patients, moderated by age of onset and first episode versus recurrent episode status.
Pierre Bettencourt est un créateur aux multiples facettes : poète, conteur, imprimeur, plasticien. Cet ami de Jean Dubuffet, Louis-René Des Forêts, Jean Paulhan et tant d’autres est plus connu pour ...ses hauts-reliefs que pour son oeuvre éditoriale qui fait le bonheur des bibliophiles et qui révèle un esprit irréductible, facétieux, sans doute sacrilège mais également sérieux avec son inquiétude métaphysique, sa liberté de croire et de transgresser le monde sans oublier Eros.
AI in Africa: Basics Over Buzz Mutiso, Rose M
Science (American Association for the Advancement of Science),
03/2024, Letnik:
383, Številka:
6690
Journal Article
Recenzirano
When Buti Manamela visited Lengau, Africa's fastest supercomputer, he had more prosaic technology in mind: electricity. South Africa's Deputy Minister of Higher Education, Science and Technology was ...at the Center for High Performance Computing in Cape Town for what should have been a showcase tour of a facility providing the country with the computing power needed to run and analyze the kinds of complex models and huge datasets that underpin artificial intelligence (AI) and machine learning (ML). But Manamela was there to better understand the impact of South Africa's rolling power blackouts on the center's operations. Lengau, which means "cheetah" in Setswana, is one of the most important outposts in Africa's AI infrastructure landscape; yet, it is struggling to operate at full capacity because of unreliable power.
Integrated assessment models used to generate influential publications, such as Intergovernmental Panel on Climate Change reports, often lump together African countries, or even 'Africa and the ...Middle East' - ignoring huge differences in socio-economic status and available resources. ...centre sustainable development when modelling Africa's energy transition. ...support more African institutions and analysts doing this work.
Psychological Reasoning in Infancy Baillargeon, Renée; Scott, Rose M; Bian, Lin
Annual review of psychology,
01/2016, Letnik:
67, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Adults routinely make sense of others' actions by inferring the mental states that underlie these actions. Over the past two decades, developmental researchers have made significant advances in ...understanding the origins of this ability in infancy. This evidence indicates that when infants observe an agent act in a simple scene, they infer the agent's mental states and then use these mental states, together with a principle of rationality (and its corollaries of efficiency and consistency), to predict and interpret the agent's subsequent actions and to guide their own actions toward the agent. In this review, we first describe the initial demonstrations of infants' sensitivity to the efficiency and consistency principles. We then examine how infants identify novel entities as agents. Next, we summarize what is known about infants' ability to reason about agents' motivational, epistemic, and counterfactual states. Finally, we consider alternative interpretations of these findings and discuss the current controversy about the relation between implicit and explicit psychological reasoning.
At the UN climate summit (COP28) kicking off in Dubai next week, we can expect the nations of the world to issue a flurry of energy- and climate-related announcements, pledges, and plans. Like their ...global peers, African governments will be using COP28 to demonstrate their climate ambition, building on commitments they made at the inaugural African Climate Summit held three months prior in Nairobi.
In the last decade, single-cell RNA sequencing routinely performed on large numbers of single cells has greatly advanced our understanding of the underlying heterogeneity of complex biological ...systems. Technological advances have also enabled protein measurements, further contributing to the elucidation of cell types and states present in complex tissues. Recently, there have been independent advances in mass spectrometric techniques bringing us one step closer to characterizing single-cell proteomes. Here we discuss the challenges of detecting proteins in single cells by both mass spectrometry and sequencing-based methods. We review the state of the art for these techniques and propose that there is a space for technological advancements and complementary approaches that maximize the advantages of both classes of technologies.
PDF
