Fitzpatrickvaughn0639
idism.Biological processes are incredibly complex-integrating molecular signaling networks involved in multicellular communication and function, thus maintaining homeostasis. Dysfunction of these processes can result in the disruption of homeostasis, leading to the development of several disease processes including atherosclerosis. We have significantly advanced our understanding of bioprocesses in atherosclerosis, and in doing so, we are beginning to appreciate the complexities, intricacies, and heterogeneity atherosclerosi. We are also now better equipped to acquire, store, and process the vast amount of biological data needed to shed light on the biological circuitry involved. Such data can be analyzed within machine learning frameworks to better tease out such complex relationships. Indeed, there has been an increasing number of studies applying machine learning methods for patient risk stratification based on comorbidities, multi-modality image processing, and biomarker discovery pertaining to atherosclerotic plaque formation. Here, we focus on current applications of machine learning to provide insight into atherosclerotic plaque formation and better understand atherosclerotic plaque progression in patients with cardiovascular disease.Severe hemorrhage is a leading cause of high mortality in critical situations like disaster, accidents, and warfare. The resulting wounds could induce severe physical and psychological trauma to patients and also bring an immense socio-economic burden. Hence, rapid hemostasis and wound healing techniques have become critical initiatives for life-saving treatment. Although traditional methods relying on bandages and gauzes are effective in controlling hemorrhage, they suffer from several limitations nonbiodegradability, being susceptible to infection, being unsuitable for the irregular wound, secondary tissue damage, and being almost ineffective for wound healing. Owing to the merits of high porosity, good biocompatibility, tunable physicochemical properties, and being beneficial for wound healing, hydrogels with excellent performance have drawn intensive attention and numerous novel effective hydrogel dressings have been widely developed. In this Review, after introducing some commonly used strategies for the synthesis of hydrogels, the most recent progress on polymer-based hydrogels as wound dressings is discussed. Particularly, their hemostasis, antibacterial, and biodegradation properties are introduced. Finally, challenges and future perspectives about the development of hydrogels for wound dressings are outlined.In tissue engineering, an unresolved challenge is how to build complex 3D scaffolds in order to recreate the structure and function of human tissues and organs. Additive manufacturing techniques, such as 3D bioprinting, have the potential to build biological material with unprecedented spatial control; however, printing soft biological materials in air often results in poor fidelity. Freeform Reversible Embedding of Suspended Hydrogels (FRESH) is an embedded printing approach that solves this problem by extruding bioinks within a yield-stress support bath that holds the bioinks in place until cured. In this Perspective, we discuss the challenges of 3D printing soft and liquid-like bioinks and the emergence for FRESH and related embedded printing techniques as a solution. This includes the development of FRESH and embedded 3D printing within the bioprinting field and the rapid growth in adoption, as well as the advantages of FRESH printing for biofabrication and the new research results this has enabled. Specific focus is on the customizability of the FRESH printing technique where the chemical composition of the yield-stress support bath and aqueous phase crosslinker can all be tailored for printing a wide range of bioinks in complex 3D structures. Finally, we look ahead at the future of FRESH printing, discussing both the challenges and the opportunities that we see as the biofabrication field develops.[This corrects the article DOI 10.1210/jendso/bvaa170.].
Suboptimal glycemic control among individuals with diabetes is a leading cause of hospitalizations and emergency department utilization. Use of flash continuous glucose monitoring (flash CGM) improves glycemic control in type 1 and type 2 diabetes, which may result in lower risk for acute and chronic complications that require emergency services and/or hospitalizations.
In this retrospective, real-world study, we analyzed IBM MarketScan Commercial Claims and Medicare Supplemental databases to assess the impact of flash CGM on diabetes-related events and hospitalizations in a cohort of 2463 individuals with type 2 diabetes who were on short- or rapid-acting insulin therapy. Outcomes were changes in acute diabetes-related events (ADE) and all-cause inpatient hospitalizations (ACH), occurring during the first 6 months after acquiring the flash CGM system compared with event rates during the 6 months prior to system acquisition. selleck ICD-10 codes were used to identify ADE for hypoglycemia, hypoglycemic coma, hyperglycemia, diabetic ketoacidosis, and hyperosmolarity.
ADE rates decreased from 0.180 to 0.072 events/patient-year (hazard ratio [HR] 0.39 [0.30, 0.51];
< 0.001) and ACH rates decreased from 0.420 to 0.283 events/patient-year (HR 0.68 [0.59 0.78];
< 0.001). ADE reduction occurred regardless of age or gender.
Acquisition of the flash CGM system was associated with reductions in ADE and ACH. These findings provide support for the use of flash CGM in type 2 diabetes patients treated with short- or rapid-acting insulin therapy to improve clinical outcomes and potentially reduce costs.
