Given its non-invasive nature, there is increasing interest in the use of transcutaneous vagus nerve stimulation (tVNS) across basic, translational and clinical research. Contemporaneously, tVNS can ...be achieved by stimulating either the auricular branch or the cervical bundle of the vagus nerve, referred to as transcutaneous auricular vagus nerve stimulation(VNS) and transcutaneous cervical VNS, respectively. In order to advance the field in a systematic manner, studies using these technologies need to adequately report sufficient methodological detail to enable comparison of results between studies, replication of studies, as well as enhancing study participant safety. We systematically reviewed the existing tVNS literature to evaluate current reporting practices. Based on this review, and consensus among participating authors, we propose a set of minimal reporting items to guide future tVNS studies. The suggested items address specific technical aspects of the device and stimulation parameters. We also cover general recommendations including inclusion and exclusion criteria for participants, outcome parameters and the detailed reporting of side effects. Furthermore, we review strategies used to identify the optimal stimulation parameters for a given research setting and summarize ongoing developments in animal research with potential implications for the application of tVNS in humans. Finally, we discuss the potential of tVNS in future research as well as the associated challenges across several disciplines in research and clinical practice.
An ideal therapeutic anti-SARS-CoV-2 antibody would resist viral escape
, have activity against diverse sarbecoviruses
, and be highly protective through viral neutralization
and effector functions
. ...Understanding how these properties relate to each other and vary across epitopes would aid the development of therapeutic antibodies and guide vaccine design. Here we comprehensively characterize escape, breadth and potency across a panel of SARS-CoV-2 antibodies targeting the receptor-binding domain (RBD). Despite a trade-off between in vitro neutralization potency and breadth of sarbecovirus binding, we identify neutralizing antibodies with exceptional sarbecovirus breadth and a corresponding resistance to SARS-CoV-2 escape. One of these antibodies, S2H97, binds with high affinity across all sarbecovirus clades to a cryptic epitope and prophylactically protects hamsters from viral challenge. Antibodies that target the angiotensin-converting enzyme 2 (ACE2) receptor-binding motif (RBM) typically have poor breadth and are readily escaped by mutations despite high neutralization potency. Nevertheless, we also characterize a potent RBM antibody (S2E12
) with breadth across sarbecoviruses related to SARS-CoV-2 and a high barrier to viral escape. These data highlight principles underlying variation in escape, breadth and potency among antibodies that target the RBD, and identify epitopes and features to prioritize for therapeutic development against the current and potential future pandemics.
Nordic walking (NW) has several potential benefits for individuals with cardiovascular (CV) disease, type 2 diabetes, and obesity and/or overweight. NW improves cardiovascular health, including ...exercise capacity and blood pressure control. NW enhances glycemic control and insulin sensitivity in diabetes, and aids in weight management and body composition improvement. NW offers additional advantages, such as improvement in muscular strength, joint mobility, physical activity levels, and psychological well-being.
This open-label study with 3 arms will aim to evaluate the efficacy, safety, and adherence to exercise prescription in obese and/or overweight diabetic patients with CV complications. The primary objective will be to assess the CV performance of participants after a 6-month and a 12-month follow-up period, following a 3-month NW intervention, compared with standard rehabilitation, and with cardiological counseling (control group) training lasting 3 months.
The results of the study will provide valuable insights into the comparative effectiveness of a NW intervention vs standard rehabilitation and control group training in improving CV performance in obese and/or overweight diabetic patients with CV complications. Additionally, safety and adherence data will help inform the feasibility and sustainability of the exercise prescription over an extended period.
These findings may have implications for the development of tailored exercise programs for this specific patient population, with the aim of optimizing CV health outcomes.
NCT05987410
La marche nordique offre plusieurs bienfaits potentiels aux personnes atteintes d’une maladie cardiovasculaire (CV), de diabète de type 2, de surpoids ou d’obésité. Elle améliore la santé cardiovasculaire, notamment l’endurance à l’effort et la régulation de la pression artérielle, en plus de favoriser l’équilibre glycémique et d'accroître la sensibilité à l’insuline chez les personnes diabétiques. Elle facilite également la gestion du poids et l’amélioration de la composition corporelle. Par ailleurs, la marche nordique présente d’autres avantages, comme l’augmentation de la force musculaire, de la mobilité articulaire, du niveau d’activité physique et du bien-être psychologique.
