Academic literature on the topic '363.738 4'

In [Analysis 1985, 5 (4), 301-313], J.A. Fridy proved an equivalence relation between statistical convergence and statistical Cauchy sequence. In this paper, we define $A^{I^{\ast }}$-statistical convergence and find under certain conditions, that it is equivalent to $A^{I}$-statistical convergence defined in [Appl. Math. Lett. 2012, 25 (4), 733-738]. Moreover, we define $A^{I}$- and $A^{I^{\ast }}$-statistical Cauchy sequences and find some equivalent relation with $A^{I}$- and $A^{I^{\ast }}$-statistical convergence.

Abstract Background Idiopathic cytopenia of undetermined significance (ICUS) is characterized by a persistent and clinically significant cytopenias which does not meet the diagnostic criteria for myelodysplastic syndrome (MDS). In some patients with ICUS, disease evolution to MDS or acute myeloid leukemia after variable periods of time was observed in several studies. However, the incidence and predictive factors of progression as well as management guidelines for ICUS patients are not well established. We aimed to identify the clinical and genetic characteristics of ICUS in comparison with lower-risk MDS for understanding the pathophysiologic features and providing guidance for treating physicians. Methods We performed targeted deep sequencing including 61 myeloid neoplasm-related genes with a MiSeqDx sequencer (Illumina) using bone marrow (BM) samples obtained from the patients with ICUS (n=139) and MDS (n=226) between May 2009 and December 2019. The cut-off level of variant allele frequency (VAF) was set to 2.0% of mutant allele reads. Cloncal cytopenia of undetermined significance (CCUS) was defined as ICUS with ≥ 2% VAF of mutations and lower-risk MDS was defined as MDS with revised international prognostic scoring system ≤3.5. Results When we compared the overall survival (OS) of the patients according to the disease subtypes, OS of CCUS (77.0% at 5-year) was significantly better than that of higher-risk MDS (41.0%, P<.001) and worse than non-clonal ICUS (94.1%, P=.050), but it was similar to the OS of lower-risk MDS (67.9%, P=.363). Next, we compared the clinical and mutational features between CCUS (n=78) and lower-risk MDS (n=99). As shown in Table, there was no significant difference of patient characteristics between two groups except for higher hemoglobin level (10.5 vs. 9.0 g/dL, P=.008) in CCUS than lower-risk MDS, and the rate of red blood cell transfusion dependency was not different (P=.738). The median number of mutated genes of CCUS and lower-risk MDS were 1 (range, 0-4) and 1 (range, 0-6) (P=.651), and the median mutation numbers were 1 (range, 0-5) in CCUS and 2 (range, 0-7) in lower-risk MDS, respectively (P=.711). The mutational profiles of 61 genes were also similar between CCUS and lower-risk MDS except for SF3B1 (2.6% in CCUS and 18.2% in lower-risk MDS; P=.001) and STAT3 (5.1% in CCUS and 0% in lower-risk MDS; P=.023). Overall, 11 of 78 CCUS and 24 of 99 MDS died, and the causes of death were not different between two groups (P=.861). Conclusion In our study, CCUS and lower-risk MDS showed similar OS which was significantly better than higher-risk MDS and worse than non-clonal ICUS. The clinical and mutational characteristics were also similar except for the degree of anemia and the SF3B1 and STAT3 mutation. Our findings suggest that the patients with CCUS may be regarded and treated as the lower-risk MDS despite a lack of significant dysplasia or MDS-associated definitive chromosomal abnormality. Disclosures Choi: Ingenium Therapeutics, Daejeon, Korea: Consultancy, Current holder of individual stocks in a privately-held company. Lee: Ingenium Therapeutics, Daejeon, Korea: Consultancy, Current holder of individual stocks in a privately-held company. Lee: Korean Society of Hematology: Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Other: Advisory board; Astellas Pharma, Inc.: Consultancy, Honoraria, Other: Advisory board.

On 29 September 417 'Zosimus', bishop of Rome, wrote 'Epistula' 5 ('Multa contra' - JK 334 = J3 740) to the bishops of the Gallic provinces of Viennensis and Narbonensis Secunda. It followed a synod that had been held in Rome on 22 September to consider alleged violations by Proculus of Marseille of the hierarchical relationship between the churches of southern Gaul and the authority of metropolitan bishops over the other churches of their provinces. Episcopal authority was geographically defined and circumscribed by Roman provincial boundaries, with the bishop of a provincial capital having some authority over the other bishops of the province. What was to happen, though, when those boundaries changed or a new city within a province became capital? In a series of four letters (the others being 'Epistulae' 4 ['Cum aduersus' - JK 331 = J3 737], 6 ['Mirati admodum' - JK 332 = J3 738], and 7 [Quid de 'Proculi' - JK 333 = J3 739) written immediately after the synod, of which this letter is the last, Zosimus supported the claims of Patroclus, bishop of Arles, to be not only the metropolitan of Viennensis but, surprisingly, the sole metropolitan over several Roman provinces. This paper examines how authority within the late antique church was dependent upon spatial organisational arrangements and how temporal arguments could be advanced when such spatial arrangements did not suit the personal plans of some ambitious bishops. It further considers the religious conflict that arose over disputed areas of authority and the mechanism by which attempts were made at its resolution and how Zosimus' action contributed ultimately to a developing concept of papal primacy.

Two novel thiopyrano [4,3-d] pyrimidine derivatives 7 and 8 were synthesized from dimethyl 3,3'-thiodipropanoate through six steps including two times of cyclization, chlorination, oxidation, substitution with morpholine and piperazine and their structures were confirmed by1H NMR and MS spectrum. The total yield of the six steps was 18.6% (calculated from methyl dimethyl 3,3'-thiodipropanoate). The synthetic routes of them can be used to synthesize PI3K/mTOR inhibitors bearing a thiopyrano [4,3-d] pyrimidine nucleus.

Анапластическая Т-клеточная лимфома, ассоциированная с имплантами молочных желез, или имплант-ассоциированная Т-клеточная лимфома (ИА-ТКЛ), является редкой формой неходжкинскихT-клеточных лимфом (CD30+/ALK-), развивающейся в фиброзной капсуле (или за ее пределами), возникающей вследствие длительного контакта импланта с тканями реципиента. Заболеваемость данным видом лимфом неуклонно увеличивается – по данным на конец 2021 г. в мире зарегистрировано 733 случая ИА-ТКЛ и 36 летальных исходов, связанных с ИА-ТКЛ, большая часть в США – 363, Австралии – 112, Франции – 86. В России зарегистрировано только 4 случая без летальных исходов. В статье описаны современный подход к диагностике и лечению ИА-ТКЛ и собственный клинический опыт. Breast implant-associated anaplastic T-cell lymphoma or implant-associated T-cell lymphoma (BIA-TCL) is a rare type of non-Hodgkin T-cell lymphoma (CD30+/ALK-) which evolves from fibrous cap or outside due to long-term contact between the implant and the recipient tissue. The incidence of this type lymphoma is increasing – 733 cases of BIA- TCL and 36 deaths in the end of 2021 worldwide. Most cases in the United States – 363, Australia – 112, France – 86, in Russia only 4 cases are registered without fatalities. The article describes the current approach to the diagnosis and treatment of BIA-TCL and own clinical experience.

A series of 1,3,5-triazine derivatives that contain 4-amino-2-trifl uoromethyl-benzonitrile, 8-hydroxyquinoline, and different piperazines as substituents at the carbon atoms of the triazine ring have been synthesized by a simple and efficient synthetic protocol. The chemical structures of the compounds were elucidated with the aid of IR, 1H NMR and 13C NMR spectroscopy, and elemental analysis. The antimicrobial activity of the compounds was tested against seven bacteria (Staphylococcus aureus MTCC 96, Bacillus cereus MTCC 619, Escherichia coli MTCC 739, Pseudomonas aeruginosa MTCC 741, Klebsiella pneumoniae MTCC 109, Salmonella typhi MTCC 733, Proteus vulgaris MTCC 1771) and four fungi (Aspergillus niger MTCC 282, Aspergillus fumigatus MTCC 343, Aspergillus clavatus MTCC 1323, Candida albicans MTCC 183). The results indicate that some of the novel s-triazines have noteworthy activity in minimum inhibitory concentration as well as agar diffusion tests.

