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Kim, Dong Hwi, Sang Yun e Il-Ho Kim. "Thermoelectric Chalcostibite: Solid-State Synthesis and Thermal Properties". Korean Journal of Metals and Materials 62, n.º 6 (5 de junho de 2024): 480–86. http://dx.doi.org/10.3365/kjmm.2024.62.6.480.
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In this study, thermoelectric chalcostibite (CuSbS2) compounds were fabricated using mechanical alloying (MA) and hot pressing (HP), and phase identification, microstructural observation, and thermal analysis were conducted. The thermal properties were then measured and compared with those of other Cu–Sb–S ternary compounds synthesized by the same solid-state process, namely, skinnerite (Cu3SbS3), famatinite (Cu3SbS4), and tetrahedrite (Cu12Sb4S13). Both the MA powder and HP-sintered samples contained a single-phase chalcostibite with an orthorhombic structure, and relative densities of 94.6–99.7% were obtained based on HP temperature. The full width at half maximum of the X-ray diffraction peak was significantly reduced for the HP specimens compared to that of the MA powder due to stress relaxation and grain growth during HP at elevated temperatures. However, practically no changes were observed in the lattice constants based on HP temperature. Differential scanning calorimetric analysis revealed that one endothermic reaction occurred at 814–815 K for the MA powder and at 818–821 K for the HP specimen, which were interpreted as the melting points of chalcostibite. Densely sintered compacts with densities close to the theoretical density were obtained using HP at temperatures of 623 K or higher. The constituent elements of the chalcostibites were uniformly distributed. As the HP temperature increased, thermal diffusivity and conductivity increased, but they decreased significantly as the measurement temperature increased. For the chalcostibite specimen hot-pressed at 623 K, the thermal diffusivity and conductivity were (0.75–0.36) × 10-2 cm2 s-1 and 1.47–0.72 W m-1 K-1 at 323–623 K, respectively. Compared with other Cu–Sb–S ternary compounds, the thermal diffusivity was higher at low temperatures but similar at high temperatures, and the thermal conductivity above 500 K was lower than 1 W m-1 K-1.
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Kweon, Suc-hyun, Jin sung Park e Byung Ha Park. "Sarcopenia and Its Association With Change of Bone Mineral Density and Functional Outcome in Old-Aged Hip Arthroplasty Patients". Geriatric Orthopaedic Surgery & Rehabilitation 13 (janeiro de 2022): 215145932210928. http://dx.doi.org/10.1177/21514593221092880.
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Aim This study aimed to investigate the relationship between sarcopenia and change in bone mineral density (BMD) and functional outcome in hip arthroplasty patients. Methods: Among the 221 patients who had undergone hip arthroplasty, 147 patients were enrolled. All patients were divided into 2 groups according to presence of sarcopenia. Bone mineral density (BMD) at hospitalization and 1-year after surgery and Barthel index was measured at the time of before injury, hospitalization, 3 months and 1-year after surgery. Results: BMD at hospitalization showed .627 ± .082 (g/cm2) in Sarcopenia and .726 ± .059 (g/cm2) in Non-sarcopenia at femur (total) site ( P < .001), .531 ± .085 (g/cm2) vs .629 ± .057 (g/cm2) at femur neck site (P=.002), .715 ± .084 (g/cm2) vs .807 ± .058 (g/cm2) at lumbar (L1-L4) site ( P < .001). BMD at 1-year follow-up period, Sarcopenia showed .626 ± .082 (g/cm2) and Non-sarcopenia showed .725 ± .060 (g/cm2) at femur (total) site ( P < .001), .530 ± .085 (g/cm2) vs .629 ± .058 (g/cm2) at femur neck site ( P < .001), .715 ± .084 (g/cm2) vs .806 ± .058 (g/cm2) at lumbar (L1-L4) site ( P < .001). Change of BMD showed −.01 ± .25% for Sarcopenia and −.15 ± .47% for Non-sarcopenia in femur (total) site (P=.089), −.08 ± .63% vs −.01 ± 1.01% in femur neck site ( P = .058), .00 ± .09% vs −.12 ± .33% for each group in lumbar (L1-L4) site ( P = .052). Barthel index score showed 79.94 ± 5.66 for Sarcopenia and 84.74 ± 5.36 for Non-sarcopenia at pre-injury status ( P < .001), 33.89 ± 4.94 vs 33.87 ± 5.36 at the time of hospitalization ( P = .977), 57.42 ± 7.19 vs 60.06 ± 5.39 at 3 months follow up ( P = .015), 73.86 ± 5.94 vs 80.71 ± 4.81 for each group at 1-year follow up ( P < .001). Conclusions: Our study found that the sarcopenia showed lower BMD than the non-sarcopenia, but there was no significant difference of BMD change in the follow-up period. In addition, the sarcopenia showed poor functional results at all points except at the time of hospitalization.
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Gonzalez Vargas, Juan Mauricio, e Jana María Gallardo Pérez. "Análisis descriptivo de variables de rendimiento físico en un equipo de fútbol de primera división chilena femenina (Descriptive analysis of physical performance variables in a Chilean women's first division football team)". Retos 48 (13 de março de 2023): 657–66. http://dx.doi.org/10.47197/retos.v48.95406.
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Las capacidades físicas de velocidad, fuerza, resistencia y flexibilidad están relacionadas con el potencial metabólico y mecánico del músculo, que al ser orientadas correctamente de acuerdo con las demandas del juego pueden ser factores que contribuyan al rendimiento y al estado de salud de las deportistas. El objetivo de este estudio fue realizar un análisis descriptivo del rendimiento de la velocidad, la fuerza, la resistencia y la flexibilidad en futbolistas chilenas de primera división en función a la posición de juego. Las participantes de este estudio fueron 30 jugadoras con edades comprendidas entre los 18 y 28 años, las cuales se encontraban iniciando el periodo de preparación. Fueron agrupadas según la posición de juego en 3 guardametas (PO), 4 centrales (CT), 6 laterales (LT), 6 mediocentros (MC), 5 mediocentros de banda (MB) y 6 delanteras (DC). Las jugadoras completaron las pruebas de velocidad en 30 metros lineales (V30M), Arrowhead Agility Test (AAT), Counter Movement Jump (CMJ), Intermittent Fitness Test (30-15IFT) y Elevación de la Pierna Recta (EPR). No se observaron diferencias significativas para las variables de velocidad, fuerza, resistencia y flexibilidad según la posición de juego (p<.05), pero si se encontraron relaciones significativas entre V30M y AAT (r=.435, p=.001), CMJ (r=-.599, p=.000), VIFT (r=-.621, p=.000), VO2máx (r=-.562, p=.001) y EPR-D (r=-.418, p=.019), entre EPR-ND y AAT (r=.448, p=.012), EPR-D y CMJ (r=.537, p=.002), VIFT y VO2máx (r=.934, p=.000), EPR-D y EPR-ND (r=.813, p=.000). En conclusión, las capacidades físicas de velocidad, fuerza, resistencia y flexibilidad no difieren en función a la posición de juego, pero presentan relaciones significativas entre ellas, especialmente la velocidad. Palabras clave: Mujer, Fútbol, Capacidad Física, Posición de Juego. Abstract. The physical capacities of speed, strength, resistance, and flexibility are related to the metabolic and mechanical potential of the muscle, which, when correctly oriented according to the demands of the game, can be factors that contribute to the performance and health status of athletes. The objective of this study was to carry out a descriptive analysis of the performance of the speed, strength, resistance, and flexibility in Chilean soccer players of the first division based the playing position. The participants of this study were 30 players, aged between 18 and 28 years, who were beginning the preparation period. They were grouped according to the position of the game according to 3 goalkeepers (PO), 4 center backs (CT), 6 full backs (LT), 6 midfielders (MC), 5 wide midfielders (MB) and 6 forwards (DC). The players completed the 30 linear meter sprint tests (V30M), Arrowhead Agility Test (AAT), Counter Movement Jump (CMJ), Intermittent Fitness Test (30-15IFT) and Straight Leg Raise (EPR). No significant differences were observed for the variables of speed, strength, resistance, and flexibility according to the game position (p<.05), but if significant relationships were found between V30M and AAT (r=.435, p=.001), CMJ (r=-.599, p=.000), VIFT (r=-.621, p=.000), VO2máx (r=-.562, p=.001) and EPR-D (r=-.418, p=.019), between EPR-ND y AAT (r=.448, p=.012), EPR-D and CMJ (r=.537, p=.002), VIFT and VO2máx (r=.934, p=.000), EPR-D and EPR-ND (r=.813, p=.000). In conclusion, the physical capacities of speed, strength, resistance, and flexibility do not differ depending on the playing position, but they do present significant relationships between them, especially the speed. Keywords: Woman, Soccer, Physical Capacity, Playing Position.
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Gregg, S. G., R. S. Mazzeo, T. F. Budinger e G. A. Brooks. "Acute anemia increases lactate production and decreases clearance during exercise". Journal of Applied Physiology 67, n.º 2 (1 de agosto de 1989): 756–64. http://dx.doi.org/10.1152/jappl.1989.67.2.756.
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We evaluated whether elevated blood lactate concentration during exercise in anemia is the result of elevated production or reduced clearance. Female Sprague-Dawley rats were made acutely anemic by exchange transfusion of plasma for whole blood. Hemoglobin and hematocrit were reduced 33%, to 8.6 +/- 0.4 mg/dl and 26.5 +/- 1.1%, respectively. Blood lactate kinetics were studied by primed continuous infusion of [U-14C]lactate. Blood flow distribution during rest and exercise was determined from injection of 153Gd- and 113Sn-labeled microspheres. Resting blood glucose (5.1 +/- 0.2 mM) and lactate (1.9 +/- 0.02 mM) concentrations were not different in anemic animals. However, during exercise blood glucose was lower in anemic animals (4.0 +/- 0.2 vs. 4.6 +/- 0.1 mM) and lactate was higher (6.1 +/- 0.4 vs. 2.3 +/- 0.5 mM). Blood lactate disposal rates (turnover measured with recyclable tracer, Ri) were not different at rest and averaged 136 +/- 5.8 mumol.kg-1.min-1. Ri was significantly elevated in both control (260.9 +/- 7.1 mumol.kg-1.min-1) and anemic animals (372.6 +/- 8.6) during exercise. Metabolic clearance rate (MCR = Ri/[lactate]) did not differ during rest (151 +/- 8.2 ml.kg-1.min-1); MCR was reduced more by exercise in anemic animals (64.3 +/- 3.8) than in controls (129.2 +/- 4.1). Plasma catecholamine levels were not different in resting rats, with pooled mean values of 0.45 +/- 0.1 and 0.48 +/- 0.1 ng/ml for epinephrine (E) and norepinephrine (NE), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Ringoringo, Harapan Parlindungan. "The Role of Atorvastatin in Management of Eruptive Xanthoma on a Boy: A Case Report". Open Access Macedonian Journal of Medical Sciences 9, n.º C (15 de setembro de 2021): 151–53. http://dx.doi.org/10.3889/oamjms.2021.6941.
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Background: Eruptive xanthoma is a benign skin lesion caused by the accumulation of cholesterol and triglycerides in the skin's dermis. Xanthoma can be an early clinical manifestation of systemic diseases such as dyslipidemia, cardiovascular disease, diabetes mellitus. Clinical presentation varies from asymptomatic skin lesions to intense pruritus and tenderness.
Aim: This study aims that oral atorvastatin is effective in treating a child with eruptive xanthoma.
Case report: A three-year-old boy with an 8.4 kg body weight and 82.5 cm height came to the hospital with the chief complaint of small yellowish-white papules and nodes, discrete, 2-5 mm in size, painless on pressing, itchy, scattered, mainly in the lower extremity around the buttocks. On laboratory examination, Hb 11.5 g/dL, leukocyte 9,900/ul, platelet 413,000/uL, blood glucose 66 mg/dL. Further evaluation revealed total cholesterol 814 mg/dL, LDL 970 mg/dL, HDL 341 mg/dl, triglycerides 621 mg/dL; there is no evidence of familial hypercholesterolemia. The diagnosis is eruptive xanthoma. After starting treatment with atorvastatin 0.2 mg/kg body weight/day in one dose for six months, his cutaneous lesions gradually subsided and significantly decreased cholesterol, LDL, HDL, and triglyceride levels. Conclusion: Early therapy with atorvastatin will reduce the morbidity and mortality of eruptive xanthoma.
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Tokoro, Roberto, Mauro Bertotti e Lúcio Angnes. "Polarographic studies of indium(III) in aqueous medium of sodium azide". Canadian Journal of Chemistry 73, n.º 2 (1 de fevereiro de 1995): 232–40. http://dx.doi.org/10.1139/v95-032.
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In this paper, some aspects of the polarography of indium(III) in azide/hydrazoic acid buffer are presented. The electrode process is mostly governed by diffusion in the complexing medium. Nevertheless, for controlled-potential coulometry (involving a large time window) a catalytic process was observed, ascribed to the reaction of the hydrazoic acid and indium amalgam. The stability of azide complexes of In(III) was studied polarographically, and the formation of four mononuclear species was confirmed by computational analysis of data obtained from polarograms of In(III) in different azide concentrations. The values of the global constants obtained are: β1 = 3.7 × 103 M−1, β2 = 8.6 × 105 M−2, β3 = 5.0 × 107 M−3, β4 = 2.1 × 109 M−4, in a constant ionic strength medium held at 2.0 M with NaClO4. These data are in good agreement with those obtained by potentiometry. The value found for E0′ of the In(III)/In couple was −512.2 mV vs. calomel electrode (3 M NaCl), the mean diffusion coefficient of the complex being (6.1 ± 0.2) × 10−6 cm2 s−1 in perchlorate medium (T = 25 °C). Keywords: polarography, indium(III), azide, stability constants, catalytic wave.
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Knop, Stefan, Katja Bauer, Holger Hebart, Hannes Wandt, Lorenz Trumper, Peter Liebisch, Georg Maschmeyer et al. "A Randomized Comparison of Total-Marrow Irradiation, Busulfan and Cyclophosphamide with Tandem High-Dose Melphalan in Patients with Multiple Myeloma." Blood 110, n.º 11 (16 de novembro de 2007): 728. http://dx.doi.org/10.1182/blood.v110.11.728.728.
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Abstract Background Myeloablative chemotherapy with support of autologous peripheral blood stem cells (APBSC) has widely been accepted as a standard of care in patients (pts) with newly diagnosed multiple myeloma (MM). High-dose (HD) melphalan (Mel) 200 mg/m2 was considered superior to total-body irradiaton (TBI) plus Mel 140 mg/m2 for toxicity reasons. Since MM plasma cells are inherently responsive to irradiation, our group evaluated TBI aimed at reduced organ toxicity by shielding lungs and liver (total-marrow irradiation [TMI], 9 Gy) combined with busulfan (Bu, 12 mg/kg) and cyclophosphamide (Cy, 120 mg/kg) in a previous phase I/II trial (Einsele et al, Bone Marrow Transplant, 2003). Patients and methods In the current study (DSMM I), subjects with previously untreated MM in Durie-Salmon stages II/III were randomly assigned to either receive one course of TMI/Bu/Cy versus two cycles of HD Mel 200 mg/m2 each with APBSC transplantation if having had an adequate number of stem cells collected and at least stable disease. Primary end point was event-free survival (EFS), secondary end points overall (OS) and disease-free survival (DFS). Results A total of 294 pts (median age, 54 years), 246 of whom completed stem cell harvest were enrolled between 8/1998 and 1/2002 by 46 centres. Eventually, 198 (n=100 TMI/Bu/Cy and n=98 HD Mel) pts were randomized and included into the ITT population. The safety population (n=80 TMI and n=118 HD Mel, due to 18 pts switching to Mel) was analyzed for toxicity and response. CR rate before HD therapy was 7.0% (7/100) in the TMI and 6.1% (6/98) in the Mel arm respectively. Significantly more pts receiving TMI/Bu/Cy experienced WHO grades 3 and 4 pulmonary and gastrointestinal toxicity and pain. Following HDT, CR rate increased to 17.5% (14/80, TMI) and 32.2% (38/118, HD Mel; p=.022) respectively. After a median follow-up of 1447 days, median EFS in the TMI group was 1161 days versus 1090 days for HD Mel (p=.812). Probability of 4-year OS was 72.7% (95%-CI: 62.1–80.7) with TMI and also 72.7% (95%-CI: 61.7–81.1) after HD Mel (p=.754). For pts in CR following HD therapy, probability of 4 year DFS was 62.4% (95%-CI: 33.6–81.6) for TMI vs. 50.4% (95%-CI: 30.6–67.3) for HD-Mel (p=.138). Conclusion In this randomized trial on pts with newly diagnosed MM, the irradiation-based regimen was associated with more pulmonary and GI toxicity when compared to HD Mel. Incidences of other toxicities including hepatotoxicity, however, were not different between the two treatment arms. CR rate was superior for HD-Mel, while there was no difference in OS and EFS between the two treatment arms. Subjects achieving CR may be more likely to enjoy prolonged DFS after TMI/Bu/Cy.
