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Riskiana, Wulan, Moehamad Aman, and Affan Rifa'i. "Analisis Risiko Rantai Pasok Dengan House of Risk di PT. Petrogas Prima Service." Borobudur Engineering Review 1, no. 2 (September 28, 2021): 89–95. http://dx.doi.org/10.31603/benr.3165.
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Perkembangan manajemen rantai pasok menfokuskan pada kajian tentang efektifitas dan efisiensi aliran barang, sistem informasi dan aliran keuangan sehingga mencakup semua rantai pasok dengan semua pihak yang bersangkutan. Salah satu permasalahan yang dihadapi dalam PT Petrogas Prima Services perusahaan repair tabung gas LPG volume 3 kg adalah keterlambatan kedatangan material. Pada pengiriman sealtape hanya 97,4% dari pemesanan, Pada pemesanan valve melebihi hari pengiriman dan pada saat distribusi terdapat kendala yang tidak bisa diprediksi. Oleh kerena itu, dibutuhkan manajemen rantai pasok untuk koordinasi dan mengelola aktifitas rantai pasok supaya proses produksi berjalan dengan baik dan tidak ada keterlambatan produksi maupun distribusi. Penelitian ini dilakukan untuk menganalisis risiko pada aktivitas rantai pasok mengunakan metode House of Risk. Dari House of risk fase I menghasilkan 5 penyebab risiko dominan yaitu gangguan teknis (mesin tidak optimal), karyawan kurang teliti, perencanan kurang maksimal, babhan baku tidak sesuai dan system informasi yang tidak efektif. Melalui House of Risk Fase II dihasilkan 13 langkah aksi pencegahan yang direkomendasikan bagi perusahaan untuk mengurangi potensi kejadian risiko, yaitu melakukan pemeriksaan rutin (PA2), melakukan pencegahan (PA4), menyusun SOP perawatan (mesin/transportasi) (PA1), pembagian sift kerja yang sesuai (PA5), menejemen persediaan sperpart mesin (PA3), pengendalian bahan baku (PA11), pengadaan training (PA6), menyusun SOP pengadaan (inventory) dan supplier (PA8), meningkatkan pengelolaan terhadap menenjemen (PA9), menyusun alternative perencanaan (PA10), pelatihan (PA13), pemberian sangsi disiplin (PA7), dan dukungan software (PA12).
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Morrison, Kyle M., John Cairney, Joe Eisenmann, Karin Pfeiffer, and Dan Gould. "Associations of Body Mass Index, Motor Performance, and Perceived Athletic Competence with Physical Activity in Normal Weight and Overweight Children." Journal of Obesity 2018 (2018): 1–10. http://dx.doi.org/10.1155/2018/3598321.
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Children who are overweight and obese display lower physical activity levels than normal weight peers. Measures of weight status, perceived motor competence, and motor skill performance have been identified as potential correlates explaining this discrepancy. 1881 children (955 males; 926 females; 9.9 years) were assessed as part of the Physical Health Activity Study Team project. The age, habitual physical activity participation (PAP), body mass index (BMI), socioeconomic status (SES), motor performance (MP), and perceived athletic competence (PAC) of each child included were assessed. Gender-specific linear regression analyses (main effects model) were conducted to identify the percent variance in PAP explained by the following variables: BMI, MP, and PAC. For males, 18.3% of the variance in PAP was explained by BMI, MP, and PAC. PAC explained 17% of the variance, while MP, BMI, and SES only accounted for 0.6%, 0.7%, and 0.5%, respectively. PAC explained 17.5% of PAP variance in females; MP explained 0.8%. BMI, SES, and chronological age were not significant correlates of PAP in girls. An established repertoire of motor skill performance has been seen as a vehicle to PAP in children; however, this study indicates that PAC should not be overlooked in intervention strategies to promote increased PAP.
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Huang, Shengyi, and Chenju Liang. "Evaluation of the Engineering Properties of Powdered Activated Carbon Amendments in Porous Asphalt Pavement." Processes 9, no. 4 (March 26, 2021): 582. http://dx.doi.org/10.3390/pr9040582.
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Porous asphalt pavement (PAP) with a high drainage capacity was modified with powdered activated carbon (PAC) addition to produce permeable reactive pavement (PRP), which may exhibit the potential to reduce environmental non-point source (NPS) pollution. The experimental design mixtures used to produce and test the PRP incorporated with PAC (named PRP-PACs) were conducted as follows: first, the PACs were initially tested to determine their feasibility as an additive in PAP; second, different amounts of PAC were added during the preparation of PAP to produce PRP-PAC, and the unregulated and regulated physical characteristics for the mechanical performance of PRP-PACs were examined to ensure that they meet the regulatory specifications. Third, the aqueous contaminants, namely benzene, toluene, ethyl-benzene, and xylene (BTEX), column adsorption tests were preliminarily conducted to demonstrate their adsorption capacities compared to traditional PAP. The compositions of 0.8% and 1.5% PAC (by wt.) (PRP-PAC08 and PRP-PAC15) met all the regulated specifications. As compared to PAP, PRP-PAC08 exhibited higher BTEX adsorption capacities than PAP, which were 47%, 49%, 29% and 2%. PRP-PAC08 showed both superior physical properties and adsorption performance than PAP and may be recommended as an engineering application that reduces the potential for NPS contamination of air, soil, groundwater, and surface water.
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Adnan, Muhammad Luthfi. "Peran Reseptor IL-21 (IL-21R) sebagai Target Terapi Pada Penyakit Arteri Perifer." SCRIPTA SCORE Scientific Medical Journal 3, no. 1 (August 28, 2021): 68–75. http://dx.doi.org/10.32734/scripta.v3i1.4440.
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Background: Peripheral Artery Disease (PAD) is caused due to the disruption of blood supply to the periphery caused by blockages in the arteries. PAD is a disease that is difficult to detect and the current therapy is still limited to pharmacological therapy to reduce the risk of PAP incidence and surgical therapy if complications of PAD arise. The interleukin-21 receptor (IL-21R) is a family of interleukins that has been widely studied for its role in many diseases. Objectives: The aim of this review is to discuss the effect of IL-21R on the pathogenesis of PAP. Methods: A literature search was performed with PubMed, Google Scholar, and ScienceDirect using the keywords “peripheral artery disease”, “interleukin-21 receptor”, “inflammation”, “angiogenesis”, and “therapy”. Discussion: PAD can arise due to the formation of atherosclerotic plaques that block arteries so that blood supply is impaired. In the case of PAD, activation of IL-21R has the ability to stimulate angiogenesis thereby modulating the perfusion of hypoxic tissues in cases of PAD. Further research is needed regarding IL-21R activity in the future to study the potential of IL-21R for the more effective treatment of PAD cases in the future. Conclusion: IL-21R can activate angiogenesis and avoid further tissue damage in PAP. Keywords: interleukin-21 receptors, peripheral artery disease, therapy Latar Belakang: Penyakit Arteri Perifer (PAP) disebabkan karena gangguan suplai darah ke bagian perifer yang disebabkan karena sumbatan pada pembuluh darah arteri. PAP merupakan penyakit yang sulit terdeteksi dan terapi yang ada saat ini masih terbatas pada terapi farmakologis untuk menurunkan risiko kejadian PAP dan terapi pembedahan apabila timbul komplikasi PAP. Reseptor interleukin-21 (IL-21R) merupakan salah satu famili interleukin yang telah banyak dipelajari terkait perannya pada banyak penyakit. Tujuan: Tujuan dari tinjauan ini adalah untuk membahas pengaruh IL-21R terhadap perjalanan penyakit PAP. Metode: Pencarian literatur dilakukan dengan PubMed, Google Scholar, dan ScienceDirect menggunakan kata kunci “peripheral artery disease”, “reseptor interleukin-21”, “inflamasi”, ”angiogenesis”, dan “terapi”. Pembahasan: PAP dapat timbul karena pembentukan plak aterosklerosis yang menyumbat pembuluh darah arteri sehingga suplai darah terganggu. Pada kasus PAP, aktivasi IL-21R memiliki kemampuan untuk menstimulasi angiogenesis sehingga memodulasi perfusi jaringan yang mengalami hipoksia pada kasus PAP. Masih diperlukan penelitian lebih lanjut mengenai aktivitas IL-21R di masa depan untuk mempelajari potensi IL-21R untuk pengobatan kasus PAP yang lebih efektif di masa depan. Kesimpulan: IL-21R dapat mengaktivasi angiogenesis dan menghindari kerusakan jaringan lebih lanjut pada PAP. Kata Kunci: penyakit arteri perifer, reseptor interleukin-21, terapi
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Frantsiyants, E. M., V. A. Bandovkina, I. V. Kaplieva, N. D. Cheryarina, E. I. Surikova, I. V. Neskubina, Yu A. Pogorelova, and L. A. Nemashkalova. "Changes in levels of urokinase receptor and other components of fibrinolytic system in brain tissues in urokinase gene-knockout mice with B16/F10 melanoma growing together with chronic neurogenic pain." Research and Practical Medicine Journal 9, no. 1 (February 18, 2022): 12–22. http://dx.doi.org/10.17709/2410-1893-2022-9-1-1.
