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Advanced Drug Delivery Reviews 2020Hyperthermia has demonstrated clinical success in improving the efficacy of both chemo- and radio-therapy in solid tumors. Pre-clinical and clinical research studies...
Hyperthermia has demonstrated clinical success in improving the efficacy of both chemo- and radio-therapy in solid tumors. Pre-clinical and clinical research studies have demonstrated that targeted hyperthermia can increase tumor blood flow and increase the perfused fraction of the tumor in a temperature and time dependent manner. Changes in tumor blood circulation can produce significant physiological changes including enhanced vascular permeability, increased oxygenation, decreased interstitial fluid pressure, and reestablishment of normal physiological pH conditions. These alterations in tumor physiology can positively impact both small molecule and nanomedicine chemotherapy accumulation and distribution within the tumor, as well as the fraction of the tumor susceptible to radiation therapy. Hyperthermia can trigger drug release from thermosensitive formulations and further improve the accumulation, distribution, and efficacy of chemotherapy.
Topics: Antineoplastic Agents; Capillary Permeability; Combined Modality Therapy; Drug Delivery Systems; Drug Liberation; Humans; Hydrogen-Ion Concentration; Hyperthermia; Hyperthermia, Induced; Neoplasms; Oxygen; Radiotherapy; Time Factors; Tumor Microenvironment
PubMed: 32681862
DOI: 10.1016/j.addr.2020.07.007 -
Frontiers in Public Health 2020Research on air quality and human health "co-benefits" from climate mitigation strategies represents a growing area of policy-relevant scholarship. Compared to other...
Research on air quality and human health "co-benefits" from climate mitigation strategies represents a growing area of policy-relevant scholarship. Compared to other aspects of climate and energy policy evaluation, however, there are still relatively few of these co-benefits analyses. This sparsity reflects a historical disconnect between research quantifying energy and climate, and research dealing with air quality and health. The air quality co-benefits of climate, clean energy, and transportation electrification policies are typically assessed with models spanning social, physical, chemical, and biological systems. This review article summarizes studies to date and presents methods used for these interdisciplinary analyses. Studies in the peer-reviewed literature ( = 26) have evaluated carbon pricing, renewable portfolio standards, energy efficiency, renewable energy deployment, and clean transportation. A number of major findings have emerged from these studies: [1] decarbonization strategies can reduce air pollution disproportionally on the most polluted days; [2] renewable energy deployment and climate policies offer the highest health and economic benefits in regions with greater reliance on coal generation; [3] monetized air quality health co-benefits can offset costs of climate policy implementation; [4] monetized co-benefits typically exceed the levelized cost of electricity (LCOE) of renewable energies; [5] Electric vehicle (EV) adoption generally improves air quality on peak pollution days, but can result in ozone dis-benefits in urban centers due to the titration of ozone with nitrogen oxides. Drawing from these published studies, we review the state of knowledge on climate co-benefits to air quality and health, identifying opportunities for policy action and further research.
Topics: Air Pollution; Climate Change; Humans; Ozone; Particulate Matter; Public Health
PubMed: 33330312
DOI: 10.3389/fpubh.2020.563358 -
Critical Care Medicine Jul 2023To map the scope, methodological rigor, quality, and direction of associations between social determinants of health (SDoH) and extracorporeal membrane oxygenation...
OBJECTIVES
To map the scope, methodological rigor, quality, and direction of associations between social determinants of health (SDoH) and extracorporeal membrane oxygenation (ECMO) utilization or outcomes.
DATA SOURCES
PubMed, Web of Science, Embase, and Cochrane Library databases were systematically searched for citations from January 2000 to January 2023, examining socioeconomic status (SES), race, ethnicity, hospital and ECMO program characteristics, transport, and geographic location (context) with utilization and outcomes (concept) in ECMO patients (population).
STUDY SELECTION
Methodology followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses scoping review extension. Two reviewers independently evaluated abstracts and full text of identified publications. Exclusion criteria included non-English, unavailable, less than 40 patients, and periprocedural or mixed mechanical support.
DATA EXTRACTION
Content analysis used a standardized data extraction tool and inductive thematic analysis for author-proposed mediators of disparities. Risk of bias was assessed using the Quality in Prognosis Studies tool.
DATA SYNTHESIS
Of 8,214 citations screened, 219 studies were identified. Primary analysis focuses on 148 (68%) including race/ethnicity/SES/payer variables including investigation of ECMO outcomes 114 (77%) and utilization 43 (29%). SDoH were the primary predictor in 15 (10%). Overall quality and methodologic rigor was poor with advanced statistics in 7%. Direction of associations between ECMO outcomes or utilization according to race, ethnicity, SES, or payer varied. In 38% adverse outcomes or lower use was reported in underrepresented, under-resourced or diverse populations, while improved outcomes or greater use were observed in these populations in 7%, and 55% had no statistically significant result. Only 26 studies (18%) discussed mechanistic drivers of disparities, primarily focusing on individual- and hospital-level rather than systemic/structural factors.