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Nwankwo, Philip Abuchi, Hycinth Igwesi Ogbodo, Vitus Chinedu Ogbunuju e Oguanobi Chimezie Alex. "Self-Concept Dimensions and their Impact on Product Adoption in Nigeria". Journal of Basic and Applied Research International 31, n.º 1 (6 de fevereiro de 2025): 25–43. https://doi.org/10.56557/jobari/2025/v31i19093.
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The present study aimed to finding out the influence of each of these variables-actual self-concepts, ideal self-concepts, social self-concept, ideal social concept and ought to self-concept on consumer’s product adoption. The study adopted survey research design. The population of the study was 620 drawn from students of high institutions in Nigeria. The study adopted census sample sample size determination. The findings of the study indicated that consumers' actual self-concept has a significant and positive effect on product adoption (r = 0. 856; t = 31. 072; p< 0.05) .There is a significant positive relationship between consumers' ideal self-concept and product adoption (r =.819, P<.05). There is a significant positive relationship between consumes' ideal social self-concept and product adoption (r =.769, P<.05). There is a significant positive relationship between Consumers' social self-concept and traits of product adoption (r =.843, P<.05). Implication of the study is that the manufacturers of consumer products should differentiate products that ‘fit into one of the aforementioned variables to improve consumer’s self-perception. The study recommends that consumers should match the knowledge of self-concept to product adoption to determine areas of optimal strengths, eliminate areas of unprofitable laggards, and ignite the culture of product quality adoption excellence. Among other things, conclusions were made that the perception and the way and manner consumers see themselves serve as a determinant of the response that may lead to product adoption.
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Gregg, S. G., M. Kern e G. A. Brooks. "Acute anemia results in an increased glucose dependence during sustained exercise". Journal of Applied Physiology 66, n.º 4 (1 de abril de 1989): 1874–80. http://dx.doi.org/10.1152/jappl.1989.66.4.1874.
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We evaluated whether acute anemia results in altered blood glucose utilization during sustained exercise at 26.8 m/min on 0% grade, which elicited approximately 60–70% maximal O2 consumption. Acute anemia was induced in female Sprague-Dawley rats by isovolumic plasma exchange transfusion. Hemoglobin and hematocrit were reduced 33% by exchange transfusion to 8.6 +/- 0.4 g/dl and 26.5 +/- 1%, respectively. Glucose kinetics were determined by primed continuous infusion of [6–3H]glucose. Rates of O2 consumption were similar during rest (pooled means 25.1 +/- 1.8 ml.kg-1.min-1) and exercise (pooled means 46.8 +/- 3.0 ml.kg-1.min-1). Resting blood glucose and lactate concentrations were not different in anemic animals (pooled means 5.1 +/- 0.2 and 0.9 +/- 0.02 mM, respectively). Exercise resulted in significantly decreased blood glucose (4.0 +/- 0.2 vs. 4.6 +/- 0.1 mM) and elevated lactate (6.1 +/- 0.4 vs. 2.3 +/- 0.5 mM) concentrations in anemic animals. Glucose turnover rates (Rt) were not different between anemic and control animals at rest and averaged 58.8 +/- 3.6 mumol.kg-1.min-1. Exercise resulted in a 30% greater increase in Rt in anemic (141.7 +/- 3.2 mumol.kg-1.min-1) than in control animals (111.2 +/- 5.2 mumol.kg-1.min-1). Metabolic clearance rates (MCR = Rt/[glucose]) were not different at rest (11.6 +/- 7.4) but were significantly greater in anemic (55.2 +/- 5.7 ml.kg-1.min-1) than in control animals (24.3 +/- 1.4 ml.kg-1.min-1) during exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
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Li, Ke, Dehuang Guo, Haidong Zhu, Kathleen S. Hering-Smith, L. Lee Hamm, Jingping Ouyang e Yanbin Dong. "Interleukin-6 stimulates epithelial sodium channels in mouse cortical collecting duct cells". American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 299, n.º 2 (agosto de 2010): R590—R595. http://dx.doi.org/10.1152/ajpregu.00207.2009.
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The aim of this study is to elucidate the effects of interleukin-6 (IL-6) on the expression and activity of the epithelial sodium channel (ENaC), which is one of the key mechanisms underlying tubular sodium reabsorption. M-1 cortical collecting duct cells were treated with IL-6 (100 ng/ml) for 12 h. Real-time polymerase chain reaction and immunoblotting were employed to examine the mRNA and protein abundance. Transepithelial voltage ( Vte) and resistance ( Rte) were measured with an ohm/voltmeter (EVOM, WPI). The equivalent current was calculated as the ratio of Vte to Rte. Treatment with IL-6 ( n = 5) increased the mRNA abundance of α-ENaC by 11 ± 7% ( P = not significant), β-ENaC by 78 ± 14% ( P = 0.01), γ-ENaC by 185 ± 38% ( P = 0.02), and prostasin by 29 ± 5% ( P = 0.01), all normalized by β-actin. Treatment with IL-6 increased the protein expression of α-ENaC by 19 ± 3% ( P = 0.001), β-ENaC by 89 ± 21% ( P = 0.01), γ-ENaC by 36 ± 12% ( P = 0.02), and prostasin by 33 ± 6% ( P = 0.02). The amiloride-sensitive sodium current increased by 37 ± 5%, from 6.0 ± 0.4 to 8.2 ± 0.3 μA/cm2 ( P < 0.01), in the cells treated with IL-6 compared with controls ( P = 0.01). Aprotinin (28 μg/ml), a prostasin inhibitor, reduced the amiloride-sensitive sodium current by 61 ± 5%, from 6.1 ± 0.3 to 3.7 ± 0.2 μA/cm2 ( P = 0.01). The magnitude of the IL-6-induced amiloride-sensitive sodium current in the presence of aprotinin dropped by 57 ± 2%, from 8.6 ± 0.2 to 4.9 ± 0.2 μA/cm2 ( P < 0.01). This study has identified a novel function of IL-6, namely, IL-6 may activate ENaC. Therefore, renal inflammation mediated by IL-6 likely contributes to impaired pressure natriuresis.
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Tuomisto, Leena, Lilli Frondelius, Jaakko Mononen e Auvo Sairanen. "Haluaako lehmä laiduntaa?" Suomen Maataloustieteellisen Seuran Tiedote, n.º 26 (31 de janeiro de 2010): 1–6. http://dx.doi.org/10.33354/smst.76860.
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Maidontuotannon rakennemuutoksesta johtuva tilakokojen suureneminen voi johtaa siihen, että laidunalaei enää riitä ja laiduntamisen järjestäminen suurelle eläinmäärälle on vaikeaa. Koska laiduntamisenkuitenkin katsotaan yleisesti vaikuttavan edullisesti nautojen hyvinvointiin, tutkimuksessa selvitettiinlehmien tarvetta laiduntaa. Kokeen 24 lehmää oli jaettu kahteen 12 lehmän ryhmään, jotka laidunsivatympäri vuorokauden pois lukien lypsyajat. Kontrolliryhmän eläimet laidunsivat tavanomaisesti,mutta koejaksojen aikana häkkiryhmän lehmille tarjottiin lisäksi samalta laidunlohkolta niitettyäruohoa ruokintahäkistä. Kaikki lehmät saivat väkirehua lypsyjen yhteydessä (9 kg/lehmä/vrk). Koejaksojen,yksi heinäkuussa ja yksi elokuussa, kesto oli viisi vuorokautta. Lehmiä tarkkailtiin hetkelliselläseurannalla kymmenen minuutin havaintovälillä koejaksojen viimeisen 48 h ajan pois lukien lypsyajat(klo 05:30–09:00 ja 14:30–18:00). Tilastollinen testaus tehtiin lineaarisella sekamallilla käyttäen yksittäistenlehmien havaintoja toisistaan riippumattomina havaintoina. Mallissa kiinteinä tekijöinä olivatkäsittely, koejakso sekä näiden yhdysvaikutus ja satunnaistekijänä blokki. Häkkiryhmän lehmät laidunsivatvähemmän kuin kontrolliryhmän eläimet (keskimäärin 3,5 vs. 7,1 h vuorokaudesta, P<0,001),ja käyttivät vuorokaudesta keskimäärin 2,6 h häkistä tarjotun rehun syömiseen. Kaikkiaan häkkiryhmänlehmät käyttivät syömiseen vähemmän aikaa kuin kontrolliryhmän eläimet (keskimäärin 6,1 vs.7,1 h vuorokaudesta, P<0,001). Häkkiryhmän eläimet märehtivät enemmän kuin kontrolliryhmäneläimet (keskimäärin 6,9 vs. 6,3 h vuorokaudesta, P<0,05). Kontrolli- ja häkkiryhmän lehmien välilläei ollut eroa lehmien kävelemiseen (keskimäärin 0,2 vs. 0,2 h vuorokaudesta), muuhun aktiivisuuteenmakuulla ja seisaalla (1,0 vs. 1,1 h), joutilaana makaamiseen ja seisomiseen (3,0 vs. 3,3 h) tai yhteensämakaamiseen (8,6 vs. 9,1 h) käyttämässä ajassa. Kun lehmillä oli mahdollisuus hankkia ravintonsalaiduntamalla tai syömällä ruokintahäkistä, ne valitsivat helpomman häkkiruokintavaihtoehdon vainosittain. Kokeemme tulokset viittaavat siihen, että lehmillä on tarve hankkia ainakin osa ravinnostaanlaiduntamalla. Lehmän sosiaalinen asema ja terveys saattavat kuitenkin vaikuttaa yksittäisten lehmientekemiin valintoihin.
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Zhang, Qingfeng, Chenxi Zhao e Kai Kang. "A Wideband Reconfigurable CMOS VGA Based on an Asymmetric Capacitor Technique with a Low Phase Variation". Electronics 11, n.º 5 (28 de fevereiro de 2022): 751. http://dx.doi.org/10.3390/electronics11050751.
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This paper presents a wideband digitally controlled variable gain amplifier (VGA) with a reconfigurable gain tuning range and gain step in a 65 nm CMOS process. A unique asymmetric capacitor-based reconfigurable technique is proposed to extend the gain tuning range and realize gain step reconfiguration. An active neutralization topology based on a stackless transistor is utilized to compensate for the additional phase shift introduced by the gain tuning. Moreover, a current-type digital-to-analog converter (DAC) is also integrated for easier precise gain control. With the asymmetric capacitor varying from 1000 fF to 200 fF with a step of 400 fF, the proposed VGA achieves a 12.2/9.2/6.1 dB gain tuning range with a 0.4/0.3/0.2 dB gain resolution, respectively. At the maximum gain tuning range mode, the measured minimum root-mean-square (RMS) phase error is 1.7° at 23.4 GHz. At the finest gain step control mode, the RMS phase error measured across 20–30 GHz is lower than 1.9°. The tested result also shows the proposed VGA achieves a peak gain of 13 dB with a 3 dB bandwidth of 21.4–29 GHz, and the output 1 dB compression point (OP1dB) is up to 8.6 dBm at 25 GHz.
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Harrowfield, Jack M., Raj Pal Sharma, Brian W. Skelton e Allan H. White. "Structural Systematics of 2/4-Nitrophenoxide Complexes of Closed-Shell Metal Ions. III 2/4-Nitrophenoxides of Univalent Heavy Metals". Australian Journal of Chemistry 51, n.º 8 (1998): 735. http://dx.doi.org/10.1071/c97100.
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Room-temperature single-crystal X-ray studies are recorded for 2- and 4-nitrophenoxide salts of silver(I) and thallium(I), M(2-np) and Tl(4-np) (anhydrous), and Ag(4-np).H2O. Ag(2-np) is monoclinic, P21/c, a 9·012(4), b 5·743(5), c 12·594(5) Å, β 104·34(4)°, Z = 4; conventional R on |F| was 0·042 for No 1378 independent ‘observed’ (I > 3σ(I)) reflections. Tl(2-np) is monoclinic, C2/c, a 27·250(3), b 3·712(1), c 15·147(3) Å, β 114·41(1)°, Z = 8, R 0·025 for No 1346. Ag(4-np).H2O is monoclinic, P21/a, a 5·613(6), b 13·191(7), c 9·844(5) Å, β 92·50(6)°, Z = 4, R 0 ·033 for No 622. Tl(4-np) is tetragonal, I 41/a, a 18·037(8), c 8·979(8) Å, Z = 16, R 0·043 for No 924. An acid salt of the latter, Tl(4-np).(4-npH)3, triclinic, P-1, a 11·861(8), b 11·45(1), c 11· 423(1) Å, α 114·00(6), β 109·78(5), γ 96·87(7)°, Z = 2, R 0·042 for No 3814, is isomorphous with its rubidium analogue. These comprise a novel array of structures: although the structures of the silver(I) complexes are two-dimensional sheets with familiar head-tail connecting ligands, a strong silver-aromatic carbon interaction is found in Ag(2-np) (Ag–C 2·496(5) Å). Tl(2-np) and Tl(4-np) both present unusual forms related to the stair-polymer and cubane adducts found in 1 : 1 coinage metal(I)/halide-unidentate nitrogen base adducts; Tl(2-np) is a double-stranded stair-polymer array, with the phenoxide oxygen atoms incorporated in the stair and the nitro oxygen atoms linking successive thallium atoms. The structure of Tl(4-np) is based on a tetranuclear cubane motif of -4 symmetry, [Tl(O-phenoxide)]4, these being linked into a three-dimensional network by further Tl · · · O-nitro interactions from adjacent units. The structure of silver(I) picrate monohydrate, isomorphous with its sodium counterpart, is also recorded: monoclinic, C 2/m, a 12·818(7), b 20·208(8), c 3· 741(1) Å, β 88·25(3)°, Z = 4, R 0·047 for No 1042, void of any significant Ag · · · C contacts.
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Shemetova, Svetlana A., Rudolf S. Arakelyuan, Tatyana V. Nikeshina, Gennadyi L. Shendo, Altin K. Mukasheva, Svetlana V. Kiseleva, Diana A. Crawchenko, Anna V. Kovalenko e Maria F. Petruhnova. "Contamination of environmental objects by helminth-protozoan infestations in Astrakhan region. Аnalysis of activities of “Сenter for hygiene and epidemiology in Astrakhan region” for 2011–2020". Perm Medical Journal 38, n.º 5 (15 de setembro de 2021): 123–36. http://dx.doi.org/10.17816/pmj385123-136.
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Objective. To study and analyze the contamination of environmental objects in the Astrakhan Region (by the example of soil, water, and washout samples from solid household surfaces) based on the results of laboratory studies of the Center for Hygiene and Epidemiology in the Astrakhan Region for 20112020.
Materials and methods. The work was carried out on the basis of the Laboratory of Bacteriological and Parasitological Research of the Center for Hygiene and Epidemiology in the Astrakhan Region and in the laboratories of the Branches of the Center for Hygiene and Epidemiology in the Astrakhan Region in 20112020.
As a whole, during the analyzed period, the laboratory and its branches conducted laboratory studies of 79 742 samples taken from various environmental objects, and 94 495 studies were performed. The number of samples that do not meet the hygiene standards was 1.01 % (806 samples).
Results. The objects of sampling for the study of their parasitic purity were water, soil and wash-out from solid household surfaces.
The share of water samples in the structure of all the studied samples taken from environmental objects was 7.3 % (5858 samples), of which 172 samples were contaminated with pathogens of parasitic diseases, the extent of invasion was 2.9 %.
The structure of positive findings in the water samples was represented by 6 nosological forms of helminths 88.0 % (154 samples) and 3 nosoforms of protozoa 12.0 %.
The share of the studied soil samples in the overall structure of sanitary and parasitological studies of the environment was 11.2 % (8895 samples). The number of unsatisfactory samples in the structure of all positive findings revealed during the study of soil, water and washouts during the analyzed period was 70.4 % (625 samples). The total soil contamination for the period of 20112020 was 7.0 % (625 samples).
In most cases, helminth eggs and larvae were detected 99.8 % (624 samples). The proportion of pathogenic protozoan cysts detected in the soil was 0.2 % (1 sample).
In addition to water and soil samples, the washout samples, taken from solid household surfaces were studied 81.5 % (64989 samples), of which 0.01 % (9 samples) were unsatisfactory.
All positive findings in the washout samples were represented by two nosological forms of helminthiasis: Enterobius vermicularis eggs 0.012 % (8 samples) and teniid oncospheres 0.002 (1 sample).
Conclusions. The presence of helminth eggs and cysts of pathogenic intestinal protozoa in the studied soil and water samples indicates contamination of these objects with the feces of infected persons and/or contamination by sewage runoff resulting from various accidents. The presence of toxocara eggs and strongylid larvae in the soil and water indicates contamination of these objects with the feces of infected animals (dogs, cats). The presence of positive findings in wastewater samples indicates poor-quality disinfection of these objects. The presence of contact helminth eggs in the studied samples of washout samples taken from hard surfaces indicates direct contact of infected persons with these samples.
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Castell, A. G., e R. L. Cliplef. "Evaluation of pea screenings and canola meal as a supplementary protein source in barley-based diets fed to growing-finishing pigs". Canadian Journal of Animal Science 73, n.º 1 (1 de março de 1993): 129–39. http://dx.doi.org/10.4141/cjas93-012.
