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Journal of Thoracic Disease May 2024Despite improvements in management, infective endocarditis (IE) is still associated with high mortality and morbidity. The outcome of patients with IE remains unclear in...
Postoperative follow-up of 221 patients with infective endocarditis from Gaoligong mountain area of Yunnan in China: a retrospective, single-center, observational cohort study.
BACKGROUND
Despite improvements in management, infective endocarditis (IE) is still associated with high mortality and morbidity. The outcome of patients with IE remains unclear in high-altitude areas of China. To characterize the epidemiological features and surgical outcomes, a retrospective analysis was conducted to 221 patients diagnosed with IE from a single center. In addition, to assess the prognosis of patients, a multivariate logistic regression model was performed to analyze the affecting risk factors.
METHODS
A retrospective analysis was conducted on the clinical data of 221 patients with IE who underwent surgical treatment at the Department of Cardiac Surgery of Yan'an Hospital Affiliated to Kunming Medical University from January 2013 to December 2019. The analysis evaluated patient demographics, pathogenic bacterial composition, echocardiography results, and surgical treatment outcomes. After a 1-year follow-up period, the mortality rate was statistically analyzed. The patients were divided into two groups based on their survival status: those who survived and those who did not. Relevant factors were compared between the two groups, and a multivariate logistic regression model was used to analyze the risk factors that affect the prognosis of patients with IE.
RESULTS
Out of the 221 patients diagnosed with IE, 164 were male and 57 were female, with an average age of 39.25±14.36 years. The most common underlying heart diseases were bicuspid aortic valve disease (24.9%), congenital heart disease (19.5%), rupture of aortic sinus aneurysm (5.0%) and rheumatic valvular disease (2.3%). The blood culture had a positive rate of 48.42% (107/221), with (29.9%) and (13.1%) being the main specifically pathogenic bacteria identified. Transthoracic echocardiography produced positive results in 89.6% (198/221) of cases. The findings included vegetation formation (100%), valve perforation or tear (21.7%), and perivalvular abscess formation (5.6%). Out of the patients, 174 underwent elective surgery, 47 received emergency surgery, and 11 died within 1 year after surgery, resulting in a mortality rate of 5.0%. However, the death group had longer operation time, cardiopulmonary bypass (CPB) time and higher EuroSCORE II compared to the non-death group (P<0.05). Logistic regression analysis identified preoperative hematocrit decrease, prolonged operation time and CPB time, high New York Heart Association (NYHA) cardiac function grade, and liver diseases as risk factors for 1-year mortality in patients with IE (OR =1.003, 0.000, 1.006, 1.026, 1.624 and 4.746).
CONCLUSIONS
IE primarily affects young and middle-aged men with rheumatic heart valvular disease as the main underlying heart disease and as the main pathogen. Surgical intervention significantly reduces early mortality in IE patients. To improve postoperative prognosis, clinicians should remain vigilant, especially in high-risk groups with preoperative hematocrit, prolonged operation time, and CPB time, high NYHA cardiac function grade, EuroSCORE II, and vegetation formation.
PubMed: 38883629
DOI: 10.21037/jtd-24-470 -
International Journal of Infectious... Jun 2024To determine the efficacy and safety of respiratory syncytial virus (RSV) vaccines in infants and older adults.
OBJECTIVES
To determine the efficacy and safety of respiratory syncytial virus (RSV) vaccines in infants and older adults.
METHODS
We performed a systematic review and meta-analysis of randomized control trials that evaluated the efficacy of maternal RSV immunization against infections in infants, as well as the efficacy of RSV vaccines in older adults. The primary outcome was the vaccine efficacy against RSV-related lower respiratory tract disease (LRTD). GRADE criteria was used to evaluate the level of evidence.
RESULTS
Ten trials were included in the review. For maternal vaccination, the RSV vaccine showed favourable efficacy against RSV-related LRTD (vaccine efficacy 57.3%, 95% CI 31.3 to 73.5; low certainty) and RSV-related severe LRTD (vaccine efficacy 81.9%, 95% CI 56.8 to 92.4; moderate certainty) in infants within 90 days after birth. For older adults, Meta-analysis showed that RSV vaccines could also reduce the risk of RSV-related LRTD (vaccine efficacy 78.3%, 95% CI 65.6 to 86.3; moderate certainty) and RSV-related severe LRTD (vaccine efficacy 86.5%, 95% CI 68.3 to 94.3; moderate certainty). There was no significant difference in serious adverse events between RSV vaccines and placebo.
