Notes

Mortality risks in kidney-transplanted people with COVID-19: A deliberate evaluation along with regression examination.
It has long been debated whether it is preferable to perform conventional carotid endarterectomy (CEA) with or without patch closure. Although most contemporary surgeons patch, many still do not. Recent small studies have surfaced implying patching is unnecessary. The objective of our analysis was to determine the difference in short- and long-term outcomes according to patch use in a large modern, cross-specialty database.

Analyzing more than 118,000 records from the Vascular Quality Initiative, multimodel inference was used to evaluate the effect of patch use on important outcomes of conventional CEA. The composite short-term outcome included any ipsilateral neurological event, return to the operating room for a neurological event, and an increase in the Rankin score postoperatively. Late composite outcome incorporated restenosis as well as early and late ipsilateral neurological events.

Patch use for conventional CEA closure was found to be a strong predictor of both early and late outcomes, as evidenced by its Akaike importance weight of 0.99. Examining predischarge events, patch closure is associated with a decrease in major negative events (odds ratio, 0.5; 95% confidence interval, 0.4-0.6). For long-term events, such closure offers a decrease in untoward outcome (odds ratio, 0.8; 95% confidence interval, 0.7-0.9).

Analysis in a large current-day database suggests that patch closure of conventional CEA effects superior short- and long-term outcomes.
Analysis in a large current-day database suggests that patch closure of conventional CEA effects superior short- and long-term outcomes.
Fiber Optic RealShape (FORS) technology has recently been introduced as an adjunctive guidance technology that allows real-time three-dimensional visualization of dedicated endovascular devices while avoiding radiation exposure. It consists of equipment which sends pulses of light through hair-thin optical fibers that run within a dedicated hydrophilic wire and selective catheters. The purpose of the study was to report the observed benefits and limitations related to the first edition of FORS technology.

Data were collected prospectively from the first 50 patients undergoing FORS-guided endovascular repair at a single center between February 2020 and February 2021 as part of the global multicenter FORS Learn registry. All consecutive, elective procedures with one or more navigation tasks attempted with FORS were included. Factors related to FORS navigation task success were assessed. The time required for the catheterization of each task as well as the amount of radiation exposure (fluoroscopy time, dose catheterization using FORS guidance was associated with a shorter catheterization time 6minutes (interquartile range, 3-11minutes) versus 16minutes (interquartile range, 10-24minutes) (P< .001) and lower radiation exposure compared with unsuccessful catheterization (dose area product, 4.4cGy/cm
vs 12.5cGy/cm
; P< .001).

FORS technology was implemented successfully as a new guidance technology in a complex endovascular aortic repair program and was associated with an encouraging success rate and a high potential for radiation reduction.
FORS technology was implemented successfully as a new guidance technology in a complex endovascular aortic repair program and was associated with an encouraging success rate and a high potential for radiation reduction.
Aortic remodeling of the thoracic aorta has been studied in patients treated with medical or endovascular therapy for the treatment of acute aortic dissections; however, particular attention has not yet focused on identifying specific growth patterns and rates across all aortic zones. Additionally, previous studies have not delineated between dissections with and without visceral aortic involvement, and we hypothesize that these two cohorts may exhibit distinct differences. The aim of this study is to investigate aortic behavior over time in medically managed acute Society for Vascular Surgery/Society of Thoracic Surgeons (SVS/STS) type B dissections with visceral aortic involvement and identify potential associations of subsequent aortic behavior with clinical outcomes.

A single-center retrospective review was performed of all patients between 2010 and 2020 with acute SVS/STS type B aortic dissections with visceral aortic involvement that were not surgically managed. Short-axis centerline measurements ofdictable linear growth in all dissected zones. Patients with aortic enlargement demonstrated higher gross changes in diameter in addition to higher yearly rates of change compared with all comers. Odds for enlargement were impacted by both patient demographic and anatomic dissection characteristics. Growth in zone 3 and zone 9 significantly increased odds for aortic intervention. Odds for 5-year mortality were significantly increased in the presence of large thoracic aneurysms. Results highlight risk of progressive degeneration beyond acute phase in SVS/STS Type B aortic dissections with visceral aortic involvement, with life-long surveillance remaining crucial in management of dissections.
Neutrophilic asthma is associated with disease severity and corticosteroid insensitivity. selleck chemicals llc Novel therapies are required to manage this life-threatening asthma phenotype. Programmed cell death protein-1 (PD-1) is a key homeostatic modulator of the immune response for T-cell effector functions.

We sought to investigate the role of PD-1 in the regulation of acute neutrophilic inflammation in a murine model of airway hyperreactivity (AHR).

House dust mite was used to induce and compare neutrophilic AHR in wild-type and PD-1 knockout mice. Then, the therapeutic potential of a human PD-1 agonist was tested in a humanized mouse model in which the PD-1 extracellular domain is entirely humanized. Single-cell RNA sequencing and flow cytometry were mainly used to investigate molecular and cellular mechanisms.

