340880 research outputs found
Sort by
Anticoagulation and thromboembolic risk in critically ill patients with trigger-induced atrial fibrillation-A systematic review and meta-analysis
No full textIntroduction: In critically ill patients with trigger-induced atrial fibrillation, there are no definitive recommendations on the use of anticoagulation. This study aimed to evaluate the association between anticoagulation therapy and outcomes (i.e. thromboembolism, bleeding and mortality) and examine prescription patterns in high-risk individuals based on CHA 2DS 2-VASc scores. Methods: A systematic search was conducted to identify studies reporting on anticoagulation prescription, thromboembolism, bleeding, and mortality. Anticoagulation rates and CHA 2DS 2-VASc scores were correlated, and a meta-analysis was conducted to compare short- and long-term outcomes. Results: Anticoagulation prescription rates ranged from 3 to 86%; in over 50% of patients, CHA 2DS 2-VASc scores were ≥ 2 (n = 28 studies). A meta-analysis of eight observational studies, in which 95% of patients had sepsis/infection as the precipitant, demonstrated no association between anticoagulation and reduced short-term thromboembolism (OR 0.89, 95% CI 0.61–1.28) or increased bleeding (OR 1.05, 95% CI 0.90–1.22). Short-term mortality was lower in the anticoagulation group (OR 0.54, 95% CI 0.39–0.75), but a higher long-term thromboembolic risk was observed (OR 1.45, 95% CI 1.04–2.03). Conclusion: The prescription of anticoagulation in critically ill patients with TIAF is highly variable. There is no clear evidence of benefit or harm, and neither routine use nor systematic omission is supported.</p
Repair versus Replacement in mitral valve papillary muscle rupture:a multicenter study
No full textObjectives Papillary muscle rupture (PMR) is a rare but potentially fatal mechanical complication after acute myocardial infarction (AMI). Although surgery is considered the gold-standard treatment for post-AMI PMR, the optimal surgical strategy remains unclear. Methods Data from post-AMI PMR patients submitted to mitral valve replacement (MVR) or mitral valve repair (MVr) surgery in the period between 2001 and 2019, from 20 international centres, were collected in the CAUTION study database. In-hospital and long-term post-discharge mortality were the endpoints. A multivariable logistic regression model was used to determine mortality independent factors. Results The patient cohort available included 218 patients. MVR was the most frequent type of surgery (81.6%). Complete PMR was more common in the MVR group (71.9%, . 008), while partial PMR was more frequent in MVr patients (75%, . 008). In-hospital mortality rate was 25.8% in the MVR subgroup and 20% in MVr subjects (. 440). In MVR subgroup, concomitant coronary artery bypass grafting (CABG) was associated with lower in-hospital mortality (n = 20/96, 21%) than no concomitant CABG (31.7%, . 035). Survival at 1, 3, 5, and 10 years was 59.3%, 55.9%, 53.1%, 46.9% in the MVR group and 59.9%, 56.8%, 54.1%, and 43.2% in MVr patients, respectively, with no statistical differences (. 474). Patients underwent MVr surgery, and 1-, 3-, 5-, and 10-year survival was 79.8%, 75.4%, 68.5%, and 37.5%, respectively, when CABG revascularization was performed, while no CABG survival was 16.7%, 16.7%, 8.3%, and 8.3% (P <. 001). Conclusions MVR is the most commonly performed in complete post-AMI PMR and MVr in partial PMR. No differences were observed regarding in-hospital and long-term mortality in the 2 surgical groups, and no independent factors were associated with overall mortality. Concomitant CABG was associated with higher in-hospital survival. Clinical Registration Number Clinicaltrials.gov, NCT03848429.</p
Global perspectives of midwifery ethics:Crucial features for practice via an international Delphi study
