463 results match your criteria: "Duke University Medical Center -Durham[Affiliation]"
A perspective of lipid nanoparticles for RNA delivery.
Exploration (Beijing)
December 2024
CAS Key Laboratory for Biomedical Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience National Center for Nanoscience and Technology Beijing China.
Over the last two decades, lipid nanoparticles (LNPs) have evolved as an effective biocompatible and biodegradable RNA delivery platform in the fields of nanomedicine, biotechnology, and drug delivery. They are novel bionanomaterials that can be used to encapsulate a wide range of biomolecules, such as mRNA, as demonstrated by the current successes of COVID-19 mRNA vaccines. Therefore, it is important to provide a perspective on LNPs for RNA delivery, which further offers useful guidance for researchers who want to work in the RNA-based LNP field.
View Article and Find Full Text PDF2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.
J Arrhythm
December 2024
Department of Medicine, Division of Cardiology Columbia University Vagelos College of Physicians and Surgeons New York NY USA.
In the last three decades, ablation of atrial fibrillation (AF) has become an evidence-based safe and efficacious treatment for managing the most common cardiac arrhythmia. In 2007, the first joint expert consensus document was issued, guiding healthcare professionals involved in catheter or surgical AF ablation. Mounting research evidence and technological advances have resulted in a rapidly changing landscape in the field of catheter and surgical AF ablation, thus stressing the need for regularly updated versions of this partnership which were issued in 2012 and 2017.
View Article and Find Full Text PDFRacial and Ethnic Disparities in the Use and Outcomes With WATCHMAN FLX: A SURPASS Analysis of the NCDR Left Atrial Appendage Occlusion Registry.
J Am Heart Assoc
December 2024
Section of Cardiovascular Medicine Yale University School of Medicine, New Haven, Connecticut and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital New Haven CT USA.
Background: Left atrial appendage occlusion (LAAO) is increasingly used as an alternative to oral anticoagulation for stroke prevention in select patients with atrial fibrillation. Data on outcomes in racial and ethnic minority individuals are limited. This analysis assessed differences in the use and outcomes of LAAO by race and ethnicity in a large national registry.
View Article and Find Full Text PDFPurpose: The purpose of this study was to understand how objective measures of daily activity change following unicompartmental knee arthroplasty (UKA). Objective data on post-operative changes in daily physical activity following UKA are limited, highlighting the need for studies using wearable technologies to provide real-time assessments of recovery.
Methods: This pilot study included a secondary analysis of a prospective study of 33 consecutive UKA patients, with data collected using an Apple Watch and a digital care management application.
Article Synopsis
- Gaucher disease type 3 is a genetic disorder caused by a deficiency in the enzyme β-glucocerebrosidase, leading to a variety of health issues, particularly affecting the cardiac, neurological, and eye systems, with symptoms typically appearing before age 18.
- Type 3c, a specific form of this disease, is linked to a genetic variant and is unique for its association with heart problems, although few cases have been documented, making its full range of symptoms unclear.
- The case of a 20-year-old female with an unusual presentation of type 3c that includes eye inflammation and nerve damage—yet normal heart function—highlights the diverse manifestations of the disease and the need for better guidelines in evaluating
Harnessing deep learning and statistical shape modelling for three-dimensional evaluation of joint bony morphology.
J Exp Orthop
October 2024
Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden.
Article Synopsis
- Diagnostic variables from insertable cardiac monitors can help identify heart failure (HF) patients at risk, but high-risk alerts must be paired with interventions to improve patient outcomes.
- The ALLEVIATE-HF study involved patients with recent HF events, using a risk score based on various monitor diagnostics to guide intervention protocols, including diuretic uptitration.
- Results showed that the intervention was generally safe, with positive symptom resolution in most cases, indicating the feasibility of tailored medication management based on high-risk alerts.
Endovascular Ablation of the Greater Splanchnic Nerve in Heart Failure With Preserved Ejection Fraction: The REBALANCE-HF Randomized Clinical Trial.
JAMA Cardiol
December 2024
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Article Synopsis
- This study evaluated the effectiveness and safety of a new procedure called splanchnic nerve ablation for managing fluid volume in patients with heart failure and preserved ejection fraction (HFpEF).* -
- Conducted as a phase 2, double-blind, randomized trial involving 90 patients across 15 centers, the study compared the outcomes of the nerve ablation procedure to a sham control.* -
- Results showed no significant differences in both the primary outcomes (reduction in pulmonary capillary wedge pressure) and safety events between the treatment and control groups, suggesting that the nerve ablation may not provide the expected benefits for these patients.*
Relationship Between Infarct Artery, Myocardial Injury, and Outcomes After Primary Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction.
J Am Heart Assoc
September 2024
The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai New York NY.
