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Journal articles on the topic "141.132 : 37"
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Nitschke, Tobias, Philipp Groene, Alice-Christin Acevedo, Tobias Kammerer, and Simon T. Schäfer. "Coagulation under Mild Hypothermia Assessed by Thromboelastometry." Transfusion Medicine and Hemotherapy 48, no. 4 (2021): 203–9. http://dx.doi.org/10.1159/000513922.
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<b><i>Introduction:</i></b> While previous studies have shown a significant impact of extreme hypo- and hyperthermia on coagulation, effects of much more frequently occurring perioperative mild hypothermia are largely unknown. This study therefore aimed to analyze the effects of mild hypothermia using rotational thromboelastometry in vitro. <b><i>Materials and Methods:</i></b> Twelve healthy volunteers were included in this study. Standard thromboelastometric tests (EXTEM, INTEM, FIBTEM) were used to evaluate coagulation in vitro at 39, 37, 35.5, 35, and 33°C. Beyond standard thromboelastometric tests, we also evaluated the effects of mild hypothermia on the TPA-test (ClotPro, Enicor GmbH, Munich, Germany), a new test which aims to detect fibrinolytic capacity by adding tissue plasminogen activator to the sample. Data are presented as the median with 25/75th percentiles. <b><i>Results:</i></b> Extrinsically activated coagulation (measured by EXTEM) showed a significant increase in clot formation time (CFT; 37°C: 90 s [81/105] vs. 35°C: 109 s [99/126]; <i>p</i> = 0.0002), while maximum clot firmness (MCF) was not significantly reduced. Intrinsically activated coagulation (measured by INTEM) also showed a significant increase in CFT (37°C: 80 s [72/88] vs. 35°C: 94 s [86/109]; <i>p</i> = 0.0002) without significant effects on MCF. Mild hypothermia significantly increased both the lysis onset time (136 s [132/151; 37°C] vs. 162 s [141/228; 35°C], <i>p</i> = 0.0223) and lysis time (208 s [184/297; 37°C] vs. 249 s [215/358; 35°C]; <i>p</i> = 0.0259). <b><i>Conclusion:</i></b> This demonstrates that even under mild hypothermia coagulation is significantly altered in vitro. Perioperative temperature monitoring and management are greatly important and can help to prevent mild hypothermia and its adverse effects. Further investigation and in vivo testing of coagulation under mild hypothermia is needed.
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Visser, Philip, Alison Dwyer, Juli Moran, Mary Britton, Melodie Heland, Filomena Ciavarella, Sandy Schutte, and Daryl Jones. "Medical emergency response in a sub-acute hospital: improving the model of care for deteriorating patients." Australian Health Review 38, no. 2 (2014): 169. http://dx.doi.org/10.1071/ah13245.
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Objective To assess the frequency, characteristics and outcomes of medical emergency response (MER) calls in a sub-acute hospital setting. Methods The present study was a retrospective observational study in a sub-acute hospital providing aged care, palliative care, rehabilitation, veteran’s mental health and elective surgical services. We assessed annual MER call numbers between 2005 and 2011 in the context of contemporaneous changes to hospital services. We also assessed MER calls over a 12-month period in detail using standardised case report forms and the scanned medical record. Results There were 2285 multiday admissions in the study period where 141 MER calls were triggered in 132 patients (61.7 calls per 1000 admissions). The median patient age was 83.0 years, and 55.3% of patients were men. Most calls occurred on weekdays and during the daytime, and were triggered by altered conscious state, low oxygen saturations and hypotension. Documentation of escalation of care before the MER call was not present in 99 of 141 (70.2%) calls. Following the call, in 70 of 141 (49.6%) cases, the patient was transferred to the acute campus, where 52 (74.2%) and 14 (20%) patients required ward and intensive care level treatment, respectively. Thirty-seven of 132 (28%) patients died. A palliative care physician adjudicated that most of these patients who died (24/37; 64.9%) were appropriate for a call, but that 19 (51.4%) should have received palliation at the time of the call. Compared with survivors, patients who died after the MER call were more likely originally admitted from supported accommodation. Conclusions MER calls in our sub-acute hospital occurred in elderly patients and are associated with an in-hospital mortality of 28%. A small proportion of patients required intensive care level treatment. There is a need to improve processes involving escalation of care before MER call activation and to revise advance care directives. What is known about this topic? Rapid response team (RRT) activation has been well described in the acute hospital setting. Although the impact on survival benefit to patients remains controversial, it has been widely adopted as a model of care to respond to deteriorating ward patients. This is particularly relevant in Australia at present with the implementation of the new National Safety and Quality Health Service Standards. What does this paper add? There have not been any previous papers published on rapid response systems in a sub-acute hospital. This paper describes some of the changes and challenges associated with increasing RRT activations in a sub-acute health care facility. What are the implications for practitioners? For clinicians in a sub-acute setting, the study reinforces the importance of pre-emptively documenting and communicating advance care directives. In addition, it is important to identify patients with reversible pathology likely to benefit from transfer and acute care, and to avoid the transfer of those who will not and, instead, provide appropriate palliation. For practitioners involved in models of care for deteriorating patients, the study provides information on where problems occurred in our system and the strategies used to address these issues.
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Awada, Hassan, Jibran Durrani, Tariq Zuheir Kewan, Ashwin Kishtagari, Valeria Visconte, and Reda Z. Mahfouz. "Comprehensive Characterization of Cytogenetic and Mutational Analysis of Acute Promyelocytic Leukemia: Is PML-Rara Everything?" Blood 134, Supplement_1 (November 13, 2019): 1404. http://dx.doi.org/10.1182/blood-2019-131724.
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Acute promyelocytic leukemia (APL) is characterized by PML-RARA fusion caused by the t(15;17)(q24;q21) translocation. Although PML-RARA fusion explains the dedifferentiation in most of APL patients, it still does not entirely represent the unique cause of all the clinical manifestations of the disease failing to determine the full leukemic phenotype. Up to 40 % of APL patients have an additional chromosomal abnormality other than PML-RARA. Murine studies have reported that additional cytogenetic abnormalities and secondary somatic mutations (for instance FLT3-ITD) might contribute to leukemia progression. Indeed, mice expressing mutant PML-RARA develop definitive leukemia after one year, suggesting that additional hits are required for transformation. Moreover, no distinct genetic signature has been characterized by next generation sequencing (NGS). This confirms that no gene has been reproducibly identified. APL respond to all-trans retinoic acid (ATRA) in the great majority of patients. However, one quarter of APL develop ATRA resistance suggesting that additional secondary chromosomal abnormalities might be evolving resistance. Combination of low dose arsenic, modify certain epigenetics, with ATRA decreased resistance potential and improved response. In the line with other possible factors involved in ATRA resistance, is the broad nature of the targets of ATRA. A molecular core network of ATRA's targets has been clustered in differentiation, growth factors and nuclear receptors possibly cooperating with PML-RARA and additional chromosomal abnormalities. Herein, we aimed to characterize the gene mutations and chromosomal abnormalities playing key roles in cellular differentiation and epigenetic regulation and to correlate the occurrence of these alterations with treatment response and survival outcomes in APL. We took advantage of a large cohort of APL patients (n=145). Median age of the cohort was 50 yrs (19-85); equal gender distribution; median blood counts were: [WBC 6.2 x 109/L (0.4-155); 37% had leukopenia], hemoglobin [9.8 g/dL (2.7-16.2); 32% had anemia] and platelets [29 x 109/L (range of 0-228); 93% had thrombocytopenia]. In terms of karyotype, 15% of the patients carried +8, 7% had complex karyotyping (≥3 cytogenetic abnormalities), 2% had -7/del (7q) or del (12p), 1% had -17/del(17p), and 1 patient had -5. Mutational analysis of 30 genes panel, identified 141 mutations carried by 65% (94/145) of APL patients. The most frequent mutations were observed in FLT3-ITD (61/143; 43%), WT1 (26/139; 23%), and ASXL1 (7/136; 5%) genes. Less frequent mutations were found in 3.7% of CEBPA, KRAS, and NRAS genes as well as in CBL, EZH2, TET2 (3% each) genes. Additionally, we noted that all mutations were recurrent in specific functional pathways and patients carried mutations in more than 1 gene of the same pathway. Of note, cell signaling and proliferation genes (CBL, NRAS, KRAS, KIT, FLT3) were the most frequently mutated (77/141, 55%) and impacted OS (HR: 1.7, P=0.02). Moreover, transcriptional factors which are often mutated in AML (e.g. CEBPA, TP53, NPM1, RUNX1, WT1) as well as major determinants of cell's fate were markedly mutated (38/141, 27%) suggesting that genetic impairment of signaling and transcription might contribute to the lack of differentiation observed in APL phenotypes. Mutations in epigenetic genes and histone methyltransferases (ASXL1, BCORs, DNMT3A, EZH2, IDH1/2, TET2) were also found in 18/141 (13%) while genes regulating cell proliferation and RAS family (CBL, NRAS, KRAS, NPM1) were enriched in 16/132 (12%) of APL cohort. We then analyzed the genetic picture of remission (APLRm, n=131, 90%) and relapsed (APLR, 1sr relapsed to ATRA, n=14, 10%) patients. Acknowledging the low number of APLR, we observed that molecular mutations did not make a key difference in APLRvs. APLRm [except for a complete lack of mutations in epigenetic pathways (0% vs. 13%)]. Contrarily, specific cytogenetic abnormalities were more common in APLR compared to APLRm as the case of +8 (36% vs. 11%; P= .02) and -17/del(17p) (2/14 vs. 0/131; P= .008). In sum, our study demonstrates that PML-RARA might be accompanied by additional acquired chromosomal change with a variety of genetic mutations in key pathways driving cellular differentiation. These molecular/ cytogenetic associations could determine resistance to ATRA and overall APL patients' survival. Disclosures No relevant conflicts of interest to declare.
