| 1. |
- Marto, João Pedro, et al.
(författare)
-
Safety and Outcome of Revascularization Treatment in Patients With Acute Ischemic Stroke and COVID-19: The Global COVID-19 Stroke Registry.
- 2023
-
Ingår i: Neurology. - 1526-632X. ; 100:7
-
Tidskriftsartikel (refereegranskat)abstract
- COVID-19-related inflammation, endothelial dysfunction, and coagulopathy may increase the bleeding risk and lower the efficacy of revascularization treatments in patients with acute ischemic stroke (AIS). We aimed to evaluate the safety and outcomes of revascularization treatments in patients with AIS and COVID-19.This was a retrospective multicenter cohort study of consecutive patients with AIS receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021 tested for severe acute respiratory syndrome coronavirus 2 infection. With a doubly robust model combining propensity score weighting and multivariate regression, we studied the association of COVID-19 with intracranial bleeding complications and clinical outcomes. Subgroup analyses were performed according to treatment groups (IVT-only and EVT).Of a total of 15,128 included patients from 105 centers, 853 (5.6%) were diagnosed with COVID-19; of those, 5,848 (38.7%) patients received IVT-only and 9,280 (61.3%) EVT (with or without IVT). Patients with COVID-19 had a higher rate of symptomatic intracerebral hemorrhage (SICH) (adjusted OR 1.53; 95% CI 1.16-2.01), symptomatic subarachnoid hemorrhage (SSAH) (OR 1.80; 95% CI 1.20-2.69), SICH and/or SSAH combined (OR 1.56; 95% CI 1.23-1.99), 24-hour mortality (OR 2.47; 95% CI 1.58-3.86), and 3-month mortality (OR 1.88; 95% CI 1.52-2.33). Patients with COVID-19 also had an unfavorable shift in the distribution of the modified Rankin score at 3 months (OR 1.42; 95% CI 1.26-1.60).Patients with AIS and COVID-19 showed higher rates of intracranial bleeding complications and worse clinical outcomes after revascularization treatments than contemporaneous non-COVID-19 patients receiving treatment. Current available data do not allow direct conclusions to be drawn on the effectiveness of revascularization treatments in patients with COVID-19 or to establish different treatment recommendations in this subgroup of patients with ischemic stroke. Our findings can be taken into consideration for treatment decisions, patient monitoring, and establishing prognosis.The study was registered under ClinicalTrials.gov identifier NCT04895462.
|
|
| 2. |
- Downey, Harriet, et al.
(författare)
-
Training future generations to deliver evidence-based conservation and ecosystem management
- 2021
-
Ingår i: Ecological Solutions and Evidence. - : Wiley. - 2688-8319. ; 2:1
-
Forskningsöversikt (refereegranskat)abstract
- 1. To be effective, the next generation of conservation practitioners and managers need to be critical thinkers with a deep understanding of how to make evidence-based decisions and of the value of evidence synthesis.2. If, as educators, we do not make these priorities a core part of what we teach, we are failing to prepare our students to make an effective contribution to conservation practice.3. To help overcome this problem we have created open access online teaching materials in multiple languages that are stored in Applied Ecology Resources. So far, 117 educators from 23 countries have acknowledged the importance of this and are already teaching or about to teach skills in appraising or using evidence in conservation decision-making. This includes 145 undergraduate, postgraduate or professional development courses.4. We call for wider teaching of the tools and skills that facilitate evidence-based conservation and also suggest that providing online teaching materials in multiple languages could be beneficial for improving global understanding of other subject areas.
|
|
| 3. |
- Ferreira, Cláudia, et al.
(författare)
-
Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease : the LIFEwithIBD intervention
- 2024
-
Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study tested the acceptability and efficacy of an Acceptance and Commitment Therapy and compassion-based intervention (LIFEwithIBD) in people with IBD through a two-arm RCT.Methods: Participants were recruited at the Gastroenterology Department of the Coimbra University Hospital between June and September 2019. Of the 355 patients screened, those who accepted to participate were randomly assigned to one of two conditions: experimental group (LIFEwithIBD; n = 25) or control group (waitlist; n = 29). Participants completed self-report measures at baseline (T0), post-intervention (T1), and 3-month (T2) and 12-month (T3) follow-ups. Intervention acceptability was assessed. Efficacy was examined using intent-to-treat ANCOVA at post-intervention after adjusting for baseline values of depressive, anxiety, and stress symptoms (primary outcomes). Linear mixed models for all longitudinal outcomes were also analysed. Inflammatory and disease biomarkers were determined at T0 and T3.Results: Acceptability results revealed a high level of satisfaction and perceived usefulness regarding the intervention. Both groups experienced a significant decrease in stress symptoms and IBD symptom perception at T1. No significant differences were observed at follow-up for the primary outcomes. The experimental group reported significantly lower Crohn’s disease Symptom severity at T2 than the control group. Post-hoc analyses designed to mitigate floor effects revealed substantial treatment effects for the experimental group regarding anxiety symptoms. No significant differences were observed in clinical biomarkers from T0 to T3.Conclusion: The LIFEwithIBD intervention shows promising, although preliminary, benefits for managing disease activity and reducing anxiety symptoms in IBD patients with high severity of psychological distress.
|
|
| 4. |
- Huang-Doran, Isabel, et al.
