The statistician will see you now Stratton, I. M.; Thorne, K. I.
Diabetic medicine,
April 2021, 2021-04-00, 20210401, Letnik:
38, Številka:
4
Journal Article
Aim
To determine current practice regarding the diabetes management of people undergoing cardiac surgery in the UK.
Methods
We conducted an online survey of UK cardiothoracic surgeons. All ...cardiothoracic surgeons listed in the Society of Cardiothoracic Surgery membership directory were invited to participate. The survey, compiled using SurveyMonkey software, comprised 15 closed and open‐ended questions about the management of people with diabetes pre‐ and peri‐operatively.
Results
Sixty‐two cardiothoracic surgeons from all 33 UK cardiac centres completed the survey. Of these, 44% responded that they routinely measure HbA1c preoperatively for all patients, 19% had an HbA1c threshold above which they would not operate and 21% currently undertake a point‐of‐care HbA1c measurement during the cardiothoracic outpatient visit. A total of 74% of respondents reported that it was ‘easy’ or ‘very easy’ to obtain a diabetes team review; diabetes nurse specialists were the members of the diabetes team working most closely with cardiac surgeons. Up to a third of the surgeons did not provide physical activity recommendations prior to admission and over 80% did not have a different preoperative or surgical diabetes protocol. Inconsistency in the responses within centres suggests that differences in practice may depend on individual surgeons rather than local policy.
Conclusions
The study demonstrates there is only limited peri‐operative management of diabetes in people undergoing cardiac surgery in the UK. There is an opportunity for greater involvement of the diabetes specialist team both before and during admission for surgery to improve outcomes.
(Trial registration: ISRCTN10170306)
Despite increasing attention, disparities in outcomes for Black and Hispanic patients undergoing orthopedic surgery are widening. In other racial-ethnic minority groups, outcomes often go unreported. ...We sought to quantify disparities in surgical outcomes among Asian, American Indian or Alaskan Native, and Native Hawaiian or Pacific Islander patients across multiple orthopedic subspecialties.
The National Surgical Quality Improvement Program was queried to identify all surgical procedures performed by an orthopedic surgeon from 2014 to 2020. Multivariable logistic regression models were used to investigate the impact of race and ethnicity on 30-day medical complications, readmission, reoperation, and mortality, while adjusting for orthopedic subspecialty and patient characteristics.
Across 1,512,480 orthopedic procedures, all patients who were not White were less likely to have arthroplasty-related procedures (
<.001), and Hispanic, Asian, and American Indian or Alaskan Native patients were more likely to have trauma-related procedures (
<.001). American Indian or Alaskan Native (adjusted odds ratio AOR, 1.005; 95% CI, 1.001-1.009;
=.011) and Native Hawaiian or Pacific Islander (AOR, 1.009; 95% CI, 1.005-1.014;
<.001) patients had higher odds of major medical complications compared with White patients. American Indian or Alaskan Native patients had higher risk of reoperation (AOR, 1.005; 95% CI, 1.002-1.008;
=.002) and Native Hawaiian or Pacific Islander patients had higher odds of mortality (AOR, 1.003; 95% CI, 1.000-1.005;
=.019) compared with White patients.
Disparities regarding surgical outcome and utilization rates persist across orthopedic surgery. American Indian or Alaskan Native and Native Hawaiian or Pacific Islander patients, who are under-represented in research, have lower rates of arthroplasty but higher odds of medical complication, reoperation, and mortality. This study highlights the importance of including these patients in orthopedic research to affect policy-related discussions.
. 2024;47(3):e131-e138..
A method for assaying glutathione reductase (GSH; EC 1.6.4.2) in crude plant extracts is described. The method is based on the increase in absorbance at 412 nm when 5,5'-dithiobis(2-nitrobenzoic ...acid) (DTNB) is reduced by GSH. The effects of the following parameters on the assay were tested: various buffers, pH, buffer concentration, compounds commonly present in enzyme preparations, thiols, and the presence of another NADPH-dependent enzyme. The assay is more sensitive and less subject to interference than the widely used assay where NADPH oxidation is monitored. In particular, the specificity of DTNB allows assay of glutathione reductase in the presence of other NADPH-dependent enzymes and common protein extract contaminants.
