Background
A patent ductus arteriosus (PDA) with significant left to right shunt increases morbidity and mortality in preterm infants. Early closure of the ductus arteriosus may be achieved ...pharmacologically or by surgery. The preferred initial treatment of a symptomatic PDA, surgical ligation or treatment with indomethacin, is not clear.
Objectives
To compare the effect of surgical ligation of PDA versus medical treatment with cyclooxygenase inhibitors (indomethacin, ibuprofen or mefenamic acid), each used as the initial treatment, on neonatal mortality in preterm infants with a symptomatic PDA.
Search methods
For this update we searched The Cochrane Library 2012, Issue 2, MEDLINE, EMBASE, CINAHL, Clinicaltrials.gov, Controlled‐trials.com, Proceedings of the Annual Meetings of the Pediatric Academic Societies (2000 to 2011) (s2ViewTM) and Web of Science on 8 February 2012.
Selection criteria
Randomised or quasi‐randomised trials in preterm or low birth weight neonates with symptomatic PDA and comparing surgical ligation with medical treatment with cyclooxygenase inhibitors, each used as the initial treatment for closure of PDA.
Data collection and analysis
The authors independently assessed methodological quality and extracted data for the included trial. We used RevMan 5.1 for analyses of the data.
Main results
One study reporting on 154 neonates was found eligible. No significant difference between surgical closure and indomethacin treatment was found for in‐hospital mortality, chronic lung disease, necrotising enterocolitis, sepsis, creatinine level or intraventricular haemorrhage. There was a significant increase in the surgical group in the incidence of pneumothorax (risk ratio (RR) 2.68; 95% confidence interval (CI) 1.45 to 4.93; risk difference (RD) 0.25; 95% CI 0.11 to 0.38; number needed to treat to harm (NNTH) 4 (95% CI 3 to 9)) and retinopathy of prematurity stage III and IV (RR 3.80; 95% CI 1.12 to 12.93; RD 0.11; 95% CI 0.02 to 0.20; NNTH 9 (95% CI 5 to 50)) compared to the indomethacin group. There was a statistically significant decrease in failure of ductal closure rate in the surgical group as compared to the indomethacin group (RR 0.04; 95% CI 0.01 to 0.27; RD ‐0.32; 95% CI ‐0.43 to ‐0.21, number needed to treat to benefit (NNTB) 3 (95% CI 2 to 4)). No new trials were identified for inclusion in the 2012 update.
Authors' conclusions
There are insufficient data to conclude whether surgical ligation or medical treatment with indomethacin is preferred as the initial treatment for symptomatic PDA in preterm infants.
Disappearing Polymorphs Revisited Bučar, Dejan-Krešimir; Lancaster, Robert W.; Bernstein, Joel
Angewandte Chemie (International ed.),
June 8, 2015, Volume:
54, Issue:
24
Journal Article
Peer reviewed
Open access
Nearly twenty years ago, Dunitz and Bernstein described a selection of intriguing cases of polymorphs that disappear. The inability to obtain a crystal form that has previously been prepared is ...indeed a frustrating and potentially serious problem for solid‐state scientists. This Review discusses recent occurrences and examples of disappearing polymorphs (as well as the emergence of elusive crystal forms) to demonstrate the enduring relevance of this troublesome, but always captivating, phenomenon in solid‐state research. A number of these instances have been central issues in patent litigations. This Review, therefore, also highlights the complex relationship between crystal chemistry and the law.
Now you see it, now you don't: Some of the most captivating accounts of organic solid‐state chemistry in recent years concern disappearing polymorphs. This Review features notorious examples and underlines the misconceptions in understanding this phenomenon—both among scientists and in the court of law.
•Innovation quality is evaluated from substantive and sustainable innovation.•The evolution characteristics of China’s urban innovation network are revealed.•Patent inflow promotes developed cities’ ...substantive innovation.•Patent outflow has adverse effects on underdeveloped cities’ sustainable innovation.•The impact of patent transfer on innovation quality has institutional threshold effect.