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Kyriazakis, I., and J. D. Oldham. "Diet selection in sheep: the ability of growing lambs to select a diet that meets their crude protein (nitrogen × 6.25) requirements." British Journal of Nutrition 69, no. 3 (May 1993): 617–29. http://dx.doi.org/10.1079/bjn19930064.
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To test the proposition that sheep are able to select a diet that meets their crude protein (N × 6.25; CP) requirements, feeds L, A, B, C and H with the same energy content (11 MJ metabolizable energy/kg feed) but different CP contents (78, 109, 141, 172 and 235 g CP/kg fresh feed respectively) were formulated. In addition, feed U, which was feed L plus 21.4 g urea/kg (CP content 132 g/kg), was also made. The feeds were offered ad lib. either singly (n 4 per treatment) or as a choice between feed H and another feed (pairs LH, AH, BH, CH and UH; n 9 per feed pair) to individually penned Suffolk × Scottish mule wether lambs, over the live-weight range 25–45 kg. On the single feeds the rates of live-weight gain were 273, 326, 412, 418, 396 and 407 g/day (SE of difference (SED) 34; P < 0.01) and protein (excluding wool) gain were 27, 32, 44, 45, 41 and 39 g/d (SED 4; P < 0.001) for feeds L, A, B, C, H and U respectively. When sheep were given a choice between a feed below (L or A) and a feed above their CP requirements (H; as judged by the single-feeding treatments) the CP concentration selected was not different between the two pairs: 131 (SE 4) v. 133 (SE 4) g CP/kg feed for pairs LH and AH respectively. On the choices BH and CH (a choice between two feeds above requirements) the feed lower in CP was constantly preferred (874 (SE 33) and 910 (SE 33) g feed B and C respectively per kg total feed intake; CP selected was 157 and 178 g CP/kg respectively). However, this was not the case with the UH choice on which sheep consumed only 599 (SE 61) g feed U/kg total feed intake, resulting in a selection of a higher CP in their diet (173 g CP/kg). The live-weight gains of the animals given a choice between two feeds were 416, 387, 415, 410 and 383 g/d (SED 37) and protein gains were 45, 40, 46, 50 and 43 (SE 7) for pairs LH, AH, BH, CH and UH respectively, which were comparable with the best performance achieved on a single feed. The results suggest that sheep were able to select a diet that meets their CP requirements and avoid, at least to a certain extent, excess of protein intake. It is also possible that sheep discriminate against a property of feed U, such as an excess of urea, when this feed is paired with a feed high in CP.
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Beck, Julia, Markus Schirmer, Margret Rave-Fraenk, Howard Urnovitz, Kirsten Bornemann-Kolatzki, William Marvin Mitchell, Michael Oellerich, Ekkehard Schütz, and Martin Canis. "Cell-free DNA for treatment monitoring and outcome predictor in head and neck cancer." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 6055. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.6055.
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6055 Background: Copy number instability (CNI) signatures of cancers can be readily detected by Next Generation Sequencing of plasma cell-free DNA (cfDNA). HPV detected in oropharyngeal carcinomas is currently the only prognostic biomarker available. We report here CNI scores for disease monitoring of Head and Neck Cancers (HNC) with potential predictive value for personalized therapeutic options. Methods: A total of 132 plasma samples were collected from 54 HNC patients under informed consent and IRB approval. cfDNA was extracted from plasma, ~20M paired-end NGS mappable reads (reference: HG19) per sample were generated and CNI scores were calculated by read counting statistics. After unblinding CNI scores were evaluated as diagnostic parameter for association with disease characteristics and progression. Survival analysis was conducted after dichotomization of baseline CNI scores at a value of 31 corresponding to the 97.5thpercentile of a normal reference group (RG, n = 141). Results: CNI scores above the 97.5th RG percentile were detected in 40 out of 54 (74%) treatment naïve baseline samples. 29 patients with tumors ≤ T3 (62%, n = 42) and 11 out of 12 (92%) with T4 tumors had CNI scores > 31, with significantly higher CNI scores (p = 0.04) seen for T4 tumors. Higher CNI scores were also found in patients with tumor lymph node invasion (n = 37; median: 381, Q25-Q75: 57-1573) compared to negative lymph nodes (pN0, n = 17; 27, 19-64, p= 0.0004). A steep decline of CNI scores was detected after surgical resection, with increasing CNI scores in later disease progression. The pre-operative CNI scores were a stronger predictor of time to recurrence (p = 7*10-5) than the pN status (p = 0.05) (Cox regression). High baseline CNIs ( > 31) strongly correlated with time to recurrence (Kaplan-Meier log-rank p = 0.018) with a median of 20 months and median overall survival of 30 months in the high CNI group, neither reached in the low CNI-score group (60 m follow-up). Conclusions: Chromosomal instability within HNC was quantified from plasma cfDNA as CNI score. The CNI score may serve as better predictor for the time to recurrence interval than pN status. The data suggests that cfDNA analysis as CNI score may serve as real-time marker of treatment efficacy and outcome.
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Franchini, K. G., I. A. Cestari, and E. M. Krieger. "Restoration of arterial blood oxygen tension increases arterial pressure in sinoaortic-denervated rats." American Journal of Physiology-Heart and Circulatory Physiology 266, no. 3 (March 1, 1994): H1055—H1061. http://dx.doi.org/10.1152/ajpheart.1994.266.3.h1055.
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The objective of the present study was to analyze whether the hypoxemia produced by chemoreceptor elimination influences the arterial pressure level after sinoaortic denervation (SAD) in rats. Hypoxemia and hypercapnia were observed in acute (1 day) and chronic (20 days) SAD rats [arterial PO2 (PaO2) = 65 +2- 1.6 and 71 +2- 2.2 mmHg and arterial PCO2 (PaCO2) = 46 +/- 1.3 and 37 +/- 1.8 mmHg, respectively] compared with control rats (PaO2 = 85 +/- 1.6 mmHg, PaCO2 = 31 +/- 1.07 mmHg). Increasing inspired PO2 (PIO2) from 138 mmHg (room air) to 155 mmHg restored the PaO2 of SAD rats to control levels (acute = 81 +/- 2.21 mmHg, chronic = 85 +/- 2.35 mmHg). PaO2. restoration produced pronounced elevation of mean arterial pressure (MAP) of acute (from 121 +/- 4 to 147 +/- 3.5 mmHg) and chronic (from 121 +/- 3 to 134 +/- 3.5 mmHg) SAD rats. Progressive stepwise increase of PIO2 (from 138 to 175, 210, and 235 mmHg) produced no additional elevation of MAP of acute (113 +/- 4, 137 +/- 5, 143 +/- 5, and 147 +/- 5 mmHg) and chronic (111 +/- 3.6, 131 +/- 7.4, 130 +/- 8.7, and 130 +/- 7 mmHg) SAD rats. Otherwise, the arterial pressure of control rats remained unchanged to progressive stepwise increase of PIO2 (118 +/- 5, 117 +/- 4, 118 +/- 4, 116 +/- 4 mmHg). These data suggest that the elimination of chemoreceptors in SAD rats produces hypoxemia responsible for hypotensive influences that counteract the pressor effects produced by baroreceptor elimination.
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Arobelidze, Salome, Abdo S. Haddad, Timothy Peter Spiro, and Hamed Daw. "Male breast cancer: Risk factors, treatment, and survival." Journal of Clinical Oncology 33, no. 28_suppl (October 1, 2015): 110. http://dx.doi.org/10.1200/jco.2015.33.28_suppl.110.
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110 Background: We conducted a retrospective study to investigate male breast cancer risk factors, treatment and survival. Methods: All patients with male breast cancer diagnosed between 1985 and 2014 at the Cleveland Clinic were retrospectively reviewed. Results: 131 patients were enrolled in the study. The median age at diagnosis was 66. Most of the tumors were invasive ductal carcinomas (85%, 111/131) and most were intermediate grade (47%, 41/87). Most patients had localized disease – stage 0-1 (45%, 48/107); stage 2 (35%, 37/107). Among the patients with data, 93% (94/101) were ER+, 73% (74/101) were PR+, 12% (10/80) were HER2 positive, and 6% were triple negative. Estimated median survival was 20.2 years (95% C.I. 19.0-29.4), and estimated 2 and 5-year survival were 96% + 2% and 87% + 3%. Grade was associated with outcome (p=.07). Conclusions: In our study only age at diagnosis was associated with overall survival. Further research is required to understand the treatment outcomes of this rare cancer. [Table: see text]
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Lin, Chin, Colin Edwards, Guy P. Armstrong, Anthony Scott, Hitesh Patel, Hamish Hart, and Jonathan P. Christiansen. "Prevalence and Prognostic Significance of Left Ventricular Dysfunction in Patients Presenting Acutely with Atrial Fibrillation." Clinical Medicine Insights: Cardiology 4 (January 2010): CMC.S4106. http://dx.doi.org/10.4137/cmc.s4106.
