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GATA2突变相关的异常易向髓系肿瘤转化，但其驱动突变的原因和机制尚不清楚。2016版WHO髓系肿瘤分类提出，相较其他胚系基因改变而言，伴GATA2胚系突变的患者进展为MDS、MDS/骨髓增殖性肿瘤（MPN）以及AML比例最高。GATA2缺陷综合征在成人原发性MDS中总的发生率为7％，在骨髓增生异常综合征伴原始细胞增多（MDS-EB）中发生率达15％；儿童患者中，伴−7和+8异常的MDS患者合并GATA2缺陷发生率高，文献报道，伴−7的MDS患儿中存在37％的GATA2缺陷，+8的MDS患儿中存在16％的GATA2缺陷–。因此，在接诊GATA2合并−7或+8，以及MDS-EB的MDS患者时，应高度警惕合并潜在GATA2缺陷综合征可能。此外，研究发现，GATA2缺陷综合征患者可出现进行性B细胞、单核细胞减少，而监测MDS患者中以上两群细胞是否发生减少可提示GATA2缺陷综合征，此外以上两群细胞显著减少可能是导致患者出现重症感染、以及感染分枝杆菌的原因。治疗方面，目前无统一认识或指南，有学者主张个体化用药调整，也有观点认为化疗对于此类患者不仅获益度有限，且化疗本身可导致严重感染等并发症，故不主张进行化疗，并应尽可能避免免疫抑制剂治疗。异基因造血干细胞移植作为目前唯一的可根治GATA2缺陷综合征的治疗手段，最佳的移植时机是MDS进入低增生时期，GATA2缺陷综合征进入MDS/AL阶段，或者在患者发生严重脏器功能不全前进行–。生存率方面，GATA2免疫缺陷综合征患者总生存率由54％到86％不等。
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While both adrenal hormones, DHEA and cortisol, modulate immune function, they have opposing effects. Cortisol plays an important role in immunosuppression, while DHEA enhances immune function (89). The immune-enhancement properties of DHEA is associated with changes in its production, which begin decrease after puberty reaching almost 5% circulating concentrations in the elderly compared to pre-puberty (90). On the other hand, cortisol levels remain unaltered, a fact that leads to an imbalance between the two stress hormones (89). The evidence suggests that DHEA increases mitogen-stimulated IL2 release from CD4+ cells and this counters the changes in CD8+ produced by glucocorticoids (91). This suggests that an increase in the ratio cortisol:DHEA may contribute to the decline in immune function observed in the elderly. Thus, DHEA supplementation in the elderly may provide beneficial effects to immune function (92). In addition, stress management as well as acute exercise seem to slow immunosenescence as they improve the cortisol:DHEA ratio (93).
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Unter Therapie ist keine erneute HCV-RNA-Bestimmung erforderlich, kann aber zur Bestimmung der Compliance durchgeführt werden . Eine Transaminasenbestimmung ist in den meisten Fällen jedoch ausreichend. Eine minimale Restvirämie im Verlauf unter Therapie bzw. am Therapieende ist nicht mit einem Therapieversagen assoziiert und sollte daher nicht zu einem Therapieabbruch oder gar Therapieverlängerung führen. Die Therapieüberwachung sollte sich an den Vorerkrankungen und dem Status der Lebererkrankung orientieren. Wenn Ribavirin eingesetzt wird, sollte der Hämoglobinwert aufgrund der therapieassoziierten hämolytischen Anämie überwacht werden und bezüglich gegebenenfalls notwendiger Dosisreduktion überprüft werden. Eine HCV-RNA-Messung zum Nachweis der SVR sollte 12 Wochen nach Therapieende erfolgen. Aufgrund des verbleibenden HCC-Risikos auch nach erfolgreicher Viruseradikation wird bei Patient*innen mit einer Leberzirrhose, eine (lebenslange) Überwachung (Surveillance) mittels Lebersonographie, gemäß der deutschen Leitlinie zusammen mit der Bestimmung des Alpha-Fetoproteins, alle 6 Monate empfohlen .
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Como considerações finais, reafirma-se a importância da difusão do conhecimento sobre o uso desse equipamento, por ser ele uma nova e eficaz opção de reabilitação auditiva. Pacientes portadores da síndrome de Treacher Collins se constituem num grupo que pode ser muito beneficiado com o uso dessa tecnologia.
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In the 1-way sensitivity analysis for 30-year-old women, the ICER was most sensitive to 5-year breast cancer survival, screening assay cost, cancer risk reductions after RRSO, and RRM and RRSO uptake (eFigure 3 in the Supplement). For 45-year-old women, the ICER was most sensitive to 5-year breast cancer survival, RRM and RRSO uptake, the mortality reduction applied to early-stage breast cancer, screening assay cost, and HBOC carrier prevalence.
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Although we do not still fully understand the mechanisms that contribute to muscle dysfunction in COPD, there is evidence that multiple factors are likely to influence clinical outcome, such as systemic inflammation, reduced capillary density, tissue hypoxia and subsequent oxidative stress . However, it is not known to what extent increased levels of inflammatory cytokines play a role in muscle wasting. Likewise, hypoxaemia has been linked to several drivers of muscle dysfunction in COPD such as downregulation of energy-consuming processes (for example, protein synthesis, mitochondrial respiration), impaired myogenesis, fibre type shifting and increased serum levels of cytokines , but the exact molecular mechanisms through which chronic or intermitted hypoxia affects muscle maintenance are unclear.
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All experiments were conducted after September 2011 when the reproductive season ended for the frogs . Surgical procedures are described in detail in our previous study . In short, sterile surgery was performed under deep anesthesia induced by intraperitoneal pentobarbital sodium (3 mg/100 g). Then, four cortical EEG electrodes, composed of miniature stainless steel screws (ϕ 0.8 mm), were implanted on the frog skull: the left and right sides of the telencephalon and mesencephalon (R1, R2, R3 and R4), and referenced to the electrode above the cerebellum (P, the corresponding electrode pairs were abbreviated as PR1, PR2, PR3 and PR4, respectively) (Fig. 1). Twenty seconds of typical EEG waves were presented along with the corresponding electrode pairs (Fig. 1). R1 and R2 were implanted bilaterally 2.2 mm anterior to the lambda (i.e. the point where skull sutures intersect) and 1.5 mm lateral to the midline, respectively, while R3 and R4 were implanted bilaterally 2.3 mm posterior to the lambda and 1.5 mm lateral to the midline. P was implanted 3.9 mm posterior to the lambda at the midline. One end of a formvar-insulated (except at the two ends) nichrome wire (ϕ 0.1 mm) served as a ground electrode and was fixed subcutaneously about 5 mm posterior to P.
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选择2010年1月1日-2016年12月31日期间南京医科大学第一家附属医院肿瘤科收治的644例晚期NSCLC患者。入选标准：①初诊有EGFR敏感突变:18、19或21外显子突变。患者的EGFR突变类型的检测均由我院病理科运用扩增阻滞突变系统（Amplification Refractory Mutation System, ARMS）法进行检测。②中度至大量的MPCE，经计算机断层扫描（computed tomography, CT）、心超或核磁共振成像证实，且经病理学或细胞学诊断证实为肺癌细胞。MPCE的评价标准：按Weitzman等提出的方法划分心包腔内最大舒张期暗区 < 10 mm时为少量积液，10 mm-19 mm为中量积液， > 20 mm为大量积液，本次研究中入选患者均合并中到大量MPCE。
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Samples were imaged using a confocal laser scanning microscope (Zeiss LSM 700, Germany). For 2.5D and 3D sample imaging, 20× and 10× objectives were typically used. No binning was used. The image resolution was ≈6.4 and ≈3.2 pixels µm−1 in the x–y plane. For the 3D microvessel imaging, ≈250 µm thick sections from the bottom of the vessel lumen were typically imaged by sequential z‐stacks 4 µm apart. For 2.5D or 2D monolayer imaging, ≈15–20 µm thick sections from the bottom of the monolayer were typically imaged by sequential z‐stacks 1 µm apart. The displayed projection images were generated by the maximum intensity projection of acquired z‐stacks.
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辅助化疗是从一个独特的视角去分析和完善早期可手术NSCLC的治疗，它的临床疗效已经被我们所证实和接受，在个体化的治疗原则下还需要进一步努力寻找和发现更好的运用这一治疗手段的方法。目前已经有研究者尝试在原有化疗方案的基础上加用其它一些药物进行术后治疗（如重组人血管内皮抑制素等），这项研究的中期分析显示采用NP联合重组人血管内皮抑制素治疗的患者与接受单纯NP治疗的患者相比，前者有较长的中位无病生存期（21.9个月vs 18个月，P=0.325, 7）。虽然目前尚无统计学差异，但人们对其最终结果寄予了厚望。而靶向药物作为辅助化疗的临床试验尚缺乏成熟的数据，不过我们依旧期待着其能给辅助化疗注入新的活力。
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Before the experiments, the position of the camera (MQ013MG-ON, XIMEA GmbH) was fixed after the focusing. And the plane light source was placed in a proper position so that the edge of the contact radius can be obviously distinguished. The coordinates of the center of the contact area were recorded before the tests. The change of the contact area during the experiments was recorded by the camera with 500 frames per second. Then the video was converted into a series of pictures frame by frame. These pictures was processed in Halcon HDevelop (MVTec Software GmbH) to identify the difference of the gray level near the edge of the contact area to pick up the coordinates of the boundary point. The contact radius as a function of time was obtained by calculating the relative distance between the center and the boundary point.
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Prediction Analysis of Microarray (PAM) of the “pamr” package, implemented in R, was used to develop a prognostic classifier using a training set and the performance of the classifier was tested using independent sets. Data Set 1 was treated as a training set, and Data Sets 2 and 3 were treated as test sets.