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The effects of substituting canola meal (CM) and ground pea screenings (PM) for soybean meal (SBM) in barley (B)-based diets were determined with a factorial design using 60 male castrates (3 pen−1) over the period 25–97-kg average liveweight. The five mash diets (B/SBM, with 15% SBM; B/CM, with 18.7% CM; B/CMp, with 12.4% CM + 14.1% PM; B/PMc, with 6.1% CM + 28.3% PM; and B/PM, with 42.5% PM) contained 2.4% supplement (minerals and vitamins) and were fed ad libitum. Growth rate (821, 845, 850, 880 and 812 g d−1, respectively, P < 0.06) was increased with the CM–PM blends, but gain:feed was unaffected (283, 289, 294, 298 and 293 g kg−1, P > 0.10). Compared with the SBM-fed pigs, using CM reduced the dressing percent, carcass grade, apparent digestibility of energy and nitrogen but increased liver weight (P < 0.01). The B/PM diet may have been deficient in isoleucine for pigs in the initial weeks, but subsequent performance was not impaired. Compared with B/CM-fed pigs, B/PM pigs had higher carcass grades (P < 0.05) and their lean tissue had relatively more marbling (P < 0.01) and a higher degree of saturated fat (P < 0.01). Differences among the five diets, however, did not affect the sensory evaluation of the cooked lean (P > 0.05). Apart from an apparently lower digestibility of energy and nitrogen, results with the mixed-source diets confirmed that CM and PM were complementary sources of supplementary amino acids for growing-finishing pigs. Key words: Pigs, canola meal, peas, growth rate, carcass
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Özkoç, Songül Erdem, Mehmet Guli Çetinçakmak e Salih Hattapoğlu. "Evaluation of Dural Venous Sinus Variations through Three-dimensional Phase-Contrast Magnetic Resonance Venography". Journal of the Anatomical Society of India 73, n.º 4 (outubro de 2024): 318–22. https://doi.org/10.4103/jasi.jasi_98_24.
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Objective: The aim of this study was to evaluate the anatomy of dural venous sinus variations through three-dimensional phase-contrast (3D-PC) magnetic resonance venography (MRV). Awareness of the normal anatomical variations of venous sinuses and apparent MRV flow gaps prevent misdiagnosis of dural venous sinus diseases. Materials and Methods: The dural venous sinuses were assessed using nonenhanced 3D PC-MRV. Of these 968 patients, 154 were excluded due to venous thrombosis and mass invasion. A total of 814 patients (186 male and 628 female) were included in the study. Results: The most common variation of superior sagittal sinus (SSS) was atresia of anterior one-third SSS 19 (2.3%). Other variations were hypoplasia of the anterior half of SSS 2 (0.2%), atresia of posterior one-third of SSS (7, 0.9%), and combined variation of SSS (13, 1.6%). The left transverse sinus was hypoplastic in 224 (27.5%) and aplastic/atretic in 259 (31.8%) cases. The right transverse sinus was hypoplastic in 76 (9.3%) and aplastic/atretic in 57 (7.0%) patients. The combined variation of bilateral transverse sinuses had 42 (5.2%) cases. The left sigmoid sinus was hypoplastic in 22.2% (181) of cases. The right sigmoid sinus was hypoplastic in 60 (7.4%). Two patients had hypoplastic bilateral sigmoid sinuses (0.2%). The right occipital sinus was identified in 20 (2.5%) patients. Left occipital sinus was noted in 2 (0.2%) patients. Duplication or triplication of the occipital sinus is noted in 5 (0.6%) study populations. Straight sinus continued in 13 (1.6%) cases with the right transverse sinus and in 29 (3.6%) patients with left transverse sinus. Conclusion: These anatomical variants can be a potential pitfall in the MRV diagnosis of dural sinus variations, especially when there are no supportive imaging features such as brain infarcts or appropriate clinical background. 3D PC-MRV is a great option for patients with gadolinium allergy/renal insufficiency/pregnant patients. We hope this article can add information and assist in preoperative venous analysis for neurosurgeons and neuroradiologists.
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Naik, Mude Bhaskar, Vinayak S. Sirsat, Shailendra Chauhan e Deepak M. Kokane. "A Comparison of Analgesic Effect of Different Doses of Intrathecal Nalbuphine Hydrocloride with Bupivacaine and Bupivacaine alone for Lower Abdominal and Orthopedic Surgeries". Indian Journal of Anesthesia and Analgesia 9, n.º 1 (15 de fevereiro de 2022): 15–19. http://dx.doi.org/10.21088/ijaa.2349.8471.9122.2.
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Objective: To compare the analgesic effect of different doses of nalbuphine when added to bupivacaine in spinal anaesthesia. To compare the onset of sensory blockade (time taken form 3, 5 min and then every 5 min until the end of the procedure. Methods: 100 ASA grade 1 and 2 patients grouped into group A, group B, group C and group D randomly. Age group of 18-60 years. Patient undergoing elective lower abdominal and orthopedic surgery received with Group A : included 25patients with 0.5% hyperbaric bupivacaine 3 cc (15mg) + N.S. 0.2 ml. Group B: included 25 patients with 0.5% hyperbaric bupivacaine (3 cc) 15 mg + 0.8mg nalbuphine + N.S. 0.2 ml. Group C: included 25 patients with 0.5% hyperbaric bupivacaine (3 cc) 15 mg + 1.6mg nalbuphine + N.S. 0.2 ml. Group D: included 25 patients with 0.5% hyperbaric bupivacaine (3 cc) 15 mg + 2.4 mg nalbuphine + N.S. 0.2 ml. Results: The mean sensory onset of study subjects in group A, B, C and D were 8.4±0.5, 5±0.9, 5.6±1 and 8.2±1.4 respectively and this difference was statistically significant. The mean motor onset of study subjects in group A, B, C and D were 10.2±0.7, 6.8±0.9, 6.1±1.2 and 8.6±1.1 respectively and this difference was statistically significant. The mean sensory duration of study subjects in group A, B, C and D were 176.8±29.3, 282±6.8, 300.2±6.6 and 286.2±9.8 respectively and this difference was statistically significant. The mean time for maximum sensory level of study subjects in group A, B, C and D were 11.5±1, 8.8±0.8, 5.6±1.6 and 8.2±1.2 respectively and this difference was statistically significant. The mean T 10 time of study subjects in group A, B, C and D were 8.5±0.5, 8.7±0.7, 5.6±1.6 and 8.6±1 respectively and this difference was statistically significant. The mean time for 2 segment regression of study subjects in group A, B, C and D were 76.6±2, 92.2±2.3, 95.8±3 and 90.6±4.4 respectively and this difference was statistically significant. The mean motor duration of study subjects in group A, B, C and D were 179.8±8.9, 184.6±6, 203.2±7 and 187±9.9 respectively and this difference was statistically significant. The mean analgesic duration of study subjects in group A, B, C and D were 175.8±4.1, 271.1±7.8, 303.8±9.9 and 279±10.7 respectively and this difference was statistically significant. Conclusion: We came to conclusion that 0.5% hyperbaric bupivacaine (15mg) with nalbuphine (0.8mg, 1.6 mg, 2.4 mg) in subarachnoid block. Therefore addition of 1.6 mg nalbuphine to 15mg of 0.5% hyperbaric bupivacaine 15 mg in subarachnoid block can be considered safe with minimum complication, and provides excellent quality and longer duration of postoperative analgesia with good sedation compared with 0.8 mg and 2.4 of nalbuphine. So it is useful for prolonged duration of postoperative analgesia.
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Lee, Hee-Kyung, Sung-Hwan Choi, Dong Fan, Kyung-Mi Jang, Min-Seon Kim e Chung-Ju Hwang. "Evaluation of characteristics of the craniofacial complex and dental maturity in girls with central precocious puberty". Angle Orthodontist 88, n.º 5 (30 de abril de 2018): 582–89. http://dx.doi.org/10.2319/112317-809.1.
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ABSTRACT Objectives: To identify unique characteristics of the craniofacial complex and dental maturity in girls with central precocious puberty (CPP). Materials and Methods: This study included 34 Korean girls with idiopathic CPP (mean age, 8.6 ± .5 years) and 28 normal healthy girls of the same chronological age. An initial evaluation of the growth pattern of the craniofacial complex and dental maturity was conducted by analyzing lateral cephalometric and panoramic radiographs. Results: The mandibular ramus height (44.4 ± 4.1 mm) and total mandibular length (10.8 ± 4.3 mm) (P = .004 and .021, respectively) were greater and the lower anterior facial height was lesser (63.2 ± 2.4 mm) (P = .040) in the CPP group than in the reference group. In addition, the gonial angle (12.9 ± 6.1°; P = .045) and the mandibular plane angle (34.9 ± 4.8°; P = .012) were smaller in girls with CPP than in normal healthy girls. All the mandibular teeth were more mature in girls with CPP (P < .001). A strong positive correlation was observed between the mandibular tooth formation stages and the presence of CPP in girls (r = .756 to .957; P < .001). Conclusions: CPP had an effect on the anteroposterior growth of the mandible in the craniofacial complex and the rotation of the mandibular plane angle. Early maturation of the mandibular teeth was observed in girls with CPP.
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Sarajev, A. R. "Assessment of the severity of patients with widespread peritonitis based on the new classification". Health care of Tajikistan, n.º 4 (3 de fevereiro de 2022): 88–93. http://dx.doi.org/10.52888/0514-2515-2021-351-4-88-93.
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Aim. To study the efficiency of a new classification of the widespread peritonitis in the estimation of patients’ state severity.Material and methods. 160 patients with widespread peritonitis aged 16 to 76 were examined; 104 (65%) were men and 56 (35%) were women. The patients were divided into 3 groups: 1 - endogenous intoxication (n=95), 2 - abdominal sepsis (n=46), and 3 - septic shock (n=19). The results of treatment were evaluated according to the incidence of postoperative complications, terms of hospitalization, mortality rate.Results and discussion. When analyzing the results of clinical studies, it was found that according to the stages of endogenous intoxication, abdominal sepsis and septic shock, the indicators were as follows: APACHE II 13.8±0.5 - 16.1±0.4 - 18.5±0.5; MIP 22 - 25 - 25; SOFA 3.3±0.2 - 3.7±0.1 - 4.2±0.1; presepsin (pg/mL) 355.6±8.6 - 783.4±24.0 - 1587.7±70.5; tumor necrosis factor-α (pg/mL) 105.5±1.9 - 853.3±17.6 - 24.5±6.8 p/o complications (%) 13.6±3.6 - 35.1±6.1 - 41.9±7.1; hospital stay (days) 19.2±0.8 - 25.9±2.2 - 13.8±1.9; 12 patients died in the stage of septic shock. There were statistically significant differences between the groups (p<0,01).Conclusion. The improved classification stratifies patients with diffuse peritonitis according to severity into the following groups: endogenous intoxication, abdominal sepsis, septic shock. It allows determining in time the necessary volume of intensive therapy and surgical tactics.
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Rabijewski, Michał, Lucyna Papierska, Wojciech Zgliczyński e Paweł Piątkiewicz. "The Incidence of Hypogonadotropic Hypogonadism in Type 2 Diabetic Men in Polish Population". BioMed Research International 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/767496.
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The aim of this study was to investigate the incidence of hypogonadotropic hypogonadism (HH) in type 2 diabetic men (T2DM) in population of Polish men and examine the possible influence of estradiol levels and glycemic control. We evaluated TT, cfT, estradiol, and glycemic control (HbA1c) in 184 diabetic men and in 149 nondiabetic control group. The mean HbA1c was 8.6 ± 0.2% and 6.1 ± 0.3% and cfT concentration was 0.315 ± 0.08 nmol/L and 0.382 ± 0.07 nmol/L, respectively. T2DM had higher E2 concentration than nonobese control men (29.4 ± 3.7 pg/mL versus 24.5 ± 2.9 pg/mL). Forty-six percent of T2DM were hypogonadal and 93% had HH. We observed inverse relationship between BMI and cfT (r=-0.341,P<0.01) and positive between BMI and E2 (r=0.329,P<0.01). E2 concentration was higher in T2DM with HH versus T2DM with normal TT/cfT concentration (34.5 ± 5.2 versus 27.4 ± 3.4 pg/mL). We observed negative correlation between HbA1c and cfT (r=-0.336,P<0.005) but positive between HbA1c and E2 levels (r=0.337,P<0.002). The prevalence of obesity, hypertension, and CVD was higher in men with hypogonadism. High incidence of hypogonadotropic hypogonadism in type 2 diabetic men in Polish population is associated with poor glycemic control and can be secondary to an increase in estradiol concentrations.
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Sibley, C. P., B. S. Ward, J. D. Glazier, W. M. Moore e R. D. Boyd. "Electrical activity and sodium transfer across in vitro pig placenta". American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 250, n.º 3 (1 de março de 1986): R474—R484. http://dx.doi.org/10.1152/ajpregu.1986.250.3.r474.
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Electrical activity generated by pieces of pig placenta, taken from anesthetized animals and mounted in Ussing chambers, has been investigated. Ten minutes after the start of voltage clamping, potential difference (PD; fetal side positive, open circuit), short circuit current (SCC), and resistance were 5.9 +/- 0.4 (SE) mV, 8.6 +/- 0.5 microA X cm-2, and 720 +/- 45 omega X cm2, respectively (n = 50). Ouabain (10(-4) M) added to the fetal side caused a maximum decline in PD and SCC from the time of addition of -3.7 +/- 0.98 mV and -3.9 +/- 1.4 microA X cm-2 (n = 6); epinephrine (10(-5) M) added to the fetal side caused increases of +1.0 +/- 0.2 mV and +4.0 +/- 1.4 microA X cm-2, respectively (n = 14). Drug concentrations for 50% maximum response for the effect of a series of adrenergic agonists on SCC were (in M) isoproterenol 1.2 +/- 0.05 X 10(-8), norepinephrine 6.1 +/- 0.3 X 10(-8), epinephrine 2.4 +/- 0.1 X 10(-7), and phenylephrine 4.7 +/- 0.2 X 10(-5), suggesting the involvement of fetally oriented beta-adrenergic receptors. Fetal epinephrine (10(-5) M) also stimulated net Na+ flux (Jnet) toward the fetal side to an extent equal to its effect on SCC. In control experiments Jnet was small but was inhibited by fetal side ouabain (10(-4) M) to produce a maternally directed Jnet, significantly different to the SCC. Replacement of Na+ by choline reduced SCC markedly but did not abolish it. In the absence of Na+, epinephrine had no effect on SCC. These results suggest that active Na+ transfer is not completely responsible for the control electrical activity of pig placenta. Epinephrine, however, modulates SCC entirely by stimulating net Na+ transfer toward the fetal side.
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Lipton, Allan, Kim Leitzel, Hilary A. Chaudri-Ross, Dean B. Evans, Suhail M. Ali, Laurence Demers, Peter Hamer et al. "Serum TIMP-1 and Response to the Aromatase Inhibitor Letrozole Versus Tamoxifen in Metastatic Breast Cancer". Journal of Clinical Oncology 26, n.º 16 (1 de junho de 2008): 2653–58. http://dx.doi.org/10.1200/jco.2007.15.4336.
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Purpose To determine the effect of elevated serum TIMP-1 on the response of patients with metastatic breast cancer to an aromatase inhibitor versus tamoxifen. Patients and Methods Five hundred twenty-two patients estrogen receptor–positive metastatic breast cancer were randomly assigned to receive first-line hormone therapy with letrozole or tamoxifen. Serum tissue inhibitor of metalloproteinases-1 (TIMP-1) levels were measured using an enzyme-linked immunosorbent assay. Results Pretreatment serum TIMP-1 was elevated in 120 (23%) of 522 patients. Patients with elevated serum TIMP-1 had a significantly reduced objective response rate (19.2% v 30.6%; odds ratio, 0.54; P = .01), duration of response (median, 15.5 v 26.2 months; P = .001), time to treatment progression (TTP; median, 4.5 v 9.2 months; HR, 1.78; P = .0001), time to treatment failure (median, 3.5 v 9.0 months; HR, 1.77; P = .0001), and overall survival (median, 20.3 v 35.8 months; HR, 1.77; P = .0001) compared with patients with normal pretreatment TIMP-1 levels. Letrozole was superior to tamoxifen in both the normal serum TIMP-1 group (median TTP, 11.8 v 8.6 months; P = .003) and in the elevated serum TIMP-1 group (median, 6.1 v 3.2 months; P = .03) In multivariate analysis, elevated serum TIMP-1 remained an independent predictor of both shorter TTP (HR, 1.46; P = .002) and survival (HR, 1.44; P = .002), as did serum HER-2. Combined analysis of both serum TIMP-1 and HER-2/neu conferred additional ability to predict significantly different clinical outcomes compared to using either biomarker alone. Conclusion Patients with elevated pretreatment serum TIMP-1 had a significantly reduced response and survival. Serum TIMP-1 was an independent predictive and prognostic factor. Blockade of TIMP-1 and HER-2/neu activity may be beneficial in a subset of patients with breast cancer.