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The prevalence and prognostic importance of CM occurring as a consequence of AF is poorly defined. This study investigated the incidence of CM in patients with AF, its clinical features and long-term outcomes. We demonstrated that CM is common in patients presenting acutely with newly diagnosed rapid AF, and carries a worse long-term prognosis. Systolic dysfunction was reversible in an important proportion of patients, suggesting a greater prevalence of rate-related CM in AF than has previously been postulated. This underscores the importance of appropriate rhythm management strategies and repeat imaging studies. Background Atrial fibrillation (AF) may precipitate LV dysfunction, potentially leading to cardiomyopathy (CM). The prevalence and prognostic importance of CM occurring as a consequence of AF is poorly defined. We investigated the incidence of CM in patients with AF, its clinical features and long-term outcomes. Methods We reviewed 292 consecutive patients (average age 72 ± 13yrs) presenting acutely with AF and tachycardia over a 3 year period from June 2004. Clinical details were obtained from medical records. CM was defined as ejection fraction (EF) ≤ 50% on index admission. Results Echo was performed 93% of patients at index admission, and 69 (24%) had CM (average EF% = 37 ± 11), 60 of which were newly diagnosed. Patients with CM had significantly higher presenting heart rate (141 ± 19 vs. 132 ± 23 bpm), larger end-diastolic (5.7 vs. 5.2 cm) and end-systolic (4.5 vs. 3.2 cm) dimensions, and larger left atrial size (4.6 vs. 4.3 cm) ( P < 0.05 for all). They were also statistically more likely ( P < 0.05) to be male, present with breathlessness, have a history of coronary disease, and be treated with digoxin and warfarin. Follow-up echo between 6 and 12 months was performed in 46% of patients with new CM, and average EF rose to 53 ± 12%. At an average follow-up of 2.5 years, there was a significant increase in mortality in CM patients (16% vs. 9.5%, P < 0.05). Conclusion CM is common in patients presenting acutely with newly diagnosed rapid AF, and carries a worse long-term prognosis. Systolic dysfunction was reversible in an important proportion of patients, suggesting a greater prevalence of rate-related CM in AF than has previously been postulated. This underscores the importance of appropriate rhythm management strategies and repeat imaging studies.
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Michallet, Mauricette, Mohamad Sobh, Sandrine Leroy, Fiorenza Barraco, Xavier Thomas, Sophie Ducastelle, Bruno Lina, et al. "Impact of Single or Associated CMV, EBV and BK Virus Reactivation Early after Allogeneic Hematopoietic Stem Cell Transplantation on Relapse Incidence." Blood 124, no. 21 (December 6, 2014): 1428. http://dx.doi.org/10.1182/blood.v124.21.1428.1428.
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Abstract Background: Many recent studies have evaluated the impact of cytomegalovirus (CMV) reactivation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) showing a significant association with reduced risk of relapse. On the other hand, other frequent viral infections or reactivations like Epstein-Barr virus (EBV) and BK virus (BK-V) have not been evaluated in the same context and we do not know whether their association has an impact on transplantation outcomes or not. Objective: The aim of this study is to evaluate the impact of CMV, EBV and BK-V reactivation up to 3 months after allo-HSCT whether alone or associated on the relapse incidence of patients with hematological malignancies. Patients and methods: We evaluated 359 consecutive patients with hematological malignancies who received allo-HSCT and were followed in our center between January 2008 and June 2013; there were 218 (61%) males and 141 (39%) females with a median age of 48 years (range: 18-70), 182 (51%) had acute myeloid leukemia, 44 (12%) multiple myeloma, 34 (9%) myelodysplastic syndrome, 30 (8%) Non-Hodgkin lymphoma, 7 (2%) chronic lymphocytic leukemia, 21 (6%) myeloproliferative syndrome, 14 (4%) Hodgkin disease, 13 (4%) chronic myeloid leukemia and 14 (4%) aplastic anemia. At transplantation, 227 (63%) patients were in complete response (CR) or chronic phase (CP) and 132 (37%) were in less than CR or CP. For conditioning regimen, 171 (48%) were myeloablative and 188 (52%) were reduced intensity. DNA levels of CMV, EBV and BK-V in blood were detected by quantitative real-time polymerase chain reaction (RQ-PCR) after weekly monitoring up to 3 months after allo-HSCT. CMV-DNA, EBV-DNA or BK-V-DNA was considered positive when the copies exceeded 1000 copies/ml. Results: Among 359 patients, there were 102 patients who had CMV reactivation after a median time of 1.4 months (1.1-1.8) after allo-HSCT with a cumulative incidence of 25 % (24-26) at 3 months; 222 patients had EBV reactivation after a median time of 1.3 months (0.7-2.5) after allo-HSCT with a cumulative incidence of 48 % (47-50) at 3 months; and 38 patients had BK-V reactivation after a median time of 1.1 months (0.7-1.5) after allo-HSCT with a cumulative incidence of 10 % (9-11) at 3 months. The cumulative incidence of relapse at one and two years for the whole population was 27% (26-28) and 34% (33-35) respectively and the cumulative incidence of transplant-related mortality (TRM) was 22% (21-23) and 25% (24-26) respectively. The multivariate analysis took into account the type of disease, the type of conditioning, the disease status at transplantation, the presence of acute GVHD and single or the association of viral reactivation; this analysis showed that the presence of a single viral reactivation was associated with a significant lower relapse rate, for CMV: sdHR=0.34 [0.12-0.92], p=0.03, for EBV: sdHR= 0.52 [0.35-1], p=0.05 and for BK-V: sdHR=0.58[0.24-0.7], p=0.002; and that patients who have an associated CMV and EBV reactivation had significantly higher risk of relapse, sdHR= 5 [1.59-16], p=0.006. There was no significant impact of these reactivations on TRM. Conclusion: We confirmed the positive impact of CMV reactivation on relapse incidence, in addition we demonstrated that this impact exists also for EBV and BK-V, however we showed for the first time that the association of CMV and EBV was significantly associated with a higher risk of relapse. More investigations are ongoing to evaluate the immunological status of these patients and the different administered anti-viral treatments. Disclosures No relevant conflicts of interest to declare.
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Heimlich, Jonathan Brett, Godwin Chipoka, Portia Kamthunzi, Yuri D. Fedoriw, Nigel S. Key, Kenneth I. Ataga, and Satish Gopal. "Establishing Sickle Cell Diagnostics and Characterizing a Pediatric Sickle Cell Disease Cohort in Malawi." Blood 126, no. 23 (December 3, 2015): 2070. http://dx.doi.org/10.1182/blood.v126.23.2070.2070.