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We recently showed that the functional status of a mouse model of amyloidosis is sustained in the presence of a genetic Tyrobp deletion . Moreover, it has been suggested that the microglial- and complement-dependent pathways that prune excess synapses in development are inappropriately activated and mediate synapse loss in AD [20, 28, 29]. Therefore, we hypothesized that the decrease of C1q observed in MAPTP301S mice deficient for TYROBP may also correlate with beneficial effects on learning and memory. We first evaluated spatial learning and memory using the Barnes Maze task on 6-month-old WT, MAPTP301S and MAPTP301S;Tyrobp-/- mice. Both percentages of time spent and distance traveled in the target quadrant (TQ), the location of the hole for the escape box, were higher in WT and MAPTP301S;Tyrobp-/- mice compared with MAPTP301S mice (Fig. 5a, b). Despite that difference, MAPTP301S mice spent >25% of time and distance in TQ meaning that the deficit in these mice at this age is present, albeit subtle. Because approximately 80% of MAPTP301S die by 12–13 months of age , we also assayed 10-month-old mice in the same task. Although the impairment is worsened in MAPTP301S at this age, MAPTP301S;Tyrobp-/- mice spent >60% of time and distance in TQ on the last day of training (Fig. 5c, d). We also tested the mice on the Novel Object Recognition task often used to evaluate working memory, attention, anxiety and preference for novelty in rodents [34, 35]. MAPTP301S;Tyrobp-/- mice spent significantly more time in the novel object area when compared with the time spent in the area of the familiar object, relative to MAPTP301S mice (Fig. 5e, f). Consistent with our previous report in an amyloidosis mouse model of AD , Tyrobp deletion prevents the development of functional and behavioral changes in MAPTP301S mice.Fig. 5TYROBP deficiency enhances Barnes Maze and Novel Object Recognition performances and reduces synaptic impairments. a, b Wild-type and MAPTP301S mice with and without knock-out of Tyrobp were tested at 6 months of age in the Barnes Maze. Training was performed on 4 days with two trials per day, and the percentage of time (a) or distance (b) spent in the target quadrant (TQ) containing the entry for the escape zone is located were measured. c, d Barnes Maze testing was performed in the same cohort at 10 months of age. e, f The same mice used in Figs. 5a–d were tested with the Novel Object Recognition task at 10 months of age. The percentage of time spent in the novel object area (e), as well as the percentage of entries into the novel object area (f) were measured. The dotted lines represent 25 and 50% for Figs. 5 a–d, e–f, respectively. n = 6 (WT), n = 7 (MAPTP301S) or n = 7 (MAPTP301S;Tyrobp-/-) mice per group. Error bars represent the means ± SEM. A two-way ANOVA corrected for multiple comparisons by a Tukey’s post-hoc test was used for Figs. 5a–d. A one-way ANOVA followed by a Tukey’s post-hoc test was used for Figs. 5e, f, *p < 0.05; **p < 0.01; ***p < 0.001. Males and females were used for experiments, and results were combined for analysis. g Input–output relationship measuring basal synaptic function in 11-month-old wild-type (WT; n = 5 mice; 16 recordings), MAPTP301S (n = 5; 16 recordings) and MAPTP301S;Tyrobp-/- (n = 5 mice; 18 recordings) mice. h Long-term depression (LTD) was induced using (RS)-3,5-dihydroxyphenylglyine (DHPG) in mice of the same genotype series described above: WT (n = 5 mice; 8 recordings), MAPTP301S (n = 5 mice; 9 recordings) and MAPTP301S;Tyrobp-/- (n = 5 mice; 9 recordings) mice. Mean values for the first 15’ after DHPG induction or for the last 5’ after DHPG induction are presented in the panels on the right side of the figure. i Synaptically induced long-term potentiation (LTP) over 60 min was induced by high-frequency stimulation in mice of the same genotype series described above: WT (n = 5 mice; 9 recordings), MAPTP301S (n = 5; 9 recordings) and MAPTP301S;Tyrobp-/- (n = 5 mice; 9 recordings) mice. For panels g-i, representative traces are shown on the top. j Western blots for synaptophysin, calcium/calmodulin-dependent protein kinase II (CaMKII) phosphorylated on threonine 286, PSD-95 and GAPDH were performed on extracts of prefrontal cortex from the same cohorts: WT (n = 3), MAPTP301S (n = 5) and MAPTP301S;Tyrobp-/- (n = 5). Extracts were prepared from samples of prefrontal cortex removed prior to slicing for the electrophysiological recordings. Error bars represent means ± SEM. Males and females were used for experiments, and results were combined for analysis. Statistical analyses were performed using a one-way ANOVA followed by a Tukey’s post-hoc test, *p < 0.05; **p < 0.01; ***p < 0.001
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Compared with chitosan, COS has improved physical and chemical properties, including water solubility, low viscosity, non-toxicity, biocompatibility, and biodegradability . Therefore, COS has recently been paid increasing attention from a wide range of research interests, particularly in the field of drugs and foods as food additives, owing to its biological and pharmacological activities such as anti-inflammatory, anti-oxidant, anti-bacterial, anti-tumor, and immune-modulating effects . In view of this study, we demonstrated that COS with the average MW of 5000 Da, which had more AMPK-enhancing effect than those with higher MW in our previous work in IECs, and DD of ~90% ameliorated forskolin-induced cyst swelling in MDCK cyst model via the activation of AMPK, proposing for the first time that COS is a novel class of the AMPK activator in MDCK cells and a potential renal cyst growth inhibitor. The involvement of AMPK and COS-induced inhibition of cyst growth may be addressed by using the AMPK inhibitor compound C or dorsomorphin. In the MDCK cyst model, compound C should be added to investigate whether COS-induced inhibition of cyst growth could be reversed by compound C. However, the limitation of compound C is its specificity to AMPK, as it also inhibits several kinases other than AMPK . As several lines of evidence have capitulated for the anti-inflammatory effect of COS and the suppression of inflammatory processes by AMPK, COS might exert the inhibitory effect on MDCK cyst progression by AMPK-mediated anti-inflammatory activities . Previously, we have reported that COS stimulates the activation of AMPK and inhibits nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) in intestinal epithelial cells . In addition, COS has been shown to attenuate tumor necrosis factor alpha (TNF-α)-induced inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) expressions in synoviocytes . It is possible that the inhibitory effects of COS via AMPK activation might be relevant to NF-κB or other downstream proteins of TNF-α. However, in our setting, we used forskolin, which mediates the AC/cAMP/protein kinase A (PKA)/cAMP response element-binding protein (CREB) signaling cascade, separately from the NF-κB-induced inflammatory pathway.
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Studien bestätigten nicht nur eine statische, sondern auch geschlechterspezifische longitudinale Entwicklung der Mediennutzung . Es veränderte sich neben der Medienfrequenzerhöhung auch die Affinität zu präferierten Geräten, da mit steigendem Alter Kompetenzen zur Nutzung weiterer Technologien ermöglicht wurden . Als Konsequenz ist ersichtlich, dass der Einbezug des Geschlechtes und des spezifischen Alters für den Einsatz digitaler Maßnahmen von Interesse ist. Dies spiegelt sich in den Empfehlungen der DAG-Leitlinien für die analogen Behandlungsweisen. Hier wird für effektive Gewichtsveränderungen auf die Berücksichtigung der geschlechterspezifischen Interessen und körperlichen Voraussetzungen hingewiesen .
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Another possibility for doping is that the matrix material, rather than the QDs, is doped by the impurity atoms and that this then provides free carriers which are captured by the QDs. This 'modulation doping' mechanism is commonly used in III-V nanostructures. But in III-Vs, the barrier height is typically only a few 100 meV and hence ionisation of dopant atoms is relatively easy . In the dielectric matrices used in the Si QD work (particularly for the SiO2 barriers), the barrier height is several electronvolts. Under these circumstances, there would be no ionisation of dopant atoms at room temperature and hence modulation doping could only occur by direct tunnelling of carriers from dopants in SiO2 less than 1 nm from the QDs.
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The high-level looks at the state representations (nodes) in the PC-GWR network and learns a policy πH over these nodes (subgoals) to select the subgoal for the low-level policy to complete. QH(s,g;θH) measures the maximum total discounted extrinsic reward re received by choosing subgoal g in state s while following the policy πH. The extrinsic reward re is received from the environment and is the objective to be maximized by the entire navigation policy.
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Die Idee, Russland solle sich politisch wie ökonomisch stärker nach Osten orientieren, ist nicht neu. Bereits in den 1990er Jahren sprach sich der damalige Außenminister Jewgeni Primakow dafür aus, vor allem den Sicherheitsdialog mit China und Indien zu intensivieren und ein sogenanntes strategisches Dreieck Moskau-Peking-Neu-Delhi aufzubauen (Kommersant 1996). In den Folgejahren betonten auch der russische Präsident Wladimir Putin und Mitglieder seiner Regierung immer wieder, wie wichtig für Russland gute Beziehungen zu den aufstrebenden asiatischen Mächten, allen voran China, seien (Putin 2012a; Lawrow 2006). Das Projekt erhielt mit Russlands politisch-militärischem Eingreifen nach dem Kiewer Euromaidan im Jahr 2014 und den sich anschließend massiv verschlechternden Beziehungen zu den westlichen Staaten für Moskau eine neue Relevanz und Dringlichkeit. Es zeigt sich allerdings, dass das innenpolitische Ziel, die ökonomische Entwicklungsdynamik Asiens für eine nachhaltige regionale Entwicklung zu nutzen, bisher nicht erreicht werden konnte. Außenpolitisch sind im Verhältnis zu China durchaus Fortschritte zu verzeichnen, auch wenn vorerst offenbleiben muss, als wie nachhaltig sich diese tentative Annäherung angesichts konkurrierender Integrationsprojekte für die Region erweisen wird.
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En México, el servicio amigable es gratuito. Sin embargo, se presentaron casos en que trámites como, cobro y requisitos de afiliación representaron una barrera. El cobro por el servicio es una barrera importante muy documentada para el acceso a los servicios de salud16. Si los adolescentes incurren en costos por el uso de los servicios, esto reduce las probabilidades de que vuelvan a utilizar el servicio o a solicitar métodos anticonceptivos. Adicionalmente, los adolescentes evitan utilizar servicios a través del seguro médico familiar, por temor a que sus padres se enteren 5 .
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A hipercolesterolemia familiar (HF) é uma doença autossômica codominante associada a níveis elevados de LDL-colesterol e a doença cardiovascular aterosclerótica prematura.1 A condição é pouco reconhecida e devem ser implementadas ferramentas de rastreamento para melhorar o diagnóstico e promover o tratamento precoce.2 Os métodos de triagem incluem triagem universal, seletiva, em cascata, cascata reversa e triagem oportunística;3,4 no entanto, em cidades pequenas de certas regiões, onde o efeito fundador pode estar presente, a busca por novos casos a partir de indivíduos afetados pode ser uma opção interessante. O HipercolBrasil é um programa de rastreamento genético em cascata realizado no Instituto do Coração, com mais de 2.000 pacientes identificados com variantes patogênicas5 e, a partir desses resultados, foram selecionados casos índices (CI) de pequenas cidades com variantes patogênicas para amplificar a cascata. O programa realiza testes genéticos para HF em indivíduos com LDL-C ≥ 210 mg/dL confirmados em duas análises separadas: (CI)6 e em parentes de primeiro grau daqueles nos quais foram identificadas variantes patogênicas ou provavelmente patogênicas.
