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Effect of Regular, Low-Dose, Extended-release Morphine on Chronic Breathlessness in Chronic Obstructive Pulmonary Disease : The BEAMS Randomized Clinical Trial

IMPORTANCE: Chronic breathlessness is common in people with chronic obstructive pulmonary disease (COPD). Regular, low-dose, extended-release morphine may relieve breathlessness, but evidence about its efficacy and dosing is needed.OBJECTIVE: To determine the effect of different doses of extended-release morphine on worst breathlessness in people with COPD after 1 week of treatment.DESIGN, SETTING

Plasma and cerebrospinal fluid neurofilament light concentrations reflect neuronal damage in systemic lupus Erythematosus

BACKGROUND: Neuronal damage in systemic lupus erythematosus (SLE) is common, but the extent and mechanisms are unclear. Neurofilament light (NfL) concentrations rise in plasma and cerebrospinal fluid (CSF) during neuronal damage in various neurological disorders. In this cross-sectional study, plasma and CSF concentrations of NfL were explored as a marker of neuronal damage in SLE.METHODS: Seventy

Mesenchymal heterogeneity in the adult human lung

The human lung is a complex tissue consisting of a heterogeneous mix of different structures and cells, each which a specific role that together contribute to the primary function of the organ: the gas exchange. Different mesenchymal cells populate the interstitial areas around airways and blood vessels and form the connective tissue together with the extracellular matrix. Fibroblasts constitute o

Preterm Delivery and Long-term Risk of Hypertension in Women

Importance: Preterm delivery has been associated with future cardiometabolic disorders in women. However, the long-term risks of chronic hypertension associated with preterm delivery and whether such risks are attributable to familial confounding are unclear. Such knowledge is needed to improve long-term risk assessment, clinical monitoring, and cardiovascular prevention strategies in women. Objec

Neoadjuvant Trastuzumab, Pertuzumab, and Docetaxel vs Trastuzumab Emtansine in Patients with ERBB2-Positive Breast Cancer : A Phase 2 Randomized Clinical Trial

Importance: Trastuzumab emtansine (T-DM1) is presently approved for treatment of advanced breast cancer and after incomplete response to neoadjuvant therapy, but the potential of T-DM1 as monotherapy is so far unknown. Objective: To assess pathologic complete response (pCR) to standard neoadjuvant therapy of combination docetaxel, trastuzumab, and pertuzumab (DTP) vs T-DM1 monotherapy in patients

Methodology for developing reduced reaction mechanisms, and their use in combustion simulations

Combustion, present in a vast majority of energy and material production as well as in transportation, represents a foundation of our modern society. To improve and optimize the applications relying on combustion demand a high level of knowledge, and an ability to simulate the combustion process. To do so three-dimensional Computational Fluid Dynamic (CFD) combustion simulations can be used, whereCombustion, present in a vast majority of energy and material production as well as in transportation, represents a foundation of our modern society. To improve and optimize the applications relying on combustion demand a high level of knowledge, and an ability to simulate the combustion process. To do so three-dimensional Computational Fluid Dynamic (CFD) combustion simulations can be used, where

Association of Sleep Duration with All- And Major-Cause Mortality among Adults in Japan, China, Singapore, and Korea

Importance: The association between long sleep duration and mortality appears stronger in East Asian populations than in North American or European populations. Objectives: To assess the sex-specific association between sleep duration and all-cause and major-cause mortality in a pooled longitudinal cohort and to stratify the association by age and body mass index. Design, Setting, and Participants

Association Between Preoperative Opioid and Benzodiazepine Prescription Patterns and Mortality After Noncardiac Surgery

IMPORTANCE: The number of patients prescribed long-term opioids and benzodiazepines and complications from their long-term use have increased. Information regarding the perioperative outcomes of patients prescribed these medications before surgery is limited.OBJECTIVE: To determine whether patients prescribed opioids and/or benzodiazepines within 6 months preoperatively would have greater short- a

Biological mechanisms of resilience to tau pathology in Alzheimer’s disease

Background: In Alzheimer’s disease (AD), the associations between tau pathology and brain atrophy and cognitive decline are well established, but imperfect. We investigate whether cerebrospinal fluid (CSF) biomarkers of biological processes (vascular, synaptic, and axonal integrity, neuroinflammation, neurotrophic factors) explain the disconnection between tau pathology and brain atrophy (brain re

Global, regional, and national burden of stroke and its risk factors, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standard

