The present ex vivo study evaluated the influence of periodontal ligament simulation, load inclination, and tip morphology on fracture strength test results on intact premolars. Forty maxillary premolars were divided into four groups, Group 1, with a 90° load inclination, spherical tip with a diameter of 3mm and periodontal ligament simulation (PDL+); Group 2, with a 90° load inclination, flat tip with a diameter of 2mm, PDL+; Group 3, with a 45° load inclination, flat tip with 2mm of diameter, PDL+; Group 4, 90° load inclination, spherical tip with 3mm diameter, without periodontal ligament reproduction. Interactions among variables and intergroup significance were tested with Wilcoxon rank-sum and Kruskal Wallis’s tests (p≤0.05). Statistically significant differences were found between groups B and C, but they were not found for the others. A 90° load inclination significantly increases fracture strength, while periodontal ligament simulation and tip morphology did not significantly influence the results.
{"title":"Influence of Methodological Variables on Fracture Strength Test Results of Intact Premolars: an ex-vivo study","authors":"Carlo Gaeta, Giulia Malvicini, Emanuele Mignosa, Gianmarco Cecot, Simone Grandini, Crystal Marruganti","doi":"10.18103/mra.v11i9.4217","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4217","url":null,"abstract":"The present ex vivo study evaluated the influence of periodontal ligament simulation, load inclination, and tip morphology on fracture strength test results on intact premolars. Forty maxillary premolars were divided into four groups, Group 1, with a 90° load inclination, spherical tip with a diameter of 3mm and periodontal ligament simulation (PDL+); Group 2, with a 90° load inclination, flat tip with a diameter of 2mm, PDL+; Group 3, with a 45° load inclination, flat tip with 2mm of diameter, PDL+; Group 4, 90° load inclination, spherical tip with 3mm diameter, without periodontal ligament reproduction. Interactions among variables and intergroup significance were tested with Wilcoxon rank-sum and Kruskal Wallis’s tests (p≤0.05). Statistically significant differences were found between groups B and C, but they were not found for the others. A 90° load inclination significantly increases fracture strength, while periodontal ligament simulation and tip morphology did not significantly influence the results.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135909855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
John Robertson, Amr Issa, Mariana Gomez, Kathleen Sullivan, Ryan Senger
Background: Many systemic and urinary tract diseases alter renal structure and function, including changing the composition of urine. While routine urinalysis (physical properties, sediment evaluation, urine chemistry analytes) is useful in screening, it has limitations on separating disease processes, structural changes, and functional abnormalities. Likewise, while many individual ‘biomarkers’ have been used to screen for disease, they have not met with widespread clinical adoption. The recent COVID19 Pandemic and the recognition of post-acute sequelae SARS-CoV-2 infection (PASC) have highlighted the need for rapid, scalable, economical, and accurate screening tools for managing disease. Aims: Validate a Raman spectroscopy-based screening technology for urine analysis that could be used for recognition and quantification of systemic and renal effects of acute and PASC COVID19 disease. Methods: One hundred ten (110) urine specimens were obtained from consented adults diagnosed with COVID19 disease by RT-PCR and/or proximate (household) contact With RT-PCR-confirmed COVID19 disease. Samples were analyzed using Raman chemometric urinalysis, a technology that detects hundreds of discrete chemicals in urine and applies computational comparison-machine learning to detect COVID19-associated molecular patterns (‘fingerprints’). Results: When compared with the urine multimolecular ‘fingerprints’ of healthy individuals and patients with known systemic diseases (diabetes mellitus, lupus) that alter renal structure and function, patients with acute and PASC COVID19 had unique ‘fingerprints’ indicative of alterations in renal function (i.e. – infection altered urine composition). Differences in disease severity (mild to severe) were reflected by different ‘fingerprints’ in urine. Roughly 20% of hospitalized patients developed a degree of renal dysfunction (decrements in eGFR) that were correlated with distinct changes in urine fingerprints. Conclusion: Raman chemometric urinalysis may be a useful tool in management of patients with COVID19 disease, particularly in detecting patients with evolving renal dysfunction for whom there should be attention to medication use and renal health restoration/preservation.
