Latest news with #multidisciplinary
Medscape
02-07-2025
- Health
- Medscape
Fast Five Quiz: Transthyretin Amyloid Cardiomyopathy Management
Transthyretin amyloid cardiomyopathy (ATTR-CM) is a type of systemic amyloidosis that causes restrictive cardiomyopathy and can affect the peripheral and autonomic nervous systems. After diagnosis, patients should be referred to consultation with cardiologists as well as other specialists to develop a treatment plan based on their symptoms. Because this condition can affect several different organ systems, disease management requires a multidisciplinary approach. Are you up to date on your understanding of ATTR-CM management ? Test your knowledge with this quick quiz. ATTRwt, the more common type of ATTR-CM, usually occurs as a function of age, whereas hATTR usually occurs as a result of TTR mutations. Several siRNA agents and ASOs are available to treat polyneuropathy associated with either type. Liver transplantation, which removes mutant TTR from the blood, has been used to treat hATTR, but the development of newer medications has reduced the need for transplant. Patients with ATTR-CM should be treated with interventions that address all their symptoms, including heart failure, arrhythmias, conduction system disorders, and extracardiac manifestations. Learn more about treatment considerations for hATTR and ATTR-CM. Volume management is an essential element of cardiac amyloidosis treatment, especially if heart failure symptoms are present. In patients with ATTR-CM and heart failure symptoms, loop diuretics are used to maintain euvolemia. Because diuretics can reduce preload, blood pressure should be carefully monitored to prevent adverse effects on renal perfusion and cardiac output. Renin-angiotensin system inhibitors can exert vasodilative effects and have been shown to cause hypertension in this setting. Beta-adrenoceptor blockers have been shown to exert negative chronotropic effects and can worsen symptoms of heart failure Cardiac glycosides, such as digoxin, are usually not recommended in patients with ATTR-CM. Learn more about treating cardiac involvement in ATTR-CM. Transthyretin stabilizers, including tafamidis, vutrisiran, and acoramidis, are approved to treat cardiomyopathy in both hATTR and ATTR-CM in adults. They work to reduce cardiovascular mortality and cardiovascular-related hospitalization. However, they have not been shown to reverse existing damage. Clinical trials have demonstrated that this medication class significantly reduced all-cause mortality and lowered hospitalization rates in addition to slowing disease progression. This medication class was also generally well tolerated in most patients with minor side effects, including urinary tract infection. Clinical data also showed that starting this medication class earlier in the disease course might provide improved long-term outcomes. Learn more about transthyretin stabilizers for ATTR-CM. OH is defined as a reduction of ≥ 20 mm Hg in systolic blood pressure or 10 mm Hg in diastolic blood pressure within 3 minutes of standing or upright tilt; further, it is a common complication of ATTR-CM. Nonpharmacologic management of OH can include compression stockings (which can produce ≥ 15-20 mm Hg of pressure) and elastic abdominal binders. Reduced fluid intake has been shown to worsen OH but specifics regarding intake amount in the setting of ATTR-CM can be individualized according to the patient. Though magnesium supplementation has been shown to help manage blood pressure in certain cases, there is limited evidence regarding its role in the treatment of OH associated with ATTR-CM. Evidence regarding vitamin D supplementation in this setting is also limited. Learn more about managing different conditions associated with ATTR-CM. siRNAs and ASOs, considered to be TTR ' silencers,'work in similar ways to 'knock down' the production of TTR in the liver. Their mechanism of action involves targeting TTR mRNA for degradation. This prevents it from being translated, reducing the amount of TTR protein in circulation and disables retinol (vitamin A) transport. TTR stabilizers bind thyroxine 4 into one of two transthoracic echocardiography interdimeric binding pockets. This prevents dissociation into amyloidogenic TTR monomers and oligomers, thereby increasing the stability of the tetramer. Learn more about how different medications treat ATTR-CM. Editor's Note: This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication.