BACE1 is responsible for the first step in APP proteolysis, leading to toxic Aβ production, and has been indicated to play a key role in the pathogenesis of Alzheimer’s disease. The related isoform ...BACE2 is thought to be involved in processing of the pigment cell-specific melanocyte protein. To avoid potential effects on pigmentation, we investigated the feasibility for developing isoform-selective BACE1 inhibitors. Cocrystal structures of 47 compounds were analyzed and clustered according to their selectivity profiles. Selective BACE1 inhibitors were found to exhibit two distinct conformational features proximal to the flap and the S3 subpocket. Several new molecules were designed and tested to make use of this observation. The combination of a pyrimidinyl C-ring and a methylcyclohexyl element resulted in lead molecule 28, which exhibited ∼50-fold selectivity. Compared to a nonselective BACE1/2 inhibitor, 28 showed significantly less inhibition of PMEL processing in human melanocytes, indicating good functional selectivity of this inhibitor class.
Please cite this paper as: Townsend C, Schulte J, Thorne C, Dominguez K, Tookey P, Cortina‐Borja M, Peckham C, Bohannon B, Newell M, for the Pediatric Spectrum of HIV Disease Consortium, the European ...Collaborative Study and the National Study of HIV in Pregnancy and Childhood. Antiretroviral therapy and preterm delivery—a pooled analysis of data from the United States and Europe. BJOG 2010;117:1399–1410.
Objective To investigate reported differences in the association between highly active antiretroviral therapy (HAART) in pregnancy and the risk of preterm delivery among HIV‐infected women.
Design Combined analysis of data from three observational studies.
Setting USA and Europe.
Population A total of 19 585 singleton infants born to HIV‐infected women, 1990–2006.
Methods Data from the Pediatric Spectrum of HIV Disease project (PSD), a US monitoring study, the European Collaborative Study (ECS), a consented cohort study, and the National Study of HIV in Pregnancy and Childhood (NSHPC), the United Kingdom and Ireland surveillance study.
Main outcome measure Preterm delivery rate (<37 weeks of gestation).
Results Compared with monotherapy, HAART was associated with increased preterm delivery risk in the ECS (adjusted odds ratio AOR 2.40, 95% CI 1.49–3.86) and NSHPC (AOR 1.43, 95% CI 1.10–1.86), but not in the PSD (AOR 0.92, 95% CI 0.67–1.26), after adjusting for relevant covariates. Because of heterogeneity, data were not pooled for this comparison, but heterogeneity disappeared when HAART was compared with dual therapy (P = 0.26). In a pooled analysis, HAART was associated with 1.5‐fold increased odds of preterm delivery compared with dual therapy (95% CI 1.19–1.87, P = 0.001), after adjusting for covariates.
Conclusions Heterogeneity in the association between HAART and preterm delivery was not explained by study design, adjustment for confounders or a standard analytical approach, but may have been the result of substantial differences in populations and data collected. The pooled analysis comparing HAART with dual therapy showed an increased risk of preterm delivery associated with HAART.
Identification of variants predicting development of renal dysfunction would offer substantial clinical benefits. There is evidence that coding non-synonymous variants in the gene encoding ...paraoxonase 2 (PON2) are associated with nephropathy in both type 1 and type 2 diabetes.
We examined the relationship between variation at the C311S and A148G polymorphisms (together with PON2 intronic variant rs12704795) and indices of renal dysfunction (progression to micro- and macroalbuminuria, plasma creatinine increases) in 3,374 newly diagnosed type 2 diabetic subjects from the UK Prospective Diabetes Study followed prospectively (median 14.0 years), using proportional hazards models, adjusted for sex, ethnicity and other known or putative risk factors.
rs12704795 genotypes were associated with differing rates of development of microalbuminuria (relative risk RR for CC vs AA homozygotes 0.68 95% CI 0.54-0.87, p=0.002) but not other measures of worsening renal function. Heterozygotes for C311S were more likely to develop microalbuminuria (RR=1.31 95% CI 1.11-1.54, p=0.001) but less likely to double creatinine levels during follow-up (RR=0.49 95% CI 0.27-0.89, p=0.02). There was no corroboration of this latter association for related outcomes and no prior evidence supports heterosis effects at this locus.
We conclude that the PON2 variants typed in this study have, at best, a small effect on the risk of renal dysfunction in type 2 diabetes.
THE NEED FOR A DYNAMICAL CLIMATE REANALYSIS Bengtsson, Lennart; Arkin, Phil; Berrisford, Paul ...
Bulletin of the American Meteorological Society,
04/2007, Letnik:
88, Številka:
4
Journal Article
Recenzirano
Odprti dostop
4 experimental reanalyses using selected sets of observations (Bengtsson et al. 2004b) to explicitly assess the impact of different observations and provide quantitative justification for ...assimilation decisions and a focus for data rescue and homogenization efforts Such experimental studies can now be undertaken by remote research groups with high-speed access to advanced data assimilation systems and databases made available by operational agencies such as ECMWF.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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