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Purpose of the study. An analysis of the changes in components of the urokinase system in the brain of urokinase gene-knockout mice (uPA-/-) with B16/F10 melanoma growing alone and together with chronic neurogenic pain (CNP).Materials and methods. The study included male and female C57BL/6-PlautmI.IBug-ThisPlau6FDhu/GFDhu mice (uPA-/-) (n = 48) and C57BL/6 mice (uPA+/+) (n = 80) with transplanted B16/F10 melanoma growing solitarily and together with CNP. Levels of the urokinase receptor (uPAR) and plasmin (PAP) and activity and levels of the PAI-I inhibitor were measured in the brain of animals by ELISA.Results. Levels of uPAR, PAI-I and PAP in the brain differed only in intact uPA-/- males, being on average 1.6 times higher (p < 0.05) than in uPA+/+ mice. Among animals with CNP, uPA-/- males showed increased PAI-I by 1.3 times (p < 0.05) and decreased PAP by 2.6 times (p < 0.05), while in uPA+/+ males, changes in PAI-I and PAP were opposite; in uPA-/- females, levels of all indicators increased by 1.6–2.1 times (p < 0.05), unlike uPA+/+ females. Among animals with melanoma only, changes in the levels of uPAR, PAI-I and PAP in the brain tissues in uPA-/- males differed from the group with CNP and from uPA+/+ males; in uPA+/+ females, levels of uPAR and PAP increased by 1.7 and 3.0 times (p < 0.05), and only PAP increased in uPA-/- females by 3.2 times (p < 0.05). Combination of CNP with melanoma in uPA-/- mice, regardless of their gender, down-regulated levels of uPAR and PAI-I on the average by 1.5 and 2.0 times, respectively (p < 0.05), and up-regulated PAP on the average by 2.2 times (p < 0.05) compared to the levels in animals with CNP; in uPA+/+ animals, similar decline of uPAR by 3.7 times (p < 0.05) was registered only in males, and an increase of PAI-I by 2.0 times (p < 0.05) was noted in all mice.Conclusion. Changes in the studied parameters in the brain tissue of urokinase gene-knockout animals in response to stress factors indicate the role of the brain urokinase system in the response to both CNP and melanoma growth, and the gender specificity of these changes may be another factor that conditions gender differences in the risk of occurrence and course of cutaneous melanoma.
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Ünal, Aydin, Murat Sipahioglu, Fatih Oguz, Mehmet Kaya, Hamit Kucuk, Bulent Tokgoz, Hakan Buyukoglan, Oktay Oymak, and Cengiz Utas. "Pulmonary Hypertension in Peritoneal Dialysis Patients: Prevalence and Risk Factors." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 29, no. 2 (March 2009): 191–98. http://dx.doi.org/10.1177/089686080902900214.
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Aim To investigate the prevalence of pulmonary arterial hypertension (PAH) and the possible contributing factors for PAH in patients receiving regular continuous ambulatory peritoneal dialysis (CAPD). Patients and Methods The study included 135 CAPD patients and 15 disease-free controls. Patients that had chronic obstructive pulmonary disease, severe mitral or aortic valve disease, connective tissue disease, history of pulmonary embolism, left ventricular ejection fraction <50%, or chest wall or parenchymal lung disease were excluded. All patients and controls were examined using echocardiography and bioelectrical impedance analysis. PAH was defined as systolic pulmonary artery pressure (PAP) >35 mmHg at rest. Results Mean systolic PAP was higher in the CAPD patients than in the controls (19.66 ± 11.66 vs 14.27 ± 4.55 mmHg, p = 0.001). PAH was detected in 17 (12.6%) of the 135 CAPD patients. Mean systolic PAP was significantly higher in patients with PAH than in those without PAH (42.00 ± 9.13 vs 16.44 ± 7.83 mmHg, p = 0.001). Serum albumin level and ejection fraction were lower in patients with PAH than in those without PAH ( p = 0.001 and 0.003 respectively). The ratio of extracellular water/total body water (ECW/TBW), which can reflect hydration status, was significantly higher in patients with PAH than in those without PAH ( p = 0.008). In the PD group, no patients were hypovolemic; 51 (37.8%) of the 135 PD patients were hypervolemic and 84 (62.2%) were normovolemic. Only 3 of the 17 patients with PAH were normovolemic; the rest were hypervolemic. Mean systolic PAP was significantly higher in hypervolemic PD patients (24.57 ± 14.19 mmHg) than in normovolemic PD patients (16.68 ± 7.61 mmHg) ( p = 0.001). PAP correlated with ECW/TBW ( r=0.317, p = 0.001) and left ventricular mass index (LVMI; r=0.286, p = 0.001). On the other hand, it inversely correlated with serum albumin level ( r = –0.281, p = 0.001), hemoglobin level ( r = –0.165, p = 0.044), and ejection fraction ( r = –0.263, p = 0.001). Serum albumin level, ECW/TBW, and LVMI were found in multivariate analysis to be independent risk factors for PAP. Conclusion PAH is a frequent cardiovascular complication in CAPD patients. Serum albumin level, hypervolemia, and LVMI are major risk factors for PAH. Therefore, strategies for treatment of hypervolemia, left ventricular hypertrophy, and hypoalbuminemia should be enhanced to prevent the development of PAH in CAPD patients.
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Prins, Kurt W., E. Kenneth Weir, Stephen L. Archer, Jeremy Markowitz, Lauren Rose, Marc Pritzker, Richard Madlon-Kay, and Thenappan Thenappan. "Pulmonary Pulse Wave Transit Time is Associated with Right Ventricular–Pulmonary Artery Coupling in Pulmonary Arterial Hypertension." Pulmonary Circulation 6, no. 4 (December 2016): 576–85. http://dx.doi.org/10.1086/688879.
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Pulmonary pulse wave transit time (pPTT), defined as the time for the systolic pressure pulse wave to travel from the pulmonary valve to the pulmonary veins, has been reported to be reduced in pulmonary arterial hypertension (PAH); however, the underlying mechanism of reduced pPTT is unknown. Here, we investigate the hypothesis that abbreviated pPTT in PAH results from impaired right ventricular–pulmonary artery (RV-PA) coupling. We quantified pPTT using pulsed-wave Doppler ultrasound from 10 healthy age- and sex-matched controls and 36 patients with PAH. pPTT was reduced in patients with PAH compared with controls. Univariate analysis revealed the following significant predictors of reduced pPTT: age, right ventricular fractional area change (RV FAC), tricuspid annular plane excursion (TAPSE), pulmonary arterial pressures (PAP), diastolic pulmonary gradient, transpulmonary gradient, pulmonary vascular resistance, and RV-PA coupling (defined as RV FAC/mean PAP or TAPSE/mean PAP). Although the correlations between pPTT and invasive markers of pulmonary vascular disease were modest, RV FAC ( r = 0.64, P < 0.0001), TAPSE ( r = 0.67, P < 0.0001), and RV-PA coupling (RV FAC/mean PAP: r = 0.72, P < 0.0001; TAPSE/mean PAP: r = 0.74, P < 0.0001) had the strongest relationships with pPTT. On multivariable analysis, only RV FAC, TAPSE, and RV-PA coupling were independent predictors of pPTT. We conclude that shortening of pPTT in patients with PAH results from altered RV-PA coupling, probably occurring as a result of reduced pulmonary arterial compliance. Thus, pPTT allows noninvasive determination of the status of both the pulmonary vasculature and the response of the RV in patients with PAH, thereby allowing monitoring of disease progression and regression.
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Agustiani, Winni, Mansyur Arif, and Ilhamjaya Patellongi. "Correlation between Inflammation and Fibrinolysis Impairment on Central Obesity: A Study for hsCRP, PAI-1, PAP and TAFI." Indonesian Biomedical Journal 3, no. 2 (August 1, 2011): 127. http://dx.doi.org/10.18585/inabj.v3i2.143.
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BACKGROUND: Inflammation in the vascular wall plays an important role in the pathogenesis of atherosclerosis. Current studies have shown that increase of systemic inflammatory marker like the acute phase component C-reactive protein (CRP) are associated with an unfavorable progression of disease and an increased risk for acute cardiovascular events. Recently, a close association of Metabolic Syndrome (MetS) with hemostatic abnormalities has been reported. Among hemostatic abnormalities, an increase in plasminogen activator inhibitor (PAI)-1, a strong inhibitor of fibrinolysis, is considered a core feature of MetS. High PAI-1 concentrations may be associated with thrombus formation, also causing cardiovascular events. Therefore, we investigated the association between markers for chronic inflammation (CRP) and the markers of fibrinolytic impairment (PAI-1, PAP, TAFI) in subjects with central obesity.METHODS: This was a cross-sectional study in 80 male Indonesian subjects, aged 30-60 years old with central obesity, conducted from January to March 2008 in Bandung.RESULTS: The study results showed that there was a difference of PAI-1 levels between MetS and Non-MetS group. There were significant correlations between hsCRP and PAI-1 (r=0.252, p=0.024 ), hsCRP and PAP (r=0.253, p=0.024), and also between PAI-1 and PAP (r=-0.239, p=0.033 ) respectively. But, no correlation found between hsCRP and TAFI.CONCLUSIONS: There was correlation between inflammation and fibrinolysis impairment on central obesity. Concentrations oh hsCRP, PAI-1 and TAFI were significantly higher in MetS.KEYWORDS: inflammation, fibrinolysis impairment, hsCRP, PAI-1, PAP, TAFI
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Davidson, D., and D. Drafta. "Prolonged pulmonary hypertension caused by platelet-activating factor and leukotriene C4 in the rat lung." Journal of Applied Physiology 73, no. 3 (September 1, 1992): 955–61. http://dx.doi.org/10.1152/jappl.1992.73.3.955.