PD-1 was highly induced on pulmonary T cells in our inflammatory model. PD-1 deficiency was associated with an increased neutrophilic AHR and high recruitment of inflammatory cells to the lungs. Consistently, PD-1 agonist treatment dampened AHR, decreased neutrophil recruitment, and modulated cytokine production in a humanized PD-1 mouse model. Mechanistically, we demonstrated at the transcriptional and protein levels that the inhibitory effect of PD-1 agonist is associated with the reprogramming of pulmonary effector T cells that showed decreased number and activation.

PD-1 agonist treatment is efficient in dampening neutrophilic AHR and lung inflammation in a preclinical humanized mouse model.
PD-1 agonist treatment is efficient in dampening neutrophilic AHR and lung inflammation in a preclinical humanized mouse model.We investigated whether device-measured sleep parameters are associated with cortical thickness in older adults with probable mild cognitive impairment (MCI). We performed a cross-sectional, exploratory analysis of sleep and structural MRI data. Sleep data were collected with MotionWatch8© actigraphy over 7 days. We computed average and variability for sleep duration, sleep efficiency, and fragmentation index. T1-weighted MRI scans were used to measure cortical thickness in FreeSurfer. We employed surface-based analysis to determine the association between sleep measures and cortical thickness, adjusting for age, sex, Montreal Cognitive Assessment (MoCA) score, and sleep medication use. Our sample included 113 participants (age = 73.1 [5.7], female = 72 [63.7 %]). Higher fragmentation index variability predicted lower cortical thickness in the left superior frontal gyrus (cluster size = 970.9 mm2, cluster-wise p = 0.017, cortical thickness range = 2.1 mm2 to 3.0 mm2), adjusting for age, sex, MoCA, and sleep medication. Our results suggest that higher variability in sleep fragmentation, an indicator of irregular sleep pattern, is linked to lower cortical thickness. Future longitudinal studies are needed to determine the directionality of these associations.
The pathophysiology of sarcopenia is complex and multifactorial; however, it has not yet been fully elucidated. Identifying metabolomic profiles may help clarify the mechanisms underlying sarcopenia.

This pilot study explored potential noninvasive biomarkers of severe sarcopenia through metabolomic analysis in community-dwelling older men.

Twenty older men (mean age 81.9±2.8years) were selected from the Korean Frailty and Aging Cohort Study. Participants with severe sarcopenia (n=10) were compared with non-sarcopenic, age- and body mass index-matched controls (n=10). Severe sarcopenia was defined as low muscle mass, low muscle strength, and low physical performance using the Asian Working Group for Sarcopenia 2019 criteria. Non-targeted metabolomic profiling of plasma metabolites was performed using capillary electrophoresis time-of-flight mass spectrometry and absolute quantification was performed in target metabolites.

Among 191 plasma metabolic peaks, the concentrations of 10 metabolites significanomic analysis demonstrated that L-alanine, gluconic acid, proline, and tryptophan may be potential biomarkers of severe sarcopenia. The identified metabolites can provide new insights into the underlying pathophysiology of severe sarcopenia and serve as the basis for preventive interventions.
Arterial stiffening - a process that is largely due to intimal thickening, collagen disposition or elastin fragmentation - significantly contributes to cardiovascular events and mortality. There is also some evidence that it may negatively affect physical function. This study aimed to evaluate whether arterial stiffness was associated with measures of walking capacity in a large, population-based sample of highly aged older adults.

A population-based sample of 910 community-dwelling adults (aged 75, 80, or 85years) were investigated in a cross-sectional observational study. Pulse wave velocity (PWV), a surrogate marker of arterial stiffness, was estimated based on the oscillometric recording of pulse waves at the brachial artery site. Walking capacity was assessed by 10-meter habitual walking speed, 10-meter maximum walking speed, and six-minute walk distance. We used multiple linear regression models to examine possible associations between PWV and parameters of walking capacity, and we adjusted the moden arterial stiffness and walking capacity in old age. Longitudinal studies, potentially taking additional confounders into account, are needed to disentangle the complex relationship between the two factors.
Falls are a leading cause of severe injuries and a major threat to quality of life in older adults. Elderly fallers demonstrate insufficient eccentric quadriceps control during the weight acceptance phase of initial single limb stance. However, the functional role of eccentric control of the perturbed (leading) leg during walking balance recovery and its age-related differences have not yet been studied; thus we investigated age-related differences in eccentric control at the knee of the perturbed leg and its influence on the postural sway and stability of the trailing leg during balance recovery following unexpected surface drop perturbations.

Ten younger and ten older healthy adults were compared during balance recovery following an 8cm unexpected surface drop perturbation at gait initiation. Outcomes related to perturbed leg included 1) eccentric knee extensor work; 2) electromyography (EMG) peak amplitude, peak latency, and eccentric EMG burst duration of the rectus femoris (RF); and 3) knee flexion angle during the single limb support.
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