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647 results on '"Rayman P"'

4. Simulation of Other-Initiated Repair Using AAC

Author

Alexis S. Rayman, Antara Satchidanand, and Jeff Higginbotham

Abstract

This simulation study assessed the ability of Speech-Output Technologies (SOTs) to keep in-time during conversational repair. Fifty-eight Other Initiated Repair (OIR) initiators were collected from transcripts of repair interaction sequences collected from past research. A range of selection latencies were then used to calculate simulated utterance composition delays for the OIR initiators using two popular SOT software apps, with and without the use of word prediction. To determine whether OIR utterances could be produced within a socially sensitive temporal gap, composition delay was compared to a conservative temporal limit obtained for oral communicators (Kendrick, 2015). Even at the fastest 0.5 s selection latency level, utterance-level composition delays for both SOTs were substantially greater than the OIR limit set for this study. Next, AAC production rate data spanning a variety of technologies, access methods, tasks and user profiles was obtained from the literature. Communication performance for these groups was then evaluated against the identified temporal OIR limit. None of the user groups were found to be capable of producing full OIR utterances within the temporal limits of oral-speech conversation, with most unable to type even a single selection within these bounds. Because of the frequency and importance of repair in conversation, these results have important implications for designing devices to enable their users to successfully engage in such important conversational activities.

Published
2024
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7. A Glycemia Risk Index (GRI) of Hypoglycemia and Hyperglycemia for Continuous Glucose Monitoring Validated by Clinician Ratings

Author

Klonoff, David C, Wang, Jing, Rodbard, David, Kohn, Michael A, Li, Chengdong, Liepmann, Dorian, Kerr, David, Ahn, David, Peters, Anne L, Umpierrez, Guillermo E, Seley, Jane Jeffrie, Xu, Nicole Y, Nguyen, Kevin T, Simonson, Gregg, Agus, Michael SD, Al-Sofiani, Mohammed E, Armaiz-Pena, Gustavo, Bailey, Timothy S, Basu, Ananda, Battelino, Tadej, Bekele, Sewagegn Yeshiwas, Benhamou, Pierre-Yves, Bequette, B Wayne, Blevins, Thomas, Breton, Marc D, Castle, Jessica R, Chase, James Geoffrey, Chen, Kong Y, Choudhary, Pratik, Clements, Mark A, Close, Kelly L, Cook, Curtiss B, Danne, Thomas, Doyle, Francis J, Drincic, Angela, Dungan, Kathleen M, Edelman, Steven V, Ejskjaer, Niels, Espinoza, Juan C, Fleming, G Alexander, Forlenza, Gregory P, Freckmann, Guido, Galindo, Rodolfo J, Gomez, Ana Maria, Gutow, Hanna A, Heinemann, Lutz, Hirsch, Irl B, Hoang, Thanh D, Hovorka, Roman, Jendle, Johan H, Ji, Linong, Joshi, Shashank R, Joubert, Michael, Koliwad, Suneil K, Lal, Rayhan A, Lansang, M Cecilia, Lee, Wei-An, Leelarathna, Lalantha, Leiter, Lawrence A, Lind, Marcus, Litchman, Michelle L, Mader, Julia K, Mahoney, Katherine M, Mankovsky, Boris, Masharani, Umesh, Mathioudakis, Nestoras N, Mayorov, Alexander, Messler, Jordan, Miller, Joshua D, Mohan, Viswanathan, Nichols, James H, Nørgaard, Kirsten, O’Neal, David N, Pasquel, Francisco J, Philis-Tsimikas, Athena, Pieber, Thomas, Phillip, Moshe, Polonsky, William H, Pop-Busui, Rodica, Rayman, Gerry, Rhee, Eun-Jung, Russell, Steven J, Shah, Viral N, Sherr, Jennifer L, Sode, Koji, Spanakis, Elias K, Wake, Deborah J, Waki, Kayo, Wallia, Amisha, Weinberg, Melissa E, Wolpert, Howard, Wright, Eugene E, Zilbermint, Mihail, and Kovatchev, Boris

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Diabetes, Adult, Humans, Blood Glucose, Blood Glucose Self-Monitoring, Hypoglycemia, Hyperglycemia, Glucose, ambulatory glucose profile, composite metric, continuous glucose monitor, diabetes, glycemia risk index, hyperglycemia, hypoglycemia, time in range, Nutrition and dietetics
Abstract