{"title":"Profiling renal dysfunction using Raman chemometric urinalysis, with special reference to COVID19, lupus nephritis, and diabetic nephropathy","authors":"John Robertson, Amr Issa, Mariana Gomez, Kathleen Sullivan, Ryan Senger","doi":"10.18103/mra.v11i9.4384","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4384","url":null,"abstract":"Background: Many systemic and urinary tract diseases alter renal structure and function, including changing the composition of urine. While routine urinalysis (physical properties, sediment evaluation, urine chemistry analytes) is useful in screening, it has limitations on separating disease processes, structural changes, and functional abnormalities. Likewise, while many individual ‘biomarkers’ have been used to screen for disease, they have not met with widespread clinical adoption. The recent COVID19 Pandemic and the recognition of post-acute sequelae SARS-CoV-2 infection (PASC) have highlighted the need for rapid, scalable, economical, and accurate screening tools for managing disease. Aims: Validate a Raman spectroscopy-based screening technology for urine analysis that could be used for recognition and quantification of systemic and renal effects of acute and PASC COVID19 disease. Methods: One hundred ten (110) urine specimens were obtained from consented adults diagnosed with COVID19 disease by RT-PCR and/or proximate (household) contact With RT-PCR-confirmed COVID19 disease. Samples were analyzed using Raman chemometric urinalysis, a technology that detects hundreds of discrete chemicals in urine and applies computational comparison-machine learning to detect COVID19-associated molecular patterns (‘fingerprints’). Results: When compared with the urine multimolecular ‘fingerprints’ of healthy individuals and patients with known systemic diseases (diabetes mellitus, lupus) that alter renal structure and function, patients with acute and PASC COVID19 had unique ‘fingerprints’ indicative of alterations in renal function (i.e. – infection altered urine composition). Differences in disease severity (mild to severe) were reflected by different ‘fingerprints’ in urine. Roughly 20% of hospitalized patients developed a degree of renal dysfunction (decrements in eGFR) that were correlated with distinct changes in urine fingerprints. Conclusion: Raman chemometric urinalysis may be a useful tool in management of patients with COVID19 disease, particularly in detecting patients with evolving renal dysfunction for whom there should be attention to medication use and renal health restoration/preservation.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135952957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For the first time in human history, we encounter global limits of essential resources and are being challenged by the consequences of man-made climate change, reduced biodiversity and pollution by chemical substances. Feeding the extra 5.5 billion urban people in this century requires transformation of the present unsustainable agrifood system. Residents can take part in this transformation by changing to healthy diets, recycle food waste and come closer to the food markets, while public and private sectors could look for innovative ways to produce food and to design city infrastructure and buildings that will enhance recycling of limited resouces and reduce environmental foot prints. Global data are forthcoming on resources and on causes of human and environmental ill heatlh, making it possible to conjure future resources restrictions and imbalances of nutrients. Today, the global agrifood system contributes more than a quarter of the global GHG emissions, four-fifth of eutrophication and more than nine-tenth of biodiversity losses. Revised diets, reduced food waste and soilless food production will significantly shrink agricultural land use – and proportionally reduce greenhouse gas emissions and biodiversity losses. Emerging infrastructure and technologies in combination with recycling of nutrients can close the resource gaps by halving the global demand for fertilisers and still feed the world.
{"title":"Living The Future: Who Can Do What to Improve Human and Environmental Health While Securing Nutritious Food?","authors":"Jan Drangert","doi":"10.18103/mra.v11i9.4361","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4361","url":null,"abstract":"For the first time in human history, we encounter global limits of essential resources and are being challenged by the consequences of man-made climate change, reduced biodiversity and pollution by chemical substances. Feeding the extra 5.5 billion urban people in this century requires transformation of the present unsustainable agrifood system. Residents can take part in this transformation by changing to healthy diets, recycle food waste and come closer to the food markets, while public and private sectors could look for innovative ways to produce food and to design city infrastructure and buildings that will enhance recycling of limited resouces and reduce environmental foot prints. Global data are forthcoming on resources and on causes of human and environmental ill heatlh, making it possible to conjure future resources restrictions and imbalances of nutrients. Today, the global agrifood system contributes more than a quarter of the global GHG emissions, four-fifth of eutrophication and more than nine-tenth of biodiversity losses. Revised diets, reduced food waste and soilless food production will significantly shrink agricultural land use – and proportionally reduce greenhouse gas emissions and biodiversity losses. Emerging infrastructure and technologies in combination with recycling of nutrients can close the resource gaps by halving the global demand for fertilisers and still feed the world.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135952970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction The TBICheck TM Rapid test is an immunochromatographic rapid test capable of assisting in the triage of patients with mild Traumatic Brain Injury (mTBI) suspected of brain lesions. It quantitatively determines heart-type Fatty Acid Binding Protein (H-FABP) levels in whole blood, serum, or plasma. The aim of the present study was to evaluate its technical performance and test it in two different cohorts of mTBI patients as a potential diagnostic tool for detecting brain lesions in patients with mTBI. Material and methods Description of the assay: Linearity and low limit of quantification (LLOQ) of TBICheck TM lateral flow assay were determined using serial dilution of standardized samples. Results were read using the TBICheck TM Reader, a mobile photometric immunoassay analyzer based on reflectance measurements to capture the optical density. Obtained results were compared to classical ELISA assays, Meso Scale Diagnostics (MSD). Patient cohorts: Two different cohorts of adult mTBI patients were included: a retrospective one including 82 patients and a prospective one including 65 patients. Values of H-FABP area under the curve (AUC), specificity (SP), sensitivity (SE) and negative predictive value (NPV) were calculated. Results The H-FABP dose response fitted a linear regression within the range of 0.5-25 ng/mL. LLOQ in blood was 0.5 ng/mL. High Spearman correlation was found (ρ=0.933, p<0.001) when MSD ELISA and TBICheck TM concentrations were compared. In the retrospective cohort, when the clinical sensitivity was set at 100%, a specificity value of 32.9% was obtained. In the prospective cohort, the SP value raised to 66.1% with 100% SE, meaning that 6 out of 10 patients might be discharged on the basis of their serum H-FABP concentration at hospital admission. Conclusions The quantification of H-FABP by using the TBICheck TM Rapid test on adult mTBI patients may allow to rule out the need of a CT-scan reducing the radiation exposure and avoiding the long waiting times in emergency units. It may lead to savings in hospital resources and assists medical doctors to provide the most appropriate treatment to the patients.