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Abstract Sickle cell disease (SCD) is highly prevalent in sub-Saharan Africa; however, there are relatively few studies describing the clinical profile for children with laboratory-confirmed SCD. Prior to December 2014, neither neonatal screening nor standardized methods for SCD diagnosis were routinely available in Malawi, as hemoglobin electrophoresis and alternative diagnostic methods were absent. We describe implementation of hemoglobin electrophoresis for children with clinically suspected SCD at Kamuzu Central Hospital, one of two national teaching hospitals in Malawi. Children with clinically suspected SCD were recruited January - May 2015 and underwent comprehensive clinical and laboratory characterization. 137 total patients were recruited and 117 were confirmed to have HbSS disease. Among children who were being cared for as SCD prior to enrollment, 86% had HbSS suggesting generally accurate clinical diagnosis by local providers. Baseline clinical parameters and self-reported SCD complications for the study population are displayed in Table 1. Of those with confirmed SCD, median age was 7.3 years (IQR 2.7-10.4) with 53% males. Prior malaria was reported by 39% of patients, and was higher in the 0-5 age group compared with the over 5 age group (46% vs. 31%, p=0.03). The most commonly reported SCD complications were anemia (72%), joint pain (56%), jaundice (52%), and acute pain episodes (50%). Children with confirmed SCD had median hemoglobin of 7.3 g/dL (IQR 6.9-7.9), total bilirubin of 1.7 mg/dL (IQR 1.1-2.6) and lactate dehydrogenase of 658 IU/L (IQR 527-773). Urinalysis demonstrated 26% of patients with blood and 7% with proteinuria by dipstick. As of May 2015, more than 250 samples for enrolled children as well as routine clinical care had been batch-processed weekly with an average turn-around time of 36 hours for results. Three Malawian laboratory technicians were trained to perform hemoglobin electrophoresis, all of whom have been performing the test independently since April 2015. Our findings highlight a need for wider implementation of resource-appropriate diagnostics as an essential foundation for care and research. Children had substantial clinical and laboratory evidence of SCD-related morbidity. Earlier diagnosis can improve care for this population by facilitating earlier therapeutic interventions, as well as providing a basis for research to better understand SCD-related morbidity in sub-Saharan Africa. These efforts can ultimately inform management strategies to improve outcomes and increase life expectancy among children with SCD in Malawi. Table 1. All (n=117) Male (n= 62) Female (n=55) p value Age years, median (IQR) 7.3 (2.7-10.4) 5.3 (2.3-9.4) 8.9 (4.2-11.9) 0.004 Height cm, median (IQR, n) 115 (88-131, 60) 111 (89-128, 36) 119.5 (93-140, 24) 0.21 Weight kg, median (IQR, n) 19 (13-27, 108) 16.5 (12-23.6, 58) 21 (14-30, 50) 0.01 Blood Pressure Systolic mmHg, median (IQR, n) 103 (98-110, 83) 101 (94-108, 43) 103 (99-110, 40) 0.37 Blood Pressure Diastolic mmHg, median (IQR, n) 60 (55-65, 83) 58 (53-65, 43) 61 (56-68, 40) 0.13 Heart Rate BPM, median (IQR, n) 104 (91-118, 114) 105 (94-123, 61) 104 (88-112, 53) 0.15 O2 Saturation %, median (IQR, n) 93 (88-97, 108) 91 (85-96, 59) 95 (91-98, 49) 0.004 % Hypoxemic (SPO2 < 90%), n (%) 36 (30.7) 26 (41.9) 10 (18.2) 0.005 Body Temperature Celsius, median (IQR, n) 37 (36.7-37.4, 91) 37 (36.7-37, 46) 37 (36.4-37.2, 45) 0.22 Positive History of: Malaria, n (%) 45 (38.5) 22 23 0.34 0-5 years, n (%) 25 (46.3) - - 0.03 6-18 years, n (%) 20 (31.7) - - Pneumonia, n (%) 29 (24.8) 10 (16.1) 19 (34.5) 0.02 HIV, n (%) 0 0 0 - Anemia, n (%) 84 (71.8) 49 (79.0) 35 (63.6) 0.06 Pallor, n (%) 16 (13.7) 7 (11.3) 9 (16.4) 0.43 Jaundice, n (%) 61 (52.1) 33 (53.2) 28 (50.9) 0.82 Received Blood Transfusion, n (%) 87 (74.4) 47 (75.8) 40 (72.7) 0.47 Days since last transfusion, median (IQR) 316 (133-1144) 240 (111-410) 577 (180-1784) 0.03 Pain episodes, n (%) 58 (49.6) 27 (43.5) 31 (56.4) 0.16 Joint pain, n (%) 66 (56.4) 33 (53.2) 33 (60.0) 0.34 Dactylitis, n (%) 41 (35.0) 19 (30.6) 22 (40.0) 0.29 Leg ulcers, n (%) 5 (4.3) 5 (8.1) 0 0.03 Stroke, n (%) 10 (8.5) 5 (8.1) 5 (9.1) 0.84 Nocturnal Enuresis, n (%) 24 (20.5) 12 (19.4) 12 (21.8) 0.74 Disclosures No relevant conflicts of interest to declare.
Books on the topic "141.132 : 37"
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Schuhmacher, Christian. Initiative und Referendum in der Verfassung des Kantons Zürich: Kommentar zu den Art. 23 - 37, 139 und 140 KV. Zürich: Schulthess Juristische Medien, 2007.
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Batún Guerrero, Antonio del Jesús, Luis Giovanni Ramírez Sánchez, Ángel Guadalupe Priego Santander, and José Manuel Camacho Sanabria. Paisajes físico-geográficos de ocho municipios del Estado de México, México a escala 1:250 000. Universidad Nacional Autónoma de México, Centro de Investigaciones en Geografía Ambiental, 2022. http://dx.doi.org/10.22201/ciga.002b.2022.
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Este producto cartográfico muestra la localización y distribución espacial de los paisajes físico-geográficos en ocho municipios del poniente del Estado de México a escala 1:250,000. Se determinaron geosistemas a nivel taxonómico de clase (5), subclase (14), localidades (37), parajes complejos (64) y parajes simples (137). Derivado del análisis de las unidades de paisaje, se tiene que más del 70% del territorio corresponde a montañas y lomeríos. En la litología existe una predominancia en formaciones de basalto (31.62%) y Andesita (18.1%). Siendo el suelo dominante el Andosol húmico (43.67%).
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Peter, Hilpold. 4 Legal Acts, 4.2 Solange I, BverfGE 37, 291, 29 May 1974; Solange II , BverfGE 73, 339, 22 October 1986; Solange III, BverfGE 89, 155 12 October 1993; and Solange IV, BverfGE 102, 147, 7 June 2000. Oxford University Press, 2016. http://dx.doi.org/10.1093/law/9780198743620.003.0020.
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The Solange case-law stands for a specific form of interaction between the legal order of the European Union (EU) and the legal orders of the member states (MS) or, respectively, between the European Court of Justice (ECJ) and the national Constitutional Courts of the MS. At the start of this line of cases the German Constitutional Court (Bundesverfassungsgericht—BverfG) first upheld its power to consider the compatibility of Community law rules with fundamental rights of the Basic Law (Grundgesetz) ‘as long as the integration process has not progressed so far that Community law receives a catalogue of fundamental rights’ (Solange I). Afterwards, when fundamental rights protection had become sufficiently strong within the EC/EU the BVerfG declared to refrain from such a control activity ‘as long as the European Communities ensure effective protection of fundamental rights’ (Solange II). Subsequently, this case-law was further clarified.
Book chapters on the topic "141.132 : 37"
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Song, Guo-qing, and Ken-ichi Yamaguchi. "Sweet Potato [Ipomoea batatas (L.) Lam.]." In Agrobacterium Protocols Volume 2, 37–44. Totowa, NJ: Humana Press, 2006. http://dx.doi.org/10.1385/1-59745-131-2:37.
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von Roth, Dominik, and Ulrike Roesler. "Nr. 131 | Oscar Comettant, „Liszt, Wagner, Schumann, and Baron, and the Vital Fluids!“, in: The Musical World 37 (1859), Nr. 37 (10. September), S. 588f." In Die Neudeutsche Schule – Phänomen und Geschichte, 1644–53. Stuttgart: J.B. Metzler, 2020. http://dx.doi.org/10.1007/978-3-476-04923-0_131.
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Rigaudias, Cecilia Alvarez, and Alessandro Spina. "Article 38 Position of the data protection officer." In The EU General Data Protection Regulation (GDPR). Oxford University Press, 2020. http://dx.doi.org/10.1093/oso/9780198826491.003.0076.
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Article 13(1)(b) (Information to be provided where personal data are collected from the data subject) (see too recitals 60–61); Article 14(1)(b) (Information to be provided where personal data have not been obtained from the data subject) (see too recital 61); Article 30 (Records of processing activities) (see too recital 82); Article 33 (Notification of a personal data breach to the supervisory authority) (see too recital 85); Article 35 (Data protection impact assessment) (see too recitals 90–91); Article 36 (Prior consultation) (see too recital 94); Article 37 (Designation of the Data Protection Officer) (see too recital 97); Article 39 (Tasks of the data protection officer) (see too recitals 77 and 97); Article 47 (Binding corporate rules) (see too recital 108); Article 52(1) (Independence of supervisory authorities) (see too recitals 117–118 and 120–121); Article 57 (Tasks of supervisory authorities) (see too recital 122); Article 69 (Independence of the EDPB) (see too recital 139).
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Taber, Douglass. "New Methods for Functional Group Conversion." In Organic Synthesis. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199764549.003.0008.
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Yujiro Hayashi of Tokyo University of Science and Teruaki Mukaiyama of the Kitasato Institute developed (Chem. Lett. 2008, 37, 592) a reduction-oxidation method for converting primary, secondary (such as 1, with clean inversion) and tertiary alcohols to sulfides. Peter A. Crooks of the University of Kentucky found (Chem. Lett. 2008, 37, 528) that tetrabenzylpyrophosphate 5 was an effective agent for condensing an acid 4 with an amine 6 to give the amide 7. This protocol, that runs in near quantitative yield in an hour at room temperature, with all impurities readily removable by washing with aqueous base and aqueous acid, appears to be well-suited both for scale-up, and for solid-phase synthesis. Balchandra M. Bhanage of the University of Mumbai reported (Tetrahedron Lett. 2008, 49, 965) the reductive amination of aldehydes, including 8, and ketones to the corresponding amines, using H2 and an inexpensive Fe catalyst. André Charette of the Université de Montréal showed (J. Am. Chem. Soc. 2008, 130, 18) that the Hantzsch ester 12 , in the presence of Tf2O, reduced amides selectively to amines. Esters, epoxides, ketones, nitriles and alkynes were stable to these conditions. Matthew Tudge of Merck Rahway demonstrated (Tetrahedron Lett . 2008, 49, 1041) that Br2 in DME activated NaBH4 , allowing facile reduction of esters, including the congested diester 14, at ambient temperature. David J. Procter of the University of Manchester made (J. Am. Chem. Soc. 2008, 130, 1136) the remarkable observation that six-membered ring lactones such as 16 were reduced to the corresponding diol with SmI2 . Five-membered ring and seven-membered ring lactones were not reduced under these conditions. Bruce H. Lipshutz of the University of California, Santa Barbara devised (Organic Lett . 2008, 10, 289) a convenient and economical procedure for CuH, using Cu and an inexpensive ligand in catalytic amounts, with PMHS as the bulk reductant. The reduction of 18 presumably proceeds by electron transfer, as with dissolving metal reduction, delivering 19 with the more stable trans ring fusion. In the presence of t-BuOH as a proton source, the reduction goes on to the alcohol 20.