BackgroundA composite metric for the quality of glycemia from continuous glucose monitor (CGM) tracings could be useful for assisting with basic clinical interpretation of CGM data.MethodsWe assembled a data set of 14-day CGM tracings from 225 insulin-treated adults with diabetes. Using a balanced incomplete block design, 330 clinicians who were highly experienced with CGM analysis and interpretation ranked the CGM tracings from best to worst quality of glycemia. We used principal component analysis and multiple regressions to develop a model to predict the clinician ranking based on seven standard metrics in an Ambulatory Glucose Profile: very low-glucose and low-glucose hypoglycemia; very high-glucose and high-glucose hyperglycemia; time in range; mean glucose; and coefficient of variation.ResultsThe analysis showed that clinician rankings depend on two components, one related to hypoglycemia that gives more weight to very low-glucose than to low-glucose and the other related to hyperglycemia that likewise gives greater weight to very high-glucose than to high-glucose. These two components should be calculated and displayed separately, but they can also be combined into a single Glycemia Risk Index (GRI) that corresponds closely to the clinician rankings of the overall quality of glycemia (r = 0.95). The GRI can be displayed graphically on a GRI Grid with the hypoglycemia component on the horizontal axis and the hyperglycemia component on the vertical axis. Diagonal lines divide the graph into five zones (quintiles) corresponding to the best (0th to 20th percentile) to worst (81st to 100th percentile) overall quality of glycemia. The GRI Grid enables users to track sequential changes within an individual over time and compare groups of individuals.ConclusionThe GRI is a single-number summary of the quality of glycemia. Its hypoglycemia and hyperglycemia components provide actionable scores and a graphical display (the GRI Grid) that can be used by clinicians and researchers to determine the glycemic effects of prescribed and investigational treatments.

Published
2023

11. Robust Real-time Computing with Chemical Reaction Networks

Author

Fletcher, Willem, Klinge, Titus H., Lathrop, James I., Nye, Dawn A., and Rayman, Matthew

Subjects
Computer Science - Emerging Technologies
Abstract

Recent research into analog computing has introduced new notions of computing real numbers. Huang, Klinge, Lathrop, Li, and Lutz defined a notion of computing real numbers in real-time with chemical reaction networks (CRNs), introducing the classes $\mathbb{R}_\text{LCRN}$ (the class of all Lyapunov CRN-computable real numbers) and $\mathbb{R}_\text{RTCRN}$ (the class of all real-time CRN-computable numbers). In their paper, they show the inclusion of the real algebraic numbers $ALG \subseteq \mathbb{R}_\text{LCRN} \subseteq \mathbb{R}_\text{RTCRN}$ and that $ALG \subsetneqq \mathbb{R}_\text{RTCRN}$ but leave open where the inclusion is proper. In this paper, we resolve this open problem and show $ALG= \mathbb{R}_\text{LCRN} \subsetneqq \mathbb{R}_\text{RTCRN}$. However, their definition of real-time computation is fragile in the sense that it is sensitive to perturbations in initial conditions. To resolve this flaw, we further require a CRN to withstand these perturbations. In doing so, we arrive at a discrete model of memory. This approach has several benefits. First, a bounded CRN may compute values approximately in finite time. Second, a CRN can tolerate small perturbations of its species' concentrations. Third, taking a measurement of a CRN's state only requires precision proportional to the exactness of these approximations. Lastly, if a CRN requires only finite memory, this model and Turing machines are equivalent under real-time simulations., Comment: 15 pages, 1 figure

Published
2021

12. The Truth about Power Laws: Theory and Reality

Author

Zhang, Xiaojun, He, Zheng, Zhang, Liwei, Rayman-Bacchus, Lez, Xiao, Yue, and Shen, Shuhui

Subjects
Physics - Physics and Society, Nonlinear Sciences - Adaptation and Self-Organizing Systems
Abstract

Consensus about the universality of the power law feature in complex networks is experiencing profound challenges. To shine fresh light on this controversy, we propose a generic theoretical framework in order to examine the power law property. First, we study a class of birth-and-death networks that is ubiquitous in the real world, and calculate its degree distributions. Our results show that the tails of its degree distributions exhibits a distinct power law feature, providing robust theoretical support for the ubiquity of the power law feature. Second, we suggest that in the real world two important factors, network size and node disappearance probability, point to the existence of the power law feature in the observed networks. As network size reduces, or as the probability of node disappearance increases, then the power law feature becomes increasingly difficult to observe. Finally, we suggest that an effective way of detecting the power law property is to observe the asymptotic (limiting) behaviour of the degree distribution within its effective intervals.

