Notes

[Analysis in the effect of target-directed therapy according to nutrition-oriented information application about nutritional complying price in older adults with severe traumatic brain injury: a combined cohort study].
8% (95% CI 85.5-92.9%), respectively. PPV and NPV for AF/Afl were 45.7% (95% CI 22.4-70.9%) and 98.8% (95% CI 97.1-99.5%), respectively. GP interpretation skills did not improve in case-vignettes where the outcome of automatic AF-detection algorithm was provided. In detecting any relevant ECG abnormality (prevalence 22%), sensitivity, specificity, PPV and NPV were 96.3% (95% CI 92.8-98.2%), 68.8% (95% CI 62.4-74.6%), 43.9% (95% CI 27.7-61.5%) and 97.9% (95% CI 94.9-99.1%), respectively.

GPs can safely rule out cardiac arrhythmias with 1L-ECGs. However, whenever an abnormality is suspected, confirmation by an expert-reader is warranted.
GPs can safely rule out cardiac arrhythmias with 1L-ECGs. However, whenever an abnormality is suspected, confirmation by an expert-reader is warranted.
How can one design and implement a system that provides a comprehensive overview of research results in the field of epi-/genetics of male infertility and germ cells?

Working at the interface of literature search engines and raw data repositories, the newly developed Male Fertility Gene Atlas (MFGA) provides a system that can represent aggregated results from scientific publications in a standardized way and perform advanced searches, for example based on the conditions (phenotypes) and genes related to male infertility.

PubMed and Google Scholar are established search engines for research literature. Additionally, repositories like Gene Expression Omnibus and Sequence Read Archive provide access to raw data. Selected processed data can be accessed by visualization tools like the ReproGenomics Viewer.

The MFGA was developed in a time frame of 18 months under a rapid prototyping approach.

In the context of the Clinical Research Unit 'Male Germ Cells' (CRU326), a group of around 50 domain experts in tublications from the development process. However, a structured process for the prospective literature search and inclusion into the MFGA has been defined and is currently implemented.

The technical implementation of the MFGA allows for accommodating a wide range of heterogeneous data from aggregated research results. This implementation can be transferred to other diseases to establish comparable systems and generally support research in the medical field.

This work was carried out within the frame of the German Research Foundation (DFG) Clinical Research Unit 'Male Germ Cells from Genes to Function' (CRU326). The authors declare no conflicts of interest.
This work was carried out within the frame of the German Research Foundation (DFG) Clinical Research Unit 'Male Germ Cells from Genes to Function' (CRU326). The authors declare no conflicts of interest.
Ledipasvir/sofosbuvir increases tenofovir plasma exposures by up to 98% with tenofovir disoproxil fumarate (TDF), and exposures are highest with boosted PIs. There are currently no data on the combined use of the newer tenofovir prodrug, tenofovir alafenamide (TAF), boosted PIs and ledipasvir/sofosbuvir.

To compare the plasma and intracellular pharmacokinetics and renal safety of TAF with ledipasvir/sofosbuvir when co-administered with boosted PIs.

Persons with HIV between 18 and 70 years and on a boosted PI with TDF were eligible. The study was comprised of four phases (1) TDF 300 mg with boosted PI; (2) TAF 25 mg with boosted PI; (3) TAF 25 mg with boosted PI and ledipasvir/sofosbuvir; and (4) TAF 25 mg with boosted PI. Pharmacokinetic sampling, urine biomarker collection [urine protein (UPCR), retinol binding protein (RBP) and β2 microglobulin (β2M) normalized to creatinine] and safety assessments occurred at the end of each phase. Plasma, PBMCs and dried blood spots were collected at each visit.

Ten participants were enrolled. Plasma tenofovir exposures were 76% lower and tenofovir-diphosphate (TFV-DP) concentrations in PBMCs increased 9.9-fold following the switch to TAF. Neither of these measures significantly increased with ledipasvir/sofosbuvir co-administration, nor did TAF plasma concentrations. No significant changes in estimated glomerular filtration rate or UPCR occurred, but RBPcreatinine and β2Mcreatinine improved following the switch to TAF.

Ledipasvir/sofosbuvir did not significantly increase plasma tenofovir or intracellular TFV-DP in PBMCs with TAF. These findings provide reassurance that the combination of TAF, boosted PIs and ledipasvir/sofosbuvir is safe in HIV/HCV-coinfected populations.
Ledipasvir/sofosbuvir did not significantly increase plasma tenofovir or intracellular TFV-DP in PBMCs with TAF. These findings provide reassurance that the combination of TAF, boosted PIs and ledipasvir/sofosbuvir is safe in HIV/HCV-coinfected populations.We describe a patient with a HeartMate 3 left ventricular assist device in whom we attempted transcatheter aortic valve implantation for severe aortic regurgitation. The valve migrated into the left ventricle and lodged on the left ventricular assist device inflow cannula. Caution should be exercised when considering the use of transcatheter aortic valve implantation in patients with an implanted left ventricular assist device, with pure aortic regurgitation.Africa is the World Health Organization-region least affected by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic. Here, we compare the situation in severely hit Italy with that in less hit Burkina Faso, focussing on the differences in epidemiological, geographical, demographical, cultural and medical conditions to highlight how a full-blown war on the pandemic can impact on other, equally important aspects of global child health.
To investigate the determinants of patient well-being over time, and the influence of age, gender and education in patients with early axial spondyloarthritis (axSpA).