CONCLUSION
RSV vaccines have the potential to offer protection against RSV disease in both infants and older adults, without apparent safety concerns.
PubMed: 38878994
DOI: 10.1016/j.ijid.2024.107118 -
Preventive Veterinary Medicine Jun 2024Oral vaccination is one of the most effective interventions for disease control in wildlife. As a result of the recent global reemergence of African swine fever and...
Oral vaccination is one of the most effective interventions for disease control in wildlife. As a result of the recent global reemergence of African swine fever and ongoing classical swine fever and animal tuberculosis, oral vaccination of Eurasian wild boar (Sus scrofa) receives increased interest. Several baits for wild boar and feral pigs have been described, but developing more stable and personalized formulations is important. This paper proposes a new bait formulation primarily composed of corn flour, piglet feed, sugar, and honey as a binder to obtain improved elasticity. The bait consists of a matrix with no protective coats, has a hemispherical shape (ø 3.4 ×1.6 cm), and displays an anise aroma and blue color. The color and aroma did not affect bait choice by wild boar, while bait coloring contributed to avoid consumption by non-target species (corvids). Baits with the new formulation were significantly more resistant to humidity and high temperatures than previous versions. Simulations suggest that baits with the new formulation are elastic enough to resist impacts from a maximum altitude of 750 m. Thus, the new bait prototype solves several problems of previous bait formulations while keeping a format that can be selectively consumed by piglets and adult wild boar.
PubMed: 38878496
DOI: 10.1016/j.prevetmed.2024.106241 -
European Journal of Sport Science Jun 2024This study investigates whether exercise as a strategy for improving physical fitness at sea level also offers comparable benefits in the unique context of high... (Randomized Controlled Trial)
Randomized Controlled Trial
This study investigates whether exercise as a strategy for improving physical fitness at sea level also offers comparable benefits in the unique context of high altitudes (HA), considering the physiological challenges of hypoxic conditions. Overall, 121 lowlanders who had lived on the Tibetan Plateau for >2 years and were still living at HA during the measurements were randomly classified into four groups. Each individual of the low-intensity (LI), moderate-intensity (MI), and high-intensity (HI) groups performed 20 sessions of aerobic exercise at HA (3680 m) over 4 weeks, while the control group (CG) did not undergo any intervention. Physiological responses before and after the intervention were observed. The LI and MI groups experienced significant improvement in cardiopulmonary fitness (0.27 and 0.35 L/min increases in peak oxygen uptake [ O], both p < 0.05) after exercise intervention, while the hematocrit (HCT) remained unchanged (p > 0.05). However, HI exercise was less efficient for cardiopulmonary fitness of lowlanders (0.02 L/min decrease in O, p > 0.05), whereas both the HCT (1.74 %, p < 0.001) and glomerular filtration rate (18.41 mL/min, p < 0.001) increased with HI intervention. Therefore, LI and MI aerobic exercise, rather than HI, can help lowlanders in Tibet become more acclimated to the HA by increasing cardiopulmonary function and counteracting erythrocytosis.
Topics: Humans; Tibet; Exercise; Altitude; Male; Adult; Acclimatization; Oxygen Consumption; Cardiorespiratory Fitness; Female; Hematocrit; Young Adult; Glomerular Filtration Rate; Physical Fitness; Heart Rate
PubMed: 38874991
DOI: 10.1002/ejsc.12110 -
European Journal of Sport Science Jun 2024We examine the impact of the acute manipulation of oxygen availability during discrete phases (active and passive) of a repeated-sprint cycling protocol on performance,...
We examine the impact of the acute manipulation of oxygen availability during discrete phases (active and passive) of a repeated-sprint cycling protocol on performance, physiological, and perceptual responses. On separate days, twelve trained males completed four sets of five 5-s 'all out' cycle sprints (25-s inter-sprint recovery and 5-min interset rest) in four randomized conditions: normobaric hypoxia (inspired oxygen fraction of 12.9%) applied continuously (C-HYP), intermittently during only the sets of sprints (I-HYP) or between-sets recovery periods (I-HYP), or not at all (C-NOR). Peak and mean power output, peripheral oxygen saturation, heart rate, blood lactate concentration, exercise-related sensations, and vastus lateralis muscle oxygenation using near-infrared spectroscopy were assessed. Peak and mean power output was ∼4%-5% lower for C-HYP compared to C-NOR (P ≤ 0.050) and I-HYP (P ≤ 0.027). Peripheral oxygen saturation was lower during C-HYP and I-HYP compared with C-NOR and I-HYP during sets of sprints (∼83-85 vs. ∼95%-97%; P < 0.001), while lower values were obtained for C-HYP and I-HYP than C-NOR and I-HYP during between-sets rest period (∼84-85 vs. ∼96%; P < 0.001). Difficulty in breathing was ∼21% higher for C-HYP than C-NOR (P = 0.050). Ratings of perceived exertion (P = 0.435), limb discomfort (P = 0.416), heart rate (P = 0.605), blood lactate concentration (P = 0.976), and muscle oxygenation-derived variables (P = 0.056 to 0.605) did not differ between conditions. In conclusion, the method of hypoxic exposure application (continuous vs. intermittent) affects mechanical performance, while internal demands remained essentially comparable during repeated cycle sprints.