AbstractObjective:To evaluate the food and nutrient intake of members of a birth cohort study when young children in 1950 and investigate differences from present-day children's diets.Design:One-day recall diet records from the MRC National Survey of Health and Development (NSHD) (1946 Birth Cohort) at age 4 years were analysed for energy and selected nutrients and compared to the published results for 4-year-olds in the 1992/93 National Diet and Nutrition Survey (NDNS).Setting:England, Scotland and Wales in 1950 and 1992/93.Subjects:4599 children in 1950 and 493 children in 1992/93.Results:Mean (SD) daily intakes in 1950 were energy 1445 (343) kcal, or 6.1 (1.4) MJ, protein 46 (11)g, fat 64 (20)g, starch 117 (33)g, sugar 62 (24)g, unavailable carbohydrate 13 (4)g, calcium 736 (230)mg, iron 7.7 (2.1)mg, retinol 738 (1273) μg, carotene 1049 (1130) μg and vitamin C 40 (26) mg. Compared to 1992/93, the 1950 diet contained substantially more bread and vegetables and less sugar and soft drinks, giving it a higher starch and fibre content and making it more in line with current recommendations on healthy eating. However, fat provided 40% of energy in 1950, compared to 35% in 1992/93. In 1950, red meat was an important source of iron, but by 1992 most iron came from fortified breakfast cereals. Vitamin C came mainly from vegetables in 1950, but from soft drinks in 1992.Conclusions:The relative austerity of post-war food supplies resulted in food and nutrient intakes in 1950 which in many respects may well have been beneficial to the health of young children, despite fat intake being higher than present-day recommendations.

Цель. Оценка информативности и осуществление отбора признаков для классификации объектов, на цифровых изображениях микроскопических препаратов, окрашенных по методу Циля-Нильсена с помощью методов Шеннона и Кульбака, а также сравнение результатов их применения.Материалы и методы. Использовались данные о 343 687 объектах, выделенных на цифровых изображениях микроскопических препаратов: 6 708 объектов – кислотоустойчивые микобактерии, 336 979 – иные объекты. Анализ объектов производился по 240 цветовым и морфометрическим признакам, оценка информативности которых осуществлялась с помощью методов Шеннона и Кульбака. Оценка качества отбора признаков осуществлялась с применением наивного Байесовского классификатора.Результаты. Наибольшую информативность по методу Шеннона имели цветовые признаки объектов и соотношения их размеров, а наибольшая доля верно классифицированных объектов (84,6%) была достигнута при включении в классификационную модель 6 признаков с наибольшей информативностью по методу Шеннона. Наибольшую информативность по методу Кульбака имели радиальные размеры объектов и их соотношения, а наибольшая доля верно классифицированных объектов (78,0%) была достигнута при включении в классификационную модель 14 признаков с наибольшей информативностью по методу Кульбака.Заключение. Методы Шеннона и Кульбака могут применяться для снижения признакового пространства при классификации объектов. Метод Шеннона позволяет в большей мере сократить количество признаков, обеспечивая при этом наибольшую долю верной классификации объектов.

Dissertação de mestrado em Economia, Bancária e Financeira
Este trabalho tem como objetivo analisar a influência que a crise financeira de 2008 teve nas duas grandes áreas monetárias, Estados Unidos da América e União Europeia, e de que forma esta crise alterou os sistemas financeiros das duas áreas de moeda única. Deste modo, analisa-se a evolução dos sistemas financeiros até 2008 e a sua reação à crise financeira, tomando-se conhecimento das forças e fragilidades reveladas pelos setores financeiros das duas áreas em observação, nos anos anteriores e posteriores ao momento de eclosão da crise. Neste sentido, compara-se o que foi feito nos dois sistemas financeiros norte-americano e europeu, realçando algumas das principais diferenças que estas duas áreas monetárias apresentam em relação ao setor bancário. Com os conhecimentos adquiridos na análise acima referida, torna-se possível propor um possível caminho que os países da União Europeia deverão percorrer a curto e médio prazo. Com efeito, propõem-se aqui a criação de uma união bancária europeia, enfatizando mesmo a sua urgência, não só para evitar danos de eventuais crises financeiras futuras, mas também para avançar com o objetivo principal da União Europeia, de criação de uma área monetária robusta, independente, com crescimento económico e capaz de proporcionar melhorias na qualidade de vida de todos os cidadãos europeus.
This dissertation aims to analyze the influence of the 2008 financial crisis in the two major currency areas, the United States and the European Union, as well as how this crisis changed the financial systems of the two single currency areas. Thus, we analyze the evolution of these two financial systems until 2008, and their reaction to the financial crisis, acquiring knowledge of the strengths and weaknesses revealed by the financial sectors of the two areas under observation in the years before and after the crisis onset. In this sense, we compare what was done in the north American and European financial systems, highlighting some key differences between these two monetary areas regarding the banking sector. With the knowledge acquired in the above referred analysis, it is possible to propose a path that EU countries should follow, in the short and medium term. Indeed, here, we propose the creation of a European banking union, emphasizing, in fact, its urgency, not only to prevent damage from future financial crises, but also to move forward with the main goal of the European Union: the creation of a robust monetary area, independent, with economic growth, and able to provide improvements in the quality of life of all European citizens.

