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  • 1
    Online Resource
    Online Resource
    Real-World Use of AKI Biomarkers: A Quality Improvement Project Using Urinary Tissue Inhibitor Metalloprotease-2 and Insulin-Like Growth Factor Binding Protein 7 ([TIMP-2]*[IGFBP7])
    S. Karger AG ; 2023
    In:  American Journal of Nephrology
    Details
    In: American Journal of Nephrology, S. Karger AG
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Novel urinary biomarkers, including tissue inhibitor metalloprotease-2 and insulin-like growth factor binding protein 7 ([TIMP-2]*[IGFBP7] ), have been developed to identify patients at risk for acute kidney injury (AKI). We investigated the “real-world” clinical utility of [TIMP-2]*[IGFBP7] in preventing AKI. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We performed a before and after single-center quality improvement study of intensive care unit (ICU) patients at risk for severe (KDIGO stage 2 or 3) AKI. In the prospective cohort, ICU providers were allowed to order [TIMP-2]*[IGFBP7] for patients at their discretion, then offered AKI practice recommendations based on the results. Outcomes were compared to a historical cohort in which biomarker values were not reported to clinical teams. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There was no difference in 7-day progression to severe AKI between the prospective ( 〈 i 〉 n 〈 /i 〉 = 116) and historical cohorts ( 〈 i 〉 n 〈 /i 〉 = 63) when [TIMP-2]*[IGFBP7] ≥0.3 (24 [28%] versus 8 [21%] , 〈 i 〉 p 〈 /i 〉 = 0.38) despite more stage 1 AKI at time of biomarker measurement in the prospective cohort (58 [67%] versus 9 [23%] , 〈 i 〉 p 〈 /i 〉 & lt; 0.001). In the prospective cohort, patients with higher [TIMP-2] *[IGFBP7] values were more likely to receive a nephrology consult. Early consultation (within 24 h of biomarker measurement, 〈 i 〉 n 〈 /i 〉 = 20) had a nonsignificant trend toward net negative volume balance (−1,787 mL [6,716 mL] versus + 4,974 mL [15,540 mL] ) and more diuretic use (19 [95%] versus 8 [80%] ) and was associated with less severe AKI (9 [45%] versus 10 [100%] , 〈 i 〉 p 〈 /i 〉 = 0.004) and inpatient dialysis (2 [10%] versus 7 [70%] , 〈 i 〉 p 〈 /i 〉 = 0.002) compared to delayed consultation ( 〈 i 〉 n 〈 /i 〉 = 10). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Despite the prospective cohort having more preexisting stage 1 AKI, there were equal rates of progression to severe AKI in the prospective and historical cohorts. In the setting of [TIMP-2]*[IGFBP7] reporting, there were more nephrology consults in response to elevated biomarker levels. Early nephrology consultation resulted in improved volume balance and favorable outcomes compared to delayed consultation.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000531641
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1468523-1
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  • 2
    Online Resource
    Online Resource
    Body mass index and B‐lines on lung ultrasonography in chronic and acute heart failure
    Wiley ; 2020
    In:  ESC Heart Failure Vol. 7, No. 3 ( 2020-06), p. 1201-1209
    Details
    In: ESC Heart Failure, Wiley, Vol. 7, No. 3 ( 2020-06), p. 1201-1209
    Abstract: Increased body mass index (BMI) is common in heart failure (HF) patients and is associated with lower levels of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP). We evaluated the influence of BMI on lung ultrasonography (LUS) findings indicative of pulmonary congestion (i.e. B‐lines) in patients with chronic and acute HF (AHF). Methods and results We analysed ambulatory chronic HF ( n  = 118) and hospitalized AHF ( n  = 177) patients (mean age 70 years, 64% men, mean BMI 29 kg/m 2 , mean ejection fraction 42%) undergoing echocardiography and LUS in eight chest zones. B‐lines and chest wall thickness (skin to pleura) on ultrasound were quantified offline and blinded to clinical findings. NT‐proBNP was available in AHF patients ( n  = 167). In chronic HF, B‐line number decreased by 18% per 5 unit increase in BMI [95% confidence interval (CI) −35% to +5%, P  = 0.11]. In AHF, the number of B‐lines decreased by 12% per 5 unit increase in BMI (95% CI −19% to −5%, P  = 0.001), whereas NT‐proBNP concentration decreased by 28% per 5 unit increase in BMI (95% CI −40% to −16%, P   〈  0.001). For AHF, B‐line number declined to a lesser degree than NT‐proBNP concentration with increasing BMI ( P  = 0.020), and 〉 6 B‐lines were observed in half of AHF patients with severe obesity. There was an inverse relationship between B‐line number and chest wall thickness, and this association varied by chest region. Conclusions Despite an inverse relationship between B‐lines and BMI, B‐lines declined to a lesser degree than NT‐proBNP with increasing BMI. These data suggest that LUS may be useful in patients with HF despite obesity.