{"title":"TBICheck: a rapid test to rule-out CT scans in mild Traumatic Brain Injury patients","authors":"Jean-Charles Sanchez","doi":"10.18103/mra.v11i9.4297","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4297","url":null,"abstract":"Introduction The TBICheck TM Rapid test is an immunochromatographic rapid test capable of assisting in the triage of patients with mild Traumatic Brain Injury (mTBI) suspected of brain lesions. It quantitatively determines heart-type Fatty Acid Binding Protein (H-FABP) levels in whole blood, serum, or plasma. The aim of the present study was to evaluate its technical performance and test it in two different cohorts of mTBI patients as a potential diagnostic tool for detecting brain lesions in patients with mTBI. Material and methods Description of the assay: Linearity and low limit of quantification (LLOQ) of TBICheck TM lateral flow assay were determined using serial dilution of standardized samples. Results were read using the TBICheck TM Reader, a mobile photometric immunoassay analyzer based on reflectance measurements to capture the optical density. Obtained results were compared to classical ELISA assays, Meso Scale Diagnostics (MSD). Patient cohorts: Two different cohorts of adult mTBI patients were included: a retrospective one including 82 patients and a prospective one including 65 patients. Values of H-FABP area under the curve (AUC), specificity (SP), sensitivity (SE) and negative predictive value (NPV) were calculated. Results The H-FABP dose response fitted a linear regression within the range of 0.5-25 ng/mL. LLOQ in blood was 0.5 ng/mL. High Spearman correlation was found (ρ=0.933, p<0.001) when MSD ELISA and TBICheck TM concentrations were compared. In the retrospective cohort, when the clinical sensitivity was set at 100%, a specificity value of 32.9% was obtained. In the prospective cohort, the SP value raised to 66.1% with 100% SE, meaning that 6 out of 10 patients might be discharged on the basis of their serum H-FABP concentration at hospital admission. Conclusions The quantification of H-FABP by using the TBICheck TM Rapid test on adult mTBI patients may allow to rule out the need of a CT-scan reducing the radiation exposure and avoiding the long waiting times in emergency units. It may lead to savings in hospital resources and assists medical doctors to provide the most appropriate treatment to the patients.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135953821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dialysis plastic waste is a growing problem in India, with an estimated 3 million kilograms generated each year. Effective disposal of dialysis plastic waste is not uniformly addressed, and there is a need for sustainable solutions. This study evaluated a plastic pebble model made from surrogate plastic equivalent to twice that generated during dialysis. The model was evaluated for its potential to offset dialysis plastic waste and its role in achieving sustainability in dialysis. Additionally, the model was used to advocate for and carry forward a campaign for plastic neutrality in dialysis. The amount of dialysis plastic waste generated in one month by 25 patients was quantified. The sinkable plastic pebble aggregate model was created by purchasing waste plastic, double the quantity of calculated DPW, from the market. The purchased plastic was then repurposed into sinkable plastic pebble aggregate to mimic blue metal. Various sample products were made in the form of slabs and bricks using sinkable plastic pebble aggregate, and compared to those made from blue metal and fired bricks. The stability and strength of the different products were compared, and the costs were analysed. The methodology was further used for advocacy and to campaign for plastic neutrality. The results showed that the sinkable plastic pebble aggregate model is a feasible and effective way to reduce plastic waste in dialysis. It is cost-effective, contributes to a circular economy, and helps reduce mining for blue metal and fertile soil for bricks. The model can also advocate for the use of plastic-neutral materials in dialysis to reduce environmental pollution. To conclude Sinkable plastic pebble surrogate model is a promising solution for offsetting plastic waste in dialysis. It is cost-effective, environmentally friendly, and it helps to campaign for plastic neutrality in dialysis. Further study is needed to assess its impact on a larger scale.