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Platelet-activating factor (PAF) and leukotrienes (LTs) are potent pulmonary hypertensive and inflammatory mediators produced by the lung. Previously we showed that a rapid injection of PAF into the pulmonary artery of an isolated rat lung produced an extended elevation in mean pulmonary arterial pressure (PAP). The objective of the present study was to determine whether the extended pressor response induced by PAF was caused by prolonged activation of the 5-lipoxygenase pathway or slow clearance of LTs from the lung parenchyma. Rat lungs were perfused with a nonrecirculating physiological salt solution that contained indomethacin and albumin. Five minutes after a rapid injection of PAF into the pulmonary artery catheter, the following elevations (mean % above baseline) were observed: PAP (83%), LTB4 (3,260%), LTC4 (1,490%), LTD4 (970%), and LTE4 (1,500%). At 20 min these levels declined but were still significantly elevated above baseline. The 5-lipoxygenase inhibitor diethylcarbamazine (DEC), administered before the PAF injection, inhibited the elevations of PAP and all LTs. DEC administration that began 5 min after PAF reduced PAP and only LTC4 levels at 20 min in comparison to lungs with no DEC. The 5-lipoxygenase-activating protein inhibitor MK886, administered orally 2–6 h before perfusion, also inhibited the pressor response to PAF as well as LT production, as did DEC. We conclude that 1) the extended pulmonary hypertension induced by PAF was caused mainly by prolonged activation of 5-lipoxygenase with LTC4 production, 2) the relative overall lung clearance of LTB4, LTD4, and LTE4 was slower than that of LTC4, and 3) LTB4, LTD4, and LTE4 had no appreciable pressor effect.
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Urboniene, Dalia, Idith Haber, Yong-Hu Fang, Thenappan Thenappan, and Stephen L. Archer. "Validation of high-resolution echocardiography and magnetic resonance imaging vs. high-fidelity catheterization in experimental pulmonary hypertension." American Journal of Physiology-Lung Cellular and Molecular Physiology 299, no. 3 (September 2010): L401—L412. http://dx.doi.org/10.1152/ajplung.00114.2010.
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High-frequency echocardiography and high-field-strength magnetic resonance imaging (MRI) are new noninvasive methods for quantifying pulmonary arterial hypertension (PAH) and right ventricular (RV) hypertrophy (RVH). We compared these noninvasive methods of assessing the pulmonary circulation to the gold standard, cardiac catheterization (micromanometer-tipped catheters), in rats with monocrotaline-induced PAH and normal controls. Closed-chest, Sprague-Dawley rats were anesthetized with inhaled isoflurane (25 monocrotaline, 6 age-matched controls). Noninvasive studies used 37.5-MHz ultrasound (Vevo 770; VisualSonics) or a 9.4-T MRI (Bruker BioSpin). Catheterization used a 1.4-F micromanometer-tipped Millar catheter and a thermodilution catheter to measure cardiac output (CO). We compared noninvasive measures of pulmonary artery (PA) pressure (PAP) using PA acceleration time (PAAT) and CO, using the geometric PA flow method and RV free wall (RVFW) thickness/mass with cardiac catheterization and/or autopsy. Blinded operators performed comparisons using each method within 2 days of another. In a subset of rats with monocrotaline PAH, weekly echocardiograms, catheterization, and autopsy data assessed disease progression. Heart rate was similar during all studies (>323 beats/min). PAAT shortened, and the PA flow envelope displayed systolic “notching,” reflective of downstream vascular remodeling/stiffening, within 3 wk of monocrotaline. MRI and echocardiography measures of PAAT were highly correlated ( r2 = 0.87) and were inversely proportional to invasive mean PAP ( r2 = 0.72). Mean PAP by echocardiography was estimated as 58.7 − (1.21 × PAAT). Invasive and noninvasive CO measurement correlated well ( r2 ≥ 0.75). Noninvasive measures of RVFW thickness/mass correlated well with postmortem measurements. We conclude that high-resolution echocardiography and MRI accurately determine CO, PAP, and RV thickness/mass, offering similar results as high-fidelity right heart catheterization and autopsy, and that PAAT accurately estimates PAP and permits serial monitoring of experimental PAH. These tools are useful for assessment of the rodent pulmonary circulation and RVH.
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Mukhopadhyay, Bhubandeep, and P. Banerjee. "A unique study of post mitral valve surgery status of patients in pre and intra COVID-19 era." International Journal of Research in Medical Sciences 10, no. 2 (January 29, 2022): 470. http://dx.doi.org/10.18203/2320-6012.ijrms20220294.
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Background: In this study we have studied the change of pulmonary artery pressure after mitral valve replacement and closed mitral commissurotomy. We have also correlated pulmonary artery pressure before and after operation with postoperative outcome.Methods: This study was conducted at Department of CTVS of NRS Medical College and Hospitals from August 2019 to September 2021. All 81 patients had rheumatic mitral valve disease. Among these 73 patients underwent mitral valve replacement (MVR) and 8 patients underwent closed mitral commissurotomy (CMC). Group 1 (n=35) consisted of patients who underwent MVR having preoperative systolic PAP measured by TTE was less than 50 mmHg. Group 2 patients (n=38) had preoperative systolic PAP more than or equal to 50 mmHg measured by TTE. Group 3 patients (n=8), consists of patients who underwent CMC. Compared the results between group 1 and 2 and documented the results of group 3 separately.Results: Our results showed a significant decrease in SPAP after MVR, and further fall of SPAP in the immediate and late postoperative period.Conclusions: In conclusion, PAP returns to near-normal values after MVR in patients with severe preoperative PAH and to normal values in patients with mild preoperative PAH. Reductions in PAP in patients with preoperative PAH occur immediately after MVR. Postoperative period of patients with severe PAH may be hectic. CMC may be a valid option in isolated MS in selected patients and is very much cost-effective. There were no differences noted among the types of valves used.
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Bödeker, Hans, Volker Keim, Fritz Fiedler, Jean Charles Dagorn, and Juan L. Iovanna. "PAP I Interacts with Itself, PAP II, PAP III, and Lithostathine/regIα." Molecular Cell Biology Research Communications 2, no. 3 (September 1999): 150–54. http://dx.doi.org/10.1006/mcbr.1999.0166.
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Barducci, R. S., L. M. Sarti, D. D. Millen, R. D. L. Pacheco, S. R. Baldin, F. S. Parra, T. C. Putarov, C. L. Martins, and M. D. B. Arrigoni. "Aditivos alimentares na dieta de bovinos confinados." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 65, no. 6 (December 2013): 1593–602. http://dx.doi.org/10.1590/s0102-09352013000600002.
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O objetivo do presente trabalho foi avaliar o efeito da inclusão do preparado de anticorpos policlonais (PAP) e/ou da monensina sódica (MON) sobre o desempenho, as características da carcaça, o perfil de ácidos graxos da carcaça (PAG) e a concentração de lipoproteínas sanguíneas (CLS) de bovinos confinados. O delineamento experimental foi inteiramente ao acaso, em arranjo fatorial 2 x 2, com medidas repetidas no tempo, sendo os fatores a inclusão ou não de MON e PAP avaliados em dois períodos, em que 72 bovinos machos da raça Brangus, não castrados, foram alocados em 24 baias (três animais/baia), totalizando seis repetições por tratamento. Não foi observado efeito (P>0,05) da inclusão do PAP para nenhuma das varáveis de desempenho e características de carcaça. Contudo, foi observado efeito (P<0,05) da inclusão de MON, em que animais que receberam MON apresentaram maiores ganho de peso diário (1,666 vs. 1,552), ganho de peso total (179,95 vs. 167,68), peso vivo final (474,86 vs. 459,61), peso de carcaça quente (248,46 vs. 240,20), melhor conversão alimentar (5,57 vs. 5,79) e reduzido custo para ganhar um quilo de peso vivo (3,06 vs. 3,18). Ainda não foi observado efeito principal (P>0,05) dos aditivos para o PAG e a CLS. Assim, a inclusão do PAP não foi boa alternativa à substituição da MON. Por outro lado, a inclusão do PAP não afetou negativamente os itens estudados.
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Shader, Richard I. "The PAP Test and the Pap Smear." Clinical Therapeutics 37, no. 1 (January 2015): 1–3. http://dx.doi.org/10.1016/j.clinthera.2014.12.002.
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Smith, M. "Periodic Abstinence From Pap (PAP) Smear Study: Women's Perceptions of Pap Smear Screening." Annals of Family Medicine 1, no. 4 (November 1, 2003): 203–8. http://dx.doi.org/10.1370/afm.32.
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Laishram, Rakesh S. "Poly(A) polymerase (PAP) diversity in gene expression - Star-PAP vs canonical PAP." FEBS Letters 588, no. 14 (May 27, 2014): 2185–97. http://dx.doi.org/10.1016/j.febslet.2014.05.029.
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Stack, Peter S. "Pap smears." Postgraduate Medicine 101, no. 4 (April 1997): 207–14. http://dx.doi.org/10.3810/pgm.1997.04.204.
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Denenberg, Risa. "Pap Smear." Annals of Internal Medicine 156, no. 6 (March 20, 2012): 462. http://dx.doi.org/10.7326/0003-4819-156-6-201203200-00010.
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Maughan, G. M. "Pap Smear." CA: A Cancer Journal for Clinicians 36, no. 4 (July 1, 1986): 254–55. http://dx.doi.org/10.3322/canjclin.36.4.254-b.
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Jay, Venita. "PAP Smear." Journal of Histotechnology 21, no. 3 (September 1998): 249–50. http://dx.doi.org/10.1179/his.1998.21.3.249.
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Gall, Stanley A. "Pap smears." Postgraduate Medicine 85, no. 6 (May 1989): 235–39. http://dx.doi.org/10.1080/00325481.1989.11700704.
