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L´autogreffe chez les patients atteints de lymphome est indiquée en cas de rechute, en cas d´une maladie réfractaire et après d´obtention d´une rémission par une chimiothérapie de rattrapage. Elle est rarement proposée comme un traitement de consolidation en première ligne, comme en cas du lymphome du manteau . La mobilisation était à base du G-CSF associée ou non à une chimiothérapie. Cette association était utilisée chez 14% de nos malades qui ont reçu plus de 2 lignes de chimiothérapie. L´utilisation du cyclophosphamide à la dose de 3g/m2 est utilisée pour la mobilisation par certaines équipes . Le régime de conditionnement repose sur le protocole BEAM utilisé chez 93% de nos malades. L´utilisation de la bendamustine a été indiquée chez un malade en raison de non disponibilité de la carmustine à l´échelle nationale au cours d´une période donnée. Le Tableau 6 résume les principales caractéristiques de notre série en les comparants à certaines données de la littérature [3, 6, 18].

Le carcinome épidermoïde ou carcinome à cellules squameuses du sein est une tumeur métaplasique rare dont l'histogenèse est controversée. Elle se caractérise par une évolution rapide et par un traitement non codifié. Nous rapportons un nouveau cas de carcinome épidermoïde du sein, nous insisterons à travers une revue de littérature sur les caractéristiques de cette forme particulière de cancer du sein.

Our main data source is the India Human Development Survey (IHDS), a nationally- representative panel of nearly 40,000 Indian households: the same set of households was observed in 2005 and again in 2012. The IHDS includes economic, social, and health modules. The IHDS has been widely used, such as in studies of human capital (Azam et al., 2013), education and immunization (Vikram et al., 2012), and the nutritional effects of sanitation (Duh and Spears, 2016). Our dependent variable of interest is whether the household reports any member having sought medical attention for a cough or cold within the past year.5 Similar data is also reported for diarrhea and for fever, which we will use in falsification tests, as we would not expect these variables to be importantly influenced by coal plants, relative to other sources of variation in them.

WBBS was performed 4 h after the injection of 740 MBq technetium-99m hydroxymethylene diphosphonate (99mTc-HDP). Anterior and posterior views were acquired with a speed of 20 cm/min, zoom of 1.0, pixel size of 2.2 mm, and resolution of 256 × 1024 matrix, using a double-headed gamma camera equipped with a NMCT/670 low-energy high-resolution collimator (GE Healthcare, Pittsburgh, PA, USA). Subsequently, SPECT/CT images of both knees were obtained using the NMCT/670 SPECT/CT scanner (GE Healthcare). SPECT images over the knee area were acquired using step-and-shoot mode (10 s/step, 4 angular increment, total 90 steps) and zoom factor of 1.14 with a photon peak of 140.5 keV (10% window) and a scatter window of 120 keV (5% window). A CT image without any contrast was acquired using a tube voltage of 120 kVp with a tube current of auto mA (60–210 mA). An adaptive statistical iterative reconstruction algorithm (ASiR, GE Healthcare) was used to reconstruct CT images into 2.5-mm-thick transaxial slices with 512 × 512 image matrix. SPECT images were processed using automated motion correction, CT-based attenuation correction, scatter correction, and resolution recovery using the Volumetrix MI Evolution for Bone (GE Healthcare) software program . Reconstruction of the SPECT image was performed in different ways depending on purpose. For visual analysis, ordered-subset expectation maximization (OSEM) with 2 iterations, and 10 subsets was used for image reconstruction with Butterworth post-filtering (frequency of 0.60 cycles/cm, power 10), and the images were displayed as a 128 × 128 matrix with a section thickness of 3.88 mm. For quantitative analysis, the images were reconstructed using OSEM with 4 iterations and 10 subsets without post-filtering, which is a proven optimized reconstruction method for quantification [13–15].

El MAIS planteó el cambio de enfoque desde lo curativo hacia lo promocional y preventivo, lo cual a su vez determina la necesidad de realizar modificaciones estructurales en la provisión de los servicios de salud y en el perfil de los profesionales que proveerán dichos servicios (5). Ello se plasmó en el desarrollo de carteras de servicios acordes con una nueva tipología de los establecimientos de salud (6) y en la definición de nuevos perfiles para el personal de salud, lo cual permitió identificar posteriormente la brecha del talento humano requerido. Con esta información, se creó el Programa de Becas para Fortalecimiento del Talento Humano en Salud (7), destinado a proveer fondos para promover la formación de profesionales de la salud en las especialidades con deficiencias.