Published
2021

14. Google COVID-19 Search Trends Symptoms Dataset: Anonymization Process Description (version 1.0)

Author

Bavadekar, Shailesh, Dai, Andrew, Davis, John, Desfontaines, Damien, Eckstein, Ilya, Everett, Katie, Fabrikant, Alex, Flores, Gerardo, Gabrilovich, Evgeniy, Gadepalli, Krishna, Glass, Shane, Huang, Rayman, Kamath, Chaitanya, Kraft, Dennis, Kumok, Akim, Marfatia, Hinali, Mayer, Yael, Miller, Benjamin, Pearce, Adam, Perera, Irippuge Milinda, Ramachandran, Venky, Raman, Karthik, Roessler, Thomas, Shafran, Izhak, Shekel, Tomer, Stanton, Charlotte, Stimes, Jacob, Sun, Mimi, Wellenius, Gregory, and Zoghi, Masrour

Subjects
Computer Science - Cryptography and Security
Abstract

This report describes the aggregation and anonymization process applied to the initial version of COVID-19 Search Trends symptoms dataset (published at https://goo.gle/covid19symptomdataset on September 2, 2020), a publicly available dataset that shows aggregated, anonymized trends in Google searches for symptoms (and some related topics). The anonymization process is designed to protect the daily symptom search activity of every user with $\varepsilon$-differential privacy for $\varepsilon$ = 1.68.

Published
2020

18. Robotic Versus Laparoscopic Left and Extended Left Hepatectomy: An International Multicenter Study Propensity Score-Matched Analysis

Author

Sucandy, Iswanto, Rayman, Shlomi, Lai, Eric C., Tang, Chung-Ngai, Chong, Yvette, Efanov, Mikhail, Fuks, David, Choi, Gi-Hong, Chong, Charing C., Chiow, Adrian K. H., Marino, Marco V., Prieto, Mikel, Lee, Jae-Hoon, Kingham, T. Peter, D’Hondt, Mathieu, Troisi, Roberto I., Choi, Sung Hoon, Sutcliffe, Robert P., Cheung, Tan-To, Rotellar, Fernando, Park, James O., Scatton, Olivier, Han, Ho-Seong, Pratschke, Johann, Wang, Xiaoying, Liu, Rong, and Goh, Brian K. P.

Published
2022
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20. Ceres' opposition effect observed by the Dawn framing camera

Author

Schröder, Stefan E., Li, Jian-Yang, Rayman, Marc D., Joy, Steven P., Polanskey, Carol A., Carsenty, Uri, Castillo-Rogez, Julie C., Ciarniello, Mauro, Jaumann, Ralf, Longobardo, Andrea, McFadden, Lucy A., Mottola, Stefano, Sykes, Mark, Raymond, Carol A., and Russell, Christopher T.

Subjects
Astrophysics - Earth and Planetary Astrophysics
Abstract

The surface reflectance of planetary regoliths may increase dramatically towards zero phase angle, a phenomenon known as the opposition effect (OE). Two physical processes that are thought to be the dominant contributors to the brightness surge are shadow hiding (SH) and coherent backscatter (CB). The occurrence of shadow hiding in planetary regoliths is self-evident, but it has proved difficult to unambiguously demonstrate CB from remote sensing observations. One prediction of CB theory is the wavelength dependence of the OE angular width. The Dawn spacecraft observed the OE on the surface of dwarf planet Ceres. We characterize the OE over the resolved surface, including the bright Cerealia Facula, and to find evidence for SH and/or CB. We analyze images of the Dawn framing camera by means of photometric modeling of the phase curve. We find that the OE of most of the investigated surface has very similar characteristics, with an enhancement factor of 1.4 and a FWHM of 3{\deg} (broad OE). A notable exception are the fresh ejecta of the Azacca crater, which display a very narrow brightness enhancement that is restricted to phase angles $< 0.5${\deg} (narrow OE); suggestively, this is in the range in which CB is thought to dominate. We do not find a wavelength dependence for the width of the broad OE, and lack the data to investigate the dependence for the narrow OE. The prediction of a wavelength-dependent CB width is rather ambiguous. The zero-phase observations allow us to determine Ceres' visible geometric albedo as $p_V = 0.094 \pm 0.005$. A comparison with other asteroids suggests that Ceres' broad OE is typical for an asteroid of its spectral type, with characteristics that are primarily linked to surface albedo. Our analysis suggests that CB may occur on the dark surface of Ceres in a highly localized fashion., Comment: Credit: Schr\"oder et al, A&A in press, 2018, reproduced with permission, \copyright ESO

Published
2018
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23. Utilization patterns of glucagon like Peptide-1 receptor agonists prior to bariatric and metabolic surgery: a multicenter study.