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Kevei, Péter. "Gyula Pap." Acta Scientiarum Mathematicarum 86, no. 34 (2020): 347–49. http://dx.doi.org/10.14232/actasm-020-728-z.
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Anderson, Eric G. "‘Pap’ Psychology." Postgraduate Medicine 98, no. 2 (August 1995): 23–24. http://dx.doi.org/10.1080/00325481.1995.11946027.
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Kravetz, Robert E. "Pap boat." American Journal of Gastroenterology 95, no. 1 (January 2000): 271. http://dx.doi.org/10.1111/j.1572-0241.2000.01734.x.
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Spitzer, Mark. "Pap smears." Medical Update for Psychiatrists 1, no. 3 (May 1996): 97–100. http://dx.doi.org/10.1016/s1082-7579(96)80059-8.
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Pedersen, Ole Dyg, Jørgen Gram, and Jørgen Jespersen. "Plasminogen Activator Inhibitor Type-1 Determines Plasmin Formation in Patients with Ischaemic Heart Disease." Thrombosis and Haemostasis 73, no. 05 (1995): 835–40. http://dx.doi.org/10.1055/s-0038-1653877.
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SummaryThe aim of the present study was to find out whether plasminogen activator inhibitor type-1 (PAI-1) controls the formation of plasmin in patients with ischaemic heart disease.We examined PAI activity, PAI-1 antigen, tissue type plasminogen activator (t-PA) activity, t-PA antigen, plasmin-α2-antiplasmin complex (PAP-complex) and fibrin degradation products D-dimer in 62 patients before (unstimulated) and after infusion of l-desamino-8- D-arginine vasopressin (DDAVP; stimulated). DDAVP was used in a standardized dose to trigger the release of t-PA from the vascular endothelium.We observed that under basal conditions (unstimulated) median plasma t-PA activity for the whole group of patients was 86.5 mlU/ml (0-900), and after stimulation 2550 mlU/ml (0-6800), P <0.0001; median plasma concentration of t-PA antigen was 14.7 ng/ml (7.0-115.5) under basal conditions, and after stimulation 34.1 ng/ml (15.8-58.6), P <0.0001; median plasma PAI activity was 16.9 IU/ml (1.5-144.8) under basal conditions, and after stimulation 3.1 IU/ml (0-118.5), P <0.0001; median plasma concentration of PAI-1 antigen was 21.5 ng/ml (8.1-132.2) under basal conditions, and after stimulation 14.9 ng/ml (4.8-149.0), P <0.0001; the median plasma concentration of PAP-complex was 469.5 ng/ml (185.0-1802.0) under basal conditions, and after stimulation 695.5 (243.0-2292.0), P <0.0001; median plasma concentration of D-dimer was 298.0 ng/ml (103.0-948.0) under basal conditions, and after stimulation 296.5 ng/ml (97.0-917.0), P <0.0008.Under basal conditions plasma PAI activities and plasma concentrations of PAI-1 antigen were both significantly negatively correlated with plasma concentrations of PAP-complex (rs = -0.32; P <0.02 and rs = -0.42; P <0.002, respectively). After stimulation of the fibrinolytic system by infusion of DDAVP, plasma PAI activities and plasma concentrations of PAI-1 antigen were also significantly negatively correlated with plasma concentrations of PAP-complex (rs = -0.41; P <0.002 and rs = - 0.33; P <0.009, respectively).Our results indicate that PAI-1 regulates formation of plasmin in patients with ischaemic heart disease. These observations support that PAI-1 may play a critical role in the evolution of thrombosis.
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Hassan, Fathelrahman M. "THE FIBRINOLYTIC ALTERATION ASSOCIATED WITH DAILY ADMINISTRATION OF SILDENAFIL." Asian Journal of Pharmaceutical and Clinical Research 11, no. 8 (August 7, 2018): 107. http://dx.doi.org/10.22159/ajpcr.2018.v11i8.23144.
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Objective: The objective of this study was to determine the fibrinolytic alteration associated with daily administration of sildenafil.Methods: A total of 12 adult male rabbits without mortality rate had been fed standard and subdivided into four groups; their average weight was 1.5, 2.5, 1.9, and 2 kg randomly selected during the period of March 2012–July 2013. Depending on weight, the control groups (2.25 mg/1.5 kg day) and sildenafil groups (3 mg/2 kg/day, 2.85 mg/1.9 kg/day, and 1.7 mg/2.5 kg/day) were injected by normal saline and sildenafil concentration, respectively to create four groups, every group was composed of three rabbits; saline rabbit (control group, n=3) and sildenafil rabbits (sildenafil group, n=9). All rabbit’s plasma samples have been investigated for prothrombin time, activated partial thromboplastin time, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), prothrombin fragment 1+2, tissues plasminogen activator (tPA), plasmin antiplasmin (PAP), plasminogen, and D-dimer after 24 h of administration.Results: The PAP level was significantly (p<0.05) decreased following sildenafil injection. Sildenafil-injected (3 mg/ml) rabbits had decreased the means of PAI-1 and mean tPA, as early as 1-day post-injection, with a considerable lower PAP first determined 3 days after injection that continued into each rabbit 2 and 3.Conclusion: Better strategies are to initiate and manipulate this drug ought to reduce the chance of each thrombosis and hemorrhage, at the same time as minimizing the need for laboratory monitoring with the aid of the use of PAI-1, tPA, and PAP checks.
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Ferreira, P. B., P. R. N. Rorato, F. C. B. Mello, B. Bevilaqua, A. Macedo, and L. B. P. Brittes. "Egg production evaluation of laying hens by multivariate analysis." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 69, no. 3 (June 2017): 676–82. http://dx.doi.org/10.1590/1678-4162-8540.
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ABSTRACT This study aimed to verify the existence of differences between hens from the Barred Plymouth Rock (PRB) breed and White Plymouth Rock (PRW) breed by multivariate analysis of weekly egg production and cumulative during the years of 1998 and 2010, from the Laboratório de Avicultura (LAVIC) of the Departamento de Zootecnia at the Universidade Federal de Santa Maria (UFSM). For the analysis of the univariate and multivariate variance, the experimental design was completely randomized with two treatments (breed) and 299 repetitions of the PRW breed and 350 of the PRB breed. The parameters analyzed were the weekly productions of eggs per bird from the 21st to the 50th week of age (P21, P22, ..., P50) and production of eggs accumulated being from the 21st to the 25th (PA1), 21st to the 30th (PA2), 21st to the 35th (PA3), 21st to the 40th (PA4), 21st to the 45th (PA5) and 21st to 50th (PA6). Analyzes of univariate and multivariate variance were conducted and the comparison of means were made by "T" Student and Wilks respectively (P < 0, 05). Based on the results, an analysis of the principal components was performed with parameters PA1, PA2, PA4, PA5 and PA6. With the average egg production per family accumulated, a cluster analysis using Euclidean distance and single linkage method (nearest neighbors) was performed. The first two principal components meet the total variation in egg production accumulated from the 21st to 25th, 21st to 30th, 21st to 40th, 21st to 45th and 21st to 50th weeks of age. Most of the phenotypic variation of the layers can be explained by the production of eggs accumulated from the 21st until the 40th week of age, and this variable is highly correlated with total egg production. Families from the PRW and PRB breed form seven distinct groups, but homogeneous by the similarity between them. This allows direct crossings between different groups, in the pursuit for heterosis.
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Bingen-Bidois, Martine, Olivier Clermont, Stéphane Bonacorsi, Mustapha Terki, Naïma Brahimi, Chawki Loukil, Dominique Barraud, and Edouard Bingen. "Phylogenetic Analysis and Prevalence of Urosepsis Strains of Escherichia coli Bearing Pathogenicity Island-Like Domains." Infection and Immunity 70, no. 6 (June 2002): 3216–26. http://dx.doi.org/10.1128/iai.70.6.3216-3226.2002.
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ABSTRACT We characterized 100 Escherichia coli urosepsis isolates from adult patients according to host compromise status by means of ribotyping, PCR phylogenetic grouping, and PCR detection of papG alleles and the virulence-related genes sfa/foc, fyuA, irp-2, aer, hly, cnf-1 and hra. We also tested these strains for copies of pap and hly and their direct physical linkage with other virulence genes in an attempt to look for pathogenicity islands (PAIs) described for the archetypal uropathogenic strains J96, CFT073, and 536. Most of the isolates belonged to E. coli phylogenetic groups B2 and D and bore papG allele II, aer, and fyuA/irp-2. papG allele II-bearing strains were more common in noncompromised patients, while papG allele-negative strains were significantly more frequent in compromised patients. Fifteen ribotypes were identified. The three archetypal strains harbored different ribotypes, and only one-third of our urosepsis strains were genetically related to one of the archetypal strains. Three and 18 strains harbored three and two copies of pap, respectively, and 5 strains harbored two copies of hly. papGIII was physically linked to hly, cnf-1, and hra (reported to be PAI IIJ96-like genetic elements) in 14% of the strains. The PAI IIJ96-like domain was inserted within pheR tRNA in 11 strains and near leuX tRNA in 3 strains. Moreover, the colocalized genes cnf-1, hra, and hly were physically linked to papGII in four strains and to no pap gene in three strains. papGII and hly (reported to be PAI ICFT073-like genetic elements) were physically linked in 16 strains, pointing to a PAI ICFT073-like domain. Three strains contained both a PAI IIJ96-like domain and a PAI ICFTO73-like domain. Forty-two strains harbored papGII but not hly, in keeping with the presence of a PAI IICFT073-like domain. Only one strain harbored a PAI I536-like domain (hly only), and none harbored a PAI IJ96-like domain (papGI plus hly) or a PAI II536-like domain (papGIII plus hly). This study provides new data on the prevalence and variability of physical genetic linkage between pap and certain virulence-associated genes that are consistent with their colocalization on archetypal PAIs.