The hydrazide–hydrazone moiety can be identified via spectroscopic methods. The IR spectrum shows signals at around 3050 cm−1, 1650 cm−1 and 1550 cm−1, corresponding to the -NH-, C=O and C=N group, respectively. Two singlets appear in the 1H NMR spectrum, one in the range of δ 8–9 ppm and the other in the range of δ 10–13 ppm, signals corresponding to the -CH= and -NH- group, respectively. In the 13C NMR spectrum, there are signals of carbon atoms from the CH= and C=O group in the range of δ 145–160 ppm and δ 160–170 ppm, respectively .

Animals used for microscopy were paralyzed in 1mM levamisole and mounted on agar pads with glass coverslips and immediately analyzed using an Olympus BX51 upright microscope. Similar results were obtained in the absence of levamisole (data not shown). Animals expressing GFP were analyzed using 470/40 nm excitation and 525/50 nm emission wavelengths. Autofluorescent age-pigment accumulation was analyzed using 350/50 nm excitation and 460/50 nm emission wavelengths. Approximately 20 animals per condition were used and normalized to the mid-line length of the animal. All experiments were repeated at least three times with similar results. Quantification of pixel densities was analyzed with Image J™.

The HPA axis is the primary regulator of the stress response. Under normal conditions (schematized in Figure 1), an acute stressor will signal the paraventricular nucleus (PVN) of the hypothalamus to release corticotropin-releasing factor (CRF) and arginine vasopressin into the hypophyseal portal veins, which cause the anterior pituitary gland to release adrenocorticotrophic hormone (ACTH). Circulating ACTH signals the adrenal cortex to release glucocorticoids (GCs; cortisol in humans and corticosterone in rodents) that have downstream metabolic effects (Herman et al., 2005; Ulrich-Lai and Herman, 2009). A negative feedback loop is established to turn off activation of the HPA axis by suppressing the production of CRF and ACTH upon cessation of the initial stressor (Kageyama and Suda, 2009; Tasker and Herman, 2011). Regulation of the HPA axis is driven in part by glucocorticoid and CRF receptors that are located at each level of the HPA axis and in higher limbic regions (Ulrich-Lai and Herman, 2009). Corticotropin-releasing factor receptor 1 (CRF1) and 2 (CRF2) are G-protein coupled receptors that play a prominent role in HPA axis regulation by binding CRF and its related ligands, Urocortin (Ucn) 1–3. Once activated, CRF1 and CRF2 work in opposition to one another to enhance and reduce HPA output, respectively (Bale and Vale, 2004). Glucocorticoid-mediated regulation occurs via two receptors, mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) that function both as transcriptional regulators (Reul and de Kloet, 1985) and through glucocorticoid-mediated retrograde endocannabinoid release from parvocellular neurons, which suppresses the release of excitatory glutamatergic molecules from pre-synaptic terminals and subsequently inhibits the hypothalamic release of CRF (Di et al., 2003).

Метод GWAS – достаточно новый, и, как видно по данным анализа публикаций, индексируемых в базе данных Scopus (рис. 1), в течение последних лет количество работ, выполненных с применением GWAS на ячмене, неуклонно возрастает. В настоящее время благодаря этому подходу обнаружены геномные районы, ассоциированные со многими признаками ячменя. Для нахождения компонентов урожайности и качества зерна ячменя с помощью GWAS изучаются агрономические признаки: высота растения, длина колоса, количество зерен в колосе, масса 1000 зерен, количество продуктивных побегов. Существует ~40 работ по исследованиям с использованием GWAS устойчивости ячменя к различным болезням и ~25 работ – по устойчивости к абиотическому стрессу – засухоустойчивости, устойчивости к засолению и др. Помимо этого, выполнены работы по изучению свойств крахмала, содержания белка, β-глюкана и микроэлементов в зерне. (Более подробно обзор работ представлен в Приложении 2.)

Finally, the experimental results indicate that in most cases (at least in all of the experiments conducted) the reliability of the virtual screening is improved in the top half and the top third of the screening set according to any of the applicability domain formulations, compared to an evaluation of the whole data set. Thus, instead of defining a default threshold for the AD estimation, the consideration of the lower half of the respective domain as the probable outlier set should be a good rule-of-thumb in most applications. An additional positive effect is that on the respective applicability level, a large proportion of the ligands are usually retained in the domain and the screening reliability is improved. However, the removal of some of the ligands from the screening set due to their low applicability score should not be considered as a drawback of the applicability domain estimation and consideration because these molecules can be expected to be badly predicted otherwise and thus to be neglected because of their low rank regardless.

