| 3271. |
- Samelson, Elizabeth J, et al.
(författare)
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Cortical and trabecular bone microarchitecture as an independent predictor of incident fracture risk in older women and men in the Bone Microarchitecture International Consortium (BoMIC): a prospective study.
- 2019
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Ingår i: The lancet. Diabetes & endocrinology. - 2213-8595. ; 7:1, s. 34-43
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Tidskriftsartikel (refereegranskat)abstract
- Although areal bone mineral density (aBMD) assessed by dual-energy x-ray absorptiometry (DXA) is the clinical standard for determining fracture risk, most older adults who sustain a fracture have T scores greater than -2·5 and thus do not meet the clinical criteria for osteoporosis. Importantly, bone fragility is due to low BMD and deterioration in bone structure. We assessed whether indices of high-resolution peripheral quantitative CT (HR-pQCT) were associated with fracture risk independently of femoral neck aBMD and the Fracture Risk Assessment Tool (FRAX) score.We assessed participants in eight cohorts from the USA (Framingham, Mayo Clinic), France (QUALYOR, STRAMBO, OFELY), Switzerland (GERICO), Canada (CaMos), and Sweden (MrOS). We used Cox proportional hazard ratios (HRs) to estimate the association between HR-pQCT bone indices (per 1 SD of deficit) and incident fracture, adjusting for age, sex, height, weight, and cohort, and then additionally for femoral neck DXA aBMD or FRAX.7254 individuals (66% women and 34% men) were assessed. Mean baseline age was 69 years (SD 9, range 40-96). Over a mean follow-up of 4·63 years (SD 2·41) years, 765 (11%) participants had incident fractures, of whom 633 (86%) had femoral neck T scores greater than -2·5. After adjustment for age, sex, cohort, height, and weight, peripheral skeleton failure load had the greatest association with risk of fracture: tibia HR 2·40 (95% CI 1·98-2·91) and radius 2·13 (1·77-2·56) per 1 SD decrease. HRs for other bone indices ranged from 1·12 (95% CI 1·03-1·23) per 1 SD increase in tibia cortical porosity to 1·58 (1·45-1·72) per 1 SD decrease in radius trabecular volumetric bone density. After further adjustment for femoral neck aBMD or FRAX score, the associations were reduced but remained significant for most bone parameters. A model including cortical volumetric bone density, trabecular number, and trabecular thickness at the distal radius and a model including these indices plus cortical area at the tibia were the best predictors of fracture.HR-pQCT indices and failure load improved prediction of fracture beyond femoral neck aBMD or FRAX scores alone. Our findings from a large international cohort of men and women support previous reports that deficits in trabecular and cortical bone density and structure independently contribute to fracture risk. These measurements and morphological assessment of the peripheral skeleton might improve identification of people at the highest risk of fracture.National Institutes of Health National Institute of Arthritis Musculoskeletal and Skin Diseases.
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| 3272. |
- Sanabria, M, et al.
(författare)
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Remote Patient Monitoring Program in Automated Peritoneal Dialysis: Impact on Hospitalizations
- 2019
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Ingår i: Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. - : SAGE Publications. - 1718-4304 .- 0896-8608. ; 39:5, s. 472-478
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Tidskriftsartikel (refereegranskat)abstract
- Automated peritoneal dialysis (APD) is a growing PD modality but as with other home dialysis methods, the lack of monitoring of patients’ adherence to prescriptions is a limitation with potential negative impact on clinical outcome parameters. Remote patient monitoring (RPM) allowing the clinical team to have access to dialysis data and adjust the treatment may overcome this limitation. The present study sought to determine clinical outcomes associated with RPM use in incident patients on APD therapy. Methods A retrospective cohort study included 360 patients with a mean age of 57 years (diabetes 42.5%) initiating APD between 1 October 2016 and 30 June 2017 in 28 Baxter Renal Care Services (BRCS) units in Colombia. An RPM program was used in 65 (18%) of the patients (APD-RPM cohort), and 295 (82%) were treated with APD without RPM. Hospitalizations and hospital days were recorded over 1 year. Propensity score matching 1:1, yielding 63 individuals in each group, was used to evaluate the association of RPM exposure with numbers of hospitalizations and hospital days. Results After propensity score matching, APD therapy with RPM ( n = 63) compared with APD-without RPM ( n = 63) was associated with significant reductions in hospitalization rate (0.36 fewer hospitalizations per patient-year; incidence rate ratio [IRR] of 0.61 [95% confidence interval (CI) 0.39 – 0.95]; p = 0.029) and hospitalization days (6.57 fewer days per patient-year; IRR 0.46 [95% CI 0.23 – 0.92]; p = 0.028). Conclusions The use of RPM in APD patients is associated with lower hospitalization rates and fewer hospitalization days; RPM could constitute a tool for improvement of APD therapy.
