Monradgrau2109
Critical donor shortages have impulsed the need to expand donor heart eligibility through the use of marginal hearts in cardiac transplantation. Donor valvular disease has been considered as an absolute contraindication for transplant. A 39-year-old male patient with end-stage non-compaction cardiomyopathy, an INTERMACS II heart failure, and a left ventricular ejection fraction of 8% was taken to an orthotopic heart transplantation. During donor bench graft examination, a congenital bicuspid and calcified aortic valve was found. The native bicuspid valve was removed and the annular calcification debrided; a #21 bioprosthetic aortic valve was then implanted.Current protocols for synthesizing monodisperse platinum (Pt) nanoparticles typically involve the use of hydrocarbon molecules as surface-capping ligands. Using Pt nanoparticles as catalysts for the oxygen reduction reaction (ORR), however, these ligands must be removed to expose surface sites. Here, highly durable ORR catalysts are realized without ligand removal; instead, the native ligands are converted into ultrathin, conformal graphitic shells by simple thermal annealing. Phleomycin D1 mw Strikingly, the annealing temperature is a critical factor dictating the ORR performance of Pt catalysts. Pt nanoparticles treated at 500 °C show a very poor ORR activity, whereas those annealed at 700 °C become highly active along with exceptional stability. In-depth characterization reveals that thermal treatment from 500 to 700 °C gradually opens up the porosity in carbon shells through graphitization. Importantly, such graphitic-shell-coated Pt catalysts exhibit a superior ORR stability, largely retaining the activity after 20 000 cycles in a membrane electrode assembly. Moreover, this ligand carbonization strategy can be extended to modify commercial Pt/C catalysts with substantially enhanced stability. This work demonstrates the feasibility of boosting the ORR performance of common Pt nanoparticles by harnessing the native surface ligands, offering a robust approach of designing highly durable catalysts for proton-exchange-membrane fuel cells.
Melanomas developing on anatomic sites other than the trunk and extremities have a special pathogenetic and mutational profile, morphologic characteristics and biologic behaviour.
By retrospectively screening the databases of our centres, we aimed to investigate the dermatoscopic morphology of early scalp melanoma, including in situ and invasive tumours with a Breslow thickness up to 1 mm.
The databases of three specialized centres for skin cancer diagnosis and management in Greece were retrospectively evaluated to retrieve dermatoscopic images of scalp melanomas. Patients' age and sex were recorded, as well as the precise location of the tumour, using 6 possible sub-locations frontal, parietal, occipital, temporal, nuchal scalp and vertex. The dermatoscopic images were evaluated by 3 independent investigators for the presence of pre-defined criteria. The dermatoscopic criteria included in the evaluation were selected based on available literature and were categorized in 2 groups 'classic melanoma criteria' and 'lentigo maligna (LM) criteria'.
Of 38 melanomas, 37 (97.4%) displayed brown colour and 23 (60.5%) displayed additional grey or blue colour. The most frequent dermatoscopic criteria were regression (18/38, 47.4%), grey dots/globules (17/38, 44.7%), atypical network (16/38, 42.1%), obliterated follicles (16/38, 42.1%) and angulated lines (15/38, 39.5%). Of 38 melanomas, 28 (73.7%) displayed at least 1 classic melanoma criterion plus at least 1 LM criterion. Of the remaining melanomas, 8 (21.1%) displayed only classic melanoma criteria, 1 (2.6%) only LM criteria and 1 (2.6%) did not exhibit any of the evaluated criteria.
This study demonstrates that early scalp melanoma combines classic with LM criteria in terms of colours and structures.
This study demonstrates that early scalp melanoma combines classic with LM criteria in terms of colours and structures.
To examine the independent associations between relative protein intake (gkg
day
) and markers of physical function in those with type 2 diabetes, while also comparing with current guidelines for protein intake.
This analysis reports data from the ongoing Chronotype of Patients with Type 2 Diabetes and Effect on Glycaemic Control (CODEC) study. Functional assessments included Short Physical Performance Battery (SPPB), 60s sit-to-stand (STS-60), 4-m gait speed, time to rise from a chair (×5) and handgrip strength. Participants also completed a self-reported 4day diet diary. Regression analyses assessed whether relative protein intake was associated with markers of physical function. Interaction terms assessed whether the associations were modified by sex, age, HbA1c or body mass index (BMI).
413 participants were included (mean±SDage=65.0±7.7years, 33% female, BMI=30.6±5.1kg/m
). The average total protein intake was 0.88±0.31gkg
day
. 33% of individuals failed to meet the reference nutrient intake for the United Kingdom (≥0.75gkg
day
), and 87% for European recommendations (≥1.2gkg
day
). After adjustment, each 0.5g/kg of protein intake was associated with an 18.9% (95% CI 2.3, 35.5) higher SPPB score, 22.7% (1.1, 44.3) more repetitions in STS-60, 21.1% (4.5, 37.7) faster gait speed and 33.2% (16.9, 49.5) lower chair rise time. There were no associations with handgrip strength or any interactions.
