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1.
J Environ Sci (China) ; 148: 27-37, 2025 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-39095163

RESUMEN

Naphthenic acids, NAs, are a major contaminant of concern and a focus of much research around remediation of oil sand process affected waters, OSPW. Using activated carbon adsorbents are an attractive option given their low cost of fabrication and implementation. A deeper evaluation of the effect NA structural differences have on uptake affinity is warranted. Here we provide an in-depth exploration of NA adsorption including many more model NA species than have been assessed previously with evaluation of adsorption kinetics and isotherms at the relevant alkaline pH of OSPW using several different carbon adsorbents with pH buffering to simulate the behaviour of real OSPW. Uptake for the NA varied considerably regardless of the activated carbon used, ranging from 350 mg/g to near zero highlighting recalcitrant NAs. The equilibrium data was explored to identify structural features of these species and key physiochemical properties that influence adsorption. We found that certain NA will be resistant to adsorption when hydrophobic adsorbents are used. Adsorption isotherm modelling helped explore interactions occurring at the interface between NA and adsorbent surfaces. We identified the importance of NA hydrophobicity for activated carbon uptake. Evidence is also presented that indicates favorable hydrogen bonding between certain NA and surface site hydroxyl groups, demonstrating the importance of adsorbent surface functionality for NA uptake. This research highlights the challenges associated with removing NAs from OSPW through adsorption and also identifies how adsorbent surface chemistry modification can be used to increase the removal efficiency of recalcitrant NA species.


Asunto(s)
Ácidos Carboxílicos , Contaminantes Químicos del Agua , Adsorción , Ácidos Carboxílicos/química , Contaminantes Químicos del Agua/química , Carbón Orgánico/química , Modelos Químicos , Cinética , Concentración de Iones de Hidrógeno
3.
Nanomaterials (Basel) ; 14(16)2024 Aug 14.
Artículo en Inglés | MEDLINE | ID: mdl-39195383

RESUMEN

Optical fiber Raman and surface-enhanced Raman scattering (SERS) probes hold great promise for in vivo biosensing and in situ monitoring of hostile environments. However, the silica Raman scattering background generated within the optical fiber increases in proportion to the length of the fiber, and it can swamp the signal from the target analyte. While filtering can be applied at the distal end of the fiber, the use of bulk optical elements has limited probe miniaturization to a diameter of 600 µm, which in turn limits the potential applications. To overcome this limitation, femtosecond laser micromachining was used to fabricate a prototype micro-optical filter, which was directly integrated on the tip of a 125 µm diameter double-clad fiber (DCF) probe. The outer surface of the microfilter was further modified with a nanostructured, SERS-active, plasmonic film that was used to demonstrate proof-of-concept performance with thiophenol as a test analyte. With further optimization of the associated spectroscopic system, this ultra-compact microprobe shows great promise for Raman and SERS optical fiber sensing.

4.
Artículo en Inglés | MEDLINE | ID: mdl-39134907

RESUMEN

BACKGROUND: Sedentary behavior has been identified as a significant risk factor for Metabolic Syndrome (MetS). However, it is unclear if the sedentary pattern measurement approach (posture vs. movement) impacts observed associations or if associations differ for Hispanic/Latino communities, who have higher risk of MetS. METHODS: Participants from the Community of Mine (CoM) study (N = 602) wore hip-based accelerometers for 14 days and completed MetS-associated biomarker assessment (triglycerides, blood pressure, fasting glucose, HDL cholesterol, waist circumference). Sedentary patterns were classified using both cutpoints (movement-based) and the Convolutional Neural Network Hip Accelerometer Posture (CHAP) algorithm (posture-based). We used logistic regression to estimate associations between MetS with sedentary patterns overall and stratified by Hispanic/Latino ethnicity. RESULTS: CHAP and cutpoint sedentary patterns were consistently associated with MetS. When controlling for total sedentary time and moderate to vigorous physical activity, only CHAP-measured median sedentary bout duration (OR = 1.15, CI: 1.04, 1.28) was significant. In stratified analysis, CHAP-measured median bout duration and time spent in sedentary bouts ≥ 30 min were each associated with increased odds of MetS, but the respective associations were stronger for Hispanic/Latino ethnicity (OR = 1.71 and 1.48; CI = 1.28-2.31 and 1.12-1.98) than for non-Hispanic/Latino ethnicity (OR = 1.43 and 1.40; CI = 1.10-1.87 and 1.06-1.87). CONCLUSIONS: The way sedentary patterns are measured can impact the strength and precision of associations with MetS. These differences may be larger in Hispanic/Latino ethnic groups and warrants further research to inform sedentary behavioral interventions in these populations.