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Akgul, F., T. A. Batyraliev, D. V. Fettser, E. Seyfeli, A. G. Arystan, T. Seydaliyeva, E. Gali, F. Yalcin, and B. A. Sidorenko. "Decreased Heart Rate Variability in Sickle Cell Anemia as Effect of Pulmonary Arterial Hypertension." Kardiologiia 59, no. 4 (April 18, 2019): 39–44. http://dx.doi.org/10.18087/cardio.2019.4.10237.
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Decreased heart rate variability (HRV) is associated with increased mortality risk in various diseases. Theobjective of this investigation:to study HRV in patients with sickle cell anemia (SCA) and to assess the effect of pulmonary arterial hypertension (PAH) on HRV in these patients.Materials and methods. HRV registration and Doppler echocardiographic assessment of systolic pulmonary arterial pressure (PAP) was carried out in 61 stable patients with SCA and 24 healthy subjects.Results. Low frequency power (LFP) and high frequency power (HFP) were decreased in SCA patients compared to healthy subjects. Among SCA patients, PAH patients had lower LFP and HFP than patients without PAH. In SCA patients, systolic PAP showed significant negative correlation with LFP and HFP. Conclusion.HRV is significantly decreased in SCA patients, especially in those with PAH. HRV may be particularly useful in early detection of PAH patients who may have worse prognosis and higher mortality risk.
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Podsiadły, R., J. Mayer, J. A. Janik, J. Krawczyk, and T. Stanek. "Fast Stochastic Reorientations in Nematic PAA and PAP." Acta Physica Polonica A 91, no. 3 (March 1997): 513–18. http://dx.doi.org/10.12693/aphyspola.91.513.
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Teoh, Deanna Gek Koon, Lisa A. Fall, Erin A. Beitelspacher, and Charles W. Lais. "Pap Hub: A system to improve compliance with pap smear screening guidelines in a large health care system." Journal of Clinical Oncology 31, no. 31_suppl (November 1, 2013): 193. http://dx.doi.org/10.1200/jco.2013.31.31_suppl.193.
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193 Background: Cervical cancer is the most prevalent gynecologic cancer worldwide, but is third in the U.S. due to pap smear screening. However, American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines are complex and frequently changed, resulting in guideline adherence as low as 33-44%. We describe a centralized pap smear tracking system (“pap hub”) and report preliminary results. Methods: On 1/1/13 we implemented the pap hub, routing all screening pap smear results to a dedicated OB/Gyn nursing staff with a new Epic workbench. Epic Health Maintenance Modifier updated to recommend pap smears for women age 21-65 years (not younger or older per guidelines). Screening Pap/HPV results auto routed to Pap Pool Epic inbasket (not to individual providers). Centralized nurse reviews results alongside past pap results on Pathology flowsheet in Epic If normal Normal history -> appropriate follow-up interval per screening guidelines If abnormal history -> repeat pap as determined by previous history and treatment If abnormal -> manage per ASCCP guidelines Document plan in Epic Result Note Update Epic problems list If Normal: document “Pap Hub Normal History” If Abnormal: document “Pap Hub Abnormal History” with specifics in Overview History Communicate results/plan to the patient. Update Health Maintenance Modifier with next step. Review abnormal results to ensure proper follow-up, with reminders as indicated. Results: Guideline recommendations against pap smears for patients <21 years and >65 years have not changed since 2009. Comparison of first-quarter data for 2010 (pre-Pap Hub) to 2013 (post-Pap Hub) have shown a 63.86% reduction in pap smears in women <21 years. Pap smears in women >65 years has always been low, but has decreased slightly from 2.4% of all pap smears in 2010 to 1.5% of all pap smears in 2013. The 2012 ASCCP guidelines have changed recommended pap smear frequency and abnormal pap smear follow-up, and compliance with these new recommendations is being collected. Conclusions: Pap smear screening has decreased the incidence of invasive cervical cancer in the United States. The Pap Hub, a centralized pap smear tracking system, improves compliance with pap smear screening guidelines.
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Reeves, G. E. M., N. Collins, P. Hayes, J. Knapp, M. Squance, H. Tran, and B. Bastian. "SAPHIRE: Stress and Pulmonary Hypertension in Rheumatoid Evaluation—A Prevalence Study." International Journal of Rheumatology 2016 (2016): 1–7. http://dx.doi.org/10.1155/2016/4564531.
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Pulmonary artery hypertension (PAH) is a disorder of elevated resistance in the pulmonary arterial vessels, reflected by elevation of measured pulmonary artery pressure (PAP), and presenting with breathlessness and, if untreated, progressing to right heart failure and death. The heightened prevalence of PAH in populations with underlying systemic autoimmune conditions, particularly scleroderma and its variants, is well recognised, consistent with the proposed autoimmune contribution to PAH pathogenesis, along with disordered thrombotic, inflammatory, and mitogenic factors. Rheumatoid arthritis (RA) is one of a group of systemic autoimmune conditions featuring inflammatory symmetrical erosive polyarthropathy as its hallmark. This study explored the prevalence of PAH in a population of unselected individuals with RA, using exercise echocardiography (EchoCG). The high prevalence of EchoCG-derived elevation of PAP (EDEPP) in this population (14%) suggests that, like other autoimmune conditions, RA may be a risk factor for PAH. Patients with RA may therefore represent another population for whom PAH screening with noninvasive tools such as EchoCG may be justified.
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Schifferli, J. A., P. Roth, G. Steiger, J. P. Paccaud, and M. Schmidt. "Macro-prostatic acid phosphatase in a patient's serum." Clinical Chemistry 34, no. 10 (October 1, 1988): 2172–74. http://dx.doi.org/10.1093/clinchem/34.10.2172.
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Abstract A patient without prostatic carcinoma had a high concentration of prostatic acid phosphatase (PAP; EC 3.1.3.2) in his serum. This PAP was bound to IgG ("macro-PAP"), and IgG autoantibodies against PAP were demonstrated in serum. The patient's IgG prolonged the biological half-life of radiolabeled PAP in rats, suggesting that the formation of IgG-PAP complexes was responsible for decreased PAP catabolism. Furthermore, macro-PAP was inactivated in serum more slowly than PAP. These factors accounted for the increases in the enzymatic activity and antigenic concentration of PAP measured in the patient's serum. Inappropriate therapy was prescribed on the basis of this laboratory result. The diagnosis of prostatic carcinoma requires clinical or histological evidence of malignant disease, and should not rely solely on PAP measurements.
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Topalian, Suzanne L., Syuzo Kaneko, Monica I. Gonzales, Gareth L. Bond, Yvona Ward, and James L. Manley. "Identification and Functional Characterization of Neo-Poly(A) Polymerase, an RNA Processing Enzyme Overexpressed in Human Tumors." Molecular and Cellular Biology 21, no. 16 (August 15, 2001): 5614–23. http://dx.doi.org/10.1128/mcb.21.16.5614-5623.2001.
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ABSTRACT Poly(A) polymerase (PAP) plays an essential role in polyadenylation of mRNA precursors, and it has long been thought that mammalian cells contain only a single PAP gene. We describe here the unexpected existence of a human PAP, which we call neo-PAP, encoded by a previously uncharacterized gene. cDNA was isolated from a tumor-derived cDNA library encoding an 82.8-kDa protein bearing 71% overall similarity to human PAP. Strikingly, the organization of the two PAP genes is nearly identical, indicating that they arose from a common ancestor. Neo-PAP and PAP were indistinguishable in in vitro assays of both specific and nonspecific polyadenylation and also endonucleolytic cleavage. Neo-PAP produced by transfection was exclusively nuclear, as demonstrated by immunofluorescence microscopy. However, notable sequence divergence between the C-terminal domains of neo-PAP and PAP suggested that the two enzymes might be differentially regulated. While PAP is phosphorylated throughout the cell cycle and hyperphosphorylated during M phase, neo-PAP did not show evidence of phosphorylation on Western blot analysis, which was unexpected in the context of a conserved cyclin recognition motif and multiple potential cyclin-dependent kinase (cdk) phosphorylation sites. Intriguingly, Northern blot analysis demonstrated that each PAP displayed distinct mRNA splice variants, and both PAP mRNAs were significantly overexpressed in human cancer cells compared to expression in normal or virally transformed cells. Neo-PAP may therefore be an important RNA processing enzyme that is regulated by a mechanism distinct from that utilized by PAP.
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Lee, H., T. M. Chu, S. S. L. Li, and C. L. Lee. "Homodimer and heterodimer subunits of human prostate acid phosphatase." Biochemical Journal 277, no. 3 (August 1, 1991): 759–65. http://dx.doi.org/10.1042/bj2770759.