Five-year data from DESIR, a cohort of early axSpA, were analysed. The outcome was the BAS-G over 5 years. Generalized estimating equations (GEE) were used to test the relationship between potential explanatory variables from five outcome domains (disease activity, physical function, spinal mobility, structural damage and axial inflammation) and BAS-G over time. Longitudinal relationships were analysed using an autoregressive GEE model. Age, gender and educational level were tested as effect modifiers or confounders.

A total of 708 patients were included. Higher BASDAI questions on fatigue [β (95% CI) 0.17 (0.13, 0.22)], back pain [0.51 (0.46, 0.56)], peripheral joint pain [0.08 (0.04, 0.12)] and severity of morning stiffness [0.08 (0.03-0.13)], and higher BASFI [0.14 (0.08, 0.19)] were associated with a higher BAS-G. In the autoregressive model, the same variables except for morning stiffness were associated with a worsening in BAS-G. Age, gender and educational level were neither effect modifiers nor confounders.

A higher level of back pain is associated with a worsening of patient well-being, as are, though to a lesser extent, higher levels of fatigue, peripheral joint pain and physical disability. Age, gender and educational level do not have an impact on these relationships.
A higher level of back pain is associated with a worsening of patient well-being, as are, though to a lesser extent, higher levels of fatigue, peripheral joint pain and physical disability. Age, gender and educational level do not have an impact on these relationships.
Because of its wide tissue distribution, elevation of serum lactate dehydrogenase (LD) is a nonspecific finding. Although serum LD is still included in the prognosis and staging of metastatic melanoma and germ cell tumors, its nonspecificity has led to decreased usefulness.

In this study, we analyzed the serum LD assays performed in a 726-bed hospital during a 1-year period and reviewed charts of patients with serum LD of >3 standard deviations (SD).

Of 312 patients with elevated serum LD, only 9 were patients with melanoma and germ cell tumors. The other 303 patients had other malignancies, chronic conditions, and sepsis.

Elevated serum LD (even >3 SD) is an extremely nonspecific finding that does not contribute to clinical management in a majority of patients. As such, serum LD testing should be retired from routine clinical order sets and restricted in use.
3 SD) is an extremely nonspecific finding that does not contribute to clinical management in a majority of patients. As such, serum LD testing should be retired from routine clinical order sets and restricted in use.
The need to conserve antibiotic efficacy, through the management of respiratory tract infections (RTIs) without recourse to antibiotics, is a global priority. A key target for interventions is the antibiotic prescribing behaviour of healthcare professionals including non-medical prescribers (NMPs nurses, pharmacists, paramedics, physiotherapists) who manage these infections.

To identify what evidence exists regarding the influences on NMPs' antimicrobial prescribing behaviour and analyse the operationalization of the identified drivers of behaviour using the Theoretical Domains Framework (TDF).

The search strategy was applied across six electronic bibliographic databases (eligibility criteria included original studies; written in English and published before July 2019; non-medical prescribers as participants; and looked at influences on prescribing patterns of antibiotics for RTIs). Study characteristics, influences on appropriate antibiotic prescribing and intervention content to enhance appropriate angiven to overcoming social influences (patients, other clinicians) and reassurance in relation to beliefs about negative consequences (missing something that could lead to a negative outcome).
The study sought to describe the literature related to the development of methods for auditing the Unified Medical Language System (UMLS), with particular attention to identifying errors and inconsistencies of attributes of the concepts in the UMLS Metathesaurus.

We applied the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach by searchingthe MEDLINE database and Google Scholar for studies referencing the UMLS and any of several terms related to auditing, error detection, and quality assurance. A qualitative analysis and summarization of articles that met inclusion criteria were performed.

Eighty-three studies were reviewed in detail. We first categorized techniques based on various aspects including concepts, concept names, and synonymy (n = 37), semantic type assignments (n = 36), hierarchical relationships (n = 24), lateral relationships (n = 12), ontology enrichment (n = 8), and ontology alignment (n = 18). We also categorized the methods according to their level o techniques due to their critical use of and impact on the UMLS.Malignant progression of normal tissue is typically driven by complex networks of somatic changes, including genetic mutations, copy number aberrations, epigenetic changes, and transcriptional reprogramming. To delineate aberrant multi-omic tumor features that correlate with clinical outcomes, we present a novel pathway-centric tool based on the multiple factor analysis framework called padma. Using a multi-omic consensus representation, padma quantifies and characterizes individualized pathway-specific multi-omic deviations and their underlying drivers, with respect to the sampled population. Selleckchem INCB059872 We demonstrate the utility of padma to correlate patient outcomes with complex genetic, epigenetic, and transcriptomic perturbations in clinically actionable pathways in breast and lung cancer.
Website: https://www.selleckchem.com/products/incb059872-dihydrochloride.html