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Los Equipos de Tratamiento Asertivo Comunitario (ETAC) se desarrollaron en EEUU en los años 70, con el objetivo explícito de ofrecer soporte comunitario de muy alta intensidad para pacientes graves dados de alta de unidades hospitalarias [2, 3]. Su objetivo fundamental es el de mantener a los pacientes en contacto con los servicios, evitar abandonos de tratamiento, mejorar la integración comunitaria y evitar hospitalizaciones. Los ETAC se han impuesto como modelo estándar de asistencia comunitaria de alta intensidad para personas con enfermedad mental grave en buena parte de los países con sistemas sanitarios de atención a la salud mental avanzados . En el estado español, los ETAC se han ido implantando de forma progresiva en diversas comunidades, implantación liderada por los Servicios Asturianos de Salud Mental desde hace más de diez años. El llamado “modelo Avilés”, localidad pionera en el desarrollo de este tipo de servicios, ha sido reconocido como ejemplo de buenas prácticas en la Estrategia en Salud Mental del Sistema Nacional de Salud.
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Pre-clinical data suggest that disruption of the LRT microbiota precedes chronic lung epithelial injury and repair [7, 10], potentially perpetuating inflammation . Bacterial load is currently the LRT microbiota feature most consistently associated with disease, in terms of progression, exacerbations and mortality. Bacterial load is higher in IPF patients than in healthy subjects, making it a potential therapeutic target . Although antimicrobial treatment with doxycycline or co-trimoxazole in addition to standard care did not improve time to death or nonelective hospitalisation , the effects of microbiome alterations by disease or drug treatment are poorly understood.
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Nosotros hemos demostrado que consumir el L. mutabilis mejora la sensibilidad del receptor de la insulina y consecuentemente disminuye los niveles de glucosa en sangre en pacientes con DM2 42,43. Estos estudios también demostraron que el consumo de L. mutabilis crudo (3.1 mg/kg) por jóvenes saludables no modificó las concentraciones ni de glucosa ni de insulina, en tanto que en personas con disglicemia disminuyó las concentraciones séricas de glucosa e insulina 42, mientras que el consumo de L. mutabilis cocido (2.5 mg/kg) a pacientes recientemente diagnosticadas de DM2 disminuyó significativamente las concentraciones de glucosa e insulina 43, lo que demuestra que el efecto hipoglucemiente de L. mutabilis cocido es mayor que el consumo de lupinus crudo (14.3% vs 5.9%) 43. el consumo de L. mutabilis cocido no causó efectos adversos, y es importante para la población de la región Andina, principalmente en Bolivia, Ecuador, y Perú, donde el consumo de L. mutabilis desamargado por cocción es común y bien aceptado.
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Data were extracted from a paper based QA/QI tool and entered into a Microsoft Access (Microsoft Corp., Redmond, USA) database for data management and exported to Microsoft Excel, Statistical Package for Social Sciences software version 21(SPSS Inc., Chicago, USA) and STATA version 12 (Stata Corp., College Station, Texas, USA) for analysis.
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În medii concentrate, prezenţa interacţiilor intra-moleculare (în special al moleculelor cu greutate moleculară mare), afectează dimensiunea ghemului polimeric. Molecula condroitinei sulfat în interacţie cu NaHA va influenţa conformaţia şi dimensiunea ghemului polimeric. Lanţurile hialuronatului pot forma o conformaţie expandată comportament tipic unui polielectrolit anionic flexibil.
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La frecuencia de positividad para VIH sigue siendo alta en personas en contexto de mayor riesgo (Tabla 1), similar a la reportada para Colombia en estas poblaciones 4,7,8. Para el grupo de personas no tradicional de riesgo, la positividad para VIH fue superior al estimado nacional en población general 2. Estos resultados evidencian la necesidad de orientar estrategias diferenciadas en las poblaciones que promuevan la continuidad en los esfuerzos de prevención en VIH que se han venido adelantando en el país.
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In the modified pole test the mice were placed with their head downwards onto a rough-surfaced pole. With a scoring system from 0 to 3 (0 = ntg-like, 1 = altered locomotion, 2 = sliding down the pole, 3 = falling down the pole), their locomotion and grip strength were analyzed. The test was repeated three times, and the score sum was built. The pole test was performed weekly from the age of 7 weeks to 20 weeks.
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We used the K/BxN serum-transferred model of inflammatory arthritis. This model allows consistent induction of distal, symmetric polyarthritis when serum from T cell receptor transgenic, spontaneously arthritic K/BxN animals is injected intraperitoneally into recipient mice. Like rheumatoid arthritis in humans, the K/BxN serum-transferred arthritis causes inflammation due to IgG autoantibodies present in the serum14. Evaluation of the model in mice not exposed to US revealed considerable swelling in the ankles and paws in the days following serum transfer before naturally declining as the transferred antibodies were catabolized (Supplementary Fig. 1). Ankle thickness changes were measured with a caliper, and composite clinical scores were determined based on the established method of assessing rodent arthritis severity on a 0–12 scale; in brief, each paw was assigned a clinical score between 0 and 3, with 0 indicating no swelling as described in Methods15,16. Change in bodyweight was also monitored over the course of the study.
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poprzedzone było instrukcją: zaznacz znakiem X jedną kratkę w każdym wierszu, a każde stwierdzenie miało kategorie odpowiedzi: wcale; od 1 do 3 dni; od 4 do 6 dni; od 7 do 14 dni; od 15 do 28 dni. Dla potrzeb analiz kategoriom tym przyporządkowano odpowiednio od 0 do 4 punktów. Odpowiedzi zostały wykorzystane do opracowania indeksu sumarycznego przyjmującego zakres od 0 do 12 punktów. Im wyższy wynik uzyskany na skali, tym częściej badana młodzież odczuwała dolegliwości somatyczne w ciągu ostatnich 4 tygodni. Dokonano podziału na trzy kategorie w zależności od częstości odczuwania dolegliwości somatycznych: rzadko (0-1 punkt); przeciętnie (2-6 punktów); często (7-12 punktów).
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Details of the index SNP at each locus with conjunctional FDR < 0.1 are given in S1 Table. Locus 1 is intragenic in PHACTR1 (encoding phosphatase and actin regulator 1 protein), and is the strongest shared risk locus between migraine and CAD in the analyses based on either C4D or CARDIoGRAM (conjunctional FDR for index SNP = 3.50 x 10−5 and 3.90 x 10−5, respectively). The top SNP rs9349379 is associated with the expression of PHACTR1 in various arterial tissues (Table 2). Locus 2 is intragenic in KCNK5, a gene encoding a two-pore domain potassium channel (conjunctional FDR = 0.021 and 0.065 in C4D or CARDIoGRAM, respectively). Locus 3 is intragenic in AS3MT, that encodes arsenite methyltransferase. The locus shows cross-phenotype association between migraine and CARDIoGRAM (conjunctional FDR for index SNP = 0.044; not available in C4D). Top SNP rs10786719 is an eQTL for AS3MT in heart and adrenal gland, and in cerebellum for nearby gene ARL3 (ADP-Ribosylation Factor-Like Protein 3), the SNP being located 204 kb upstream from this gene (Table 2). Previously reported genome-wide significant associations at each of the three loci are given in S2 Table.
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The herbal treatment is a well-known treatment modality since the infancy of the humanity. It is used worldwide and in the Sudan, it is part of the local culture and religious beliefs (unpublished data). The WHO had estimated the prevalence of herbal and other non-conventional treatment as 70–80% . In the Sudan, herbal treatment is more popular than the conventional treatment in many communities and that is due to social believes, the massive lack of health education, scarcity of medical and health facilities in remote areas, transport difficulties and financial constraints.
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Com base nessas observações, este estudo teve por objetivo avaliar a associação de diagnóstico de MAC ao nascimento e morte por MAC no primeiro ano de vida com o índice de desenvolvimento humano (IDH) e a disponibilidade de recursos humanos tecnológicos para o diagnóstico e tratamento de MAC por macrorregião brasileira.
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Les études recensées montrent un taux élevé des ISO dans les hôpitaux allant de 6,80% à 26% en Afrique Subsaharienne (Tableau 1). Elle était plus élevée au Nigeria avec une incidence de 25,2% (n=5800). L’incidence poolée des ISO était de 14.8% (intervalle de confiance (IC) à 95%: 15.5-16.2%)tous pays confondus(Figure 2). Une importante hétérogénéité de l’incidence était observée selon le type de spécialité avec une incidence des ISO de 19,1% (IC 95%: 18,2-19,9%) en chirurgie générale et viscérale, de 14,8% (IC 95%: 11,3-18,3%) en orthopédie et de 8,6% (IC 95%: 7,4-9,8%) en gynécologie obstétrique. L’incidence des ISO était supérieure lorsque des données microbiologiques de surveillance étaient disponibles24, 5% (IC 95%: 23,5-25,5%) et 8,2% (7,3-9,2%) en l’absence de données microbiologiques (Figure 3, Figure 4). Ceci est à l’origine des surcoûts liés à la prise en charge postopératoire, à une morbi-mortalité élevée et peut altérer l’image des formations hospitalières. A l’opposé, les progrès faits en matière de surveillance des infections nosocomiales dans les pays développés ont permis de réduire son incidence. On retrouve par exemple en France des taux de 1,16% (en 2007 et 2008) à 1 % (en 2009 et 2010) et continue à baisser grâce à la surveillance continue . Mais aussi en Afrique du Nord, des taux plus bas sont retrouvés; par exemple une incidence de 5,2% au Maroc . Même si des études similaires ont généralisés les infections nosocomiales en chirurgie sans spécificité sur les ISO [23, 24], son incidence est toujours le plus élevé. L’hétérogénéité de l’incidence selon la spécialité est expliquée par des niveaux de risque et de propreté différente avec une incidence supérieure en chirurgie générale et digestive qui est plus fréquemment une chirurgie contaminée (Figure 4). L’hétérogénéité des taux d’ISO selon la présence de données microbiologiques ou non souligne l’apport des informations bactériologiques dans la prise en charge du patient mais aussi pour l’estimation précise de l’incidence. Une méta-analyse similaire en chine sur 84 articles sélectionnés avait trouvée une incidence moyenne des ISO de 5% (95% CI: 3.1-5.8) entre 2001 et 2012. La stratification par spécialité chirurgicale a montrée une incidence élevée en chirurgie abdominale (8.3%, 95% CI: 6.5-10.0) .