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Aydın, Murat. "A Review of BIM-Based Automated Code Compliance Checking: A Meta-Analysis Research." In Automation and Control - Theories and Applications. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.101690.
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This study aims to discuss the articles which are only available in electronic academic databases and only written in English in the subject of BIM and ACCC. Statistical results about the articles are obtained by the meta-analysis. In this study, meta-analysis method was selected as the method, and the general situation of the articles is presented based on statistical analysis data in the AEC industry. For meta-analysis, adapting from previous studies, a meta-analysis template consisting of four main categories is created and each category is subdivided into sub-categories. As a result of the study conducted in the electronic academic databases of the ITU (Istanbul Technical University) library website, there are 168 studies, including 131 articles and 37 proceedings until 31.12.2020. Only articles are analyzed in this study, and proceedings are not included. A literature review is carried out in the publications on the subject of ACCC through BIM by the ITU library website’s academic databases to determine in which research trend is, in which areas are concentrated, and which areas are available. The study gives detailed information about the articles on ACCC subject area in the AEC industry in sub-categories when making general evaluation in categories.
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Bialyk, V. D. "SOME CRITERIA OF A LEXICAL QUANTOR TYPOLOGY." In TRADITIONS AND INNOVATIONS IN TEACHING PHILOLOGICAL DISCIPLINES, 37–53. Liha-Pres, 2019. http://dx.doi.org/10.36059/978-966-397-131-5/37-53.
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Taber, Douglass. "Construction of Alkenes, Alkynes and Allenes." In Organic Synthesis. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199764549.003.0020.
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Products such as 3 and 6 are usually prepared by phosphonate condensation. J. S. Yadav of the Indian Institute of Technology, Hyderabad found (Tetrahedron Lett. 2008, 49, 4498) that the cation-exchange resin Amberlyst-15 in CH2Cl2 mediated the condensation of a terminal alkyne such as 1 with an aldehyde to give the enone 3. Similarly, Teruaki Mukaiyama of Kitasato University showed (Chemistry Lett. 2008, 37, 704) that tetrabutylammonium acetate mediated the condensation of 5 with an aldehyde such as 4 to give the ester 6. David M. Hodgson of the University of Oxford described (J. Am. Chem. Soc. 2008, 130, 16500) the optimization of the Schlosser protocol for the condensation of a phosphorane with an aldehyde 7 followed by deprotonation and halogenation, to deliver the alkenyl halide 9 with good geometric control. Jun Terao of Kyoyo University and Nobuaki Kambe of Osaka University accomplished (Chem. Commun. 2008, 5836) the homologation of a halide such as 10 to the corresponding allylic Grignard reagent 12. Primary, secondary and tertiary halides worked well. Jennifer Love of the University of British Columbia developed (Organic Lett. 2008, 10, 3941) a Rh catalyst for the addition of thiols to terminal alkynes such as 13, and found that the product thioether 14 coupled smoothly with Grignard reagents to deliver the 1,1-disubstituted alkene 15. Glenn C. Micalizio, now at Scripps Florida, established (J. Am. Chem. Soc. 2008, 130, 16870) what appears to be a general method for the construction of Z-trisubstituted alkenes such as 18. The Ohira protocol has become the method of choice for converting an aldehyde 19 to the alkyne 21. We have found (Tetrahedron Lett. 2008, 49, 6904) that the reagent 20 offers advantages in price, preparation and handling. Bo Xu and Gerald B. Hammond of the University of Louisville observed (Organic Lett. 2008, 10, 3713) that an allene ester such as 22 is readily homologated to the alkyne 23. Ashton C. Partridge of Massey University extended (Tetrahedron Lett. 2008, 49, 5632) condensation with the aryl phosphonate 25 to porphyrin aldehydes, leading to alkynes such as 26.
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"DUST-BORNE TRACE GASES AND ODORANTS The analysis of dust-borne trace gases requires their i-solation from the dust particles. Procedures for the isolation and characterization of trace gases and odorants in the dust from pig houses are given by SCHAEFER et al. (29), HAMMOND et al.(30) and TRAVIS and ELLIOTT (31). Alcoholic solvents were found to be effective for the extraction of volatile fatty ac ids and phenols from the dust of hen (32) and pig houses (33), (34). Today, gas chromatography is usually used for the sepa ration and identification of the trace gases. Table IV gives a literature review of compounds identified in the dust of pig houses. There are only very few reports on investigations on the dust from hen houses (32). Most of the odours coming from livestock production units are associated with the biological degradation of the animal wastes (35), the feed and the body odour of the animals (1). Volatile fatty acids and phenolic compounds were found to con tribute mostly to the strong, typical odour of animal houses by the help of sensory evaluations parallel to the chemical analysis (29),(30). Table V gives quantitative values of volatile fatty acids and phenolic/indolic compounds found in the aerosol phase and in settled dust of piggeries, respectively. The results from the aerosol phase coincide, particularly as far as acetic acid is concerned. For the investigations of the settled dust the coefficients of variation (CV) and the relative values (%) characterizing the percentage of the single compounds as part of the total amount are quoted. The values are corrected with the dry matter content of the dust. Main components are acetic acid and p-cresol, respectively. Table VI compares results from air, dust and slurry in vestigations on VFA and phenolic/indolic compounds in piggeries. Relative values are used. When comparing the results derived from investigations on dust, air or slurry it is necessary to use relative values because of the different dimensions, for experience shows that in spite of large quantitative differ ences between two samples within the group of carboxylic acids and within the group of phenolic/indolic compounds the propor tions of the components remain rather stable (36). In the group of VFA acetic acid is the main component in air, dust, and slurry followed by propionic and butyric acid. The other three acids amount to less than 25%. In the group of phenols/ indoles p-cresol is the main component in the four cited in vestigations. However, it seems that straw bedding can reduce the p-cresol content; in this case phenol is the main compo nent , i nstead (37 ). 4. EMISSION OF DUST-BORNE VFA AND PHENOLS/INDOLES FROM PIGGERIES The investigations of dust from piggeries show that both VFA and phenols/indoles are present in a considerable amount. However, compared to the air-borne emissions calculated on the base of the results of LOGTENBERG and STORK (38) less than the tenth part (1/10) of phenols/indoles and about the hundredth part (1/100) of VFA are emitted by the dust, only. Table VII compares the dust-borne and air-borne emissions of VFA and." In Odour Prevention and Control of Organic Sludge and Livestock Farming, 337. CRC Press, 1986. http://dx.doi.org/10.1201/9781482286311-131.
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Taber, Douglass. "Best Synthetic Methods: Carbon-Carbon Bond Construction." In Organic Synthesis. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199764549.003.0018.
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In the context of peptidyl ketone synthesis, Troels Skrydstrup of the University of Aarhus developed (J. Org. Chem. 2008, 73, 1088) the elegant SmI2-mediated conjugate addition of acyl oxazolidinones such as 1 to acceptors such as 2. Sadagopan Raghavan of the Indian Institute of Chemical Technology, Hyderabad reported (Tetrahedron Lett. 2008, 49, 1601) that the addition of a Pummerer intermediate, generated by exposure of 4 to TFAA, to the terminal alkene 5 and SnCl4 led to efficient C-C bond formation, to give the sulfide 6 as a single (unassigned) diastereomer. Pd-catalyzed carbonylation of aryl halides and triflates is a well-established process. Stephen L. Buchwald of MIT has now (J. Am. Chem. Soc. 2008, 130, 2754) extended this transformation to much less expensive tosylates and mesylates such as 7. β-Amino acids have often been prepared from α-amino acids by Arndt-Eistert homologation. Geoffrey W. Coates of Cornell University has devised (Angew. Chem. Int. Ed. 2008, 47, 3979) a more practical alternative, the direct Co-catalyzed carbonylation of an oxazoline 9 to the 2-oxazine-6-one 10. Eiji Shirakawa and Tamio Hayashi of Kyoto University also used (Chem. Lett . 2008, 37, 654) a Co catalyst to promote the coupling of aryl and alkenyl Grignard reagents with enol trifl ates such as 11. Alois Fürstner of the Max-Planck-Institut, Mülheim optimized (Chem. Commun. 2008, 2873) promoters for the Pd-catalyzed Stille-Migata coupling of iodo alkenes such as 14 with alkenyl stannanes such as 15 to give 16. It is particularly noteworthy that their system is fluoride free. The stereocontrolled construction of trisubstituted alkenes continues to be challenging. We described (J. Org. Chem. 2008, 73, 1605) the facile preparation of the diioide 18 from the inexpensive 2-butyn-1,4-diol 17 . Sequential coupling of 18 with an aryl Grignard followed by CH3 Li delivered 19. Brian S. J. Blagg of the University of Kansas established (Tetrahedron Lett . 2008, 49, 141) that Still-Genari homologation of 20 with 21 gave (E)- 22 with high geometric control. Biao Jiang of the Shangahi Institute of Organic Chemistry reported (Organic Lett. 2008, 10, 593) a convenient alternative protocol to give ( Z )-α- bromo unsaturated esters.
