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TLR8： the forgotten relative revindicated

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Cellular & Molecular Immunology 2012年第6期9卷 434-438页

作者： jorge L Cervantes bennett Weinerman Chaitali basole Juan C salazar Department of Pediatrics Immunology University of Connecticut Health Center Farmington CT USA Division of Pediatric Infectious Diseases Connecticut Children's Medical Center Hartford USA Parmington CT 06030 USA

The endosomal Toll-like receptors （TLRs） TLR3, TLR7, TLR8 and TLR9 are important in sensing foreign nucleic acids encountered by phagocytes. because TLR8 was initially thought to be non-functional in mice, less is known about TLR8 than the genetically and functionally related TLR7. Originally associated with the recognition of single-stranded RNA of viral origin, there is now evidence that human TLR8 is also able to sense bacterial RNA released within phagosomal vacuoles, inducing the production of both nuclear factor （NF）-κb-dependent cytokines and type I interferons （IFNs）, such as IFN-β. The functions of TLR8 extend beyond the recognition of foreign pathogens and include cross-talk with other endosomal TLRs, a process that may also have a role in the generation of autoimmunity.

关键词： human monocytes TLR8 type I interferon

Innovative treatments for congenital heart defects

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World Journal of Pediatrics 2023年第1期19卷 1-6页

作者： Antonio F.Corno Taylor S.Koerner jorge D.salazar McGovern Medical School Children's Heart InstituteMemorial Hermann Children's HospitalUniversity of Texas Health Science Center in Houston6410 Fannin StreetMSB 6.274HoustonTX 77030USA

The past few decades have witnessed substantial advances in the treatment of complex congenital heart defects,with most significant advances in surgical treatment strategies and improved outcomes dependent upon well-educated and calculated risk-taking *** the present surgical era,doing nothing for complex congenital heart defects is unacceptable,and pioneering surgeons are willing to under-take and accept the substantial risks of innovative pediatric cardiac surgery[1].

关键词： congenital treatment defects

Clinical pharmacology relevant to older adults with cardiovascular disease

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Journal of Geriatric Cardiology 2015年第3期12卷 192-195页

作者： jorge A brenes-salazar Laith Alshawabkeh Kenneth E Schmader Joseph T Hanlon Daniel E Forman Department of Medicine Division of Cardiovascular Diseases Mayo Clinic Rochester MN USA Department of Medicine Division of Cardiovascular Medicine University of lowa Iowa City IA USA Department of Medicine Division of Geriatrics Duke University School of Medicine Durham NC USA Departments of Medicine (Division of Geriatric Medicine) Pharmacy and Epidemiology University of Pittsburgh Geriatric Research Education and Clini- cal Center and Center for Health Equity Research and Promotion VA Pittsburgh Health System Pittsburgh PA USA Department of Medicine (Divisions of Geriatric Medicine and Cardiology) University of Pittsburgh Medical Center Geriatric Research Education and Clinical Center VA Pittsburgh Health System Pittsburgh PA USA

1 Introduction Although older adults are generally among the highest users of cardiovascular medications, they are typically underrepresented or excluded from most efficacy and safety trials. Drug developers are usually reluctant to include many senior adults in randomized controlled clinical trials in part due to their high prevalence of multiple comorbidities, frailty, and polypharmacy; and to age-related pharmacokinetic and pharmacodynamic complexities. Consequently, there is often insufficient high quality evidence-based data to inform pharmacologic management of common cardiovascular conditions on older adults. In the absence of data, clinicians often rely on conceptual principles regarding metabolism and drug-drug interactions to minimize adverse drug events, but this is often not well-substantiated or standardized. A related challenge is poor cardiovascular medication adherence among older adults, and its detrimental impact on their health outcomes. In this brief review we highlight some aspects of these topics.

关键词： Metabolism Pharmacokinetics Pharmacodynamics Polypharmacy

Echocardiography in centenarians： characteristics, utility and follow-up

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Journal of Geriatric Cardiology 2018年第5期15卷 328-333页

作者： jorge A brenes-salazar Jaime de la Fuente Punnaiah Marella Hari Chaliki Christopher Scott Heidi M Connolly Roger L Click Department of Cardiovascular Diseases Mayo Clinic Rochester USA Department of Internal Medicine Mayo Clinic Rochester USA Department of Cardiovascular Diseases Mayo Clinic Arizona USA Division of biostatistics Mayo Clinic Rochester USA