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Expression of known marker genes in clusters of 3 brain regions, ACC (anterior cingulate cortex), MTG (middle temporal gyrus) and VISp (primary visual cortex). A Boxplot representing the average expression of cluster genes related to specific cell types (known marker genes); box plots showing median, interquartile range (IQR) with whiskers adding IQR to the 1st and 3rd quartile. Y-axis represents normalised gene expression, x-axis represents known marker genes of brain cell types, oligodendrocytes, astrocytes, OPC, microglia and neurons. B Donut plot displaying the composition of top 20 DE genes in comparison to known marker gene list (yellow-astrocytes, orange-microglia, pink-oligodendrocytes, grey-others). C Feature plot to visualise the expression of known marker gene related to specific cell types on tSNE plot. Expression of astrocytes (ADGRV1), oligodendrocytes (MOG) and microglia (P2RY12/ CX3CR1) across different clusters are also shown
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In the initial grip test (pre-match 1), the players showed values of 49.1 kg in the dominant hand and 44.6 kg in the non-dominant hand (Table 2). These values are similar to the values reported for wheelchair basketball, being near to 45 kg , and for racket sports such as tennis (50 kg) or badminton (44–47 kg) . The influence of the match on the handgrip strength has been studied in other racket sports, such as badminton, with different results . In the study of Abián-Vicent et al. , measurements were conducted in official competitions with a duration between 34 and 42 min, and no decrease in hand strength was observed. On the contrary, in the study by Phomsoupha et al. (2019) , a decrease in hand strength was found after 60 min of simulated matches. The differences in the results found between both studies could be due to the playing time; in Phomsoupha et al.’s (2019) study, the strength values decreased after 50 min. This suggests that players are able to maintain a high level of isometric strength for the duration of a classic match lasting less than 35 min . A typical duration of a high-level WT match is 60–70 min longer than that of a badminton match, resulting in a probable decrease in hand strength in players in WT matches of a typical duration. The pre-match strength values in the dominant hand decreased throughout the matches, showing differences between the first and fourth matches (p = 0.045; ES: 1.04). The hand strength values decreased by 4.6% between the first and third matches and 6.4% between the first and fourth matches. Keeping high levels of hand strength is important for several reasons. On the one hand, forces applied on the rims determine both the velocity and direction of locomotion , and the low effectiveness of force application could result in an ineffective push technique, as well as acting as a possible cause of injury . On the other hand, previous studies have shown a grip strength correlation of 0.58 with service speed . The serve is one of the most important strokes in the modern game , and an increasing serve speed reduces the time required for the opponent to successfully return the ball and increases the probability of the server’s dominance in the rally or of winning a direct point . In addition, previous studies have shown a significant reduction in service speed (−1.8 m·s−1) after prolonged matches (3 h) . Although the present study did not record service speeds, it can be assumed that there may be a negative influence on the hitting speed due to a decrease in dominant hand strength.
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Сегодня многими ПЭТ воспринимается как более современная технология радиоизотопной диагностики, чем ОФЭКТ. Некоторые даже считают, что ПЭТ по этой причине со временем вытеснит ОФЭКТ из клинической практики. Это в корне ошибочное представление. Метод ПЭТ действительно обладает более высокой чувствительностью и разрешающей способностью визуализации, однако по специфичности методы значимо не различаются. При этом ПЭТ, например, не может быть использована для дозиметрического планирования и оценки эффективности радионуклидной терапии, это «юрисдикция» ОФЭКТ. Не уходя в глубины сравнительного анализа, хочется прояснить, что это комплементарные методы молекулярной визуализации, прекрасно дополняющие и развивающие друг друга, особенно в концепции радиотераностики.
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Therefore, most of the commercial solution-diffusion membrane units contain polymeric materials , which can be divided into rubbery and glassy polymers. While glassy polymers show very attractive separation characteristics, rubbery polymers show comparably low selectivity with high permeability for common gas pairs such as O2/N2, H2/CH4, CO2/CH4, etc. . Of the glassy polymers, polyimides have been found to be very promising as membrane materials because they not only have better separation characteristics than the commonly used ones (e.g., polycarbonates) but also offer good thermal and chemical resistance and are easy to process . Additionally they can be easily functionalized and therefore customized for any given separation problem.
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On the molecular level, we could detect differential expression of Ceacam1 not only in bone marrow derived osteoclast progenitors, but also in the pure macrophage cell line RAW264.7, providing a potential explanation for the increased osteoclast formation in Ceacam1-deficient mice. Since the formation of mature osteoclasts primarily depends on RANKL-induced activation of key transcription factors and the subsequent expression of several osteoclast marker genes, we monitored the expression of NF-κβ, Nfatc1, Acp5, Tmf7sf4, Tnfrsf11a, c-Fos, and Calcr during osteoclastogenesis in bone marrow cells derived from WT and Ceacam1-deficient mice. While indicators of mature osteoclasts, including Calcr and Acp5, were found to be expressed at similar or only temporarily elevated levels compared to WT controls, respectively, increased expression of Nfatc1 in Ceacam1-deficient cells was found at day 4 and 7 of osteoclast differentiation. As this coincided with the induction of monocyte/macrophage fusion into mature osteoclasts by the addition of RANKL to these cultures, it appears tempting to speculate that CEACAM1 may modulate osteoclastogenesis through the regulation of NFATC1, the master transcription factor required for osteoclast differentiation. Although a previous study reported a stimulatory effect of a short splice variant of CEACAM1 on the expression of Nfatc1 in CD4+ T cells , further research is necessary to elucidate the influence of CEACAM1 on the regulation of this transcription factor specifically in osteoclasts and myeloid-derived cells. This is of particular importance, as the liver-specific inactivation of Ceacam1, characterized by hyperinsulinemia and glucose intolerance, results in decreased osteoclastogenesis . Thus, it appears that the impact of global Ceacam1 deletion, including cells of the osteoclast lineage, is dominant over the effects of hepatic Ceacam1 expression on bone metabolism.
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Control y mitigación: intervención que se aplica cuando la infección en la población alcanza la fase de epidemia o pandemia. El objetivo es proveer cuidado oportuno y de calidad a los pacientes que lo necesiten, mitigar o reducir el impacto de la enfermedad y reducir su incidencia, morbimortalidad, así como las alteraciones secundarias de los sistemas económicos, sociales y políticos.
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Some S. aureus strains often contain in their genomes virulence genes that are not found in all strains and that may be carried on discrete genetic elements. Genome analyses revealed that there are different sets of genes encoding different virulence factors in S. aureus, as many of these genes are located in pathogenicity islands wherein genes are translocated by horizontal genome transfer (HGT) via phage transduction, conjugation or by direct uptake of naked DNA by genetic competence. The presence/absence of certain genes on the pathogenicity island of any strain may be a consequence of unique horizontal gene transfer events that occurred within specific S. aureus lineages; in this way, a non-virulent strain may become pathogenic. As all staphylococci, not only S. aureus, may contain similar genes or ability to acquire genes from related species by a horizontal gene transfer (HGT) process, thus, CoNS also become increasingly infective. Therefore treatment of infections caused by CoNS is becoming more and more difficult due to the growing rates of resistance to antibiotics and virulence
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All the study protocols were approved by the Institutional Review Board of Pusan National University Hospital. Informed consent was obtained from all patients and their parents. The palatine tonsils were obtained from four patients with chronic tonsillitis. Tonsil tissues were washed with phosphate-buffered saline (PBS) followed by the digestion in 0.075% collagenase type I (Sigma-Aldrich, St. Louis, MO, USA) at 37 °C for 30 min. After the neutralization of enzyme activity with alpha-modified Eagle’s medium (α -MEM) containing 10% fetal bovine serum (FBS), the sample was centrifuged and the pellet was filtered through a 100-μm mesh. Cells were incubated overnight in control medium (a-MEM, 10% FBS, 100 U/mL penicillin, and 100 mg/mL streptomycin) and the attached cells were maintained after washing with PBS. To induce cellular senescence, etoposide (Sigma-Aldrich, St. Louis, MO, USA), one of FDA-proved chemotherapeutic agent, was treated at low concentration (100 nM and 200 nM) for 48 to 72 h. Replicative senescence of MSCs was also induced by repeated subculture every 3-4 days when the cells reach 80% confluence (by passage 24). For the present study, MSCs derived from tonsil tissues of two different donors were used.
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DNA samples were subjected to a first PCR with primers LLW1 y LLW2 , which amplify a region within the BamHI W fragment repeated in tandem in the EBV genome . The PCR mix (50 μL) contained 200 ng of template DNA, 200 μM of dNTP mix, 2.5 mM of MgCl2, 5 μL of Taq Polymerase buffer 10× with (NH4)2SO4, 200 nM of each primer, and 2.5 U of Taq Polymerase (buffer and polymerase from Thermo Fisher Scientific, Waltham, MA, USA). The PCR reaction was: an initial denaturation step of 5 min at 94 °C and then 30 cycles of 94 °C for 1.5 min, 57 °C for 45 s and 72 °C for 1 min, and a final extension of 72 °C for 7 min.
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Selon l'Organisation Mondiale de la santé (OMS) : « le partogramme est l'enregistrement graphique des progrès du travail et des principales données sur l'état de la mère et du foetus » . Dans le cadre de son programme de santé maternelle et maternité sans risque et dans le but d'uniformiser les différents graphiques et afin d'en généraliser rapidement leur adoption, l'OMS a établi en 1988 un modèle de partogramme inspiré de nombreux travaux [2, 3]. C'est un outil clé pour le suivi de l'évolution du travail et d'accouchement. Il permet la synthèse des éléments de la surveillance materno-foetale et de détecter précocement les anomalies du travail, facilite la prise de décision et la communication entre les professionnels .Par ailleurs il s'agit d'un document médico-légal, d'un support pour l'enseignement, pour la recherche clinique et l'évaluation des pratiques professionnelles. Par conséquent, la qualité de sa tenue est primordiale. Nos objectifs étaient d'évaluer la conformité de la tenue du partogramme au sein de la maternité du CHU Ibn El Jazzar de Kairouan et de proposer des axes d'amélioration de la qualité de sa tenue.
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Written informed consent was obtained from all subjects participating in the study. The study was conducted in full compliance with the Declaration of Helsinki, and the protocol of the present study was approved by the ethical review board at Umeå University, Umeå, Sweden (Dnr 2014-361-31M and Dnr 2015-45-32M).
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Thus, whereas lexical triggering is observed in corpus research, the evidence on lexical triggering in sentence production experiments is a bit scarce and mixed. One factor that could play a role is the extent to which code-switched responses are internally generated versus externally induced (cf., Gullberg et al., 2009). In Kootstra et al. (2012) participants were indeed forced to produce code-switched sentences yet were free to choose how to code-switch. Thus, the responses in Kootstra et al. (2012) study could be regarded as internally generated, similar to corpus data. In contrast, Bultena et al. (2015) explicitly instructed participants to switch according to the sentence presented to them, which is less like corpus data. Another factor that may have played a role is that Kootstra et al. used noun cognates, whereas Bultena et al. focused on verb cognates. As made clear in another study by Bultena et al. (2013), effects of noun cognates tend to be stronger than those of verb cognates. Thus, it may well be that lexical triggering only emerges under specific circumstances and with specific types of words. An important goal of this study is to examine these possible circumstances and words in more detail.