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Hurl-Eamon, Jennine, and Lynn MacKay. "Robert Grenville Wallace, Fifteen Years in India or, Sketches of a Soldier's Life (London, 1823), PP. 51–6, 71–3, 80–1, 85–6, 101–4, 108–9, 115, 133–7, 167–9, 189–90, 224–5, 227-35, 251–4, 256, 261–2, 267–9, 270–1, 275, 280, 305–6, 314–15, 328–9, 375–6, 377–9, 403, 406, 439–47, 511, 512–15." In Women, Families and The British Army 1700-1880, 124–49. Routledge, 2020. http://dx.doi.org/10.4324/9781003011767-37.
Full textConference papers on the topic "141.132 : 37"
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Lenkov, Sergey, and Nadezhda Rubtsova. "Involvement into Cyber-Socialisation as a New Factor of Psychological Well-Being." In The Public/Private in Modern Civilization, the 22nd Russian Scientific-Practical Conference (with international participation) (Yekaterinburg, April 16-17, 2020). Liberal Arts University – University for Humanities, Yekaterinburg, 2020. http://dx.doi.org/10.35853/ufh-public/private-2020-37.
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The study is underpinned by a new author’s approach to understanding the involvement into cyber-socialisation as an integral psychological construct consisting of two relatively autonomous components: positive and negative involvement. The aim of this study was to identify relationships between youth engagement in cybersocialisation and the heterogeneous measures of a psychological well-being. For measurements the authors used the author’s ‘Questionnaire of involvement in cybersocialisation’, as well as Russian-language adaptations of the ‘Scale of psychological well-being’ C. D. Ryff, ‘Life satisfaction scale’ by E. Diener et al., and ‘Perceptible stress scale’ by S. Cohen & G. M. Williamson. The sample consisted of 268 persons aged 17 to 30 years, including 143 males (53.4 %) and 125 females (46.6 %), 131 employees in various organisations (48.9 %) and 137 full-time university and college students (51.1 %). Using an analysis of variance and regression, constructive engagement in cybersocialisation was found to increase indicators of psychological well-being and life satisfaction, and to decrease indicators of perceived stress, while destructive engagement in cybersocialisation had the opposite, negative impact on many of these indicators, and a significantly greater impact than constructive engagement. The findings confirm the ambivalent nature of cybersocialisation of contemporary youth and determine the prospects for a more detailed study of the structure and consequences of cybersocialisation processes in the developing information society of modern civilisation.
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Gomes Filho, José Euderaldo Costa, Ariane Silva da Rocha, Gisele Aparecida Fernandes, Rossana Verónica Mendoza López, and Maria Paula Curado. "PRE- AND POSTMENOPAUSAL BREAST CANCER IN COMPARISON OF CLINICAL AND PATHOLOGICAL FEATURES, HISTOLOGY, BIOMARKERS, AND MOLECULAR CLASSIFICATION." In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2043.
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The aim of this study was to analyze the clinical and pathological evolution, morphology, hormonal biomarkers (estrogen, progesterone, HER2, and Ki-67), and molecular classification in pre- and postmenopausal patients (age ≤50 years and >50 years). This is a cross-sectional study of 705 female patients with breast cancer. A total of 55.9% (n=394) of patients were above 50 years, whereas 44.1% (n=311) were aged 50 years or below. The laterality of the tumor was similar in both age groups on the right side, 50.2% (n=156) for premenopausal and 53.3 (n=210) for postmenopausal (p=0.226), as was the anatomical sublocation in the external upper quadrant, 44.9% (n=140) for premenopausal and 48.7% (n=192) for postmenopausal (p=0.063). As for T clinical staging, 37% (n=115) were classified as T2 in premenopausal while 47% (n=185) as T1 in postmenopausal (p <0.001); N0, 46.3% (n=144) and 57.6% (n=227) (p=0.043); M0, 92.3% (n=287) and 95.7% (n=377) (p=0.072); and pathological grade T1, 41.8 (n=130) and 48.2% (n=190) (p=0.056); N0, 52.4% (n=163) and 60.4% (n=238) (p=0.121); M0 94.9% (n=374) and 93.9% (n=292) (p=0.332); invasive ductal carcinoma, 86.5% (n=269) and 81% (n=319) (p=0.134); histological grade 2, 42.1% (n=131) and 44.9 (n=177) (p<0.001); nuclear grade 3, 67.2% (n=209) and 54.1% (n=213) (p=0.002); HER2 negative, 75.7% (n=234) and 77.2% (n=295) (p=0.062); estrogen positive, 78.4% (n=243) and 78.4% (n=309) (p=0.731); progesterone positive, 70.6% (n=219) and 68.8% (n=271) (p=0.503); Ki-67 positive, 99.7% (n=303) and 100% (n=368) (p=0.005); and molecular classification defined as luminal B, 57.8% (n=178) and 49% (n=187) (p=0.009), respectively. We observed that in pre- and postmenopausal women with breast cancer, there was no difference in characteristics, anatomical location, and T staging. However, there was a significant difference in histological grade, nuclear grade, and the molecular subtype and staging.
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Reichel, Thilo, Vitaliy Pavlyk, Jochem Beissel, Ivan Aretov, and Stelios Kyriakides. "On the Collapse Pressure of Impanded Large Diameter Pipe (JCO-C)." In 2012 9th International Pipeline Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/ipc2012-90735.
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Current manufacturing technology for large diameter pipe, such as the UOE process, is known to result in pipe with reduced collapse pressure compared to a seamless one of the same steel grade and D/t. It has recently been demonstrated [1,2] that such deficient performance can be alleviated by finishing longitudinally welded pipe by compression. A newly developed cold sizing press, called Impander®, is used to produce pipe with reduced ovality, reduced residual stresses and increased compressive yield strength. The combination of these factors can lead to a significant increase in the collapse pressure of the pipe. The paper will review experimental and analytical results that demonstrate the improved collapse pressure of pipes manufactured by it. This improved performance was confirmed in a full-scale collapse experiment on a pipe finished by impansion of 1.1%. The test showed perfect agreement with the modelling. The collapse pressure was 37% higher than current design codes allow. Additional work has been performed aimed at evaluating the effect of low temperature heat treatment on the collapse pressure. A full-scale collapse test on impanded and heat-treated pipe has shown that a significant additional enhancement in collapse pressure results from the heat treatment. The paper will discuss the thermomechanical causes of these enhancements of the collapse pressure.
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Savin, Anatol, Oleg Ciocoi, Mihail Scerbliuc, Gheorghe Grosu, and Victoria Nistreanu. "Seasonal and multiannual dynamics of sedentary species populations of hunting interest." In Xth International Conference of Zoologists. Institute of Zoology, Republic of Moldova, 2021. http://dx.doi.org/10.53937/icz10.2021.59.
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The aim of the research was to study the number dynamics of the populations of dominant sedentary species of hunting interest as a theoretical context in arguing sustainable measures for the management of economic interest fauna. The studies between 2000-2021 shows that after a period of depression in the populations of sedentary species of hunting interest in 2004-2012 there is an increase from 2016-2017 till present of reproductive stocks in all studied species on average by 95%. The losses in the cold period of the year varied depending on the climatic conditions of the cold period of the year, as well as the age structure at the end of the reproductive period: for the hare between 14% and 30%, with an average of 23%; in grey partridge from 56% to 71% and in pheasant they fluctuate between 48% and 56% of the autumn number, being lower in warm winters (37%). Analyzing the dynamics of annual increases in sedentary small game species in different climatic conditions, it was found that arid conditions during nesting and offspring growth, decrease annual increases by 143% in pheasants, 122% in hares, and only 74% in partridges, which is a species less dependent on aridizations in the vegetative period.
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STRAZDINA, Vija, Valentina FETERE, Liga FEODOROVA-FEDOTOVA, Janis JASKO, and Olga TREIKALE. "REACTION OF WINTER WHEAT GENOTYPES ON THE YELLOW (STRIPE) RUST PUCCINIA STRIIFORMIS, WES." In RURAL DEVELOPMENT. Aleksandras Stulginskis University, 2018. http://dx.doi.org/10.15544/rd.2017.124.