Cette étude ouverte à 3 groupes vise à évaluer l’efficacité, la sécurité et l’observance des exercices prescrits chez des sujets diabétiques obèses ou en surpoids présentant des complications CV. Le principal objectif consistera à évaluer la performance CV des participants au cours d'une période de suivi de 6 et 12 mois après un programme de marche nordique de 3 mois, comparativement à un programme de réadaptation standard et à un programme d’encadrement en soins CV (groupe témoin) de 3 mois.
Les résultats de l’étude fourniront de précieux renseignements sur l’efficacité d’un programme de marche rapide comparativement à un programme de réadaptation standard et à un programme d’encadrement (groupe témoin) pour améliorer la performance CV chez des sujets diabétiques obèses ou en surpoids présentant des complications CV. Les données relatives à la sécurité et à l’observance permettront également d’évaluer la faisabilité et la viabilité de la prescription d’exercices sur une longue période.
Ces résultats pourraient s’avérer utiles dans l’élaboration de programmes d’exercices spécifiquement conçus pour cette population de patients, afin d’optimiser les résultats en santé CV.
NCT05987410
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Importance
While the relationship between persistent elevations in intracranial pressure (ICP) and poorer outcomes is well established for patients with traumatic brain injury (TBI), there is no ...consensus on how ICP measurements should drive treatment choices, and the effectiveness of ICP monitoring remains unknown.
Objective
To evaluate the effectiveness of ICP monitoring on short- and mid-term outcomes of patients with TBI.
Design, Setting, and Participants
CREACTIVE was a prospective cohort study that started in March 2014 and lasted 5 years. More than 8000 patients with TBI were enrolled at 83 intensive care units (ICUs) from 7 countries who joined the CREACTIVE Consortium. Patients with TBI who met the Brain Trauma Foundation guidelines for ICP monitoring were selected for the current analyses, which were performed from January to November 2022.
Exposure
Patients who underwent ICP monitoring within 2 days of injury (exposure group) were propensity score–matched to patients who were not monitored or who underwent monitoring 2 days after the injury (control group).
Main Outcome and Measure
Functional disability at 6 months as indicated by Glasgow Outcome Scale–Extended (GOS-E) score.
Results
A total of 1448 patients from 43 ICUs in Italy and Hungary were eligible for analysis. Of the patients satisfying the ICP-monitoring guidelines, 503 (34.7%) underwent ICP monitoring (median IQR age: 45 years 29-61 years; 392 males 77.9%, 111 females 22.1%) and 945 were not monitored (median IQR age: 66 years 48-78 years; 656 males 69.4%, 289 females 30.6%). After matching to balance the variables, worse 6-month recovery was observed for monitored patients compared with nonmonitored patients (death/vegetative state: 39.2% vs 40.6%; severe disability: 33.2% vs 25.4%; moderate disability: 15.7% vs 14.9%; good recovery: 11.9% vs 19.1%, respectively;
P
= .005). Monitored patients received medical therapies significantly more frequently.
Conclusions and Relevance
In this cohort study, ICP monitoring was associated with poorer recovery and more frequent medical interventions with their relevant adverse effects. Optimizing the value of ICP monitoring for TBI requires further investigation on monitoring indications, clinical interventions, and management protocols.
Dès ses premières critiques littéraires, Maurice Blanchot a commenté les plus grands écrivains allemands : Kafka, Thomas Mann, Rilke, Goethe, Eckermann, Hölderlin, Nietzsche, Musil, Broch, Hesse, ...Celan... Blanchot a toujours lu en allemand. Il connaît parfaitement la philosophie de Hegel à Heidegger, de Scholem à Adorno, ainsi que les œuvres critiques de la littérature et la philosophie allemandes. La plupart de ses œuvres portent d’ailleurs les traces de la culture allemande : les romantiques pour l’écriture fragmentaire, Kafka pour les premiers romans, ou encore Thomas Mann pour certains motifs littéraires. Il n’est pas rare en fait de trouver dans les romans ou les récits de Blanchot des citations à peine réécrites de certaines œuvres germanophones. Cet ouvrage a pour intention de faire le point sur ces correspondances de pensée tout en insistant sur des auteurs plus secondaires pour Blanchot comme Maître Eckhart, Leibniz, Novalis, Heidegger, Wittgenstein, Schelling, Benjamin, Freud…
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