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Voor het doel van dit onderzoek was geen gevalideerde vragenlijst beschikbaar en daarom is er gebruikgemaakt van een zelfontworpen vragenlijst. De vragenlijst is opgesteld en beoordeeld op begrip door mensen met lage gezondheidsvaardigheden. Daarna is de vragenlijst getest door medewerkers van het ZGT en mensen met DMT2. De huidige wetenschappelijke onderzoeken streven ernaar om er meer respondenten bij te betrekken. Het zou een goede investering zijn om een vragenlijst over wensen voor participatief onderzoek te ontwikkelen en te valideren, zodat onderzoek kan worden gedaan naar de bereidheid en wensen van mensen om te participeren. Verder zou naast kwantitatief onderzoek ook kwalitatief onderzoek moeten worden gedaan. Op die manier kan diepere informatie verkregen worden over manieren en momenten waarop mensen betrokken willen worden. Daarbij kunnen specifieke vragen opgenomen worden om meer te weten te komen over mensen met bijvoorbeeld lage gezondheidsvaardigheden.
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The f-scores shown in Table 3 confirm that SVM, MLP1, and NB improve over MLP2 regardless of RCV number of folders. An F-test carried out over these results confirms (p<0.01) that the performance differences between predictive models are statistically significant. Ensuing specific one-sided t-tests comparing each pair of modeling approaches confirms that SVM, MLP1, and NB perform significantly better than MLP2. The AUC results in Table 3 confirm that NB is significantly better than the remaining approaches (F-test p<0.01, pairwise t-test p <0.001). However, the superiority of NB relative to MLP1 is less pronounced (pairwise t-test p<0.05). Notice that statistical significance is due also to small standard deviation of the results; if we consider the mean performance values, we can assert that SVM and NB show comparable performances.
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There is increasing evidence that the activity of CYP is decreased in cancer. In a small study of patients (n=16) with advanced cancer (Williams et al, 2000), all individuals had normal CYP2C19 genotype but 25% of these patients were CYP2C19 PM phenocopies. However, the mechanism behind this genotype–phenotype discordance was not investigated. Previous studies have demonstrated that the activity of a different enzyme, CYP3A4, is also decreased in advanced cancer patients and that the decreased activity correlates with inflammatory response (Rivory et al, 2002). An inverse relationship between plasma cytokine (TNF-α and IL-6) concentrations and CYP2C19 activity has been demonstrated in patients with congestive heart failure (Frye et al, 2002). Moreover, CYP2C19 mRNA expression is reported to be downregulated by cytokines in human hepatocyte in vitro cultures (Aitken and Morgan, 2007). Hence, limited evidence indicates that advanced cancer patients may have decreased capacity to metabolise certain chemotherapeutic agents due to decreased CYP activity.
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Die Akutversorgung einer Nadelstichverletzung umfasst auch eine Risikoanalyse mit Untersuchung der Indexperson. Diese Untersuchung ist jedoch nicht Voraussetzung zur Nachsorge der verletzten Person; eine Aufklärung und Einverständnis werden empfohlen . Sofort nach dem Übertragungsereignis sollten folgende Serologien aus dem Blut der Indexperson bestimmt werden:HBsAg und Anti-HBc (Anti-HBs) nur, wenn bei der verletzter Person kein sicherer HBV-Immunschutz besteht,Anti-HCV oder HCV-NAT bei positiver oder bei unzureichender antiviraler Behandlung der Indexperson sowie bei immundefizienter Indexperson (und)HIV-Screeningtest der 4. Generation oder Bestimmung der Viruslast mittels HIV-NAT bei positivem Indexpatienten .
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A inclinação da queda máxima da SpO2 teve uma correlação moderada negativa com o tempo para atingir a SpO2 mínima (r = −0,467; p < 0,001), com o tempo para uma dessaturação de 4 % (r = −0,437; p < 0,001) e com o menor valor da SpO2 (r = −0,393; p < 0,001). A distância caminhada no TC6 (DTC6) não apresentou correlações significativas com a SpO2 e suas variações e nem com o VEF1%.
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Le retard diagnostic du TB est bien établi. Plusieurs diagnostiques peuvent masquer le trouble conduisant à un retard de prise en charge. Ces données devraient alerter les psychiatres pour favoriser un meilleur dépistage de la manie et de l'hypomanie qui reste les éléments clés du diagnostic de TB, garant d'une instauration de traitements appropriés dans les délais optimaux.
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影像学检查是诊断肺部转移瘤的主要手段，文献报道PMBL转移瘤主要表现为双肺实性结节。Horstamann等回顾性总结了23例PMBL患者的影像学检查发现最常见的为双肺多发性实性结节（16例，70%），少数可有分叶或空洞，其次为单侧多发性肿块（4例，17%），而单侧肿块较少（3例，13%），罕见粟粒样弥漫性病变。北京协和医院冯敏等报道6例患者中有1例患者为囊性肿块。本院资料中有1例患者右肺上叶肿块直径约4 cm，伴偏心性空洞。BML转移可发生于全身多处部位，包括皮肤、骨盆、腹部、大网膜、下腔静脉等处，但以肺和淋巴结多见。本组资料中有一例患者双肺多发性结节同时伴有左肾转移，于呼吸内科反复行肺穿刺活检细胞学检查未能明确诊断，后经胸腔镜下活检病理及免疫组化检查诊断明确。因此在临床工作中发现双肺多发性实性肿块甚至伴全身其余部位转移灶或者伴有空洞时，不能盲目诊断为肺癌或非特异性感染病灶，应考虑该病可能，仔细询问病史，尤其是否有子宫肌瘤病史。
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Em metanálise incluindo oito estudos com pacientes acompanhados após uma SCA, o GDF-15 foi considerado um forte preditor de mortalidade com risco relativo (RR) de 6,08 (IC 95%: 4,79-7,71; p < 0,001) e reinfarto não-fatal, com RR de 1,76 (IC 95%: 1,49-2,07; p < 0,001). 24 Uma metanálise mais recente com 13 estudos e um total de 43 547 pacientes com SCA corrobora esses resultados: RR para mortalidade de 6,75 (IC 95%: 5,81-7,84; p < 0,001) e para reinfarto não-fatal 1,95 (IC 95%: 1,72-2,21, p < 0,001). 25
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Postoperative pain management. Comparison of proportion of patients receiving postoperative pain medication (subgraphs) at different time points between patients who underwent elective cholecystectomy (white bars) and patients who underwent emergency cholecystectomy (grey bars). For readability purpose, p values of > 0.05 not displayed. Subgraphs: a) Paracetamol b) Metamizole c) IV/SC morphium d) Tramadol e) Oxycodone (Oxynorm®) f) Oxycodone (Oxycontin®). RR – recovery room, IV – intravenous, SC – subcutaneous
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Knockdown of SNHG4 inhibits cell proliferation, migration, invasion, but promotes cell apoptosis in RCC cell lines. a qRT-PCR assay analysis of the level of SNHG4 in 769-P and ACHN cell lines after transfection with two parallel siSNHG4 (siSNHG4#1 and siSNHG4#2) or siSCR. b, c CCK-8 assay (b) and Western blot assay (c) analysis of the proliferative ability of 769-P and ACHN cells transfected with siSNHG4#1 or siSCR. d The activity of caspase-3, -8, and -9 assay analysis of cell apoptosis of RCC cell lines after transfection with the indicated vectors. e The wound healing assay analysis of cell migration in 769-P and ACHN cell lines after transfection with the indicated vectors. f, g The transwell assay without (f) or with (g) matrigel analysis of cell migration and invasion in 769-P and ACHN cell lines after transfection with the indicated vectors. Data are presented as mean ± standard deviation from triplicate experiments. A t-test was used to evaluate the statistical significance as compared to the control. SCR: scramble; RCC: renal cell carcinoma. *P < 0.05; **P < 0.01; ***P < 0.001
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Micromasses were fixed in 4% buffered formalin and rinsed twice in PBS. Next, the micromasses were processed and embedded in paraffin. After preparation, 5-µm-thick sections were stained with HE, MT, PR and AB. The results are shown in Figure 4. HE shows the production of cartilage matrix in pinkish and bluish staining (high amount of proteoglycans), and cell nuclei appear in blue. Collagen production is shown by MT in blue staining that permeated all the sections in red; the cells contained black nuclei. In PR-stained sections, collagen appears pale yellow to light brown; when several collagen fibers aggregate, they appear red. Glycosaminoglycans (GAGs) appear light blue with AB staining.
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A definição de cardiotoxicidade subclínica continua sendo um desafio também para a população infantojuvenil. Alguns estudos relatam alterações segmentares mesmo antes da queda do strain global longitudinal, o que tem levantado a atenção quanto à maior acurácia desse método na detecção precoce de disfunção miocárdica. As atuais recomendações internacionais consideram a queda percentual de 15% do strain global longitudinal, comparados com os valores iniciais (basais), como indicativa de disfunção subclínica, desde que em condições hemodinâmicas comparativamente semelhantes. 239
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Access to the underlying data stores and services within the MIDAS Platform is managed by a local LDAP server (running OpenLDAP), although this could be replaced with a user-specific local server or a centralized server (e.g., Active Directory) within a pilot site. This provides role-based access to the user applications as well as HDFS and Hive. Access to data within HDFS can be limited to a specific user-group or MIDAS applications, for instance, restricting access to the raw data to a pre-processing group of users or the GYDRA application.
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From the obtained displacements, the corresponding strain components were derived. The longitudinal strain (εyy) was defined as strain occurring in direction of the applied load. Transverse strain (εxx) was defined as strain measured in a direction perpendicular to the applied load. The shear strain (εxy) was defined as strain occurring in a direction angulated 45° to the longitudinal and transverse strain.
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Os resultados da avaliação de capacidade funcional são apresentados na Figura 1 . Na população geral do estudo, houve diferenças significativas entre os grupos (p<0,001). Pacientes com a forma indeterminada da doença de Chagas tinham VO2pico semelhante aos dos sujeitos saudáveis. Pacientes com CCH e função cardíaca preservada apresentaram uma redução significativa da capacidade funcional em relação aos participantes saudáveis e os pacientes com doença de Chagas na forma indeterminada (p<0,001 para ambos), com médias de diferenças de 15,7 mL.kg.min (IC 95% 10,5 – 20,8) e 16,1 mL.kg.min (IC 95% 11,6 – 20,6), respectivamente. Por último, pacientes com CCH dilatada tiveram VO2pico mais baixo em comparação a sujeitos saudáveis e pacientes na forma indeterminada (p<0,001 para ambos), com médias de diferenças de 20,0 mL.kg.min (IC 95% 13,3 – 26,6) e 20,3 mL.kg.min (IC 95% 14,2 – 26,5), respectivamente. Não houve diferenças de VO2pico entre pacientes com CCH dilatada e com CCH e função cardíaca preservada (p=0,467).
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Martins et al.28 verificaram que fatores correlatos adversos para a prática de atividade física não estavam associados aos comportamentos sedentários em adolescentes. Esses resultados sugerem que a exposição excessiva aos comportamentos sedentários não decorre necessariamente de condições adversas para a prática de atividades físicas (menor percepção de autoeficácia, menos apoio social e ambientes prática de atividade física).