Neste livro são apresentados resultados de trabalhos científicos aplicados à grande área de Engenharia. De abordagem objetiva, a obra se mostra de grande relevância para graduandos, alunos de pós-graduação, docentes e profissionais. Os capítulos estão agrupados em duas seções: i) materiais; ii) águas continentais e oceânicas. Pelo capítulo um é apresentado o desenvolvimento de uma metodologia para obter-se reprodutibilidade da área superficial de um eletrodo de estanho durante o estudo do crescimento de óxidos de estanho. A reprodutibilidade da área superficial pode ser comprovada pela reprodutibilidade das densidades de carga anódicas dos voltamogramas anódicos a 50 mVs-1 posteriores a cada tratamento. Por meio do capítulo dois é analisada a substituição de parte do carvão mineral, utilizado em siderúrgicas, por biomassa. Entre os grandes desafios do setor estão a produção de aço a preços competitivos e a substituição de parte do carvão mineral utilizado por biomassa. A biomassa é considera neutra em emissões de CO2, devido a captura do mesmo durante o processo de fotossíntese, o que a torna atraente para seu uso nos processos siderúrgicos. Além disso, o seu uso pode gerar redução de custos, principalmente se for considerado os rejeitos do agronegócio que não possuem um alto valor agregado. Neste contexto, por este capítulo serão mostradas algumas possíveis utilizações de biomassa nos processos siderúrgicos através de estudos que vem sendo realizado no tema e aplicações na indústria. Será possível notar que o uso de biomassa é uma alternativa viável a curto prazo para atender as crescentes restrições ambientais atuais. Através do capítulo três é analisado o crescimento voltamétrico de óxido de estanho em solução tampão fosfato, pH 8,7. Medidas elipsométricas ex-situ foram realizadas para determinar a espessura dos óxidos crescidos. A partir desses resultados, o volume do filme por unidade de carga, Vf, foi calculado para diferentes densidades de carga. As medidas elipsométricas mostram que filmes de óxido de estanho crescidos a 2 mVs-1 são menos densos para valores de espessura 3,37 nm, tendo Vf próximo a 1,70 x 10-4 cm3C-1. Para valores mais altos de espessura (11,0 – 12,4 nm) os filmes se tornam mais densos tendo Vf próximo a 0,5 x 10-4 cm3C-1. No caso de 100 mVs-1 os filmes apresentam o mesmo comportamento, tendo Vf próximo de 3,74 x 10-4 cm3.C-1 para espessura de 4,56 nm e Vf próximo de 1,32 x 10-4 cm3.C-1 para espessura de 7,42 nm. Imagens de Microscopia de Força Atômica mostraram que a morfologia muda e a rugosidade dos filmes aumenta com o aumento da espessura e do potencial final da voltametria. O capítulo quatro trata do Nitreto cúbico de boro (cBN), material imprescindível para usinagem com alta precisão e alta velocidade de APRESENTAÇÃO materiais ferrosos como aço. O cBN é recomendado para trabalhos sob condições severas, tais como corte intermitente, em que dureza deve estar associada com tenacidade para evitar a quebra. Na síntese do cBN, são aplicados, basicamente, dois tipos de catalisadores: nitreto de magnésio e magnésio. Cada qual oferece diferentes possibilidades, tais como maiores valores de profundidade de corte ou menor nível de rugosidade superficial. Este capítulo contribui para uma melhor compreensão da manipulação dos parâmetros aplicados no regime de síntese deste elemento e, favorecendo o desenvolvimento da tecnologia de sua produção. Por meio do capítulo cinco é avaliada a aplicação de separação magnética de alta intensidade no beneficiamento de itabiritos pobres. Na rota de processo avaliada (separação magnética + flotação), a etapa de separação magnética executa a função de pré-concentração e deslamagem. O teor de SiO2 no concentrado foi de 1,46% (menor que o teor objetivo de 2,00%). As recuperações mássica e metalúrgica obtidas com a rota separação magnética + flotação foram maiores em termos absolutos 3,3% e 4,4%, respectivamente. Através do capítulo seis é realizada a otimização de injeção de poliamida PA66 com 50% GF usando o método Taguchi. O estudo se justifica pela necessidade crescente de materiais mais leves e de maior produtividade em substituição às ligas metálicas, o que demanda o constante desenvolvimento de compósitos poliméricos e eficazes processos de fabricação. Como resposta do estudo, mediu-se a resistência máxima de tração (RTmáx), numa poliamida 66 com carga de 50% de fibra de vidro, Grivory GV-5H®. Fez-se uso da metodologia ANOVA para indentificar-se os fatores de maior significância para o processo. A melhor resistência máxima de tração obtida de 242,6 N/m2, mostrou-se como uma opção na substituição à aplicações de ligas metálicas de alumínio. A melhor resultado se obteve com a temperatura de processamento em 270°C, o fluxo volumétrico de 83 cm³/s, a pressão de recalque de 300 bar, a contrapressão de 10 bar, velocidade da rosca de 50 min-1 e o tempo de recalque com valor de 5 s. As porcentagens de contribuição encontradas foram pressão de recalque com contribuição de 61%, seguido da temperatura de processamento, com contribuição de 17% e em terceiro, o fluxo volumétrico com contribuição de 12%. A instalação de grandes equipamentos submarinos em águas profundas apresenta uma série de desafios. O capítulo sete trata da análise de estabilidade hidrodinâmica de Manifolds submarinos durante a instalação pelo método pendular. O presente capítulo racionaliza tal método e, além disso, considera sistemas para evitar o capotamento, durante um momento crítico do método que é o início da descida, apresentando uma modelagem matemática fenomenológica a partir de casos similares. A etapa de validação foi realizada pela análise comparativa entre a modelagem proposta e resultados de testes experimentais realizados com modelos físicos. Com a confirmação da aderência dos resultados numéricos com os experimentos, esta abordagem se confirma como uma ferramenta de engenharia para dimensionamento dos equipamentos submarinos instalados pelo Método Pendular para que sejam direcionalmente estáveis. Por meio do capítulo oito são apresentados os resultados da simulação da distribuição espacial das ondas geradas pela ação de ventos severos sobre o reservatório da barragem de Salto Caxias, no rio Iguaçu, estado do Paraná. Os ventos severos foram estimados através da análise de frequência regional para várias estações anemométricas do Instituto Meteorológico do Paraná (SIMEPAR) para o período de 1998 a 2005. As alturas de ondas foram estimadas pelo método paramétrico SMB, que usa como dados de entrada o fetch e a velocidade do vento. O método SMB foi aplicado pelo modelo computacional ONDACAD. Os testes estatísticos indicaram que a distribuição de Wakeby foi a mais robusta para as séries curtas de ventos horários máximos anuais, produzindo estimativas de ventos severos que variaram entre 25,7 ms-1 (tempo de retorno de Tr=10 anos) a 50,9 ms-1 (Tr=100 anos). O estudo presta grande contribuição à compreensão da quantificação das alturas de ondas geradas por ventos severos neste importante reservatório do estado do Paraná. Pelo capítulo nove é apresentada uma análise comparativa bidimensional entre alturas de ondas resultantes da aplicação dos modelos paramétricos MARQUES e JONSWAP ao reservatório da Usina Hidrelétrica de Itaipu Binacional, localizado no Rio Paraná entre o Brasil e o Paraguai. Os campos de vento uniforme relacionados a períodos de recorrência de 10, 20, 50 e 100 anos foram obtidos pelos registros realizados pelo Sistema Meteorológico do Paraná (SIMEPAR). Através da utilização do modelo ONDACAD foram determinados os campos de fetch e a transformação em campos de ondas pela utilização dos modelos paramétricos MARQUES e JONSWAP. Ao proceder a análise constatou-se que, ao majorar os resultados do modelo JONSWAP em 78% chega-se aos resultados bidimensionais gerados pelo modelo Marques. Esta condição foi verificada para situações de ventos extremos, ou seja, superiores a 20ms-1 e corpos hídricos que possuem fetch máximo da ordem de 10 quilômetros. O estudo contribui para a compreensão da distribuição das magnitudes das alturas de ondas neste reservatório de grande importância no âmbito da América do Sul, de grande utilidade para estudos relacionados, por exemplo, a erosões marginais, ecossistemas aquáticos continentais, psicultura por tanques-rede, quantificação de gases de efeito estufa devido à ressuspensão de sedimentos devido a propagação de ondas.

