340880 research outputs found
Sort by
PPG-based smartphone application vs usual care for atrial fibrillation screening:A European Multicenter Randomized Trial
No full textBackground: Atrial fibrillation (AF) is the most frequent arrhythmia worldwide and a major cause of ischemic stroke. Screening tools are becoming increasingly popular to detect AF for stroke prevention, yet data from randomized trials are lacking. Objective: The purpose of this study was to analyze AF detection rates using a smartphone application with early intervention (intervention group) compared with no intervention (sham group). Methods: This is an international, multicenter, prospective, randomized, sham-controlled, double-blinded trial conducted between October 2019 and May 2024. Patients with no prior AF were randomized 1:1 to an intervention group or a sham group. The study application used the smartphone camera to generate photoplethysmography signals. If an arrhythmia was detected, patients in the intervention group received a notification and a 7-day patch electrocardiogram to confirm AF. Results: A total of 1021 patients from 8 centers were randomized. The mean CHA 2DS 2-VASc score was 3.4 ± 0.92 in the intervention group and 3.5 ± 1.02 in the sham group. Arrhythmia was detected in 32 (3.1%) cases: 20 (3.9%) in the intervention group and 12 (2.4%) in the sham group. AF was diagnosed in 13 (1.3%) patients. AF detection rates were numerically higher in the intervention group (10 [1.9%] vs 3 [0.5%]; P = .094), especially in cases of asymptomatic AF (4 [0.8%] vs 0 [0%]; P = .13). There was no difference in the rate of stroke, transient ischemic attack, or systemic embolism after 6 months. Conclusion: In this multicenter trial, application usage in combination with early intervention did not significantly increase overall AF detection rates. However, asymptomatic AF detection was numerically higher in the intervention group, aligning with current guidelines that recommend photoplethysmography–based devices for AF screening.</p
Temperature-controlled surface adhesion in graphene materials:experimental trends, surfaces, and interfaces physical chemistry
No full textUnderstanding the role of temperature in modulating surface adhesion properties of graphene and its derivatives is essential for their effective integration in nano- and optoelectronic devices. In this study, the temperature-dependent dispersive and polar components of work of adhesion was systematically investigated across graphene (G), reduced graphene oxide (rGO), and graphene oxide (GO), using inverse gas chromatography (IGC) and selected polar/nonpolar solvent interactions. Our results reveal a consistent hierarchy in adhesion energies (G > rGO > GO) and show that elevated temperatures significantly influence interfacial interactions by modifying surface energy components. Furthermore, the solvent-specific trends suggest a strong interplay between molecular polarity and surface functionalization. This study not only provides thermodynamic insights into graphene-based adhesion but also contributes to rational interface engineering in 2D materials under thermal fluctuation
What is a healthy dating relationship and what helps it get there? Perceptions of Chilean adolescents from a gender and inclusivity perspective
No full textINTRODUCTION: Relationships are often the focal point of life and can have a positive or a negative impact on a child's or adolescent's development, thus understanding the traits of healthy dating relationships may benefit wellbeing during this period of life and into adulthood. METHODS: In this transversal study, a sample of 65 adolescents between 10 and 19 years of age were recruited from schools in Araucanía and metropolitan regions of Chile during 2023, and they were distributed into 10 focus groups stratified by gender and age. A qualitative methodology with a phenomenological approach was used. Content análisis was performed stratified by age group (10-14 years, 15-19 years) and gender identity. RESULTS: Information was obtained from adolescents about what they considered a healthy relationship, making distinctions between different types of unhealthy relationships and capturing subtleties about what they considered protective and risk factors. The adolescents were not more consumers of information; they required commitment and support in their development processes. DISCUSSION: Listening to their own voice could help generate solutions that made more sense to them. In the view of an adolescent, the formation of romantic couples was a fundamental and important issue that should be considered in public policies that promote health and prevent dating violence and its consequences