Forbes
01-07-2025
- Entertainment
- Forbes
At YSP William Kentridge Asks What We Can Trust in Image and Memory
William Kentridge in his studio with Laocoön, Johannesburg, 2021 Stella Olivier for William Kentridge William Kentridge works with drawing, sculpture, tapestry, film, theatre, opera, and writing—exploring all manner of material, from paper to clay to bronze. His creations move and migrate between media and criss-cross time lucidly. And his multidisciplinary practice has left a distinct mark on contemporary visual culture, reshaping how we think about image, memory, time. A native of Johannesburg, and the son of prominent anti-apartheid lawyers (his father represented Nelson Mandela), Kentridge's practice is inevitably entangled in the socio-political history of South Africa and the wider world. Yet he rejects the idea of offering fixed truths. Instead, his work constantly questions the grand narratives of history, politics, science, literature, and music—opening up spaces that interrogate the legacies of colonialism and power, and invite multiple ways of seeing. William Kentridge, Cursive, 2020 Thys Dullaart for William Kentridge 'William Kentridge: The Pull of Gravity' dips into the artist's visionary world. Staged across the indoor gallery and the lawns of Yorkshire Sculpture Park in the north of England, the exhibition features 40 works made between 2007 and 2024. They join a distinguished lineup of sculptures in the park's landscape, including works by Henry Moore, Barbara Hepworth, Elisabeth Frink, and James Turrell. This is the first museum presentation for Kentridge outside South Africa to focus on his sculptures. He says, 'I never thought of myself as a sculptor, but I had worked a lot with shadows in performance and in drawings and I was interested in the possibility of making something like a shadow—so ephemeral and without any substance—to be solid.' William Kentridge's Paper Procession (Palermo Cash Book) I (2023) is part of a series of hand‑torn paper cutout miniature silhouettes which inspired the new commissions Thys Dullaart for William Kentridge At the heart of the exhibition is 'Paper Procession', a new YSP commission featuring six monumental, brightly colored sculptures that appear to be paper thin but are in fact made from painted aluminium panels fixed to steel armatures. They parade human-like outdoors along a century-old yew hedge and are joined in the main YSP park by four of the artist's largest bronzes. The idea for the new commissions 'derived from anxiety,' he tells me. 'I had to find something for this place and it happened innocently.' Like much of his work, the sculptures evolved intuitively—from flat paper puppets to freestanding forms to these towering outdoor figures. One of William Kentridge's Paper Procession works at Yorkshire Sculpture Park Nargess Banks The central YSP gallery features two major video works shown in rotation. 'More Sweetly Play the Dance' (2015) is a hauntingly moving and strangely beautiful silhouetted procession of figures—a brass band, skeletons, refugees—referencing displacement, disease and endurance. 'Oh To Believe in Another World' (2022) takes an even darker, more politically charged turn. Set to Dmitri Shostakovich's Symphony No.10 (a work long associated with the composer's fraught relationship with Stalin) the film interrogates the tension between artistic freedom and totalitarian control. In the past, Kentridge has spoken of art's role in giving a sense of agency in the world—for the maker and the viewer. Here music becomes a lens for thinking about the artist as witness, as resister, as someone navigating between public history and private reckoning. William Kentridge, More Sweetly Play the Dance (2015) at LUMA Foundation, Arles Victor & Simon, Joana Luz for William Kentridge YSP brings in visitors from all walks of life who come for the art, the beautiful walks and scenery, and for a day out. It also attracts large numbers of school children from nearby cities, many of whom may not have been exposed to art, and certainly not contemporary art. I ask Kentridge how it feels to be exhibiting here. 'With these sculptures its not like looking at an old master, where we think there's no possible way I could imagine making this. With my sculptures you can see very clearly how things are constructed, how they're put together. And visitors may think: I too can also be an artist.' William Kentridge, Oh To Believe In Another World (2022), at LUMA Foundation, Arles Vicor & Simon, Joana Luz for William Kentridge 'The Pull of Gravity' is a thoughtful show, with a curatorial approach that highlights Kentridge's constant movement across disciplines. He is also a committed collaborator, and you sense that at YSP—just as you sense the movement of ideas from one exhibition space to the next—often sparked, he says, by a studio member's particular talent or a material's own response to form. Kentridge speaks of provisional coherence as the concept central to his practice: that meaning, form, even understanding are never fixed and certainly never absolute. Coherence, for him, emerges through process, through these layers and fragments that come together for a moment, only to shift again. It's a kind of order that remains open to change, to revision, and is always shaped by its context. William Kentridge, Still from Self-Portrait as a Coffee-Pot, 2022 Kentridge Studio, William Kentridge To my mind, be it in two or three dimensions, Kentridge's work is always collage. This is how he sees the world, and it is fundamental to how he would like us to view the world since collage requires us to understand the world as fragmented. And it is precisely this that makes Kentridge's work so exciting and so right for our black-and-white, left-or-right, painfully polarizing times. 'Things that seem so clear are clear for a moment,' he tells me when I probe him on the concept, 'and then the clarity disappears and you have to find a different kind of clarity.' This is work that adamantly refuses to instruct or be didactic. Instead, it gestures toward hope, brimming with poeticism, beauty and metaphor. William Kentridge, Untitled VI (Nose on Horse, Napoleon), 2007 William Kentridge As an artist in constant engagement with societal concerns, I ask if he has hope in a world that, for many of us, feels increasingly dark and difficult to digest. His face grows serious as he tells me, 'I have both hope and pessimism—both running together. I think to have only one or the other is to blind yourself to part of the world.' It is this holding of contradictions—beauty and brutality, doubt and belief—that makes Kentridge's work resonate so widely. 'I'm interested in moments of clarity,' he says, 'but ones that don't pretend to last.' And the YSL show invites us to sit inside uncertainty, and to think, to feel, and to keep looking. 'William Kentridge: The Pull of Gravity' is at Yorkshire Sculpture Park from June 28, 2025 to April 19, 2026. For more on art and design, follow my reviews here .