Neste livro são apresentados resultados de trabalhos científicos aplicados à grande área de Engenharia. De abordagem objetiva, a obra se mostra de grande relevância para graduandos, alunos de pós-graduação, docentes e profissionais. Os capítulos estão agrupados em duas seções: i) materiais; ii) águas continentais e oceânicas. Pelo capítulo um é apresentado o desenvolvimento de uma metodologia para obter-se reprodutibilidade da área superficial de um eletrodo de estanho durante o estudo do crescimento de óxidos de estanho. A reprodutibilidade da área superficial pode ser comprovada pela reprodutibilidade das densidades de carga anódicas dos voltamogramas anódicos a 50 mVs-1 posteriores a cada tratamento. Por meio do capítulo dois é analisada a substituição de parte do carvão mineral, utilizado em siderúrgicas, por biomassa. Entre os grandes desafios do setor estão a produção de aço a preços competitivos e a substituição de parte do carvão mineral utilizado por biomassa. A biomassa é considera neutra em emissões de CO2, devido a captura do mesmo durante o processo de fotossíntese, o que a torna atraente para seu uso nos processos siderúrgicos. Além disso, o seu uso pode gerar redução de custos, principalmente se for considerado os rejeitos do agronegócio que não possuem um alto valor agregado. Neste contexto, por este capítulo serão mostradas algumas possíveis utilizações de biomassa nos processos siderúrgicos através de estudos que vem sendo realizado no tema e aplicações na indústria. Será possível notar que o uso de biomassa é uma alternativa viável a curto prazo para atender as crescentes restrições ambientais atuais. Através do capítulo três é analisado o crescimento voltamétrico de óxido de estanho em solução tampão fosfato, pH 8,7. Medidas elipsométricas ex-situ foram realizadas para determinar a espessura dos óxidos crescidos. A partir desses resultados, o volume do filme por unidade de carga, Vf, foi calculado para diferentes densidades de carga. As medidas elipsométricas mostram que filmes de óxido de estanho crescidos a 2 mVs-1 são menos densos para valores de espessura 3,37 nm, tendo Vf próximo a 1,70 x 10-4 cm3C-1. Para valores mais altos de espessura (11,0 – 12,4 nm) os filmes se tornam mais densos tendo Vf próximo a 0,5 x 10-4 cm3C-1. No caso de 100 mVs-1 os filmes apresentam o mesmo comportamento, tendo Vf próximo de 3,74 x 10-4 cm3.C-1 para espessura de 4,56 nm e Vf próximo de 1,32 x 10-4 cm3.C-1 para espessura de 7,42 nm. Imagens de Microscopia de Força Atômica mostraram que a morfologia muda e a rugosidade dos filmes aumenta com o aumento da espessura e do potencial final da voltametria. O capítulo quatro trata do Nitreto cúbico de boro (cBN), material imprescindível para usinagem com alta precisão e alta velocidade de APRESENTAÇÃO materiais ferrosos como aço. O cBN é recomendado para trabalhos sob condições severas, tais como corte intermitente, em que dureza deve estar associada com tenacidade para evitar a quebra. Na síntese do cBN, são aplicados, basicamente, dois tipos de catalisadores: nitreto de magnésio e magnésio. Cada qual oferece diferentes possibilidades, tais como maiores valores de profundidade de corte ou menor nível de rugosidade superficial. Este capítulo contribui para uma melhor compreensão da manipulação dos parâmetros aplicados no regime de síntese deste elemento e, favorecendo o desenvolvimento da tecnologia de sua produção. Por meio do capítulo cinco é avaliada a aplicação de separação magnética de alta intensidade no beneficiamento de itabiritos pobres. Na rota de processo avaliada (separação magnética + flotação), a etapa de separação magnética executa a função de pré-concentração e deslamagem. O teor de SiO2 no concentrado foi de 1,46% (menor que o teor objetivo de 2,00%). As recuperações mássica e metalúrgica obtidas com a rota separação magnética + flotação foram maiores em termos absolutos 3,3% e 4,4%, respectivamente. Através do capítulo seis é realizada a otimização de injeção de poliamida PA66 com 50% GF usando o método Taguchi. O estudo se justifica pela necessidade crescente de materiais mais leves e de maior produtividade em substituição às ligas metálicas, o que demanda o constante desenvolvimento de compósitos poliméricos e eficazes processos de fabricação. Como resposta do estudo, mediu-se a resistência máxima de tração (RTmáx), numa poliamida 66 com carga de 50% de fibra de vidro, Grivory GV-5H®. Fez-se uso da metodologia ANOVA para indentificar-se os fatores de maior significância para o processo. A melhor resistência máxima de tração obtida de 242,6 N/m2, mostrou-se como uma opção na substituição à aplicações de ligas metálicas de alumínio. A melhor resultado se obteve com a temperatura de processamento em 270°C, o fluxo volumétrico de 83 cm³/s, a pressão de recalque de 300 bar, a contrapressão de 10 bar, velocidade da rosca de 50 min-1 e o tempo de recalque com valor de 5 s. As porcentagens de contribuição encontradas foram pressão de recalque com contribuição de 61%, seguido da temperatura de processamento, com contribuição de 17% e em terceiro, o fluxo volumétrico com contribuição de 12%. A instalação de grandes equipamentos submarinos em águas profundas apresenta uma série de desafios. O capítulo sete trata da análise de estabilidade hidrodinâmica de Manifolds submarinos durante a instalação pelo método pendular. O presente capítulo racionaliza tal método e, além disso, considera sistemas para evitar o capotamento, durante um momento crítico do método que é o início da descida, apresentando uma modelagem matemática fenomenológica a partir de casos similares. A etapa de validação foi realizada pela análise comparativa entre a modelagem proposta e resultados de testes experimentais realizados com modelos físicos. Com a confirmação da aderência dos resultados numéricos com os experimentos, esta abordagem se confirma como uma ferramenta de engenharia para dimensionamento dos equipamentos submarinos instalados pelo Método Pendular para que sejam direcionalmente estáveis. Por meio do capítulo oito são apresentados os resultados da simulação da distribuição espacial das ondas geradas pela ação de ventos severos sobre o reservatório da barragem de Salto Caxias, no rio Iguaçu, estado do Paraná. Os ventos severos foram estimados através da análise de frequência regional para várias estações anemométricas do Instituto Meteorológico do Paraná (SIMEPAR) para o período de 1998 a 2005. As alturas de ondas foram estimadas pelo método paramétrico SMB, que usa como dados de entrada o fetch e a velocidade do vento. O método SMB foi aplicado pelo modelo computacional ONDACAD. Os testes estatísticos indicaram que a distribuição de Wakeby foi a mais robusta para as séries curtas de ventos horários máximos anuais, produzindo estimativas de ventos severos que variaram entre 25,7 ms-1 (tempo de retorno de Tr=10 anos) a 50,9 ms-1 (Tr=100 anos). O estudo presta grande contribuição à compreensão da quantificação das alturas de ondas geradas por ventos severos neste importante reservatório do estado do Paraná. Pelo capítulo nove é apresentada uma análise comparativa bidimensional entre alturas de ondas resultantes da aplicação dos modelos paramétricos MARQUES e JONSWAP ao reservatório da Usina Hidrelétrica de Itaipu Binacional, localizado no Rio Paraná entre o Brasil e o Paraguai. Os campos de vento uniforme relacionados a períodos de recorrência de 10, 20, 50 e 100 anos foram obtidos pelos registros realizados pelo Sistema Meteorológico do Paraná (SIMEPAR). Através da utilização do modelo ONDACAD foram determinados os campos de fetch e a transformação em campos de ondas pela utilização dos modelos paramétricos MARQUES e JONSWAP. Ao proceder a análise constatou-se que, ao majorar os resultados do modelo JONSWAP em 78% chega-se aos resultados bidimensionais gerados pelo modelo Marques. Esta condição foi verificada para situações de ventos extremos, ou seja, superiores a 20ms-1 e corpos hídricos que possuem fetch máximo da ordem de 10 quilômetros. O estudo contribui para a compreensão da distribuição das magnitudes das alturas de ondas neste reservatório de grande importância no âmbito da América do Sul, de grande utilidade para estudos relacionados, por exemplo, a erosões marginais, ecossistemas aquáticos continentais, psicultura por tanques-rede, quantificação de gases de efeito estufa devido à ressuspensão de sedimentos devido a propagação de ondas.

The paper focuses on Helen and its ‘presence’ in Sophoclean drama. After a brief introduction (1), section 2 analyses the few references to Helen that are found in Sophocles’ extant plays (from Ajax and Electra). Sections 3‑5 all variously, and selectively, deal with Helen as a character in a few fragmentary plays. In particular, section 4 tentatively associates a one-word fragment from Sophocles’ Ἑλένης ἀπαίτησις (179 R.2) with the heroine; section 5 focuses on Λάκαιναι – a play most likely featuring Helen among its dramatis personae – and especially on fr. 368 R.2; the latter, it is argued, is incompatible with the hypothesis that Helen was its addressee.

In the course of a synthesis of (-)-sclerophytin A 3, James P. Morken of Boston College showed (J. Am. Chem. Soc. 2010, 132, 16380) that Oshima-Utimoto conditions transformed 1 into 2 with high stereo-and regiocontrol. En route to (+)-dictyosphaeric acid 6, Richard J. K. Taylor of the University of York found (Angew. Chem. Int. Ed. 2010, 49, 5574) that the intramolecular Michael cyclization of 4 proceeded smooothly to give 5. Xingang Xie and Xuegong She of Lanzhou University devised (Synlett 2010, 2283) the In-mediated cyclization of 7 with benzaldehyde, to effect an elegant synthesis of goniothalesdiol A 9. The carbene-mediated cyclization of 10 to 11 developed (Org. Lett. 2010, 12, 4836) by David W. Lupton of Monash University set the stage for the synthesis of (-)-7-deoxyloganin 12. Jun’ichi Uenishi of Kyoto Pharmaceutical University showed (Org. Lett. 2010, 12, 4160) that the Pd-mediated cyclization of 13 proceeded with high diastereocontrol. Intramolecular esterification than led to (-)-apicularen A 15. Martin G. Banwell of the Australian National University established (Heterocycles 2010, 82, 313) that LiHMDS was effective for the cyclization of the alkynyl Weinreb amide 16 to 17. Reduction and deprotection completed the synthesis of the resorcylic lactone L-783, 277 18.

Abstract The longest selection in the Reader is excerpted from an extended interview with Kenneth Leish, arranged in twelve parts (392 double-spaced pages of typescript and a two-page index of names). Although only the first four parts include dates, It is clear from references to current productions at places like the Music Theater at Lincoln Center that the final portions of the interview did not extend much beyond Summer and Fall 1968.* In a portion of the Reminiscences not reprinted here readers learn that the press suppressed Hart’s excessive drinking as well as his homosexuality, not because Rodgers threatened the publisher of a scandal rag when confronted with questions about Hart’s sexuality, but “because the newspaper people were all crazy about him” (p. 200}. Also in this section Rodgers discloses that For the archivally curious this footnote offers topics, dates (when provided in the interviews), and page numbers for each section: (I) Rodgers’s current activities (December I4, I967), I-39; (2) Background (December I9, I967), 40-84; (3) Producing Avanti and The Garrick Gaieties through A Connecticut Yankee (February 2I, I968), 85-u8; (4) I927-I932 (March I, I968), II9-43; (5) I932-I936, I44-67; (6) Working with Hart, I68-203 [marked on the title page “closed during lifetime”]; (7) Pal Joey and Oklahoma!, 204-46; (8) State Fair and Carousel, 247-78; (9) Allegro and South Pacific, 279-307; (IO) The King and I, Victory at Sea, and Me and Juliet, 308-36; (II) Pipe Dream and The Sound of Music, 337-62; (I2) After Hammerstein, 363-92.