CONCLUSIONS
Associations between ECMO utilization and outcomes with SDoH are inconsistent, complicated by population heterogeneity and analytic shortcomings with limited consideration of systemic contributors. Findings and research gaps have implications for measuring, analyzing, and interpreting SDoH in ECMO research and healthcare.
Topics: Humans; Extracorporeal Membrane Oxygenation; Healthcare Disparities
PubMed: 36975216
DOI: 10.1097/CCM.0000000000005866 -
Environmental Pollution (Barking, Essex... Nov 2019A number of systematic reviews have investigated the association between air pollutants and health impacts, these mostly focus on morbidity and mortality from hospital... (Meta-Analysis)
Meta-Analysis
A number of systematic reviews have investigated the association between air pollutants and health impacts, these mostly focus on morbidity and mortality from hospital data. Previously, no reviews focused solely on ambulance dispatch data. These data sets have excellent potential for environmental health research. For this review, publications up to April 2019 were identified using three main search categories covering: ambulance services including dispatches; air pollutants; and health outcomes. From 308 studies initially identified, 275 were excluded as they did not relate to ambulance service dispatches, did not report the air pollutant association, and/or did not study ambient air pollution. The main health outcomes in the remaining 33 studies were cardiac arrest (n = 14), cardiovascular (n = 11) and respiratory (n = 10) dispatches. Meta-analyses were performed to summarise pooled relative risk (RR) of pollutants: particulate matter less than 2.5 and 10 μm (PM, PM), the fraction between PM and PM (coarse) and suspended particulate matter (SPM) per 10 μg/m increase, carbon monoxide (CO) per 1 ppm increase and of sulphur dioxide (SO), nitrogen dioxide (NO), and ozone (O) per 10 ppb increment and ambulance dispatches. Statistically significant associations were found for ambulance dispatch data for all-respiratory and PM at 1.03 (95% CI:1.02-1.04) and at 1.10 (95% CI:1.00-1.21) for asthma and NO associations. For dispatches with subsequent paramedic assessment for cardiac arrest with PM, CO and coarse dispatches at 1.05 (95% CI:1.03-1.08), 1.10 (95% CI:1.02-1.18) and 1.04 (95% CI:1.01-1.06) respectively. For dispatches with subsequent physician diagnosis for all-respiratory and PM at 1.02 (95% CI:1.01-1.03). In conclusion, air pollution was significantly associated with an increase in ambulance dispatch data, including those for cardiac arrest, all-respiratory, and asthma dispatches. Ambulance services should plan accordingly during pollution events. Furthermore, efforts to improve air quality should lead to decreases in ambulance dispatches.
Topics: Air Pollutants; Air Pollution; Ambulances; Asthma; Carbon Monoxide; Environmental Exposure; Environmental Health; Humans; Male; Nitrogen Dioxide; Ozone; Particulate Matter; Risk; Sulfur Dioxide
PubMed: 31419665
DOI: 10.1016/j.envpol.2019.06.065 -
Interactive Cardiovascular and Thoracic... Dec 2020The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected all health care professionals. The outbreak required a thorough reorganization of the Italian...
The coronavirus disease 2019 (COVID-19) pandemic has profoundly affected all health care professionals. The outbreak required a thorough reorganization of the Italian regional local health care system to preserve resources such as ventilators, beds in intensive care units and surgical and anaesthesiological staff. Levels of priority were created, together with a rigorous triage procedure for patients with COVID-19, which led to postponement of all elective procedures. Urgent cases were discussed with the local heart team and percutaneous approaches were selected as the first treatment option to reduce hospital stay. COVID-19 and COVID-19-free pathways were created, including adequate preparation of the operating room, management of anaesthesiological procedures, transportation of patients and disinfection. It was determined that patients with chronic diseases were at increased risk of adverse outcomes. Systemic inflammation, cytokine storm and hypercoagulability associated with COVID-19 increased the risk of heart failure and cardiac death. In this regard, the early use of extracorporeal membrane oxygenation could be life-saving in patients with severe forms of acute respiratory distress syndrome or refractory heart failure. The goal of this paper was to report the Italian experience during the COVID-19 pandemic in the setting of cardiovascular surgery.