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Okoronkwo, Ijeoma N., e Nnaji Akuchukwu Oprah. "Ocio-Economic Factors That Influence Child Labour in Nigeria". British Journal of Multidisciplinary and Advanced Studies 5, n.º 1 (8 de janeiro de 2024): 1–15. http://dx.doi.org/10.37745/bjmas.2022.0383.
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This study examined the socio-economic factors influencing child labour in Nigeria. The instruments for data collection were the questionnaire and the in-depth interview schedules. The sample size used for the study was 621 (615 for the quantitative distribution and 6 for the IDIs). The quantitative data gathered were analysed with Statistical Package for the Social Sciences using percentages (%) and Chi-square (χ2) statistics was used to test the three hypotheses, while the qualitative data gathered was analysed in themes as complement to the quantitative data. The study found that religious sex (χ2 = (615), .081; df = 1, pے =.776), education (χ2 = (N615), 2.024; df = 1, pے =.155) and marital status (χ2 = (N=615), .055; df = 1, pے =.815) had no statistically significant relationship with the effect of child labour practice while only age (χ2= (N=615), 14.577; df=1, pے =.000) had a statistical significant relationship. Furthermore, sex (χ2 = (N=615), .678; df = 1, pے =.410), marital status (χ2 = (N= 615), .012; df = 1, pے =.911), religious affiliation (χ2 = (N=615), .003; df = 1, pے =.957), education (χ2 = (N= 615), .310; df = 1, pے =.578) and occupation (χ2 = (N=615), .849; df = 1, pے =.357) showed no statistically significant relationship with the influence of child labour practices. Three hypotheses were tested and they were all accepted. Results from the regression analysis showed that only marital status had the most positive influence on child labour pratices. Results from the study has shown that child labour practices have negative effect on the child, thus, there is the need to eradicate all forms of child labour through championing sensitization and enlightenment programmes. Also, people who still choose to engage children in child labour after these sensitization and enlightenment programmes should be severely punished by the law to deter others from engaging in such acts. Finally, the study revealed that, government, youth corps members, community leaders and the general public have a role to play in putting an end to the socio-economic factors influencing child labour practices in Nigeria.
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Volkamer, R., S. Baidar, T. L. Campos, S. Coburn, J. P. DiGangi, B. Dix, T. K. Koenig et al. "Aircraft measurements of bromine monoxide, iodine monoxide, and glyoxal profiles in the tropics: comparison with ship-based and in situ measurements". Atmospheric Measurement Techniques Discussions 8, n.º 1 (19 de janeiro de 2015): 623–87. http://dx.doi.org/10.5194/amtd-8-623-2015.
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Abstract. Tropospheric chemistry of halogens and organic carbon over tropical oceans modifies ozone and atmospheric aerosols, yet atmospheric models remain largely untested for lack of vertically resolved measurements of bromine monoxide (BrO), iodine monoxide (IO), and small oxygenated hydrocarbons like glyoxal (CHOCHO) in the tropical troposphere. BrO, IO, glyoxal, nitrogen dioxide (NO2), water vapor (H2O) and O2-O2 collision complexes (O4) were measured by the CU Airborne Multi AXis Differential Optical Absorption Spectroscopy (CU AMAX-DOAS) instrument, in situ aerosol size distributions by an Ultra High Sensitivity Aerosol Spectrometer (UHSAS), and in situ H2O by Vertical-Cavity Surface-Emitting Laser hygrometer (VCSEL). Data are presented from two research flights (RF12, RF17) aboard the NSF/NCAR GV aircraft over the tropical Eastern Pacific Ocean (tEPO) as part of the "Tropical Ocean tRoposphere Exchange of Reactive halogens and Oxygenated hydrocarbons" (TORERO) project. We assess the accuracy of O4 slant column density (SCD) measurements in the presence and absence of aerosols, and find O4-inferred aerosol extinction profiles at 477 nm agree within 5% with Mie calculations of extinction profiles constrained by UHSAS. CU AMAX-DOAS provides a flexible choice of geometry which we exploit to minimize the SCD in the reference spectrum (SCDREF, maximize signal-to-noise), and to test the robustness of BrO, IO, and glyoxal differential SCDs. The RF12 case study was conducted in pristine marine and free tropospheric air. The RF17 case study was conducted above the NOAA RV Ka'imimoana (TORERO cruise, KA-12-01), and provides independent validation data from ship-based in situ Cavity Enhanced- and MAX-DOAS. Inside the marine boundary layer (MBL) no BrO was detected (smaller than 0.5 pptv), and 0.2–0.55 pptv IO and 32–36 pptv glyoxal were observed. The near surface concentrations agree within 20% (IO) and 10% (glyoxal) between ship and aircraft. The BrO concentration strongly increased with altitude to 3.0 pptv at 14.5 km (RF12, 9.1 to 8.6° N; 101.2 to 97.4° W). At 14.5 km 5–10 pptv NO2 agree with model predictions, and demonstrate good control over separating tropospheric from stratospheric absorbers (NO2 and BrO). Our profile retrievals have 12–20 degrees of freedom (DoF), and up to 500 m vertical resolution. The tropospheric BrO VCD was 1.5 × 1013 molec cm−2 (RF12), and at least 0.5 × 1013 molec cm−2 (RF17, 0–10 km, lower limit). Tropospheric IO VCDs correspond to 2.1 × 1012 molec cm−2 (RF12) and 2.5 × 1012 molec cm−2 (RF17), and glyoxal VCDs of 2.6 × 1014 molec cm−2 (RF12) and 2.7 × 1014 molec cm−2 (RF17). Surprisingly, essentially all BrO, and the dominant IO and glyoxal VCD fraction was located above 2 km (IO: 58 ± 5%, 0.1–0.2 pptv; glyoxal: 52 ± 5%, 3–20 pptv). To our knowledge there are no previous vertically resolved measurements of BrO and glyoxal from aircraft in the tropical free troposphere.
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Rantins, Peter P., Monica Ly, Alexandra L. Clark, Alexandra J. Weigand, Kayla S. Walker, Victoria C. Merritt, Katherine J. Bangen e Kelsey R. Thomas. "56 TBI Severity Moderates the Association between Subjective and Objective Attention in Older Veterans". Journal of the International Neuropsychological Society 29, s1 (novembro de 2023): 363–64. http://dx.doi.org/10.1017/s1355617723004927.
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Objective:Prior work on associations between self-reported cognition and objective cognitive performance in Veterans has yielded mixed findings, with some evidence indicating that mild traumatic brain injury (TBI) may not impact the associations between subjective and objective cognition. However, few studies have examined these relationships in both mild and moderate-to-severe TBI, in older Veterans, and within specific cognitive domains. Therefore, we assessed the moderating effect of TBI severity on subjective and objective cognition across multiple cognitive domains.Participants and Methods:This study included 246 predominately male Vietnam-Era Veterans (age M=69.61, SD=4.18, Range = 60.87 – 85.16) who completed neuropsychological testing and symptom questionnaires as part of the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (DoD-ADNI). Participants were classified as having history of no TBI (n=81), mild TBI (n=80), or moderate-tosevere TBI (n=85). Neuropsychological composite scores in the domains of memory, attention/executive functioning, and language were included as the outcome variables. The Everyday Cognition (ECog) measure was used to capture subjective cognition and, specifically, the ECog domain scores of memory, divided attention, and language were chosen as independent variables to mirror the objective cognitive domains. General linear models, adjusting for age, education, apolipoprotein E ε4 carrier status, pulse pressure, depressive symptom severity, and PTSD symptom severity, tested whether TBI severity moderated the associations of domain-specific subjective and objective cognition.Results:Across the sample, subjective memory was associated with objective memory (β=-.205, 95% CI [-.332, -.078], p=.002) and subjective language was associated with objective language (β=-.267, 95% CI [-.399, -.134], p<.001). However, the main effect of subjective divided attention was not associated with objective attention/executive functioning (p=.124). The main effect of TBI severity was not associated with any of the objective cognitive domain scores after adjusting for the other variables in the model. The TBI severity x subjective cognition interaction was significant for attention/executive functioning [F(2,234)=5.18, p=.006]. Specifically, relative to Veterans without a TBI, participants with mild TBI (β=-.311, 95% CI [-.620, -.002], p=.048) and moderate-to-severe TBI (β=-.499, 95% CI [-.806, -.193], p=.002) showed stronger negative associations between subjective divided attention and objective attention/executive functioning. TBI severity did not moderate the associations between subjective and objective cognition for memory or language domains. The pattern of results did not change when the total number of TBIs was included in the models.Conclusions:In this DoD-ADNI sample, stronger associations between subjective and objective attention were evident among individuals with mild and moderate-to-severe TBI compared to Veterans without a TBI history. Attention/executive functioning measures (Trails A and B) may be particularly sensitive to detecting subtle cognitive difficulties related to TBI and/or comorbid psychiatric symptoms, which may contribute to these attention-specific findings. The strongest associations were among those with moderate-to-severe TBI, potentially because the extent to which their attention difficulties are affecting their daily lives are more apparent despite no significant differences in objective attention performance by TBI group. This study highlights the importance of assessing both subjective and objective cognition in older Veterans and the particular relevance of the attention domain within the context of TBI.
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Guo, Yufeng, Guoqiang Zhang, Zhenghong Li, Xueyi Liao, Wu Sun e Xinhao Jiang. "Revealing the Effects of Zinc Sulphate Treatment on Melatonin Synthesis and Regulatory Gene Expression in Germinating Hull-Less Barley through Transcriptomic Analysis". Genes 15, n.º 8 (15 de agosto de 2024): 1077. http://dx.doi.org/10.3390/genes15081077.
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This study investigated the transcriptomic mechanisms underlying melatonin accumulation and the enhancement of salt tolerance in hull-less barley seeds subjected to zinc sulphate stress. Following zinc sulphate treatment, hull-less barley seeds demonstrated increased melatonin accumulation and improved salt tolerance. Through transcriptome analysis, the study compared gene expression alterations in seeds (using the first letter of seed, this group is marked as ‘S’), seeds treated with pure water (as the control group, is marked as ‘C’), and germinated seeds exposed to varying concentrations of zinc sulphate (0.2 mM and 0.8 mM, the first letter of zinc sulphate, ‘Z’, is used to mark groups ‘Z1’ and ‘Z2’). The analysis revealed that 8176, 759, and 622 differentially expressed genes (DEGs) were identified in the three comparison groups S.vs.C, C.vs.Z1, and C.vs.Z2, respectively. Most of the DEGs were closely associated with biological processes, including oxidative-stress response, secondary metabolite biosynthesis, and plant hormone signaling. Notably, zinc sulphate stress influenced the expression levels of Tryptophan decarboxylase 1 (TDC1), Acetylserotonin O-methyltransferase 1 (ASMT1), and Serotonin N-acetyltransferase 2 (SNAT2), which are key genes involved in melatonin synthesis. Furthermore, the expression changes of genes such as Probable WRKY transcription factor 75 (WRKY75) and Ethylene-responsive transcription factor ERF13 (EFR13) exhibited a strong correlation with fluctuations in melatonin content. These findings contribute to our understanding of the mechanisms underlying melatonin enrichment in response to zinc sulphate stress.
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Timmerman, Michelle, Misoo Chung, Randall B. Wilkening, Paul V. Fennessey, Frederick C. Battaglia e Giacomo Meschia. "Relationship of fetal alanine uptake and placental alanine metabolism to maternal plasma alanine concentration". American Journal of Physiology-Endocrinology and Metabolism 275, n.º 6 (1 de dezembro de 1998): E942—E950. http://dx.doi.org/10.1152/ajpendo.1998.275.6.e942.
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Uterine and umbilical uptakes of alanine (Ala) were measured in 10 ewes before (control) and during intravenous infusion of Ala, which increased maternal arterial Ala concentration from 115 ± 14 to 629 ± 78 μM ( P < 0.001). In 8 of these ewes, placental Ala fluxes were traced by constant intravenous infusion ofl-[3,3,3-2H3]Ala in the mother andl-[1-13C]Ala in the fetus. Rates are reported as micromoles per minute per kilogram fetus. Ala infusion increased uterine uptake (2.5 ± 0.6 to 15.6 ± 3.1, P < 0.001), umbilical uptake (3.1 ± 0.5 to 6.9 ± 0.8, P < 0.001), and net uteroplacental utilization (−0.7 ± 0.8 to 8.6 ± 2.7, P < 0.01) of Ala. Control Ala flux to fetus from mother ( R f,m) was much less than the Ala flux to fetus from placenta ( R f,p) (0.17 ± 0.04 vs. 5.0 ± 0.6). Two additional studies utilizingl-[U-13C]Ala as the maternal tracer confirmed the small relative contribution of R f,m to R f,p. During maternal Ala infusion, R f,m increased significantly ( P < 0.02) but remained a small fraction of R f,p (0.71 ± 0.2 vs. 7.3 ± 1.3). We conclude that maternal Ala entering the placenta is metabolized and exchanged for placental Ala, so that most of the Ala delivered to the fetus is produced within the placenta. An increase in maternal Ala concentration increases placental Ala utilization and the fetal uptake of both maternal and placental Ala.
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Sapozhnikova, E., M. Sapozhnikov, E. Guryanova e N. Alekseeva. "AB1196 INFLUENCE OF NEUROPATHIC PAIN ON THE FUNCTIONAL STATUS OF ELDERLY PATIENTS WITH RHEUMATOID ARTHRITIS". Annals of the Rheumatic Diseases 81, Suppl 1 (23 de maio de 2022): 1713.2–1713. http://dx.doi.org/10.1136/annrheumdis-2022-eular.629.
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ObjectivesThe aim of the study was to study the influence of neuropathic pain on functional status in elderly patients with rheumatoid arthritis (RA) with moderate disease activity.MethodsMethods. The study included 115 geriatric patients who were divided into two groups. Group G1 included 80 patients (mean age 76.9 ± 9.6 years) with neuropathic pain, group G2 - 35 persons of comparable age (77.1 ± 8.6 years) without signs of neuropathic pain. Neuropathic pain was identified using the DN4 questionnaire. The RA activity in patients of both groups did not differ statistically significantly. All patients underwent a comprehensive geriatric assessment (CGA) to determine the functional status and diagnose geriatric syndromes [1]. All patients received basic anti-inflammatory drugs. Patients G1 and G2 were compared in terms of the following parameters, such as pain intensity according to a visual analogue scale (VAS, 0-100 mm), Rivermead Mobility Index (0-15), functional disorders according to International Classification of Function (ICF) (0-4), signs of anxiety and depression (HADS).ResultsAccording to the CGA data, senile asthenia syndrome was detected in 32 (40.2%) patients with neuropathic pain and in 10 (28.6%) patients without neuropathic pain (p = 0.035). The average number of geriatric syndromes in G1 was 6.06 ± 1.03, in group B - 4.5 ± 1.0 (p <0.05). Patients with G1 showed higher indices of pain severity according to VAS than in patients of the control group: 68.2 ± 10.1 and 52.1 ± 4.1 mm, respectively (p <0.001). In G1, patients had a significant decrease in mobility, in the domain «Activity and participation» in the ICF categories d450 (walking), d 540 (dressing), the indicator of dysfunction was 2.9 ± 0.3 versus 2.2 ± 0.2 (p = 0.049), there were more symptoms of anxiety and depression 56.5% and 35.2% (HADS ≥7; p <0.001), respectively.ConclusionElderly patients with chronic neuropathic pain have higher signs of senile asthenia and decreased mobility and physical functioning in daily life. It is necessary to include the help of a psychologist and occupational therapist in planning the most effective comprehensive strategies for the treatment and prevention of exacerbations of neuropathic pain.References[1]Guryanova E.A., Rechapova E.A., Sidyakina E.S. Effectiveness of Comprehensive Geriatric Assessment in Improving the Quality of Life of Older People and Reducing the Workload of Their Caregivers // Acta medica Eurasica. – 2021. – № 4. – С. 79–90. – URL: http://acta-medica-eurasica.ru/single/2021/4/9. DOI: 10.47026/2413- 4864-2021-4-79-90.Disclosure of InterestsNone declared
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Moon, Mi Young. "Correlation between Communication Competence, Problem-Solving Skills, Clinical Competence, and Critical Thinking Competence on Person-Centered Care Competence of Nursing Students in who Experienced Clinical Practice". Forum of Public Safety and Culture 28 (30 de março de 2024): 121–37. http://dx.doi.org/10.52902/kjsc.2024.28.121.
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Purpose: This study is a descriptive research study conducted to identify the relationship and influencing factors between communication competence, critical thinking competence, problem-solving ability, clinical performance competence and person-centered care competence of nursing students who have experienced clinical practice.
Method: The subjects of this study were students enrolled in the nursing departments of two four-year universities located in 2 areas, and the 3rd and 4th graders who had more than 1 semester of clinical practice were conveniently extracted. Data were collected from September to December 2023. Data analysis was analyzed using the SPSS 21.0 program by t-test, one-way ANOVA, and Pearson's correlation coefficient.