PubMed: 38874584
DOI: 10.1002/ejsc.12146 -
Heliyon Jun 2024Understanding the combining ability effects, heterosis, and genetic relationships between parental lines would be helpful in the maize breeding program to develop...
Understanding the combining ability effects, heterosis, and genetic relationships between parental lines would be helpful in the maize breeding program to develop high-yielding and genetically stable maize varieties for various contrasting environments. Hence, the objective of this study was to estimate combining ability effects, heterosis, genetic distance (GD) and associations for grain yield and other agronomic traits. Forty-five F diallel crosses, four commercial checks, and ten inbred lines were evaluated at Bako and Jima Agricultural Research Centers, Ethiopia. Significant differences were observed among environments, genotypes and genotype by environment interaction for grain yield and almost all studied agronomic traits. Combining ability analysis showed both additive and non-additive gene effects significantly controlled grain yield and all other studied traits. The preponderance of general combining ability (GCA) effects indicates the importance of additive gene action inheriting most agronomic traits. Lines L2, L7, and L9 were the best combiners for grain yield, whereas lines L3 and L4 had desirable GCA values to improve days to flowering and plant height. Among the top ten crosses, L6 × L9, L6 × L7 and L4 × L9 were good specific combiners and had 18.8 %, 17.2 % and 16.2 % grain yield advantage over the best check, BH546. These hybrids also had high mid and better-parent heterosis compared with other crosses. The associations of GD with mean of F and SCA effects were positive and highly significant for grain yield and some other traits. In contrast, correlations of GD with mid and better parent heterosis were non-significant for grain yield and most other traits. The results of this study are particularly useful for breeders who envisage combining conventional and molecular methods.
PubMed: 38873668
DOI: 10.1016/j.heliyon.2024.e32267 -
Frontiers in Neurorobotics 2024Unmanned Aerial Vehicles (UAVs) and quadrotors are being used in an increasing number of applications. The detection and management of forest fires is continually...
Unmanned Aerial Vehicles (UAVs) and quadrotors are being used in an increasing number of applications. The detection and management of forest fires is continually improved by the incorporation of new economical technologies in order to prevent ecological degradation and disasters. Using an inner-outer loop design, this paper discusses an attitude and altitude controller for a quadrotor. As a highly nonlinear system, quadrotor dynamics can be simplified by assuming several assumptions. Quadrotor autopilot is developed using nonlinear feedback linearization technique, LQR, SMC, PD, and PID controllers. Often, these approaches are used to improve control and to reject disturbances. PD-PID controllers are also deployed in the tracking and surveillance of smoke or fire by intelligent algorithms. In this paper, the efficiency using a combined PD-PID controllers with adjustable parameters have been studied. The performance was assessed by simulation using matlab Simulink. The computational study conducted to assess the proposed approach showed that the PD-PID combination presented in this paper yields promising outcomes.
PubMed: 38873025
DOI: 10.3389/fnbot.2024.1363366 -
Health Science Reports Jun 2024Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide. There have been limited studies...
BACKGROUND AND AIMS
Acute respiratory failure (ARF) is the most frequent cause of cardiorespiratory arrest and subsequent death in children worldwide. There have been limited studies regarding ARF in high altitude settings. The aim of this study was to calculate mortality and describe associated factors for severity and mortality in children with ARF.
METHODS
The study was conducted within a prospective multicentric cohort that evaluated the natural history of pediatric ARF. For this analysis three primary outcomes were studied: mortality, invasive mechanical ventilation, and pediatric intensive care unit (PICU) length of stay. Eligible patients were children older than 1 month and younger than 18 years of age with respiratory difficulty at the time of admission. Patients who developed ARF were followed at the time of ARF, 48 h later, at the time of discharge, and at 30 and 60 days after discharge. It was conducted in the pediatric emergency, in-hospital, and critical-care services in three hospitals in Bogotá, Colombia, from April 2020 to June 2021.