    Type of Medium: Online Resource
    ISSN: 2055-5822 , 2055-5822
    URL: Issue
    URL: Article
    DOI: 10.1002/ehf2.v7.3
    DOI: 10.1002/ehf2.12640
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2814355-3
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  • 3
    Online Resource
    Online Resource
    Blockchain Based Electronic Health Record System
    Elsevier BV ; 2021
    In:  SSRN Electronic Journal
    Details
    In: SSRN Electronic Journal, Elsevier BV
    Type of Medium: Online Resource
    ISSN: 1556-5068
    URL: Article
    DOI: 10.2139/ssrn.3761589
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 4
    Online Resource
    Online Resource
    Comparative study between lymphocyte-monocyte ratio and platelet-lymphocyte ratio: novel markers for critical limb ischemia in peripheral arterial disease
    Medip Academy ; 2019
    In:  International Surgery Journal Vol. 6, No. 10 ( 2019-09-26), p. 3638-
    Details
    In: International Surgery Journal, Medip Academy, Vol. 6, No. 10 ( 2019-09-26), p. 3638-
    Abstract: Background: Peripheral arterial occlusive disease (PAOD) is frequent and often not diagnosed in time. If treatment is not initiated early, disease progression and development of Critical limb ischemia (CLI) is one possible complication. CLI is an entity with high mortality and high risk of limb amputation. As monocytes play a leading role in progression of atherosclerosis and platelets play a key role in atherosclerosis and atherothrombosis, we investigated Lymphocyte-monocyte ratio (LMR), Platelet lymphocyte ratio (PLR) and its association with CLI in peripheral arterial disease.Methods: Retrospective observational study conducted between January 2015-December 2017 including 50 patients admitted in Rajarajeswari Medical College and Hospital, Bangalore. As an optimal cut-off value, a PLR of 150 and LMR of 5 were identified. Their association with CLI noted.Results: 50 patients with critical limb ischemia, stage 3 and 4 of Fontaine classification were included in this study. 72% patients had LMR less than 5.40% patients had PLR more than 150 and 36% patients had both LMR less than 5 and PLR more than 150. 96% patients with LMR 〈 5 and 72% patients with PLR 〉 150 underwent amputation.Conclusions: An increased PLR and reduced LMR are significantly associated with patients at high risk for CLI. They are broadly available and cost effective. When done in early stage of the disease serves as a marker for CLI and aggressive treatment in such patients will reduce the risk of amputation.