Results: As a result of the study, There were significant differences in communication competence in gender (p=.029), age (p=.039), grade (p=.030), satisfaction with nursing department (p<.001), satisfaction with clinical practice (p<.001), number of participation in personality-related education (p=.012), volunteer time (p=.011), the need for person-centered care at the nursing site (p<.001), and the degree of interpersonal relationships (p<.001). In terms of problem-solving skill, there were significant differences in grade (p=.011), religion (p<.001), clinical practice satisfaction (p=.003), volunteer time (p=.003), clinical practice experience department (p=.041), the need for person-centered care at the nursing site (p<.001), and interpersonal relations (p<.001). In terms of clinical performance competence, there were significant differences in religion (p=.005), satisfaction with clinical practice (p<.005), number of participation in personality-related education (p=.030), volunteer time (p=.002), clinical practice experience department (p=.005), the need for person-centered care at the nursing site (p<.001), and interpersonal relationship (p<.001). In terms of person-centered care competence of nursing, there were significant differences in gender (p=.008), religion (p=.002), satisfaction with clinical practice (p<.001), volunteer time (p=.002), the need for person-centered care at the nursing site (p<.001), and interpersonal relationship (p<.001). Subject's communication competence averaged 4.04 out of 5, problem-solving skill was 3.87 points, clinical performance competence was 4.09, critical thinking competence was 3.87 points, and person-centered care competence was 4.21 points. Person-centered care competence was found to have a significant positive correlation with communication competence (r=.511, p<.001), problem-solving skill (r=.601, p<.001), clinical performance competence (r=.813, p<.001), and critical thinking competence (r=.423, p<.001). The more time nursing students spent volunteering, the better their interpersonal relationships, and the more they felt the need for person-centered care at the nursing site, the higher their person-centered care competence.
Conclusion: Based on the results of this study, it is necessary to induce nursing students to use a lot of volunteer programs in order to increase their person-centered care competence, and it is necessary to develop and actively guide convergence extracurricular activities linked to subjects. In the clinical field, it is necessary to develop and apply an effective clinical practice program based on a person-centered nursing model in which students analyze subjects and solve problems through the reasoning process of critical thinking.
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Dehghan, Melody, Gabriel Wong, Eddie Neuberger, Cindy Kin, Florian Rieder e K. T. Park. "Worse outcomes and higher costs of care in fibrostenotic Crohn’s disease: a real-world propensity-matched analysis in the USA". BMJ Open Gastroenterology 8, n.º 1 (dezembro de 2021): e000781. http://dx.doi.org/10.1136/bmjgast-2021-000781.
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BackgroundPatients with Crohn’s disease (CD) may develop fibrostenotic strictures. No currently available therapies prevent or treat fibrostenotic CD (FCD), making this a critical unmet need.AimTo compare health outcomes and resource utilisation between CD patients with and without fibrostenotic disease.MethodsPatients aged ≥18 years with FCD and non-FCD between 30 October 2015 and 30 September 2018 were identified in the Truven MarketScan Commercial Claims and Encounters Database. We conducted 1:3 nearest neighbour propensity score matching on age, sex, malnutrition, payer type, anti-tumour necrosis factor use, and Charlson Comorbidity Index score. Primary outcomes up to 1 year from the index claim were ≥1 hospitalisation, ≥1 procedure, ≥1 surgery, and steroid dependency (>100 day supply). Associations between FCD diagnosis and outcomes were estimated with a multivariable logistic regression model. This study was exempt from institutional review board approval.ResultsPropensity score matching yielded 11 022 patients. Compared with non-FCD, patients with FCD had increased likelihood of hospitalisations (17.1% vs 52.4%; p<0.001), endoscopic procedures (4.4% vs 8.6%; p<0.001), IBD-related surgeries (4.7% vs 9.1%; p<0.001), steroid dependency (10.0% vs 15.7%; p<0.001), and greater mean annual costs per patient ($47 575 vs $77 609; p<0.001). FCD was a significant risk factor for ≥1 hospitalisation (adjusted OR (aOR), 6.1), ≥1 procedure (aOR, 2.1), ≥1 surgery (aOR, 2.0), and steroid dependency (aOR, 1.7).ConclusionsFCD was associated with higher risk for hospitalisation, procedures, abdominal surgery, and steroid dependency. Patients with FCD had a greater mean annual cost per patient. FCD represents an ongoing unmet medical need.
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Zhang, Ming-Zhu, e Guang-rong Yu. "Treatment of late-stage Freiberg disease using a double stemmed flexible silicone prosthesis". Foot & Ankle Orthopaedics 3, n.º 3 (1 de julho de 2018): 2473011418S0053. http://dx.doi.org/10.1177/2473011418s00537.
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Category: Lesser Toes Introduction/Purpose: The purpose of this study was to evaluate the clinical outcomes using a double stemmed flexible silicone prosthesis for the treatment of Freiberg disease in its late stages. Methods: The subjects consisted of 13 feet from 13 cases suffering from Freiberg disease in their late stages. They underwent double stemmed flexible silicone prosthesis replacement for metatarsophalangeal joints. The average age was 63.8 (range 30~88) years. The average follow up period was 26 (range 18–42) months. The investigation was carried out using the range of motion (ROM), visual analog scale (VAS), AOFAS and Maryland metatarsophalangeal joints scale before surgery and at the latest follow-up. Results: The average ROM of dorsal flexion improved from 39.3±6.1° before surgery to 75.4±8.6° at latest follow-up (p<0.001). The average ROM of plantar flexion improved from 19.0±11.4° before surgery to 20.2±9.3° at latest follow-up (p=0.14). The average VAS significantly improved from 8.1±0.5 before surgery to 2.6±0.2 at latest follow-up (p<0.001). The average Maryland metatarsophalangeal joints score significantly improved from 65.3±9.3 points before surgery to 90.3±4.1 points at the latest follow-up (p<0.001). The average AOFAS was 89.4±8.5 after surgery compared 56.3±6.4 preoperatively (p<0.005). Conclusion: A flexible silicone prosthesis replacement was carried out to treat Freiberg disease in its late stages. The function was observed in all cases with improved clinical results. The silicone prosthesis was considered to be useful in certain cases.
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Mirzazadeh, Ali, Mostafa Shokoohi, Mohammad Karamouzian, Haleh Ashki, Razieh Khajehkazemi, Apameh Salari, Negin Abedinzadeh et al. "Declining trends in HIV and other sexually transmitted infections among female sex workers in Iran could be attributable to reduced drug injection: a cross-sectional study". Sexually Transmitted Infections 96, n.º 1 (13 de dezembro de 2019): 68–75. http://dx.doi.org/10.1136/sextrans-2018-053800.
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ObjectiveThe HIV trend among female sex workers (FSWs) is understudied. We assessed the prevalence and trend of HIV and five other STIs among FSWs in Iran.MethodsWe recruited FSWs (1337 in 2015, 1005 in 2010) from 21 sites in 13 cities in two cross-sectional biobehavioural surveys. Eligible FSWs were women aged ≥18 years who reported selling sex to more than one male client in the past 12 months. Consenting FSWs were interviewed using a behavioural questionnaire and tested for HIV and five other STIs. We considered study sites as clusters in the analysis and two-sided Fisher’s exact test to compare the HIV prevalence between the two survey rounds.ResultsHIV prevalence was 2.1% in 2015 (vs 4.0% in 2010, p=0.007). Lifetime drug injection was reported by 6.1% of participants in 2015 (vs 14.6% in 2010, p=0.003). In 2015, among FSWs with history of lifetime drug injection, HIV prevalence was 8.6% (vs 9.8% in 2010, p=0.425). The prevalence of other STIs in 2015 was 0.4% (95% CI 0.2 to 1.0) for syphilis, 1.3% (95% CI 0.8 to 2.1) for gonorrhoea, 6.0% (95% CI 4.8 to 7.4) for chlamydia, 11.9% (95% CI 8.5 to 16.5) for trichomoniasis and 41.8% (95% CI 39.2 to 44.5) for human papillomavirus.ConclusionsHIV prevalence among FSWs in Iran decreased, but remains considerably high. The decrease in HIV prevalence compared with 2010 might be explained by a decrease in drug injection. Other STIs are also high in this population. Harm reduction programmes need to be continued and scaled up among this underserved population in Iran.
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Wright, Kathy, Karen Moss, Nathan Helsabeck, Ingrid Richards Adams, Karen Rose e Maryanna D. Klatt. "AN OBJECTIVE MEASURE OF STRESS REACTIVITY/RESILIENCE IN BLACK WOMEN DEMENTIA FAMILY CAREGIVERS". Innovation in Aging 8, Supplement_1 (dezembro de 2024): 1129. https://doi.org/10.1093/geroni/igae098.3621.
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Abstract Real-time objective measures of stress are crucial for identifying mechanisms applicable to health behavior change research for dementia caregivers. We explore the Pittsburgh Stress Battery (PSB) in a non-laboratory setting (R21AG077069) as an objective measure of stress reactivity/resilience. The PSB was administered to 16 Black American women caregivers with hypertension (40-65 years old). PSB includes three challenging tasks (Stroop, Mental Math, and Mirror Tracing). An automatic cuff measured systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) at three intervals during the 20-minute battery followed by a 30-minute recovery. Average participant age was 62.4 (SD= 6.1). Ten assessments were completed in an office and six at home. One Stroop and three Mental Math were not completed due to computer/internet issues or refusal. Mean SBP, DPB, and HR at baseline were 128.9 mmHg, 81.6 mmHg, and 71.3 (beats per minute). The difference from baseline in SBP was 10.5 mmHg (SD= 8.3) for Stroop, Mental Math -.94 mm Hg (SD= -0.6), and Mirror Tracing 1.6 mmHg (SD= 9.4). For DBP, Stroop was 5.0 mm Hg (SD=4.6), Mental Math 0.2 mm Hg (SD= 3.2), and Mirror Tracing 0.3 mm Hg (SD= 7.0). HR difference from baseline was 3.8 (SD= 0.5), Mental Math -4.24 (SD= 8.2), and Mirror test -0.75 (SD= -3.4). Findings indicate that PSB elicits SBP/DBP/HR stress reactivity/resilience. PSB was portable for use in community settings. Study results will help guide interventions for behavior change, aiming to improve health outcomes in Black Americans.
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Wright, Kathy, Karen Moss, Nathan Helsabeck, Ingrid Richards Adams, Karen Rose e Maryanna D. Klatt. "AN OBJECTIVE MEASURE OF STRESS REACTIVITY/RESILIENCE IN BLACK WOMEN DEMENTIA FAMILY CAREGIVERS". Innovation in Aging 8, Supplement_1 (dezembro de 2024): 969–70. https://doi.org/10.1093/geroni/igae098.3123.
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Abstract Real-time objective measures of stress are crucial for identifying mechanisms applicable to health behavior change research for dementia caregivers. We explore the Pittsburgh Stress Battery (PSB) in a non-laboratory setting (R21AG077069) as an objective measure of stress reactivity/resilience. The PSB was administered to 16 Black American women caregivers with hypertension (40-65 years old). PSB includes three challenging tasks (Stroop, Mental Math, and Mirror Tracing). An automatic cuff measured systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) at three intervals during the 20-minute battery followed by a 30-minute recovery. Average participant age was 62.4 (SD= 6.1). Ten assessments were completed in an office and six at home. One Stroop and three Mental Math were not completed due to computer/internet issues or refusal. Mean SBP, DPB, and HR at baseline were 128.9 mmHg, 81.6 mmHg, and 71.3 (beats per minute). The difference from baseline in SBP was 10.5 mmHg (SD= 8.3) for Stroop, Mental Math -.94 mm Hg (SD= -0.6), and Mirror Tracing 1.6 mmHg (SD= 9.4). For DBP, Stroop was 5.0 mm Hg (SD=4.6), Mental Math 0.2 mm Hg (SD= 3.2), and Mirror Tracing 0.3 mm Hg (SD= 7.0). HR difference from baseline was 3.8 (SD= 0.5), Mental Math -4.24 (SD= 8.2), and Mirror test -0.75 (SD= -3.4). Findings indicate that PSB elicits SBP/DBP/HR stress reactivity/resilience. PSB was portable for use in community settings. Study results will help guide interventions for behavior change, aiming to improve health outcomes in Black Americans.
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Callhoff, Johanna, Klaus Berger, Katinka Albrecht e Anja Strangfeld. "Depression, anxiety and cognitive function in persons with inflammatory rheumatic diseases: cross-sectional results from the German National Cohort (NAKO)". RMD Open 10, n.º 4 (outubro de 2024): e004808. http://dx.doi.org/10.1136/rmdopen-2024-004808.
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ObjectiveTo assess the presence of mental health disorders in persons with rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE) and Sjögren’s disease (SjD) (all: inflammatory rheumatic disease, iRMD) in a population-based cohort.MethodsBaseline data from 101 601 participants of the German National Cohort (NAKO) were analysed. Self-reported physician’s diagnoses of depression and anxiety, the depression scale of the Patient Health Questionnaire (PHQ-9), the Generalised Anxiety Disorder Symptoms Scale (GAD-7), the depression section of the Mini-International Neuropsychiatric Interview (MINI) and cognitive tests on memory and executive functions were analysed. Results of participants with iRMD were compared with participants with osteoarthritis (OA), stratified by age and sex. Cognitive function was described for iRMD and OA using a linear regression model, adjusted for sex and education.Resultsn=3257 participants (3.2%) had an iRMD (2.3% RA, 0.6% AS, 0.5% PsA, 0.2% SLE, 0.1% SjD) and n=24 030 (24%) had OA. Physicians’ diagnoses of depression (26% vs 21%), anxiety (15% vs 11%), current depressive (PHQ-9 ≥10: 13% vs 9.0%) and anxiety symptoms (GAD-7 ≥10: 8.6% vs 5.8%) were more frequent in iRMDs compared with OA. In all age groups, women were more often affected than men. Linear regression models showed no differences in neuropsychological test results between iRMD and OA.ConclusionIndividuals with iRMD frequently experience mental disorders. The study provides an assessment of both self-report and test-based occurrences in this group. Depression and anxiety are more frequent in iRMD compared with OA, whereas levels of cognitive dysfunction were comparable.
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Spindler, Klaus-Dieter, e Brigitte Funke-Höpfner. "N-Acetyl-ß-ᴅ-hexosaminidases of the Brine Shrimp Artemia: Partial Purification and Characterization". Zeitschrift für Naturforschung C 46, n.º 9-10 (1 de outubro de 1991): 781–88. http://dx.doi.org/10.1515/znc-1991-9-1010.
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Abstract N-Acetyl-β-ᴅ-hexosaminidases (EC 3.2.1.52) from Artemia nauplii were isolated and characterized. Three different enzymes I, II1 and II2 were separated according to their behaviour on anion exchange chromatography and gel filtration columns. Their apparent molecular masses were 83,000 ± 7000, 110,000 ± 10,000 and 56,000 ± 5000 Da with corresponding S-values of 8.6, 11.9 and 7.9. All three enzymes also differ in their apparent pH-optima (5.1, 4.5 and 6.1) and they all bind to concanavalin A. The three enzymes have about the same affinities (app. Km between 0.16 and 0.72 mmol/1) for the three substrates (p-nitrophenyl-N-acetyl-β-ᴅ-glucosamine or p-nitrophenyl-N-acetyl-β-ᴅ-galactosamine and N ,N′-diacetyl-chitobiose) and are therefore N-acetyl-β-ᴅ-hexosaminidases. In contrast, the three enzymes behave quite differently, both in terms of their inhibitor constants and the type of inhibition. The substrates inhibit both enzymes II1 and II2 but not enzyme I. On the other hand, N-acetyl-β-ᴅ-galactosamine inhibits enzyme I in a non-competitive way but not enzymes II1 and II2. All three enzymes are inhibited by the end product N-acetyl-β-ᴅ-glucosamine, enzyme I in a competitive manner, both enzymes II1 and II2 in a non-competitive way. 2-Acetamido-2-deoxy-ᴅ-galactonolactone is a strong inhibitor for enzyme I (Ki = 13 μtmol/l) with much lower affinities towards enzymes II1 and II2 (Ki = 0.63 and 1.03 mmol/l). All three enzymes are inhibited in a dose-dependent way and completely reversible by α-methyl-mannoside.
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Forrest, Christopher B., Candice P. Chen, Eliana M. Perrin, Christopher J. Stille, Ruth Cooper, Katherine Harris, Qian Luo, Mitchell G. Maltenfort e Lauren E. Parlett. "Pediatric Medical Subspecialist Use in Outpatient Settings". JAMA Network Open 7, n.º 1 (4 de janeiro de 2024): e2350379. http://dx.doi.org/10.1001/jamanetworkopen.2023.50379.