Association Between Dietary Habits in Midlife With Dementia Incidence Over a 20-Year Period

BACKGROUND AND OBJECTIVES: Dementia cases are expected to triple during the next 30 years, highlighting the importance of finding modifiable risk factors for dementia. The aim of this study is to investigate whether adherence to conventional dietary recommendations or to a modified Mediterranean diet are associated with subsequent lower risk of developing all-cause dementia, Alzheimer's disease (A

Time to Blood Culture Positivity: An Independent Predictor of Mortality in Streptococcus Pyogenes Bacteremia

BackgroundStreptococcus pyogenes bacteremia is a severe condition with high mortality. Time to blood culture positivity (TTP) is known to predict the outcome in bacteremia with other pathogens. This study aimed to determine the association between TTP and outcome in S pyogenes bacteremia.MethodsThis retrospective observational cohort study comprised adults with S pyogenes bacteremia, identified thBackgroundStreptococcus pyogenes bacteremia is a severe condition with high mortality. Time to blood culture positivity (TTP) is known to predict the outcome in bacteremia with other pathogens. This study aimed to determine the association between TTP and outcome in S pyogenes bacteremia.MethodsThis retrospective observational cohort study comprised adults with S pyogenes bacteremia, identified th

Normalization of puberty and adult height in girls with Turner syndrome : results of the Swedish Growth Hormone trials initiating transition into adulthood

Objective: To study the impact of GH dose and age at GH start in girls with Turner syndrome (TS), aiming for normal height and age at pubertal onset (PO) and at adult height (AH). However, age at diagnosis will limit treatment possibilities. Methods: National multicenter investigator-initiated studies (TNR 87-052-01 and TNR 88-072) in girls with TS, age 3–16 years at GH start during year 1987–1998

Abnormal cerebral hemodynamics and blood-brain barrier permeability detected with perfusion MRI in systemic lupus erythematosus patients

Objective: Dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) has previously shown alterations in cerebral perfusion in patients with systemic lupus erythematosus (SLE). However, the results have been inconsistent, in particular regarding neuropsychiatric (NP) SLE. Thus, we investigated perfusion-based measures in different brain regions in SLE patients with and without NP invo

Incidence of pre-eclampsia : effect of deprivation

Objectives: To examine the relationship between the English index of multiple deprivation (IMD) and the incidence of pre-eclampsia (PE), evaluate the distribution of IMD in a cohort of ethnically diverse pregnant women in South East England and assess whether IMD improves the prediction of PE compared with that provided by the ‘history-only’ competing-risks model (based on maternal characteristics

Evaluation of the Post Stroke Checklist: a pilot study in the United Kingdom and Singapore

Background There is currently no standardized process for long-term follow-up care. As a result, management of post-stroke care varies greatly, and the needs of stroke survivors are not fully addressed. The Post Stroke Checklist was developed by the Global Stroke Community Advisory Panel as a means of standardizing long-term stroke care. Since its development, the Post Stroke Checklist has gained

Spectroscopic differences in posterior insula in patients with chronic temporomandibular pain

Chronic pain including temporomandibular disorder (TMD) pain involves a complex interplay between peripheral and central sensitization, endogenous modulatory pathways, cortical processing and integration and numerous psychological, behavioral and social factors. The aim of this study was to compare spectroscopic patterns of N-Acetyl-aspartate (NAA), total creatine (tCr), choline (Cho), myo-inosito

Perceived and functional balance control is negatively affected by diminished touch and vibration sensitivity in relatively healthy older adults and elderly

Background: Severe diminished foot somatosensation, for example, caused by neuropathies and advanced aging, contributes to balance deficits and increased fall risk. However, little is known about somatosensory impairment and functional and subjective balance problems in relatively healthy elderly. Method: Vibration perception thresholds (VPTs) were assessed with a biothesiometer and tactile pressu

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with as

Researching materiality and children’s biographies

Children’s biographies are only rarely and more recently considered. In this paper, we make a case for thinking biographically about children’s relational lives. Using two qualitative case studies from research with children in middle childhood, in the UK and Sweden, we attend to the materiality of children’s biographies. We explore the way in which home spaces, possessions, family mementoes and mChildren’s biographies are only rarely and more recently considered. In this paper, we make a case for thinking biographically about children’s relational lives. Using two qualitative case studies from research with children in middle childhood, in the UK and Sweden, we attend to the materiality of children’s biographies. We explore the way in which home spaces, possessions, family mementoes and m