Background and purpose
The aim was to systematically review the effectiveness and safety of telemedicine combined with usual care (in‐person visits) compared to usual care for the therapeutic ...management and follow‐up assessment of neurological diseases.
Methods
The electronic databases MEDLINE, Embase, Web of Science and Cochrane Central Register of Controlled Trials were searched (June 2021). Randomized controlled trials (RCTs) on patients of any age with neurological diseases were considered. Two reviewers screened and ed data in duplicate and independently and assessed risk of bias using the Cochrane risk‐of‐bias tool for randomized trials (RoB 2). When possible, pooled effect estimates were calculated.
Results
Of a total of 3018 records initially retrieved, 25 RCTs (n = 2335) were included: 11 (n = 804) on stroke, four (n = 520) on Parkinson's disease, three (n = 110) on multiple sclerosis, two (n = 320) on epilepsy, one (n = 63) on dementia, one (n = 23) on spina bifida, one (n = 40) on migraine, one (n = 22) on cerebral palsy and one (n = 433) on brain damage. Types of telemedicine assessed were online visits (11 studies), tele‐rehabilitation (seven studies), telephone calls (three), smartphone apps (two) and online computer software (two). The evidence was quite limited except for stroke. Compared to usual care alone, telemedicine plus usual care was found to improve depressive symptoms, functional status, motor function, executive function, generic quality of life, healthcare utilization and healthy lifestyle in patients in post‐stroke follow‐up.
Conclusions
Well‐designed and executed RCTs are needed to confirm our findings on stroke and to have more scientific evidence available for the other neurological diseases.
•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.
SERS permits identifying the nature of molecules in extremely low concentrations, but it is hindered by poor enhancement or low reproducibility. We demonstrate controllable ∼1010 signal amplification ...reaching the zeptomol detection limit for a nonresonant molecule by sandwiching the analyte between the tips of star-shaped gold nanoparticles and a planar gold surface using a simple synthetic procedure. This unprecedented control over light-intensity amplification opens a new avenue toward high-yield, fully reproducible, SERS-based, zeptomol detection and holds promise for nonlinear optics applications at the single-particle level.
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.
Summary
As part of the innate immune response, neutrophils are at the forefront of defence against infection, resolution of inflammation and wound healing. They are the most abundant leucocytes in ...the peripheral blood, have a short lifespan and an estimated turnover of 1010 to 1011 cells per day. Neutrophils efficiently clear microbial infections by phagocytosis and by oxygen‐dependent and oxygen‐independent mechanisms. In 2004, a new neutrophil anti‐microbial mechanism was described, the release of neutrophil extracellular traps (NETs) composed of DNA, histones and anti‐microbial peptides. Several microorganisms, bacterial products, as well as pharmacological stimuli such as PMA, were shown to induce NETs. Neutrophils contain relatively few mitochondria, and derive most of their energy from glycolysis. In this scenario we aimed to analyse some of the metabolic requirements for NET formation. Here it is shown that NETs formation is strictly dependent on glucose and to a lesser extent on glutamine, that Glut‐1, glucose uptake, and glycolysis rate increase upon PMA stimulation, and that NET formation is inhibited by the glycolysis inhibitor, 2‐deoxy‐glucose, and to a lesser extent by the ATP synthase inhibitor oligomycin. Moreover, when neutrophils were exposed to PMA in glucose‐free medium for 3 hr, they lost their characteristic polymorphic nuclei but did not release NETs. However, if glucose (but not pyruvate) was added at this time, NET release took place within minutes, suggesting that NET formation could be metabolically divided into two phases; the first, independent from exogenous glucose (chromatin decondensation) and, the second (NET release), strictly dependent on exogenous glucose and glycolysis.
Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main extra-articular organ affected is the lung, sometimes in the form of diffuse interstitial lung disease (ILD) and conditions the ...prognosis. A multicenter, observational, descriptive and cross-sectional study of consecutive patients diagnosed with RA-ILD. Demographic, analytical, respiratory functional and evolution characteristics were analyzed to evaluate the predictors of progression and mortality. 106 patients were included. The multivariate analysis showed that the diagnostic delay was an independent predictor of mortality (HR 1.11, CI 1.01-1.23, p = 0.035). Also, age (HR 1.33, 95% CI 1.09-1.62, p = 0.0045), DLCO (%) (HR 0.85, 95% CI 0.73-0.98, p = 0.0246), and final SatO2 (%) in the 6MWT (HR 0.62, 95% CI 0.39-0.99, p = 0.0465) were independent predictor variables of mortality, as well as GAP index (HR 4.65, 95% CI 1.59-13.54, p = 0.0051) and CPI index (HR 1.12, 95% CI 1.03-1.22, p = 0.0092). The withdrawal of MTX or LFN after ILD diagnosis was associated with disease progression in the COX analysis (HR 2.18, 95% CI 1.14-4.18, p = 0.019). This is the first study that highlights the diagnostic delay in RA-ILD is associated with an increased mortality just like happens in IPF.
