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e ≥ 91.961 pg/ml (3 rd quartile)). PA was not associated with (Aβ)42/40. Mixed-model linear regressions demonstrated that the reverse relationship between PA and cognitive decline tended to be more pronounced as Aβ42/40 increased, while it was dampened with increasing levels of (ln)NFL concentrations. This study demonstrates that PA is associated with blood NFL but not with Aβ42/40. Further, it suggests that PA may attenuate the negative association between amyloid load and cognition, while having high NFL levels mitigates the favourable relationship between PA and cognition. More investigations on older adults not involved any interventional study are required for further validation of the present findings.
Coronary artery bypass graft (CABG) is one of the most performed cardiac surgery globally. CABG is known to have a high rate of short-term readmissions. The 30-day unplanned readmission rate as a quality measure is associated with adverse health outcomes. This study aimed to identify and synthesize the perioperative risk factors for 30-day unplanned readmission after CABG.
We systematically searched seven databases and reviewed studies to identify all eligible English articles published from 1 October 1999 to 30 September 2019. Random-effect models were employed to perform pooled analyses. Odds ratio and 95% confidence interval were used to estimate the risk factors for 30-day unplanned readmission. The 30-day hospital readmission rates after CABG ranged from 9.2% to 18.9% in 14 cohort studies. Among preoperative characteristics, older adults, female, weight loss, high serum creatinine, anticoagulant use or dialysis, and comorbidities were found to be statistically significant. Postoperative complicationsective cohort samples are needed to identify the personal or psychosocial factors influencing readmission after CABG, including perioperative risk factors.
The European Heart Failure Self-care Behaviour Scale (EHFScBS) is frequently used to assess self-care behaviours in patients with heart failure. This scale has been translated into several languages. The COnsensus-based Standards for the selection of health status Measurement INstrument (COSMIN) Risk of Bias checklist for a systematic review has recently been published. The aim of the study was to assess the methodological quality of studies reporting on psychometric evaluations of the EHFScBS using the COSMIN methodology.
To identify relevant studies, a systematic literature search was performed using PubMed and CINAHL databases in December 2019 and the search was updated in June 2020. The COSMIN Risk of Bias checklist was used to assess the methodological quality. In total, 21 relevant studies were rated. The overall methodological quality of content validity was rated as inadequate in 17 studies and a main reason of the inadequate rating was a lack of patient involvement. Structural validity was adequately addressed in 12 studies, internal consistency in seven, and eight of 11 studies reporting on construct validity and had good methodological quality.
Although the use of the EHFScBS has grown rapidly and the validity and reliability are reported to be good, the methodological quality of studies reporting on psychometric properties of the scale is not optimal. Further studies are necessary to strengthen the evidence on validity and reliability of the EHFScBS.
Although the use of the EHFScBS has grown rapidly and the validity and reliability are reported to be good, the methodological quality of studies reporting on psychometric properties of the scale is not optimal. Further studies are necessary to strengthen the evidence on validity and reliability of the EHFScBS.
Cardiovascular rehabilitation (CR) improves aerobic capacity and quality of life in patients after myocardial infarction (MI). The aim was to examine the associations between exercise capacity improvement and different clinically relevant cardiovascular events.
This was a registry-based study of post-MI patients, referred to CR. All patients were submitted to exercise testing before and after CR (36 sessions, 2-3 times/week, and combined exercise). Patients were divided into two groups, based on the difference in exercise capacity before and after the CR programme with the cut-off of two metabolic equivalents (METs) improvement. We assessed the correlation between the extent of exercise capacity improvement and the following cardiovascular events major adverse cardiac events (MACE), cardiovascular-related hospitalizations, and unplanned coronary angiography. A total of 499 patients were included (mean age 56 ± 10 years, 20% women). Both groups significantly improved in terms of exercise capacity, natriuretic peptide levels, resting heart rate, and resting diastolic pressure; however, lipid status significantly improved only in patients with ≥2 METs difference in exercise capacity. A total of 13.4% patients suffered MACE (median follow-up 858 days); 21.8% were hospitalized for cardiovascular reasons (median follow-up 791 days); and 19.8% had at least one unplanned coronary angiography (median follow-up 791 days). Exercise capacity improvement of ≥2 METs was associated with lower rates of MACE, cardiovascular hospitalizations, and unplanned coronary angiography in all examined univariate and multivariate models.
This study has shown that exercise improvement of ≥2 METs is associated with a significant decrease in MACE, cardiac hospitalizations, and unplanned coronary angiography.
This study has shown that exercise improvement of ≥2 METs is associated with a significant decrease in MACE, cardiac hospitalizations, and unplanned coronary angiography.
The dearth of research on age-related differences in risk factors for tobacco use disorder (TUD) among sexual minorities, particularly among older adults, can obscure the differential needs of sexual minority age groups for tobacco prevention and cessation. We examined the association of cumulative ethnic/racial discrimination and sexual orientation discrimination with moderate-to-severe TUD among U.S. sexual minority adults aged 50 years and older.