(författare)
-
Insulin resistance uncoupled from dyslipidemia due to C-terminal PIK3R1 mutations.
- 2016
-
Ingår i: JCI insight. - 2379-3708. ; 1:17
-
Tidskriftsartikel (refereegranskat)abstract
- Obesity-related insulin resistance is associated with fatty liver, dyslipidemia, and low plasma adiponectin. Insulin resistance due to insulin receptor (INSR) dysfunction is associated with none of these, but when due to dysfunction of the downstream kinase AKT2 phenocopies obesity-related insulin resistance. We report 5 patients with SHORT syndrome and C-terminal mutations in PIK3R1, encoding the p85α/p55α/p50α subunits of PI3K, which act between INSR and AKT in insulin signaling. Four of 5 patients had extreme insulin resistance without dyslipidemia or hepatic steatosis. In 3 of these 4, plasma adiponectin was preserved, as in insulin receptor dysfunction. The fourth patient and her healthy mother had low plasma adiponectin associated with a potentially novel mutation, p.Asp231Ala, in adiponectin itself. Cells studied from one patient with the p.Tyr657X PIK3R1 mutation expressed abundant truncated PIK3R1 products and showed severely reduced insulin-stimulated association of mutant but not WT p85α with IRS1, but normal downstream signaling. In 3T3-L1 preadipocytes, mutant p85α overexpression attenuated insulin-induced AKT phosphorylation and adipocyte differentiation. Thus, PIK3R1 C-terminal mutations impair insulin signaling only in some cellular contexts and produce a subphenotype of insulin resistance resembling INSR dysfunction but unlike AKT2 dysfunction, implicating PI3K in the pathogenesis of key components of the metabolic syndrome.
|
|
| 5. |
- Migliavacca, Mirco, et al.
(författare)
-
Semiempirical modeling of abiotic and biotic factors controlling ecosystem respiration across eddy covariance sites
- 2011
-
Ingår i: Global Change Biology. - : Wiley. - 1354-1013. ; 17:1, s. 390-409
-
Tidskriftsartikel (refereegranskat)abstract
- In this study we examined ecosystem respiration (R-ECO) data from 104 sites belonging to FLUXNET, the global network of eddy covariance flux measurements. The goal was to identify the main factors involved in the variability of R-ECO: temporally and between sites as affected by climate, vegetation structure and plant functional type (PFT) (evergreen needleleaf, grasslands, etc.). We demonstrated that a model using only climate drivers as predictors of R-ECO failed to describe part of the temporal variability in the data and that the dependency on gross primary production (GPP) needed to be included as an additional driver of R-ECO. The maximum seasonal leaf area index (LAI(MAX)) had an additional effect that explained the spatial variability of reference respiration (the respiration at reference temperature T-ref=15 degrees C, without stimulation introduced by photosynthetic activity and without water limitations), with a statistically significant linear relationship (r2=0.52, P < 0.001, n=104) even within each PFT. Besides LAI(MAX), we found that reference respiration may be explained partially by total soil carbon content (SoilC). For undisturbed temperate and boreal forests a negative control of total nitrogen deposition (N-depo) on reference respiration was also identified. We developed a new semiempirical model incorporating abiotic factors (climate), recent productivity (daily GPP), general site productivity and canopy structure (LAI(MAX)) which performed well in predicting the spatio-temporal variability of R-ECO, explaining > 70% of the variance for most vegetation types. Exceptions include tropical and Mediterranean broadleaf forests and deciduous broadleaf forests. Part of the variability in respiration that could not be described by our model may be attributed to a series of factors, including phenology in deciduous broadleaf forests and management practices in grasslands and croplands.
|
|
| 6. |
- Oliveira, Helena Rodrigues, et al.
