Objective:To evaluate morphine's risk-benefit profile in the treatment of acute heart failure.Method:Different electronic databases,including PubMed,MEDLINE,Cochrane Library,and Google Scholar,as well as clinicalt...Objective:To evaluate morphine's risk-benefit profile in the treatment of acute heart failure.Method:Different electronic databases,including PubMed,MEDLINE,Cochrane Library,and Google Scholar,as well as clinicaltrails.gov,were searched for articles published between 2012 and 2022.The risk of bias in the present study was evaluated by employing randomized controlled trials(RCTs)checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment groups.The two-part tool was used to address the five specific domains such as selection bias,performance bias,detection bias,attrition bias,and selective reporting bias.Evaluation of the quality of diagnostic accuracy studies was conducted using the RevMan software(version 5.4),a quality assessment tool.Results:A total of 13 studies were included in the present review,in which there were 5 retrospective studies,3 randomized-control studies,2 prospective studies,1 multicenter pharmacodynamics study,1 multicenter cardiac magnetic resonance imaging study,and 1 open-label,cross-over study.The mortality of acute heart failure patients treated with morphine was higher compared to those without morphine.Conclusions:Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive morphine.Considering the adverse effects,including mortality associated with morphine,there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.展开更多
INTRODUCTION:The radiological phenotype represents the radiological characteristics of coronavirus disease 2019(COVID-19)pneumonia.Radiological outcomes initially interpreted as post-COVID-19 lung fibrosis have been d...INTRODUCTION:The radiological phenotype represents the radiological characteristics of coronavirus disease 2019(COVID-19)pneumonia.Radiological outcomes initially interpreted as post-COVID-19 lung fibrosis have been detected in short-term follow-up of recovered COVID-19 cases,but long-term radiological evaluation suggests that these abnormalities should be defined as post-COVID-19 sequelae.The present study aimed to evaluate the radiological phenotypes of post-COVID-19 residual radiological lung abnormalities(RLAs)in recovered COVID-19 cases.METHODS:This prospective,observational study included 3000 patients with polymerase chain reaction-confirmed COVID-19,with documented lung involvement and radiological severity categorized as mild,moderate,or severe by high-resolution computed tomography(HRCT)at admission.Final radiological outcomes were based on radiological assessments at 6 months and 1 year after hospital discharge.Final radiological phenotypes were defined as RLAs and categorized as resolving,persistent,or progressive,based on HRCT imaging at 1 year of follow-up.A total of 622 cases with RLAs were finally included.The final outcome phenotypes were evaluated in relation to age,sex,comorbidities,laboratory parameters,and interventions,including oxygen and ventilator-support requirements during hospitalization.The data were analyzed using Chi-square tests.RESULTS:RLAs were documented in 622 of the 3000 COVID-19 pneumonia cases(20.73%).The final radiological outcomes were defined as resolving in 77.17%(480/622),persistent in 15.43%(96/622),and progressive in 7.39%(46/622).Radiological outcome phenotypes and RLAs were significantly associated with the duration of illness at admission(P<0.00001),laboratory parameters(D-dimer,C-reactive protein,and interleukin-6)at admission(P<0.00001),radiological severity on computed tomography(P<0.00001),and inpatient interventions(P<0.00001).Radiological outcome phenotypes and RLAs were also significantly associated with age,sex,diabetes mellitus,ischemic heart disease,hypertension,chronic obstructive pulmonary disease,obesity,and lung functions assessed by spirometry at 1-year follow-up(P<0.00001).CONCLUSIONS:Radiological outcome phenotypes have a crucial role in assigning final radiological outcomes in patients with COVID-19 pneumonia and differentiating between post-COVID-19 lung fibrosis and post-COVID-19 lung sequelae.RLAs,categorized as resolving,persistent,and progressive,provide a novel radiological classification of post-COVID-19 lung sequelae.Final phenotypic classification may play an important role in further workups and treatment planning for RLAs;some patients with progressive phenotypes may have underlying rheumatological predispositions and many cases may have resolving phenotypes requiring no further treatment,whereas cases with persistent RLAs require further follow-up.展开更多
The novel phases Rb_(4)NaU_(3)O_(12-x)F_(x)(1),K_(4)NaU_(3)O_(12-x)F_(x)(2),and Rb_(2.1)K_(1.9)KU_(3)O_(12-x)F_(x)(3)were synthesized by molten flux methods using mixed alkali fluoride melts.The oxyfluorides crystalli...The novel phases Rb_(4)NaU_(3)O_(12-x)F_(x)(1),K_(4)NaU_(3)O_(12-x)F_(x)(2),and Rb_(2.1)K_(1.9)KU_(3)O_(12-x)F_(x)(3)were synthesized by molten flux methods using mixed alkali fluoride melts.The oxyfluorides crystallize in the cubic space group Im3m with a lattice parameters of 8.7472(2)Å,8.6264(2)Å,and 8.8390(3)Å,respectively.All three structures crystallize in a cubic perovskite structure,ABO_(3)(A_(4)BB’_(3)O_(12)).展开更多