The complexity and sustainability of technology are both important standards to measure innovation quality. As the diffusion of innovation is generated outside the region, patent transfer may have a promoting or crowding-out effect on urban innovation quality. We analyzed the spatial distribution characteristics of China’s urban patent transfer network. This empirical study, considering the heterogeneity of cities and patents, found that patent introduction in developed cities will promote substantive innovation measured by the proportion of invention patent. Additionally, the patent outward transfer has a crowding-out effect on the sustainable innovation of underdeveloped cities. Further analysis shows that when the institutional threshold of intellectual property protection is exceeded, the promotion of patent introduction and outward transfer in developed cities to local substantive innovation will be significantly enhanced. Conversely, in underdeveloped cities, the impact of patent outward transfer on substantive and sustainable innovation will change from promoting effect to crowding-out effect, that is, it induces the market failure of local technological innovation.
"Observational studies have identified a relationship between patent foramen ovale (PFO) and migraine headache. In people who have migraine with aura, 40% to 60% have a PFO, compared with 20% to 30% ...in the general adult population. It is hypothesized that migraine, especially migraine with aura, may be triggered by hypoxemia or vasoactive chemicals (eg, serotonin), which are ordinarily metabolized during passage through the lungs. Although PFO closure is currently not a FDA-approved therapy for migraines, randomized trials suggest that this intervention may benefit a subgroup of migraineurs."
Transcatheter closure of patent foramen ovale (PFO) is a highly effective therapy for patients with left circulation thromboembolism, not attributable to other conditions.
This retrospective cohort ...study investigates the impact of baseline foramen ovale anatomy on the severity of the postclosure shunt.
Patients with PFO, who underwent percutaneous closure, were followed up for at least 5 years postimplantation. Patients were classified into two groups based on the presence of high-risk features of the baseline PFO anatomy. At the follow-up follow-up, residual right-to-left shunt was assessed for the high and non-highrisk anatomy groups, via transcranial Doppler at rest and after performing the Valsalva maneuver, with the injection of agitated saline.
38 patients were examined after a mean follow-up period of 9 ± 3 years after implantation. After retrospective evaluation of the baseline transthoracic and transesophageal echo studies, 14 patients with high-risk PFO anatomy were identified. The degree of the residual right-to-left shunt, as assessed by the number of microbubbles was higher in the high-risk PFO anatomy group compared to the non-high-risk group, both at rest 1.50 (IQR: 0.00-3.25) vs. 0.00 (IQR: 0.00-0.00), p < 0.001 and post-Valsalva maneuver 7.50 (IQR: 1.50- 10.25) vs. 0.00 (IQR: 0.00-3.75), p = 0.003. Furthermore, in the high-risk group, more microbubbles were detected at rest (p = 0.008) and post-Valsalva (p = 0.002) in subjects without antiplatelet treatment compared to subjects on prolonged antiplatelet therapy.
Baseline PFO anatomy affects the severity of the residual right-to-left shunt. Prolonged antiplatelet therapy may benefit patients with high-risk anatomical features.
Our objective was to compare postprocedure hemodynamic decompensation in extremely premature infants who had their patent ductus arteriosus (PDA) closed with surgical ligation (SL) versus cardiac ...catheter-based closure (CCC).This is a single-center retrospective review of extremely premature ( < 28 weeks) infants who had their PDA closed by SL or CCC.Of the total of 69 infants, 53 underwent SL, and 16 had CCC. Infants in 2 groups were comparable at birth. However, at the time of the procedure, infants in the SL group were smaller, less mature, and had higher respiratory support. Vasopressor use, both pre- and postprocedure, was more common in the SL group. Nineteen percent of the infants in the SL group, compared to 6% in the CCC group (P = .34), required dose escalation or use of vasopressors after the PDA closure.There was no significant difference between the 2 groups in postoperative hemodynamic decompensation. Large, multicenter, prospective study or randomized control trial will help to confirm our findings.
