88 research outputs found
Hypertension and renal failure prevention and management after cancer therapy
No full textNo abstract available
Vascular toxicities with VEGF inhibitor therapies-focus on hypertension and arterial thrombotic events
No full textThe vascular endothelial growth factor (VEGF) signaling pathway (VSP) fulfills a cardinal role in endothelial cells and its inhibition has profound cardiovascular impact. This is true not only for the normal vasculature but also for the tumor vasculature when VSP inhibitors are used as anti-angiogenic therapies. Generalized endothelial dysfunction predisposes to vasoconstriction, atherosclerosis, platelet activation, and thrombosis (arterial more than venous). All of these have been reported with VSP inhibitors and collectively give rise to vascular toxicities, the most concerning of which are arterial thromboembolic events (ATE). VSP inhibitors include antibodies, acting extracelluarly on VEGF, such as bevacizumab and tyrosine kinases inhibitors, acting intracellularly on the kinase domain of VEGF receptors, such as sunintib and sorafenib. The addition of bevacizumab and VSP tyrosine kinase inhibitor therapy to the cancer treatment regimen is associated with a 1.5–2.5-fold and 2.3–4.6-fold increase risk of ATEs, respectively. Risk factors for ATEs while on VSP inhibitor therapy include age older than 65 years, previous thromboembolic events, history of atherosclerotic disease, and duration of VSP inhibitor therapy. In clinical practice, hypertension remains the most commonly noted vascular manifestation of VSP inhibition. Optimal blood pressure goals and preferred therapeutic strategies toward reaching these goals are not defined at present. This review summarizes current data on this topic and proposes a more intensive management approach to patients undergoing VSP inhibitor therapy including Systolic Blood PRessure Intervention Trial (SPRINT) blood pressure goals, pleiotropic vasoprotective agents such as angiotensin converting enzyme inhibitors, amlodipine, and carvedilol, high-dose statin therapy, and aspirin
Margins of international banking: is there a productivity pecking order in banking, too?
No full textModern trade theory emphasizes firm-level productivity differentials to explain the cross-border activities of non-financial firms. This study tests whether a productivity pecking order also determines international banking activities. Using a novel dataset that contains all German banks' international activities, we estimate the ordered probability of a presence abroad (extensive margin) and the volume of international assets (intensive margin). Methodologically, we enrich the conventional Heckman selection model to account for the self-selection of banks into different modes of foreign activities using an ordered probit. Four main findings emerge. First, similar to results for non-financial firms, a productivity pecking order drives bank internationalization. Second, only a few non-financial firms engage in international trade, but many banks hold nternational assets, and only a few large banks engage in foreign direct investment. Third, in addition to productivity, risk factors matter for international banking. Fourth, gravity-type variables have an important impact on international banking activities. --International banking,extensive and intensive margin,productivity pecking order,ordered probit,selection models
Managing processes and information technology in mergers - the integration of finance processes and systems
No full textMany companies use mergers to achieve their growth goals or target technology position. To realise synergies that justify the merger transaction, an integration of the merged companies is often necessary. Such integartion takes place across company business areas (such as finance or sales) and across the layers of management consideration, which are strategy, human resources, organisation, processes, and information technology.
In merger integration techniques, there is a significant gap regarding the management of operational level issues. Yet, especially for the finance business area, an integration of processes and information technology is of high importance and often required swiftly after the merger. The author therefore presents an approach designed for managing the operational level merger in the finance business area.
To close the gap in considering operational level issues, the author has developed a model for integraring finance processes and information technology of merging companies. For such model development, literature resources have been used along with merger experiences of the author, and interviews with merger experts. Validation of the developed model has been conducted by using in-depth case studies for showing the effects of applying the model. Further validation interviews have been conducted to support the generality of the approach.
Accommodating the significant increase of task complexity during mergers compared to normal business operation, the presented approach focuses on managing interdependencies instead of project detail. Features of this approach comprise:
An organisational proposal to settinmg up merger programme management;
An interdependency model, vertically interconnecting the finance business area with strategic and organisational merger decisions, and horizontally interconnecting the finance business area with other business areas.