Several new routes to furans and to pyrroles have recently been put forward. Inspired by the Achmatowicz ring expansion, Patrick J. Walsh of the University of Pennsylvania developed (J. Am. Chem. Soc. 2008, 130, 4097) the oxidative rearrangement of 3-hydrox-alkyl furans such as 1 to the 3-aldehyde 2. José M. Aurrecoechea of the Universidad del País Vasco established (J. Org. Chem. 2008, 73, 3650) that cumulated alcohols, available by reduction of alkynes such as 3 with SmI2, rearrange under Pd catalysis, and then add to an acceptor alkene such as 4, to give the furan 5. Vladimir Gevorgyan of the University of Illinois at Chicago used (J. Am. Chem. Soc. 2008, 130, 1440) an Au catalyst to rearrange an allene such as 6 to the bromo furan 7. Fabien L. Gagosz of the Ecole Polytechnique, Palaiseau, also found (Organic Lett. 2007, 9, 3181) that an Au catalyst rearranged the eneyne 8 to the pyrrole 9. Azido esters such as 10 are readily prepared from the corresponding aldehyde by phosphonate condensation. Shunsuke Chiba and Koichi Narasaka of Nanyang Technology University demonstrated (Organic Lett. 2008, 10, 313) that thermal condensation of 10 with acetyl acetone 11 gave the pyrrole 12, while Cu catalyzed condensation with acetoacetate 13 gave the complementary pyrrole 14. Huan-Feng Jiang of South China University of Technology observed (Tetrahedron Lett. 2008, 49, 3805) that condensation of an acid chloride 15 with an alkyne 16, presumably to give the alkynyl ketone, followed by the addition of hydrazine delivered the pyrazole 17. Masanobu Uchiyama of RIKEN and Florence Mongin of the Université de Rennes 1 established (J. Org. Chem. 2008, 73, 177) that a pre-formed pyrazole 18 could be metalated and then iodinated, to give 19. Xiaohu Deng of Johnson & Johnson, San Diego reported (Organic Lett. 2008, 10, 1307; J. Org. Chem. 2008, 73, 2412) complementary routes to pyrazoles, combining 20 and 21 under acidic conditions to give 22, and under basic conditions to give 23.

For a review of a monograph by C. Wiles and P. Watts on applications of flow reactors in organic synthesis, see Org. Process. Res. Dev. 2011, 15, 947. For a review by Klavs S. Jensen of MIT of flow approaches, see Angew. Chem. Int. Ed. 2011, 50, 7502. Hans-René Bjørsvik of the University of Bergen described (Org. Process. Res. Dev. 2011, 15, 997) a multijet oscillating disc microreactor, and Andreas Schmid of the Technische Universität Dortmund (Adv. Synth. Catal. 2011, 353, 2511) and László Poppe of the Budapest University of Technology and Economics discussed (Adv. Synth. Catal. 2011, 353, 2481) continuous flow reactors for biotransformations. Gases are readily handled in a flow apparatus. S. Chandrasekhar of the Indian Institute of Chemical Technology, Hyderabad demonstrated (Tetrahedron Lett. 2011, 52, 3865) partial deuteration of 1 to 2, using D2O as the deuterium source. Peter H. Seeberger of the Max Planck Institute, Potsdam oxidized (Org. Lett. 2011, 13, 5008) 3 to 4 with singlet oxygen. Dong-Pyo Kim of Chungnam National University and Robert H. Grubbs of Caltech effected (Org. Lett. 2011, 13, 2398) ethenolysis of 5 to give 6 and 7. Takashi Takahashi of the Tokyo Institute of Technology showed (Chem. Commun. 2011, 47, 12661) that even phosgene could be handled in a flow system, using it to activate 8 for condensation with benzylamine to give 9. In the liquid phase, Stephen L. Buchwald of MIT prepared (Angew. Chem. Int. Ed. 2011, 50, 8900) 11 by the fluorination of 10. Jesús Alcázar of Janssen Pharmaceutical, Toledo, showed (Tetrahedron Lett. 2011, 52, 6058) that a nitrile 12 could be reduced in a flow system to the aldehyde 13. Mark York of CSIRO prepared (Tetrahedron Lett. 2011, 52, 6267) the furan 16 by condensation of 14 with 15. Floris P.J.T. Rutjes of Radboud University Nijmegen used (Org. Process Res. Dev. 2011, 15, 783) the careful controls of a flow reactor to optimize the exothermic combination of 17 with 18 to give 19. Professor Buchwald demonstrated (Angew. Chem. Int. Ed. 2011, 50, 10665) a flow protocol for the lithiation of 20 with in situ borylation and Pd-catalyzed coupling with 21 to give 22.

One of the more powerful applications of organocatalysis has been the enantioselective transformation of preformed prochiral rings. In the five-membered ring series, Nobuyuki Mase of Shizuoka University effected (Synlett 2010, 2340) enantioselective addition of malonate to cyclopentenone 1, and Eric N. Jacobsen of Harvard University devised (Angew. Chem. Int. Ed. 2010, 49, 9753) a guanidinium catalyst for the Claisen rearrangement of 4 to 5. Jacek Mlynarski of Jagiellonian University accomplished (Tetrahedron Lett. 2010, 51, 4088) the enantioselective hydroxymethylation of 6. This worked equally well for cyclopentanone and cycloheptanone. The dynamic kinetic resolution/reductive amination of 8 described (Angew. Chem. Int. Ed. 2010, 49, 4612) by Benjamin List of the Max-Planck-Institut Mülheim worked best with cyclohexanones such as 8. Organocatalysts can also be effective for the construction of carbocyclic rings. Teck-Peng Loh of Nanyang Technological University found (Chem. Sci. 2010, 1, 739) a commercial phosphine catalyst that efficiently mediated the condensation of 10 with 11. David W. C. MacMillan of Princeton University used (J. Am. Chem. Soc. 2010, 132, 10015) a SOMO catalyst to combine 13 with 14 to make 15. Dawei Ma of the Shanghai Institute of Organic Chemistry employed (Org. Lett. 2010, 12, 3634) the Hayashi catalyst in the double Michael condensation of 16 with 17. Daniel Romo of Texas A&M University showed (Org. Lett. 2010, 12, 3764) that the appropriate organocatalyst could direct 19 to either diastereomer of the β-lactone 20. Professor Romo also reported (Angew. Chem. Int. Ed. 2010, 49, 9479) the desymmetrization of 2-alkyl cyclohexane-1,3-diones using a similar approach. In the six-membered ring series, José Alemán and José Luis García Ruano of the Universidad Autónoma de Madrid carried out (Eur. J. Org. Chem. 2010, 4482) Robinson annulation of 17 with 21. Ying-Chun Chen of Sichuan University, again using the Hayashi catalyst, reported (Angew. Chem. Int. Ed. 2010, 49, 6418) the addition of 17 to 23 to give 24. In another elegant application of visible light–mediated organocatalysis, Professor MacMillan described (Chem. Sci. 2010, 1, 37) the addition of the commercial boronic acid 25 to 17.