5.
Hepatol Commun ; 8(8)2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39101793

RESUMEN

BACKGROUND: Cholangiocarcinoma (CCA) features highly desmoplastic stroma that promotes structural and functional resistance to therapy. Lysyl oxidases (LOX, LOXL1-4) catalyze collagen cross-linking, thereby increasing stromal rigidity and facilitating therapeutic resistance. Here, we evaluate the role of lysyl oxidases in stromal desmoplasia and the effects of pan-lysyl oxidase (pan-LOX) inhibition in CCA. METHODS: Resected CCA and normal liver specimens were analyzed from archival tissues. Spontaneous and orthotopic murine models of intrahepatic CCA (iCCA) were used to assess the impact of the pan-LOX inhibitor PXS-5505 in treatment and correlative studies. The functional role of pan-LOX inhibition was interrogated through in vivo and ex vivo assays. RESULTS: All 5 lysyl oxidases are upregulated in CCA and reduced lysyl oxidase expression is correlated with an improved prognosis in resected patients with CCA. Spontaneous and orthotopic murine models of intrahepatic cholangiocarcinoma upregulate all 5 lysyl oxidase isoforms. Pan-LOX inhibition reversed mechanical compression of tumor vasculature, resulting in improved chemotherapeutic penetrance and cytotoxic efficacy. The combination of chemotherapy with pan-LOX inhibition increased damage-associated molecular pattern release, which was associated with improved antitumor T-cell responses. Pan-LOX inhibition downregulated macrophage invasive signatures in vitro, rendering tumor-associated macrophages more susceptible to chemotherapy. Mice bearing orthotopic and spontaneously occurring intrahepatic cholangiocarcinoma tumors exhibited delayed tumor growth and improved survival following a combination of pan-LOX inhibition with chemotherapy. CONCLUSIONS: CCA upregulates all 5 lysyl oxidase isoforms, and pan-LOX inhibition reverses tumor-induced mechanical forces associated with chemotherapy resistance to improve chemotherapeutic efficacy and reprogram antitumor immune responses. Thus, combination therapy with pan-LOX inhibition represents an innovative therapeutic strategy in CCA.


Asunto(s)
Neoplasias de los Conductos Biliares , Colangiocarcinoma , Proteína-Lisina 6-Oxidasa , Colangiocarcinoma/tratamiento farmacológico , Colangiocarcinoma/patología , Animales , Neoplasias de los Conductos Biliares/tratamiento farmacológico , Neoplasias de los Conductos Biliares/patología , Proteína-Lisina 6-Oxidasa/antagonistas & inhibidores , Ratones , Humanos , Microambiente Tumoral/efectos de los fármacos , Resistencia a Antineoplásicos/efectos de los fármacos , Antineoplásicos/uso terapéutico , Antineoplásicos/farmacología , Masculino , Aminoácido Oxidorreductasas/antagonistas & inhibidores , Modelos Animales de Enfermedad , Línea Celular Tumoral
6.
Adv Rheumatol ; 64(1): 55, 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39107865