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ImportanceA first step toward understanding whether pediatric medical subspecialists are meeting the needs of the nation’s children is describing rates of use and trends over time.ObjectivesTo quantify rates of outpatient pediatric medical subspecialty use.Design, Setting, and ParticipantsThis repeated cross-sectional study of annual subspecialist use examined 3 complementary data sources: electronic health records from PEDSnet (8 large academic medical centers [January 1, 2010, to December 31, 2021]); administrative data from the Healthcare Integrated Research Database (HIRD) (14 commercial health plans [January 1, 2011, to December 31, 2021]); and administrative data from the Transformed Medicaid Statistical Information System (T-MSIS) (44 state Medicaid programs [January 1, 2016, to December 31, 2019]). Annual denominators included 493 628 to 858 551 patients younger than 21 years with a general pediatric visit in PEDSnet; 5 million beneficiaries younger than 21 years enrolled for at least 6 months in HIRD; and 35 million Medicaid or Children’s Health Insurance Program beneficiaries younger than 19 years enrolled for any amount of time in T-MSIS.ExposureCalendar year and type of medical subspecialty.Main Outcomes and MeasuresAnnual number of children with at least 1 completed visit to any pediatric medical subspecialist in an outpatient setting per population. Use rates excluded visits in emergency department or inpatient settings.ResultsAmong the study population, the proportion of girls was 51.0% for PEDSnet, 51.1% for HIRD, and 49.3% for T-MSIS; the proportion of boys was 49.0% for PEDSnet, 48.9% for HIRD, and 50.7% for T-MSIS. The proportion of visits among children younger than 5 years was 37.4% for PEDSnet, 20.9% for HIRD, and 26.2% for T-MSIS; most patients were non-Hispanic Black (29.7% for PEDSnet and 26.1% for T-MSIS) or non-Hispanic White (44.9% for PEDSnet and 43.2% for T-MSIS). Annual rates for PEDSnet ranged from 18.0% to 21.3%, which were higher than rates for HIRD (range, 7.9%-10.4%) and T-MSIS (range, 7.6%-8.6%). Subspecialist use increased in the HIRD commercial health plans (annual relative increase of 2.4% [95% CI, 1.6%-3.1%]), but rates were essentially flat in the other data sources (PEDSnet, −0.2% [95% CI, −1.1% to 0.7%]; T-MSIS, −0.7% [95% CI, −6.5% to 5.5%]). The flat PEDSnet growth reflects a balance between annual use increases among those with commercial insurance (1.2% [95% CI, 0.3%-2.1%]) and decreases in use among those with Medicaid (−0.9% [95% CI, −1.6% to −0.2%]).Conclusions and RelevanceThe findings of this cross-sectional study suggest that among children, 8.6% of Medicaid beneficiaries, 10.4% of those with commercial insurance, and 21.3% of those whose primary care is received in academic health systems use pediatric medical subspecialty care each year. There was a small increase in rates of subspecialty use among children with commercial but not Medicaid insurance. These data may help launch innovations in the primary-specialty care interface.
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Lee, So-Ryoung, Chan Soon Park, Eue-Keun Choi, Hyo-Jeong Ahn, Kyung-Do Han, Seil Oh e Gregory Y. H. Lip. "Hypertension Burden and the Risk of New-Onset Atrial Fibrillation". Hypertension 77, n.º 3 (3 de março de 2021): 919–28. http://dx.doi.org/10.1161/hypertensionaha.120.16659.
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The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130–139 mm Hg or diastolic BP of 80–89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.
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Schwellnus, Martin, Sonja Swanevelder, Wayne Derman, Mats Borjesson, Karen Schwabe e Esme Jordaan. "Prerace medical screening and education reduce medical encounters in distance road races: SAFER VIII study in 153 208 race starters". British Journal of Sports Medicine 53, n.º 10 (9 de novembro de 2018): 634–39. http://dx.doi.org/10.1136/bjsports-2018-099275.
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ObjectivesTo examine the efficacy and feasibility of an online prerace medical screening and educational intervention programme for reducing medical complications in long-distance races.MethodsThis was an 8-year observational study of medical encounter rates among 153 208 Two Oceans race starters (21.1 and 56 km) in South Africa. After the first 4-year control (CON) period, we introduced an online prerace medical screening (based on European pre-exercise screening guidelines) and an automated educational intervention programme. We compared the incidence of medical encounters (per 1000 starters; all and serious life threatening) in the CON versus the 4-year intervention (INT) period.ResultsIn comparison to the CON period (2008–2011: 65 865 starters), the INT period (2012–2015: 87 343 starters) had a significantly lower incidence (adjusted for age group, sex, race distance) of all medical encounters by 29% (CON=8.6 (7.9–9.4); INT=6.1 (5.6–6.7), p<0.0001), in the 21.1 km race by 19% (CON=5.1 (4.4–5.9); INT=4.1 (3.6–4.8), p=0.0356) and in the 56 km race by 39% (CON=14.6 (13.1–16.3); INT=9.0 (7.9–10.1), p<0.0001). Serious life-threatening encounters were significantly reduced by 64% (CON=0.6 (0.5–0.9); INT=0.2 (0.1–0.4); p=0.0003) (adjusted for age group and sex). Registration numbers increased in the INT period (CON=81 345; INT=106 743) and overall % race starters were similar in the CON versus INT period. Wet-bulb globe temperature was similar in the CON and INT periods.ConclusionAll medical encounters and serious life-threatening encounters were significantly lower after the introduction of a prescreening and educational intervention programme, and the programme was feasible.
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Пилипів, Леся Ігорівна, e Олена Мирославівна Радченко. "СТАНДАРТНІ ТА ІНТЕГРАЛЬНІ ГЕМАТОЛОГІЧНІ МАРКЕРИ У ХВОРИХ НА ХРОНІЧНЕ ОБСТРУКТИВНЕ ЗАХВОРЮВАННЯ ЛЕГЕНЬ, ПОЄДНАНЕ З НАДМІРНОЮ МАСОЮ ТІЛА Й ОЖИРІННЯМ". Health & Education, n.º 2 (27 de agosto de 2024): 75–82. http://dx.doi.org/10.32782/health-2024.2.10.
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Увага наукової спільноти приділяється вивченню нових маркерів перебігу хвороби, серед яких провідне місце посідають індекси, розраховані за стандартною гемограмою, що робить доступним їх використання у лікарській практиці. Оскільки всі клітини крові відіграють важливу роль у патогенезі хронічного обструктивного захворювання легень (ХОЗЛ) та його ускладнень, ми вирішили розрахувати окремі гематологічні індекси, які враховують вміст різних клітинних елементів та їх співвідношення. Метою дослідження було проаналізувати показники гемограми й інтегральних гематологічних індексів у пацієнтів із загостренням ХОЗЛ, яке поєднане з надмірною масою тіла й ожирінням. Обстежено 145 хворих із загостренням ХОЗЛ (96 чоловіків і 49 жінок), медіана віку ‒ 51 рік. За індексом маси тіла (ІМТ) ми поділили пацієнтів на 3 групи: з нормальною (n = 42; 1-ша група), надмірною (n = 41; 2-га група) масою тіла й ожирінням (n = 62; 3-тя група). Крім стандартних та інтегральних гематологічних показників (співвідношення гранулоцитів і моноцитів до лімфоцитів – ГМ/Лі, співвідношення лейкоцитів до ШОЕ – Л/ШОЕ; індекс еритроцитів – ІЕ), визначали С-реактивний білок (якісний тест) і функцію зовнішнього дихання (ФЗД) методом комп’ютерної спірометрії. Результати опрацьовано статистично, рівень істотності р < 0,05. Встановлено, що в пацієнтів з ХОЗЛ та ожирінням істотно вищими були кількість еритроцитів (5,6 проти 5,3 х 1012/л; р = 0,005) та індекс анізоцитозу еритроцитів (14,8 проти 14,4 %; р = 0,02) та істотно нижчими, ніж за умов нормальної маси тіла, середній вміст гемоглобіну в еритроциті (34,0 проти 34,4 пг; р = 0,03) і середній об’єм еритроцита (81,5 проти 84,4 фл; р = 0,001). За умов ожиріння істотно вищим, ніж за умов нормальної маси тіла, був рівень лейкоцитів за рахунок гранулоцитів (8,6 проти 7,9 х 109/л; 6,1 проти 5,2 х 109/л; обидва р < 0,05), а зростання індексу анізоцитозу еритроцитів асоціювалось із важкістю перебігу ХОЗЛ (τ = 0,2; р = 0,03). Відношення ГМ/Лі та Л/ШОЕ істотно зростали за умов ожиріння (3,9 проти 2,5 у. о. за умов нормальної маси тіла; 1,0 проти 0,7 у. о.; усі р < 0,05), що корелювало зі зниженням об’єму форсованого видиху за першу секунду (ОФВ1), життєвої ємності легень (ЖЄЛ) (за ГМ/Лі; τ1,2 = –0,1; р1 = 0,004; р2 = 0,02), форсованої ЖЄЛ (ФЖЄЛ) (за ГМ/Лі і Л/ШОЕ: τ1,2 = –0,1; р1,2 < 0,005) і пікової об’ємної швидкості видиху (ПОШв) (за Л/ШОЕ: τ = –0,1; р = 0,02), більш вираженим запаленням у бронхах із збільшенням вмісту лейкоцитів, епітелію бронхів та альвеолярних макрофагів у мокротинні (за ГМ/Лі: τ1,3 = 0,3; р1,3 < 0,0001; τ2 = 0,2; р2 = 0,0001; за Л/ШОЕ: τ1,2,3 = 0,2; р1 = 0,001; р2 = 0,002; р3 = 0,0003) і важчою легеневою недостатністю (ЛН) (за ГМ/Лі: τ = 0,2; р = 0,005). Підвищення ІЕ у пацієнтів з ожирінням асоційоване з тютюнопалінням, наявністю емфіземи легень, збільшенням вираженості бронхіальної обструкції (τ1,2,3 = 0,3; р1 = 0,01; р2 = 0,003; р3 = 0,02) і підвищенням рівня глюкози натще (τ = 0,2; р = 0,04). Таким чином, ГМ/Лі та Л/ШОЕ істотно зростають за умов ожиріння, що супроводжується погіршенням показників ФЗД, більш вираженими запальним процесом у бронхах і ЛН. Підвищення ІЕ у пацієнтів з ожирінням асоційоване з тютюнопалінням, розвитком емфіземи легень, збільшенням вираженості бронхіальної обструкції та порушенням вуглеводного обміну.
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Koç, A., e K. Kizilkaya. "Some factors influencing milk somatic cell count of Holstein Friesian and Brown Swiss cows under the Mediterranean climatic conditions". Archives Animal Breeding 52, n.º 2 (10 de outubro de 2009): 124–33. http://dx.doi.org/10.5194/aab-52-124-2009.
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Abstract. The aim of this study was to determine the influencing factors on somatic cell count (SCC) in the milk of Holstein Friesian (HF) and Brown Swiss (BS) cows raised on three dairy farms under the Mediterranean climatic conditions in Turkey. For a two-year period, farms were visited monthly to measure daily milk yield (DMY) and collect milk samples from each cow during the morning and evening milking. Total of 1 429 SCC readings from 67 HF and 16 BS cows were analyzed by using repeated measures. Breed (P<0.01), lactation number (LN) (P<0.01), milking time (MT) (P<0.05), lactation month (LM) (P<0.01) and the interactions of breed-LM (P<0.05), herd-LM (P<0.01) and LN-LM (P<0.01) effects on SCC were statistically significant as did the co-variable DMY effect (P<0.01). The effect of herd and herd-MT interactions on SCC were statistically insignificant (P>0.05). The SCC means for BS and HF cows were 5.464±0.060 (291 072 cells/ml) and 5.654±0.029 (450 817 cells/ml), respectively. The SCC mean for morning milking (338 065 cells/ml) was 25 850 cells/ml lower than that of evening milking. The LN4 had the highest SCC mean (490 908 cells/ml) and was statistically different from those of LN1 (P<0.01) and LN2 (P<0.05). The SCC level was the highest in the first LM (601 174 cells/ml) and this level then decreased in the later months. Possible reasons for the difference in SCC means between the breeds are different resistance mechanisms against mastitis, different morphological conformations of udders and different milk yields between these two breeds. The insignificant differences found among herds show the similarities of management, milking hygiene and barn conditions. In order to decrease SCC in milk and increase udder health, some precautions need to be taken like improving milking management, hygiene and barn conditions, milking the cow at uniform intervals, feeding the cows after the milking and applying a mastitis control program.
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Kwan, Karen W., Stephanie W. Morton e Joanie Chung. "Abstract P2-09-04: Timing and acceptance of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers enrolled in an integrated community-based health care system". Cancer Research 82, n.º 4_Supplement (15 de fevereiro de 2022): P2–09–04—P2–09–04. http://dx.doi.org/10.1158/1538-7445.sabcs21-p2-09-04.
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Abstract BACKGROUND Risk reducing bilateral salpingo-oophorectomy (rrBSO) can provide up to a 90% reduction in the risk of developing ovarian cancer in women who are carriers of pathogenic variants in the BRCA1 and BRCA2 genes. National guidelines recommend risk reducing rrBSO once childbearing is complete and/or between the ages of 35-45. Previous studies have found that a large percentage of women who are eligible for rrBSO do not undergo the procedure and surgery is often done at later ages than recommended in the national guidelines. Research on factors associated with the uptake and timing of rrBSO is limited. Our study describes the percentages of women who are BRCA1 or BRCA2 carriers who elected rrBSO and ascertains the timing of the surgery relative to recommended age guidelines. We also identify patient characteristics associated with uptake of rrBSO. METHODS We conducted a retrospective cohort study in a large, integrated healthcare system in Southern California. The study population included women who were identified as BRCA1 or BRCA2 carriers in our electronic health record by ICD 9 and ICD 10 codes, and by review of our internal Cancer DNA database. Inclusion criteria included adults 18 years and older who were members of Kaiser Permanente Southern California between 2008 - 2018. Exclusion criteria included patients with an established diagnosis of ovarian cancer, with rrBSO at the time of study entry, and who were KP members for less than 12 months. Crude logistic regression models were used to determine odds ratios and 95% confidence intervals for associations between patient variables and uptake of rrBSO. RESULTS Of the 2,592 patients in the cohort, 1,326 were BRCA1 carriers and 1,266 were BRCA2 carriers. 1,003 (38.6%) women underwent rrBSO at a median age of 48.0 years (IQR: 42.0, 57.0). For the entire cohort, 38.6% identified as Caucasian, 30% identified as Hispanic/Latin American/Caribbean, 9.4% identified as Ashkenazi Jewish, 8.6% identified as Asian/Pacific Islander, and 1.5% identified as Black/African, and 1.4% identified as Near East/Middle Eastern. The baseline characteristics of our cohort can be seen in Table 1. Ovarian malignancy was incidentally detected on pathology evaluation in 1.5% of patients who elected rrBSO. The odds of rrBSO were lower among those who had used oral contraceptives for more than one year compared to those who hadn’t (OR=0.18, 95% CI: 0.11-0.30). A family history of ovarian cancer or breast cancer were also associated with higher odds of rrBSO, (OR=1.45, 95% CI: 1.21-1.73) and (OR=1.75; 95% CI: 1.48-2.08), respectively. The odds of rrBSO were also higher for those with a personal history of breast cancer (OR=2.29, 95% CI: 1.95-2.70). CONCLUSIONS In this large cohort of women who were BRCA1 and BRCA2 carriers and who were eligible for rrBSO, only a third of patients underwent risk reducing surgery. Among those who did undergo surgery, the median age at the time of procedure was higher than what is recommended in national guidelines. Family history of breast cancer and/or ovarian cancer, as well as personal history of breast cancer were associated with women selecting rrBSO. Table 1.No Oophorectomy (N=1589)rrBSO (N=1003)Total (N=2592)p valueAge at BRCA diagnosis<0.00011 N158910032592 Mean (SD)43.9 (15.73)49.5 (11.11)46.1 (14.38) Median42.048.345.5 Range(18.1-95.7)(19.8-79.7)(18.1-95.7)Gene0.03522 BRCA1839 (52.8%)487 (48.6%)1326 (51.2%) BRCA2750 (47.2%)516 (51.4%)1266 (48.8%)Race/Ethnicity0.01002 African72 (4.5%)61 (6.1%)133 (5.1%) Ashkenazi Jewish134 (8.4%)110 (11%)244 (9.4%) Asian/Pacific Islander138 (8.7%)86 (8.6%)224 (8.6%) Black24 (1.5%)14 (1.4%)38 (1.5%) Hispanic/Latin American/Caribbean486 (30.6%)291 (29%)777 (30%) Multiple2 (0.1%)2 (0.2%)4 (0.2%) Native American/Alaskan2 (0.1%)0 (0%)2 (0.1%) Near East/Mideast24 (1.5%)13 (1.3%)37 (1.4%) White/Caucasian (Western/Northern/Central European)611 (38.5%)389 (38.8%)1000 (38.6%) Other77 (4.8%)37 (3.7%)114 (4.4%) Unknown19 (1.2%)0 (0%)19 (0.7%)Oral contraceptive use ≥ 1 year<0.00012 N1456 (91.6%)987 (98.4%)2443 (94.3%) Y133 (8.4%)16 (1.6%)149 (5.7%)Family history of ovarian cancer0.00012 N1236 (77.8%)710 (70.8%)1946 (75.1%) Y353 (22.2%)293 (29.2%)646 (24.9%)Family history of breast cancer<0.00012 N650 (40.9%)284 (28.3%)934 (36%) Y939 (59.1%)719 (71.7%)1658 (64%)Personal history of breast cancer<0.00012 N1094 (68.8%)492 (49.1%)1586 (61.2%) Y495 (31.2%)511 (50.9%)1006 (38.8%)Age at prophylactic surgery NN/A893893 Mean (SD)49.6 (10.36)49.6 (10.36) Median48.048.0 Q1, Q342.0, 57.042.0, 57.0 Range(21.0-80.0)(21.0-80.0)Ovarian cancer<0.00012 N1589 (100%)988 (98.5%)2577 (99.4%) Y0 (0%)15 (1.5%)15 (0.6%)1Kruskal Wallis 2Chi-Square Citation Format: Karen W Kwan, Stephanie W Morton, Joanie Chung. Timing and acceptance of bilateral prophylactic salpingo-oophorectomy among BRCA1 and BRCA2 mutation carriers enrolled in an integrated community-based health care system [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-09-04.