Поражение нижних конечностей (НК) при сахарном диабете (СД) является частой причиной ампутации, что приводит к значительному снижению качества жизни пациентов. Несмотря на широкий спектр совре- менных методов лечения СД, прогрессивный рост количества ампутаций у данных пациентов является актуальной проблемой. ЦЕЛЬ: изучить клинико-лабораторные характеристики пациентов центра спасения конечностей (ЦСК) с сахарным диабетом 2 типа (СД2). МАТЕРИАЛЫ И МЕТОДЫ: проведен ретроспективный анализ 729 историй болезни пациентов, имею- щих СД2 и госпитализированных в ЦСК ГБУЗ ГКБ им. В.П. Демихова в период с 2019 по 2020 гг. РЕЗУЛЬТАТЫ: всего в анализ вошло 729 пациентов. Медиана возраста – 66,0 лет [59,0; 73,0]. У 50,89% (n=371) пациентов стаж СД2 более 10 лет. Средний ИМТ составил 31,82±0,43 (95% ДИ 30,96-32,67). Наиболее частой сопутствующей патологией являлась артериальная гипертензия (АГ) – 89,57% (n=653). У 63,24% (n=461) пациентов имелась ИБС, из них у 19,62% (n=143) был инфаркт миокарда в анамнезе. У 16,87% (n=123) наблюдалось острое нарушение мозгового кровообращения, у 44,31% (n=323) – хрони- ческая болезнь почек (ХБП). Медиана гликированного гемоглобина (HbA1c) составляла 7,8% [6,7; 9,1]. Медиана гликемии – 9,9 [7,2; 13,8] ммоль/л. На инсулинотерапии находились 75,99% (n=554) пациентов, из них 14,9% получали только инсулин (n=83), а 85,01% (n=471) – базальный инсулин и пероральные сахароснижающие препараты (ПССП). Только ПССП получали 14,95% (n=109) пациентов. 14,13% (n=103) получали метформин, 6,31% (n=46) – ингиби- торы дипептидилпептидазы-4 (иДПП-4), 0,41% (n=3) – агонисты глюкагоноподобного пептида (аГПП-1), 3,70% (n=27) – ингибиторы натрий-глюкозного ко-транспортера (иНГЛТ-2), 16,46% (n=120) – препараты сульфонилмочевины. Лечение статинами получали 38,59% пациентов (n=225). Среди имевших АГ терапия ингибиторами ренин-ангиотензин-альдостероновой системы была назначена 79,46% (n=472) пациентам, блокаторами кальциевых каналов – 20,55% (n=128). При поступлении у 72,7% пациентов (n=530) был диагностирован СДС. У 27,2% (n=199) – облитериру- ющий атеросклероз артерий НК, из них у 66% (n=133) – критическая ишемия НК. У 26% пациентов с СДС (n=244) имела место гангрена, у 34,5% (n=183) – язва, у 23,9% (n=127) – флегмона, у 9,05% (n=48) – абсцесс, остеомиелит встречался у 11,8 (n=63) пациентов данной группы. В отделении 15,5% (n=113) пациентам провели реваскуляризацию, 14,4% (n=105) было проведено стен- тирование, 1,1% (n=8) – шунтирование. Ампутация НК была выполнена 51% пациентов (n=372), из них 9,95% (n=37) – высокая ампутация, 90,05% (n=335) – низкая ампутация. Среди пациентов с СДС только местное лечение получили 33,5% (n=244), антибактериальную терапию получали 7,2% пациентов (n=53). Выписаны с улучшением 98,5% (n=718) пациентов, летальность стала исходом госпитализации в 1,5% случаев (n=11). ВЫВОДЫ: большинство пациентов ЦСК с СД2, госпитализированных в 2019-2020 г., были старше 60 лет (68,86% (n=502)), имели ожирение (64,14% (n=127)), а также атеросклеротические сердечно-сосудистые за- болевания (АГ – 89,57% (n=653), ИБС – 63,24% (n=461), ОНМК в анамнезе – 16,87% (=123)). У 50,89% (n=371) пациентов стаж СД2 составлял более 10 лет, у 44,31% (n=323) имелась ХБП. Исходом 51% (n=372) госпита- лизаций стала ампутация НК, что требует более тщательного подхода к профилактике и своевременной диагностике поражения НК у пациентов с СД.

The search for new modern methods of prevention and treatment of skin diseases remains relevant today. The aim is to evaluate the effectiveness of ozone therapy in the treatment of occupational allergodermatoses of chemical etiology. Materials and methods. Two groups of patients with occupational allergodermatoses (78 people) were examined and treated. Group 1 received only traditional treatment, in group 2 ozone therapy was added to the treatment complex. Immunological studies were performed using standard methods. Results. The use of ozone therapy in patients with allergodermatoses had a positive effect on cellular and humoral immunity: the content of CD3+ and CD8+-lymphocytes increased by 1,2-1,5 times, the ratio of CD4+/CD8+ normalized, the level of IL-10 and IL-4 decreased by 1,6 times, the number of patients with a positive effect according to indicators IdA, IgM, IgG, IgE accounted for more than 80 %. There was an improvement in the clinical course of the skin process, an increase in the remission period. Conclusion. The method of ozone therapy has shown its effectiveness, so it can be used for immunorehabilitation, prevention and treatment of this pathology.

Introduction: Breast cancer is a major cause of mortality in Brazil and worldwide. It is a heterogeneous disease with specific molecular subtypes, which are associated with different prognosis and responses to treatment. Objectives: The present study aimed at assessing the incidence of local recurrence in patients undergoing conservative surgery and its impact on overall survival. As a secondary outcome, there are the prognostic factors of local recurrence in addition to the relationship with systemic metastasis. Methods: It is a retrospective cohort including 500 patients submitted to conservative surgical treatment, from March 2014 to March 2019 at Hospital do Servidor Público Estadual de São Paulo. Results: The results are compatible with the literature, with local recurrence in 4% of patients and more relapses with triple-negative subtype; 367 patients had hormonal treatment: five (1.4%) relapsed and 51 patients did not use hormonal treatment, four (7.8%) relapsed. This shows a higher percentage of recurrence in the group without adjuvant hormone therapy when compared to the group that underwent treatment (p=0.016); 7.4% of patients developed metastasis, which was more prevalent in patients diagnosed with triple-negative subtype cancer and pure Her. This group had an estimated probability of survival significantly lower (72.3%) than the group without metastases (98%) (p <0.001). In this cohort, disease-free survival was 93.4% and overall survival was 96% over a median of three years of follow-up. Other prognostic factors, established in the literature, such as age, lymph node involvement, tumor size, in addition to systemic treatment and radiotherapy had no significant difference between patients who did or did not relapse. Conclusion: In this cohort, patients diagnosed with breast cancer and who underwent conservative surgery, evolving with local recurrence, did not present a higher risk of death, and we found tumor biology as a risk factor for locoregional recurrences. Patients who evolved with systemic metastases showed a reduction in the overall survival rate.

Introdução: A Leishmaniose Visceral (LV) trata-se de uma zoonose negligenciada, causada pelo protozoário do gênero Leishmania, considerada um grande problema de saúde pública em diferentes países, podendo ser fatal. Objetivo: Desse modo, o objetivo deste estudo foi analisar retrospectivamente a casuística de Leishmaniose Visceral Humana (LVH) e Leishmaniose Visceral Canina (LVC) no município de Teresina de Goiás entre os anos de 2007 a 2021. Material e métodos: Os dados foram obtidos por meio do banco de dados do Sistema de Informação de Agravos de Notificação (SINAN), do Ministério da Saúde (MS), Instituto Brasileiro de Geografia e Estatística (IBGE) e da Coordenação Estadual de Zoonoses do estado de Goiás. Na análise estatística, somente os casos do município de Teresina do Goiás foram compilados. Utilizou-se o programa EpiInfoTM 7 para execução dos cálculos. O município de Teresina de Goiás possui uma população estimada de 3.583 habitantes de acordo com a estimativa do IBGE de 2021, durante o período analisado foram diagnosticadas 19 pessoas infectadas com LVH, sendo uma média de 2 indivíduos por ano, sem nenhum caso de óbito. A maior prevalência foi em 2014 com seis indivíduos infectados. Não foram reportados casos para no período de 2007 a 2012. Estimou-se na última campanha antirrábica no município uma população canina de 783 animais no ano de 2020. Durante o período avaliado foram diagnosticados 373 cães infectados, uma média de 27 casos/ano, com uma taxa de mais de 48% animais positivos, ou seja, quase metade da população canina. Resultado: Assim como nos humanos, os casos de LVC foi mais prevalente no ano de 2014, com 88 casos confirmados, não sendo reportado nenhum caso para os anos de 2007 a 2013. No ano de 2021 coleiras a base de Deltametrina a 4% foram incorporadas ao Programa de Vigilância e Controle da Leishmaniose Visceral (PVC-LV) do MS como ferramenta adicional no controle da doença e no estado de Goiás apenas dois municípios foram contemplados, sendo Teresina de Goiás um deles. Os resultados desta campanha serão divulgados quando em momento oportuno. Conclusão: Informações sobre os aspectos da cadeia epidemiológica e população afetada por essa doença se faz necessário para estabelecer medidas profiláticas efetivas.