INTRODUCTION:Radiological phenotypes are observable radiological patterns or characteristics.Robust data are available regarding the role of high‑resolution computed tomography(HRCT)in coronavirus disease 2019(COVID‑1...INTRODUCTION:Radiological phenotypes are observable radiological patterns or characteristics.Robust data are available regarding the role of high‑resolution computed tomography(HRCT)in coronavirus disease 2019(COVID‑19)pneumonia.We evaluated the role of radiological phenotyping in assessing severity and predicting the response to therapy,as well as its association with outcomes in COVID‑19 pneumonia.METHODS:This prospective observational study included 3000 COVID‑19 reverse transcription polymerase chain reaction‑confirmed cases with lung involvement who underwent thoracic HRCT on hospital admission and were categorized as mild,moderate,or severe according to lung segment bilateral involvement(mild 1–7,moderate 8–15,and severe 16–25).Follow‑up thoracic CT imaging was also conducted 6 months after hospital discharge.Response to treatment phenotypes was categorized as“easy to treat”or“difficult to treat”based on the response and interventions required in indoor settings,including ventilatory support.Age,gender,comorbidities,laboratory parameters,the use of bilevel‑positive airway pressure/noninvasive ventilation,and outcomes(with or without lung fibrosis)were key observations.The Chi‑square test was used for statistical analysis.RESULTS:Easy‑to‑treat and difficult‑to‑treat radiological response phenotypes were observed in 20%and 80%of the cases,respectively.There were significant associations between the radiological phenotypes and the duration of illness at hospital admission.The duration of illness(<7 days,7–14 days,and>14 days)could predict the radiological phenotype(P<0.00001).Laboratory parameters at hospital admission(C‑reactive protein,interleukin‑6,ferritin,lactate dehydrogenase,and D‑dimer)were significantly associated with the radiological phenotypes(P<0.00001),as were interventions required in indoor units(P<0.00001).The HRCT severity score at admission was significantly correlated with the radiological phenotype(P<0.00001).Post‑COVID lung fibrosis or sequelae were also significantly associated with the radiological phenotype(P<0.00001).CONCLUSION:Easy‑to‑treat and difficult‑to‑treat phenotypic differentiation had a crucial role during the initial assessment of COVID‑19 cases on hospitalization and was used for planning targeted intervention treatments in intensive care units.In addition,phenotypic differentiation had an important role in analyzing the radiological sequelae and predicting final treatment outcomes.展开更多
文摘Objective:To evaluate morphine's risk-benefit profile in the treatment of acute heart failure.Method:Different electronic databases,including PubMed,MEDLINE,Cochrane Library,and Google Scholar,as well as clinicaltrails.gov,were searched for articles published between 2012 and 2022.The risk of bias in the present study was evaluated by employing randomized controlled trials(RCTs)checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment groups.The two-part tool was used to address the five specific domains such as selection bias,performance bias,detection bias,attrition bias,and selective reporting bias.Evaluation of the quality of diagnostic accuracy studies was conducted using the RevMan software(version 5.4),a quality assessment tool.Results:A total of 13 studies were included in the present review,in which there were 5 retrospective studies,3 randomized-control studies,2 prospective studies,1 multicenter pharmacodynamics study,1 multicenter cardiac magnetic resonance imaging study,and 1 open-label,cross-over study.The mortality of acute heart failure patients treated with morphine was higher compared to those without morphine.Conclusions:Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive morphine.Considering the adverse effects,including mortality associated with morphine,there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.
文摘INTRODUCTION:The radiological phenotype represents the radiological characteristics of coronavirus disease 2019(COVID-19)pneumonia.Radiological outcomes initially interpreted as post-COVID-19 lung fibrosis have been detected in short-term follow-up of recovered COVID-19 cases,but long-term radiological evaluation suggests that these abnormalities should be defined as post-COVID-19 sequelae.The present study aimed to evaluate the radiological phenotypes of post-COVID-19 residual radiological lung abnormalities(RLAs)in recovered COVID-19 cases.METHODS:This prospective,observational study included 3000 patients with polymerase chain reaction-confirmed COVID-19,with documented lung involvement and radiological severity categorized as mild,moderate,or severe by high-resolution computed tomography(HRCT)at admission.Final radiological outcomes were based on radiological assessments at 6 months and 1 year after hospital discharge.Final radiological phenotypes were defined as RLAs and categorized as resolving,persistent,or progressive,based on HRCT imaging at 1 year of follow-up.A total of 622 cases with RLAs were finally included.The final outcome phenotypes were evaluated in relation to age,sex,comorbidities,laboratory parameters,and interventions,including oxygen and ventilator-support requirements during hospitalization.The data were analyzed using Chi-square tests.RESULTS:RLAs were documented in 622 of the 3000 COVID-19 pneumonia cases(20.73%).The final radiological outcomes were defined as resolving in 77.17%(480/622),persistent in 15.43%(96/622),and progressive in 7.39%(46/622).Radiological outcome phenotypes and RLAs were significantly associated with the duration of illness at admission(P<0.00001),laboratory parameters(D-dimer,C-reactive protein,and interleukin-6)at admission(P<0.00001),radiological severity on computed tomography(P<0.00001),and inpatient interventions(P<0.00001).Radiological outcome phenotypes and RLAs were also significantly associated with age,sex,diabetes mellitus,ischemic heart disease,hypertension,chronic obstructive pulmonary disease,obesity,and lung functions assessed by spirometry at 1-year follow-up(P<0.00001).CONCLUSIONS:Radiological outcome phenotypes have a crucial role in assigning final radiological outcomes in patients with COVID-19 pneumonia and differentiating between post-COVID-19 lung fibrosis and post-COVID-19 lung sequelae.RLAs,categorized as resolving,persistent,and progressive,provide a novel radiological classification of post-COVID-19 lung sequelae.Final phenotypic classification may play an important role in further workups and treatment planning for RLAs;some patients with progressive phenotypes may have underlying rheumatological predispositions and many cases may have resolving phenotypes requiring no further treatment,whereas cases with persistent RLAs require further follow-up.