RESULTS
Out of a total of 685 eligible patients, 296 developed ARF for a calculated incidence of ARF of 43.2%. Of the ARF group, 90 patients (30.4%) needed orotracheal intubation, for a mean of 9.57 days of ventilation (interquartile range = 3.00-11.5). Incidence of mortality was 6.1% ( = 18). The associated factors for mortality in ARF were a history of a neurologic comorbidity and a higher fraction of inspired oxygen at ARF diagnosis. For PICU length of stay, the associated factors were age between 2 and 5 years of age, exposure to smokers, and respiratory comorbidity. Finally, for mechanical ventilation, the risk factors were obesity and being unstable at admission.
CONCLUSIONS
ARF is a common cause of morbidity and mortality in children. Understanding the factors associated with greater mortality and severity of ARF might allow earlier recognition and initiation of prompt treatment strategies.
PubMed: 38872789
DOI: 10.1002/hsr2.1994 -
ELife Jun 2024Compared with lowlander migrants, native Tibetans have a higher reproductive success at high altitude though the underlying mechanism remains unclear. Here, we compared...
Compared with lowlander migrants, native Tibetans have a higher reproductive success at high altitude though the underlying mechanism remains unclear. Here, we compared the transcriptome and histology of full-term placentas between native Tibetans and Han migrants. We found that the placental trophoblast shows the largest expression divergence between Tibetans and Han, and Tibetans show decreased immune response and endoplasmic reticulum stress. Remarkably, we detected a sex-biased expression divergence, where the male-infant placentas show a greater between-population difference than the female-infant placentas. The umbilical cord plays a key role in the sex-biased expression divergence, which is associated with the higher birth weight of the male newborns of Tibetans. We also identified adaptive histological changes in the male-infant placentas of Tibetans, including larger umbilical artery wall and umbilical artery intima and media, and fewer syncytial knots. These findings provide valuable insights into the sex-biased adaptation of human populations, with significant implications for medical and genetic studies of human reproduction.
Topics: Humans; Female; Placenta; Male; Pregnancy; Fetal Development; Tibet; Infant, Newborn; Transcriptome; Altitude; Sex Factors; Sex Characteristics
PubMed: 38869160
DOI: 10.7554/eLife.89004 -
Heliyon Jun 2024The agricultural sector, in particular viticulture, is highly susceptible to variations in the environment, crop conditions, and operational factors. Effectively...
The agricultural sector, in particular viticulture, is highly susceptible to variations in the environment, crop conditions, and operational factors. Effectively managing these variables in the field necessitates observation, measurement, and responsive actions. Leveraging new technologies within the realm of precision agriculture, vineyards can enhance their long-term efficiency, productivity, and profitability. In our work we propose a novel analysis of the impact of pedoclimatic factors on wine, with a case study focusing on the Denomination of Controlled and Guaranteed Origin Chianti Classico (DOCG), a prime wine-producing region located in Tuscany, between the provinces of Siena and Florence. We first collected a novel dataset, where geographic information as well as wine quality information were collected, using publicly available sources. Using such geographic information retrieved and an unsupervised machine learning approach, we conducted an in-depth examination of pedoclimatic and production data. To collect the whole set of possibly relevant features, we first assessed the region's morphological attributes, including altitude, exposure, and slopes, while pinpointing individual wineries. Subsequently we then calculated crucial viticultural indices such as the Winkler, Huglin, Fregoni, and Freshness Index by utilizing daily temperature records from Chianti Classico, and we further related them to an assessment of wine quality. In addition to this, we designed and distributed a survey conducted among a sample of wineries situated in the Chianti Classico area, obtaining valuable insights into local data. The primary goal of this study is to elucidate the interrelationships between various parameters associated with the region, considering influential factors such as the environment, viticulture, and field operations that significantly impact wine production. By doing so, wineries could potentially unlock the full potential of their resources. In fact, through the unsupervised and correlation analysis we could elucidate the relationships existing between the pedoclimatic parameters of the region, considering the most important factors such as viticulture and field operations, and relate them to wine quality as for instance using the survey data collected. This study represents an unprecedent in the literature, and it could pave the path for future studies focusing on the importance of climatic factors into production and quality of wines.
PubMed: 38868017
DOI: 10.1016/j.heliyon.2024.e31648