Imaging of metabolic dysfunction in genetic cardiomyopathies
No full textGenetic cardiomyopathies (CMPs) are a known cause of morbidity and mortality, with up to 50% of patients diagnosed below the age of 40 years for certain CMPs. With the improved availability of advanced imaging tools, significant progress has been made in early diagnosis and subsequent management. Due to the growing scientific interest in the genetic variants underlying these CMPs, data supporting a possible direct effect of the disease-defining genetic variant on cardiac metabolism have accumulated. Moreover, metabolic impairment seems to be correlated with phenotype, performance status and eventually prognosis at any stage of the disease. In this review we aim to outline the existing evidence supporting the use of imaging techniques to visualize and quantify myocardial metabolism in different CMPs. The review focuses on positron emission tomography (PET), single photon emission computed tomography (SPECT) and magnetic resonance spectroscopy (MRS), describing the basics of their functioning, strengths and weaknesses, and their use in the context of different CMPs. Finally, the latest technologies in this field and potential future directions in disease diagnosis and management are described
Immunomodulation of the Breast Cancer Microenvironment by Tumor-Derived Exosomes:Implications for Immunotherapy
No full textExosomes are 30–150 nm extracellular vesicles released by nearly all cells, including tumor cells. Cancer cell-derived exosomes carry various molecular contents - proteins, mRNAs, microRNAs- that are transferred to recipient cells, contributing to cancer development, angiogenesis, metastasis, and immune evasion. Breast cancer-derived exosomes (BEXs) express multiple immunomodulatory molecules, particularly the ectoenzymes CD39 and CD73, which catalyze the conversion of adenosine triphosphate (ATP) into adenosine. Adenosine then binds its receptors (ADORs) to transmit immunosuppressive signals. BEXs also express immune checkpoint molecules such as programmed death ligand 1 (PD-L1), CD200, and CD47 that suppress immune surveillance through interaction with programmed cell death protein 1 (PD-1), CD200R, and signal-regulatory protein alpha (SIRPα), respectively. Notably, PD-L1 appears to be more enriched on exosomes than on tumor cell surfaces, underscoring the pivotal role of BEXs in immune regulation. Given their influence on several hallmarks of cancer, BEXs are promising candidates for future diagnostic and therapeutic strategies, particularly in immunotherapy.</p
Detection of genome-wide methylation changes in bladder cancer by long-read sequencing of urinary DNA
No full textBACKGROUND: Non-invasive urine tests for bladder cancer (BC) could reduce dependence on flexible cystoscopy for diagnosis and surveillance. Most recent developments in urine testing are based on targeted detection of genomic and/or epigenomic markers. We hypothesised that long-read whole-genome sequencing of urinary DNA with direct methylation profiling may allow accurate BC detection and insights into disease biology. However, the feasibility of such an approach has not yet been reported. METHODS: We applied long-read whole-genome sequencing with direct methylation detection to urine cell pellet DNA (ucpDNA) from 21 haematuria clinic patients: 13 BCs and 8 non-BCs. The modkit Hidden Markov Model algorithm was used to define differentially methylated regions across the genome. The ability to discriminate between BC and non-BC, and the cellular pathways affected were tested using PCA, h-clust and GSEA. RESULTS: We observed global hypomethylation and cancer-specific patterns of promoter hypermethylation in urine from BC patients. Sequencing of a single ucpDNA sample per flow cell yielded read depths of 18-34x; furthermore, BC methylation patterns were also evident with 2-5x multiplex sequencing. Copy number changes were also evident in ucpDNAs from BC patients. A limitation of the study is the small number of samples analysed; however, the detection of cancer-specific events demonstrates the feasibility of the approach, both in single and multiplexed flow-cell runs. CONCLUSIONS: Even at low-read depths, genome-wide methylation patterns in urinary DNA reflect the presence of BC, potentially permitting rapid, non-invasive and cost-effective BC detection
