Background Peripheral artery disease (PAD) is both a common comorbidity and a contributing factor to heart failure. Whether PAD is associated with hospitalization for recurrent decompensation among patients with established heart failure is uncertain. Methods and Results Since 2005, the ARIC (Atherosclerosis Risk in Communities) study has conducted active surveillance of hospitalized acute decompensated heart failure (ADHF), with events verified by physician review. From 2005 to 2016, 1481 patients were hospitalized with ADHF and discharged alive (mean age, 78 years; 69% White). Of these, 207 (14%) had diagnosis of PAD. Those with PAD were more often men (55% versus 44%) and smokers (17% versus 8%), with a greater prevalence of coronary artery disease (72% versus 52%). Patients with PAD had an increased risk of at least 1 ADHF readmission, both within 30 days (11% versus 7%) and 1 year (39% versus 28%) of discharge from the index hospitalization. After adjustments, PAD was associated with twice the hazard of ADHF readmission within 30 days (HR, 2.02; 95% CI, 1.14-3.60) and a 60% higher hazard of ADHF readmission within 1 year (HR, 1.60; 95% CI, 1.25-2.05). The 1-year hazard of ADHF readmission associated with PAD was stronger with heart failure with reduced ejection fraction (HR, 2.01; 95% CI, 1.29-3.13) than preserved ejection fraction (HR, 1.04; 95% CI, 0.69-1.56); P for interaction=0.05. Conclusions Patients with ADHF and concomitant PAD have a higher likelihood of ADHF readmission. Strategies to prevent ADHF readmissions in this high-risk group are warranted.
3,4-Methylenedioxy-N-methylamphetamine (MDMA) is increasing being used by youth in Europe and in France, but characteristics of its use are unknown.
The aim was to characterize MDMA use in a sample of French medical students.
Cross-sectional study of Paris VII medical students (
= 592) with an online self-reporting questionnaire.
592 students completed the online questionnaire. 21.5% (
= 127) had experimented with MDMA. Use of MDMA was associated with male sex (
< 0.001), older age (
< 0.001), left the parent's home (
< 0.01), and belonging to a fraternity (
< 0.05). Most experimenters (90.7%) used MDMA in a club or during a music festival. Among users, 42.5% used it more than once a year and less than once a month. During the use, users drank alcohol (90.6%), smoked tobacco (70.9%), smoked cannabis (42.0%) or used cocaine (20.5%). In the days after the use, some smoked tobacco (40.9%), smoked cannabis (29.1%), drank alcohol (22.0%), used cocaine (1.6%) and also took benzodi0.001). Conclusions Other studies focusing on drug consumption among students are necessary to define specific public health strategies of prevention and harmful reduction.Objectives Five-factor model (FFM) personality traits, including higher conscientiousness and lower neuroticism, are associated with lower risk of dementia and cognitive impairment. In this research, we test whether retirement status moderates and/or mediates the relation between personality and cognitive impairment. Method We used data from the Health and Retirement Study (N = 9899), a longitudinal study of Americans over the age of 50 years, to examine moderating and mediating associations between personality traits and retirement status on risk of dementia and cognitive impairment not dementia (CIND) over an 8-10 year follow-up. Results Personality and retirement each had strong, independent associations with risk of dementia and CIND. There were not, however, strong or consistent, moderating or mediating associations between personality and retirement predicting impairment risk. Discussion Overall, these results indicate that personality and retirement are independent risk factors for incident cognitive impairment. Mechanisms other than retirement are likely to explain this association.Neonatal maternal separation is an experimental model used to evaluate the effects of toxic stress in neonates, or early life stress. Although various physiological and psychological stresses during childhood have been reported, the effects of neonatal maternal separation on the male reproductive system remain unclear. Therefore, the present study evaluated the effects of neonatal maternal separation on the male reproductive system. In neonatal male ICR mice, maternal separation was performed for 0.5, 1, 2, and 4 hours/day, from postnatal day 1 to 10. At 10 weeks of age, the neonatal maternal separation mice exhibited decreases in both testicular weight and epididymal sperm number, along with various testicular morphological changes involving germ cells, Sertoli cells, and interstitial cells. Notably, neonatal maternal separation mice showed decreased numbers of Sertoli cells. Animals subjected to 0.5-, 1-, and 2-h/day neonatal maternal separation exhibited decreases in serum levels of testosterone but not in those of gonadotropin (luteinizing hormone and follicle-stimulating hormone). Together, these data showed that neonatal maternal separation in male mice causes decreased Sertoli cell numbers following puberty, resulting in subsequent decreased spermatogenic activity.This article describes the application of an empowerment evaluation approach to nurturing the growth and priority setting of a regional organization. https://www.selleckchem.com/products/tcpobop.html A model is provided of the processes whereby the Southern Gerontological Society (SGS) identified research and service priorities by conducting a survey of stakeholder perceptions of regional needs. The survey goal was to identify important issues faced by older adults in the South as a prelude to refining SGS research and service priorities and developing its contemporary regional gerontological agenda. We trace how the survey findings were translated into actions including shaping the annual meeting program, creating new standing committees, and developing service activities. Underlying the process of developing and refining this agenda are a set of key principles that have come to characterize the operation of SGS. These principles are discussed and provide a model for comparable organizations seeking to develop agendas consistent with their mission and identity.