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The development of an autonomous and in situ ocean environmental monitoring system is of high priority in oceanographic research . Optofluidics bring new ideas for the miniaturization of detection systems and has been increasingly considered as a powerful technology to realize ocean environmental monitoring. At present, although a few integrated systems based on optofluidic platform have been reported, a detailed review on its applications on ocean environmental monitoring is absent. Here, we describe the optofluidics-based autonomous monitoring of nutrients, pH, DO, and heavy metals in oceans, with a focus on their principles, sensing properties, advantages, and disadvantages compared with other reported ocean monitoring methods. Much attention has been paid to the most commonly used colorimetric/spectrophotometric detection method, as it has the capability of integrating all of the processes involved in the analysis into a small chip. At last, we forecast that an autonomous and in situ system based on optofluidic platforms will play important roles in the development of ocean environmental monitoring.
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While FCS is the essential data standard in FCM, and is supported by all instrument vendors and third party software tools, it does not capture the protocol used or the computational post-processing and data analysis performed in an FCM experiment. Recently, ISAC's Data Standards Task Force (DSTF) developed additional file formats capturing details about FCM data analysis as required by the Minimum Information about a Flow Cytometry Experiment (MIFlowCyt, ).
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NCI neither colonized nor infected, LGCC low-grade Candida spp. colonization, HGCC high-grade Candida spp. colonization, IAC intra-abdominal candidiasis, BDG (1-3)-ß-D-glucan, CAGTA Candida albicans germ tube antibody, mannan-Ag mannan antigen; mannan-Ab mannan antibody, C-PCR PCR-based Candida detection
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43. DESENDER, K., DEKONINCK, W., 2006. ‘in de ban van de ring’: diversiteit en kwaliteit van een aantal invertebratengroepen op de bermen, taluds en restgronden van de R0 (Ring van Brussel). Brussel, Cursusmap ‘Natuurtechnische Milieubouw’, Themadag Bermbeheer langs wegen, 19 mei 2006: 4 pp.
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It is interesting to note that the single ingredient GlycoCarn® (in addition to 16 grams of maltodextrin as used in the present design) results in similar or more-favorable effects in terms of blood flow (StO2 start of exercise; as measured by NIRS), as well as the total volume load measured during the 10 set bench press protocol. Although not of statistical significance, from a practical standpoint, the percent increases in volume load above placebo and the other supplements may be of importance to serious athletes desiring a slight performance advantage. Moreover, while a slight to moderate increase in lipid specific oxidative stress (as measured by MDA) was observed with all other conditions, the noted decrease with GlycoCarn® may be of interest to those seeking antioxidant support within a pre-workout dietary supplement. Admittedly, the importance of these subtle differences in blood flow, total volume load, and MDA in relation to exercise performance and recovery are unknown at the present time and require additional study. Hence, athletes will need to consider the cost to benefit ratio when making such a decision as to whether or not to use an ingredient such as GlycoCarn®.
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B3: ‘The different personalities, values, and beliefs of the nurses affect their approaches to patients—so while observing how the seniors manage the situations, the juniors eventually have to try out what works and what does not work for them, to develop their own way of approaching the patients in certain situations.’
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In the social domain, ‘being allowed to be active’ was rated important by all classes. In addition, ‘ambience’ may be another important potential determinant, as it was rated important by three of the four classes. According to the students, important aspects of a good ambience in the environment include that it should be cosy together with others, and fun for everyone. Similarly, a systematic review of qualitative studies concluded that having fun was frequently mentioned as a physical activity facilitator in adolescents . The importance of being together with others was also previously found to be important for adolescents’ physical activity, in both qualitative and quantitative research [22, 27, 28], although the main focus was on social support rather than having fun and cosiness.
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To examine the within‐session reliability of TMS map features (map volume, area, CoG latitude, CoG longitude) in the absence of motor training, data from the maps acquired during the Baseline phase were compared using absolute intraclass correlation coefficients (ICCs). The ICCs were interpreted with the following values: <0.50 = poor; 0.50–0.64 = moderate; 0.65–0.79 = good; and ≥0.80 = excellent reliability (Cavaleri, Schabrun, & Chipchase, 2017; Higgins & Green, 2015). The second map acquired during this phase was used as the baseline map during the subsequent phases.
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Many people in the deaf community use sign language to communicate. They usually communicate with other people who are signers or receive assistance from an interpreter. This last option, in many cases, is the preferred one, even if they could have good language competence, thanks to lip reading and hearing residuals, to have better communicational access through their language . This is because deafness is also considered as a socio-cultural condition for them. Some people do not want to use sign language but only lip read or hearing residuals because these people think that sign language can be seen as marginalizing and consider deafness as a handicap .
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We study nanovesicles with a diameter of about 36 nm. These vesicles are exposed to small solute molecules in the exterior aqueous solution. The equilibration of these systems requires simulation times of many microseconds. To gain access to these length and time scales, we use a coarse-grained molecular model which we study by dissipative particle dynamics.52 Our molecular system is built up from four types of beads that represent small molecular groups corresponding to water (W) beads, lipid chain (C) beads, lipid head (H) beads, as well as solute (S) beads. The lipid molecules have a headgroup consisting of three H beads and two hydrocarbon chains, each of which consists of six C beads. All beads have the diameter d, corresponding to about 0.8 nm. Each pair of beads interacts with short-ranged pairwise additive forces as described previously,52 including the conservative force6with the force parameter fij, the unit vector r̂ij pointing from bead j to bead i, and the distance rij between bead i and bead j. The numerical values of the force parameters fij are displayed in Table 1. If we delete the right-most column with force parameters fiS and the bottom row with fSj, we recover the force parameters that have been used before19 in the absence of solute.
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WGS и SNP (whole genome sequencing – полногеномное секвенирование, single nucleotide polymorphism – однонуклеотидный полиморфизм). В последнее время методы высокотехнологичного секвенирования стали при- влекаться и в исследования видов рода Rubus. Насколько нам известно, на сегодня существуют полногеномные сиквенсы двух видов этого рода – R. idaeus (Wight et al., 2019) и близкого ему R. occidentalis (VanBuren, 2016). С помощью современных технологий секвенирования и генетического анализа выявлен высокий уровень синте- нии геномов R. occidentalis и земляники лесной Fragaria vesca L. (VanBuren, 2016).
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En Nouvelle-Calédonie, la période de confinement total sur l’ensemble du territoire a débuté le 25 mars 2020. Le travail sur les outils de continuité pédagogique en éducation à la santé a commencé la semaine précédente, dès l’annonce du confinement. Nous avons pris en compte deux éléments qui nous apparaissaient cruciaux : les représentations des enseignants sur l’éducation à la santé et les compétences des élèves devant être développées en période de COVID-19. Nous nous sommes appuyés sur une étude qualitative réalisée en février 2020 : nous avions interrogé en présentiel via un entretien semi-guidé 17 enseignants répartis sur l’ensemble du territoire et exerçant dans différents milieux (urbain aisé, urbain défavorisé, urbain mixte, village, tribu) afin d’identifier leurs représentations de l’éducation à la santé et leurs pratiques de classe. Leurs réponses ont orienté la définition des contenus proposés lors de la continuité pédagogique. Nous avons ensuite mobilisé les acteurs du dispositif REBEE. Un travail collectif a été engagé de façon à identifier, parmi les ressources déjà élaborées dans le cadre de ce dispositif, des supports permettant aux enseignants et aux familles d’aborder les problématiques suivantes en période de pandémie et de confinement : éviter la propagation des virus, gérer ses émotions et son bien-être, construire un esprit critique face aux informations. D’autres ressources ont été identifiées et mises à disposition. Un site internet (27) a été créé et est accessible via le site Internet de la Direction de l’Enseignement de la Nouvelle-Calédonie (DENC). Ce site dédié regroupe 36 fiches destinées aux éducateurs des enfants entre 6 et 11 ans (parents, enseignants et professionnels de la santé intervenant dans les écoles) avec pour objectif de leur permettre d’aborder les thématiques de santé suivantes : microbes et gestes d’hygiène, bien-être et connaissance de soi, médias et information, santé et attitude. En ce qui concerne les parents, c’est l’enseignant, dans le cadre de sa progression, qui les invite à travailler telle ou telle fiche à la maison. Différentes solutions ont été expérimentées pour permettre aux gens sans connexion Internet d’accéder aux ressources : permanence dans les écoles, distribution des activités sous format papier ou sur clé USB dans le respect des gestes barrières par les enseignants, ou les gendarmes pour les lieux isolés.
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Für die Bestätigung von Wirksamkeit und Verträglichkeit einer Therapie ist die möglichst präzise Kenntnis des natürlichen Krankheitsverlaufs, am besten über die gesamte Lebensspanne und für unterschiedliche Schweregrade, von großer Bedeutung. In der Praxis stehen bei seltenen Krankheiten allerdings meist nur Daten von kleinen, vielleicht auch noch heterogenen Patientengruppen sowie einem begrenzten Beobachtungszeitraum zur Verfügung.
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Finally, the present study has serious limitations in its statistical power regarding IPTp since the sample sizes are small. Therefore, the non-significant OR of IPTp shall not be considered as reflecting a poor effectiveness but rather as the reflection of an insufficient statistical power. Moreover the short questionnaire did not allow for the collection of data about parity, which would have been preferable to adjust for. Similarly, the non-significant additional effect of both LLIN and IRS over one single intervention might be attributed to a lack of statistical power since the analysis has been conducted on a small subset of the whole database.
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A fisiopatologia da SCA em pacientes jovens pode ser diferente daquela encontrada em paciente idosos. A clássica teoria de ruptura da placa de aterosclerose com ativação da cascata de coagulação e obstrução do vaso era considerada rara nas primeiras décadas de vida há até pouco tempo. Por outro lado, o tabagismo, o vasoespasmo, as trombofilias e o uso de cocaína parecem estar mais relacionados nessa fase da vida.7,8 A incidência de trombofilias e vasoespasmo chega a representar cerca de 76% dos pacientes com menos de 30 anos com diagnóstico IAM.1 Apesar dessas descrições, somente encontramos na população estudada oito (3%) casos de SCA associadas ao uso de cocaína e quatro (1,5%) casos de trombofilias (três relacionados à presença de anticorpo antifosfolípide e um ao fator V de Leiden).
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In order to define cell position in the large MCTSs, different microscopy techniques, such as multi-photon and light sheet microscopy (or selective plane illumination microscopy, i.e., SPIM) can be employed . Both imaging approaches allow deep penetration near their core. Multi-photon microscopy supports imaging of up to 500 μm in depth, and light-sheet-based microscopy allows for numerous MCTS views and has become the most commonly used method for imaging their entire volume .