We analyzed cross-sectional data from the National Epidemiologic Survey of Alcohol and Related Conditions-III (NESARC-III, n=36,309 U.S. adults). Our sample consisted of 1,258 adults (lesbian/gay, bisexual, and heterosexual-identified adults with same-sex attraction/behavior) aged ≥50 years. Multivariable logistic regression analyses estimated the association of cumulative lifetime ethnic/racial discrimination and sexual orientation discrimination with past-year moderate-to-severe TUD and tested whether the association differed for adults aged 50-64 years versinority adults aged ≥65 years. Our findings underscore the importance of age considerations in understanding the role of discrimination in the assessment and treatment of TUD.In the present study, we investigated the effect of the synthetic analog of prostaglandin F2α (PGF2α)-cloprostenol-on cultured steroidogenic luteal cells of selected felid species over a 2-day culture period. The changes induced by cloprostenol were measured based on progesterone concentration and mRNA expression analysis of selected genes. Cloprostenol significantly reduced concentration of progesterone in cell culture medium of small luteal cells isolated from domestic cat corpora lutea (CL) at the development/maintenance stage (P less then 0.05), but did not influence progesterone production in cultured cells from the regression stage. A decrease or complete silencing of progesterone production was also measured in cultured luteal cells of African lion (formation stage) and Javan leopard (development/maintenance stage). Gene-expression analysis by real-time PCR revealed that treatment with cloprostenol did not have an influence on expression of selected genes coding for enzymes of steroidogenesis (StAR, HSD3B, CYP11A1) or prostaglandin synthesis (PTGS2, PGES), nor did it effect hormone receptors (AR, ESR1, PGR, PTGER2), an anti-oxidative enzyme (SOD1) or factors of cell apoptosis (FAS, CASP3, TNFRSF1B, BCL2) over the studied period. Significant changes were measured only for expressions of luteinizing hormone (P less then 0.05), prolactin (P less then 0.05) and PGF2α receptors (P less then 0.005) (LHCGR, PRLR, and PTGFR). The obtained results confirm that PGF2α/cloprostenol is a luteolytic agent in CL of felids and its impact on progesterone production depends on the developmental stage of the CL. Cloprostenol short-term treatment on luteal cells was associated only with functional but not structural changes related to luteal regression.
The goal of this study was to investigate the association between the localization of the distal anastomosis (zone 2/3), the stent graft length (100-160 mm), the position of the distal end of the hybrid prosthesis and the need for secondary aortic intervention (SAI) in acute and chronic thoracic aortic disease after the frozen elephant trunk procedure.
From 2009 through 2020, a total of 232 patients (137 men; mean age, 61.7 ± 13.8 years) were treated with the frozen elephant trunk procedure. The main indications were acute aortic dissection type A (n = 106, 46%), chronic aortic dissection type A (n = 52, 22%) and degenerative thoracic aortic aneurysm (n = 74, 32%).
The rate of SAI was significantly higher when we performed a distal anastomosis in zone 2 rather than in zone 3, whereas the rate of SAI was less frequent if the distal positioning of the hybrid prosthesis was below TH 4-5. Combining the zone 2 concept and the short stent graft length (100 mm) was associated with a significantly higher rate of SAIs. Patients with a distal anastomosis in zone 2 were significantly less likely to have a recurrent laryngeal nerve injury (P < 0.001). However, no association between a specific arch zone of a distal anastomosis and the occurrence of spinal cord injury was observed.
Rates of SAIs are highest in patients who were treated with a distal anastomosis in zone 2 and a short stent graft (100 mm) with the distal end of the hybrid prosthesis at vertebral level TH 2-3.
Rates of SAIs are highest in patients who were treated with a distal anastomosis in zone 2 and a short stent graft (100 mm) with the distal end of the hybrid prosthesis at vertebral level TH 2-3.Recovering genomes from shotgun metagenomic sequence data allows detailed taxonomic and functional characterization of individual species or strains in a microbial community. Retrieving these metagenome-assembled genomes (MAGs) involves seven stages. First, low-quality bases, along with adapter and host sequences, are removed. Second, overlapping sequences are assembled to create longer contiguous fragments. Third, these fragments are clustered based on sequence composition and abundance. Fourth, these sequence clusters, or bins, undergo rounds of quality assessment and refinement to yield MAGs. The optional fifth stage is dereplication of MAGs to select representatives. Next, each MAG is taxonomically classified. learn more The optional seventh stage is assessing the fraction of diversity that has been recovered. The output of this protocol is draft genomes, which can provide invaluable clues about uncultured organisms. This protocol takes ~1 week to run, depending on computational resources available, and requires prior experience with high-performance computing, shell script programming and Python.
