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- Carraminana, Albert, et al.
(författare)
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Rationale and Study Design for an Individualized Perioperative Open Lung Ventilatory Strategy in Patients on One-Lung Ventilation (iPROVE-OLV)
- 2019
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Ingår i: Journal of Cardiothoracic and Vascular Anesthesia. - : W B SAUNDERS CO-ELSEVIER INC. - 1053-0770 .- 1532-8422. ; 33:9, s. 2492-2502
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this clinical trial is to examine whether it is possible to reduce postoperative complications using an individualized perioperative ventilatory strategy versus using a standard lung-protective ventilation strategy in patients scheduled for thoracic surgery requiring one-lung ventilation. Design: International, multicenter, prospective, randomized controlled clinical trial. Setting: A network of university hospitals. Participants: The study comprises 1,380 patients scheduled for thoracic surgery. Interventions: The individualized group will receive intraoperative recruitment maneuvers followed by individualized positive end-expiratory pressure (open lung approach) during the intraoperative period plus postoperative ventilatory support with high-flow nasal cannula, whereas the control group will be managed with conventional lung-protective ventilation. Measurements and Main Results: Individual and total number of postoperative complications, including atelectasis, pneumothorax, pleural effusion, pneumonia, acute lung injury; unplanned readmission and reintubation; length of stay and death in the critical care unit and in the hospital will be analyzed for both groups. The authors hypothesize that the intraoperative application of an open lung approach followed by an individual indication of high-flow nasal cannula in the postoperative period will reduce pulmonary complications and length of hospital stay in high-risk surgical patients. (C) 2019 Published by Elsevier Inc.
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| 2. |
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| 3. |
- Albert, Marie Christine, et al.
(författare)
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Identification of FasL as a crucial host factor driving COVID-19 pathology and lethality
- 2024
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Ingår i: Cell Death and Differentiation. - 1350-9047.
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Tidskriftsartikel (refereegranskat)abstract
- The dysregulated immune response and inflammation resulting in severe COVID-19 are still incompletely understood. Having recently determined that aberrant death-ligand-induced cell death can cause lethal inflammation, we hypothesized that this process might also cause or contribute to inflammatory disease and lung failure following SARS-CoV-2 infection. To test this hypothesis, we developed a novel mouse-adapted SARS-CoV-2 model (MA20) that recapitulates key pathological features of COVID-19. Concomitantly with occurrence of cell death and inflammation, FasL expression was significantly increased on inflammatory monocytic macrophages and NK cells in the lungs of MA20-infected mice. Importantly, therapeutic FasL inhibition markedly increased survival of both, young and old MA20-infected mice coincident with substantially reduced cell death and inflammation in their lungs. Intriguingly, FasL was also increased in the bronchoalveolar lavage fluid of critically-ill COVID-19 patients. Together, these results identify FasL as a crucial host factor driving the immuno-pathology that underlies COVID-19 severity and lethality, and imply that patients with severe COVID-19 may significantly benefit from therapeutic inhibition of FasL.
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| 4. |
- Axfors, Cathrine, et al.
(författare)
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Association between convalescent plasma treatment and mortality in COVID-19 : a collaborative systematic review and meta-analysis of randomized clinical trials
- 2021
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Ingår i: BMC Infectious Diseases. - : BioMed Central (BMC). - 1471-2334. ; 21:1
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Forskningsöversikt (refereegranskat)abstract
- Background: Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, ). Methods: In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence. Results: A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I-2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis. Conclusions: Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.
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| 5. |
- Hillier, Charles, et al.
(författare)
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Landscape of the Plasmodium Interactome Reveals Both Conserved and Species-Specific Functionality
- 2019
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Ingår i: Cell Reports. - : Elsevier. - 2211-1247. ; 28:6, s. 1635-1647
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Tidskriftsartikel (refereegranskat)abstract
- Malaria represents a major global health issue, and the identification of new intervention targets remains an urgent priority. This search is hampered by more than one-third of the genes of malaria-causing Plasmodium parasites being uncharacterized. We report a large-scale protein interaction network in Plasmodium schizonts, generated by combining blue native-polyacrylamide electrophoresis with quantitative mass spectrometry and machine learning. This integrative approach, spanning 3 species, identifies > 20,000 putative protein interactions, organized into 600 protein clusters. We validate selected interactions, assigning functions in chromatin regulation to previously unannotated proteins and suggesting a role for an EELM2 domain-containing protein and a putative microrchidia protein as mechanistic links between AP2-domain transcription factors and epigenetic regulation. Our interactome represents a high-confidence map of the native organization of core cellular processes in Plasmodium parasites. The network reveals putative functions for uncharacterized proteins, provides mechanistic and structural insight, and uncovers potential alternative therapeutic targets.