Author

Rayman, Shlomi, Morduch, Evyatar, Reiner-Benaim, Anat, Catzman, Netta-lee, Carmeli, Idan, Froylich, Dvir, and Goitein, David

Abstract

Glucagon-like-peptide-1 receptor agonists (G1RA) have gained popularity as a treatment for weight loss in patients who are overweight or obese, but their utilization patterns and impact on candidates for metabolic and bariatric surgery (MBS) remain understudied. We aimed to investigate the prevalence, characteristics, and outcomes of patients with a history of G1RA utilization among MBS candidates. Five high-volume MBS centers in Israel. Data were collected retrospectively from February 1st, 2023, to September 30th, 2023. Demographic, clinical, and treatment data were analyzed to assess a history of G1RA use, associated factors, adverse events, and treatment outcomes. Four hundred thirty-four MBS candidates were included in the study. A history of G1RA utilization was obtained in 275 (63%) MBS candidates, with Liraglutide and Semaglutide being the most commonly used agents. Younger age, type 2 diabetes mellitus, dyslipidemia, and no previous MBS history were associated with a higher rate of G1RA utilization. With these medications, median maximal weight loss was 5.38 kg, and mean duration of use was 19 weeks. Patients using G1RA for ≥6 weeks experienced significantly greater weight loss compared to those using it for shorter periods (6.3 ± 6.43 vs 1.65 ± 1.69; P <.001). GI-related adverse events were reported in 57.8% of patients. Over 95% of patients discontinued G1RA due to insufficient weight loss and/or adverse effects. Patients reaching the maximal recommended dose exhibited significantly greater weight loss versus patients who did not reach it for both Liraglutide (5.9 ± 4.98 kg vs. 3.9 ± 5.53 kg; P =.03) and Semaglutide (6.5 ± 7.8 kg vs. 2.5 ± 3.8 kg; P =.016). Pre-MBS G1RA utilization and failure are prevalent among MBS candidates. Our study underscores the need for further research to understand the role of G1RA therapy in obesity management and the development of guidelines for its appropriate use in MBS candidates. • Over 60% of MBS candidates have utilized G1RA drugs prior to surgery. • G1RA use was prevalent in younger patients with T2D or dyslipidemia with no prior MBS. • 95% of G1RA utilizers discontinued therapy due to IWL or adverse events. • The most common (57%) adverse events follow G1RA treatment was GI-related. [ABSTRACT FROM AUTHOR]

Published
2025
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24. ASO Visual Abstract: Robotic Versus Laparoscopic Left and Extended Left Hepatectomy—An International Multicenter Study Propensity-Score-Matched Analysis

Author

Sucandy, Iswanto, Rayman, Shlomi, Lai, Eric C., Tang, Chung-Ngai, Chong, Yvette, Efanov, Mikhail, Fuks, David, Choi, Gi-Hong, Chong, Charing C., Chiow, Adrian K. H., Marino, Marco V., Prieto, Mikel, Lee, Jae-Hoon, Kingham, T. Peter, D’Hondt, Mathieu, Troisi, Roberto I., Choi, Sung-Hoon, Sutcliffe, Robert P., Cheung, Tan-To, Rotellar, Fernando, Park, James O., Scatton, Olivier, Han, Ho-Seong, Pratschke, Johann, Wang, Xiaoying, Liu, Rong, and Goh, Brian K. P.

Published
2022
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27. Variations in the amount of water ice on Ceres' surface suggest a seasonal water cycle.