Молекулярно-генетические исследования у подростков с сахарным диабетом 2 типа (СД2) привлекает особое внимание в силу слабой изученности и большого вклада генетических факторов в процессы ран- него развития СД2, ранее считавшегося заболеванием пожилого возраста. ЦЕЛЬ: описание результатов исследования семейного случая СД2 у подростка с выраженным ожире- нием и инсулинорезистентностью. Клинический случай: пациент А, 16 лет, наблюдается в дет. отделении ГНЦ ФГБУ «НМИЦ Эндокринологии» МЗ РФ в теч. 2 лет. Из анамнеза: масса тела при рождении 3200 гр., рост 51 см. С 6 лет наблюдается у эндокринолога по поводу ожирения: рост 128 см (SDS +3,32), вес 43 кг (SDS ИМТ +3,63). В 13 лет диагностирован СД2: гликемия натощак 11,5 ммоль/л, гликированный гемоглобин 6,7%. Получал метформин в дозе 2000мг/сутки. За 1,5 года прибавил 12 кг. Наследственность: мать - избыток массы тела, СД2 с 37 лет, принимает метформин, НвА1с - 7,8%; бабушка СД2 с 45 лет, без ожирения, инсули- нотерапия, НвА1с - 7,3%. При поступлении: рост 178 см (SDS 0.58), вес 131 кг, ИМТ 41 кг/м2 (SDS +3,71). Распространенный, выраженный acanthosis nigricans на шее, в подмышечных впадинах, в паховой об- ласти, на локтевых сгибах, тыльной стороне кистей. HbA1c 10,4%. Аутоантитела GADA, ZnT8A, IA-2 от- рицательные. ПГТТ: глюкоза 8,2-11,53-11,3 ммоль/л, ИРИ 60,81- 312,2-298,8 мкЕд/мл, HOMA – 22,16 (нор- ма до 3,2). Метаболический индекс по данным гиперинсулинемического эугликемического клэмп-теста равен 0.7, что соответствует тяжелой степени инсулинорезистентности. Другие проявления МС: дисли- пидемия (ТГ — 2,91 ммоль/л, ЛПНП— 3,62 ммоль/л), жировой гепатоз, повышенный уровень АЛТ, АД до 160/90 мм рт.ст. В психологическом статусе - нарушение пищевого поведения (прием пищи только вече- ром). Через 6 мес.: рост 1790 см (SDS 0.69), вес 129.0 кг. ИМТ 40.3 кг/м2 (SDS+3.62). НвА1с – 9,8%. ПГТТ: глю- коза 8,19-11,6-9,2 ммоль/л, ИРИ 53,97-190,1-98,09 мкЕд/мл, HOMA – 19,65 (норма до 3,2). Назначен Гларгин в дозе 20 ед., лечение у психотерапевта. При полноэкзомном секвенировании у пациента и матери выявлен патогенный, ранее не описанный гетерозиготный вариант мутации в гене AKT2, hg38, chr19:40265221C>T, AKT2 (NM_001626.6): c.46+1G>A, находится в донорном сайте сплайсинга 2 экзона. Дальнейшие исследова- ния необходимы, чтобы проверить влияние данный замены на сплайсинг. У бабушки данной замены не вы- явлено. По литературным данным, функция гена AKT2 заключается в участии инсулинового сигнального пути, индуцируя транспорт глюкозы (активируя транслокацию глюкозного переносчика 4-го типа (GLUT4) из цитоплазматических везикул в плазмалемму. Т.о., описана семья с аутосомно-доминантным типом на- следования в 3 поколениях с СД2, инсулинореистентностью, с мутацией в гене AKT2 в 2 поколениях. ВЫВОДЫ: клинический случай демонстрирует развитие СД2 у подростка с ожирением, тяжелой инсу- линорезистентностью при мутации в гене AKT2, имеющего мать с СД2 и такой же мутацией.

A rapidly increasing body of data indicates that the vascular endothelium plays an active role in the development of inflammatory and thrombotic processes. Our laboratory has focused on the modulation of certain endothelial cell functions by inflammatory/immune mediators. Initially, we demonstrated that human monocyte derived interleukin-1 (hmIL-1) can act directly on cultured human endothelial cells (HEC) to increase the expression of tissue factor procoagulant activity in a time- and protein-synthesis dependent fashion (J. Exp. Med. 160:618, 1984). Increased expression of HEC tissue factor was also elicited with recombinant IL-1α (rlL-lα), rIL-1 β, and recombinant human tumor necrosis factor (rTNF), as well as with bacterial endotoxin (1 ipopolysaccharide, LPS) (Am. J. Pathol. 121:393, 1985; Proc. Natl. Acad. Sci. USA 83:4533, 1986). The kinetics of the HEC tissue factor responses to these stimuli were similar, demonstrating a rapid use rise to peak activity at ~ 4 hr, and a decline toward basal levels by 24 hr. This characteristic decline in tissue factor PCA after prolonged incubation with IL-1 or TNF was accompanied by selective endothelial hyporesponsiveness to the initially stimulating monokine. Interestingly, the effects of IL-1 and TNF were found to be additive even at apparent maximal doses of the individual monokines. We have also examined the effects of IL-1 and other mediators on HEC production of fibrinolytic components (J. Clin. Invest. 78:587, 1986). HEC monolayers which had been treated for 24 hr with IL-1 or TNF exhibited decreased tissue type plasminogen activator (tPA) and increased plasminogen activator inhibitor (PAI) as assessed in functional and immunological assays. Thus, certain inflammatory mediators such as IL-1 and TNF can act on vascular endothelial cells to induce the expression of tissue factor in a rapid and transient fashion, and to decrease the expression of fibrinolytic activity in a more prolonged fashion. In a parallel series of studies, we have demonstrated that IL-1, TNF and LPS also act on HEC to increase the adhesion of polymorphonuclear leukocytes (PMN), monocytes and the related cell lines HL-60 and U937 (J. Clin. Invest. 76:2003, 1985; Fed. Proc. 46:405A, 1987). The kinetics of this modulation of HEC adhesiveness parallel that of the change in tissue factor PCA. Recently, we have developed two monoclonal antibodies (mAb), H4/18 and H18/7, which identify a surface antigen expressed on monokine- and LPS-stimulated HEC but not on unstimulated HEC. The mediator specificity, kinetics, and protein synthesis-dependence of the expression of this antigen correlate with increased HEC adhesiveness for leukocytes. Neither mAb binds to unstimulated or stimulated PMN, HL-60 cells or dermal fibroblasts. H18/7 inhibits the adhesion of PMN (>50%) and HL-60 cells (>60%) to stimulated HEC by comparison to isotype matched control mAb; H4/18 also inhibits HL-60 adhesion but to a lesser extent. H4/18 and H18/7 immunoprecipitate the same polypeptides from biosynthetically-1abeled monokine-stimulated HEC, but not unstimulated HEC. We have designated this inducible endothelial cell surface protein, endothelial-leukocyte adhesion molecule-1 (E-LAM 1). Thus, vascular endothelium can be activated by inflammatory/immune mediators to express both prothrombotic and pro-inflammatory functions. In vivo, these endothelial responses may contribute to a variety of pathophysiologic processes.