background Echocardiography has been shown to be a valuable resource in the diagnosis of many cardiac conditions, and can be used in all age groups, from the fetus to the oldest old. In the context of an increasingly aging population, the impact and utility of echocar- diography in centenarians is largely unknown. This study is to determine whether echocardiography in centenarians aids in making clinical patient management decisions. Methods A retrospective review of echocardiograms from 1986 to 2014, at two affiliated tertiary centers, in individuals who were 100 years or older at the time of the examination. Patient and echocardiogram characteristics, management decisions based on echocardiography, and mortality were documented. Results 114 centenarians had echocardiograms, with ages ranging from 100 to 107 years （101 - 1.4 years）. In 82 of the centenarians evaluated （72%）, no changes in management occurred as a consequence of the echocardiogram. From all management changes directly related to the echocardiogram, 81% （n = 26） of these corresponded to medication adjustments; interventional or surgical procedures followed the echocardiogram only in 4% （n = 5） of the total number of centenarians. Echocardiogram-based changes in management were only significant in patients that were referred for congestive heart failure （P = 0.02）. After the echocardiogram was performed, 1-month and 1-year mortality were 15% and 47%, respectively. The median survival after the echocardiogram was obtained was 13 months （range 0.03 to 145 months）, with no difference if there was a change or no change in manage- ment （P = 0.21）. Conclusions Among centenarians undergoing echocardiography, despite additional diagnostic information, echocardio- grams in centenarians influence management in a minority of cases, most commonly in the form of medication changes for treatment of heart failure. A significant proportion of centenarians are deceased within a year of undergoing echocardiographic ass

关键词： Centenarian Echocardiography Geriatric

Openwork Walls and Their Solar Applicability Range jorge Hernan salazar Trujillo

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Journal of Civil Engineering and Architecture 2015年第4期9卷 373-383页

作者： jorge Hernan salazar Trujillo Faculty of Architecture Universidad Nacional de Colombia (National University of Colombia) Medellin Colombia

The environmental potential of perforated surfaces in the tropics is noticeable. They allow obtaining higher attenuation and spatial dispersion of both direct and diffuse lighting in indoor spaces, whereas in outdoor areas, the openwork elements reduce surfaces temperature and mitigate the characteristic glare of smooth surfaces when exposed to sunlight. Openwork walls have an immense sustainability potential in modern tropical buildings： they limit the solar rays＇ admission, as well as provide an advantageous use of natural light and cross ventilation, but the research on their solar behavior is scarce. In order to obtain suitable levels of solar gain, relationships among shape, proportion, thickness and partitions composing openwork elements must be studied. This research evaluates solar gain in perforated surfaces by defining the ＂solar applicability range＂, a property useful to identify intervals of guidance where a perforated pattern shape will present a definite solar gain, giving valuable input in the geometric design of openwork elements and introducing shade performance in the design of openwork walls. Results give geometric guidelines that allow to widen the solar applicability range of a perforation pattern and to define two perforation features that have impact on the solar performance of perforated surfaces： focalization and solar performance shift.

关键词： Openwork bricks openwork walls solar performance shadow tropic architecture.

Early Design Method to Improve Shading Device Efficiency:The Solar Coupling Index

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Journal of Civil Engineering and Architecture 2019年第6期13卷 390-400页

作者： jorge Hernán salazar Trujillo Facultad de Arquitectura Universidad Nacional de ColombiaCalle 59 A N 63-20 Bl 24MedellínC.P.050034Colombia

To reduce solar gains,regions of the sky dome are masked,where the solar path will pass in the moments in which the shade will be *** these regions masked by the shadow devices could also provide diffuse lighting,reducing the need for daytime artificial *** a shadow device is perfectly designed it does not mask more sky than necessary avoiding unwanted solar *** the early stages of architectural design many decisions that will affect the project’s energy efficiency have not yet been made and information is lacking to carry out realistic energy or daylighting *** objective was to define an index to qualify,from minimum input data,the effectiveness of a shaded opening by maximizing the visibility to the sky while minimizing undesirable unshaded solar *** basic 3D models and AutoLISP algorithms,it was possible to calculate the aforementioned *** results demonstrate that similar shadow devices present variable Solar Coupling Indices,explaining why the pre-design of an efficient shadow device is an unintuitive *** method allows quantifying the gap between the best solar performance achievable and the performance achieved by a specific solar control device,helping to increase the energy efficiency of the architectural enclosures from the early design stages.

关键词： Shadow efficiency shading device solar control diffuse lighting shadow desirability

Clinical outcomes with a new microincisional diffractive multifocal IOL

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Eye and Vision 2015年第1期2卷 7-15页

作者： jorge L Alió Alfredo Vega-Estrada Ana b Plaza-Puche Vissum Corporation AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain Avda de Denia s/n Edificio Vissum03016 AlicanteSpain

background:To evaluate the refractive outcomes and the optical performance as well as the quality of life in patients implanted with a new diffractive multifocal intraocular lens(IOL).Methods:Prospective,clinical study including 41 cases of patients who underwent cataract surgery and were divided in two groups:group 1,including 20 eyes implanted with the multifocal IOL SeeLens MF(Hanita Lenses,Israel);group 2,21 eyes implanted with the Acrysof SA60AT *** acuity,defocus curve,intraocular aberrations,contrast sensitivity function and quality of life were assessed during a follow up period of 6 ***:Significant improvement was observed in the uncorrected distance visual acuity(UDVA)and corrected distance visual acuity(CDVA)in both groups(pbetter results in terms of uncorrected near visual acuity(UNVA)and distance-corrected near visual acuity(DCNVA)(pboth groups showed better visual acuities for the multifocal IOL group in defocus levels from-3.0 D to-1.50 D(p≤0.01).At 6 months,there was a significant reduction of the internal higher order aberrations(p≤0.04).A significant increase in scotopic contrast sensitivity was detected for 6 cycles/°spatial frequency during follow up(p=0.04),but no significant changes were observed for the rest of spatial frequencies(p≥0.06).Visual Functioning Index(VF-14)questionnaire showed that patients reported high levels of satisfaction when performing daily ***:The SeeLens MF IOL is able to successfully restore distance,near and intermediate visions after cataract *** also provides functional intermediate vision with optimal intraocular optical quality.