Article Synopsis
- The study analyzed data from 7 trials with 1,774 STEMI patients to understand how the location of the infarct artery affects heart injury and outcomes after primary coronary intervention.
- Results showed that patients with anterior STEMI (affecting the left anterior descending artery) had a larger median infarct size and were at a higher risk for mortality and heart failure hospitalization compared to those with nonanterior STEMI.
- The research concluded that anterior STEMI leads to more severe heart damage and worse overall prognosis, highlighting the importance of infarct location in patient outcomes.
Ergonomic Wellness in Endoscopy: Obstacles and Ways Forward.
Gastroenterol Hepatol (N Y)
August 2024
Professor of Medicine Division of Gastroenterology Duke University Medical Center Durham, North Carolina.
Randomized Trials of Renal Denervation for Uncontrolled Hypertension: An Updated Meta-Analysis.
J Am Heart Assoc
August 2024
Division of Cardiovascular Medicine, Department of Medicine Henry Ford Health Detroit MI.
Article Synopsis
- A meta-analysis was conducted to evaluate the effectiveness and safety of catheter-based renal denervation (RDN) in patients with uncontrolled hypertension, including those on and off antihypertensive medications.
- The analysis included 15 randomized trials with a total of 2,581 patients, showing significant reductions in blood pressure for both groups, with larger decreases observed in those not taking medications.
- RDN was found to be effective in lowering blood pressure while also demonstrating a good safety profile, confirming its potential as a treatment option for uncontrolled hypertension.
Cardiac Magnetic Resonance Studies in a Large Animal Model That Simulates the Cardiac Abnormalities of Human Septic Shock.
J Am Heart Assoc
August 2024
Critical Care Medicine Department, Clinical Center National Institutes of Health, (NIH, CC) Bethesda MD USA.
Article Synopsis
- Septic shock leads to increased end-diastolic volume (EDV) and decreased ejection fraction in survivors, unlike nonsurvivors, whose EDV does not increase due to more severe diastolic dysfunction early in the condition.* -
- In a study with beagles, findings indicate that septic animals experienced significant heart issues, including wall edema and thinning, resulting in decreased heart performance, particularly in nonsurvivors during the initial phase of sepsis.* -
- The research suggests that cardiac dysfunction during sepsis is connected to microvascular injury and edema, with important implications for understanding heart changes and recovery in septic patients.*
In a Canine Model of Septic Shock, Cardiomyopathy Occurs Independent of Catecholamine Surges and Cardiac Microvascular Ischemia.
J Am Heart Assoc
August 2024
Critical Care Medicine Department, Clinical Center National Institutes of Health Bethesda MD USA.
Article Synopsis
- * Beagles were given either saline or epinephrine infusions, with results indicating that while epinephrine significantly increased plasma levels, it did not worsen heart function compared to saline.
- * The findings suggest that heart dysfunction in sepsis is not mainly caused by high levels of catecholamines, but also highlight changes in microcirculatory perfusion and heart function variability between treated and untreated groups.
Objective Ischemia, Subjective Angina, and Psychological Distress in Angina With No Obstructive Coronary Disease.
J Am Heart Assoc
August 2024
Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology) Shenzhen Guangdong China.
Background: Angina with no obstructive coronary disease (ANOCA) and ischemia with no obstructive coronary disease, prevalent yet underrecognized conditions, mostly affect women. Previous studies rarely distinguished between them. We aimed to compare the prevalence of objective ischemia through various examinations in women with ANOCA and assess the impact of objective and subjective ischemia on their mental health.
View Article and Find Full Text PDFScience over language: a plea to consider language bias in scientific publishing.
Crit Care Sci
July 2024
Division of Pediatric Critical Care Medicine, Duke University Medical Center -Durham, North Carolina, United States.
Predictors of Shock-Reduction Programming and Its Impact on Implantable Cardioverter-Defibrillator Therapies and Mortality: The CERTITUDE Registry.
J Am Heart Assoc
August 2024
Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York- Presbyterian Hospital New York NY.
Background: Shock-reduction implantable cardioverter-defibrillator programming (SRP) was associated with fewer therapies and improved survival in randomized controlled trials, but real-world studies investigating SRP and associated outcomes are limited.
Methods And Results: The BIOTRONIK CERTITUDE registry was linked with the Medicare database. We included all patients with an implantable cardioverter-defibrillator implanted between August 22, 2012 and September 30, 2021 in the United States.
Priming antibody responses to the fusion peptide in rhesus macaques.
NPJ Vaccines
July 2024
Department of Integrative Structural and Computational Biology, The Scripps Research Institute, La Jolla, CA, 92037, USA.
Article Synopsis
- Immunodominance of antibodies targeting non-neutralizing epitopes and high somatic hypermutation in germinal centers (GCs) are major challenges in developing a successful HIV vaccine.