No full textBACKGROUND: Practising ethically as a midwife is essential for providing high quality care during pregnancy, childbirth, and the postpartum period. Whilst midwives may have theoretical knowledge of ethics, applying ethical care in practice may be challenging. There is a gap in the literature that describes how midwives themselves conceptualise, interpret, and apply ethics in their practice. AIM: To describe midwives' perceptions, and experiences of ethics in midwifery practice, and to determine the crucial features of midwifery ethics. METHODS: Fifty participants from 21 countries participated in the study. A two-round Delphi approach was employed. Round Two required participants to enter the REDCap portal to rank and comment on statements about midwifery ethics that were derived from qualitative data collected and thematically analysed in Round One. FINDING: Fourteen characteristics captured in four domains were developed from the study that describe what midwives perceive ethical midwifery and maternity care to be. The four domains are: Midwifery ethics are founded in midwifery philosophy, Midwifery ethics as relational Care, Midwifery ethics are embodied (lived or intrinsic), Midwifery ethics demonstrate advocacy. CONCLUSION: The domains and characteristics of midwifery ethics provide insights into midwives' unique ethical practices and represent foundational information to inform the practical application of midwifery ethics. The participants' perceptions and experiences demonstrate a deeply rooted desire for a midwifery ethics construct that is underpinned by midwifery philosophy, focused on reproductive justice, and is aligned to and demonstrates solidarity with women's autonomy in childbearing and more broadly
Adding Weight to the Evidence:MMP-9 as a Predictor of COPD Development
No full textSee related article.</p
Immune-mediated dilated cardiomyopathy:Next steps towards targeted immunotherapy
No full textImmune-mediated dilated cardiomyopathies (DCM) are heart muscle diseases in which immune processes lead to or contribute to the development, maintenance, or progression of heart muscle disease. This thesis examines the societal impact of these variants of DCM, studies new immunotherapies, and investigates which patients may benefit from these immunotherapies. We show that patients with immune-mediated DCM have a poorer quality of life and generate higher societal costs. This thesis cites several examples of immunotherapies that could be used in the near future or later for DCM, such as therapies against cytotoxic T cells or against interleukins 1, 6, or 17
Innovations in targeted and untargeted spatial omics
Get PDFThis thesis explores new ways to study biology by looking more closely at the building blocks of life called molecules inside our cells and tissues. The main tool used in mass spectrometry imaging (MSI) which can detect many different types of molecules and localise them all at once. The work looks at two main approaches: one that gives a wide view of multiple different molecules at once and another that focuses only on a few selected molecules. As part of the thesis, new methods for utilising these approaches are presented, such as using MSI to study sugars in tissue, a new method (MALDI-IHC) to look at specific proteins, and ways to make these methods work on single cells. Overall, this thesis shows how MSI is a powerful tool for mapping biology and can help us better understand the molecular details that contribute to both health and disease
Capital Adjustment, Technology Vintages and Training: Role of capital investment spikes in firm’s skill formation strategy
No full textWe study how investment spikes in technologies and complementary infrastructure influence firms’ hiring and training strategies. While prior work emphasizes how technologies reallocate skill demand, few focus on how firms acquire the required skills. Using linked employer-employee data on German establishments, we identify spikes by their technological composition and capital vintages. Event study estimates show that investment spikes in ICT and production line technologies lead to an upscaling effect raising employment by external hiring followed by training of young apprentices. Combining technologies with factories and plants induces firms to use apprenticeship training without an increase in external hiring. Incumbent workers are trained when investment spikes renew the vintage of firm’s capital. Our findings support a vintage human capital framework in which technology adoption induces firms to gradually adjust workforce through hiring and training while preserving expertise of incumbent workers
Proceedings of the 8th International Workshop on Semantic Web Solutions for Large-scale Biomedical Data Analytics - SeWebMeDa-2025
No full textThis preface summarises the 8th International Workshop on Semantic Web Solutions for Large-scale Biomedical Data Analytics (SeWebMeDa-2025), a co-event with The ESWC 2025: Extended Semantic Web Conference, held on June 1st 2025, in Portorož, Slovenia