Test whether high dose corticosteroid pulse therapy (HDCPT) with either methylprednisolone or dexamethasone is associated with increased survival in COVID-19 patients at risk of hyper-inflammatory ...response. Provide some initial diagnostic criteria using laboratory markers to stratify these patients.
This is a prospective observational study, 318 met the inclusion criteria. 64 patients (20.1%) were treated with HDCPT by using at least 1.5mg/kg/24h of methylprednisolone or dexamethasone equivalent. A multivariate Cox regression (controlling for co-morbidities and other therapies) was carried out to determine whether HDCPT (among other interventions) was associated with decreased mortality. We also carried out a 30-day time course analysis of laboratory markers between survivors and non-survivors, to identify potential markers for patient stratification.
HDCPT showed a statistically significant decrease in mortality (HR = 0.087 95% CI 0.021-0.36; P < 0.001). 30-day time course analysis of laboratory marker tests showed marked differences in pro-inflammatory markers between survivors and non-survivors. As diagnostic criteria to define the patients at risk of developing a COVID-19 hyper-inflammatory response, we propose the following parameters (IL-6 > = 40 pg/ml, and/or two of the following: C-reactive protein > = 100 mg/L, D-dimer > = 1000 ng/ml, ferritin > = 500 ng/ml and lactate dehydrogenase > = 300 U/L).
HDCPT can be an effective intervention to increase COVID-19 survival rates in patients at risk of developing a COVID-19 hyper-inflammatory response, laboratory marker tests can be used to stratify these patients who should be given HDCPT. This study is not a randomized clinical trial (RCT). Future RCTs should be carried out to confirm the efficacy of HDCPT to increase the survival rates of COVID-19.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Health surveys allow exploring health indicators that are of great value from a public health point of view and that cannot normally be studied from regular health registries. These indicators are ...usually coded as ordinal variables and may depend on covariates associated with individuals. In this article, we propose a Bayesian individual‐level model for small‐area estimation of survey‐based health indicators. A categorical likelihood is used at the first level of the model hierarchy to describe the ordinal data, and spatial dependence among small areas is taken into account by using a conditional autoregressive distribution. Post‐stratification of the results of the proposed individual‐level model allows extrapolating the results to any administrative areal division, even for small areas. We apply this methodology to describe the geographical distribution of a self‐perceived health indicator from the Health Survey of the Region of Valencia (Spain) for the year 2016.
•Intensity of social media usage is formed by updating news and searching for information.•The intensity affects the motives for receiving UGC in social media.•The motives for receiving UGC ...influences on trust in UGC and in UGC providers.•Potential tourists will generate trust in UGC, and then the expectations.•Trust in UGC providers does not have any influence on expectations.
Social media are transforming the tourism industry from its traditional pattern into an intense informational pattern. Our study aims to investigate the causes underlying the use of user-generated contents (UGC) to receive tourist information and its effect on tourists’ expectations. Our empirical work was analysed by means of a multiple indicators multiple causes model (MIMIC) and a structural equation model (SEM). The main finding showed that when users receive UGC related to tourist destinations, they will create expectations about the destination by placing their trust in the contents received. It is recommended that tourism organizations should maintain the quality level in order to allow more UGC, and then further trust in the contents of social media and expectations will occur.
We report the optical conductivity in high-quality crystals of the chiral topological semimetal CoSi, which hosts exotic quasiparticles known as multifold fermions. We find that the optical response ...is separated into several distinct regions as a function of frequency, each dominated by different types of quasiparticles. The low-frequency intraband response is captured by a narrow Drude peak from a high-mobility electron pocket of double Weyl quasiparticles, and the temperature dependence of the spectral weight is consistent with its Fermi velocity. By subtracting the low-frequency sharp Drude and phonon peaks at low temperatures, we reveal two intermediate quasilinear interband contributions separated by a kink at 0.2 eV. Using Wannier tightbinding models based on first-principle calculations, we link the optical conductivity above and below 0.2 eV to interband transitions near the double Weyl fermion and a threefold fermion, respectively. We analyze and determine the chemical potential relative to the energy of the threefold fermion, revealing the importance of transitions between a linearly dispersing band and a flat band. More strikingly, below 0.1 eV our data are best explained if spin-orbit coupling is included, suggesting that at these energies, the optical response is governed by transitions between a previously unobserved fourfold spin-3/2 node and a Weyl node. Our comprehensive combined experimental and theoretical study provides a way to resolve different types of multifold fermions in CoSi at different energy. More broadly, our results provide the necessary basis to interpret the burgeoning set of optical and transport experiments in chiral topological semimetals.