- The study utilized implantable osmotic pumps to deliver epitope-targeted immunogens to rhesus macaques, aiming to enhance antibody responses against the conserved fusion peptide over six months.
- Results indicated that while antibody responses against the FP/N611 glycan hole were primed, they showed limited neutralization breadth, and cryoEMPEM revealed key residue information to guide future vaccine design.
Background: Black patients meeting indications for implantable cardioverter-defibrillators (ICDs) have lower rates of implantation compared with White patients. There is little understanding of how mental health impacts the decision-making process among Black patients considering ICDs. Our objective was to assess the association between depressive symptoms and ICD implantation among Black patients with heart failure.
View Article and Find Full Text PDFArticle Synopsis
- Alzheimer's disease is a condition marked by cognitive and functional declines, and the study examined the effects of tilavonemab on these declines using the Clinical Dementia Rating (CDR) scale.
- Researchers used longitudinal Item Response Theory (IRT) models to analyze changes in early-stage AD patients, finding that cognitive decline was faster than functional decline, and tilavonemab did not provide significant benefits.
- The study highlighted a significant relationship between baseline severities and their progression rates, indicating that cognitive and functional declines in AD are interconnected, and suggested the usefulness of multidimensional IRT models for understanding disease progression.
Association Between Sleep Apnea Treatment and Health Care Resource Use in Patients With Atrial Fibrillation.
J Am Heart Assoc
May 2024
Charles Perkins Centre, Faculty of Medicine and Health University of Sydney Sydney Australia.
Article Synopsis
- * A study analyzed insurance claims data of 5867 patients, revealing that those who adhered to positive airway pressure (PAP) therapy had fewer emergency department visits, hospitalizations, and lower healthcare costs compared to nonadherent patients.
- * The findings emphasize the importance of diagnosing and managing OSA, showing that enhancing PAP therapy adherence can lead to both clinical and economic benefits for patients with atrial fibrillation.
Controlling glass forming kinetics in 2D perovskites using organic cation isomers.
Chem Sci
May 2024
Department of Mechanical Engineering and Materials Science, Duke University Durham North Carolina 27708 USA
The recent discovery of glass-forming metal halide perovskites (MHPs) provides opportunities to broaden the application domain beyond traditionally celebrated optoelectronic research fueled by associated crystalline counterparts. In this regard, it is crucial to diversify the compositional space of glass-forming MHPs and introduce varied crystallization kinetics synthetic structural engineering. Here, we compare two MHPs with slightly varying structural attributes, utilizing isomer organic cations with the same elemental composition, and demonstrate how this change in functional group position impacts the kinetics of glass formation and subsequent crystallization by multiple orders of magnitude.
View Article and Find Full Text PDFPatient Risk-Benefit Preferences for Transcatheter Versus Surgical Mitral Valve Repair.
J Am Heart Assoc
March 2024
Duke Clinical Research Institute, Duke University School of Medicine Durham NC USA.
Article Synopsis
- Transcatheter edge-to-edge repair (TEER) is a less invasive option for treating mitral regurgitation but carries higher long-term mortality and reintervention risks compared to surgery.
- A survey of 201 patients showed a clear preference for TEER over surgery, even if it meant accepting greater risks of reintervention and hospitalizations.
- For patients to prefer surgery over TEER, they would require significant functional improvement, equivalent to moving from class III to class I of the New York Heart Association classification over 5 years.
Cost Effectiveness of Dapagliflozin for Heart Failure Across the Spectrum of Ejection Fraction: An Economic Evaluation Based on Pooled, Individual Participant Data From the DELIVER and DAPA-HF Trials.
J Am Heart Assoc
March 2024
Division of Cardiovascular Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA USA.
Article Synopsis
- Sodium glucose cotransporter-2 (SGLT2) inhibitors, like dapagliflozin, are recommended for heart failure treatment, but their economic impact when added to standard care hasn't been thoroughly evaluated.
- A cost-effectiveness analysis was conducted using data from key trials showing that adding dapagliflozin can improve patient quality of life by 0.53 QALYs, with varying cost-effectiveness ratios depending on the price of the drug.
- The results suggest that dapagliflozin can be valuable in treating heart failure, with its cost-effectiveness sensitive to its price and impact on cardiovascular mortality, indicating it remains a beneficial option for patients under certain cost conditions.
Article Synopsis
- In patients with atherosclerotic cardiovascular disease, increased age is linked to higher risks of both ischemic and bleeding events, prompting a study on the effect of aspirin dosage based on age.
- The ADAPTABLE trial involved nearly 15,100 participants who were randomly assigned to take either 81 mg or 325 mg of aspirin daily, with outcomes measured over an average follow-up of 26.2 months.
- Results indicated that age did not significantly affect how aspirin dosage influenced clinical outcomes, suggesting that both doses are similarly effective for elderly and younger patients in preventing cardiovascular events.