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Yellow rust, caused by Puccinia striiformis Wes. is one of the most significant diseases constraint to winter wheat production in the world. Since 2011 in Europe have appeared distinct new races – Warrior, Kranich, Warrior (-) that have caused wide epidemics on different cultivars of wheat. Grain yield losses can be prevented by using a combination of varietal resistance and fungicides. Information on wheat variety susceptibility to local yellow (stripe) rust Puccinia striiformis Wes. races can help to reduce the risk of yield losses in high disease pressure situations. Field trials with eight most popular and perspective winter wheat varieties in Latvia were established in the North-Western part of Latvia (Stende Research Centre) in autumn of 2016. The trial was designed as two randomized complete blocks (treated and untreated) and data were statistically interpreted. Two applications of fungicides at BBCH 29-32 by T1 (prothioconazol 53 g L-1, spiroxamin 224 g L-1, tebucanazole 148 g L-1) and at BBCH 37-39 - T2 (bixafen 65 g L-1, prothioconazol 130 g L-1, fluopyram 65 g L-1- 1.5 L ha-1) were used to control the YR. Yield and 1000 kernel weight (TKW) were determined. Preliminary results indicated the difference between genotypes resistance/susceptibility to YR. The severity of infection level was 1- 80% depending on genotype resistance. Application of fungicides increased grain yield by 2.9 % to 33.0% and TKW by 3.4% - 33.2 % depending on variety. Observations showed the difference in the occurrence of symptoms on YR in different varieties of winter wheat under conditions of 2017 in Stende.
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Blum, Catharina Maria Facciolli, Ellen Tieko Tsugami Dalla Costa, Paula Faria Campos, Lorena da Silva Rosa, Carolina Genaro Pultrin, and Enzio Galvão Diniz Torreão Braz. "A importância do diagnóstico diferencial diante da proteinúria na gestação: um relato de caso de síndrome nefrótica." In 45º Congresso da SGORJ XXIV Trocando Ideias. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/jbg-0368-1416-20211311103.
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Introdução: A síndrome nefrótica (SN) é classicamente definida por proteinúria severa, hipoalbuminemia, hiperlipidemia e edema. Na gestação ocorre o aumento fisiológico da taxa de filtração glomerular e da proteinúria, que é considerada anormal quando ultrapassa 0,3 g/dia. Embora dados sobre a prevalência da SN na gestação sejam escassos, é comum a associação entre pré-eclâmpsia (PE) e proteinúria nefrótica. Diante de quadros clínicos de proteinúria, edema e hipertensão, é desafiador fazer o diagnóstico diferencial entre PE isolada, SN nefrogênica e SN com PE sobreposta. O diagnóstico preciso e tempestivo é fundamental, pois o manejo e o prognóstico materno-fetal são distintos. Relato de caso: W.C.S., 23 anos, primigesta, 21 semanas e 5 dias, previamente hígida, deu entrada na maternidade com queixa de edema de membros inferiores (MMII) há um mês, evoluindo com anasarca e pico hipertensivo há um semana. Exame físico: estado geral regular, hipocorada e com discreto edema palpebral. Abdome globoso, gravídico, com sinais de ascite. Edema de MMII 4+/4+, simétrico. Pressão arterial de 130×88 mmHg. Exames laboratoriais mostraram: hipoalbuminemia severa (1,4 g/dL), proteinúria nefrótica (relação proteína/creatinina urinária =11,4) e hipertrigliceridemia (577 mg/dL). Durante a internação, a paciente foi acompanhada pela nefrologia e foram investigadas causas da SN. Foi excluído inicialmente lúpus eritematoso sistêmico pela ausência de critérios diagnósticos. Hepatites B e C foram excluídas, por sorologia, assim como malformações nos rins e vias urinárias, por ecografia. O tratamento proposto foi prednisona 1 mg/kg/dia, anticoagulação profilática com enoxaparina, furosemida e medidas de suporte clínico. A paciente teve evolução clínica favorável, apresentando normotensão e ausência de disfunção renal, de modo que se optou por não realizar a biópsia renal e manter a abordagem conservadora. Durante o acompanhamento ambulatorial, com 29 semanas, detectou-se crescimento intrauterino restrito estágio 1 pelo protocolo de Barcelona. Foi realizado controle ecográfico semanal e foi indicada a interrupção da gestação com 37 semanas. O parto cesáreo ocorreu sem intercorrências, e paciente e recém-nascido receberam alta hospitalar em boas condições. Conclusão: Este relato contribui para reforçar a importância do tratamento individualizado e do acompanhamento multidisciplinar, resultando em um bom desfecho materno-fetal. Dada a precocidade da detecção das alterações clínicas e laboratoriais, sem etiologia definida, optou-se por corticoterapia, com controle e mitigação da patologia materna. Não há evidências na literatura sobre vantagens da realização de biópsia renal em todos os casos. Sangramento e hematoma renal são possíveis complicações, devendo-se avaliar os riscos e benefícios desse procedimento. Por fim, é de suma importância monitorizar o crescimento fetal, bem como alterações na dopplerfluxometria, a fim de indicar a interrupção da gestação no momento mais oportuno.
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Rademaker, M., R. H. Meyrick Thomas, J. D. Kirby, and I. B. Kovaos. "EFFECT OF THE CALCIUM CHANNEL BLOCKER, NIFEDIPINE, ON HAEMOSTASIS, CLOTTING, AND THROMBOLYSIS EX VIVO." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1643436.
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Nifedipine, as other calcium channel blockers, has been shown to inhibit platelet aggregation induced by various agonists in vitro. The therapeutic relevance of these findings are, however, questionable, as in vitro inhibition of platelet function occurs at plasma concentrations of nifedipine in excess of 50 uM, while the peak plasma concentration following a single 10 mg oral dose of nifedipine is only 0.2 uM. We have used the Haemostatometer, to assess the effect of nifedipine on haemostasis ex vivo. This instrument allows quantitative assessment of haemostasis by monitoring the pattern of haemostatic plug formation (HPF) in holes punched through polyethylene tubing through which non-anticoagulated blood flows under standard conditions (1,2). The pattern and speed of blood coagulation subsequent to HPF was measured as was the spontaneous thrombolysis time (STT) (taken as the time until expulsion of the haemostatic plug from heparinised blood). All values are for mean + SEM.Blood samples were taken from 10 healthy volunteers before and ninety minutes after a single 10 mg oral dose of nifedipine. Following nifedipine, the initial phase of the haemostatic reaction (HPF) was prolonged from 0.95 ± 0.12 min to 1.57 ± 0.14 min, (p< 0.01); clotting time was also increased from 13.1 ± 1.1 min to 20.7 ± 2.3 min, (p=0.013), and the STT fell from 48.0 ± 9.9 min to 27.5 ± 4.6 min (p=0.014).The increased bleeding time (HPF) provides evidence that a therapeutic dose of nifedipine evokes an anti-platelet effect. The prolongation of the clotting time seen in this study could be explained by,an effect of nifedipine on platelets and hence clotting. The mechanism of the enhanced spontaneous thrombolysis following nifedipine is not known.We suggest that the effect of nifedipine on haemostasis and thrombolysis may contribute to its therapeutic effect.(1) Gorog P and Kovacs I B. Haemostasis 16: 337-345, 1986.(2) Gorog P. Angiology 37: 99-105, 1986.
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Kerr, Matthew, Sara Rohling, Maria Sousa Fialho, Colleen Lopez, Damian Tyler, and Lisa C. Heather. "P32 Mitochondria must choose between resistance to fatty acyl coa regulation or rapid respiration in the type 2 diabetic heart." In British Society for Cardiovascular Research, Autumn Meeting 2017 ‘Cardiac Metabolic Disorders and Mitochondrial Dysfunction’, 11–12 September 2017, University of Oxford. BMJ Publishing Group Ltd and British Cardiovascular Society, 2018. http://dx.doi.org/10.1136/heartjnl-2018-bscr.37.
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Teitel, J. M., M. B. Garvey, and J. J. Freedman. "THE ENDOTHELIAL CELL AS THE SII$ OF THE FACTOR VIII BYPASSING ACTIVITY OF PROTHROMBIN COMPLEX CONCENTRATE (PCC)." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644731.
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PCC is used empirically for its factor VIII (FVIII) bypassing activity in hemophiliacs with inhibitors to FVIII. The effect of of PCC on plasma coagulation tests is variable and is not predictive of clinical response. We are testing the hypothesis that bypass activity is expressed locally at the vessel wall, which functions as a procoagulant surface at times of hemostatic stress. Monolayer cultures of umbilical vein endothelial cells (EC) were incubated for 1 hour with commerical PCC (1 u/ml), and then extensively washed to remove fluid phase PCC components. Ellagic acid-activated PTT determinations were then done over the treated monolayers using plasma deficient in FVIII (<1 u/ml). PTTs over EC pre-treated with PCC were shorter than PTTs with control EC or EC pre-treated with commercial FVIII concentrate (control 101 s, PCC treated 57.7 s, FVIII treated 84 s, means of n=3). Similar results were obtained using non-activated PTTs and with adult saphenous vein EC. The bypass effect of PCC was dose-related:non-activated PTTs were 172 s (control),134 s (PCC 0.1 u/ml),and 107 s (PCC 1 u/ml). Pre-treatment of EC with cycloheximide shortened the PTT of FVIII deficient plasma, presumably due to impaired expression of endogenous anticoagulant activity.Subsequent incubation of cycloheximide pre-treated EC with PCC still provided FVIII bypass activity. In contrast, FVIII consistently failed to shorten the PTT using FVIII deficient plasma added to cycloheximide pre-treated EC. Thfe ability of PCC to bypass the FVIII defect was not impaired using paraformaldehyde 1fixed in place of live EC, but was reduced or abolished if the ECwere incubated with PCC at 4° instead of 37°.The putative FVIII bypassing component present in PCC may therefore express its activity only upon interacting with EC at sites of vascular interruption. Further studies using purified reagents will be necessary to identify the responsible substance(s). These observations may help explain the discrepancy between the clinical. efficacy of PCC and its inconsistent effect on plasma coagulation tests.