Author

Raponi, Andrea, De Sanctis, Maria Cristina, Frigeri, Alessandro, Ammannito, Eleonora, Ciarniello, Mauro, Formisano, Michelangelo, Combe, Jean-Philippe, Magni, Gianfranco, Tosi, Federico, Carrozzo, Filippo Giacomo, Fonte, Sergio, Giardino, Marco, Joy, Steven P, Polanskey, Carol A, Rayman, Marc D, Capaccioni, Fabrizio, Capria, Maria Teresa, Longobardo, Andrea, Palomba, Ernesto, Zambon, Francesca, Raymond, Carol A, and Russell, Christopher T

Abstract

The dwarf planet Ceres is known to host a considerable amount of water in its interior, and areas of water ice were detected by the Dawn spacecraft on its surface. Moreover, sporadic water and hydroxyl emissions have been observed from space telescopes. We report the detection of water ice in a mid-latitude crater and its unexpected variation with time. The Dawn spectrometer data show a change of water ice signatures over a period of 6 months, which is well modeled as ~2-km2 increase of water ice. The observed increase, coupled with Ceres' orbital parameters, points to an ongoing process that seems correlated with solar flux. The reported variation on Ceres' surface indicates that this body is chemically and physically active at the present time.

Published
2018

28. Automated insulin delivery during the first 6 months postpartum (AiDAPT): a prespecified extension study

Author

Lee, Tara T M, Collett, Corinne, Bergford, Simon, Hartnell, Sara, Scott, Eleanor M, Lindsay, Robert S, Hunt, Katharine F, McCance, David R, Reynolds, Rebecca M, Wilinska, Malgorzata E, Sibayan, Judy, Kollman, Craig, Hovorka, Roman, Murphy, Helen R, Hunt, Katharine F, Rogers, Helen, Morris, Damian, Fowler, Duncan, Rosier, Josephine, Banu, Zeenat, Barker, Sarah, Rayman, Gerry, Gurnell, Eleanor, Byrne, Caroline, Lake, Andrea, Davenport, Katy, Grisoni, Jeannie, Savine, Shannon, Murphy, Helen R, Lee, Tara T M, Wallace, Tara, McKelvey, Alastair, Willer, Nina, Collett, Corinne, Man, Mei-See, Flanagan, Emma, Hammond, Matt, Shepstone, Lee, Brackenridge, Anna, White, Sara, Reid, Anna, Okolo, Olanike, Scott, Eleanor, Endersby, Del, Dover, Anna, Dougherty, Frances, Johnstone, Susan, Reynolsd, Rebecca M, Lindsay, Robert S, Carty, David, Mackin, Sharon, Crawford, Isobel, Buchan, Ross, McCance, David, Jones, Louisa, Quinn, Joanne, Cains, Sarah, and Ayman, Goher

Abstract

Clinical guidelines in the UK and elsewhere do not specifically address hybrid closed loop (HCL) use in the postpartum period when the demands of caring for a newborn are paramount. Our aim was to evaluate the safety and efficacy of HCL use during the first 6 months postpartum compared with standard care.

Published
2025
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29. Decay of Scale-Free Property in Birth-and-Death Network

Author

Zhang, Xiaojun, He, Zheng, and Rayman-Bacchus, Lez

Subjects
Physics - Physics and Society
Abstract

Sorry, there are some calculation errors in this paper, Comment: there are some calculation errors in this paper

Published
2015

30. Improving the identification of frail elderly newly diagnosed multiple myeloma patients

Author

Stege, Claudia A. M., Nasserinejad, Kazem, Klein, Saskia K., Timmers, Gert-Jan, Hoogendoorn, Mels, Ypma, Paula F., Nijhof, Inger S., Velders, Gerjo A., Strobbe, Leonie, Durdu-Rayman, Nazik, Westerman, Matthijs, Davidis-van Schoonhoven, Marjan A., van Kampen, Roel J. W., Beeker, Aart, Koster, Ad, Dijk, Amanda C., van de Donk, Niels W. C. J., van der Spek, Ellen, Leys, Rineke B. L., Silbermann, Matthijs H., Groen, Kaz, van der Burg-de Graauw, Nicole C. H. P., Sinnige, Harm A. M., van der Hem, Klaas G., Levenga, Henriette, Bilgin, Yavuz M., Sonneveld, Pieter, Levin, Mark-David, and Zweegman, Sonja

Published
2021
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33. Random Birth-and-Death Networks

Author

Zhang, Xiaojun, Zhan, Suoyue, and Rayman-Bacchus, Lez

Subjects
Physics - Physics and Society, Mathematics - Probability
Abstract

In this paper, a baseline model termed as random birth-and-death network model (RBDN) is considered, in which at each time step, a new node is added into the network with probability p (0