    Type of Medium: Online Resource
    ISSN: 2349-2902 , 2349-3305
    URL: Article
    DOI: 10.18203/2349-2902.isj20194417
    Language: Unknown
    Publisher: Medip Academy
    Publication Date: 2019
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  • 5
    Online Resource
    Online Resource
    Selection of Optimal Tire and Design Optimisation of Steering System for a Formula Student Race Car through Tire Data Treatment
    IOP Publishing ; 2020
    In:  Journal of Physics: Conference Series Vol. 1478, No. 1 ( 2020-04-01), p. 012032-
    Details
    In: Journal of Physics: Conference Series, IOP Publishing, Vol. 1478, No. 1 ( 2020-04-01), p. 012032-
    Abstract: Selection of tires plays a crucial role in Vehicle Dynamics, which is important to design the steering and suspension system. An attempt is made to select the most optimum tire for lateral performance by using the tire data acquired from Tire Testing Consortium. Parameters including the tire’s lateral grip, cornering stiffness, cornering stiffness coefficient, camber stiffness, and lateral frictional coefficient have aided this selection. The tire is modelled using the Pacejka Magic Formula where the lateral and aligning coefficients are found, and used to get pneumatic trail, a parameter not provided in the raw data. The novelty of the work is seen when the selected tire is analysed to set the camber, pressure, and caster using the Design of Experiments method, without the need for building and testing a car. Making the best use of the tires’ forces and moments, the steering geometry is designed for a target range of radii by operating the tire slip angles at its optimum value. Further the influence of the change in toe angle on the Ackermann percentage is examined. Steering moment, calculated using the aligning moment curves of the tire, is applied to the steering column to conduct finite element analysis.
    Type of Medium: Online Resource
    ISSN: 1742-6588 , 1742-6596
    URL: Article
    DOI: 10.1088/1742-6596/1478/1/012032
    Language: Unknown
    Publisher: IOP Publishing
    Publication Date: 2020
    detail.hit.zdb_id: 2166409-2
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  • 6
    Online Resource
    Online Resource
    Ability of non-physicians to perform and interpret lung ultrasound: A systematic review
    Oxford University Press (OUP) ; 2019
    In:  European Journal of Cardiovascular Nursing Vol. 18, No. 6 ( 2019-08), p. 474-483
    Details
    In: European Journal of Cardiovascular Nursing, Oxford University Press (OUP), Vol. 18, No. 6 ( 2019-08), p. 474-483
    Abstract: Lung ultrasound is a useful tool in the assessment of pulmonary congestion in heart failure that is typically performed and interpreted by physicians at the point-of-care. Aims: To investigate the ability of nurses, students, and paramedics to accurately identify B-lines and pleural effusions for the detection of pulmonary congestion in heart failure and to examine the training necessary. Methods and results: We conducted a systematic review and searched online databases for studies that investigated the ability of nurses, students, and paramedics to perform lung ultrasound and detect B-lines and pleural effusions. Of 979 studies identified, 14 met our inclusion criteria: five in nurses, eight in students, and one in paramedics. After 0–12 h of didactic training and 58–62 practice lung ultrasound examinations, nurses were able to identify B-lines and pleural effusions with a sensitivity of 79–98% and a specificity of 70–99%. In image adequacy studies, medical students with 2–9 h of training were able to acquire adequate images for B-lines and pleural effusions in 50–100%. Only one eligible study investigated paramedic-performed lung ultrasound which did not support the ability of paramedics to adequately acquire and interpret lung ultrasound images after 2 h of training. Conclusions: Our findings suggest that nurses and students can accurately acquire and interpret lung ultrasound images after a brief training period in a majority of cases. The examination of heart failure patients with lung ultrasound by non-clinicians appears feasible and warrants further investigation.