{"title":"A Model for Plastic Neutrality in Dialysis: Converting Surrogate Plastic Waste to Sinkable Pebbles","authors":"Palani Ravichandran","doi":"10.18103/mra.v11i9.4380","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4380","url":null,"abstract":"Dialysis plastic waste is a growing problem in India, with an estimated 3 million kilograms generated each year. Effective disposal of dialysis plastic waste is not uniformly addressed, and there is a need for sustainable solutions. This study evaluated a plastic pebble model made from surrogate plastic equivalent to twice that generated during dialysis. The model was evaluated for its potential to offset dialysis plastic waste and its role in achieving sustainability in dialysis. Additionally, the model was used to advocate for and carry forward a campaign for plastic neutrality in dialysis. The amount of dialysis plastic waste generated in one month by 25 patients was quantified. The sinkable plastic pebble aggregate model was created by purchasing waste plastic, double the quantity of calculated DPW, from the market. The purchased plastic was then repurposed into sinkable plastic pebble aggregate to mimic blue metal. Various sample products were made in the form of slabs and bricks using sinkable plastic pebble aggregate, and compared to those made from blue metal and fired bricks. The stability and strength of the different products were compared, and the costs were analysed. The methodology was further used for advocacy and to campaign for plastic neutrality. The results showed that the sinkable plastic pebble aggregate model is a feasible and effective way to reduce plastic waste in dialysis. It is cost-effective, contributes to a circular economy, and helps reduce mining for blue metal and fertile soil for bricks. The model can also advocate for the use of plastic-neutral materials in dialysis to reduce environmental pollution. To conclude Sinkable plastic pebble surrogate model is a promising solution for offsetting plastic waste in dialysis. It is cost-effective, environmentally friendly, and it helps to campaign for plastic neutrality in dialysis. Further study is needed to assess its impact on a larger scale.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"300 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135954310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and aim: Diabetes Type 2 is a non-communicable disease which is characterized by chronic hyperglycaemia and disruption of metabolism. A poor management of diabetes leads to serious cardiovascular and neural complications. The prevalence of Diabetes Type 2 is increasing globally; in the United Kingdom, the number of people living with a diabetes increased by more than 100,000 from 2018 to 20191. In 2019, 3,9 million people had diagnosis of diabetes, and predictions are that this number will increase to 5,3 million in 2025. The aim of this research is to examine the main contributing factors and their influence on the prevalence of Diabetes Type 2 among people aged 17+ in England based on the routine epidemiological data for 2017-2022 years. Additionally, this research will analyze trends for hospital admissions with the diagnosis of Diabetes Type 2 and diabetes mortality statistics. Methods: The Pearson’s and the Spearman’s correlation analyses are used to investigate possible associations, their strength, monotonicity and direction between the prevalence of diabetes, deprivation, low physical activity, obesity and density of fast food outlets. Stratified random sampling of 153 England counties & unitary authorities (the division of 2017) are used for the statistical analysis. A comparative analysis is used to analyze trends for hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality statistics. Descriptive statistics and quantitative analysis of secondary routine numerical data collected by the National Health Service Digital, the National Health Survey and the Office for Health Improvement & Disparities is used. Findings: The analysis revealed positive correlations between the prevalence of diabetes and indicators of deprivation, obesity, low physical activity. In general, diabetes, obesity and physically inactive adults are more prevalent in counties with higher deprivation score. The strong positive correlation was found between density of fast food outlets and deprivation; the analysis of mean values indicated a positive linear relationships between obesity, diabetes indicators and density of fast food outlets. The comparative analysis revealed an upward trend for both, hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality. Conclusion: In conclusion, analysis based on 80 counties & unitary authorities of England indicated that the main contributing factors for the increasing trend of Diabetes Type 2 can be the increasing prevalence of overweight and obese adults, low physical activity and deprivation. Additionally, the analysis demonstrated that the availability and abundance of fast food outlets, especially in more deprived deciles of England are closely associated with obesity and indirectly with the prevalence of Diabetes Type 2. Additionally, an increasing trend in the prevalence of Diabetes Type 2 is accompanied by a similar growth of hospital admissions with the diagno