(författare)
-
Biogas potential of biowaste: A case study in the state of Rio de Janeiro, Brazil
- 2024
-
Ingår i: Renewable energy. - : PERGAMON-ELSEVIER SCIENCE LTD. - 0960-1481 .- 1879-0682. ; 221
-
Tidskriftsartikel (refereegranskat)abstract
- Anaerobic digestion has been widely applied for waste treatment, renewable energy generation , biofertilizer production. The biogas potential in Brazil is sizable, but the state of Rio de Janeiro is largely dependent on fossil fuels , there is a lack of biogas potential assessments in the state. Thus, this study evaluated biomethane, electricity and biofertilizer potentials in the region. Three different scenarios of biomass supply were considered for four major biowaste streams: sewage sludge; cattle manure; sugarcane processing waste; and food waste. Biomethane generation from the assessed sources could reach 0.6-1.3 billion Nm(3) year(-1), corresponding to 1,768-3,961 GWh year(-1) of electricity , 1.6-3.3 million Mg year- 1 of biofertilizer. Cattle manure was responsible for 73-84% of the projected biomethane production, presenting an opportunity to reduce the sig-nificant emissions from livestock farming. The estimated biofertilizer production could meet the demands of the state , the produced electricity could offset up to 10% of the demand. The gas grid could facilitate the dis-tribution of upgraded biomethane, and 10-22% of the natural gas demand could be met. The findings of this work highlight the high potential for biogas generation in Rio de Janeiro, which is up to seven times larger than the current production.
|
|
| 7. |
- Petrakli, Fotini, et al.
(författare)
-
End-of-life recycling options of (nano)enhanced CFRP composite prototypes waste-a life cycle perspective
- 2020
-
Ingår i: Polymers. - : MDPI AG. - 2073-4360. ; 12:9
-
Tidskriftsartikel (refereegranskat)abstract
- Life cycle assessment is a methodology to assess environmental impacts associated with a product or system/process by accounting resource requirements and emissions over its life cycle. The life cycle consists of four stages: material production, manufacturing, use, and end-of-life. This study highlights the need to conduct life cycle assessment (LCA) early in the new product development process, as a means to assess and evaluate the environmental impacts of (nano)enhanced carbon fibre-reinforced polymer (CFRP) prototypes over their entire life cycle. These prototypes, namely SleekFast sailing boat and handbrake lever, were manufactured by functionalized carbon fibre fabric and modified epoxy resin with multi-walled carbon nanotubes (MWCNTs). The environmental impacts of both have been assessed via LCA with a functional unit of '1 product piece'. Climate change has been selected as the key impact indicator for hotspot identification (kg CO2 eq). Significant focus has been given to the end-of-life phase by assessing different recycling scenarios. In addition, the respective life cycle inventories (LCIs) are provided, enabling the identification of resource hot spots and quantifying the environmental benefits of end-of-life options. © 2020 by the authors.
|
|
| 8. |
- Sartelli, Massimo, et al.
(författare)
-
Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action
- 2023
-
Ingår i: WORLD JOURNAL OF EMERGENCY SURGERY. - 1749-7922. ; 18:1
-
Forskningsöversikt (refereegranskat)abstract
- Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or "golden rules," for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice.
|
|
| 9. |
- Spencer, Rebecca, et al.
(författare)
-
Maternal PlGF and umbilical Dopplers predict pregnancy outcomes at diagnosis of early-onset fetal growth restriction
- 2023
-
Ingår i: Journal of Clinical Investigation. - 0021-9738. ; 133:18
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND. Severe, early-onset fetal growth restriction (FGR) causes significant fetal and neonatal mortality and morbidity. Predicting the outcome of affected pregnancies at the time of diagnosis is difficult, thus preventing accurate patient counseling. We investigated the use of maternal serum protein and ultrasound measurements at diagnosis to predict fetal or neonatal death and 3 secondary outcomes: fetal death or delivery at or before 28+0 weeks, development of abnormal umbilical artery (UmA) Doppler velocimetry, and slow fetal growth. METHODS. Women with singleton pregnancies (n = 142, estimated fetal weights [EFWs] below the third centile, less than 600 g, 20+0 to 26+6 weeks of gestation, no known chromosomal, genetic, or major structural abnormalities) were recruited from 4 European centers. Maternal serum from the discovery set (n = 63) was analyzed for 7 proteins linked to angiogenesis, 90 additional proteins associated with cardiovascular disease, and 5 proteins identified through pooled liquid chromatography and tandem mass spectrometry. Patient and clinician stakeholder priorities were used to select models tested in the validation set (n = 60), with final models calculated from combined data. RESULTS. The most discriminative model for fetal or neonatal death included the EFW z score (Hadlock 3 formula/Marsal chart), gestational age, and UmA Doppler category (AUC, 0.91; 95% CI, 0.86-0.97) but was less well calibrated than the model containing only the EFW z score (Hadlock 3/Marsal). The most discriminative model for fetal death or delivery at or before 28+0 weeks included maternal serum placental growth factor (PlGF) concentration and UmA Doppler category (AUC, 0.89; 95% CI, 0.83-0.94). CONCLUSION. Ultrasound measurements and maternal serum PlGF concentration at diagnosis of severe, early-onset FGR predicted pregnancy outcomes of importance to patients and clinicians.
|
|