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Rennert, J., S. Mrosek, C. Stroszczynski, O. Schöffski e A. Schreyer. "Analyse von Kosten und Erlösen der 10 häufigsten angiografischen Interventionen bei einem Krankenhaus der Maximalversorgung". Das Gesundheitswesen 79, n.º 10 (18 de maio de 2015): e85-e94. http://dx.doi.org/10.1055/s-0035-1549908.
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Zusammenfassung Ziel: Kostenanalyse und Evaluation der Vergütung durch GKV und PKV der 10 häufigsten angiografischen Verfahren an einem Universitätsklinikum. Material und Methoden: Retrospektive Auswertung aller angiografischen Eingriffe des Jahres 2010 und Evaluation der 10 am häufigsten durchgeführten (Port-, Dialysekatheter, PTA von Ober- (OS) und Unterschenkel (US), TACE, Stents (Becken, viszeral, supraaortal), SIRT, zerebrale Coilembolisation). Berechnung der DRG-Anteile und Analyse, ob die Interventionen die DRGs modifizierten und Mehreinnahmen erzeugten. Kalkulation der Vergütung gemäß GOÄ für stationäre und ambulante Patienten. Berechnung von Material-, Personal- und Sachkosten für die Interventionen. Ergebnisse: Folgende Werte (in €) wurden errechnet [Gesamt-, Material-, Personalkosten, DRG-Anteil, GOÄ (stat., amb.)]: Portkatheter: 375, 266, 59, 328, 260, 612; Dialysekatheter 456, 349, 59, 272, 343, 807; PTA OS: 595, 445, 99, 1 240, 425, 1 077; PTA US: 732, 552, 129, 1 082, 425, 1 184; Stent Becken: 1 523, 1 338, 135, 1 323, 815, n/a; Stent viszeral: 2 124, 1 875, 199, 1 326, 912, n/a; Stent supraaortal: 1 901, 1 713, 138, 6 705, 1 138, n/a; TACE: 1 359, 1 120, 188, 2 588, 598, n/a; SIRT: 1 251, 1 054, 147, 2 289, 1 107, n/a; Coiling zerebral: 6 684, 6 367, 266, 6 531, n/a, n/a. Es konnte keine Abhängigkeit der DRGs von den durchgeführten Interventionen nachgewiesen werden. Schlussfolgerung: Die Auswertungen ergaben bei Analyse der DRG-Anteile ein Mischbild aus Verlusten (Port- und Dialysekatheter, Stent Becken und viszeral) und rechnerischen Mehreinnahmen (PTA OS/US, Stent supraaortal, TACE, SIRT). Das Coiling erscheint wirtschaftlich neutral. Eine reine Abrechnung nach GOÄ führt lediglich im ambulanten Sektor zu Gewinnen. Einschränkend muss jeder radiologische Eingriff natürlich ebenfalls als Teil der gesamten DRG gesehen werden.
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Beyer, Sebastian E., Andrew B. Dicks, Scott A. Shainker, Loryn Feinberg, Marc L. Schermerhorn, Eric A. Secemsky e Brett J. Carroll. "Pregnancy-associated arterial dissections: a nationwide cohort study". European Heart Journal 41, n.º 44 (30 de julho de 2020): 4234–42. http://dx.doi.org/10.1093/eurheartj/ehaa497.
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Abstract Aims Pregnancy is a known risk factor for arterial dissection, which can result in significant morbidity and mortality in the peripartum period. However, little is known about the risk factors, timing, distribution, and outcomes of arterial dissections associated with pregnancy. Methods and results We included all women ≥12 years of age with hospitalizations associated with pregnancy and/or delivery in the Nationwide Readmissions Database between 2010 and 2015. The primary outcome was any dissection during pregnancy, delivery, or the postpartum period (42-days post-delivery). Secondary outcomes included timing of dissection, location of dissection, and in-hospital mortality. Among 18 151 897 pregnant patients, 993 (0.005%) patients were diagnosed with a pregnancy-related dissection. Risk factors included older age (32.8 vs. 28.0 years), multiple gestation (3.6% vs. 1.9%), gestational diabetes (14.3% vs. 0.2%), gestational hypertension (6.0% vs. 0.6%), and pre-eclampsia/eclampsia (2.7% vs. 0.4%), in addition to traditional cardiovascular risk factors. Of the 993 patients with dissection, 150 (15.1%) dissections occurred in the antepartum period, 232 (23.4%) were diagnosed during the admission for delivery, and 611 (61.5%) were diagnosed in the postpartum period. The most common locations for dissections were coronary (38.2%), vertebral (22.9%), aortic (19.8%), and carotid (19.5%). In-hospital mortality was 3.7% among pregnant patients with a dissection vs. <0.001% in patients without a dissection. Deaths were isolated to patients with an aortic (8.6%), coronary (4.2%), or supra-aortic (<2.5%) dissection. Conclusion Arterial dissections occurred in 5.5/100 000 hospitalized pregnant or postpartum women, most frequently in the postpartum period, and were associated with high mortality risk. The coronary arteries were most commonly involved. Pregnancy-related dissections were associated with traditional risk factors, as well as pregnancy-specific conditions.
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Diana, Inne Arline, Srie Prihianti Gondokaryono, Titi Lestari Sugito, Maya Devita Lokanata, Triana Agustin, Githa Rahmayunita, Indah Maharani, Nanny Shoraya, Haruko Toyoshima e Danang Agung Yunaidi. "A randomized, controlled, cross-over study of the safety and efficacy of superabsorbent diaper for babies with mild-to-moderate diaper rash". Medical Journal of Indonesia 29, n.º 3 (5 de outubro de 2020): 283–9. http://dx.doi.org/10.13181/mji.oa.203630.
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BACKGROUND Super-absorbent diaper is a disposable diaper with new technology which has a soft-airy structure, breathable sheet, and rich absorbent core. This study aimed to compare the safety and efficacy of super-absorbent diaper with standard absorbent diaper.
METHODS A single-blinded, randomized, controlled, cross-over study was performed in 324 months babies. A safety study was performed in 113 babies without diaper rash (group A: super-absorbent to standard and B: standard to super-absorbent) and efficacy study in 59 babies with mild-to-moderate diaper rash (group C: super-absorbent to standard and D: standard to super-absorbent). Each group used super-absorbent or standard diaper for 2 weeks. Skin assessment scores (SAS) were recorded at baseline, week-2, and week-4. Non-parametric tests were used to analyze the data.
RESULTS In the safety study, there was no significant increase of SAS in group A at week-2 and -4, but in group B there was a significant increase of SAS (1.9 to 4.1, p = 0.001) at week-2 with a significant reduction at week-4 (4.1 to 2.2, p<0.001). In the efficacy study, there was a reduction of SAS at week-2 in group C (p = 0.07) and D (p = 0.05). However, SAS increased in group C (6.4 to 8.3, p = 0.2) and decreased in group D (8.6 to 6.1, p = 0.13) at week-4. Super-absorbent diaper showed a significant reduction of SAS in the pubic areas (1.43 to 0.73, p<0.011).
CONCLUSIONS The new super-absorbent diaper is safe to use and may have efficacy in the improvement of skin conditions and diaper rash, especially in the pubic areas.
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Jiang, Huiqi, Farkas Vánky, Henrik Hultkvist, Jonas Holm, Yanqi Yang e Rolf Svedjeholm. "NT-proBNP and postoperative heart failure in surgery for aortic stenosis". Open Heart 6, n.º 1 (maio de 2019): e001063. http://dx.doi.org/10.1136/openhrt-2019-001063.
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ObjectivePostoperative heart failure (PHF) after aortic valve replacement (AVR) for aortic stenosis (AS) may initially appear mild and transient but has serious long-term consequences. Methods to assess PHF are not well documented. We studied the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) and PHF after AVR for AS.MethodsThis is a prospective, observational, longitudinal study of 203 patients undergoing elective first-time AVR for AS. Plasma NT-proBNP was assessed at preoperative evaluation, the day before surgery, and the first (POD1) and third postoperative morning. A clinical endpoints committee, blinded to NT-proBNP results, used prespecified haemodynamic criteria to diagnose PHF. The mean follow-up was 8.6±1.1 years.ResultsNo patient with PHF (n=18) died within 30 days after surgery, but PHF was associated with poor long-term survival (HR 3.01, 95% CI 1.45 to 6.21, p=0.003). NT-proBNP was significantly higher in patients with PHF only on POD1 (6415 (3145–11 220) vs 2445 (1540–3855) ng/L, p<0.0001). NT-proBNP POD1 provided good discrimination of PHF (area under the curve=0.82, 95% CI 0.72 to 0.91, p<0.0001; best cut-off 5290 ng/L: sensitivity 63%, specificity 85%). NT-proBNP POD1 ≥5290 ng/L identified which patients with PHF carried a risk of poor long-term survival, and PHF with NT-proBNP POD1 ≥ 5290 ng/L emerged as a risk factor for long-term mortality in the multivariable Cox regression (HR 6.20, 95% CI 2.72 to 14.1, p<0.0001).ConclusionsThe serious long-term consequences associated with PHF after AVR for AS were confirmed. NT-proBNP level on POD1 aids in the assessment of PHF and identifies patients at particular risk of poor long-term survival.
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Bergeron, Michael F., Melissa D. Laird, Elaina L. Marinik, Joel S. Brenner e Jennifer L. Waller. "Repeated-bout exercise in the heat in young athletes: physiological strain and perceptual responses". Journal of Applied Physiology 106, n.º 2 (fevereiro de 2009): 476–85. http://dx.doi.org/10.1152/japplphysiol.00122.2008.
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A short recovery period between same-day competitions is common practice in organized youth sports. We hypothesized that young athletes will experience an increase in physiological strain and perceptual discomfort during a second identical exercise bout in the heat, with 1 h (21°C) between bouts, even with ample hydration. Twenty-four athletes (6 boys and 6 girls: 12–13 yr old, 47.7 ± 8.3 kg; 6 boys and 6 girls: 16–17 yr old, 61.0 ± 8.6 kg) completed two 80-min intermittent exercise bouts (treadmill 60%, cycle 40% peak oxygen uptake) in the heat (33°C, 48.9 ± 6.1% relative humidity). Sweat loss during each bout was similar within each age group (12–13 yr old: bout 1, 943.6 ± 237.1 ml; bout 2, 955.5 ± 250.3 ml; 16–17 yr old: bout 1, 1,382.2 ± 480.7 ml; bout 2, 1,373.1 ± 472.2 ml). Area under the curve (AUC) was not statistically different ( P > 0.05) between bouts for core body temperature (12–13 yr old: bout 1 peak, 38.6 ± 0.4°C; bout 2, 38.4 ± 0.2°C; 16–17 yr old: bout 1 peak, 38.8 ± 0.7°C; bout 2, 38.7 ± 0.6°C), physiological strain index (12–13 yr old: bout 1 peak, 7.9 ± 0.9; bout 2, 7.5 ± 0.7; 16–17 yr old: bout 1 peak, 8.1 ± 1.5; bout 2, 7.9 ± 1.4), or thermal sensation for any age/sex subgroup or for all subjects combined. However, rating of perceived exertion AUC and peak were higher ( P = 0.0090 and 0.0004, respectively) during bout 2 in the older age group. Notably, four subjects experienced consistently higher responses throughout bout 2. With these healthy, fit, young athletes, 1 h of complete rest, cool down, and rehydration following 80 min of strenuous exercise in the heat was generally effective in eliminating any apparent carryover effects that would have resulted in greater thermal and cardiovascular strain during a subsequent identical exercise bout.
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Merga, Hailu, Kifle Woldemichael e Lamessa Dube. "Utilization of Prevention of Mother-to-Child Transmission of HIV Services and Associated Factors among Antenatal Care Attending Mothers in Sebeta Town, Central Ethiopia". Advances in Public Health 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/6250898.
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Background. HIV transmission from mother to child continues to be the major source of HIV infection among children under the age of fifteen. Targeting pregnant women attending antenatal clinics provides a unique opportunity for implementing prevention of mother-to-child transmission (PMTCT) programs against HIV infection of newborn babies. This study assessed utilization of PMTCT service of HIV and associated factors among ANC attending mothers.Methods. An institutional based cross-sectional study was conducted from February 20 to March 30, 2015, using exit interviews with 377 ANC attendees using consecutive sampling method. In-depth interviews with service provider were conducted to complement the quantitative data. Data were entered and analysed using EpiData and SPSS, respectively.Results. The prevalence of PMTCT service utilization was 86.9% in this study. Only 8.6% of respondents attended the facility for HCT. After controlling confounders using logistic regression, PMTCT service utilization was associated with age (25–34) of respondents (AOR (95% CI) = 0.46 (0.22, 0.97)), mother’s occupational status (being merchant AOR (95% CI) = 0.31 (0.12, 0.83), government employee AOR (95% CI) = 0.05 (0.01, 0.28), student AOR (95% CI) = 0.1 (0.01, 0.44), and daily laborer AOR (95% CI) = 0.13 (0.05, 0.33)), husband’s educational status (lack of formal education (AOR (95% CI) = 3.3 (1.1, 9.9))), having discussion with husband (AOR (95% CI) = 6.1 (2.6, 14.1)), partner tested (AOR (95% CI) = 8.2 (1.9, 34.46)), and being not satisfied with the service (AOR (95% CI) = 0.46 (0.2, 0.99)).Conclusions. This study revealed that utilization of HIV counseling and testing during antenatal care was high among pregnant women in Sebeta town. It highlights that focusing on improvement of quality and coverage of health services has significant effects on PMTCT service utilization. Effective use or uptake of ARV drug among HIV-positive pregnant women should be further investigated so that utilization will be enhanced.
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Marincowitz, Carl, Omar Bouamra, Tim Coates, Dhushy Kumar, David Lockey, Virginia Newcombe, Lyndon Mason, David Yates, Julian Thompson e Fiona Lecky. "1427 The effect of the COVID-19 pandemic on major trauma presentations and patient outcomes in English hospitals". Emergency Medicine Journal 39, n.º 12 (22 de novembro de 2022): A960.2—A964. http://dx.doi.org/10.1136/emermed-2022-rcem2.2.