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Human prostatic acid phosphatase (PAP) isoenzymes, designated PAP-A and PAP-B, were isolated from human seminal plasma by sequential affinity chromatography on concanavalin A and L(+)-tartrate, a classic inhibitor of PAP. Both the major PAP-A and the minor PAP-B isoenzymes exhibited a similar molecular mass (100 and 105 kDa respectively), multiple pI values (5.05-5.35 and 5.05-5.12), and substrate and inhibitor specificity. Immunological characterization revealed that PAP-B possesses distinct antigenic determinants, in addition to the common sites shared with PAP-A. SDS/PAGE indicated that both isoenzymes are composed of two subunits of 50 kDa each. At high salt concentration, PAP-B dissociated completely into single subunits of 50 kDa, whereas PAP-A remained intact at 100 kDa. PAP-B was resolved by reverse-phase h.p.l.c. into three components, designated alpha, beta and gamma, each of 50 kDa, at a molar ratio of approx. 2:1:1. PAP-A contained a single component of molecular mass 50 kDa. The single component of PAP-A and the alpha component of PAP-B possessed identical amino acid compositions and N-terminal sequences, which were different from those of the beta and gamma components. These results indicate that human PAP contains three isoforms, alpha 2, alpha beta and alpha gamma. PAP-A, the major isoenzyme, is a homodimer consisting of two identical subunits (alpha 2), and PAP-B, the minor isoenzyme, is a mixture of two heterodimers, consisting of non-identical subunits (alpha beta and alpha gamma).
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Raaphorst, Joost, Ailko Bossink, C. Erik Hack, and A. B. Johan Groeneveld. "Early Inhibition of Activated Fibrinolysis Predicts Microbial Infection, Shock and Mortality in Febrile Medical Patients." Thrombosis and Haemostasis 86, no. 08 (2001): 543–49. http://dx.doi.org/10.1055/s-0037-1616084.
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SummaryTo evaluate the contribution of an imbalance between coagulation activation and fibinolysis activation and inhibition to morbidity and mortality in sepsis, we determined in medical hospitalized patients at inclusion (day 0) for fever (temperature above 38.0° C axillary or 38.3° C rectally), and daily thereafter for two days, circulating thrombin-antithrombin III (TAT) complexes, plasmin- 2-antiplasmin (PAP) complexes (day 0 only), tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and interleukin (IL)-6, the latter as a marker of the inflammatory host response. Study variables were 1) positive microbiological results for specimens from local sites associated with a clinical infection, positive blood cultures (including parasitemia) or both, within 7 days after inclusion, 2) development of shock, i.e. systolic blood pressure <90 mmHg or a reduction of 40 mmHg from baseline within 7 days after inclusion, and 3) death related to febrile illness within 28 days after inclusion. The peak plasma levels of TAT complexes were elevated in 44% and the PAP complexes in all patients. The t-PA and PAI-1 levels were elevated in 74 and 94% of patients, respectively. Values for TAT and PAP did not differ among subgroups, while peak t-PA and IL-6 levels were higher in patients with positive microbiological results, developing shock or ultimately dying than in those without the complications (p <0.005). Peak PAI-1 levels were elevated in patients developing shock and ultimate death versus those with an uncomplicated course (p <0.05). Peak IL-6 related to PAI-1 and t-PA levels, which interrelated. Patients with elevated TAT levels had increased plasma levels of IL-6, PAP, PAI-1 and t-PA versus those with normal TAT (p <0.05). Our data indicate that inhibition of activated fibrinolysis, which may partly depend on both cytokinemia and activation of coagulation, predicts microbial infection, septic shock and mortality of febrile medical patients. This suggests an early pathogenic role of inhibition of activated fibrinolysis in the downhill course of serious microbial infection.
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Koshre, Ganesh R., Feba Shaji, Neeraja K. Mohanan, Nimmy Mohan, Jamshaid Ali, and Rakesh S. Laishram. "Star-PAP RNA Binding Landscape Reveals Novel Role of Star-PAP in mRNA Metabolism That Requires RBM10-RNA Association." International Journal of Molecular Sciences 22, no. 18 (September 15, 2021): 9980. http://dx.doi.org/10.3390/ijms22189980.
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Star-PAP is a non-canonical poly(A) polymerase that selects mRNA targets for polyadenylation. Yet, genome-wide direct Star-PAP targets or the mechanism of specific mRNA recognition is still vague. Here, we employ HITS-CLIP to map the cellular Star-PAP binding landscape and the mechanism of global Star-PAP mRNA association. We show a transcriptome-wide association of Star-PAP that is diminished on Star-PAP depletion. Consistent with its role in the 3′-UTR processing, we observed a high association of Star-PAP at the 3′-UTR region. Strikingly, there is an enrichment of Star-PAP at the coding region exons (CDS) in 42% of target mRNAs. We demonstrate that Star-PAP binding de-stabilises these mRNAs indicating a new role of Star-PAP in mRNA metabolism. Comparison with earlier microarray data reveals that while UTR-associated transcripts are down-regulated, CDS-associated mRNAs are largely up-regulated on Star-PAP depletion. Strikingly, the knockdown of a Star-PAP coregulator RBM10 resulted in a global loss of Star-PAP association on target mRNAs. Consistently, RBM10 depletion compromises 3′-end processing of a set of Star-PAP target mRNAs, while regulating stability/turnover of a different set of mRNAs. Our results establish a global profile of Star-PAP mRNA association and a novel role of Star-PAP in the mRNA metabolism that requires RBM10-mRNA association in the cell.
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Mita, Akio, Kenji Kanazawa, Susumu Kashiwabara, Nobuharu Hara, and Akihiko Asami. "Hydrogen peroxide-alkaline pulp (PAP). IV. PAP prepared from Leucaena latisiliqua (L.) Gillis (Ip. PAP)." JAPAN TAPPI JOURNAL 39, no. 2 (1985): 251–59. http://dx.doi.org/10.2524/jtappij.39.251.
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Barretto, Bronson, Jennifer Martin, Constance Fung, Joseph Dzierzewski, Carl Stepnowsky, Yeonsu Song, Michelle Zeidler, et al. "0758 Behavioral Determinants of PAP Use in Veterans with COMISA: Results of a Randomized Trial." Sleep 45, Supplement_1 (May 25, 2022): A330. http://dx.doi.org/10.1093/sleep/zsac079.754.
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Abstract Introduction Nonadherence to positive airway pressure (PAP) therapy is common in comorbid insomnia and obstructive sleep apnea (COMISA). We previously reported a novel behavioral treatment for COMISA which improves both PAP adherence and sleep. Our current goal was to assess whether improvements in PAP self-efficacy, knowledge, and decisional balance (targets of treatment) are associated with improvements in PAP use and sleep quality. We also collected participants’ perceptions of benefits and challenges of PAP during intervention. Methods 125 veterans (96% men, 39% non-Hispanic white, 24% Black, 17% Hispanic/Latino) with COMISA were randomized to a 5-week intervention integrating behavioral insomnia therapy with a PAP adherence program versus general sleep education (control). Objective PAP use data and Pittsburgh Sleep Quality Index (PSQI) were collected over 6 months. Three behavior change subscales (PAP Self-Efficacy [PAP-SE], Decisional Balance Index [DBI], Knowledge [KNOW]) were administered at 6-months. Weekly self-report of participant-perceived benefits and challenges of PAP use were collected among intervention participants. Subscale scores, PAP use and PSQI were compared between intervention and control, and associations were tested. Change in mean number of benefits and challenges of PAP use were also tested (all analyses intent-to-treat). Results At 6-months, compared to controls, intervention participants had higher scores on all three subscales: PAP-SE (4.1 intervention versus 3.5 control, respectively), DBI (8.3, 0.9) and KNOW (10.5, 9.6, all p<.05). Intervention participants had more PAP use and lower (better) PSQI scores at 6-months (all p<.05). In the total sample, PAP use and PSQI correlated with PAP-SE (r=.52 PAP use, r=-.27 PSQI, respectively), DBI (r=.49, -.35) and KNOW (r=.43, -.21; all p<.05). Among intervention participants, perceived benefits of PAP increased over time (4.3 at week 2, 5.8 at week 4, respectively), and challenges decreased (3.7, 2.3; all p<.05). Conclusion Behavioral treatment for COMISA improves behavioral determinants of PAP use, which is associated with improvements in PAP use and sleep quality. In addition, with treatment, perceived benefits of PAP increase and challenges decrease. These findings suggest improvements in self-efficacy, knowledge and perceived benefits of PAP are important mechanisms through which behavioral interventions improve PAP use in older adults with COMISA. Support (If Any) VAHSRD (IIR12–353-Alessi, RCSA20-191-Martin) and NIH (NHLBI K24HL143055-Martin, NIA K23AG049955-Dzierzewski)
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Zhao, Shifeng, Yuan He, Chungu Wang, Israa Assani, Peilei Hou, Yan Feng, Juanjuan Yang, Yehua Wang, Zhixin Liao, and Songdong Shen. "Isolation, Characterization and Bioactive Properties of Alkali-Extracted Polysaccharides from Enteromorpha prolifera." Marine Drugs 18, no. 11 (November 6, 2020): 552. http://dx.doi.org/10.3390/md18110552.
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Four new purified polysaccharides (PAP) were isolated and purified from the Enteromorpha prolifera by alkali extraction, and further characterization was investigated. Their average molecular weights of PAP-1, PAP-2, PAP-3, and PAP-4 were estimated as 3.44 × 104, 6.42 × 104, 1.20 × 105, and 4.82 × 104 Da, respectively. The results from monosaccharide analysis indicated that PAP-1, PAP-2, PAP-3 were acidic polysaccharides and PAP-4 was a neutral polysaccharide. PAP-1 and PAP-2 mainly consist of galacturonic acid, while PAP-3 and PAP-4 mainly contained rhamnose. Congo red test showed that no triple helical structure was detected in the four polysaccharides. The antioxidant activities were investigated using 1,1-diphenyl-2-picrylhydrazyl (DPPH), Superoxide, and 2, 2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical assay. In vitro antitumor activities were evaluated by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. PAP-1 exhibited relatively stronger antioxidant activities among the four polysaccharides in a dose-dependent manner. At a concentration of 1.00 mg/mL, the antioxidant activities of PAP-1 on the DPPH radical scavenging rate, superoxide anion radical scavenging rate, and ABTS radical rate at 1.00 mg/mL were 56.40%, 54.27%, and 42.07%, respectively. They also showed no significant inhibitory activity against MGC-803, HepG2, T24, and Bel-7402 cells. These investigations of polysaccharides provide a scientific basis for the use of E. prolifera as an ingredient in functional foods and medicines.
