•Women tend to have slightly longer inpatient admissions than men.•Depressive admissions were more likely for women whereas manic admissions were more likely for men.•Women were more likely to ...present with comorbid cluster B personality disorders, while men were more likely to have alcohol and substance use comorbidities.•There were no significant gender differences in receiving antipsychotics, lithium, anticonvulsants, antidepressants or psychostimulants in the three months prior to admission.•Treatment with typical and/or atypical antipsychotics within three months prior to admission were associated with shorter stays.
The influence of gender on bipolar disorder is controversial and it is unclear if inpatient care differs between men and women. Here, we investigate for gender differences in the inpatient length of stay for Swedes admitted for bipolar disorder and explore other factors that could explain any observed association.
Admission data were extracted from the Swedish National Patient Register and included all patients first admitted to a psychiatric inpatient unit with a bipolar disorder diagnosis, circa 2005–2014. Patients were then retrospectively followed for subsequent hospitalizations. Diagnostic subtypes were categorized by ICD-10 clusters: depressive, depressive with psychotic features, manic, manic with psychotic features, mixed, and other. Psychotropic therapies preceding the corresponding admissions were attained from the Prescribed Drug Register. Mixed-effects zero-truncated negative binomial regressions were employed to model the length of stay per admission.
Analysis included 39,653 admissions by 16,271 inpatients (60.0% women). Overall, when compared to men, women spent 7.5% (95% CI: 4.2–11.0%, p < 0.001) extra days hospitalized per admission. However, upon adjusting for candidate confounders, including the bipolar subtype, and selected comorbidities and psychotropics, the association weakened wherein women then spent 3.7% (95% CI: 0.1–6.9%, p = 0.028) extra days hospitalized per admission.
The integrity of register data can be variable and the adherence to outpatient dispensed psychotropics could not be validated.
Although the influence of gender on the bipolar disorder inpatient length of stay is evident, other factors attenuate and better explain this crude observation.
Methyl-Driven Overhauser Dynamic Nuclear Polarization Perras, Frédéric A.; Flesariu, Dragos F.; Southern, Scott A. ...
The journal of physical chemistry letters,
2022-May-12, Letnik:
13, Številka:
18
Journal Article
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The Overhauser effect is unique among DNP mechanisms in that it requires the modulation of the electron–nuclear hyperfine interactions. While it dominates DNP in liquids and metals, where unpaired ...electrons are highly mobile, Overhauser DNP is possible in insulating solids if rapid structural modulations are linked to a modulation in hyperfine coupling. Herein, we report that Overhauser DNP can be triggered by the strategic addition of a methyl group, demonstrated here in a Blatter’s radical. The rotation of the methyl group leads to a modulation of the hyperfine coupling to its protons, which in turn facilitates electron–nuclear cross-relaxation. Removal of the methyl protons, through deuteration, quenches the process, as does the reduction of the hyperfine coupling strength. This result suggests the possibility for the design of tailor-made Overhauser DNP polarizing agents for high-field MAS-DNP.
Machining of biocompatible materials is facing the fundamental challenges due to the specific material properties as well as the application requirements. Firstly, this paper presents a review of ...various materials which the medical industry needs to machine, then comments on the advances in the understanding of their specific cutting mechanisms. Finally it reviews the machining processes that the industry employs for different applications. This highlights the specific functional requirements that need to be considered when machining biocompatible materials and the associated machines and tooling. An analysis of the scientific and engineering challenges and opportunities related to this topic are presented.
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•An approach to calculate the equivalent pressure distribution at the weld interface.•A methodology to convert the pressure distribution in equivalent process loads.•Analysis of the ...rotordynamic behaviour of the system in process conditions.•Non-axisymmetric loads were recognised as the main cause of runout during welding.
Inertia friction welding (IFW) is a process used to create joints with high geometrical accuracy and near net shape form. To cope with the complex phenomena occurring during welding, the majority of available studies have analysed the interaction of the workpieces to be joined under simplified conditions, in which the influence of machine assembly tolerances, spindle dynamics and system compliance have been neglected. Among the dimensional properties, the headstock-tailstock concentricity is particularly important to assess the conformity of the weld, for this reason, a novel approach was developed to investigate the physical causes behind the evolution of the radial misalignment between the two workpieces, conventionally referred to as radial runout. First an inverse approach to evaluate the equivalent pressure distribution at the weld interface and the equivalent process loads was implemented starting from the experimental data of radial runout, headstock angular speed and strain extracted with a custom monitoring system during a set of steel welds. The results showed a large variability of the pressure distribution in circumferential direction and non-axisymmetric load components in particular during the conditioning and burnoff phases. Then, the equivalent process loads were used as an input for a Timoshenko beam dynamic representation of the spindle. A good agreement between the model and the experimental data was observed with an average relative error in the radial runout of 0.085. From these results, it was possible to conclude that the lack of axisymmetry in the load components has to be attributed mainly to the misalignment between two workpieces, while the irregular runout to compliance of the system to the non-ideal process loads.