Today, ≈20% of the electric consumption is devoted to refrigeration; while, ≈50% of the final energy is dedicated to heating applications. In this scenario, many cooling devices and heat‐pumps are ...transitioning toward the use of CO2 as an eco‐friendly refrigerant, favoring carbon circular economy. Nevertheless, CO2 still has some limitations, such as large operating pressures (70–150 bar) and a critical point at 31 °C, which compromises efficiency and increases technological complexity. Very recently, an innovative breathing‐caloric mechanism in the MIL‐53(Al) compound is reported, which implies gas adsorption under CO2 pressurization boosted by structural transitions and which overcomes the limitations of stand‐alone CO2. Here, the breathing‐caloric‐like effects of MOF‐508b are reported, surpassing by 40% those of MIL‐53(Al). Moreover, the first thermometry device operating at room temperature and under the application of only 26 bar of CO2 is presented. Under those conditions, this material presents values of ΔT ≈ 30 K, reaching heating temperatures of 56 °C and cooling temperatures of −10 °C, which are already useful for space heating, air‐conditioning, food refrigeration, and freezing applications.
MOF‐508b displays enhanced breathing‐caloric‐like effects related to two consecutive phase transitions, where barocaloric effects and sorption thermal changes coexist. Moreover, the first thermometry device to characterize this type of thermomaterials is presented, where MOF‐508b shows remarkable temperature changes of 30 K under CO2 pressurization of only 26 bar, which can empower existing CO2 heating and cooling systems.
Summary
Background
Chronic hepatitis delta is a severe liver disease with rapid progression to cirrhosis. The impact of hepatitis delta virus (HDV)‐RNA on disease progression and interferon treatment ...in a real‐world cohort has been barely explored.
Aim
To assess the development of clinical events in a cohort of chronic hepatitis delta patients according to the presence or absence of HDV‐RNA
Methods
Multicentre study at four academic hospitals in Spain included anti‐HDV‐positive patients with compensated liver disease with a follow‐up ≥12 months.
Results
Among 2888 HBsAg‐positive subjects, 151 (5.2%) tested positive for anti‐HDV, and 118 were included (58% men; median age, 49 years; 73% detectable HDV‐RNA and 30% cirrhosis, most often in subjects with HDV‐RNA). After a median follow‐up of 8 years, subjects with initially detectable HDV‐RNA were more prone to developing cirrhosis (31% vs 0%, P = .002) and/or liver decompensation (28% vs 3%, P = .019). Mortality rate was 0.44 per 1000 person‐months. The probability of a clinical event was 6%, 25%, and 80% according to initial baseline‐event‐anticipation score. HDV‐RNA became undetectable in 21 (24%) subjects either due to interferon or spontaneously (48% vs 52%, P = .29). Liver decompensation was reduced in interferon‐treated patients (13% vs 38%, P = .026).
Conclusions
Subjects with persistently positive HDV‐RNA had a worse prognosis in terms of clinical events. Baseline‐event‐anticipation score is useful in predicting the risk of developing liver decompensation and hepatocellular carcinoma. Interferon was beneficial in reducing liver decompensation, even in the absence of virological response.
LINKED CONTENTThis article is linked to Sonneveld and de Knegt and Palom et al papers. To view these articles, visit https://doi.org/10.1111/apt.15549 and https://doi.org/10.1111/apt.15558.
Summary
Background
Spontaneous HDV‐RNA fluctuations, assessed by nonstandardised in‐house assays, have been reported during the course of chronic hepatitis delta (CHD).
Aims
To evaluate changes in ...serum HDV‐RNA concentrations in untreated CHD patients and correlate these changes with other HBV markers.
Methods
A total of 323 consecutive serum samples from 56 CHD patients (detectable HDV‐RNA) followed for >3 years were retested for HDV‐RNA levels by a sensitive technique using the first WHO international HDV‐RNA standard. Quantitative HBsAg, HBV‐DNA, and HBV‐RNA were also determined.
Results
Most participants were male, middle‐aged, white European, and HBeAg‐negative (82%). Almost half had liver cirrhosis and 64% were receiving nucleos(t)ide analogues. At inclusion, median‐HDV‐RNA was 5.3 (4.2‐6.5) log10IU/mL, HBsAg 4.0 (3.5‐4.3) log10IU/mL, and HBV‐DNA 1.6 (1.0‐2.6) log10IU/mL; ALT values were normal in 13 (23%). During a mean follow‐up of 5.6 (3‐16) years, 14 (25%) showed ≥2log10 HDV‐RNA decline, including 11 (20%) who spontaneously achieved undetectable HDV‐RNA. Four patients (7%) lost HBsAg, with undetectable HDV‐RNA. The remaining 42 (75%) had persistently detectable HDV‐RNA. During follow‐up, patients with a ≥2log10 HDV‐RNA decline showed a greater HBsAg drop (−0.7 ± 1.1 vs −0.09 ± 0.9 log IU/mL; P = 0.039) than those with a <2 log10 HDV‐RNA decline. Overall, ALT and HBV‐DNA levels decreased over time. There were no differences in clinical outcomes between groups.
Conclusions
One‐quarter of untreated CHD patients showed a ≥2log10 decline in HDV‐RNA and 20% reached HDV‐RNA undetectability during a mean follow‐up of 5.6 years. The decline was associated with ALT decrease. These findings have implications for designing new therapies for CHD.
Patients with ≥2 log10 HDV‐RNA decline have a higher likelihood of achieving undetectable HDV‐RNA, HBsAg loss and normal ALT levels. No differences in clinical events were observed. These findings may have implications for the design of studies with new therapies for CHD.
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