Acquisition of the flash CGM system was associated with reductions in ADE and ACH. These findings provide support for the use of flash CGM in type 2 diabetes patients treated with short- or rapid-acting insulin therapy to improve clinical outcomes and potentially reduce costs.We sought to systematically review the effect of gender-affirming hormone therapy on psychological outcomes among transgender people. We searched PubMed, Embase, and PsycINFO through June 10, 2020 for studies evaluating quality of life (QOL), depression, anxiety, and death by suicide in the context of gender-affirming hormone therapy among transgender people of any age. We excluded case studies and studies reporting on less than 3 months of follow-up. We included 20 studies reported in 22 publications. Fifteen were trials or prospective cohorts, one was a retrospective cohort, and 4 were cross-sectional. Seven assessed QOL, 12 assessed depression, 8 assessed anxiety, and 1 assessed death by suicide. Three studies included trans-feminine people only; 7 included trans-masculine people only, and 10 included both. link2 Three studies focused on adolescents. Hormone therapy was associated with increased QOL, decreased depression, and decreased anxiety. Associations were similar across gender identity and age. Certainty in this conclusion is limited by high risk of bias in study designs, small sample sizes, and confounding with other interventions. We could not draw any conclusions about death by suicide. Future studies should investigate the psychological benefits of hormone therapy among larger and more diverse groups of transgender people using study designs that more effectively isolate the effects of hormone treatment.
Finding the source of adrenocorticotropic hormone (ACTH)-independent cortisol-producing adenoma in the patients with subclinical Cushing syndrome (SCS) and bilateral adrenal nodules is sometimes challenging. Computed tomography (CT) and positron emission tomography are helpful, but adrenal venous sampling (AVS) is the gold standard approach. However, interpretation of AVS is important to improve the accuracy of decision-making for surgery. We report a case and review of the literature to assess the benefit of using adrenal vein cortisol to metanephrine ratio to determine the source of cortisol production in SCS and bilateral nodules.
Three authors searched PubMed for data on patients with SCS who had AVS procedure and measurements of cortisol and catecholamines.
A 51-year-old woman with SCS and hypertension crisis presented to our clinic. Paraclinical investigations revealed that she had an ACTH-independent cortisol-producing adenoma and her CT scan showed bilateral adrenal nodules. After AVS, cortisol (high to low) lateralization ratio could not determine the source of cortisol production but the cortisol to metanephrine ratio localized the source to the left side, which included the larger nodule according to CT measurements. link3 Left adrenalectomy led to clinical and paraclinical improvement.
There is a possibility of co-secretion of other steroids accompanied with cortisol in the setting of ACTH-independent SCS. Moreover, cortisol measurement alone and interpretation of AVS results based on cortisol values may not help lateralizing the source of cortisol production with bilateral adrenal nodules. Therefore, we suggest applying cortisol to metanephrine ratio with the same gradient (gradient > 2.3, highest to lowest concentration) when the source of cortisol production cannot be determined by cortisol lateralization ratio.
2.3, highest to lowest concentration) when the source of cortisol production cannot be determined by cortisol lateralization ratio.
Polycystic ovary syndrome (PCOS) is common and associated with metabolic syndrome. In the general population, metabolic disease varies by race and ethnicity.
This work aimed to examine in depth the interaction of race and ethnicity with PCOS-related metabolic disease in adolescent youth.
A secondary analysis was conducted of data from girls (age 12-21 years) with overweight or obesity (> 90 body mass index [BMI] percentile) and PCOS. Measurements included fasting hormone and metabolic measures, a 2-hour oral glucose tolerance test (OGTT), and magnetic resonance imaging for hepatic fat. Groups were categorized by race or ethnicity.
Participants included 39 non-Hispanic White (NHW, age 15.7 ± 0.2 years; BMI 97.7 ± 0.2 percentile), 50 Hispanic (HW, 15.2 ± 0.3 years; 97.9 ± 0.3 percentile), and 12 non-Hispanic Black (NHB, 16.0 ± 0.6 years; 98.6 ± 0.4 percentile) adolescents. Hepatic markers of insulin resistance were worse in NHW, including lower sex hormone-binding globulin and higher triglycerides over high-density lipoprotein cholesterol (TGs/HDL-C) ratio (
= .002 overall, HW vs NHB [
= .009] vs NHW [
= 0.020]), although homeostasis model assessment of estimated insulin resistance was worst in NHB (
= .010 overall, NHW vs NHB
= .014). Fasting and 2-hour OGTT glucose were not different between groups, although glycated hemoglobin A
(HbA
) was lowest in NHW (overall
< .001, NHW 5.2 ± 0.3 vs HW 5.5 ± 0.3
< .001 vs 5.7 ± 0.4%,
< .001). The frequency of hepatic steatosis (HW 62%, NHW 42%, NHB 25%,
= .032); low HDL-C < 40 mg/dL (HW 82%, NHW 61%, NHB 50%,
< .001) and prediabetes HbA
5.7% to 6.4% (NHB 50%, HW 36%, NHW 5%,
< .001) were different between the groups.
Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.
Adolescents with PCOS appear to show similar racial and ethnic variation to the general population in terms of metabolic disease components.