{"title":"The analysis of the main contributing factors for the increasing trend of Diabetes Type 2, diabetes morbidity and mortality trends in England, 2017-2022.","authors":"Anzhelika Magomedova","doi":"10.18103/mra.v11i9.4403","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4403","url":null,"abstract":"Background and aim: Diabetes Type 2 is a non-communicable disease which is characterized by chronic hyperglycaemia and disruption of metabolism. A poor management of diabetes leads to serious cardiovascular and neural complications. The prevalence of Diabetes Type 2 is increasing globally; in the United Kingdom, the number of people living with a diabetes increased by more than 100,000 from 2018 to 20191. In 2019, 3,9 million people had diagnosis of diabetes, and predictions are that this number will increase to 5,3 million in 2025. The aim of this research is to examine the main contributing factors and their influence on the prevalence of Diabetes Type 2 among people aged 17+ in England based on the routine epidemiological data for 2017-2022 years. Additionally, this research will analyze trends for hospital admissions with the diagnosis of Diabetes Type 2 and diabetes mortality statistics. Methods: The Pearson’s and the Spearman’s correlation analyses are used to investigate possible associations, their strength, monotonicity and direction between the prevalence of diabetes, deprivation, low physical activity, obesity and density of fast food outlets. Stratified random sampling of 153 England counties & unitary authorities (the division of 2017) are used for the statistical analysis. A comparative analysis is used to analyze trends for hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality statistics. Descriptive statistics and quantitative analysis of secondary routine numerical data collected by the National Health Service Digital, the National Health Survey and the Office for Health Improvement & Disparities is used. Findings: The analysis revealed positive correlations between the prevalence of diabetes and indicators of deprivation, obesity, low physical activity. In general, diabetes, obesity and physically inactive adults are more prevalent in counties with higher deprivation score. The strong positive correlation was found between density of fast food outlets and deprivation; the analysis of mean values indicated a positive linear relationships between obesity, diabetes indicators and density of fast food outlets. The comparative analysis revealed an upward trend for both, hospital admissions with the diagnosis Diabetes Type 2 and diabetes mortality. Conclusion: In conclusion, analysis based on 80 counties & unitary authorities of England indicated that the main contributing factors for the increasing trend of Diabetes Type 2 can be the increasing prevalence of overweight and obese adults, low physical activity and deprivation. Additionally, the analysis demonstrated that the availability and abundance of fast food outlets, especially in more deprived deciles of England are closely associated with obesity and indirectly with the prevalence of Diabetes Type 2. Additionally, an increasing trend in the prevalence of Diabetes Type 2 is accompanied by a similar growth of hospital admissions with the diagno","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135954748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Over the past few years, Advanced Therapy Medicinal Products (ATMPs), especially cell and gene therapies, have brought about a remarkable transformation in the field of therapeutics. ATMPs have the potential to be tailored to individual patients based on their distinct molecular characteristics, making them a crucial aspect of personalized medicine (PM) strategies. Unlocking the full potential of ATMPs is crucial for them to become the treatments of the future. Despite their immense promise, their success is hindered by significant complexity, as evidenced by various systemic bottlenecks in the realms of science, clinical implementation, and regulation. Presently, ATMPs face challenges such as a limited understanding and predictability of in vivo cell fate specific to each patient, regulatory issues caused by rapid technological advancements, inadequate standardization in data acquisition, limited reproducibility during preclinical development, and insufficient knowledge exchange among key stakeholders. Addressing these aspects is essential to fully harness the benefits of ATMPs in healthcare. EATRIS, the European Research Infrastructure for Translational Medicine, is actively enhancing its capabilities in the field of PM through a series of key initiatives. These efforts aim to support also ATMP development and are focused on delivering novel and innovative scientific tools for the scientific community. The final aim is to create the right ecosystem for more effective ATMP development in Europe, by better serving academia and industry in the translation of ATMPs for patient benefit.
