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We aimed to develop and validate a nomogram for the individualized prediction of the risk of post-stroke fatigue (PSF) after discharge.
Fatigue was measured using the Fatigue Assessment Scale. Multivariable logistic regression analysis was applied to build a prediction model incorporating the feature selected in the least absolute shrinkage and selection operator regression model. Discrimination, calibration, and clinical usefulness of the predictive model were assessed using the C-index, calibration plot, and decision curve analysis. Internal validation was conducted using bootstrapping validation. Finally, a web application was developed to facilitate the use of the nomogram.
We developed a nomogram based on 95 stroke patients. The predictors included in the nomogram were sex, pre-stroke sarcopenia, acute phase fatigue, dysphagia, and depression. The model displayed good discrimination, with a C-index of 0.801 (95% confidence interval 0.700-0.902) and good calibration. A high C-index value of 0.762 could still be reached in the interval validation. Decision curve analysis showed that the risk of PSF after discharge was clinically useful when the intervention was decided at the PSF risk possibility threshold of 10% to 90%.
This nomogram could be conveniently used to provide an individual, visual, and precise prediction of the risk probability of PSF after being discharged home. Thus, as an aid in decision-making, physicians and other healthcare professionals can use this predictive method to provide early intervention or a discharge plan for stroke patients during the hospitalization period.
This nomogram could be conveniently used to provide an individual, visual, and precise prediction of the risk probability of PSF after being discharged home. Thus, as an aid in decision-making, physicians and other healthcare professionals can use this predictive method to provide early intervention or a discharge plan for stroke patients during the hospitalization period.Enhanced self-focused attention (SFA) and negative attentional bias (NAB) towards social cues are characteristic hallmarks of social anxiety. It is essential to investigate these two attentional phenomena under socially relevant situations using comparable stimuli. In the present study, individuals with high social anxiety (HSA, n = 32) and low social anxiety (LSA, n = 29) were compared according to their attention toward self-related stimuli and toward positive, neutral, and negative feedback related stimuli. Video stimuli of moving indicators of self-anxiety-status and positive, neutral, and negative feedback from an audience were presented during an impromptu speech task (high anxiety condition) and a re-watching phase (low anxiety condition). Eye movements in response to the different stimuli served as readouts for attentional preference. An interaction effect suggested that the HSA group directed more attention to self-related stimuli relative to other stimuli and the LSA group only during the high anxiety condition. The LSA group exhibited a general attentional preference toward positive feedback, especially during the low anxiety condition. Meanwhile, only the total duration of fixation on positive feedback negatively correlated with subjective anxiety rating. Our results point to increased SFA rather than NAB in HSA individuals under social threats.Acute kidney injury (AKI) diagnosis relies on plasma creatinine concentration (Crpl), a relatively insensitive, surrogate biomarker of glomerular filtration rate that increases only after significant damage befalls. However, damage in different renal structures may occur without increments in Crpl, a condition known as subclinical AKI. Thus, detection of alterations in other aspects of renal function different from glomerular filtration rate must be included in an integral diagnosis of AKI. With this aim, we adapted to and validated in rats (for preclinical research) the furosemide stress test (FST), a tubular function test hitherto performed only in humans. We also tested its sensitivity in detecting subclinical tubular alterations. In particular, we predisposed rats to AKI with 3 mg/kg cisplatin and subsequently subjected them to a triggering insult (ie, 50 mg/kg/d gentamicin for 6 days) that had no effect on nonpredisposed animals but caused an overt AKI in predisposed rats. The FST was performed immediately before adding the triggering insult. Predisposed animals showed a reduced response to the FST (namely, reduced furosemide-induced diuresis and K+ excretion), whereas nonpredisposed animals showed no alteration, compared to the controls. Computational modeling of epithelial transport of solutes and water along the nephrons applied to experimental data suggested that proximal tubule transport was only minimally reduced, the sodium-chloride symporter was upregulated by 50%, and the renal outer medullary potassium channel was downregulated by 85% in predisposed animals. In conclusion, serial coupling of the FST and computational modeling may be used to detect and localize subclinical tubular alterations.Lung cancer (LC) is the leading cause of cancer-related death worldwide and miRNAs play a key role in LC development. To better diagnose LC and to predict drug treatment responses we evaluated 228 articles encompassing 16,697 patients and 12,582 healthy controls. Based on the criteria of ≥3 independent studies and a sensitivity and specificity of >0.8 we found blood-borne miR-20a, miR-10b, miR-150, and miR-223 to be excellent diagnostic biomarkers for non-small cell LC whereas miR-205 is specific for squamous cell carcinoma. The systematic review also revealed 38 commonly regulated miRNAs in tumor tissue and the circulation, thus enabling the prediction of histological subtypes of LC. Moreover, theranostic