RESUMEN

BACKGROUND: In 2021, an EULAR task force published a definition of difficult-to-treat rheumatoid arthritis (D2T RA). Our current knowledge of D2T RA with the EULAR definition is based on European and Asian cohorts, and no North American cohort has yet to be published. The aim of this study was to compare D2T RA patients to non-D2T RA who are good responders to advanced therapy, and to describe their evolution in an university health center patient cohort. METHODS: This is a retrospective single centre study of the medical records of all adults with RA on at least one biologic or target synthetic DMARD (b/tsDMARD). D2T RA group was defined according to the EULAR definition of D2T RA. The non-D2T RA group was defined as a b/tsDMARD good responder who had low-disease activity or remission for at least one year on 1 or 2 b/tsDMARD mechanism of action. We compared the patients' comorbidities, and history of b/tsDMARD use. Descriptive statistics and proportions were calculated. Kaplan-Meier analysis with log-rank test was used to estimate and compare median survival. RESULTS: Among the 417 patients, 101 (24%) were D2T RA and 316 (76%) were non-D2T RA. D2T RA group was slightly younger (63 ± 9 years versus 65 ± 12 years, p = 0.045), more likely to have concomitant non-inflammatory pain (28% versus 8%, p < 0.0001) and to discontinue at least one b/tsDMARD due to intolerance (39% versus 10%, p < 0.0001). In the D2T RA group, JAK inhibitors were associated with longer drug continuation when used as the third b/tsDMARD. Fewer patients were using corticosteroid at their most recent follow-up in this Canadian cohort compared to others (16% versus from 29 to 74%). CONCLUSION: Concomitant non-inflammatory pain was more prevalent in D2T RA patients compared to b/tsDMARD good responder non-D2T RA patients. Steroid-sparing strategies is possible even in D2T RA patients. Future prospective research may compare JAK inhibitors with other mechanisms of action in D2T RA.


Asunto(s)
Antirreumáticos , Artritis Reumatoide , Humanos , Artritis Reumatoide/tratamiento farmacológico , Estudios Retrospectivos , Antirreumáticos/uso terapéutico , Masculino , Femenino , Persona de Mediana Edad , Anciano , Productos Biológicos/uso terapéutico , Estimación de Kaplan-Meier , Estudios de Cohortes , Inducción de Remisión , Adulto , Comorbilidad
7.
Animals (Basel) ; 14(15)2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39123696

RESUMEN

Forty castrated Holstein calves underwent an adrenocorticotropic hormone (ACTH) challenge to assess the effects of premortem stress on the longissimus lumborum (LL) following harvest. LL biopsies were collected before the challenge, at different harvest times (2, 12, 24, and 48 h; n = 10), and after 14 d aging. The expression of small heat shock proteins (SHSPs), deglycase 1 (DJ-1), and troponin were analyzed. Blood was analyzed throughout the ACTH challenge and at harvest for cortisol, oxidative stress, and complete blood count (CBC). Color and myofibrillar fragmentation index (MFI) were measured in aged samples. Unexpectedly, calves from different harvest times differed (p = 0.05) in cortisol response. Calves were divided into two different cortisol response groups (high or low; n = 20). Statistical analysis assessed the effects of cortisol response (n = 20), harvest time (n = 10), and their interaction. Harvest time altered SHSPs (p = 0.03), DJ-1 (p = 0.002), and troponin (p = 0.02) expression. Harvest time and cortisol response impacted steak color (p < 0.05), and harvest time altered steak pH (p < 0.0001). Additionally, various CBCs were changed (p < 0.05) by harvest time. Harvest time changed (p = 0.02) MFI. These data demonstrate that the protein expression, color, and MFI of the LL may be influenced by premortem stress.

8.
JCI Insight ; 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39115939

RESUMEN

Progress in cytokine engineering is driving therapeutic translation by overcoming these proteins' limitations as drugs. The interleukin-2 (IL-2) cytokine is a promising immune stimulant for cancer treatment but is limited by its concurrent activation of both pro-inflammatory immune effector cells and anti-inflammatory regulatory T cells, toxicity at high doses, and short serum half-life. One approach to improve the selectivity, safety, and longevity of IL-2 is complexation with anti-IL-2 antibodies that bias the cytokine towards immune effector cell activation. Although this strategy shows potential in preclinical models, clinical translation of a cytokine/antibody complex is complicated by challenges in formulating a multi-protein drug and concerns regarding complex stability. Here, we introduced a versatile approach to designing intramolecularly assembled single-agent fusion proteins (immunocytokines, ICs) comprising IL-2 and a biasing anti-IL-2 antibody that directs the cytokine towards immune effector cells. We optimized IC construction and engineered the cytokine/antibody affinity to improve immune bias. We demonstrated that our IC preferentially activates and expands immune effector cells, leading to superior antitumor activity compared to natural IL-2, both alone and combined with immune checkpoint inhibitors. Moreover, therapeutic efficacy was observed without inducing toxicity. This work presents a roadmap for the design and translation of cytokine/antibody fusion proteins.