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| 6. |
- Russell, Andrew J.C., et al.
(författare)
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Regulators of male and female sexual development are critical for the transmission of a malaria parasite
- 2023
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Ingår i: Cell Host and Microbe. - : Cell Press. - 1931-3128 .- 1934-6069. ; 31:2, s. 305-319.e10
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Tidskriftsartikel (refereegranskat)abstract
- Malaria transmission to mosquitoes requires a developmental switch in asexually dividing blood-stage parasites to sexual reproduction. In Plasmodium berghei, the transcription factor AP2-G is required and sufficient for this switch, but how a particular sex is determined in a haploid parasite remains unknown. Using a global screen of barcoded mutants, we here identify genes essential for the formation of either male or female sexual forms and validate their importance for transmission. High-resolution single-cell transcriptomics of ten mutant parasites portrays the developmental bifurcation and reveals a regulatory cascade of putative gene functions in the determination and subsequent differentiation of each sex. A male-determining gene with a LOTUS/OST-HTH domain as well as the protein interactors of a female-determining zinc-finger protein indicate that germ-granule-like ribonucleoprotein complexes complement transcriptional processes in the regulation of both male and female development of a malaria parasite.
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| 7. |
- Seitz, Arne, et al.
(författare)
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Concept validation study for fuselage wake-filling propulsion integration
- 2018
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Ingår i: 31st Congress of the International Council of the Aeronautical Sciences, ICAS 2018.
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Konferensbidrag (refereegranskat)abstract
- The present paper provides an overview together with intermediate results of the work-in-progress research performed in the EC-funded Horizon 2020 collaborative project CENTRELINE (“ConcEpt validatioN sTudy foR fusElage wake-filLIng propulsioN integration”), aiming at demonstrating the proof of concept for a groundbreaking approach to synergistic propulsion-airframe integration, the so-called Propulsive Fuselage Concept (PFC). The concept features a turbo-electrically driven propulsive device integrated in the very aft-section of the fuselage, dedicated to the purpose of fuselage wake-filling. Currently at TRL 1-2, CENTRELINE's target is to mature the technological key features of the PFC to TRL 3-4. The core of the targeted proof-of-concept is formed by two experimental test campaigns supported by high-fidelity 3D numerical simulation and integrated multidisciplinary design optimisation techniques for aerodynamics, aero-structures as well as the energy and propulsion system.
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| 8. |
- Seitz, Arne, et al.
(författare)
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Proof of concept study for fuselage boundary layer ingesting propulsion
- 2021
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Ingår i: Aerospace. - : MDPI AG. - 2226-4310. ; 8:1, s. 1-65
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Tidskriftsartikel (refereegranskat)abstract
- Key results from the EU H2020 project CENTRELINE are presented. The research activities undertaken to demonstrate the proof of concept (technology readiness level-TRL 3) for the so-called propulsive fuselage concept (PFC) for fuselage wake-filling propulsion integration are discussed. The technology application case in the wide-body market segment is motivated. The developed performance bookkeeping scheme for fuselage boundary layer ingestion (BLI) propulsion integration is reviewed. The results of the 2D aerodynamic shape optimization for the bare PFC configuration are presented. Key findings from the high-fidelity aero-numerical simulation and aerodynamic validation testing, i.e., the overall aircraft wind tunnel and the BLI fan rig test campaigns, are discussed. The design results for the architectural concept, systems integration and electric machinery pre-design for the fuselage fan turbo-electric power train are summarized. The design and performance implications on the main power plants are analyzed. Conceptual design solutions for the mechanical and aerostructural integration of the BLI propulsive device are introduced. Key heuristics deduced for PFC conceptual aircraft design are presented. Assessments of fuel burn, NOx emissions, and noise are presented for the PFC aircraft and benchmarked against advanced conventional technology for an entry-into-service in 2035. The PFC design mission fuel benefit based on 2D optimized PFC aero-shaping is 4.7%.
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