biomarker candidates with proven responsiveness to checkpoint inhibitor treatments were identified, notably miR-34a, miR-93, miR-106b, miR-181a, miR-193a-3p, and miR-375. Conversely, miR-103a-3p, miR-152, miR-152-3p, miR-15b, miR-16, miR-194, miR-34b, and miR-506 influence programmed cell death-ligand 1 and programmed cell death-1 receptor expression, therefore providing a rationale for the development of molecularly targeted therapies. Furthermore, miR-21, miR-25, miR-27b, miR-19b, miR-125b, miR-146a, and miR-210 predicted response to platinum-based treatments. We also highlight controversial reports on specific miRNAs. In conclusion, we report diagnostic miRNA biomarkers for in-depth clinical evaluation. Furthermore, in an effort to avoid unnecessary toxicity we propose predictive biomarkers. The biomarker candidates support personalized treatment decisions of LC patients and await their confirmation in randomized clinical trials.The research represents one of the first major qualitative studies to subjectively investigate fatigue amongst city bus drivers. Funded by TfL (grant no. 94050), the study considers the perspectives of both the bus drivers themselves and their managers. It explores opinion specifically in relation to how fatigue influences or is influenced by bus driving, and how this is managed. Data was collected from focus groups with bus drivers (n = 65 drivers) and one-to-one interviews with bus driver managers (n = 11). Fatigue was seen to be a problem, with all drivers having experienced for themselves the feeling of sleepiness whilst driving the bus, or knowing about it in others. The managers agreed that fatigue amongst drivers is evident, seeing it particularly as a contributor to serious incidents. Fatigue and sleepiness are not discussed between drivers as a general rule and they do not feel comfortable reporting instances of fatigue for fear of being disciplined. Managers would encourage drivers to report these issues and therefore hoped to create a more open culture. Factors identified as contributors to fatigue included working overtime, having insufficient sleep, spending time with family, other non-work commitments, shift schedules, and work pressure.Dr. Ben-Tzion (Bentzi) Karsh was a mentor, collaborator, colleague, and friend who profoundly impacted the fields of human factors and ergonomics (HFE), medical informatics, patient safety, and primary care, among others. C75 ic50 In this paper we honor his contributions by reflecting on his scholarship, impact, and legacy in three ways first, through an updated simplified bibliometric analysis in 2020, highlighting the breadth of his scholarly impact from the perspective of the number and types of communities and collaborators with which and whom he engaged; second, through targeted reflections on the history and impact of Dr. Karsh's most cited works, commenting on the particular ways they impacted our academic community; and lastly, through quotes from collaborators and mentees, illustrating Dr. Karsh's long-lasting impact on his contemporaries and students.The clustered regularly interspaced short palindromic repeats (CRISPR)-Cas system of bacteria has furnished programmable nucleases (e.g., Cas9) that are transforming the field of genome editing with applications in basic and biomedical research, biotechnology, and agriculture. However, broader real-world applications of Cas9 require precision control of its activity over dose, time, and space as off-target effects, embryonic mosaicism, chromosomal translocations, and genotoxicity have been observed with elevated and/or prolonged nuclease activity. Here, we review chemical and optical methods for precision control of Cas9's activity.
The Coronavirus disease (COVID-19) infection is caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) primarily affecting the lungs. All tobacco-related illnesses including asthma, chronic obstructive pulmonary disease (COPD), and coronary artery disease are known to reduce the lung capacity and impair the immune system of the body and can greatly influence the ability to fight the novel coronavirus. The purpose of this state-of-the-art literature review is to summarize the evidence of the association of tobacco use with the severity of the COVID-19 manifestations.
Articles describing the association of tobacco use with the severity of COVID-19 manifestations were searched on PubMed, MEDLINE, and Google. This review covers the relevant studies on the subject published from January 1, 2020 to September 10, 2020.
Tobacco use in all forms, whether smoking or chewing, is significantly associated with severe COVID-19 outcomes. Pre-existing comorbidities in tobacco users such as carfree world.
Impulse oscillometry (IOS) is a noninvasive method based on the forced oscillation technique able to detect small airway dysfunction (SAD) in asthma. We aimed to analyze the prevalence and the functional features of IOS-defined SAD across the different Global Initiative for Asthma (GINA) steps.
A cross-sectional, single-center study in which 400 consecutive adult patients with physician-diagnosed, community-managed asthma underwent standard spirometry and IOS, and were stratified by stepwise GINA classification. SAD was defined by IOS as a fall in resistance from 5 to 20Hz [R5-R20]>0.07kPa×s×L
.
The prevalence of IOS-defined SAD ranged between 58.3% (GINA step 2) and 78.6% (GINA step 5), without statistically significant difference within GINA steps (p>0.05 in all comparisons). Isolated SAD (i.e. without proximal airways involvement) was similarly represented across GINA steps 2-4. Peripheral airways resistance (R5-R20) tended to a progressive increase with the worsening of GINA steps, and was significantly higher in steps 4-5 compared to the other steps (p<0.
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