9.
J Environ Qual ; 2024 Jul 31.
Artículo en Inglés | MEDLINE | ID: mdl-39086206

RESUMEN

Dairy production is a key agricultural enterprise in the Upper Chesapeake Bay (UCB) basin, where phosphorous (P) and nitrogen (N) loading contribute to eutrophication. Import of forages and grains and application of mineral fertilizers contribute to nutrient imbalances in the basin. The UCB Long-Term Agroecosystem Research Cropland Common Experiment aims to evaluate diverse crop rotations that minimize the need for imported feed, maximize year-round living cover, and reduce nutrient losses. UCB's plot-scale experiment was established in 2018, incorporating an ongoing cropping system study that was established by the Pennsylvania State University in 2010. An alternative dairy cropping rotation (including silage and grain corn [Zea mayes L.], alfalfa [Medicago sativa L.]/orchardgrass [Dactylis glomerata L.] mix, winter rye silage [Secale cereale L.], and sorghum-sudangrass [Sorghum × drummondii (Steud.) Millsp. & Chas]) that employed manure injection, integrated pest management, and less frequent manure application was compared to a prevailing, conventionally managed silage corn-alfalfa rotation with higher manure application rates. A field-scale experiment was established in 2019 to monitor alternative production practices (manure injection and avoidance of neonicotinoid seed treatment) and prevailing practices in three fields on a commercial dairy farm. Findings suggest that crop rotation diversification, manure injection, and integrated pest management have the potential to increase the economic and environmental sustainability of dairy cropping systems, but long-term evaluation is needed for confirmation.

10.
JAMA Netw Open ; 7(8): e2425354, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39093563

RESUMEN

Importance: Individuals with diabetes commonly experience Alzheimer disease and related dementias (ADRD). Factors such as hypoglycemia, hyperglycemia, and glycemic variability have been associated with increased risk of ADRD. Traditional glycemic measures, such as mean glycated hemoglobin A1c (HbA1c), may not identify the dynamic and complex pathophysiologic factors in the association between diabetes and ADRD. The HbA1c time in range (TIR) is a previously developed measure of glycemic control that expresses HbA1c stability over time within specific ranges. This measure may inform the current understanding of the association between glucose levels over time and ADRD incidence. Objective: To examine the association between HbA1c TIR and incidence of ADRD in older veterans with diabetes. Design, Setting, and Participants: The study sample for this cohort study was obtained from administrative and health care utilization data from the Veterans Health Administration and Medicare from January 1, 2004, to December 31, 2018. Veterans 65 years or older with diabetes were assessed. Participants were required to have at least 4 HbA1c tests during the 3-year baseline period, which could start between January 1, 2005, and December 31, 2014. Data analysis was conducted between July and December 2023. Main Outcomes and Measures: Hemoglobin A1c TIR was calculated as the percentage of days during baseline in which HbA1c was in individualized target ranges based on clinical characteristics and life expectancy, with higher HbA1c TIR viewed as more favorable. The association between HbA1c TIR and ADRD incidence was estimated. Additional models considered ADRD incidence in participants who were above or below HbA1c target ranges most of the time. Results: The study included 374 021 veterans with diabetes (mean [SD] age, 73.2 [5.8] years; 369 059 [99%] male). During follow-up of up to 10 years, 41 424 (11%) developed ADRD. Adjusted Cox proportional hazards regression models showed that lower HbA1c TIR was associated with increased risk of incident ADRD (HbA1c TIR of 0 to <20% compared with ≥80%: hazard ratio, 1.19; 95% CI, 1.16-1.23). Furthermore, the direction of out-of-range HbA1c levels was associated with incident ADRD. Having greater time below range (≥60%, compared with ≥60% TIR) was associated with significantly increased risk (hazard ratio, 1.23; 95% CI, 1.19-1.27). Findings remained significant after excluding individuals with baseline use of medications associated with hypoglycemia risk (ie, insulin and sulfonylureas) or with hypoglycemia events. Conclusions and Relevance: In this study of older adults with diabetes, increased HbA1c stability within patient-specific target ranges was associated with a lower risk of ADRD. Lower HbA1c TIR may identify patients at increased risk of ADRD.


