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Stroke risks in women vs men in Asian patients with atrial fibrillation:A temporal trend analysis and a comparison of the CHA<sub>2</sub>DS<sub>2</sub>-VASc and CHA<sub>2</sub>DS<sub>2</sub>-VA stroke risk stratification scores
No full textBackground: The 2024 European guidelines for atrial fibrillation (AF) recommended the use of the sex-less CHA2DS2-VASc score (ie, CHA2DS2-VA) for stroke risk assessment, but this has been less well-validated in Asian cohorts. Objective: We aimed to perform a temporal analysis of stroke risks in women vs men with AF in Taiwan and to compare the performance of CHA2DS2-VASc vs CHA2DS2-VA scores. Methods: We used Taiwan's National Health Database (2000–2021) to compare CHA2DS2-VASc and CHA2DS2-VA scores by 2-year intervals, assessing performance with net reclassification index, integrated discrimination improvement, and C-statistics. Results: We analyzed 495,569 newly diagnosed, non-anticoagulated patients with AF (44% women). Across calendar years, women consistently had higher ischemic stroke risks than men (incidence rate ratio [IRR] 1.13–1.26, all P < .05). Among those with CHA2DS2-VA scores of 0–1, women had a lower stroke risk (score 0: IRR 0.81; score 1: IRR 0.88, both P < .001). For scores 2–8, stroke risk was higher in women (IRR 1.04–1.11, all P < .05). CHA2DS2-VASc significantly outperformed CHA2DS2-VA in net reclassification index from 2000 to 2021 and in integrated discrimination improvement from 2000 to 2015. C-statistics were slightly higher for CHA2DS2-VASc from 2000 to 2013 (P < .05), but not significantly different after 2014 (P > .05), suggesting comparable performance of the 2 scores in more recent years. Conclusion: Women with AF have a higher stroke risk than men only in high CHA2DS2-VA score categories, suggesting female sex is more likely to be a risk modifier of stroke in AF. Retaining the female sex as a component of the CHA2DS2-VASc score may improve the net reclassification for stroke events in Asian patients with AF.</p
In response:'Extracorporeal Shock-Wave Lithotripsy and Endoscopy for the Treatment of Pain in Chronic Pancreatitis' by Olesen et al.
No full textProteomic blood-biomarkers for personalized risk stratification of diabetic retinopathy patients
No full textINTRODUCTION: Diabetes mellitus (DM) is a challenging chronic disease worldwide. The incidence is expected to rise dramatically by 2030 due to smoking, obesity, and aging population, increasing the public health burden in coming years. Diabetic retinopathy (DR) is a common microvascular complication and a leading cause of blindness among working-age individuals. Understanding the proteomic mechanisms driving disease progression and visual loss is of paramount importance when laying novel strategies for managing patients in clinical practice.AREAS COVERED: We summarize proteomic studies addressing molecular biomarkers in human blood for DR. We discuss methodological advantages and challenges. Proteomic technology advancement has reached a level where even low-abundance proteins related to disease can be detected in blood. The pooled results of these studies suggest that the biomarkers are specific to the disease stage and hold promise for personalized risk stratification in DR.EXPERT OPINION: With the development of advanced mass spectrometry technology for the investigation of biomarkers in blood, this research area is expected to advance in the future. Similarly, it is expected that novel blood-based biomarkers for DR will be validated in international studies and implemented in clinical practice. Therefore, future perspectives hold promises of personalized risk profiling for diagnosis, disease progression, and optimal choice of treatment.</p
Evaluación del biofeedback visual, musical y combinado en el entrenamiento en pedaleo:resultados preliminares sobre rendimiento y experiencia del usuario
No full textWhat are the most important research questions within prediabetes?:A priority setting partnership in collaboration with patients, healthcare professionals and researchers
No full textAIMS/HYPOTHESIS: Research agendas are typically set by researchers and funders, meaning that priorities of end users, such as patients and healthcare professionals (HCPs), could be missed or overlooked in research. To ensure future research in prediabetes is of relevance and benefit to people with prediabetes and HCPs, it is important to involve these stakeholders in setting the research agenda. The aim of this study was to establish a top-10 list of the most important research questions in prediabetes (HbA1c 42-47 mmol/mol [6.0-6.4%]) by involving and collaborating with patients, relatives, patient organisations, HCPs and researchers.METHODS: We used a modified James Lind Alliance Priority Setting Partnership methodology, following the four-step process including: (1) Gathering uncertainties; (2) Organising uncertainties; (3) Interim priority setting; and (4) Final priority setting in a workshop. Further, the international relevance of the final top-10 list was assessed.RESULTS: A total of 1142 responses were submitted by 405 people to: 'What questions about prediabetes would you like to see answered by research?'. The collected uncertainties were categorised and condensed into 35 indicative questions. Through prioritisation, patients and relatives had different preferences from researchers and HCPs. The jointly agreed top-10 list included questions on prevention strategies, risk factors, diet advice, screening and personalised treatment. Highest prioritisation was given to: 'What is the best prevention of diabetes and will early prevention strategies reduce the number of people with type 2 diabetes?'.CONCLUSIONS/INTERPRETATION: An iterative and collaborative process identified shared priorities between patients, HCPs and relevant stakeholders in prediabetes. Findings should support academia, funders and the healthcare industry to target research within prediabetes specifically to the needs of patients and HCPs.</p