Topics: COVID-19; Cardiac Surgical Procedures; Comorbidity; Extracorporeal Membrane Oxygenation; Heart Failure; Humans; Intensive Care Units; Italy; Pandemics; SARS-CoV-2
PubMed: 33099647
DOI: 10.1093/icvts/ivaa186 -
Molecules (Basel, Switzerland) Dec 2021Proliferating cancer cells have high energy demands, which is mainly obtained through glycolysis. The transmembrane trafficking of lactate, a major metabolite produced... (Meta-Analysis)
Meta-Analysis
Proliferating cancer cells have high energy demands, which is mainly obtained through glycolysis. The transmembrane trafficking of lactate, a major metabolite produced by glycolytic cancer cells, relies on monocarboxylate transporters (MCTs). MCT1 optimally imports lactate, although it can work bidirectionally, and its activity has been linked to cancer aggressiveness and poor outcomes. AZD3965, a specific MCT1 inhibitor, was tested both in vitro and in vivo, with encouraging results; a phase I clinical trial has already been undertaken. Thus, analysis of the experimental evidence using AZD3965 in different cancer types could give valuable information for its clinical use. This systematic review aimed to assess the in vivo anticancer activity of AZD3965 either alone (monotherapy) or with other interventions (combination therapy). Study search was performed in nine different databases using the keywords "AZD3965 in vivo" as search terms. The results show that AZD3965 successfully decreased tumor growth and promoted intracellular lactate accumulation, which confirmed its effectiveness, especially in combined therapy. These results support the setup of clinical trials, but other important findings, namely AZD3965 enhanced activity when given in combination with other therapies, or MCT4-induced treatment resistance, should be further considered in the clinical trial design to improve therapy response.
Topics: Animals; Antineoplastic Agents; Cell Line, Tumor; Disease Management; Disease Progression; Drug Evaluation, Preclinical; Energy Metabolism; Glycolysis; Humans; Lactic Acid; Monocarboxylic Acid Transporters; Neoplasms; Pyrimidinones; Signal Transduction; Symporters; Thiophenes; Tumor Microenvironment; Warburg Effect, Oncologic; Xenograft Model Antitumor Assays
PubMed: 35011413
DOI: 10.3390/molecules27010181 -
Journal of Human Kinetics Mar 2020This review aimed to analyse factors that limited performance in ultra-marathons and mountain ultra-marathons. A literature search in one database (PubMed) was conducted...
This review aimed to analyse factors that limited performance in ultra-marathons and mountain ultra-marathons. A literature search in one database (PubMed) was conducted in February 2019. Quality of information of the articles was evaluated using the Oxford´s level of evidence and the Physiotherapy Evidence Database (PEDro) scale. The search strategy yielded 111 total citations from which 23 met the inclusion criteria. Twenty one of the 23 included studies had a level of evidence 2b (individual cohort study), while the 2 remaining studies had a level of evidence of 5 (expert opinion). Also, the mean score in the PEDro scale was 3.65 ± 1.61, with values ranging from 0 to 7. Participants were characterised as experienced or well-trained athletes in all of the studies. The total number of participants was 1002 (893 men, 86 women and 23 unknown). The findings of this review suggest that fatigue in ultra-endurance events is a multifactorial phenomenon that includes physiological, neuromuscular, biomechanical and cognitive factors. Improved exercise performance during ultra-endurance events seems to be related to higher VO values and maximal aerobic speed (especially during submaximal efforts sustained over a long time), lower oxygen cost of transport and greater running experience.
PubMed: 32269654
DOI: 10.2478/hukin-2019-0102 -
Water Research Aug 2024Percarbonate encompasses sodium percarbonate (SPC) and composite in-situ generated peroxymonocarbonate (PMC). SPC emerges as a promising alternative to hydrogen peroxide... (Review)
Review
Percarbonate encompasses sodium percarbonate (SPC) and composite in-situ generated peroxymonocarbonate (PMC). SPC emerges as a promising alternative to hydrogen peroxide (HO), hailed for its superior transportation safety, stability, cost-effectiveness, and eco-friendliness, thereby becoming a staple in advanced oxidation processes for mitigating water pollution. Yet, scholarly literature scarcely explores the deployment of percarbonate-AOPs in eradicating organic contaminants from aquatic systems. Consequently, this review endeavors to demystify the formation mechanisms and challenges associated with reactive oxygen species (ROS) in percarbonate-AOPs, alongside highlighting directions for future inquiry and development. The genesis of ROS encompasses the in situ chemical oxidation of activated SPC (including iron-based activation, discharge plasma, ozone activation, photon activation, and metal-free materials activation) and composite in situ chemical oxidation via PMC (namely, HONaHCO/NaCO, peroxymonosulfate/NaHCO/NaCO systems). Moreover, the ROS generated by percarbonate-AOPs, such as •OH, O, CO, HO, O, and HCO, can work individually or synergistically to disintegrate target pollutants. Concurrently, this review systematically addresses conceivable obstacles posing percarbonate-AOPs in real-world application from the angle of environmental conditions (pH, temperature, coexisting substances), and potential ecological toxicity. Considering the outlined challenges and advantages, we posit future research directions to amplify the applicability and efficacy of percarbonate-AOPs in tangible settings. It is anticipated that the insights provided in this review will catalyze the progression of percarbonate-AOPs in water purification endeavors and bridge the existing knowledge void.