Asunto(s)
Demencia , Hemoglobina Glucada , Veteranos , Humanos , Hemoglobina Glucada/análisis , Anciano , Masculino , Femenino , Demencia/epidemiología , Demencia/sangre , Anciano de 80 o más Años , Veteranos/estadística & datos numéricos , Estados Unidos/epidemiología , Incidencia , Diabetes Mellitus/epidemiología , Diabetes Mellitus/sangre , Estudios de Cohortes
11.
Iran Endod J ; 19(3): 148-157, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39086714

RESUMEN

Apical periodontitis (AP) is a common inflammatory condition predominantly caused by the response of the immune system to microbial invasion within the root canal system. Contrary to conventional perception, AP may occur in vital teeth with inflamed pulp; adding complexity to diagnosis and treatment. AP, due to its frequent lack of symptoms and reliance on radiographic evaluation for detection, often presents diagnostic challenges. In addition, AP pathogenesis involves complex interactions between microbial virulence and host immune response at the cellular and molecular levels. Comprehensive diagnostic procedures, including patient history, clinical examination, and radiographic evaluation, are essential for early detection and necessary intervention, with the recognition of clinical signs and symptoms underscoring the importance of regular dental evaluations. The current review primarily discusses the radiographic and clinical features of AP in vital and non-vital teeth; introducing a new taxonomic classification to improve diagnostic precision and treatment outcomes. Moreover, it proposes different treatment categories/options for the management of AP, based on pulp status as well as clinical and radiographic findings; emphasizing vital pulp therapy and root canal treatment for vital and non-vital teeth with AP, respectively. Furthermore, the global and regional epidemiology of AP is presented, along with its association with systemic health conditions; e.g., cardiovascular diseases, diabetes mellitus, and adverse pregnancy outcomes. Moreover, future research directions are advocated to improve the efficacy and predictability of diagnosis and treatments; paving the path for clinicians in early detection, accurate diagnosis, and effective management of AP to enhance oral health outcomes.

12.
Mayo Clin Proc ; 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-39093266

RESUMEN

The US Department of Veterans Affairs (VA) and the US Department of Defense (DoD) approved a joint clinical practice guideline for the management of type 2 diabetes. This was the product of a multidisciplinary guideline development committee composed of clinicians from both the VA and the DoD and was overseen by the VA/DoD Evidence Based Practice Work Group. The development process conformed to the standards for trustworthy guidelines as established by the National Academy of Medicine. The guideline development committee developed 12 key questions to guide an evidence synthesis. An independent third party identified relevant randomized controlled trials and systematic reviews that were published from January 2016 through April 2022. This evidence synthesis served as the basis for drafting recommendations. Twenty-six recommendations were generated and rated by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Two algorithms were developed to guide clinical decision-making. This synopsis summarizes key aspects of the VA/DoD Clinical Practice Guideline for diabetes in 5 areas: prediabetes, screening for co-occurring conditions, diabetes self-management education and support, glycemic treatment goals, and pharmacotherapy. The guideline is designed to help clinicians and patients make informed treatment decisions to optimize health outcomes and quality of life and to align with patient-centered goals of care.