Gender Nonconformity of Bisexual Men and Women Rieger, Gerulf; Holmes, Luke; Watts-Overall, Tuesday M. ...
Archives of sexual behavior,
10/2020, Letnik:
49, Številka:
7
Journal Article
Recenzirano
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The degree to which bisexual-identified individuals are distinct from either heterosexual or homosexual individuals in their sexual orientation is an ongoing debate. We examined potential differences ...between these groups with respect to a strong correlate of sexual orientation, gender nonconformity (femininity in males, masculinity in females). Across pooled data, we compared self-reports of childhood gender nonconformity (
n
= 919) and adulthood gender nonconformity (
n
= 1265) and observer ratings of adulthood gender nonconformity (
n
= 915) between sexual orientations. Most analyses suggested a steady increase in gender nonconformity from exclusively heterosexual to exclusively homosexual. However, in some analyses, bisexual men were closer to homosexual men than to heterosexual men in their gender nonconformity. The intermediate status of bisexual people in gender nonconformity was not due to the sample having a mixture of very gender-conforming and very gender-nonconforming individuals. In total, men and women with bisexual orientations appeared neither like heterosexual nor homosexual individuals, at least with respect to their gender-related traits.
During normal and pathologic immune responses, lymph nodes can swell considerably. The lymph node vascular–stromal compartment supports and regulates the developing immune responses and undergoes ...dynamic expansion and remodeling. Recent studies have shown that dendritic cells (DCs), best known for their antigen presentation roles, can directly regulate the vascular–stromal compartment, pointing to a new perspective on DCs as facilitators of lymphoid tissue function. Here, we review the phases of lymph node vascular–stromal growth and remodeling during immune responses, discuss the roles of DCs, and discuss how this understanding can potentially be used for developing novel therapeutic approaches.
While disease-modifying therapies exist for heart failure (HF) with reduced left ventricular ejection fraction (LVEF), few options are available for patients in the higher range of LVEF (>40%). ...Sacubitril/valsartan has been compared with a renin-angiotensin-aldosterone-system inhibitor alone in 2 similarly designed clinical trials of patients with reduced and preserved LVEF, permitting examination of its effects across the full spectrum of LVEF.
We combined data from PARADIGM-HF (LVEF eligibility≤40%; n=8399) and PARAGON-HF (LVEF eligibility≥45%; n=4796) in a prespecified pooled analysis. We divided randomized patients into LVEF categories: ≤22.5% (n=1269), >22.5% to 32.5% (n=3987), >32.5% to 42.5% (n=3143), > 42.5% to 52.5% (n=1427), > 52.5% to 62.5% (n=2166), and >62.5% (n=1202). We assessed time to first cardiovascular death and HF hospitalization, its components, and total heart failure hospitlizations, all-cause mortality, and noncardiovascular mortality. Incidence rates and treatment effects were examined across categories of LVEF.
Among 13 195 randomized patients, we observed lower rates of cardiovascular death and HF hospitalization, but similar rates of noncardiovascular death, among patients in the highest versus the lowest groups. Overall sacubitril/valsartan was superior to renin-angiotensin-aldosterone-system inhibition for first cardiovascular death or heart failure hospitalization (Hazard Ratio HR 0.84 95% CI, 0.78-0.90), cardiovascular death (HR 0.84 95% CI, 0.76-0.92), heart failure hospitalization (HR 0.84 95% CI, 0.77-0.91), and all-cause mortality (HR 0.88 95% CI, 0.81-0.96). The effect of sacubitril/valsartan was modified by LVEF (treatment-by-continuous LVEF interaction
=0.02), and benefit appeared to be present for individuals with EF primarily below the normal range, although the treatment benefit for cardiovascular death diminished at a lower ejection fraction. We observed effect modification by LVEF on the efficacy of sacubitril/valsartan in both men and women with respect to composite total HF hospitalizations and cardiovascular death, although women derived benefit to higher ejection fractions.
The therapeutic effects of sacubitril/valsartan, compared with a renin-angiotensin-aldosterone-system inhibitor alone, vary by LVEF with treatment benefits, particularly for heart failure hospitalization, that appear to extend to patients with heart failure and mildly reduced ejection fraction. These therapeutic benefits appeared to extend to a higher LVEF range in women compared with men.
https://www.clinicaltrials.gov. Unique identifiers: NCT01920711 (PARAGON-HF), NCT01035255 (PARADIGM-HF).
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