{"title":"It is time we got more personal with advanced therapies- How do we create the right ecosystem for more effective ATMP development in Europe?","authors":"E. Oldoni, A. Ussi, A. L. Andreu, D. Morrow","doi":"10.18103/mra.v11i9.4322","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4322","url":null,"abstract":"Over the past few years, Advanced Therapy Medicinal Products (ATMPs), especially cell and gene therapies, have brought about a remarkable transformation in the field of therapeutics. ATMPs have the potential to be tailored to individual patients based on their distinct molecular characteristics, making them a crucial aspect of personalized medicine (PM) strategies. Unlocking the full potential of ATMPs is crucial for them to become the treatments of the future. Despite their immense promise, their success is hindered by significant complexity, as evidenced by various systemic bottlenecks in the realms of science, clinical implementation, and regulation. Presently, ATMPs face challenges such as a limited understanding and predictability of in vivo cell fate specific to each patient, regulatory issues caused by rapid technological advancements, inadequate standardization in data acquisition, limited reproducibility during preclinical development, and insufficient knowledge exchange among key stakeholders. Addressing these aspects is essential to fully harness the benefits of ATMPs in healthcare. EATRIS, the European Research Infrastructure for Translational Medicine, is actively enhancing its capabilities in the field of PM through a series of key initiatives. These efforts aim to support also ATMP development and are focused on delivering novel and innovative scientific tools for the scientific community. The final aim is to create the right ecosystem for more effective ATMP development in Europe, by better serving academia and industry in the translation of ATMPs for patient benefit.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135955072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
George Karpouzas, Elizabeth Hernandez, Matthew Budoff, Sarah Ormseth
Objectives. Underweight patients with rheumatoid arthritis incur greater total and cardiovascular mortality compared to overweight or obese. We explored whether obesity confounded cardiovascular risk estimates and the potential utility of noninvasive coronary atherosclerosis assessment and cardiac damage biomarkers in optimizing risk prediction in obese patients with rheumatoid arthritis. Methods. We evaluated 150 participants undergoing screening atherosclerosis evaluation with coronary computed tomography angiography and follow-up over 6.0±2.4 years. Framingham 2008 modified general cardiovascular risk score was computed at baseline. Obesity was defined as waist circumference >88 cm in females and >102 cm in males. Serum highly-sensitive cardiac troponin I (hs-cTnI) and leptin were measured at baseline. Results. An interaction between the Framingham risk score and obesity on cardiovascular risk was observed (p=0.032); lower estimates were seen in obese (area under the curve-AUC 0.660, 95% CI 0.487-0.832) vs. non-obese patients (AUC 0.952, 95% CI 0.897-1.007, p=0.002). Likewise, risk estimates were inferior in patients with high (>22.1 ng/ml) vs. low leptin (AUC 0.618, 95% CI 0.393-0.842 vs. 0.874, 95% CI 0.772-0.976, p=0.042). In obese patients, sequential addition of the top highly-sensitive cardiac troponin I tertile values and extensive atherosclerotic plaque (>5 segments) information to a base model including the Framingham risk score alone significantly improved risk estimates, based on changes in net reclassification index (1.093 95% CI 0.517-1.574), integrated discrimination improvement (0.188, 95% CI 0.060-0.526), and AUC (0.179, 95% CI 0.058-0.378, p=0.02). The final, combined model accurately predicted 83.9% of incident cardiovascular events. Conclusion. Obesity attenuated cardiovascular risk estimate accuracy in patients with rheumatoid arthritis. Risk optimization employing non-invasive assessment of coronary atherosclerosis burden and serum cardiac damage biomarkers may warrant further study.
目标。与超重或肥胖相比，体重过轻的类风湿关节炎患者的总死亡率和心血管死亡率更高。我们探讨了肥胖是否会混淆心血管风险评估，以及无创冠状动脉粥样硬化评估和心脏损伤生物标志物在优化类风湿关节炎肥胖患者风险预测中的潜在应用。方法。我们评估了150名接受冠状动脉计算机断层血管造影筛查动脉粥样硬化评估的参与者，随访时间超过6.0±2.4年。Framingham 2008改良一般心血管风险评分以基线计算。肥胖的定义是女性腰围为88厘米，男性腰围为102厘米。在基线时测定血清高敏感心肌肌钙蛋白I (hs-cTnI)和瘦素。结果。Framingham风险评分与肥胖在心血管风险方面存在交互作用(p=0.032);肥胖患者(曲线下面积-AUC 0.660, 95% CI 0.487-0.832)比非肥胖患者(AUC 0.952, 95% CI 0.897-1.007, p=0.002)的估计值更低。同样，高瘦素(>22.1 ng/ml)患者的风险估计低于低瘦素患者(AUC 0.618, 95% CI 0.393-0.842比0.874,95% CI 0.772-0.976, p=0.042)。在肥胖患者中，根据净重分类指数(1.093 95% CI 0.517-1.574)、综合区分改善(0.188,95% CI 0.060-0.526)和AUC (0.179, 95% CI 0.058-0.378, p=0.02)的变化，将最高的高敏感心肌肌钙蛋白I值和广泛的动脉粥样硬化斑块(>5段)信息依次添加到包括Framingham风险评分在内的基础模型中，显著改善了风险估计。最终的联合模型准确预测了83.9%的心血管事件。结论。肥胖降低类风湿关节炎患者心血管风险评估的准确性。采用无创评估冠状动脉粥样硬化负荷和血清心脏损伤生物标志物的风险优化可能值得进一步研究。
{"title":"The Influence of Abdominal Obesity on the Accuracy of Cardiovascular Risk Prediction in Rheumatoid Arthritis","authors":"George Karpouzas, Elizabeth Hernandez, Matthew Budoff, Sarah Ormseth","doi":"10.18103/mra.v11i9.4432","DOIUrl":"https://doi.org/10.18103/mra.v11i9.4432","url":null,"abstract":"Objectives. Underweight patients with rheumatoid arthritis incur greater total and cardiovascular mortality compared to overweight or obese. We explored whether obesity confounded cardiovascular risk estimates and the potential utility of noninvasive coronary atherosclerosis assessment and cardiac damage biomarkers in optimizing risk prediction in obese patients with rheumatoid arthritis. Methods. We evaluated 150 participants undergoing screening atherosclerosis evaluation with coronary computed tomography angiography and follow-up over 6.0±2.4 years. Framingham 2008 modified general cardiovascular risk score was computed at baseline. Obesity was defined as waist circumference >88 cm in females and >102 cm in males. Serum highly-sensitive cardiac troponin I (hs-cTnI) and leptin were measured at baseline. Results. An interaction between the