13.
J Orthop Trauma ; 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39141357

RESUMEN

OBJECTIVES: This study seeks to evaluate the variability of Medicaid reimbursement and compare it to Medicare reimbursement using the 20 most commonly billed orthopedic trauma CPT codes nationwide. The authors anticipate significant variability between states and hypothesize that Medicaid payment will be significantly less than Medicare payment. METHODS: The top 20 most common orthopedic trauma surgery procedural codes were identified from a previous analysis performed by Haglin et al.1 The Centers for Medicare and Medicaid services physician fee schedule was used to determine reimbursement rates from Medicare, and state Medicaid fee schedules were used to determine reimbursement rates for Medicaid. State Medicaid rates were compared to their corresponding Medicare rates to determine a dollar difference. Additionally, the dollar difference for each CPT code was divided by its respective physician relative value unit (RVU). This was utilized to acknowledge the possible variability in the complexity of orthopedic procedures and the related physician effort. The Medicare Wage Index was used to adjust Medicaid rates based on the cost of living for the state as well. Coefficients of variation were calculated to represent overall variability in Medicaid and Medicare reimbursement rates. RESULTS: The mean reimbursement rates for Medicaid were lower for all 20 procedures compared to Medicare. On average, Medicaid reimbursed 16.0% less than Medicare, and 29.6% less when adjusting for cost-of-living. MCD reimbursed at a higher rate than MCR for all procedures in only nine states (Alaska, Arizona, Arkansas, Montana, Nebraska, New Jersey, New Mexico, and North Dakota, and South Dakota) while 38 states reimbursed at a lower rate than MCR, on average. The coefficient of variation ranged from 0.24 to 0.34 for the Medicaid unadjusted group and from 0.35 to 0.46 for the Medicare Wage-Index adjusted group. In contrast, the Medicare group was consistent at 0.06 for all 20 procedures. The average dollar difference across the 20 CPT codes for Medicaid reimbursement compared to Medicare ranged from -$76.89 to -$225.17, and the dollar difference per relative value unit ranged from -$5.96 to -$15.16. CONCLUSION: This study found a high amount of variation between state Medicaid reimbursement rates and average rates that were significantly lower than Medicare reimbursement rates for the top twenty most utilized orthopedic trauma CPT codes as identified by Haglin et al. The discrepancy in reimbursement was increased when Medicaid rates were adjusted for state cost-of-living. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.

14.
Chem Sci ; 2024 Aug 12.
Artículo en Inglés | MEDLINE | ID: mdl-39144453

RESUMEN

The abyssomicins are a structurally intriguing family of bioactive natural products that include compounds with potent antibacterial, antitumour and antiviral activities. The biosynthesis of the characteristic abyssomicin spirotetronate core occurs via an enzyme-catalysed intramolecular Diels-Alder reaction, which proceeds via one of two distinct stereochemical pathways to generate products differing in configuration at the C15 spirocentre. Using the purified spirotetronate cyclases AbyU (from abyssomicin C/atrop-abyssomicin C biosynthesis) and AbmU (from abyssomicin 2/neoabyssomicin biosynthesis), in combination with synthetic substrate analogues, here we show that stereoselectivity in the spirotetronate-forming [4 + 2]-cycloaddition is controlled by a combination of factors attributable to both the enzyme and substrate. Furthermore, an achiral substrate was enzymatically cyclised to a single enantiomer of a spirocyclic product. X-ray crystal structures, molecular dynamics simulations, and assessment of substrate binding affinity and reactivity in both AbyU and AbmU establish the molecular determinants of stereochemical control in this important class of biocatalysts.

15.
Kidney360 ; 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39167454

RESUMEN

BACKGROUND: Renin-angiotensin-aldosterone system inhibitor (RAASi) therapy provides cardiorenal protection but is often down-titrated or discontinued following a hyperkalemia episode. This observational study describes the extent of hyperkalemia-related RAASi reduction in patients with chronic kidney disease (CKD) and/or heart failure (HF), and estimates the number needed to treat (NNT) to avoid a first hospitalization if RAASi had been maintained at the prior dose. METHODS: Healthcare registers and claims data from Germany, Spain, Sweden, and the UK were used to identify non-dialysis patients with CKD and/or HF who had a hyperkalemia episode while on RAASi. Patients whose RAASi therapy was reduced (down-titrated/discontinued) after the hyperkalemia episode were propensity score (PS)-matched to those with maintained RAASi, and their risks of a hospitalization within 6 months were estimated using the Kaplan-Meier method. Based on the absolute difference in this 6-month risk, the NNT framework was applied to estimate the number of patients who needed to have maintained instead of reduced their RAASi to avoid a first hospitalization during this period. RESULTS: Overall, 40,059 patients from Germany, Spain, Sweden, and the UK were included. Presence of CKD at baseline was similar across countries (72%-92%), while HF was less common in Spain (18%) versus other countries (32%-71%). After the hyperkalemia episode, RAASi was reduced in 25%-57% of patients. Following PS matching, the 6-month risk of hospitalization was consistently higher in those with reduced versus maintained RAASi; the absolute risk difference ranged from 2.7% to 7.3%. Applying the NNT framework, these data suggest that a first hospitalization within 6 months could potentially have been avoided if 25 patients had maintained instead of reduced their RAASi. CONCLUSIONS: Our findings suggest a potential for avoiding a first hospitalization, even within a short time frame, by increasing adherence to guidelines to maintain instead of reduce RAASi after a hyperkalemia episode.