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Aims, Objectives and BackgroundThere is evidence that COVID-19 ‘lockdowns’ may have contributed to increased non-accidental injury, domestic violence and self-harm related to deteriorating mental health. Internationally, there is also evidence that the diversion of health care resources may led to worse outcomes for patients presenting with major trauma. There has been no previous national evaluation of ‘lockdown’ measures impact on the characteristics, treatment pathways and outcomes of trauma patients in EnglandWe aimed to assess the impact of successive lockdowns on the volume, demographics, injury mechanism, severity, treatment and outcomes of major trauma in England.Method and DesignDemographic characteristics and clinical pathways of TARN eligible patients in the first lockdown (24th March to 3rd July 2020 inclusive) and second lock down (1st November 2020 to 16th May 2021 inclusive) were compared to equivalent pre-COVID-19 periods in 2018–2019.A segmented regression model predicting the weekly risk adjusted survival was estimated and a discontinuity in the gradient (trend) or intercept (level) of the fitted model was tested for at the weekly time point of implementation of each lockdown.Abstract 1427 Figure 1Strobe diagram for inclusion of study populationAbstract 1427 Figure 2Interrupted time series analysis assessing the impact of COVID restrictions on likelihood of survival (red horizontal lines indicate introduction and relaxation of ‘lockdown’ measures)Abstract 1427 Table 1Comparison of demographics ‘lockdown’ and pre-COVID periodsPeriodPeriod24Mar19 – 03Jul19 (comparator)24Mar20 – 03Jul20 (lockdown 1)Absolute change [percentage point change (95%CI)] p-value01Nov18 – 16May19 (comparator)01Nov20 – 16May21 (lockdown 1)Absolute change [percentage point change (95%CI)] p-valueTotal2224317510-4733 (-21%)p<0.0001‡41016382622754 (–6.7%)p<0.0001‡Age (years), Median (IQR)67.6 (46.5–83.1)70.9 (50.3–84.2)3.3 (2.4 to 4.2)p<0.000169.1 (48.7–83.6)73.1 (53.3–85.1)4 (3.5 to 4.2)<0.0001Age bands, n(%)Age< 1138 (0.6%)130 (0.7%)-8 [0.1(-0.04 to 0.030)] p=0.14281 (0.7%)234 (0.6%)-47 [0.1 (-0.2 to 0.04)]p=0.1979Age <16942 (4.2%)674 (3.8%)-268 [-0.4 (-0.8 to 0]p=0.05311444 (3.5%)1218 (3.2%)-226 [-0.3(-0.6 to – 0.1)p=0.0084Age 16 – 649561 (43%)6974 (39.8%)-2587 [-3.2(-4.1 to -2.2)P<0.000117173 (41.9%)13980 (36.5%)-3193 [-5.3(-6 to -5)]p<0.0001Age 65 and over11740 (52.8%)9862 (56.3%)-1878 [3.5 (2.5 to 4.5)]p<0.000122399 (54.6%)23064 (60.3%)665 [5.7(5 to 6.3)]P<0.0001Age 85 and over4610 (20.7%)4047 (23.1%)-563 [2.4(1.6 to 3.2)]p<0.00018903 (21.7%)9731 (25.4%)828 [3.7 (3.1 to 4.3)]p<0.0001Male, n(%)12316 (55.4%)9512 (54.3%)-2804 [-1 (-2 to -0.6)]p=0.037322146 (54%)19769 (51.7%)-2377 [-2.3 (-3 to -1.6)]<0.0001CCI*, n(%)CCI 09359 (42.1%)6220 (35.5%)-3139 [ -6.5 (-7.5 to -5.6)] p<0.000116665 (40.6%)12806 (33.5%)-3859 [-7.1(-7.8 to -6.5)]p<0.0001CCI 1 – 58538 (38.4%)6896 (39.4%)-1642 [1 (0.3 to 2)]p=0.042615899 (38.8%)15667 (40.9%)-232 [2.2 (1.5 to 2.9)]p<0.0001CCI 6 – 103032 (13.6%)3061 (17.5%)29 [3.8 (3.2 to 4.6)]p<0.00015987 (14.6%)6863 (17.9%)876 [3.3(2.8 to 3.8)]p<0.0001CCI > 10927 (4.2%)1024 (5.8%)97 [1.7(1.2 to 2.1)]p<0.00011648 (4%)2410 (6.3%)762 [2.3(2 to 2.6)]p<0.0001Not recorded387 (1.7%)309 (1.8%)-88 [0.2 (-0.2 to 0.3)]p=0.8513817 (2%)516 (1.3%)-301 [-0.6(-0.8 to -0.5)]p<0.0001MOI**: RTC, n(%)Car occupant1247 (30.7%)551 (20.4%)-696 [-10.4(-12.4 to -8.2)]p<0.00012485 (35.2%)1551 (31.3%)-934 [-3.9(-5.6 to -2.2)]p<0.0001Pedestrian661 (16.3%)288 (10.6%)-373 [-5.6 (-7.2 to -4)]p<0.00011629 (23.1%)962 (19.4%)-667 [-3.7(-5.1 to -2.2)]p<0.0001Motorcycles1196 (29.4%)711 (26.3%)-485 [-3.2(-5.3 to -1)]p<0.00011524 (21.6%)976 (19.7%)-548[ -1.9(-3.3 to -0.4)]p<0.0001Cyclist912 (22.4%)1139 (42.1%)227 [19.6(17.4 to 21.9)]p<0.00011315 (18.6%)1396 (28.2%)81 [9.5(8 to 11.1)]p<0.0001Other11 (0.3%)<9 ()-10 [ -0.2(-0.4 to -0.06)p=0.025131 (0.4%)10 (0.2%)-21 [-0.23(-0.4 to -0.04)]p=0.0281MOI: Intentional, n(%)Intentional assault130 (0.6%)88 (0.5%)-42 [-0.08 (-0.2 to 0.06)]p=0.2724227 (0.6%)175 (0.5%)-52 [-0.1(-0.2 to 0.002)]P=0.0570Self harm276 (1.2%)284 (1.6%)8 [0.4 (0.1 to 0.6)]p=0.0014525 (1.3%)562 (1.5%)37 [0.2 (0.02 to 0.3)]p=0.0223NAI63 (0.3%)27 (0.2%)-36 [-0.1(-0.2 to -0.03)]p=0.007297 (0.2%)90 (0.2%)-7 [-0.001(-0.07 to 0.07)]p=0.9701Shooting34 (0.2%)40 (0.2%)6 [0.08(-0.01 to 0.2)]p=0.082680 (0.2%)56 (0.1%)-24 [ -0.05(-0.1 to 0.001)]p=0.0979Stabbing450 (2%)312 (1.8%)-138 [-0.2(-0.5 to 0.03)]p=0.0816791 (1.9%)589 (1.5%)-202 [-0.4 (-0.6 to -0.2)]p<0.0001Blows1174 (5.3%)647 (3.7%)-527 [-1.6(-1.9 to -1.2)]p<0.00012059 (5%)1299 (3.4%)-760 [-1.6(-1.9 to -1.3)]p<0.0001Unintentional, n(%)Falls>2m2055 (9.2%)1757 (10%)-298 [0.8(0.2 to 1.4)]P=0.00753740 (9,1%)3528 (9.2%)-212 [0.1(-0.3 to 0.5)]p=0.6181Falls<2m13384 (60.2%)11314 (64.6%)-2070 [4.4 (3.5 to 5.4)]p<0.000125505 (62.2%)26203 (65.8%)698 [6.3 (5.6 to 6.9)]p<0.0001Sport449 (2%)320 (1.8%)-129 [-0.2 (-0.5 to 0.01]p=0.1697615 (1.5%)489 (1.3%)-126 [-0.2 (-0.4 to -0.006)]p=0.0079GCS bands , n(%)Mild19609 (88.2%)15449 (88.2%)4160 [0.1 (-0.6 to 0.7)]p=0.826435831 (87.4%)34051 (89%)-1780 [1.6 (1.2 to 2.1)]p<0.0001Moderate689 (3.1%)625 (3.6%)-64 [0.5(0.1 to 0.8)]p=0.00901333 (3.2%)1127 (2.9%)-206 [-0.3 (-0.5 to -0.06)]p=0.0135Severe955 (4.3%)765 (4.4%)-190 [0.1 (-0.3 to 0.5)]p=0.71361886 (4.6%)1464 (3.8%)-422 [-0.8(-1 to -0.5)]p<0.0001Not recorded990 (4.5%)671 (3.8%)-319 [ -0.6(-1 to -0.2)]p=0.00221966 (4.8%)1620 (4.2%)-346 [-0.6(-0.8 to -0.3)]p=0.0002ISS***, median (IQR)9 (9–18)9 (9–18)09 (9–18)9 (9–17)0ISS bands, n(%)ISS 1 – 84545 (20.4%)3062 (17.5%)-1483 [-3 (-4 to -2)]p=<0.00018266 (20.2%)7838 (20.5%)-428 [0.3(-0.2 to 0.9)]p=0.2457ISS 9 – 159290 (41.8%)7728 (44.1%)-1562 [2.4(1.4 to 3.3)]p<0.000117207 (42%)16969 (44.3%)-233 [2.4(1.7 to 3.1)]p<0.0001ISS >158408 (37.8%)6720 (38.4%)-1688 [5.6(-0.4 to 1.5)]p=0.239115543 (37.9%)13455 (35.2%)-2088 [-2.7 (-3.4 to -2)]p<0.0001ISS >253995 (18%)3127 (17.9%)-868 [-0.1(-0.9 to 0.7 )]p=0.79217521 (18.3%)6201 (16.2%)-1320 [-2.1(-2.6 to -1.6)]p<0.0001Body regions, n(%)Head AIS 3+5911 (26.6%)4670 (26.7%)-1241 [0.1 (-0.8 to 1)]p=0.830111128 (27.1%)9629 (25.2%)-1499 [ -2(-2.6 to -1.3)]p<0.0001Face AIS 3+63 (0.3%)41 (0.2%)-22 [-0.05 (-0.1 to 0.05)]p=0.341699 (0.2%)69 (0.2%)-30 [-0.06 (-0.1 to 0)]p=0.0618Chest AIS 3+4787 (21.5%)3915 (22.4%)-872 [8.3 (0.2 to 1.6)]<0.04508515 (20.8%)8075 (21.1%)-440 [0.3 (-0.2 to 0.9)]p=0.2337Abdomen AIS 3+872 (3.9%)690 (3.9%)-182 [0.02 (-0.3 to 0.4)]p=0.91771465 (3.6%)1179 (3.1%)-286 [-0.5 (-0.7 to -0.2)]p=0.0001Spine AIS 3+1985 (8.9%)1561 (8.9%)-424 [-0.01(-0.6 to 0.5)]p=0.97443784 (9.2%)3459 (9%)-325 [-0.2(-0.6 to 0.2)]p=0.3654Pelvis AIS 3+758 (3.4%)600 (3.4%)-158 [0.02(-0.3 to 0.4)]p=0.91841501 (3.7%)1386 (3.6%)-115 [-0.04(-0.3 to 0.2)]p=0.7802Limb AIS 3+5707 (25.7%)4892 (27.9%)-815 [2.3 (1.4 to 3.2)]p<0.000110719 (26.1%)10122 (26.5%)-597 [0.3(-0.3 to 0.9)]p=0.3053Other AIS 3+217 (1%)199 (1.1%)-18 [0.2 (-0.04 to 0.3)]p=0.1176375 (0.9%)396 (1%)21 [0.1 (-0.01 to 0.2]p=0.0836Polytrauma1622 (7.3%)1350 (7.7%)-272 [0.4 (-0.1 to 0.9)]p=0.11602984 (7.3%)2429 (6.3%)-555 [-0.9(-1.2 to 0.6)]p<0.0001*CCI Charlson Comorbidity Index**MOI Mechanism of injury***ISS Injury Severity Score‡chi square test for uniform distributionAbstract 1427 Table 2Comparison care pathways ‘lockdown’ and pre-COVID periodsPeriodPeriod24Mar19 – 03Jul19 (comparator)24Mar20 – 03Jul20 (lockdown 1)Absolute Change01Nov18 – 16May19 (comparator)01Nov20 – 16May21 (lockdown 2)Absolute Change1stHospital MTC9908 (44.5%)7376 (42.1%)-2532 [-2.4 (-3.4 to -1.4)]p<0.000118099 (44.1%)15928 (41.6%)-2171 [-2.5 (-3.2 to -1.8)]p<0.0001Treated at MTC11176 (50.2%)8256 (47.2%)-2920 [-3 (-4 to -2)]p<0.000120395 (49.7%)17852 (46.7%)-2543[-3 (-4 to -2.4)]p<0.0001Consultant ED8140 (36.6%)5562 (31.8%)-2578 [-4.8(-5.8 to -3.9)]p<0.000114779 (36%)12577 (32.9%)-2202 [-3.2 (-3.8 to -2.5)]p<0.0001CT within 1 hr5062 (31.9%)3992 (30.9%)-1070 [-0.9(-2 to 0.1)]p=0.09449203 (31.6%)7776 (27.1%)-1427 [-4(-5 to -3.7)]p<0.0001Whole body CT3348 (15.1%)3210 (18.3%)-138 [3 (2 to 4)]p<0.00016040 (14.7%)6417 (16.8%)377 [2 (1.5 to 2.5)]p<0.0001ICU stay3092 (13.9%)2208 (12.6%)-884 [-1.3(-1.9 to -0.6) ]p=0.00025591 (13.6%)3850 (10.1%)-1741 [-3.6(-4 to -3)]p<0.0001Mortality*1417 (7.1%)1316 (8.3%)-101 [1.2 (0.6 to 1.7)]p<0.00012916 (7.9%)2858 (8.1%)-58 [0.2 (-0.1 to 0.6)] p=0.2040Discharge destination, n(%)Home (own)13800 (62%)10484 (59.9%)-3316 [-2(-3.1 to -1.2)]p<0.000124961 (60.9%)23368 (61.1%)-1593 [-0.7 (-1.4 to -0.05)]p=0.0340Home (relative/carer)473 (2.1%)372 (2.1%)-101 [0 (-0.3 to 0.3)]p=0.9890974 (2.4%)852 (2.2%)-122 [-0.1(-0.4 to 0.06)]p=0.1653Mortuary*1501 (6.7%)1323 (7.6%)-178 [0.8(0.3 to 1.3)]p=0.00193086 (7.5%)2977 (7.8%)-109 [0.1 (-0.3 to 0.5)]p=0.5113No fixed abode75 (0.3%)47 (0.3%)-28 (-37.3%)107 (0.3%)87 (0.2%)-20 (-18.7%)Not Known87 (0.4%)39 (0.2%)-48 (-55.2%)101 (0.2%)95 (0.2%)-6 (-5.9%)Nursing Home1190 (5.3%)1063 (6.1%)-127 [0.7(0.3 to 1.2)]p=0.00202448 (6%)2231 (5.8%)-217 [-0.2(-0.6 to 0.1)]p=0.1620Other Acute hospital2425 (10.9%)1736 (9.9%)-689 [-0.1(-1.6 to -0.4)]p=0.00144346 (10.6%)3313 (8.7%)-1033 [-0.1(-0.5 to 0.2)]p=0.4115Other institution526 (2.4%)516 (2.9%)-10 [0.6 (0.3 to 0.9)]p=0.0003980 (2.4%)870 (2.3%)-110 [-0.1 (-0.3 to 0.1)]p=0.2817Rehabilitation2077 (9.3%)1871 (10.7%)-206 [1.3(0.7 to 1.9)]p<0.00013851 (9.4%)4274 (11.2%)423 [ 1.7(1.3 to 2.2)]p<0.0001Social care63 (0.3%)50 (0.3%)-13 [0 (-0.1 to 0.1)]p=0.9657121 (0.3%)103 (0.3%)-18 [-0.2(-0.1 to 0.5)]p=0.4939*These totals do not correspond as mortality includes deaths in the community and is censored at 30 daysResults and ConclusionThe first ‘lockdown’ had a larger associated reduction in total trauma volume (-21%) compared to the pre-COVID period than the second ‘lockdown’ (-6.7%). Trauma volume increased for those 65 and over (3%) and 85 and over (9.3%) during the second ‘lockdown’.There was a reduction in likelihood of survival (-1.71; 95% CI:-2.76 to -0.66) associated with the immediate introduction of the first ‘lockdown’. However, this was followed by a trend of improving survival (0.25; 95% CI: 0.14 to 0.35) and likelihood of survival returned to pre-pandemic levels by the end of the first ‘lockdown’ period.Future research is needed understand the initial reduction in likelihood of survival after major trauma observed with the implementation of the first ‘lockdown’ to prevent this occurring if measures re-introduced.
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Khorrami, Z., F. Vakili, T. Lanz, M. Langlois, E. Lagadec, M. R. Meyer, S. Robbe-Dubois et al. "Uncrowding R 136 from VLT/SPHERE extreme adaptive optics". Astronomy & Astrophysics 602 (junho de 2017): A56. http://dx.doi.org/10.1051/0004-6361/201629279.
Texto completo da fonteResumo:
This paper presents the sharpest near-IR images of the massive cluster R 136 to date, based on the extreme adaptive optics of the SPHERE focal instrument implemented on the ESO Very Large Telescope and operated in its IRDIS imaging mode.The crowded stellar population in the core of the R 136 starburst compact cluster remains still to be characterized in terms of individual luminosities, age, mass and multiplicity. SPHERE/VLT and its high contrast imaging possibilities open new windows to make progress on these questions.Stacking-up a few hundreds of short exposures in J and Ks spectral bands over a field of view (FoV) of 10.9″ × 12.3″ centered on the R 136a1 stellar component, enabled us to carry a refined photometric analysis of the core of R 136. We detected 1110 and 1059 sources in J and Ks images respectively with 818 common sources. Thanks to better angular resolution and dynamic range, we found that more than 62.6% (16.5%) of the stars, detected both in J and Ks data, have neighbours closer than 0.2′′ (0.1′′). The closest stars are resolved down to the full width at half maximum (FWHM) of the point spread function (PSF) measured by Starfinder. Among resolved and/or detected sources R 136a1 and R 136c have optical companions and R 136a3 is resolved as two stars (PSF fitting) separated by 59 ± 2 mas. This new companion of R 136a3 presents a correlation coefficient of 86% in J and 75% in Ks. The new set of detected sources were used to re-assess the age and extinction of R 136 based on 54 spectroscopically stars that have been recently studied with HST slit-spectroscopy (Crowther et al. 2016, MNRAS, 458, 624) of the core of this cluster. Over 90% of these 54 sources identified visual companions (closer than 0.2′′). We found the most probable age and extinction for these sources are 1.8+1.2-0.8 Myr, AJ = (0.45 ± 0.5) mag and AK = (0.2 ± 0.5) mag within the photometric and spectroscopic error-bars. Additionally, using PARSEC evolutionary isochrones and tracks, we estimated the stellar mass range for each detected source (common in J and K data) and plotted the generalized histogram of mass (MF with error-bars). Using SPHERE data, we have gone one step further and partially resolved and studied the initial mass function covering mass range of (3–300) M⊙ at the age of 1 and 1.5 Myr. The density in the core of R 136 (0.1–1.4 pc) is estimated and extrapolated in 3D and larger radii (up to 6 pc). We show that the stars in the core are still unresolved due to crowding, and the results we obtained are upper limits. Higher angular resolution is mandatory to overcome these difficulties.