Framingham risk score and obesity on cardiovascular risk was observed (p=0.032); lower estimates were seen in obese (area under the curve-AUC 0.660, 95% CI 0.487-0.832) vs. non-obese patients (AUC 0.952, 95% CI 0.897-1.007, p=0.002). Likewise, risk estimates were inferior in patients with high (>22.1 ng/ml) vs. low leptin (AUC 0.618, 95% CI 0.393-0.842 vs. 0.874, 95% CI 0.772-0.976, p=0.042). In obese patients, sequential addition of the top highly-sensitive cardiac troponin I tertile values and extensive atherosclerotic plaque (>5 segments) information to a base model including the Framingham risk score alone significantly improved risk estimates, based on changes in net reclassification index (1.093 95% CI 0.517-1.574), integrated discrimination improvement (0.188, 95% CI 0.060-0.526), and AUC (0.179, 95% CI 0.058-0.378, p=0.02). The final, combined model accurately predicted 83.9% of incident cardiovascular events. Conclusion. Obesity attenuated cardiovascular risk estimate accuracy in patients with rheumatoid arthritis. Risk optimization employing non-invasive assessment of coronary atherosclerosis burden and serum cardiac damage biomarkers may warrant further study.","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135955081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite displaying efficacy in experimental stroke studies, neuroprotection has failed in clinical trials. The translational difficulties include a limited methodological agreement between preclinical and clinical studies and the heterogeneity of stroke in humans compared to standardized strokes in animal models. Promising neuroprotective approaches based on a deeper understanding of the complex pathophysiology of ischemic stroke, such as blocking pro-inflammatory pathways plus pro-survival mediators, are now evaluated in preclinical studies. Combinatorial therapy has become increasingly attractive in recent years as recognizing the complexity of stroke progression becomes evident. The paper aimed to test the hypothesis that blocking pro-inflammatory platelet-activating factor receptor (PAF-R) with LAU-0901 plus administering a selected docosanoid, aspirin-triggered neuroprotectin D1 (AT-NPD1), which activates cell-survival pathways after middle cerebral artery occlusion (MCAo), would lead to neurological recovery. We have demonstrated that LAU-0901 plus AT-NPD1 treatment affords high-grade neuroprotection in MCAo, equaling or exceeding that afforded by LAU-0901 or AT-NPD1 alone at considerably moderate doses, and it has a broad therapeutic window extending to 6 hours after stroke onset.
{"title":"Novel Lipid Mediators as a Promising Therapeutic Strategy for Ischemic Stroke.","authors":"Ludmila Belayev, Madigan M Reid, Nicolas G Bazan","doi":"10.18103/mra.v11i1.3333","DOIUrl":"https://doi.org/10.18103/mra.v11i1.3333","url":null,"abstract":"<p><p>Despite displaying efficacy in experimental stroke studies, neuroprotection has failed in clinical trials. The translational difficulties include a limited methodological agreement between preclinical and clinical studies and the heterogeneity of stroke in humans compared to standardized strokes in animal models. Promising neuroprotective approaches based on a deeper understanding of the complex pathophysiology of ischemic stroke, such as blocking pro-inflammatory pathways plus pro-survival mediators, are now evaluated in preclinical studies. Combinatorial therapy has become increasingly attractive in recent years as recognizing the complexity of stroke progression becomes evident. The paper aimed to test the hypothesis that blocking pro-inflammatory platelet-activating factor receptor (PAF-R) with LAU-0901 plus administering a selected docosanoid, aspirin-triggered neuroprotectin D1 (AT-NPD1), which activates cell-survival pathways after middle cerebral artery occlusion (MCAo), would lead to neurological recovery. We have demonstrated that LAU-0901 plus AT-NPD1 treatment affords high-grade neuroprotection in MCAo, equaling or exceeding that afforded by LAU-0901 or AT-NPD1 alone at considerably moderate doses, and it has a broad therapeutic window extending to 6 hours after stroke onset.</p>","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9910361/pdf/nihms-1869923.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10707540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01Epub Date: 2023-01-31DOI: 10.18103/mra.v11i1.3135
Amosy Ephreim M'Koma
<p><p>Inflammatory bowel disease has an enormous impact on public health, medical systems, economies, and social conditions. Biologic therapy has ameliorated the treatment and clinical course of patients with inflammatory bowel disease. The efficacy and safety profiles of currently available therapies are still less that optimal in numerous ways, highlighting the requirement for new therapeutic targets. A bunch of new drug studies are underway in inflammatory bowel disease with promising results. This is an outlined guideline of clinical diagnosis and pharmaceutical therapy of inflammatory bowel disease. Outline delineates the overall recommendations on the modern principles of desirable practice to bolster the adoption of best implementations and exploration as well as inflammatory bowel disease patient, gastroenterologist, and other healthcare provider education. Inflammatory bowel disease encompasses Crohn's disease and ulcerative colitis, the two unsolved medical inflammatory bowel disease-subtypes condition