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Morrell, Stephen, Richard Taylor, and Gerard Wain. "A study of Pap test history and histologically determined cervical cancer in NSW women, 1997–2003." Journal of Medical Screening 12, no. 4 (December 1, 2005): 190–96. http://dx.doi.org/10.1258/096914105775220769.
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Objectives: To determine the risk of a histological diagnosis of cervical cancer following a given Pap test result and for a given history of Pap test results in a screened population across the full spectrum of possible cytological results. Methods: All the Pap screening results held on the New South Wales Pap Test Register for 1997–2003 (five million tests for 1.87 million women) were analysed using Cox proportional hazards regression to estimate the odds of having a histologically determined cervical cancer for a given Pap test result and test result history. The hazard ratios of having cervical cancer in relation to Pap test result histories were estimated: (i) in regard only to the last Pap test result adjusting for age, frequency of Pap testing and proportion of high grade (≥cervical intraepithelial neoplasia 2 [CIN2]) abnormalities found in a woman's total recorded test result history; and (ii) with regard to the last Pap test result against the highest grade of cytological abnormality found prior to the last Pap test result. The hazard ratios are for a cancer diagnosis occurring before the next Pap test and were adjusted for age, quintile of socioeconomic status of residence, frequency of past Pap testing and proportion of high-grade abnormalities detected in each woman's prior Pap test history. The adjusted hazard ratios were then applied to the tabulated proportions of referent women with negative cytology in each broad age group, and for all women, to estimate the ′1 in n′ odds of being diagnosed histologically with cervical cancer for a given last Pap test result, and by a given last Pap test result for various prior Pap test result histories. Results: After adjusting for age, socioeconomic status, frequency of previous Pap testing and proportion of past high-grade screen-detected abnormalities, the adjusted hazard ratio of having a subsequent cervical cancer diagnosis for women with a negative Pap test result was 1 in 5546, compared with 1 in 833 for a low-grade epithelial abnormality (atypia, CIN1), 1 in 56 for a high-grade epithelial abnormality and 1 in seven for a cytological prediction of cervical cancer. These odds estimates were significantly modified by age and by the highest Pap test result prior to the most recent Pap test result: the higher the age and, less consistently, the higher the previous highest Pap test result for a given last Pap test result, the shorter the odds of having a subsequent histological diagnosis of cervical cancer. Conclusions: The results presented here will enable clinicians to inform their patients of their chances of being diagnosed with cervical cancer for a given Pap test result, and for some combinations of the last Pap test result and highest recorded prior Pap test result.
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Gomes, Thayse Natacha, Peter T. Katzmarzyk, Sara Pereira, Mabliny Thuany, Martyn Standage, and José Maia. "A Systematic Review of Children’s Physical Activity Patterns: Concept, Operational Definitions, Instruments, Statistical Analyses, and Health Implications." International Journal of Environmental Research and Public Health 17, no. 16 (August 12, 2020): 5837. http://dx.doi.org/10.3390/ijerph17165837.
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Despite the widespread use of the expression “physical activity pattern” (PAP), there apparently is no general consensus regarding its definition. This systematic review aimed to examine available research focussing on (1) definitions of PAP, (2) instruments/techniques used to describe PAP, (3) statistical approaches used to analyse PAP, and (4) implications of PAP on children’s health. A systematic review of the available literature was done to identify studies published up to October 2019, and 76 studies were eligible. None of the studies presented a formal definition of PAP; a wide range of instruments were used to investigate children’s PAP, and most of the revised studies did not explicitly present a formal statistical model to define PAP. Twenty-four papers purported to examine associations between PAP and health indicators. The review highlights no consensus on a clear PAP definition whatever the instrument used to capture it, and we did not find any agreement regarding how best to analyse PAP. We suggest that PAP should be used when targeting the investigation of similarities/dissimilarities, as well as stabilities and/or changes in children’s PA at an intra-personal level. In sum, PAP should be used to best describe individual streams of behaviours, and not exclusively PA levels/intensities.
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Bennett, K. L. "0648 Impact of Positive Airway Pressure (PAP) Troubleshooting Clinic Visits on Patient Satisfaction, PAP Use, Mask Leak, and Prolonged Use." Sleep 43, Supplement_1 (April 2020): A247. http://dx.doi.org/10.1093/sleep/zsaa056.644.
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Abstract Introduction Patients with sleep apnea are often prescribed positive airway pressure (PAP) treatment. Some patients have difficulty consistently using a PAP machine due to problems such as air leak, mask discomfort, and dry mouth. The purpose of this project is to evaluate the satisfaction and efficacy of a PAP Troubleshooting Clinic lead by a RN and a respiratory technician (RT). This clinic seeks to improve PAP compliance, increase PAP tolerability and increase PAP treatment efficacy Methods The PAP Troubleshooting Clinic consists of a RN and RT with specialized knowledge about sleep apnea and PAP treatment. During a 30 or 60-minute clinic visit, these providers review the patient’s experience with PAP, assess mask fit, review PAP data and PAP settings, and recommend treatment adjustments for the primary Sleep Clinic provider’s consideration. Outcomes assessment includes satisfaction (a telephone survey one week after the visit) and efficacy (30-day data on overall use, mask leak, and days with ≥ 4 hours of use downloaded from PAP machines). Results To date, 58 patients have received care in the clinic and 56 (96.5%) patients reported they were satisfied/highly satisfied with the PAP Troubleshooting Clinic. From the sample, forty-three (74.1%) patients were compliant with mask use over 30 days. Twenty-four (55.81%) showed a greater than 10% reduction in mask leak after intervention. Ten patients (23.3%) achieved an improvement with a 10% increase in number of days with > than 4 hours of PAP use. Conclusion Patients and Sleep Clinic providers are very satisfied with the PAP Troubleshooting Clinic. Patients are referred to this clinic because they have significant issues with PAP usage and are at high risk of discontinuing use. Patients find the clinic helpful and encouraging, while sleep medicine physicians and APPs appreciate the assistance in helping patients succeed with PAP, especially during the 30-day time period where PAP compliance receives scrutiny from clinics and payers. Support A PAP Troubleshooting Clinic is an effective way to improve patient PAP Use, Mask Leak, Prolonged Use and Patient Satisfaction. Importantly, this new clinical model offers a valuable alternative to provide patients with the appropriate level of care.
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Sommerburg, Olaf, and Jutta Hammermann. "Pancreatitis-Associated Protein in Neonatal Screening for Cystic Fibrosis: Strengths and Weaknesses." International Journal of Neonatal Screening 6, no. 2 (March 30, 2020): 28. http://dx.doi.org/10.3390/ijns6020028.
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There are currently four countries and one local region in Europe that use PAP in their newborn screening programme. The first country to employ PAP at a national level was the Netherlands, which started using IRT/PAP/DNA/EGA in 2011. Germany followed in 2016 with a slightly different IRT/PAP/DNA strategy. Portugal also started in 2016, but with an IRT/PAP/IRT programme, and in 2017, Austria changed its IRT/IRT protocol to an IRT/PAP/IRT program. In 2018, Catalonia started to use an IRT/PAP/IRT/DNA strategy. The strengths of PAP are the avoidance of carrier detection and a lower detection rate of CFSPID. PAP seems to have advantages in detecting CF in ethnically-diverse populations, as it is a biochemical approach to screening, which looks for pancreatic injury. Compared to an IRT/IRT protocol, an IRT/PAP protocol leads to earlier diagnoses. While PAP can be assessed with the same screening card as the first IRT, the second IRT in an IRT/IRT protocol requires a second heel prick around the 21st day of the patient’s life. However, IRT/PAP has two main weaknesses. First, an IRT/PAP protocol seems to have a lower sensitivity compared to a well-functioning IRT/DNA protocol, and second, IRT/PAP that is performed as a purely biochemical protocol has a very low positive predictive value. However, if the advantages of PAP are to be exploited, a combination of IRT/PAP with genetic screening or a second IRT as a third tier could be an alternative for a sufficiently performing CF-NBS protocol.
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Sangal, R. Bart. "Baseline Sleep Efficiency and Arousal Index Do Not Predict Who Will Benefit From Sedatives in Improving Positive Airway Pressure Adherence in Sleep Apnea to 90%." Clinical EEG and Neuroscience 49, no. 4 (May 22, 2017): 285–89. http://dx.doi.org/10.1177/1550059417709882.