It could be shown that the presented model improves merger integration quality by reducing complexity of merger management. The model is most applicable for larger companies, and can be used in any merger phase
Gait Variability and Kinematic Alterations in People with Diabetes Mellitus and Peripheral Neuropathy
No full textBackground: People with diabetes and peripheral neuropathy have been reported to show alterations in lower limb joint function compared to healthy non-diabetic people. Specifically the maximum angular movement available at certain joints can be reduced during static, non-weight bearing tasks. Limited joint range of motion has the potential to compromise balance and stability thereby increasing the risk of falling. It is unclear whether a reduction in the extent of movement available at the joints is reflected by a reduction in the amount of angular movement actually utilised during a functional task such as stair negotiation. The aim of this study was to determine if people with diabetes show reduced dynamic range of motion at the ankle, knee and hip joints during stair ascent and descent in comparison to controls. Falls risk during stair negotiation was calculated by measuring the degree of variability in dynamic joint range of motion. Methods: Data were generated from three groups: subjects with diabetes and peripheral neuropathy (DPN), diabetes without peripheral neuropathy (DM), and healthy controls (Ctl). The study was conducted in a gait laboratory using motion capture and related 3D software for analysis. Joint range of motion for the ankle, knee, and hip were captured during level walking, stair ascent, and descent. A seven step, bespoke staircase was fabricated for this purpose. Analysis of Variance (ANOVA) and Newman-Keuls tests were used to analyse the data. Results: Significantly reduced ankle range of motion, in the sagittal plane, was observed in the DPN group during stair ascent when compared to the controls. For stair descent, the DPN group demonstrated a significant increase in knee and hip ROM in the frontal plane, and also hip ROM in the transverse plane. No significant differences between the groups were identified for joint variability. Conclusions: People with DPN demonstrate alterations in dynamic range of motion at the lower limb joints during stair ascent and descent. The degree of angular movement utilised for both stair tasks was decreased at the ankle joint and this has the potential to undermine balance and stability. In contrast, angular movement at the knee and hip joints was increased in the frontal and transverse planes. This may compensate for impaired balance and stability by increasing the base of support to maintain balance and assist in foot clearance and placement. The specific combination of increased angular movement at the knee and hip may represent a compensatory stair gait strategy in response to reduced angular movement at the ankle joint
The characterization of adaptor protein homologues in Plasmodium falciparum
No full textIncludes abstract.Includes bibliographical references (leaves 148-171).Plasmodium falciparum is becoming increasingly more resistant to regular antimalarial drugs, making it necessary to identify novel drug candidates and drug targets. Components of the endocytic and secretory pathway in asexual stage parasites are attractive targets because they play a fundamental role in the normal processes of parasite metabolism. Adaptor protein complexes are components of protein coats that associate with transport vesicles of the endocytic and secretory pathways in mammalian cells. Homologues of several adaptor protein subunits are encoded by the parasite genome. The presence of these genes suggests that the parasite experiences clathrin-mediated transport processes. This study reports the cloning and characterization of selected malarial homologues of these adaptor proteins, namely three medium (μ) chain adaptin homologues and two sigma (σ) chains
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Sentinel plot surveillance of cotton leaf curl disease in Pakistan- a case study at the cultivated cotton-wild host plant interface
No full textA sentinel plot case study was carried out to identify and map the distribution of begomovirus-betasatellite complexes in sentinel plots and commercial cotton fields over a four-year period using molecular and high-throughput DNA ‘discovery’ sequencing approaches. Samples were collected from 15 study sites in the two major cotton-producing areas of Pakistan. Whitefly- and leafhopper-transmitted geminiviruses were detected in previously unreported host plant species and locations. The most prevalent begomovirus was cotton leaf curl Kokhran virus-Burewala (CLCuKoV-Bu). Unexpectedly, a recently recognized recombinant, cotton leaf curl Multan virus-Rajasthan (CLCuMuV-Ra) was prevalent in five of 15 sites. cotton leaf curl Alabad virus (CLCuAlV) and cotton leaf curl Kokhran virus-Kokhran, ‘core’ members of CLCuD-begomoviruses that co-occurred with CLCuMuV in the ‘Multan’ epidemic were detected in one of 15 sentinel plots. Also identified were chickpea