基金supported by the U.S.Department of Energy,Office of Basic Energy Sciences,Division of Materials Sciences and Engineering under Award DE-SC0016574C.Juillerat is additionally supported by an NSF IGERT Graduate Fellowship under grant number 1250052+1 种基金V.Kocevski and T.Besmann acknowledge the use computational resources provided by the National Energy Research Scientific Computing Center(NERSC)and the HPC cluster Hyperion,supported by The Division of Information Technology at University of South CarolinaXANES data collected on Beamline 10-BM-B at the Advanced Light Source,a U.S.Department of Energy(DOE)Office of Science User Facility operated for the DOE Office of Science by Argonne National Laboratory under Contract No.DE-AC02-06CH11357,and is directed by MRCAT and supported by the Department of Energy and the MRCAT member institutions.
文摘The novel phases Rb_(4)NaU_(3)O_(12-x)F_(x)(1),K_(4)NaU_(3)O_(12-x)F_(x)(2),and Rb_(2.1)K_(1.9)KU_(3)O_(12-x)F_(x)(3)were synthesized by molten flux methods using mixed alkali fluoride melts.The oxyfluorides crystallize in the cubic space group Im3m with a lattice parameters of 8.7472(2)Å,8.6264(2)Å,and 8.8390(3)Å,respectively.All three structures crystallize in a cubic perovskite structure,ABO_(3)(A_(4)BB’_(3)O_(12)).
文摘INTRODUCTION:Radiological phenotypes are observable radiological patterns or characteristics.Robust data are available regarding the role of high‑resolution computed tomography(HRCT)in coronavirus disease 2019(COVID‑19)pneumonia.We evaluated the role of radiological phenotyping in assessing severity and predicting the response to therapy,as well as its association with outcomes in COVID‑19 pneumonia.METHODS:This prospective observational study included 3000 COVID‑19 reverse transcription polymerase chain reaction‑confirmed cases with lung involvement who underwent thoracic HRCT on hospital admission and were categorized as mild,moderate,or severe according to lung segment bilateral involvement(mild 1–7,moderate 8–15,and severe 16–25).Follow‑up thoracic CT imaging was also conducted 6 months after hospital discharge.Response to treatment phenotypes was categorized as“easy to treat”or“difficult to treat”based on the response and interventions required in indoor settings,including ventilatory support.Age,gender,comorbidities,laboratory parameters,the use of bilevel‑positive airway pressure/noninvasive ventilation,and outcomes(with or without lung fibrosis)were key observations.The Chi‑square test was used for statistical analysis.RESULTS:Easy‑to‑treat and difficult‑to‑treat radiological response phenotypes were observed in 20%and 80%of the cases,respectively.There were significant associations between the radiological phenotypes and the duration of illness at hospital admission.The duration of illness(<7 days,7–14 days,and>14 days)could predict the radiological phenotype(P<0.00001).Laboratory parameters at hospital admission(C‑reactive protein,interleukin‑6,ferritin,lactate dehydrogenase,and D‑dimer)were significantly associated with the radiological phenotypes(P<0.00001),as were interventions required in indoor units(P<0.00001).The HRCT severity score at admission was significantly correlated with the radiological phenotype(P<0.00001).Post‑COVID lung fibrosis or sequelae were also significantly associated with the radiological phenotype(P<0.00001).CONCLUSION:Easy‑to‑treat and difficult‑to‑treat phenotypic differentiation had a crucial role during the initial assessment of COVID‑19 cases on hospitalization and was used for planning targeted intervention treatments in intensive care units.In addition,phenotypic differentiation had an important role in analyzing the radiological sequelae and predicting final treatment outcomes.