16.
J Chem Theory Comput ; 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39172163

RESUMEN

The accurate mapping of potential energy surfaces (PESs) is crucial to our understanding of the numerous physical and chemical processes mediated by atomic rearrangements, such as conformational changes and chemical reactions, and the thermodynamic and kinetic feasibility of these processes. Stochastic electronic structure theories, e.g., Quantum Monte Carlo (QMC) methods, enable highly accurate total energy calculations that in principle can be used to construct the PES. However, their stochastic nature poses a challenge to the computation and use of forces and Hessians, which are typically required in algorithms for minimum-energy pathway (MEP) and transition state (TS) identification, such as the nudged elastic band (NEB) algorithm and its climbing image formulation. Here, we present strategies that utilize the surrogate Hessian line-search method, previously developed for QMC structural optimization, to efficiently identify MEP and TS structures without requiring force calculations at the level of the stochastic electronic structure theory. By modifying the surrogate Hessian algorithm to operate in path-orthogonal subspaces and at saddle points, we show that it is possible to identify MEPs and TSs by using a force-free QMC approach. We demonstrate these strategies via two examples, the inversion of the ammonia (NH3) molecule and the nucleophilic substitution (SN2) reaction F- + CH3F → FCH3 + F-. We validate our results using Density Functional Theory (DFT)- and Coupled Cluster (CCSD, CCSD(T))-based NEB calculations. We then introduce a hybrid DFT-QMC approach to compute thermodynamic and kinetic quantities, free energy differences, rate constants, and equilibrium constants that incorporates stochastically optimized structures and their energies, and show that this scheme improves upon DFT accuracy. Our methods generalize straightforwardly to other systems and other high-accuracy theories that similarly face challenges computing energy gradients, paving the way for highly accurate PES mapping, transition state determination, and thermodynamic and kinetic calculations at significantly reduced computational expense.

17.
PLoS Pathog ; 20(8): e1012446, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39116185

RESUMEN

HIV persistence in the brain is a barrier to cure, and potentially contributes to HIV-associated neurocognitive disorders. Whether HIV transcription persists in the brain despite viral suppression with antiretroviral therapy (ART) and is subject to the same blocks to transcription seen in other tissues and blood, is unclear. Here, we quantified the level of HIV transcripts in frontal cortex tissue from virally suppressed or non-virally suppressed people with HIV (PWH). HIV transcriptional profiling of frontal cortex brain tissue (and PBMCs where available) from virally suppressed (n = 11) and non-virally suppressed PWH (n = 13) was performed using digital polymerase chain reaction assays (dPCR). CD68+ myeloid cells or CD3+ T cells expressing HIV p24 protein present in frontal cortex tissue was detected using multiplex immunofluorescence imaging. Frontal cortex brain tissue from PWH had HIV TAR (n = 23/24) and Long-LTR (n = 20/24) transcripts. Completion of HIV transcription was evident in brain tissue from 12/13 non-virally suppressed PWH and from 5/11 virally suppressed PWH, with HIV p24+CD68+ cells detected in these individuals. While a block to proximal elongation was present in frontal cortex tissue from both PWH groups, this block was more extensive in virally suppressed PWH. These findings suggest that the brain is a transcriptionally active HIV reservoir in a subset of virally suppressed PWH.