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Im Punkt Vertrauen, einer weiteren Herausforderung, die Führungskräfte in Bezug auf das Digital Leadership benennen, gibt es eindeutig ein Spannungsfeld im Bereich Leistung und Stundenerbringung, wobei hier die Spannung mehr mit den gesetzlichen Rahmenbedingungen zu Tage tritt als Spannungen mit den Mitarbeitern. Die momentanen Arbeitszeitgesetze lassen nur begrenzten Spielraum zu, weswegen die Führungskräfte zwar einem ortsungebundenen Dienstverhältnis zustimmen, eine zeitungebundene Variante jedoch nicht befürworten können. Viele Interviewpartner konnten jedoch die Theorie zur Stärkung der Vertrauenskultur zwischen Führungskräften und ihren Mitarbeitern von Misamer und Thies (2017) bestätigen und sahen sich keineswegs einem Kontrollverlust ausgesetzt. Ein Monitoring im Sinne des Unternehmens wird als Aufgabe aktiv wahrgenommen und ausgeführt, dem Mitarbeiter auf individueller Ebene aber das nötige Vertrauen entgegengebracht und vorgelebt.
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Differences in MN FC are not limited to neurodegenerative motor conditions. Perinatal brain insults associated with motor deficits have shown FC correlates. Neonatal prematurity showed association between thalamus-motor and BG-motor network connectivity and behavioral motor outcome scores (31). In a systematic review, neonatal diaschisis resulting in later outcomes of severe childhood motor impairments were associated with MN FC (32). Furthermore, a recent study demonstrated that the presence and typicality of FC BG networks (identified from independent component analysis; ICA) in neonates during the acute period of brain injury predicted clinically noted developmental delay and motor-tone outcomes within 6 months (33). Finally, severity of motor deficits (chronic spastic quadriplegia) after anoxic brain injury from drowning have also been correlated with the “health” of motor rs-fMRI ICA networks in children and that this can be independent of cognitive function and cognitive networks (34). Together, studies of FC after brain injury, particularly anoxic brain injury, imply that motor deficits and movement disorders can be correlated with MN FC after brain insult.
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Physical and chemical properties were characterized for “initial” samples using the thawed soils. Gravimetric water content (GWC), pH, total combustible carbon and nitrogen were measured. Soil GWC was determined by weighing approximately 10–20 g of soil from each biological replicate and drying at 105°C to a constant mass for 24 h. GWC was calculated on a per dry mass basis. Soil pH was determined by shaking a slurry of fresh soil and water (1:10) for 1 h and measured using an Accumet basic AB 15 pH meter (Thermo Fisher Scientific, Waltham, MA, United States). Soil was air dried and ground to a fine powder using a ball mill grinder fitted with plastic inserts. Ground soils were analyzed for total combustible carbon and nitrogen via thermal oxidation with gas chromatographic separation followed by thermal conductivity detection on a Costech C/H/N/S Elemental Analyzer (Costech Analytical Technologies, Inc., Valencia, CA, United States).
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Results for the TMS assessment for the group of healthy individuals for the four evaluated moments, normalized to the mean of the evaluation before the intervention: before the full intervention (PRE), right after the full intervention (POST), 30 min after the POST (POST30), and 24 h after the end of the full intervention (POST24h); for the muscles TAnt (Tibialis Anterior), RF (Rectus Femoris) and SO (Soleus). Statistical significance (post-hoc comparison) depicted by the asterisk (*).
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Apart from the metabolic-associated biological processes terms, cell surface receptor signaling pathway-related terms were also highly significant enriched, in particular in proteins associated to the Wnt pathway (Figures 3 and 4). Several proteins in the mediator list are represented in the pathway (see Additional file 4: Figure S4) including GSK-3β, a tau kinase that was also included in the most connected mediator proteins list (Table 3) and in the autophagy-related proteins (Additional file 3: Table S3). Several preclinical and clinical data strongly link GSK-3β to dementia: different inhibitors of GSK3B activity block neurodegeneration in vitro, and GSK-3β -mediated Wnt signaling can mediate amyloid peptide toxicity in vitro . Finally, in human postmortem brain, this protein is physically associated with neurofibrillary tangles, one of the pathologic hallmarks of AD . WNT pathway has also been recently linked to autophagy. In fact, autophagy negatively regulates Wnt signalling by promoting Dishevelled (Dvl) degradation, with a role for Von Hippel–Lindau protein-mediated ubiquitylation , both of them present in the dementia network mediator list.
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Se realizó un análisis y evaluación sistemática basada en el marco analítico, circunscrito en el documento de la OMS ¨Respeto de los derechos humanos cuando se proporciona información y servicios de anticoncepción: orientación y recomendaciones¨ (2014) (cuadro 1). Se evaluó si la legislación de Bolivia, Colombia y Uruguay contienen referencias generales a la población, referencias específicas para adolescentes, o no se hace referencia a estas recomendaciones. Estudios similares ya fueron realizados bajo esta metodología (6,7). El análisis sólo presenta la legislación existente y no su grado de implementación.
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Het wordt nog moeilijker wanneer de diabetespatiënt gedialyseerd moet worden. Nierdialyse heeft een directe impact op de bloedglucoseconcentraties doordat glucose en ook insuline worden uitgescheiden tijdens de dialyse. Als gevolg hiervan moet het dieet worden aangepast. Zo is het bij nierschade essentieel de inname van kalium te verminderen, maar dit is vrijwel niet verenigbaar met de richtlijnen voor diabetespatiënten. Als de richtlijnen voor groente en fruit, peulvruchten en noten worden opgevolgd, gaat de inname van kalium namelijk verder omhoog. Zo kan een overschot aan kalium uiteindelijk leiden tot een hartstilstand. Kalium blijkt dan ook voor diabetespatiënten met nierschade de beperkende factor te zijn bij het naleven van de voedingsrichtlijnen en vormt dus een grote uitdaging voor de diëtist.5,8,9 Daarbij komt dat het gebruik van extra medicatie tegen eventuele andere aandoeningen de voeding nog meer aan banden kan leggen. Zo zijn er bepaalde medicijnen tegen hypertensie die de concentraties kalium in het bloed verhogen. Ondanks het feit dat die medicatie hypertensie tegengaat, is dit ongunstig voor de nieren.
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To sum up, we can say that auscultation is very well suited for an approximate assessment of a cardiac disease, especially in rural equine practice or when transportation to an equine referral center is not possible or not wanted. However, if further sporting activities are desired, further diagnostics should be performed, especially in a moderate to loud murmur, a right-sided murmur, or multiple murmurs, as auscultation may be inaccurate in these cases.
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A histopathological examination showed tumoral cells with syncytial and whirling arrangement, indistinct cell membranes, eosinophilic cytoplasma, and rather uniform nuclei. Some intranuclear pseudoinclusions were also present. Mitotic figures were rare. Immunohistochemistry revealed positive staining for epithelial membrane antigen (EMA) a progesterone receptor (PR) [Figure 2] and negative staining for S100, CD34, and BCL2. Ki67 showed proliferative activity in about 1–2% of tumor cells. As a result, a meningotheliomatous meningioma (WHO grade 1) diagnosis was made.
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Die vorliegende Querschnittsanalyse zeigt eine enge Assoziation zwischen dem GALI und dem selbstberichteten Studienpensum auf. Sie ist nach unserem Kenntnisstand die erste empirische Studie, die diesen Zusammenhang untersucht. Gesundheit und Arbeitsfähigkeit sind Voraussetzungen, um Arbeitsaufgaben zu einem bestimmten Zeitpunkt zu bewältigen [10, 18]. Die Auswertungen belegen große Schwierigkeiten im Umgang mit relevanten Studienanforderungen aus der Perspektive der Studierenden. Bei allen abgefragten Anforderungen nahm der Anteil der Studierenden mit diesen Schwierigkeiten mit der Stärke der Gesundheitseinschränkungen zu. In multivariater Betrachtung war bei Studierenden mit starken gesundheitsbedingten Einschränkungen bei alltäglichen Aktivitäten die Wahrscheinlichkeit, dass das absolvierte Studienpensum viel weniger als die Vorgabe der Studienordnung im derzeitigen Studiengang ausmacht, um den Faktor 2,81 gesteigert. Das OR ist damit fast doppelt so hoch wie bei den gesundheitsbedingt mäßig eingeschränkten Studierenden.
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We used the Philippine tarsier mitochondrial genome (NC_012774.1) for numt insertion analysis. Masking of repetitive elements was conducted with the RepeatMasker tool (http://www.repeatmasker.org/RMDownload.html; see Supplementary Information for settings). To calculate the similarity between numts and their original mitochondrial sequences and between TINE1/2/3 consensus sequences and genomic full-length hits, we calculated the Levenshtein-Distance57 by measuring the number of character changes needed to convert one sequence into the other.
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We first examined the volume responses of CA1 pyramidal neurons and s.r. astrocytes to repeated applications of 17% and 40% hACSF (Figure 2). Neurons (Figures 2A–D) and astrocytes (Figures 2E,F) were initially labeled by patch-clamp dialysis of the fluorescent indicators Alexa Fluor 568 hydrazide or fluorescein dextran, respectively, and imaged using confocal microscopy (see “Materials and Methods” Section). As in our previous study, image stacks through cell somata were collected at 1-min intervals starting with a baseline in nACSF (Figures 2A1,E1), and proceeding through 5 min of hACSF (Figures 2A2,E2), with a final image stack acquired after a 5 min ”wash” in nACSF (Figures 2A3,E3). Stacks were post-processed and thresholded (Figure 2B) to quantify percent change from baseline at each time point (Figure 1; also see “Materials and Methods” Section). In contrast to some previous studies in which neuronal volume was insensitive to hypoosmolar shifts (Andrew et al., 2007; Caspi et al., 2009), we found that neurons rapidly swelled in response to both 17% and 40% hACSF, and this swelling was similar in magnitude and time course to volume changes in astrocytes (Figures 2A–D). Neuronal soma area significantly increased above baseline within 1 min in 17% (2.04 ± 0.33%, p < 0.001) or 40% (2.09 ± 0.72%, p = 0.044) hACSF, and continued to gradually increase to a maximum of 4.72 ± 0.41% in 17% hACSF and 10.51 ± 0.93% in 40% hACSF (Figure 2D). Overlays of baseline and 5 min 40% hACSF time points (Figure 2C2) facilitate visualization of these volume increases as magenta expansions along the outer border of the cell. Neurons largely recovered to baseline volume after a 5 min wash period in nACSF (1.27 ± 0.39% above baseline in 17%, 2.70 ± 0.92% in 40% hACSF, p < 0.05 each), as shown in Figure 2C3 overlays. These data bore a remarkable similarity to our observations of s.r. astrocytes in the same conditions (Figures 2E,F). As reported in Lauderdale et al. (2015), astrocytes also rapidly swelled in both concentrations of hACSF within the first minute (p < 0.01) and in a dose-dependent manner. Unlike neurons, astrocytes fully recovered to baseline volume upon return to nACSF for 5 min.