Improved accuracy is one of the vital innovations in designing biopolymer-based products that are gaining momentum in diverse biomedicine arenas. The innovative devices were developed utilizing ...synthetic polymers but now are replaced with ‘green polymer’ such as chitosan. These bioactive polymer-based products can control release therapeutics, even greatly minimize the post-surgery inflammations, immune responses, and are biodegradable. Past decade to date, numerous proprietary technologies have been developed and protected by numerous patents. Therefore, strategical analysis of these chitosan-based process or product patent helps to identify key innovative technologies, clinically implementation, and key manufacturers behind these biomedical products. The present article analyzed the trends in patent portfolios of chitosan-based biomedical products and the number of original research papers published over a decade. A spotlight on different marketed grades, modifications for their special use, blend composites, safety profile, and regulatory concerns of chitosan use in bioengineering are covered. A scientific prospection was performed between 2009 and 2020 using the PubMed database. For technological prospection, Lens (free, open patent, and scholarly search) portal was utilized. Chitosan-originated patents were analyzed using cooperative and international patent classifications, covering their citations by patent count. Various chitosan-based patents that are approved and commercial chitosan based biomedical products are even listed. A preliminary perusal of chitosan alone or based patent portfolios can greatly benefit various stakeholders like scientists and corporate firms for new product development, government agencies for allocation of federal funds shaping up biomedicine advances by utilizing chitosan. The present analysis indicates the overall progression and unexplored corners of chitosan in a current global biomedical proposition.
Display omitted
•Scrutiny of recent advances and trends of chitosan in multidisciplinary biomedical applications•Special modifications of chitosan along with copolymer for diverse biomedical applications•Patent prospection (Scientific & Technological) of chitosan and chitosan + biomedical application to date•Comprehensive list of commercially available chitosan based biomedical products.
Purpose
We sought to determine the prevalence of and factors associated with acute cor pulmonale (ACP) and patent foramen ovale (PFO) at the early phase of acute respiratory distress syndrome (ARDS), ...and to assess their relation with mortality.
Methods
In this prospective multicenter study, 200 patients submitted to protective ventilation for early moderate to severe ARDS PaO
2
/F
I
O
2
: 115 ± 39 with F
I
O
2
: 1; positive end-expiratory pressure (PEEP): 10.6 ± 3.1 cmH
2
O underwent transthoracic (TTE) and transesophageal echocardiography (TEE) <48 h after admission. Echocardiograms were independently interpreted by two experts. Factors associated with ACP, PFO, and 28-day mortality were identified using multivariate regression analysis.
Results
TEE depicted ACP in 45/200 patients 22.5%; 95 % confidence interval (CI) 16.9–28.9 %, PFO in 31 patients (15.5 %; 95 % CI 10.8–21.3 %), and both ACP and PFO in 9 patients (4.5 %; 95 % CI 2.1–8.4 %). PFO shunting was small and intermittent in 27 patients, moderate and consistent in 4 patients, and large or extensive in no instances. PaCO
2
>60 mmHg was strongly associated with ACP odds ratio (OR) 3.70; 95 % CI 1.32–10.38;
p
= 0.01. No factor was independently associated with PFO, with only a trend for age (OR 2.07; 95 % CI 0.91–4.72;
p
= 0.08). Twenty-eight-day mortality was 23 %. Plateau pressure (OR 1.15; 95 % CI 1.05–1.26;
p
< 0.01) and air leaks (OR 5.48; 95 % CI 1.30–22.99;
p
= 0.02), but neither ACP nor PFO, were independently associated with outcome.
Conclusions
TEE screening allowed identification of ACP in one-fourth of patients submitted to protective ventilation for early moderate to severe ARDS. PFO shunting was less frequent and never large or extensive. ACP and PFO were not related to outcome.
This paper describes a new database of declared standard‐essential patents (SEPs), discusses methods for matching declared SEPs to specific standard documents, and presents empirical evidence on ...technology standards subject to declared SEPs. Although there is a growing body of empirical research using data on declared SEPs, this research has so far focused on the declared patents, and neglected the implications of SEP declarations for specific standards. Furthermore, we present a new methodology for matching standards with technology classes, using the classification of declared SEPs. This method allows identifying other standard‐related patents, and provides information on technological relationships between standards and standard‐related patenting. The paper discusses opportunities for new empirical research using databases of declared SEPs and data on patenting in standard‐related technology classes.
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