Dye-sensitized solar cells based on organic dyes have attracted considerable attention in recent years. These dyes present important differences in geometry and electronic structure, and diverse ...mechanisms for electronic injection into semiconductor conduction band have been reported. In this work, the electronic structure and the optical response of several dyes, free and bound to TiO2, have been analyzed and compared using time-dependent density functional theory (TD-DFT) performing calculations both in real time and frequency domains. The aim is to illustrate which aspects of each sensitizer produce different electron injection mechanisms. From the analysis it is concluded that for adsorbed NKX-2311, a coumarin based dye, the photoexcitation occurs toward an orbital mainly localized on the molecule, so this molecule is classified as a type I sensitizer, which follows an indirect mechanism for electron injection. In contrast, catechol and 2,3-naphthalenediol are type II sensitizers and follow a direct mechanism for injecting electrons into the TiO2 conduction band. In this case, a new band appears in the spectrum, which corresponds to a photoexcitation from states fully localized on the dye to states mainly localized on the cluster but with appreciable dye contribution. NKX-2311 and catechol show limit behaviors. Nevertheless, intermediate ones are also possible. As we move in the sequence catechol, 2,3-naphthalenediol, C343, alizarin, and NKX-2311, we pass progressively from a purely direct injection mechanism to a purely indirect injection mechanism. This is related to the relative position of the molecule LUMO energy to the edge of the semiconductor conduction band.
The study focuses on sources of user-generated content (UGC) in social media: strong-tie sources, weak-tie sources, and tourism-tie sources and their effects on tourist satisfaction with the ...destination. It is separated into the pre- and post- travel processes. First, it addresses the influences of sources of UGC on tourist expectations about core resources and supporting factors, and then analyzes tourist satisfaction by concentrating on tourist expectations and perceptions of core resources and supporting factors. Findings suggest that UGC sources have an indirect effect on tourist satisfaction since most UGC sources have an influence on tourist expectations, which will later be compared with the real tourist perception. Main conclusions and some recommendations and limitations are provided.
We recently defined the thalamic dopaminergic system in primates; it arises from numerous dopaminergic cell groups and selectively targets numerous thalamic nuclei. Given the central position of the ...thalamus in subcortical and cortical interplay, and the functional relevance of dopamine neuromodulation in the brain, detailing dopamine distribution in the thalamus should supply important information. To this end we performed immunohistochemistry for dopamine and the dopamine transporter in the thalamus of macaque monkeys and humans to generate maps, in the stereotaxic coronal plane, of the distribution of dopaminergic axons. The dopamine innervation of the thalamus follows the same pattern in both species and is most dense in midline limbic nuclei, the mediodorsal and lateral posterior association nuclei, and in the ventral lateral and ventral anterior motor nuclei. This distribution suggests that thalamic dopamine has a prominent role in emotion, attention, cognition and complex somatosensory and visual processing, as well as in motor control. Most thalamic dopaminergic axons are thin and varicose and target both the neuropil and small blood vessels, suggesting that, besides neuronal modulation, thalamic dopamine may have a direct influence on microcirculation. The maps provided here should be a useful reference in future experimental and neuroimaging studies aiming at clarifying the role of the thalamic dopaminergic system in health and in conditions involving brain dopamine, including Parkinson’s disease, drug addiction and schizophrenia.