The emerging role of photon-counting detector CT:primary experience on the integrated assessment of acute knee injuries
No full textEarly accurate diagnosis of osseous and soft tissue injuries following acute knee trauma is crucial for guiding clinical management and preventing chronic instability. Radiography is the appropriate first imaging test applied to detect traumatic osseous injuries. CT is indicated based on clinical symptoms and radiographic concordance. In this acute phase, soft tissue injuries are often clinically overlooked due to swelling and restricted motion, which significantly limit comprehensive physical examination. Moreover, both x-ray and conventional CT imaging are insufficient for addressing this issue due to their limited soft tissue contrast resolution. If clinical suspicion of soft tissue injury persists, an MRI will be performed at a later stage. This may lead to undesirable delays in diagnosis and treatment, thereby potentially impacting patient outcomes. Photon-counting detector CT (PCD-CT) offers enhanced, integrated diagnostic possibilities. The use of spectral imaging data, including color-coded virtual non-calcium (VNCa) images, enables the detection of bone marrow edema (BME) and visualization of key stabilizing soft tissue structures, which may assist emergency department clinicians in determining initial treatment, follow-up, and the need for additional imaging. This technical note illustrates the integral use of ultra-high resolution spectral PCD-CT in a case of a knee injury following an alpine skiing accident. RELEVANCE STATEMENT: The integration of photon-counting detector computed tomography with spectral imaging in acute knee trauma enhances visualization of osseous and soft tissue structures, improving diagnostic accuracy. It may optimize early triage and guide initial treatment for soft tissue injuries. KEY POINTS: Photon-counting detector CT (PCD-CT) enables comprehensive fracture, edema, and soft tissue assessment. Case-based notable correlation between injuries suspected on color-coded spectral imaging and MRI. Photon-counting detector CT (PCD-CT) may enhance early clinical decision-making in knee trauma
Surgical Complications in Patients with (borderline) Resectable Pancreatic Cancer after Neoadjuvant Therapy in the PREOPANC-2 Randomized Controlled Trial
No full textOBJECTIVE: To compare the incidence of major surgical complications between patients with (borderline) resectable pancreatic cancer treated with neoadjuvant FOLFIRINOX versus neoadjuvant gemcitabine-based chemoradiotherapy. SUMMARY OF BACKGROUND DATA: There are ongoing concerns regarding the possible adverse impact of neoadjuvant treatment on postoperative complication rates following pancreatectomy. METHODS: This study was a predefined analysis within the investigator-initiated nationwide randomized controlled PREOPANC-2 trial. Patients with (borderline) resectable pancreatic cancer were randomized to receive neoadjuvant FOLFIRINOX (FFX group) or neoadjuvant gemcitabine-based chemoradiotherapy (CRT group), both followed by surgery, and adjuvant gemcitabine only in the CRT group. Surgical complications including postoperative pancreatic fistula, postpancreatectomy hemorrhage, bile leakage, postoperative interventions, and 90-day mortality were compared, with major complications defined as Clavien-Dindo grade =3. RESULTS: Between June 5, 2018, and January 28, 2021, in total 375 patients were randomized, of whom 280 (74.7%) underwent pancreatic resection. A pancreatoduodenectomy was performed in 238 patients (85.0%), left pancreatectomy in 41 patients (14.6%), and total pancreatectomy in one patient (0.4%). The incidence of major surgical complications was similar between the FFX and CRT groups (26.8% versus 27.5%, P=0.884). No differences were observed in the risk of postoperative pancreatic fistula grade B/C (9.9% versus 4.4%, P=0.076), postpancreatectomy hemorrhage grade B/C (7.7% versus 3.6%, P=0.137), bile leakage grade B/C (2.5% versus 2.5%, P>0.999), and postoperative interventions (26.1% versus 26.8%, P=0.886). Surgical reoperation was performed in nine patients (6.3%) in the FFX group and eight patients (5.8%) in the CRT group (P=0.850). The postoperative 90-day mortality was 1.4% in the FFX group (2/142 patients) and 2.9% in the CRT group (4/138 patients) (P=0.442). CONCLUSIONS: In the PREOPANC-2 randomized trial, the risk of major surgical complications after pancreatic resection following neoadjuvant FOLFIRINOX or neoadjuvant gemcitabine-based chemoradiotherapy was similar with an overall low 90-day mortality