Asunto(s)
Encéfalo , Infecciones por VIH , VIH-1 , Humanos , Infecciones por VIH/metabolismo , Infecciones por VIH/virología , Masculino , Encéfalo/metabolismo , Encéfalo/virología , Adulto , Persona de Mediana Edad , Femenino , Transcripción Genética , Lóbulo Frontal/metabolismo , Lóbulo Frontal/virología
18.
Proc Natl Acad Sci U S A ; 121(33): e2407465121, 2024 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-39102554

RESUMEN

The persistence and size of the Greenland Ice Sheet (GrIS) through the Pleistocene is uncertain. This is important because reconstructing changes in the GrIS determines its contribution to sea level rise during prior warm climate periods and informs future projections. To understand better the history of Greenland's ice, we analyzed glacial till collected in 1993 from below 3 km of ice at Summit, Greenland. The till contains plant fragments, wood, insect parts, fungi, and cosmogenic nuclides showing that the bed of the GrIS at Summit is a long-lived, stable land surface preserving a record of deposition, exposure, and interglacial ecosystems. Knowing that central Greenland was tundra-covered during the Pleistocene informs the understanding of Arctic biosphere response to deglaciation.


Asunto(s)
Fósiles , Hongos , Cubierta de Hielo , Insectos , Plantas , Groenlandia , Cubierta de Hielo/microbiología , Animales , Hongos/clasificación , Plantas/microbiología , Regiones Árticas , Ecosistema
19.
Proc Natl Acad Sci U S A ; 121(33): e2407357121, 2024 Aug 13.
Artículo en Inglés | MEDLINE | ID: mdl-39110724

RESUMEN

Satellite-based land use monitoring and farm-level traceability offer opportunities for targeted zero-deforestation interventions on private lands. Brazil's Rural Environmental Registry (Cadastro Ambiental Rural, or "CAR"), a land cadaster based on self-declaration of property boundaries, was created to monitor compliance with national forest laws. It has become an important enabling measure for sustainable supply chain initiatives like the Amazon Soy Moratorium. However, CAR enrollment is increasingly used to bolster illegal land claims, putting it at the heart of land grabbing dynamics. Self-declaration of properties in the CAR offers a unique situation to study land conflicts and their impact on land use decisions on a large scale. We quantified competing land claims among 846,420 registrations in the Brazilian Legal Amazon and applied a series of generalized linear mixed-effects models. We determined that CAR overlaps are more prevalent on larger registrations, in more densely settled areas, and in areas with less secure land tenure. We tested how landholders respond to land conflicts, finding significantly more deforestation and declared legal forest reserve on lands with multiple claims. CAR overlap results in an overestimation of forest reserves by up to 9.7 million hectares when considering double-counted and deforested areas of reserves, highlighting an overlooked form of Forest Code noncompliance. While the CAR continues to be used as evidence of land tenure, we conclude that the formalization of land claims through self-declarations is inadequate to decrease conflicts. CAR overlap information provides objective evidence of land conflict that authorities can leverage with field inspection to ensure peaceful occupation before issuing land titles.


Asunto(s)
Conservación de los Recursos Naturales , Brasil , Bosques , Humanos , Agricultura , Sistema de Registros , Población Rural , Monitoreo del Ambiente/métodos
20.
Sci Total Environ ; 951: 175661, 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39173747

RESUMEN

Despite the global significance of wetlands, conservation strategies often fall short in preserving these ecosystems due to failures in incorporating processes that sustain the ecosystem functioning, hydrological dynamics, ecological processes, and biodiversity of wetlands. Nature-based solutions, such as the reintroduction of beavers, have emerged as effective tools for promoting wetland restoration. Whilst the impact of beavers on wetland restoration is well known, their broader influence on ecosystem health, particularly in modifying habitats for other species, remains inadequately understood. Here we assess the impact that habitat modification through the reintroduction of beavers has on bat populations. There were significantly greater activity levels within beaver-modified wetland habitats for multiple bat species, including higher activity levels of 393 % for Barbastella barbastellus and 313 % for Plecotus spp.. Additionally, we observed positive effects on bat populations in the woodland habitat surrounding beaver-modified wetland for certain taxa. In the face of escalating challenges posed by climate change and habitat loss, addressing biodiversity loss necessitates a shift toward ecosystem-centric mitigation measures. Our study demonstrates that the reintroduction of keystone species like beavers can re-establish historical facilitative links between aquatic and terrestrial food webs, highlighting the importance of such interventions in fostering the resilience and sustainability of entire ecosystems.

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