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Araujo, Edjane Silva, Claudia Regina de Andrade Arrais, Ana Luisa Duarte Cantanhede, João Victor da Cunha Silva, Cindy Lima Pereira, William Pereira Santos, Nilviane Pires Silva Sousa, and Allan Kardec Barros. "Prevalência e fatores associados à prática de atividade física por pessoas vivendo com vírus da imunodeficiência humana atendidos em serviço de referência." In XIII Congresso da Sociedade Brasileira de DST - IX Congresso Brasileiro de AIDS - IV Congresso Latino Americano de IST/HIV/AIDS. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/dst-2177-8264-202133p259.
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Introdução: A prática de atividades físicas por pessoas vivendo com vírus da imunodeficiência humana tem sido recomendada reiteradamente na literatura médica. Tal medida não farmacológica mostra-se eficaz na prevenção e no tratamento de quadros clínicos de dislipidemia, lipodistrofia e resistência à insulina associados tanto à ação do vírus quanto aos efeitos adversos da terapia antirretroviral. No entanto, estima-se que apenas 50,7% das pessoas vivendo com vírus da imunodeficiência humana estejam em conformidade com as diretrizes de exercícios físicos recomendadas. Objetivo: Analisar a prevalência e os fatores associados à prática de atividades físicas em pessoas vivendo com vírus da imunodeficiência humana. Métodos: Trata-se de um estudo observacional retrospectivo formado por 276 pessoas vivendo com vírus da imunodeficiência humana em terapia antirretroviral, atendidos no Serviço Ambulatorial Especializado de um município do interior do Maranhão durante o ano de 2018. As variáveis analisadas foram prática de atividades físicas, sexo, idade, peso e escore de risco de Framingham. Classificou-se a amostra em dois grupos: praticantes e não praticantes de atividade física. Para a análise estatística utilizou-se o software SPSS® versão 19.0. Os resultados foram considerados significativos se p <0,05. Resultados: Entre os participantes do estudo, 44,6% (n=123) eram mulheres e 55,4% (n=153) eram homens. Ademais, desse contingente total de pacientes, 67% (n=185) eram não praticantes de atividades físicas e, desses, 91,4% (n=169) possuíam baixo risco de eventos cardiovasculares, segundo escore de risco de Framingham, e 8,6% possuíam risco moderado e alto. O grupo praticante de atividades físicas apresentou menor mediana na variável idade [37 (31–45) anos, p=0,004] e maior mediana na variável peso [68 (60–77,5) kg, p=0,015]. Entre os praticantes de atividades físicas, houve uma alta prevalência de risco baixo, onde 98,9% (n=90) apresentaram risco baixo e apenas 1,1% (1) de risco moderado e alto. Conclusão: A ausência da prática de atividades físicas é prevalente entre pessoas vivendo com vírus da imunodeficiência humana e estes estão mais associados ao moderado e alto risco de eventos cardiovasculares. Nesse sentido, é essencial que a equipe do Serviço Ambulatorial Especializado priorize ações que influenciem a prática de atividades físicas a fim de evitar morte precoce por doença cardiovascular.
Reports on the topic "141.132 : 37"
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Савосько, Василь Миколайович, Наталія Вікторівна Товстоляк, and Катерина Михайлівна Домшина. Сучасний стан вікових екземплярів дубу звичайного парку ім. Федора Мершавцева (м. Кривий Ріг). Одеський націоналний університет, 2018. http://dx.doi.org/10.31812/123456789/3630.
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За дендрометричними і санітарними характеристиками та показника- ми декоративності з’ясовували сучасний стан вікових екземплярів дубу звичайного на території парку культури та відпочинку ім. Федора Мер- шавцева (м. Кривий Ріг). В межах території парку виявлено 64 екземп- ляри вікових дерев дубу звичайного. Вони згруповані у чотири локації: Фундатори Криворіжжя (чотири дерева), Криворізька діброва (46 дерев), Криворізький квартет (п’ять дерев), Гданцівські дуби (дев’ять дерев). Ві- кові дерева парку характеризуються: 1) унікальними дендрометричними показниками висоти дерева (від 14 м до 38 м, в середньому 25 м) та ді- аметру стовбуру (від 37 см до 102 см, в середньому 62 см); 2) задовіль- ним санітарним станом та високою естетичністю; 3) наявністю вікових (100–200 років) та багатовікових (200–1000 років) екземплярів (вік двох дерев перевищує 300 р., вік восьми дерев перевищує офіційний вік на- шого міста – 245 р.). Рекомендовано створення ботанічної пам’ятки природи «Вікові дерева дубу звичайного парку імені Федора Мершавцева (м. Кривий Ріг)».
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Glewwe, Paul, Zoe James, Jongwook Lee, Caine Rolleston, and Khoa Vu. What Explains Vietnam’s Exceptional Performance in Education Relative to Other Countries? Analysis of the Young Lives Data from Ethiopia, Peru, India and Vietnam. Research on Improving Systems of Education (RISE), September 2021. http://dx.doi.org/10.35489/bsg-rise-wp_2021/078.
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Vietnam’s strong performance on the 2012 and 2015 PISA assessments has led to interest in what explains the strong academic performance of Vietnamese students. Analysis of the PISA data has not shed much light on this issue. This paper analyses a much richer data set, the Young Lives data for Ethiopia, India (Andhra Pradesh and Telangana), Peru and Vietnam, to investigate the reasons for the strong academic performance of 15-year-olds in Vietnam. Differences in observed child and household characteristics explain 37-39% of the gap between Vietnam and Ethiopia, while observed school variables explain only about 3-4 additional percentage points (although an important variable, math teachers’ pedagogical skills, is not available for Ethiopia). Differences in observed child and household characteristics explain very little of the gaps between Vietnam and India and between Vietnam and Peru, yet one observed school variable has a large explanatory effect: primary school math teachers’ pedagogical skills. It explains about 10-12% of the gap between Vietnam and India, raising the overall explained portion to 14-21% of the gap. For Peru, it explains most (65-84%) of the gap.
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Stampini, Marco, Pablo Ibarrarán, Carolina Rivas, and Marcos Robles. Adaptive, but not by design: cash transfers in Latin America and the Caribbean before, during and after the COVID-19 Pandemic. Inter-American Development Bank, November 2021. http://dx.doi.org/10.18235/0003795.
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The socioeconomic crisis associated with the pandemic put cash transfer programs back at the top of the policy agenda. It showed that the Latin American and Caribbean regions income support systems were both fundamental and insufficient. In this paper, we present novel estimates of the coverage and beneficiary distribution of all non-contributory cash transfers both before and during the COVID-19 crisis. The former is useful to show the degree of preparedness of the region. The latter analyzes the magnitude of the policy response. While the literature presents estimates of coverage and leakage of conditional cash transfers and non-contributory pensions, our results are novel because they are the first to analyze coverage and leakage implemented in response to the COVID-19 crisis. In addition, we are the first to expand the focus to all non-contributory cash transfer programs, including those that are quasi-universal and/or unconditional. This is the most appropriate focus when the goal is to assess the ability to provide protection to larger population groups (including the vulnerable) and against transitory poverty caused by systemic shocks (such as pandemic or extreme weather events, which may become more and more frequent due to climate change). Using data from the Inter-American Development Bank “Harmonized Household Surveys from Latin America and the Caribbean”, which now provide a more comprehensive coverage of Caribbean countries, we show that before the pandemic non-contributory cash transfers covered 26% of the population of 17 countries with available data. Average coverage of the extreme poor, moderate poor and vulnerable population was 56%, 43% and 28% respectively. During the crisis, LAC governments implemented 111 new cash transfer interventions, increasing coverage to 34% of the population in 12 countries with available data. Average coverage increased among the moderate poor (50%) and vulnerable population (37%), while it remained unvaried amongst the extreme poor. Moving forward, the countries of the region are called to reform their social protection systems to make them more flexible, efficient, and sustainable, and including strategies that provide protection against shocks. In this way, resilient and responsive social protection systems can contribute to the fight against climate change and support a just transition towards net-zero emission societies. These efforts must also include measures to close the historical coverage gap amongst the poorest.