chlorotic dwarf virus and ‘non-core’ CLCuD-begomoviruses, okra enation leaf curl virus, squash leaf curl virus, and tomato leaf curl New Delhi virus. Cotton leaf curl Multan betasatellite (CLCuMuB) was the most prevalent CLCuD-betasatellite, and less commonly, two ‘non-core’ betasatellites. Recombination analysis revealed previously uncharacterized recombinants among helper virus-betasatellite complexes consisting of CLCuKoV, CLCuMuV, CLCuAlV and CLCuMuB. Population analyses provided early evidence for CLCuMuV-Ra expansion and displacement of CLCuKoV-Bu in India and Pakistan from 2012-2017. Identification of ‘core’ and non-core CLCuD-species/strains in cotton and other potential reservoirs, and presence of the now predominant CLCuMuV-Ra strain are indicative of ongoing diversification. Investigating the phylodynamics of geminivirus emergence in cotton-vegetable cropping systems offers an opportunity to understand the driving forces underlying disease outbreaks and reconcile viral evolution with epidemiological relationships that also capture pathogen population shifts. © 2023 The Author(s)Open access articleThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
Long-term efficacy of repeated daily prefrontal transcranial magnetic stimulation (TMS) in treatmnt-resistant depression
No full textBackground A few studies have examined the durability of transcranial magnetic stimulation (TMS) antidepressant benefit once patients remitted. This study examined the long-term durability of clinical benefit from TMS using a protocol-specified TMS taper and either continuation pharmacotherapy or naturalistic follow-up. Methods Patients were remitters from an acute double-blind sham-controlled trial of TMS (n = 18), or from an open-label extension in patients who did not respond to the acute trial (n = 43). Long-term durability of TMS acute effect was examined in remitters over a 12-week follow-up. Relapse, defined as 24-item Hamilton Depression Rating Scale (HDRS-24) ≥20, was the primary outcome. Results Of 61 remitters in the acute trial, five entered naturalistic follow-up and 50 entered the TMS taper. Thirty-two patients completed TMS taper and 1-, 2-, and 3-month follow-up. At 3-month visit, 29 of 50 (58percent) were classified as in remission (HDRS-24 ≤10), two of 50 (4percent) as partial responders (30percenta;circ HDRS-24 reduction 50percent from baseline), and one of 50 (2percent) met criteria for relapse. During the entire 3-month follow-up, five of the 37 patients relapsed (relapse rate = 13.5percent), but four of them regained remission by the end of the study. The average time to relapse in these five patients was 7.2 ± 3.3 weeks. Patients who relapsed had higher depression scores at 1 month. Conclusions While one third of the sample was lost to follow-up, our results demonstrate that most patients contributing to observations experienced persistence of benefit from TMS followed by pharmacotherapy or no medication. Longer follow-up and more rigorous studies are needed to explore the true long-term durability of remission produced by TMS. © 2012 Wiley Periodicals, Inc.Burt T, 2002, INT J NEUROPSYCHOPH, V5, P73, DOI 10.1017-S1461145702002791; Cohen RB, 2009, DEPRESS ANXIETY, V26, P682, DOI 10.1002-da.20486; Couturier JL, 2005, J PSYCHIATR NEUROSCI, V30, P83; Dannon PN, 2002, BIOL PSYCHIAT, V51, P687, DOI 10.1016-S0006-3223(01)01274-4; Demirtas-Tatlidede A, 2008, J CLIN PSYCHIAT, V69, P930; Fitzgerald PB, 2006, AUST NZ J PSYCHIAT, V40, P764, DOI 10.1080-j.1440-1614.2006.01881.x; Freitas C, 2011, NEUROCASE, V25, P1; George MS, 2010, ARCH GEN PSYCHIAT, V67, P507, DOI 10.1001-archgenpsychiatry.2010.46; HAMILTON M, 1967, BRIT J SOC CLIN PSYC, V6, P278; Herrmann Lucie L, 2006, J Clin Psychiatry, V67, P1870; Hoencamp E, 2000, J CLIN PSYCHOPHARM, V20, P538, DOI 10.1097-00004714-200010000-00008; Holtzheimer Paul E, 2008, Curr Psychiatry Rep, V10, P465; Holtzheimer P E 3rd, 2001, Psychopharmacol Bull, V35, P149; Janicak PG, 2010, BRAIN STIMUL, V3, P187, DOI 10.1016-j.brs.2010.07.003; Kellner CH, 2006, ARCH GEN PSYCHIAT, V63, P1337, DOI 10.1001-archpsyc.63.12.1337; Langguth B, 2006, J CLIN PSYCHIAT, V67, P835; Lisanby SH, 2009, NEUROPSYCHOPHARMACOL, V34, P522, DOI 10.1038-npp.2008.118; Martin JLR, 2003, BRIT J PSYCHIAT, V182, P480, DOI 10.1192-bjp.182.6.480; McDonald WM, 2011, DEPRESS ANXIETY, V28, P973, DOI 10.1002-da.20885; O'Reardon JP, 2005, J CLIN PSYCHIAT, V66, P1524; O'Reardon JP, 2007, BIOL PSYCHIAT, V62, P1208, DOI 10.1016-j.biopsych.2007.01.018; Padberg F, 2009, EXP NEUROL, V219, P2, DOI 10.1016-j.expneurol.2009.04.020; Prudic J, 1996, AM J PSYCHIAT, V153, P985; Rush AJ, 2006, AM J PSYCHIAT, V163, P1905, DOI 10.1176-appi.ajp.163.11.1905; SACKEIM HA, 1990, J CLIN PSYCHOPHARM, V10, P96, DOI 10.1097-00004714-199004000-00004; Sackeim Harold A., 2001, Journal of Clinical Psychiatry, V62, P10; Schutter DJLG, 2009, PSYCHOL MED, V39, P65, DOI 10.1017-S0033291708003462; Slotema CW, 2010, J CLIN PSYCHIAT, V71, P873, DOI 10.4088-JCP.08m04872gre; Thase ME, 2001, BRIT J PSYCHIAT, V178, P234, DOI 10.1192-bjp.178.3.23468
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