Topics: Oxidation-Reduction; Carbonates; Wastewater; Water Pollutants, Chemical; Water Purification; Hydrogen Peroxide; Reactive Oxygen Species
PubMed: 38820735
DOI: 10.1016/j.watres.2024.121842 -
Nutrients Feb 2020The purpose of this paper was to conduct a systematic review and a meta-analysis of studies examining the acute effects of caffeine ingestion on measures of rowing... (Meta-Analysis)
Meta-Analysis
The purpose of this paper was to conduct a systematic review and a meta-analysis of studies examining the acute effects of caffeine ingestion on measures of rowing performance. Crossover and placebo-controlled experiments that investigated the effects of caffeine ingestion on measures of rowing performance were included. The PEDro checklist was used to assess the methodological quality of the included studies. Seven studies of good and excellent methodological quality were included. None of the included studies examined on-water rowing. The majority of studies that were included in the meta-analysis used a 2000m rowing distance with only one using 1000m distance. Results of the main meta-analysis indicated that caffeine enhances performance on a rowing ergometer compared to placebo with a mean difference of -4.1 s (95% confidence interval (CI): -6.4, -1.8 s). These values remained consistent in the analysis in which the study that used a 1000m distance was excluded (mean difference: -4.3 s; 95% CI: -6.9, -1.8 s). We also found a significant increase in mean power (mean difference: 5.7 W; 95% CI: 2.1, 9.3 W) and minute ventilation (mean difference: 3.4 L/min; 95% CI: 1.7, 5.1 L/min) following caffeine ingestion. No significant differences between caffeine and placebo were found for the rating of perceived exertion, oxygen consumption, respiratory exchange ratio, and heart rate. This meta-analysis found that acute caffeine ingestion improves 2000m rowing ergometer performance by ~4 s. Our results support the use of caffeine pre-exercise as an ergogenic aid for rowing performance.
Topics: Caffeine; Exercise; Female; Humans; Male; Oxygen Consumption; Performance-Enhancing Substances; Physical Exertion; Pulmonary Gas Exchange; Ships; Sports; Task Performance and Analysis
PubMed: 32046330
DOI: 10.3390/nu12020434 -
Pediatrics Jan 2022Studies of organ dysfunction in children are limited by a lack of consensus around organ dysfunction criteria.
CONTEXT
Studies of organ dysfunction in children are limited by a lack of consensus around organ dysfunction criteria.
OBJECTIVES
To derive evidence-informed, consensus-based criteria for hematologic dysfunction in critically ill children.
DATA SOURCES
Data sources included PubMed and Embase from January 1992 to January 2020.
STUDY SELECTION
Studies were included if they evaluated assessment/scoring tools to screen for hematologic dysfunction and assessed outcomes of mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. Studies of adults or premature infants, animal studies, reviews/commentaries, small case series, and non-English language studies with inability to determine eligibility were excluded.
DATA EXTRACTION
Data were abstracted from each eligible study into a standard data extraction form along with risk of bias assessment.
RESULTS
Twenty-nine studies were included. The systematic review supports the following criteria for hematologic dysfunction: thrombocytopenia (platelet count <100000 cells/µL in patients without hematologic or oncologic diagnosis, platelet count <30000 cells/µL in patients with hematologic or oncologic diagnoses, or platelet count decreased ≥50% from baseline; or leukocyte count <3000 cells/µL; or hemoglobin concentration between 5 and 7 g/dL (nonsevere) or <5 g/dL (severe).
LIMITATIONS
Most studies evaluated pre-specified thresholds of cytopenias. No studies addressed associations between the etiology or progression of cytopenias overtime with outcomes, and no studies evaluated cellular function.
CONCLUSIONS
Hematologic dysfunction, as defined by cytopenia, is a risk factor for poor outcome in critically ill children, although specific threshold values associated with increased mortality are poorly defined by the current literature.
Topics: Child; Critical Illness; Hematologic Diseases; Hemoglobinometry; Humans; Leukocyte Count; Multiple Organ Failure; Platelet Count; Prognosis; Risk Factors; Severity of Illness Index
PubMed: 34970675
DOI: 10.1542/peds.2021-052888K