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| 3273. |
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| 3274. |
- Sand, U., et al.
(författare)
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Control of Gas Bubbles and Slag Layer in a Ladle Furnace by Electromagnetic Stirring
- 2009
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Ingår i: Iron & Steel Technology. - 1547-0423. ; 6:7, s. 49-59
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Tidskriftsartikel (refereegranskat)abstract
- A study was conducted to present the numerical model and simulation results of electromagnetic and gas stirring (EMGAS) and compare with that of a water model. The new features of EMGAS regarding the gas plume, stirring energy, velocity, and mixing time were introduced. Fluent© was employed to develop the numerical modeling of the system and model the melt, slag, and gaseous atmosphere in the ladle top was conducted using the Volume of Fluid (VOF) approach. The turbulence of the flow system was modeled using the Reynolds stresses model that accounted for six equations, including one for each Reynolds stress component and the turbulent dissipation equation. The water model investigations were based on visualization using an advanced video camera. The model cases were designed to be analogous with the corresponding simulated cases. The visualization investigations focused mainly on the flow pattern and the gas plume structure.
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| 3275. |
- Sand, U., et al.
(författare)
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Numerical and Experimental Study on Fluid Dynamic Features of Combined Gas and Electromagnetic Stirring in Ladle Furnace
- 2009
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Ingår i: Steel Research Int.. ; 80:6, s. 441-449
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Tidskriftsartikel (refereegranskat)abstract
- Basic fluid dynamic features of combined electromagnetic stirring, EMS, and gas stirring (EMGAS) have been studied In the present work. A transient and turbulent multiphase numerical flow model was built. Simulations of a real size ladle furnace were conducted for 7 cases, operating with and without combined stirring and varying the argon gas inlet plug position. The results of these simulations are compared considering melt velocity, melt turbulence, melt/slag-interface turbulence and dispersion of gas bubbles. An experimental water model was also built to simulate the effects of combined stirring. The water model was numerically simulated and visual comparison of the gas plume shape and flow pattern in the numerical and in the experimental model was also done for 3 flow situations. The results show that EMGAS has a strong flexibility regarding the flow velocity, gas plume, stirring energy, mixing time, slag layer, etc.
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| 3276. |
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| 3277. |
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| 3278. |
- Sangaré, Lamba Omar, et al.
(författare)
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In Vivo CRISPR Screen Identifies TgWIP as a Toxoplasma Modulator of Dendritic Cell Migration
- 2019
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Ingår i: Cell Host and Microbe. - : Elsevier BV. - 1931-3128 .- 1934-6069. ; 26:4, s. 478-492
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Tidskriftsartikel (refereegranskat)abstract
- Toxoplasma can reach distant organs, especially the brain, leading to a lifelong chronic phase. However, genes involved in related in vivo processes are currently unknown. Here, we use focused CRISPR libraries to identify Toxoplasma genes that affect in vivo fitness. We focus on TgWIP, whose deletion affects Toxoplasmadissemination to distant organs. We show that TgWIP is secreted into the host cell upon invasion and interacts with the host WAVE regulatory complex and SHP2 phosphatase, both of which regulate actin dynamics. TgWIP affects the morphology of dendritic cells and mediates the dissolution of podosomes, which dendritic cells use to adhere to extracellular matrix. TgWIP enhances the motility and transmigration of parasitized dendritic cells, likely explaining its effect on in vivofitness. Our results provide a framework for systemic identification of Toxoplasmagenes with in vivo effects at the site of infection or on dissemination to distant organs, including the brain.
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| 3279. |
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| 3280. |
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