Fast Company
30-06-2025
- Business
- Fast Company
Urban design job listings are up 102%. This might be why
Fast Compan y's new analysis of job listings across several design disciplines puts a number on it: job postings for urban designers are up 102% compared to the previous year. This boom may reflect the increasing relevance of the kind of work urban designers do, which is to create functioning communities and regions. Spanning architecture, city planning, landscape architecture, and urban development, urban design takes in the whole picture of a city and looks for ways that interventions at all scales can improve the system. 'It's really a field of integration,' says Tyler Patrick, chair of the planning and urban design department at Sasaki, a large multidisciplinary design firm. Patrick says that Sasaki has been hiring more and more urban designers every year, and including their input on nearly every project. 'It's a field that continues to add a lot of value.'
National Post
07-05-2025
- Health
- National Post
That mystery brain disease plaguing people in New Brunswick? A new study finds it's not real
Article content 'Complex neurological disorders benefit from a second, independent and/or subspecialist evaluation and require multidisciplinary support throughout the diagnostic journey,' said the study that collected data between November 2023 and this past March. Article content 'Clinical and neuropathological evaluations demonstrated that all 25 cases were attributable to well characterized neurological disorders,' it said. 'The final primary diagnoses, and in some cases secondary diagnoses, included Alzheimer disease, Parkinson disease, progressive supranuclear palsy, other neurodegenerative conditions, functional neurological disorder, traumatic brain injury or persisting post concussion symptoms, and others.' Article content The independent assessment of 25 patients 'provides no support for an undiagnosed mystery disease in New Brunswick,' said the study. Article content 'The gold standard, neuropathological assessments with second, blinded independent evaluations, revealed well-defined diagnoses for 11 deceased patients.' Article content When all 25 cases were included in the mix, '100 per cent of patients in this sample did not have a new disease and with 95 per cent confidence, the probability of no new disease is between 87 per cent and 100 per cent,' said the study. Article content 'The lower bound of 87 per cent reflects a conservative estimate based on the data and statistical methods accounting for uncertainty in the sample, including the possibility of diagnostic error or unmeasured variability. However, practical knowledge and clinical reasoning suggest that the actual probability of no new disease is much closer to the upper bound of 100 per cent.' Article content The new study said 'it is crucial to highlight the factors that fuel persistent public concern of a mystery disease despite the provincial investigation rejecting this possibility. Public trust in health institutions has decreased since the COVID-19 pandemic, while trust in individual healthcare professionals remains high, which can make vulnerable people susceptible to claims that the institutional oversight processes are flawed, especially if originating from trusted physicians.' Article content The new research comes with a caution. Article content Misinformation regarding the New Brunswick 'cluster has proliferated in both traditional and social media, from not only the predictable and easily identifiable groups coopting the crisis to suit their agenda, such as antivaccine advocates, but also those who are unknowingly amplifying an incorrect diagnosis from their physician,' said the study. Article content 'In this way, misdiagnosis and misinformation become inextricably entwined and amplify patient harm exponentially: to the best of our knowledge, only 14 patients sought independent reevaluation by another neurologist when offered, and 52 refused a second opinion, choosing instead to remain with the one neurologist who originally made and continues to promote the diagnosis of a mystery disease. Not only do our data indicate that affected patients likely have other diagnosable neurological conditions that could benefit from multidisciplinary treatment and other resources, but the low uptake also impedes the rigorous scientific evaluations necessary to counter the claims raised in the first place.' Article content