Published
2015
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37. Iodine status of teenage girls on the island of Ireland

Author

Mullan, Karen, Hamill, Lesley, Doolan, Katy, Young, Ian, Smyth, Peter, Flynn, Albert, Walton, Janette, Meharg, Andrew A., Carey, Manus, McKernan, Claire, Bell, Marcia, Black, Neil, Graham, Una, McCance, David, McHugh, Cathy, McMullan, Paul, McQuaid, Siobhan, O’Loughlin, Aonghus, Tuthill, Antoinette, Bath, Sarah C., Rayman, Margaret, and Woodside, Jayne V.

Published
2020
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39. Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP

Author

Di Lorenzo, Nicola, Antoniou, Stavros A., Batterham, Rachel L., Busetto, Luca, Godoroja, Daniela, Iossa, Angelo, Carrano, Francesco M., Agresta, Ferdinando, Alarçon, Isaias, Azran, Carmil, Bouvy, Nicole, Balaguè Ponz, Carmen, Buza, Maura, Copaescu, Catalin, De Luca, Maurizio, Dicker, Dror, Di Vincenzo, Angelo, Felsenreich, Daniel M., Francis, Nader K., Fried, Martin, Gonzalo Prats, Berta, Goitein, David, Halford, Jason C. G., Herlesova, Jitka, Kalogridaki, Marina, Ket, Hans, Morales-Conde, Salvador, Piatto, Giacomo, Prager, Gerhard, Pruijssers, Suzanne, Pucci, Andrea, Rayman, Shlomi, Romano, Eugenia, Sanchez-Cordero, Sergi, Vilallonga, Ramon, and Silecchia, Gianfranco

Published
2020
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40. Blood Myeloid-Derived Suppressor Cells Correlate with Neutrophil-to-Lymphocyte Ratio and Overall Survival in Metastatic Urothelial Carcinoma

Author

Sheng, Iris Y., Diaz-Montero, Claudia Marcela, Rayman, Patricia, Wei, Wei, Finke, James H., Kim, Jin S., Pavicic, Jr., Paul G., Lamenza, Marcelo, Company, Donna, Stephenson, Andrew, Campbell, Steven, Haber, George, Lee, Byron, Mian, Omar, Gilligan, Timothy D., Rini, Brian I., Garcia, Jorge A., Grivas, Petros, and Ornstein, Moshe C.

Published
2020
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41. Employer Attitudes toward Study Abroad

Author

Trooboff, Stevan, Vande Berg, Michael, and Rayman, Jack

Abstract

In recent years, as study abroad professionals have come to focus more squarely on the question of what students are in fact learning abroad, there has been increasing speculation about the extent to which study abroad increases prospects for employability following graduation. Common wisdom has it that undergraduates who study abroad have an advantage over those who stay at home. A second piece of conventional wisdom somewhat tempers this optimistic view about study abroad's likely role in enhancing employability. It is commonly held that CEOs and presidents value studying abroad more than the human resource professionals and others in their firms who make the hiring decisions. The authors designed and carried out a research study to explore employers' attitudes toward study abroad. The study's results provide significant support for the belief that employers value study abroad in hiring recent college and university graduates--particularly certain classes of employers. The data both enriches one's understanding of employer attitudes about study abroad and points out several steps that can be taken to strengthen the connection between student learning abroad and enhanced possibilities for gainful employment following graduation. The data strongly suggests that human resource professionals and others responsible for hiring employees are in fact more likely to value study abroad than are CEOs and presidents. (Contains 3 tables and 11 notes.)

Published
2008

43. TLC-NOSF dressings as a first-line local treatment of chronic wounds: a systematic review of clinical evidence

Author

Meloni, Marco, Colboc, Hester, Armstrong, David G, Dissemond, Joachim, Rayman, Gerry, Lázaro-Martínez, José-Luis, Rial, Rodrigo, Hartemann, Agnès, Atkin, Leanne, Swanson, Terry, Goodeve, Michele, Lobmann, Ralf, Storck, Martin, Kröger, Knut, Borys, Sebastian, Nair, Harikrishna KR, Vaidya, Sanjay, Tran, Thua Nguyen, Huynh, Bao Le Thai, Thomassin, Laetitia, Bohbot, Serge, Manu, Chris, and Meaume, Sylvie