Thermal management of solid oxide electrolysis cell under dynamic electrothermal self-balancing strategy
Get PDFSolid oxide electrolysis cell (SOEC) is a prospective technology for converting renewable energy into hydrogen to achieve carbon neutrality. However, the large temperature gradient caused by the non-uniform temperature distribution inside SOEC may cause its severe performance degradation and even thermomechanical failure. To solve this issue, this study employs a novel dynamic electrothermal self-balancing strategy that enables SOEC to switch between electrolysis cell (EC) mode and fuel cell (FC) mode with high frequency to alleviate the temperature variation and reduce the temperature gradient. The effects of the thermal matching between EC mode and FC mode on the temperature variation and performance of the SOEC are analyzed first, and it is found that the net heat consumption of the SOEC is reduced by 82.63% compared with that under the traditional electrolysis operation, thus reducing the average temperature reduction and maximum temperature gradient by 72.95% and 59.85% respectively. Then, the sensitivity analysis is carried out to investigate the effects of key parameters under the dynamic electrothermal self-balancing operation on the temperature variation and performance of the SOEC. The results indicate that the increment in the EC mode voltage, EC mode time fraction, and feed flow rate can increase hydrogen production and obtain a minimum temperature gradient; the increment in the FC mode voltage and EC mode time fraction and the decrement in the EC mode voltage and feed hydrogen concentration can improve electrical efficiency; the increment in the air-feed ratio contributes to reducing the temperature gradient and improving the hydrogen production and electrical efficiency; the higher switching frequency has a positive effect on the stable operation of the SOEC. The present work reveals the mechanism of the dynamic electrothermal self-balancing operation strategy and brings new insights into SOEC thermal management
Preanalytical stability of 17 analytes in whole blood during transportation
No full textReliable biochemical measurements are essential to patient care and rely on the correct preanalytical handling of blood samples. In Denmark, whole blood samples are transported from general practitioners to local hospital laboratories daily, and whole blood stability for 10 h is required for analytes to be included in this transportation service in the North Jutland Region. Therefore, this study aimed to determine the stability of 17 analytes in whole blood during transportation and storage for 6 and 10 h at room temperature (21 °C). Ten randomly selected participants were included in the Department of Clinical Biochemistry at Aalborg University Hospital. Three serum vacutainer tubes were collected from each participant, and 17 analytes (lipoprotein a, immunoglobulin G1, β-2-Microglobulin, κ free light chain, λ free light chain, peptidyl peptidase A, protein, apolipoprotein B, insulin-like growth factor 1, somatotropin, thyroxin binding globulin, anticardiolipin antibodies IgM, prolactin, thyroid peroxidase antibodies, thyroglobulin, thyroglobulin antibodies,17-Hydroxyprogesterone) were measured at baseline, after 6 h, and after 10 h. All analytes showed 6- and 10-hour stability within the limits of the preestablished analytical variation, reflected by coefficients of variation, in the laboratory (accredited by ISO-15189). Thus, transportation and storage of whole blood at room temperature for 6 and 10 h did not result in significant changes in the levels of the 17 studied analytes. Therefore, all analytes were suitable for the transportation service in the North Jutland Region, Denmark.</p
Real World Case Series:A.G.E. Interrupter Ultra Serum
Get PDFBACKGROUND: The A.G.E. Interrupter serum has been developed in an oil-in-water emulsion to contain 30% proxylane, Cassia alata extract, blueberry and pomegranate extract, rhamnose, and gentiana lutea root extract. The technology has several patent ingredients as well as synergistic patents with proxylane, rhamnose, and new ones submitted for the new ingredients. An ex vivo model using this final formulation has shown upregulation of laminin-5, collagen IV, tropoelastin, and collagen III. Collagen IV and laminin are present in the dermal-epidermal junction (DEJ) and are factors in the basement membrane function. Over time, the DEJ decreases in height and in surface area, leading to weakened skin integrity and structure. The serum was tested to illustrate visible life in the jawline, forehead, cheek, and neck as well as instrumental testing showing visible improvement in the nasolabial fold and forehead wrinkle.AIM: To present a real-world case series that demonstrates the use of the A.G.E. Interrupter serum as an adjunctive therapy to collagen-stimulating procedures in a wide variety of patient ages and skin types.METHODS: Eight internationally recognized, licensed dermatologists with extensive experience in cosmetic and facial rejuvenation procedures were selected to participate in an expert panel. During the expert panel, dermatologists were asked to share 2 cases using the A.G.E. Interrupter serum in patients undergoing collagen-stimulating procedures.RESULTS: Following the panel discussion, seven patient cases were selected to illustrate the use of the A.G.E. Interrupter serum in conjunction with collagen-stimulating procedures to optimize patient outcomes and satisfaction. Experts found that daily A.G.E. Interrupter serum application post-procedure led to improved overall results and high patient satisfaction.CONCLUSION: This case series provides evidence for different integrated skincare regimens using the A.G.E. Interrupter serum in a variety of patients.</p