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Clinical characteristics of patients. Descriptive statistics of breast cancer patients with histopathological findings are shown for each group and the entire cohort. Numbers are expressed as mean and standard deviation (apart from Nottingham Prognostic Index where median and interquartile range are shown), with pathological entries expressed as number of positive observations
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Microbial translocation is a significant contributor to persistent inflammation and incomplete immune reconstitution in ARV-treated HIV infections4. In addition to the presence of circulating markers of antimicrobial immunity, translocation is characterized by the presence of circulating microbial products such as lipopolysaccharide (LPS), peptidoglycan, flagellin, and 16S or bacterial CpG DNAs5. Translocation can be visualized across the gastrointestinal epithelium, where breaches in epithelial integrity allow access to the underlying mucosa and into systemic circulation6,7. In the progressive SIV non-human primate model of HIV infection, administration of the LPS-binding compound sevelamer prevents plasma LPS and sCD14 accumulation and limits CRP and D-dimer elevation in acute, ARV-untreated infection8. Furthermore, the use of antibiotics cotrimoxazole and vancomycin have been shown to reduce, though not eliminate, adverse health effects in ARV-untreated HIV and SIV infection, respectively9,10. Though useful in treating the effects of translocation, the prolonged co-administration of antibiotics, sevelamer, and other pharmaceuticals is impractical in the setting of prolonged, non-curative, ARV therapy11.
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Notre cas est en phase avec la première cause énoncée, compte tenu de la présence de substances interférentes d'origine endogène. En effet, ces substances ont pour cible principale l'albumine en raison de ses propriétés de transport. Une augmentation de la concentration des molécules transportées étant susceptible de modifier l'aspect électrophorétique de l'albumine en général et l'aspect de son pic en particulier . Parmi ces substances endogènes on retrouve: la bilirubine libre, les lipides et les acides biliaires. Produit du catabolisme de l'hème, la bilirubine est transportée par l'albumine au niveau de son site de liaison localisé dans une poche de son sous-domaine IB (faussement appelée bilirubine libre) dans les hépatocytes où elle est conjuguée à l'acide glucuronique pour devenir la bilirubine conjuguée . Dans la réalité, en présence d'une augmentation de « bilirubine libre », le pic d'albumine s'épaissit au niveau de sa base et plus particulièrement sur son versant anodique pour revêtir un aspect de bis-albuminémie acquise. Cet aspect, plus facile à voir en « électrophorèse capillaire » est très rarement décrit dans la littérature . Nous retrouvons le même aspect de l'albumine (Figure 1) chez notre patient dans un contexte d'augmentation de la bilirubine avec une bilirubine libre à 16N. Les bis-albuminémies dues à des dyslipidémies (hyperlipémie) sont les plus fréquemment rencontrées depuis le développement de l'électrophorèse capillaire, avec laquelle les chilomicrons et les lipoprotéines (Lp) migrent dans la même zone que l'abumine . Cette migration est probablement due à la présence d'un détergent associé au tampon de migration . Notre échantillon a bénéficié d'une seconde électrophorèse sur gel d'agarose où on peut témoigner de la nature lipidique du pic X. En effet, sa migration est plus cathodique par rapport à l'albumine normale en raison de la migration préférentielle des Lp au niveau alpha2 ou bêta1. La Figure 2 montre l'aspect de l'électrophorèse sur gel d'agarose avec disparition du pic X (pouvant maintenant être nommé Lp X) et augmentation de la fraction des bêta-globulines. Ce cas de pseudo-bis-albuminémie acquise au cours d'un ictère cholestatique compliquant un cholangiocarcinome métastatique est l'un des rares cas décrit dans la littérature. En effet, Rar L. et al. ont décrit un cas similaire où la différence majeure se situe au niveau de la migration du variant d'albumine qui se situait sur le versant cathodique de la fraction normale de l'albumine et se caractérisait par un épaulement et absence de pic Lp X de migration lente.
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Bezüglich der zirkadianen Rhythmik des Cortisols mit v. a. morgens sehr hohen Konzentrationen kann diese Rhythmik bei extremen Stresssituationen, wie z. B. bei Patient*innen auf einer Intensivstation, aufgehoben sein, wobei sich bei moderateren Stresssituationen wie z. B. Infekten (ohne schwere Sepsis) oder Herzkatheteruntersuchungen weiterhin eine entsprechende, wenn auch möglicherweise etwas beeinträchtigte, Tagesrhythmik zeigt [58–61]. Dies ist insofern relevant, als dass wir bei moderaten Stresssituationen eine Dosiserhöhung unter Beibehaltung der Tagesrhythmik empfehlen, jedoch bei massivem Stress wie z. B. einer Addison-Krise und v. a. bei Säuglingen und Kleinkindern (dies auch im Hinblick auf das Hypoglykämierisiko) eine gleichmäßig über den Tag verteilte erhöhte Glukokortikoiddosis empfehlen.
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This is a first reported case of a multiple tubular enteric duplication accompanied with toxic megacolon. Temporary loop colostomy and delayed resection of the common wall was done to avoid extensive bowel resection. Decompression with colostomy was effective in treatment of toxic megacolon, and surgical management of duplication of cysts with minimal resection showed good postoperative results. In pediatric patients with atypical clinical presentations, possibility of a congenital defect must always be considered. Sonographic exams combined with physical examinations can be effective in making a diagnosis. Emergency operation to manage toxic megacolon, and delayed operation to correct the bowel deformity proved efficient and effective.
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Esta evaluación se facilitaría si el farmacéutico pudiera acceder y contribuir a los registros pertinentes sobre la salud del paciente, contando siempre con la autorización expresa del mismo, mediante la firma de un consentimiento informado, y centrando la información fundamentalmente en los datos relacionados con sus necesidades farmacoterapéuticas: estado general de salud, resultados de análisis de laboratorio, enfermedades crónicas y adherencia a la medicación, entre otros. Mediante los diferentes servicios profesionales ofertados en la farmacia, pueden detectarse problemas relacionados con la medicación (PRM) que necesitarán ser comunicados al personal médico o a otros profesionales sanitarios. Entre esos PRM se encuentran contraindicaciones, dosis/pauta/duración no adecuadas, duplicidades, errores en la prescripción, interacciones, alta probabilidad de efectos adversos u otros problemas de salud que afectan al tratamiento, etc.
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Gracias al trabajo realizado hasta la fecha, a la reputación favorable que ha adquirido, y al alto grado de interconexión social propio de la mayoría de los países del Caribe, la Coalición ha tenido acceso a los responsables de la formulación de políticas de alto nivel. La promoción de la causa que realiza la Coalición no solo aborda la rendición de cuentas, sino que también promueve acciones multisectoriales para abordar los determinantes sociales de la salud y la salud universal. La Coalición ha apoyado a una serie de “campeones” de las ENT llenos de pasión, motivación y experiencia que han participado en reuniones de alto nivel y foros internacionales; ha presentado declaraciones y documentos de posición a los responsables políticos de CARICOM (incluida la conferencia de jefes de estado y de gobierno) y a los líderes del sector público y de la sociedad civil, y se ha comunicado con los medios de comunicación nacionales, regionales e internacionales (7). En el 2015, la Coalición convocó una reunión de partes interesadas sobre el fortalecimiento de los sistemas de salud, la salud universal y las ENT (19). En el 2019, la Coalición elaboró un informe técnico sobre la salud universal (20) en preparación de la primera reunión de alto nivel de las Naciones Unidas sobre cobertura universal de salud, y lo presentó al Comité de Ministros de Salud de CARICOM en la Asamblea Mundial de la Salud del 2019.
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Le cancer de la vulve représente 5% des cancers gynécologiques . Son incidence augmente avec l'âge, avec une tendance mondiale à survenir chez des femmes de plus en plus jeunes . L’une de nos patientes a présenté un carcinome épidermoïde de la vulve à l'âge de 25 ans, l'âge précoce de ses premiers rapports sexuels ainsi que l'absence de vaccination sont des facteurs de carcinogenèse potentiels . Le délai d'apparition des premiers symptômes et la consultation ont été étudiés dans notre série, ils ont été identifiés comme un facteur pronostique dont dépend la survie globale. Sur une série rétrospective publiée par l'équipe de l'Institut National d'Oncologie au Maroc, ce délai était de 7 mois, versus 16 mois pour nos patientes , un retard de consultations qui explique la fréquence des stades localement avancés au sein de notre structure, pour des raisons d'ignorance et surtout de pudeur de la population de la région de l'Oriental du Maroc. Le traitement principal du cancer de la vulve est chirurgical, il repose sur la vulvectomie totale associée à un curage inguinal bilatéral avec incisions séparées ; c’est le traitement standard des cancers vulvaires localisés. Il a été pratiqué chez 68.2% des cas. La qualité de cette résection ainsi que l'envahissement ganglionnaire inguinale sont des facteurs pronostiques majeurs justifiant ce traitement. La vulvectomie partielle peut être indiquée dans les stades précoces, la place du ganglion sentinel dans le traitement chirurgical du cancer de la vulve est en cours d'évaluation. Le lâchage de suture et le lymphœdèmes constituent les principales complications du traitement chirurgical. Le taux de ces complications post-opératoires observées chez les patientes de notre série est similaire à celui décrit dans la littérature .
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Sportactiviteiten, feestjes en bezoek zijn al geruime tijd niet meer vanzelfsprekend. Deze activiteiten bieden structuur en sociale contacten, dienen als uitlaatklep en kunnen bijdragen aan de zingeving van het leven . Er is nog weinig zicht op kwetsbare groepen.
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A disfunção microvascular sistêmica durante o BCP resulta em fluxo sanguíneo, perfusão de órgãos, e oxigenação tecidual inadequados.4 Nós mostramos, utilizando monitoramento de perfusão por laser Doppler (LDPM, do inglês laser Doppler perfusion monitoring), que consiste em um método não invasivo acoplado com aquecimento local da pele, que o leito microcirculatório da pele da testa é um modelo apropriado para o estudo da reatividade microvascular e perfusão tecidual na cirurgia cardiovascular com BCP em adultos.5 De fato, a hiperemia térmica local (HTL) é um método útil na avaliação da função endotelial microvascular sistêmica.5,6 Além disso, utilizando LDPM, demonstramos a ocorrência de disfunção microvascular e hipoperfusão durante o BCP na correção cirúrgica de doença cardíaca congênita em lactentes e crianças, apesar de parâmetros macrohemodinâmicos adequados.7 O descompasso entre a microcirculação e a macrocirculação em pacientes graves com choque séptico ou cardiogênico, o que pode prejudicar o manejo clínico adequado desses pacientes, tem estimulado a busca por novos métodos para monitorar a perfusão da microcirculação em unidades de terapia intensiva.8
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A total of 358 (86.1%) participants were recruited to the study after screening 416 admissions. Reasons for non-inclusion included situations in which there were no data on serum sodium (15 cases), urea (42 cases), potassium (15 cases), or fasting glucose (21 cases) tested on admission.
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