Abstract

Objective:Several national and international guidelines recommend lipidocolloid technology with a nano-oligosaccharide factor (TLC-NOSF) dressings (UrgoStart dressing range, Laboratoires Urgo, France) for treating patients with chronic wounds. However, these dressings are still often reported as second-line options, potentially leading to loss of opportunity for patients and additional costs for payers. This review aimed to explore the reported wound healing and patient outcomes as well as the related costs when the dressings were used as first-line treatment in patients with different types of chronic wounds.Method:A systematic review of the literature was conducted. Databases (MEDLINE, Embase, Emcare, and Google Scholar) were searched up to 1 February 2024, without any language or time period limitations. Studies were eligible if the evaluated dressings had been used as a first-line treatment for chronic wounds, that is, as an integral part of the standard of care (SoC) at the patient's first presentation and/or in recent wounds. The main evaluation criteria included: wound healing rate; time to reach wound closure; change in patients' quality of life (QoL); and associated costs. The quality of evidence of the included studies was appraised using well-recognised risk-of-bias tools suitable for different study designs. A narrative synthesis describes the findings in three sections depending on the type of comparison. This report followed the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results:A total of 17 studies published between 2017 and 2024 met the eligibility criteria. A comparative analysis between TLC-NOSF dressings and standard dressings, both of which were used as first-line treatment, was reported in nine studies. A comparative analysis between the use of TLC-NOSF dressings as first-line and second-line treatments was reported in eight studies, and five studies reported a systematic use of the TLC-NOSF dressing as first-line treatment without a control group. Overall, the included studies had a relatively low risk of bias for the respective types of evidence. Data of 10,191 patients of both sexes and different age groups with a total of 10,203 wounds (diabetic foot ulcers, leg ulcers, pressure injuries, and other types of chronic wounds) were included in the analysis: 7775 treated with the evaluated dressing and 2428 treated with a comparator dressing. The data suggested that using TLC-NOSF as a first-line treatment for chronic wounds consistently resulted in significantly higher healing rates, shorter healing times, and cost savings compared with standard dressings used under similar conditions. Real-life evidence confirmed the results obtained in clinical trials and economic models, within similar ranges, regardless of the settings involved or of the characteristics of the patients and wounds treated. The wound healing rates ranged around 70–80% by week 20/24 and time-to-heal was reported on average around seven weeks, with slightly longer times reported in wounds with a more severe prognosis. Furthermore, the dressings were shown to improve patient QoL, and were well tolerated and accepted, supporting a wider adoption approach.Conclusion:The results of this review are aligned with the current guidelines recommending the use of TLC-NOSF dressings in the treatment of patients with chronic wounds. They support its wider implementation as a first-line treatment and as an integral part of SoC for these wounds in the daily practice of all centres involved in their management.

Published
2024
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44. Covalent Probes To Capture Legionella pneumophilaDup Effector Enzymes

Author

Kloet, Max S., Mukhopadhyay, Rishov, Mukherjee, Rukmini, Misra, Mohit, Jeong, Minwoo, Talavera Ormeño, Cami M. P., Moutsiopoulou, Angeliki, Tjokrodirijo, Rayman T. N., van Veelen, Peter A., Shin, Donghyuk, Đikić, Ivan, Sapmaz, Aysegul, Kim, Robbert Q., and van der Heden van Noort, Gerbrand J.

Abstract

Upon infection of host cells, Legionella pneumophilareleases a multitude of effector enzymes into the cell's cytoplasm that hijack a plethora of cellular activities, including the host ubiquitination pathways. Effectors belonging to the SidE-family are involved in noncanonical serine phosphoribosyl ubiquitination of host substrate proteins contributing to the formation of a Legionella-containing vacuole that is crucial in the onset of Legionnaires’ disease. This dynamic process is reversed by effectors called Dups that hydrolyze the phosphodiester in the phosphoribosyl ubiquitinated protein. We installed reactive warheads on chemically prepared ribosylated ubiquitin to generate a set of probes targeting these Legionella enzymes. In vitro tests on recombinant DupA revealed that a vinyl sulfonate warhead was most efficient in covalent complex formation. Mutagenesis and X-ray crystallography approaches were used to identify the site of covalent cross-linking to be an allosteric cysteine residue. The subsequent application of this probe highlights the potential to selectively enrich the Dup enzymes from Legionella-infected cell lysates.

Published
2024
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