The National Park Service (NPS) began monitoring landbirds at Channel Islands National Park in 1993 as part of its long-term inventory and monitoring program. The park’s landbird monitoring later became part of the NPS Inventory and Monitoring Division’s Mediterranean Coast Network long-term monitoring programs. Consequently, landbird monitoring has been conducted during every breeding season since 1993. In this report, we summarize data collected during the 2021 breeding season and we analyze trends in a select number of species. Landbird monitoring was conducted between 10 March and 22 May 2021. Using distance-based sampling methods in a standardized protocol, birds were counted on 334 of 338 permanent point count stations (99%) across the Channel Islands monitored for landbirds. These surveys were conducted at 29 of 33 points on Santa Barbara Island, 8 of 8 on East Anacapa Islet, 112 of 112 on Santa Cruz Island, 40 of 40 on San Miguel Island, and 145 of 145 on Santa Rosa Island. Four points on Santa Barbara Island were not counted due to nesting California Brown Pelicans (Pelecanus occidentalis) and Western Gulls (Larus occidentalis); 3 of 4 points (i.e., 17, 19, and 20) were also not counted in 2016–2021 to avoid disturbing breeding pelicans. This was the first monitoring season that the permanent line transects on Santa Barbara, East Anacapa, and San Miguel Islands were not surveyed. During the 2021 monitoring season, Channel Islands National Park decided to stop using line transects and focus on point count stations only, based on an external review of the landbird monitoring program. Fifty-six bird species were counted at point count stations across all of the islands in 2021. Parkwide, 40 of these species are breeders in Channel Islands National Park. Parkwide, the 10 most detected breeding landbirds in 2021 were, in descending order: Spotted Towhee, Song Sparrow, Bewick’s Wren, Orange-crowned Warbler, House Finch, Western Meadowlark, Horned Lark, Common Raven, Island Scrub-Jay, and Pacific-slope Flycatcher (scientific names in Table 2 and Appendix A). On East Anacapa Islet, 26 landbird species have been counted since 1993; 7 species were counted in 2021. No new transient species were detected in 2021; 6 transient or visiting species have been counted on the island overall since 1993. On Santa Barbara Island, 50 landbird species have been counted since 1993; 13 species were counted in 2021. Lincoln’s Sparrow was a new transient species counted in 2021 on Santa Barbara; 23 transient or visiting species have been counted on the island since 1993. On Santa Cruz Island, 78 landbird species have been counted since 2013; 45 species were counted in 2021. Hermit Warbler, Lawrence’s Goldfinch and Warbling Vireo were new transient species counted in 2021 on Santa Cruz Island; 21 transient or visiting species have been counted on this island since 2013. On San Miguel Island, 70 landbird species have been counted since 1993; 10 were counted in 2021. No transient species were counted in 2021; 32 transient or visiting species have been counted on the island since 1993. On Santa Rosa Island, 78 landbird species have been counted since 1994; 39 were detected in 2021. No new transient species were counted in 2021 on Santa Rosa; 21 transient or visiting species have been counted on the island since 1994. Nonnative and invasive birds were counted on only 1 of the 5 islands in 2021: 23 European Starlings on Santa Rosa Island. However, anecdotal sightings of nonnative species occurred more frequently (i.e., outside of survey times) on Santa Cruz and Santa Rosa Islands in 2021. The highest numbers of nonnative species detections occurred on Santa Rosa Island, with 25 detections of Eurasian Collared Dove (primarily at the Historic Ranch), 18 detections of European Starling (Historic Ranch), 2 detections of Brown-headed Cowbird, and 1 Rock Pigeon detection (Historic Ranch). Other species were not reported by Channel Islands National Park landbird monitors or in eBird in 2021. This was the first annual monitoring report since the Coonan and Dye (2016) trend report to incorporate density estimates for particular species across Channel Islands National Park. Parkwide, 13 species were analyzed using the Distance Package in R. Of the 13 species analyzed, 5 had either increasing or decreasing densities from 2016 to 2021. All park islands except for Santa Barbara had a species that showed an increasing or decreasing trend from 2016 to 2021. Horned Lark and House Finch on San Miguel Island were the only species to show decreasing trends from 2016 to 2021, which is opposite from the trend presented by Coonan and Dye (2016).

The National Park Service (NPS) began monitoring landbirds at Channel Islands National Park in 1993 as part of its long-term inventory and monitoring program. The park?s landbird monitoring later became part of the NPS Inventory and Monitoring Division?s Mediterranean Coast Network long-term monitoring programs. Consequently, landbird monitoring has been conducted in the park during every breeding season since 1993. In this report, we summarize data collected during the 2020 breeding season. Landbird monitoring was conducted between 1 April and 30 June 2020. Using distance-based sampling methods in a standardized protocol, birds were counted on 7 of 10 permanent line transects (70%) (2 of 3 on Santa Barbara Island, 1 of 1 on East Anacapa Island, and 4 of 5 on San Miguel Island). Two transects were not sampled in 2020 because of nesting California Brown Pelicans (Pelecanus occidentalis) on Santa Barbara Island (i.e., Canyons Transect) and reduced person hours and unfavorable winds on San Miguel Island (i.e., San Miguel Hill Transect). For point counts, 225 of 338 (67%) permanent stations were counted (i.e., 30 of 33 points on Santa Barbara Island, 8 of 8 on East Anacapa Island, 100 of 112 on Santa Cruz Island, 40 of 40 on San Miguel Island, and 47 of 145 on Santa Rosa Island). The 8 Prisoners? Cove points were not counted in 2020. Three points were not counted on Santa Barbara Island due to nesting pelicans: these points and the transect were also not counted in 2016?2019 to avoid disturbing breeding pelicans. Other points (i.e., on east Santa Cruz Island and Santa Rosa Island) were not counted due in large part to the global COVID-19 pandemic. Traveling to and from the park was only granted to essential NPS staff for the majority of the landbird season. Fifty-one bird species were counted from points and transects across all of the islands in 2020; 39 of these are breeding species on the island. Parkwide, the 10 most commonly detected breeding landbirds in 2020 were, in descending order: Horned Lark, Spotted Towhee, Song Sparrow, White-crowned Sparrow, Western Meadowlark, Orange-crowned Warbler, Bewick?s Wren, Island Scrub-Jay, House Finch, and Common Raven. On East Anacapa Island, 26 landbird species have been counted since 1993; 5 species were counted in 2020. No new transient species were detected in 2020; 10 transient or visiting species (nonbreeding, native species recorded only once or twice during surveys) have been counted on the island overall since 1993. On Santa Barbara Island, 49 landbird species have been counted since 1993; 15 species were counted in 2020. The highest number of Horned Lark since 1993 were counted in 2020 (n = 451). Warbling Vireo was a new transient species counted in 2020 on Santa Barbara; 30 transient or visiting species have been counted on the island since 1993. On Santa Cruz Island, 74 landbird species have been counted since 2013; 34 species were counted in 2020. Bullock?s Oriole was a new transient species counted in 2020 on Santa Cruz; 21 transient or visiting species have been counted on this island since 2013. On San Miguel Island, 69 landbird species have been counted since 1993; 14 were counted in 2020. No transient species were counted in 2020; 34 transient or visiting species have been counted on the island since 1993. On Santa Rosa Island, 75 landbird species have been counted since 1994; 26 were detected in 2020. Rose-breasted Grosbeak was a new transient species counted in 2020 on Santa Rosa Island; 30 transient or visiting species have been counted on the island since 1994. Across all the 5 islands, 3 transient or visiting bird species were newly counted in 2020, for a total of 77 such species counted since NPS monitoring began on the islands. Nonnative and invasive birds were counted on only 1 of the 5 islands in 2020: 4 European Starlings on Santa Rosa Island. However, anecdotal sightings of nonnative species occurred much more frequently (i.e., outside of the point and transect counts), and were made on all islands except Anacapa in 2020. The highest numbers of nonnative species detections occurred on Santa Cruz Island, with 33 detections of Eurasian Collared Dove (primarily at the Main Ranch area in the Central Valley), 15 detections of Brown-headed Cowbird (primarily at Scorpion Harbor), and 15 detections of European Starling (primarily at the Main Ranch and Scorpion Harbor). House Sparrows were observed fewer times, but on all islands except Anacapa; cowbirds occurred on all islands except Anacapa and San Miguel; and Rock Pigeon occurred on Santa Barbara and Santa Cruz Islands. In 2020, despite the COVID-19 pandemic, 67% of all points and 77% of all transects were counted among the 5 islands. Santa Rosa received the lightest sampling of points (32%), due to the difficulty of getting observers onto the island. Even with diminished sampling, species richness (number of species) values fell in predictable patterns: richness was greatest on the larger islands (75 on Santa Rosa, 73 on Santa Cruz) and least on the smallest islands (26 on Anacapa, 48 on Santa Barbara). We continue to recommend that nonnative invasive species, such as European Starlings on Santa Rosa Island, be removed before their numbers become harder to manage. Also, because Distance analyses assist statistically with evaluations of trends, we continue to recommend that a trend analysis using program DISTANCE, or newer hierarchical distance analyses, should be used after the 2020 season to assess 5-year trends in breeding species? numbers following the 2015 trend analysis conducted by Coonan and Dye (2016).