    Type of Medium: Online Resource
    ISSN: 1474-5151 , 1873-1953
    URL: Article
    DOI: 10.1177/1474515119845972
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2099328-6
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  • 7
    Online Resource
    Online Resource
    Lung Ultrasound in Acute Heart Failure
    Elsevier BV ; 2019
    In:  JACC: Heart Failure Vol. 7, No. 10 ( 2019-10), p. 849-858
    Details
    In: JACC: Heart Failure, Elsevier BV, Vol. 7, No. 10 ( 2019-10), p. 849-858
    Type of Medium: Online Resource
    ISSN: 2213-1779
    URL: Article
    DOI: 10.1016/j.jchf.2019.07.008
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2705621-1
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  • 8
    Online Resource
    Online Resource
    Interpretation of biological experiments changes with evolution of the Gene Ontology and its annotations
    Springer Science and Business Media LLC ; 2018
    In:  Scientific Reports Vol. 8, No. 1 ( 2018-03-23)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 8, No. 1 ( 2018-03-23)
    Abstract: Gene Ontology (GO) enrichment analysis is ubiquitously used for interpreting high throughput molecular data and generating hypotheses about underlying biological phenomena of experiments. However, the two building blocks of this analysis — the ontology and the annotations — evolve rapidly. We used gene signatures derived from 104 disease analyses to systematically evaluate how enrichment analysis results were affected by evolution of the GO over a decade. We found low consistency between enrichment analyses results obtained with early and more recent GO versions. Furthermore, there continues to be a strong annotation bias in the GO annotations where 58% of the annotations are for 16% of the human genes. Our analysis suggests that GO evolution may have affected the interpretation and possibly reproducibility of experiments over time. Hence, researchers must exercise caution when interpreting GO enrichment analyses and should reexamine previous analyses with the most recent GO version.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-018-23395-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 2615211-3
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  • 9
    Online Resource
    Online Resource
    Review of modeling and validation techniques for tire-deformable soil interactions
    Elsevier BV ; 2023
    In:  Journal of Terramechanics Vol. 109 ( 2023-10), p. 73-92
    Details
    In: Journal of Terramechanics, Elsevier BV, Vol. 109 ( 2023-10), p. 73-92
    Type of Medium: Online Resource
    ISSN: 0022-4898
    URL: Article
    DOI: 10.1016/j.jterra.2023.05.007
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2015346-6
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  • 10
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    Online Resource
    MYC Overexpression Drives Immune Evasion in Hepatocellular Carcinoma That Is Reversible through Restoration of Proinflammatory Macrophages
    American Association for Cancer Research (AACR) ; 2023
    In:  Cancer Research Vol. 83, No. 4 ( 2023-02-15), p. 626-640
    Details
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 83, No. 4 ( 2023-02-15), p. 626-640
    Abstract: Cancers evade immune surveillance, which can be reversed through immune-checkpoint therapy in a small subset of cases. Here, we report that the MYC oncogene suppresses innate immune surveillance and drives resistance to immunotherapy. In 33 different human cancers, MYC genomic amplification and overexpression increased immune-checkpoint expression, predicted nonresponsiveness to immune-checkpoint blockade, and was associated with both Th2-like immune profile and reduced CD8 T-cell infiltration. MYC transcriptionally suppressed innate immunity and MHCI-mediated antigen presentation, which in turn impeded T-cell response. Combined, but not individual, blockade of PDL1 and CTLA4 could reverse MYC-driven immune suppression by leading to the recruitment of proinflammatory antigen-presenting macrophages with increased CD40 and MHCII expression. Depletion of macrophages abrogated the antineoplastic effects of PDL1 and CTLA4 blockade in MYC-driven hepatocellular carcinoma (HCC). Hence, MYC is a predictor of immune-checkpoint responsiveness and a key driver of immune evasion through the suppression of proinflammatory macrophages. The immune evasion induced by MYC in HCC can be overcome by combined PDL1 and CTLA4 blockade. Significance: Macrophage-mediated immune evasion is a therapeutic vulnerability of MYC-driven cancers, which has implications for prioritizing MYC-driven hepatocellular carcinoma for combination immunotherapy.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
    URL: Article
    DOI: 10.1158/0008-5472.CAN-22-0232
    RVK:
    XA 36000
    RVK:
    XA 10000
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2023
    detail.hit.zdb_id: 2036785-5
    detail.hit.zdb_id: 1432-1
    detail.hit.zdb_id: 410466-3
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