Relative protein intake was positively associated with physical function outcomes, even after consideration of total energy intake. As a number of individuals were below the current guidelines, protein intake may be a modifiable factor of importance for people with type 2 diabetes.
Relative protein intake was positively associated with physical function outcomes, even after consideration of total energy intake. As a number of individuals were below the current guidelines, protein intake may be a modifiable factor of importance for people with type 2 diabetes.
α-Synuclein (αSyn) is believed to play a central role in Parkinson's disease (PD) neuropathology and is considered a target for disease modification. UB-312 is a synthetic αSyn peptide conjugated to a T helper peptide and is expected to induce antibodies specifically against oligomeric and fibrillar αSyn, making UB-312 a potential immunotherapeutic for synucleopathies.
To investigate the safety, tolerability, and immunogenicity of UB-312 vaccination in healthy participants and to determine a safe and immunologically optimal dose for the first-in-patient study.
Fifty eligible healthy participants were enrolled in a 44-week, randomized, placebo-controlled, double-blind study. Participants in seven cohorts were randomized to three intramuscular UB-312 or placebo injections at weeks 1, 5, and 13 (doses ranging between 40 and 2000 μg). Safety and tolerability were assessed by adverse events, clinical laboratory, vital signs, electrocardiograms, and neurological and physical examinations. Immunogenicity was aalthy participants. The 100 and 300 μg doses are selected for further evaluation in participants with PD. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Hospitals desire to achieve the strategy of patient-centred care but burnout inhibits its implementation. Management has a role in responding to needs of patients, junior professional staff, and the hospital, in the present and future.
To test the association between shared organisational trust (OT) of resident physicians in top-management, a systemic organisational process, and professional burnout among residents.
Participants in this cross-sectional study, are 316 residents assigned to 31 internal medicine departments at eight out of 15 academic Israeli general public hospitals in various locations and sizes. All measures were published Burnout, patient-focussed care, shared trust in top-management, and antecedents of organisational trust, which are peer support, clinical autonomy, meeting expectations, and value congruence. Structural Equation Modelling was performed.
The structural equation modelling model was recursive, explaining 14% of the variance in burnout. Shared trust in top-management was the strongest antecedent of burnout. The facilitation of patient-focussed care created shared trust in top-management which reduced burnout.
To achieve patient-centred care, management is called upon to reduce burnout by aligning organisational processes with patient-focussed care. Shared trust in top-management may reduce burnout and enhance residents' sense of meaningfulness, engagement, and well-being.
To achieve patient-centred care, management is called upon to reduce burnout by aligning organisational processes with patient-focussed care. Shared trust in top-management may reduce burnout and enhance residents' sense of meaningfulness, engagement, and well-being.Infective endocarditis is a life-threatening condition and despite advances in antibiotic therapy, about one-third of patients require surgical treatment. The choice of the most appropriate surgical treatment is crucial. The study by Asen Petrov et al. paves the way for a new, safe, simple, and useful Calamari technique for the treatment of aortic valve endocarditis complicated by aortic root abscess (ARA). This technique was initially described in a series of five patients. The most interesting part of the study is that the procedure was effective (only one patient died 30 days after surgery) and fast (mean cardiopulmonary bypass time 90 ± 10.30 min; mean cross-clamp time 73.6 ± 12.12 min). As reported by Leontyev et al., the procedure of choice in ARA is represented by a wide range of procedures ranging from aortic valve replacement with debridement of the abscess to reconstruction of the intervalvular fibrous body and replacement of both the mitral valve and the aortic root. Alternatively, pericardial patch reconstruction is required in approximately one-third of cases. Radicality is key but a fast procedure is very important. In this scenario, the Calamari procedure is very useful, especially for its rapid execution (short cardiopulmonary bypass and cross-clamp time) which is associated with a reduction in mortality. A simple procedure to treat complex diseases. However, this procedure needs to be performed on more patients and its outcomes should be compared in trials with the other available techniques for the treatment of ARA.
To examine whether the incidence rates of diagnosed depression, anxiety disorders and stress reactions, as well as prescription rates of antidepressants and anxiolytics were higher during the COVID-19 pandemic than before in persons with type 2 diabetes in Germany. Contrary to earlier studies, clinical diagnoses of psychiatric disorders (ICD classification) were used.
The German Disease Analyzer (DA) database is an outpatient database containing routine data on patients´ diseases and treatments provided by a representative panel of physician practices selected from across Germany. We assessed incidence rates of depressive disorders (ICD-10 F32, F33), anxiety disorders (F41) and stress reactions (F43) in quarters from January 2019 to March 2021 in 95,765 people with type 2 diabetes included in the DA in 2019 (mean age 68.9years, 58% men). Prescription rates of antidepressants and anxiolytics in quarters from January 2020 to March 2021 were compared with prescription rates from 1year earlier.
During the study period, the incidence rate of newly diagnosed depressive disorders in persons with type 2 diabetes declined slightly, while the incidence rates of anxiety and stress disorders remained largely constant.