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Positive airway pressure (PAP) is the preferred treatment for obstructive sleep apnea (OSA), but adherence is low. Educational or ongoing supportive intervention improves the number of PAP adherent patients from the 50% to the 70% range. A common side effect of PAP is increased awakenings. This prospective trial examined baseline polysomnographically derived sleep efficiency and arousal index in PAP adherent and nonadherent patients, and in patients needing sedating medicines to attain PAP adherence versus those who did not need such medicines. Patients with OSA were titrated on PAP during a polysomnography or treated with autotitrating PAP, followed by educational and supportive interventions. Patients with PAP related awakenings (patients describing waking up and taking PAP off in the middle of the night) or difficulty tolerating PAP were additionally treated with medicines that suppress arousals/awakenings (trazodone, mirtazapine, doxepin). A total of 120 of 151 (79%) new patients were ≥70% PAP adherent over a continuous 30-day period, typically within the first 90 days of starting PAP, without sedating medicines. Nineteen of the remaining patients were treated with medicines that suppress arousals and awakenings, and 16 became adherent, resulting in 136 (90%) of 151 new patients achieving adherence. There were no differences in baseline sleep efficiency or arousal index, between adherent and nonadherent patients, as well as between patients who needed sedating medicines for PAP adherence and those who did not. Adding medicines that suppress arousals and awakenings for patients having trouble tolerating PAP, increases the number of patients who are PAP adherent. The need for such medicines seems to be related to the PAP side effect of increased awakenings rather than baseline impaired sleep.
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Izadmehr, Sudeh, Alexander Kirschenbaum, Shen Yao, and Alice C. Levine. "Prostatic Acid Phosphatase Is a Progenitor Cell Marker That Persists After Androgen Ablation." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A1030—A1031. http://dx.doi.org/10.1210/jendso/bvab048.2108.
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Abstract Introduction: Prostatic Acid Phosphatase (PAP), a protein phosphatase and 5’ecto-nucleotidase, is expressed in prostate cancer (PCa) bone metastases and correlates with poor survival. Growing evidence suggests that PAP is not regulated by androgens, but rather by factors in the tumor microenvironment. Hypothesis: We hypothesized that PAP is a marker for a more progenitor type PCa cell and its expression is androgen-independent, persisting in castration-resistant disease. Methods: Protein expression of PAP and three androgen-regulated proteins, the Androgen Receptor (AR), Prostate-Specific Antigen (PSA), and ETS-related gene (ERG) protein, was assessed with immunohistochemistry in human fetal prostate (9.5 - 20 weeks of gestational age), archival human PCa bone metastases, and human PCa cell lines. VCaP cells were treated in vitro with dihydrotestosterone (DHT) and the effects on AR and PAP protein expression determined with Western Blotting. PAP-expressing PCa cell lines (LNCaP, C42B, and VCaP) were inoculated subcutaneously (s.c.) into SCID mice. To model tumor-bone interaction, LNCaP and MC3T3 osteoblast cells were co-inoculated s.c. into SCID mice. A VCaP castration study with surgical or sham castration was performed after tumors were palpable and effects of castration on tumor growth and protein expression determined. Results: PAP expression was observed in the fetal prostate as early as 11.5 weeks of gestational age prior to PSA and AR expression. Strong PAP expression was noted in all human PCa bone metastases examined, both treatment-naive and castrate-resistant (n=10). In vitro, VCaP cells expressed high levels of AR and PAP protein and DHT treatment increased AR and decreased PAP protein expression. In vivo, PAP expression was observed in all tumor models; LNCaP (low PAP expression), C42B (moderate PAP expression) and VCaP (high PAP expression). Castrated VCaP tumors underwent tumor stasis, were significantly smaller compared to intact mice, had decreased AR, PSA and ERG expression but persistent expression of PAP. Double staining of tumors for PAP and AR demonstrated a population of cells that were positive for PAP but negative for AR expression in hypoxic areas near necrosis. Inoculation of LNCaP cells with MC3T3 osteoblastic cells increased PAP expression in vivo. Conclusions: PAP is expressed early in human fetal prostate development prior to the secretion of significant androgens or expression of AR. In mouse xenograft tumors and human PCa bone metastases, androgens did not significantly regulate PAP expression. Both hypoxia and stroma increased PAP expression. These data demonstrate that PAP is a marker of early progenitor cells, is persistently expressed after castration and is upregulated by tumor microenvironmental factors. PAP may be a suitable target for the treatment of castration-resistant metastatic disease.
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Raab, Stephen S., Bruce A. Jones, Rhona Souers, and Joseph A. Tworek. "The Effect of Continuous Monitoring of Cytologic-Histologic Correlation Data on Cervical Cancer Screening Performance." Archives of Pathology & Laboratory Medicine 132, no. 1 (January 1, 2008): 16–22. http://dx.doi.org/10.5858/2008-132-16-teocmo.
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Abstract Context.—The use of Papanicolaou (Pap) test cytologic-histologic correlation in quality improvement activities is not well studied. Objective.—To determine if continuous monitoring of correlation data improves performance. Design.—Participants in the College of American Pathologists Q-Tracks program (213 laboratories) self-reported the number of Pap test–histologic biopsy correlation discrepancies every quarter for up to 8 years. A mixed linear model determined if the length of participation in the Q-Tracks program was associated with improved performance. Main outcome measures were predictive value of a positive Pap test, Pap test sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous cells or atypical glandular cells. Results.—Institutions evaluated 287 570 paired Pap test– histologic correlation specimens and found 98 424 (34.2%) true-positive Pap test correlations, 19 006 (6.6%) false-positive Pap test correlations, and 6575 (2.3%) false-negative Pap test correlations. The mean predictive value of a positive Pap test, sensitivity, screening and interpretive sensitivity, sampling sensitivity, and proportion of positive histologic diagnoses following a Pap test diagnosis of atypical squamous or glandular cells were 83.6%, 93.7%, 99.2%, 94.2%, 60.3%, and 38.8%, respectively. Longer participation was significantly associated with a higher predictive value of a positive Pap test (P = .01), higher Pap test sensitivity (P = .002), higher Pap test sampling sensitivity (P = .03), and higher proportion of positive histologic diagnoses for a Pap test diagnosis of atypical squamous cells (P < .001). Conclusions.—Long-term monitoring of cytologic-histologic correlation is associated with improvement in cytologic-histologic correlation performance.
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Urmey, W. F., A. De Troyer, K. B. Kelly, and S. H. Loring. "Pleural pressure increases during inspiration in the zone of apposition of diaphragm to rib cage." Journal of Applied Physiology 65, no. 5 (November 1, 1988): 2207–12. http://dx.doi.org/10.1152/jappl.1988.65.5.2207.
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The zone of apposition of diaphragm to rib cage provides a theoretical mechanism that may, in part, contribute to rib cage expansion during inspiration. Increases in intra-abdominal pressure (Pab) that are generated by diaphragmatic contraction are indirectly applied to the inner rib cage wall in the zone of apposition. We explored this mechanism, with the expectation that pleural pressure in this zone (Pap) would increase during inspiration and that local transdiaphragmatic pressure in this zone (Pdiap) must be different from conventionally determined transdiaphragmatic pressure (Pdi) during inspiration. Direct measurements of Pap, as well as measurements of pleural pressure (Ppl) cephalad to the zone of apposition, were made during tidal inspiration, during phrenic stimulation, and during inspiratory efforts in anesthetized dogs. Pab and esophageal pressure (Pes) were measured simultaneously. By measuring Ppl's with cannulas placed through ribs, we found that Pap consistently increased during both maneuvers, whereas Ppl and Pes decreased. Whereas changes in Pdi of up to -19 cmH2O were measured, Pdiap never departed from zero by greater than -4.5 cmH2O. We conclude that there can be marked regional differences in Ppl and Pdi between the zone of apposition and regions cephalad to the zone. Our results support the concept of the zone of apposition as an anatomic region where Pab is transmitted to the interior surface of the lower rib cage.
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Xanthopoulos, M. S., A. A. Williamson, I. E. Tapia, C. M. Cielo, H. Ku, J. Smith, E. Matthews, and S. E. Beck. "0885 Reduction in Emergency Department and Inpatient Hospitalization Visits and Length of Stay in a Cohort of Pediatric Patients Initiated on Positive Airway Pressure for Obstructive Sleep Apnea Syndrome." Sleep 43, Supplement_1 (April 2020): A337. http://dx.doi.org/10.1093/sleep/zsaa056.881.
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Abstract Introduction Positive Airway Pressure (PAP) is an efficacious treatment of pediatric obstructive sleep apnea syndrome (OSAS). However, it is unknown whether PAP initiation is associated with reduced healthcare utilization, an important metric of care management. We hypothesized that healthcare utilization would be reduced after initiation of PAP in a cohort of pediatric patients prescribed PAP for OSAS. Methods Data were extracted from electronic medical records of 475 patients (Mean±SD age at PAP initiation=7.7±5.7 years; 58.7% male; 40.6% White; 38.3% Black; 18.1% multiracial/other; 12.1% Hispanic/Latinx) prescribed PAP for OSAS and followed in our Sleep Center quality improvement program. We extracted the total number of emergency department (ED) visits and hospitalizations and computed the related average length of stay (LOS) in hours for these visits in the 18 months prior to and 18 months following PAP initiation. Results Paired samples t-tests showed that number of ED visits and hospitalizations, and the related visit LOS, were significantly reduced following PAP initiation. The average number of visits reduced from 2.20 pre-PAP to 1.77 post-PAP initiation [t(474) = 3.48, p<.001, effect size = 0.16], while average LOS reduced from 185.14 hours pre-PAP to 42.94 hours post-PAP initiation [t(474) = 4.81, p<.001, effect size = 0.29]. Findings for the significant reduction in LOS held after adjusting for the number of pre and post-PAP ED visits and hospitalizations, average pre-PAP LOS, and patient demographics (age at the time of initiation; sex; race/ethnicity) using multiple linear regression. Conclusion PAP initiation was associated with fewer and shorter ED visits and hospitalizations in a large sample of pediatric patients. We speculate that PAP initiation could help reduce morbidity associated with pediatric OSAS, as well as improve healthcare utilization, capacity management and care in this population. Support K23HD094905 and Sleep Research Foundation (AAW)