关键词： Visual visual IOL

Clinical outcomes with a new design in multifocal intraocular lens:a pilot study

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Eye and Vision 2020年第5期7卷 366-374页

作者： jorge L.Alió Pilar Yébana Mario Cantó Ana b.Plaza Alfredo Vega jorge L.Aliódel barrio Francisco Lugo Vissum Corporation Avda de Denia s/nEdificio Vissum03016 AlicanteSpain Division of Ophthalmology Universidad Miguel HernándezAlicanteSpain

Purpose:To evaluate the clinical and visual outcomes,quality of near vision and the influence of photic phenomena in patients bilaterally implanted with a new Precizon Presbyopic multifocal intraocular lens(IOL).Methods:In this prospective consecutive case series,20 eyes of 10 patients were included(mean age 63.80±12.55 years).Uncorrected and corrected visual acuity(far,intermediate and near),subjective refraction,binocular defocus curve,contrast sensitivity(CSV-1000)and quality of vision and satisfaction questionnaires were *** follow-up was 12 months after ***:At 12 months after surgery,uncorrected distance visual acuity(UDVA)improved with surgery(p=0.001)with a value of 0.08±0.08 *** near visual acuity(UNVA)was 0.22±0.12 logMAR and distance corrected near visual acuity(DCNVA)was 0.16±0.13 *** distance visual acuity(UIVA)was 0.22±0.10 *** sensitivity outcomes were similar to normal population in photopic conditions and slightly reduced in mesopic conditions of *** curve showed that this multifocal IOL was able to provide a visual acuity(VA)equal or better to 0.16 logMAR between defocus levels of+1.00 to−2.50 *** patient satisfaction was obtained in quality of vision and satisfaction questionnaires ***:The Precizon Presbyopic NVA IOL(OPHTEC bV)provides good visual *** multifocal IOL provides a high percentage of spectacle independence due to good VA at far,intermediate and near distances and satisfactory contrast *** patient satisfaction was observed in quality of vision and satisfaction questionnaires with a low percentage of patients manifesting photic phenomena.

关键词： Multifocal intraocular lens Near vision Photic phenomena Continuous transitional focus optic

Factors associated with change in frailty scores and long-term outcomes in older adults with coronary artery disease

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Journal of Geriatric Cardiology 2021年第3期18卷 196-203页

作者： S.Michael Gharacholou Joshua P.Slusser Ryan J.Lennon Carolyn R.Flock Leslie T.Cooper Patricia A.Pellikka jorge brenes salazar Mandeep Singh Department of Cardiovascular Medicine Mayo ClinicJacksonvilleFLUSA Department of Cardiology Mayo Health SystemLa CrosseWIUSA Department of biostatistics Mayo ClinicRochesterMNUSA Department of Cardiovascular Medicine Mayo ClinicRochesterMNUSA

ObJECTIVE Older adults with coronary artery disease(CAD)are at risk for ***,little is known regarding transition in frailty measures over time or its impact on *** sought to determine the association of temporal change in frailty with long-term outcome in older adults with *** We re-assessed for phenotypic frailty using the Fried index(0=not frail;1−2=pre-frail;≥3 frail)in a cohort of CAD patients≥65 years old at 2 time points 5 years *** associated with frailty worsening were assessed with scatterplots and outcomes estimated using the Kaplan-Meier *** models were used to assess the risk of worsening frailty on *** There were 45 subjects that completed both baseline and 5-year Fried frailty *** age was 74.6±5.9 and 30(67%)were *** incidence increased over time:baseline(3%frail,37%pre-frail);5 years(10%frail,40%pre-frail).baseline factors were not predictors of worsening frailty score,while both slower walk time(r=0.46;P=0.004)and diminishing grip strength(r=−0.39;P=0.01)were associated with worsening frailty *** follow-up(median 5.2 years),long-term major adverse cardiac event(MACE)free survival(P=0.12)or hospitalization(P=0.98)was not different for those with worsening frailty score(referent:improved/unchanged frailty).Frailty worsening had a trend towards increased risk of MACE(HR=1.86;95%CI:0.65−5.27,P=0.25).CONCLUSIONS Frailty transitions,specifically,declines in walk time and grip strength,were strongly associated with worsening frailty score in a cohort of older adults with CAD than were baseline indices,though frailty change status was not independently associated with MACE outcomes.

关键词： coronary unchanged score