with no drug for cure. The signs and symptoms on first presentation relate to the anatomical localization and severity of the disease and less with the resulting diagnosis that can clinically and histologically be non-definitive to interpret and establish criteria, specifically in colonic inflammatory bowel disease when the establishment is inconclusive is classified as indeterminate colitis. Conservative pharmaceuticals and accessible avenues do not depend on the disease phenotype. The first line management is to manage symptoms and stabilize active disease; at the same time maintenance therapy is indicated. Nutrition and diet do not play a primary therapeutic role but is warranted as supportive care. There is need of special guideline that explore solution of groundwork gap in terms of access limitations to inflammatory bowel disease care, particularly in developing countries and the irregular representation of socioeconomic stratification with a strategic plan, for the unanswered questions and perspective for the future, especially during the surfaced global COVID-19 pandemic caused by coronavirus SARS-CoV2 impacting on both the patient's psychological functioning and endoscopy services. Establishment of a global registry system and accumulated experiences have led to consensus for inflammatory bowel disease management under the COVID-19 pandemic. Painstakingly, the pandemic has influenced medical care systems for these patients. I briefly herein viewpoint summarize among other updates the telemedicine roles during the pandemic and how operationally inflammatory bowel disease centers managed patients and ensured quality of care. In conclusion: inflammatory bowel disease has become a global emergent disease. Serious medical errors are public health problem observed in developing nations i.e., to distinguish inflammatory bowel disease and infectious and parasitic diseases. Refractory inflammatory bowel disease is a still significant chal
{"title":"Inflammatory Bowel Disease: Clinical Diagnosis and Pharmaceutical Management.","authors":"Amosy Ephreim M'Koma","doi":"10.18103/mra.v11i1.3135","DOIUrl":"10.18103/mra.v11i1.3135","url":null,"abstract":"<p><p>Inflammatory bowel disease has an enormous impact on public health, medical systems, economies, and social conditions. Biologic therapy has ameliorated the treatment and clinical course of patients with inflammatory bowel disease. The efficacy and safety profiles of currently available therapies are still less that optimal in numerous ways, highlighting the requirement for new therapeutic targets. A bunch of new drug studies are underway in inflammatory bowel disease with promising results. This is an outlined guideline of clinical diagnosis and pharmaceutical therapy of inflammatory bowel disease. Outline delineates the overall recommendations on the modern principles of desirable practice to bolster the adoption of best implementations and exploration as well as inflammatory bowel disease patient, gastroenterologist, and other healthcare provider education. Inflammatory bowel disease encompasses Crohn's disease and ulcerative colitis, the two unsolved medical inflammatory bowel disease-subtypes condition with no drug for cure. The signs and symptoms on first presentation relate to the anatomical localization and severity of the disease and less with the resulting diagnosis that can clinically and histologically be non-definitive to interpret and establish criteria, specifically in colonic inflammatory bowel disease when the establishment is inconclusive is classified as indeterminate colitis. Conservative pharmaceuticals and accessible avenues do not depend on the disease phenotype. The first line management is to manage symptoms and stabilize active disease; at the same time maintenance therapy is indicated. Nutrition and diet do not play a primary therapeutic role but is warranted as supportive care. There is need of special guideline that explore solution of groundwork gap in terms of access limitations to inflammatory bowel disease care, particularly in developing countries and the irregular representation of socioeconomic stratification with a strategic plan, for the unanswered questions and perspective for the future, especially during the surfaced global COVID-19 pandemic caused by coronavirus SARS-CoV2 impacting on both the patient's psychological functioning and endoscopy services. Establishment of a global registry system and accumulated experiences have led to consensus for inflammatory bowel disease management under the COVID-19 pandemic. Painstakingly, the pandemic has influenced medical care systems for these patients. I briefly herein viewpoint summarize among other updates the telemedicine roles during the pandemic and how operationally inflammatory bowel disease centers managed patients and ensured quality of care. In conclusion: inflammatory bowel disease has become a global emergent disease. Serious medical errors are public health problem observed in developing nations i.e., to distinguish inflammatory bowel disease and infectious and parasitic diseases. Refractory inflammatory bowel disease is a still significant chal","PeriodicalId":18641,"journal":{"name":"Medical Research Archives","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10118064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9962429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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