Psychiatric patients' awareness of treatments options and their possibilities to influence their care has increased. For the clinicians, the management of evidence-based care, as well as organizational and resource aspects, set different goals for the clinical encounter. In this article we are focusing on the clinicians' experiences and ask How do the clinicians view situations in which there is a conflict between patients' individual needs and goals and other aspects in decision-making?
We implemented a qualitative study of 13 thematic semi-structured interviews with clinicians working in psychiatry. We used discourse analysis to investigate how the clinician view the doctor-patient interaction.
We identified three discources which were termed the medical standpoint, the psychodynamic standpoint and the standpoint of the patient's experience.
In their talk, the clinicians use the three discources to make sense of the diverse expectations from both the patient and the mental health care system. The three discources also reflect different aspects in psychiatric treatment cultures, such as evidence-based medicine, the ideal of patient-centeredness, therapeutic interaction and organizational requirements.
In their talk, the clinicians use the three discources to make sense of the diverse expectations from both the patient and the mental health care system. The three discources also reflect different aspects in psychiatric treatment cultures, such as evidence-based medicine, the ideal of patient-centeredness, therapeutic interaction and organizational requirements.
This study aimed to determine the chemical profile of
leaf oil.
The essential oil was extracted from dried leaf samples using the Soxhlet extraction method. The oil was separated from the solvent and the bioactive compounds were identified using gas chromatography-mass spectroscopy (GC-MS) and Fourier transform infrared spectroscopy (FTIR). The identified peaks in the mass spectrum were matched with the database of the US National Institute of Standards and Technology (NIST) library.
The FT-IR results indicated the presence of alcohols, carboxylic acids, phenols, alkanes, ketones, and primary amine compounds. GC-MS identified 43 compounds representing 95% of the total leaf essential oil components. Some of the major isolated compounds included a pyrrolizine; 1-dodecanol; 1,2-nonadecanediol; phytol; 1,3-dioxolane; 4-undecene, 9-methyl, (Z)-; 1-eicosanol; and imidazole.
The identified constituents of the extracted oil have established pharmacologic and insecticidal activities, and these compounds are also used in the drink, food, and cosmetic industries. This extract is highly valuable for the medical treatment of various ailments.
The identified constituents of the extracted oil have established pharmacologic and insecticidal activities, and these compounds are also used in the drink, food, and cosmetic industries. This extract is highly valuable for the medical treatment of various ailments.
The interaction between PD-L1 on tumor cells and the programmed death 1 (PD1) on immune cells helps them to escape the immune system elimination. Therefore, developing therapeutic agents to block this interaction has garnered a lot of attention as a therapeutic approach. In the present study, we have tried to screen for an inhibitory compound to inhibit the interaction between the PD1/PD-L1 molecules.
In this regard, the structure of PD-L1 and its inhibitor were prepared and employed to generate an e-Pharmacophore model. A library of approved compounds was prepared and toxicity analysis using Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) predictor was performed. The built e-Pharmacophore model was validated and used to screen the prepared compound library. Ligand docking and binding energy calculation were performed on the screened ligands.
A seven-feature e-Pharmacophore model was generated using the PD-L1 complex. All of the compounds within the library passed the ADMET criteria. Performing the virtual screening, only 79 compounds have survived the criteria to fit four pharmacophoric features. The compound with the highest binding energy was the liothyronine (T3).
The ability of T3 in PD1/PD-L1 checkpoint blockade along with its potential in T4 reduction could be a desirable combination in cancer treatment. These abilities of T3 could be used to restore the ability of the immune system to eliminate tumor cells.
The ability of T3 in PD1/PD-L1 checkpoint blockade along with its potential in T4 reduction could be a desirable combination in cancer treatment. These abilities of T3 could be used to restore the ability of the immune system to eliminate tumor cells.
Deceased-donor kidney transplantation (KT) from hepatitis C (HCV)-infected donors into HCV-uninfected recipients (HCV D+/R-) could become standard care in the near future. However, HCV viral replication by viral transmission might lead to a higher incidence of cytomegalovirus (CMV) infection in these recipients.
A national-registry-based retrospective cohort study was conducted using the Scientific Registry of Transplant Recipients (SRTR) data set. We assessed the incidence of CMV infection in HCV antibody (Ab) negative recipients receiving kidneys from HCV Ab positive (HCVAb D+/R-) and negative (HCVAb D-/R-) donors. The risk of CMV infection was analyzed by Cox regression analysis in a propensity score (PS) matched-cohort of HCVAb D+/R- (
= 950) versus HCVAb D-/R- (
= 950). Sensitivity analysis was also conducted in the entire cohort (
= 181082).
The mean age at baseline was 54 years, 75% were male, and 55% of the patients were African American in PS-matched cohort. Compared to the HCVAb D-/R - patients, recipients with HCVAb D+/R - showed identical probability for the incidence of CMV infection (Hazard Ratio (HR) = 1.