The thalamus relays information to the cerebral cortex from subcortical centers or other cortices; in addition, it projects to the striatum and amygdala. The thalamic relay function is subject to ...modulation, so the flow of information to the target regions may change depending on behavioral demands. Modulation of thalamic relay by dopamine is not currently acknowledged, perhaps because dopamine innervation is reportedly scant in the rodent thalamus. We show that dopaminergic axons profusely target the human and macaque monkey thalamus using immunolabeling with three markers of the dopaminergic phenotype (tyrosine hydroxylase, dopamine, and the dopamine transporter). The dopamine innervation is especially prominent in specific association, limbic, and motor thalamic nuclei, where the densities of dopaminergic axons are as high as or higher than in the cortical area with the densest dopamine innervation. We also identified the dopaminergic neurons projecting to the macaque thalamus using retrograde tract-tracing combined with immunohistochemistry. The origin of thalamic dopamine is multiple, and thus more complex, than in any other dopaminergic system defined to date: dopaminergic neurons of the hypothalamus, periaqueductal gray matter, ventral mesencephalon, and the lateral parabrachial nucleus project bilaterally to the monkey thalamus. We propose a novel dopaminergic system that targets the primate thalamus and is independent from the previously defined nigrostriatal, mesocortical, and mesolimbic dopaminergic systems. Investigating this "thalamic dopaminergic system" should further our understanding of higher brain functions and conditions such as Parkinson's disease, schizophrenia, and drug addiction.
Monocytes are versatile cells that can express different functional programs in response to microenvironmental signals. We show that primary blood monocytes secrete the CXCL12 chemokine, and express ...the CXCR4 and CXCR7 receptors, leading to an autocrine/paracrine loop that contribute to shape monocyte differentiation to a distinct type of macrophages, with an enhanced expression of CD4, CD14, and CD163, or dendritic cells, with a reduced functional ability to stimulate antigen-specific T-lymphocyte responses. The in vivo relevance of CXCL12 production by mononuclear phagocytes was studied in metastatic melanoma tissues by a thoroughly immunofluorescence phenotyping of CXCL12high expressing cells, which were CD45+, coexpressed the macrophage antigens CD68, CD163, and CD209 and constituted the 60%-90% of tumor-associated macrophages. Microarray analysis of primary monocytes revealed that the vascular endothelial growth factor and the angiogenic chemokine CCL1 mRNA levels were up-regulated in response to CXCL12, leading to enhanced expression of both proteins. In addition, we found that CXCL12 autocrine/paracrine signaling down-regulates the expression of the transcription factor RUNX3 and contributes to maintain the long-term CD4 and CD14 expression in monocytes/macrophages. Together, these results suggest that autocrine CXCL12 production modulates differentiation of monocytes toward a distinct program with proangiogenic and immunosuppressive functions.
•Epidemiological studies link MedDiet with reduction of noncommunicable diseases (NCDs) and mortality.•Cardiovascular disease, diabetes, several types of cancer, cognitive decline and depression are ...the main reduced NCDs.•Intervention studies find that MedDiet lowers cardiovascular episodes.•Intervention trials find small benefit in some intermediate cardiovascular outcomes and diabetes.•Evidence for other NCs is low/very low because of small size of the interventional studies or unclear associations.
Diet is a crucial variable for a healthy life. A rapidly growing number of studies in recent years support the hypothesis that the Mediterranean diet (MedDiet) has a beneficial effect on certain body systems, but the highly varied objectives and quality of these publications warrants an updated assessment.
In the present review we performed a comprehensive evaluation of current evidence on the impact of the MedDiet on human health, assessing its effect on the incidence or progression of the main non-communicable diseases and their intermediate outcomes and risk factors. We scrutinised the clinical evidence from observational studies and randomised controlled trials.
Cardiovascular disease was the condition with most information. The MedDiet showed a general preventive effect, which was reproduced to varying degrees for certain intermediate cardiovascular outcomes such as blood pressure, lipids, obesity, metabolic syndrome and diabetes. Benefits were also found for several types of cancer, brain function (including cognition, mood and to a lesser extent Parkinson’s disease) and mortality. The quality of the published evidence was, however, generally moderate or low.
In conclusion, the MedDiet shows a favourable impact on health. General adoption of a MedDiet is concordant with current policies promoting healthy and sustainable nutrition worldwide. Nonetheless, more high-quality research is needed to improve the consistency of the findings.
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