Die hier präsentierten Forschungsergebnisse decken sich mit anderen Umfragen im deutschsprachigen Raum zu Vertrauen in der Pandemiebewältigung. In einem Policy-Paper der Universität Konstanz wird zum Beispiel berichtet, dass Probanden durchschnittlich ein mittleres bis hohes Vertrauen in die effiziente Krisenbewältigung haben (im Durchschnitt 6 von 10 möglichen Punkten) und überzeugt sind, dass alle Patienten gleich behandelt werden (im Durchschnitt 6,8 von 10 möglichen Punkten; ).

YouTube was a popular platform for hosting content used to support this conspiracy. Certain tweets sharing the conspiracy theory also became very popular on Twitter. For instance, the tweet sent by the verified user contained a vast number of replies from other users indicating support of the view that COVID-19 is a hoax. Although our results found that some content had been deleted on Twitter and YouTube, there were still tweets and YouTube videos that remained online.

In Fig. 4 (B and D), for each condition, three biological replicates were performed. We analyzed the following number of samples per genotype: his-45::Dendra2 (n = 3), his-55::Dendra2 (n = 3), his-59::Dendra2 (n = 3), his-63::Dendra2 (n = 3), his-2::Dendra2 (n = 3), his-6::Dendra2 (n = 3), his-45::Dendra2 (n = 3), HIS4(H3::Dendra2) (n = 3), his-25::Dendra2 (n = 3), his-32::Dendra2 (n = 3), his-40::Dendra2 (n = 3), his-72::GFP (n = 3), and his-71::GFP (n = 3).

The full-cohort analyses of the open-label REVERSE-AD study was published in 2017, comprised overall 503 patients grouped into patients with uncontrolled hemorrhage (group A, n = 301) or in need for urgent invasive procedures (group B, n = 202) . The primary endpoint consisted of the maximum percentage reversal of the anticoagulant effect, measured by the dTT or ecarin-clotting time within the first 4 h after infusion of idarucizumab. Results provided for the entire cohort that on admission 92% of patients had prolonged bleeding measures and 4 h after reversal treatment the median maximum percentage reversal was 100% . For group A, including 98 patients with intracranial hemorrhage of which 53 patients experienced ICH, the median level of unbound dabigatran was initially 110 ng/ml and after reversal was 20 ng/ml and remained below this level for 24 h suggesting impairment of anticoagulation to be very unlikely. In patients with intracranial hemorrhage, protocolized follow-up imaging was not mandated; therefore, effects on HE rates cannot be reported. In patients with gastrointestinal hemorrhage (n = 137), further clinical assessment showed that median time to bleeding cessation was 2.5 h. For the entire cohort, the reported thromboembolic event rate was 5% (24/503) within 30 days and in patients with ICH 6% (3/53) experienced a thromboembolic event, all occurring more than 10 days after idarucizumab administration .

Roles of megalin and cubilin in proximal tubule uptake and activation of 25(OH)D. Vitamin D‐binding protein (DBP) binds 25(OH)D in the circulation, and the complex is freely filtered across the glomerulus to be then reabsorbed in the proximal tubule by receptor‐mediated endocytosis involving megalin and cubilin. The complex is then delivered to lysosomes where DBP is degraded and the vitamin released into the cytosol. 25(OH)D is either secreted directly or trafficked to the mitochondrial membrane where it serves as a substrate for 1‐⍺‐hydroxylase and converted to 1,25(OH)2D. 1,25(OH)2D is then released into the interstitial fluid where it is complexed by free DBP molecules [modified from reference40]

Está bem documentado que, em pacientes com anorexia nervosa, as taxas de suicídio são mais elevadas quando comparadas aos portadores de bulimia nervosa,(1,3,20) visto que mesmo os anoréxicos tentando menos suicídio, eles morrem mais devido às complicações sistêmicas causadas pela anorexia nervosa. Já os bulímicos tentam mais suicídio, tendo em vista a impulsividade característica desse transtorno, porém essas tentativas geralmente não são efetivas. Esses são alguns dos fatores que podem explicar a correlação encontrada neste estudo entre ambas as escalas do BITE (sintomatologia e gravidade) e o risco de suicídio. Tal relação é ainda mais estreita naqueles indivíduos que pontuaram positivamente na escala de gravidade do BITE (p<0,001). Os pacientes com bulimia nervosa evitam métodos mais letais: tentam suicídio por inalação de substâncias e overdose de drogas entre outros.(32,33) Isso não quer dizer que o risco de suicídio pode ser encontrado apenas em pacientes com transtornos alimentares, pois o suicídio é uma das principais causas de mortalidade e morbidade entre adolescentes e jovens adultos, já que esses períodos são caracterizados por sensibilidade aumentada, incluindo a assunção de riscos e comportamentos imprudentes, de modo que o risco e a ideação suicida podem estar relacionados a outros fatores psicossociais, tornando-o um problema multifatorial.(9)

Nowadays, patients do not merely rely on their doctors to obtain information on their medical conditions and, more specifically, invasive procedures that they may be offered to treat their conditions. Although easily and quickly accessible, the reliability and validity of internet-based sources remain controversial topics and major concerns especially for patients without any medical education .

5. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide.

Failure of hERG proteins to be exported out of the ER can directly trigger degradation. Hsp70 is the predominant molecular chaperone assisting in hERG protein folding at the ER , but once Hsp70 is dissociated from hERG, it can be recognized by certain E3 ubiquitin ligases, accelerating endoplasmic reticulum-associated protein degradation (ERAD) of hERG channels . Western blot analysis shows that the expression levels of Hsp70 remained unaltered after THIO incubation (Figures 5(a) and 5(b)). We therefore turned to exploring whether THIO prevents maturation of hERG channels via inhibiting chaperone-hERG interactions; to this end, we performed coimmunoprecipitation experiments to determine the association of hERG protein with Hsp70. The relative band density of 135 kDa hERG signal identified by anti-Hsp70 antibodies over that identified by an anti-hERG antibody was determined to indicate the changes of interactions between hERG and chaperones. As illustrated in Figures 5(c) and 5(d), hERG/Hsp70 complexes were decreased in the presence of 3 μM THIO. These results indicate that THIO disturbed the folding process of the hERG channel by reducing the interaction between hERG and Hsp70, eventually leading to the degradation of disordered hERG proteins.

Dass vor allem eine positive, aktivierende Stimmung sich förderlich auf Kreativität auswirkt, konnten Baas et al. (2008) in einer Metaanalyse bestätigen. Den von Dul (2019) beschriebenen Einfluss der Arbeitsumgebung auf die Stimmung und damit auf die Kreativität konnten wir in unserer Studie jedoch nicht nachweisen. Trotz massiver technischer Probleme während der Durchführung der Studie gaben die Studierenden an, dass Ihre Stimmung neutral bis positiv blieb. Die Studierenden schrieben den Erfolg ihrer Arbeit vor allem der hohen Arbeitsmotivation und Anstrengung der Teammitglieder zu und konnten so technische Probleme kompensieren.

Având în vedere modificările apărute pe EKG-ul de la internare la un pacient cu un bogat istoric cardiovascular, s-a decis montarea unui Holter EKG pe 24 de ore și solicitarea unui consult interdisciplinar cardiologic, din care a rezultat următorul diagnostic: Cardiomiopatie ischemică dilatativă, ICC III NYHA FEVS =35-40%, BCI, ESV cu tendință la sistematizare, HTA II, BCR III;

There is a recent report highlighting significance of transformable core-shell-based nanocarrier (CS-NG) as an effective system to deliver TRAIL and anti-angiogenic agents . CS-NG enzymatically assembled into micro-sized extracellular depots at the site of tumour with the help of an enzyme hyaluronidase, frequently overexpressed in the tumour microenvironment. Structurally, CS-NG is composed of core-NG (C-NG) loaded with therapeutics, shell-NG (S-NG) with encapsulated transglutaminase (TG), and human serum albumin (HSA), coated on the surface of C-NG. Acid-degradable polymers for delivery of therapeutically effective agents have attracted considerable attraction.

We conducted a survey to explore how researchers disseminate the findings of their research. We sought to elicit grant holder views on: the purpose of dissemination; their own current practices; their perceived role/responsibility for dissemination and that of the funders; perceived successes and failures; potential areas for improvement; and evaluation of and reflection on wider impact.

A hipótese inicial de que os indivíduos do GD apresentariam benefícios em relação ao GC se dá em função de algumas evidências a respeito dos efeitos positivos do destreinamento sobre diferentes parâmetros em outras populações11 - 13. Além disso, um programa de treinamento físico proporciona base motora e repertório neuromuscular, razão pela qual os indivíduos submetidos a destreinamento podem apresentar desempenho superior comparados àqueles que nunca realizaram treinamento físico4 , 6 - 8 , 10. Apenas McDermott et al.7, em 2019, investigaram a durabilidade dos efeitos de um programa de treinamento físico supervisionado, mas aqui não se pode considerar destreinamento, pois os indivíduos eram monitorados à distância ao final do programa presencial de treinamento físico, por meio de ligações, e encorajados a manter a rotina de exercícios. Mesmo assim, 6 meses após o treinamento físico, os indivíduos reduziram valores de DTC6M e DLDC, retomando os valores basais.

To directly determine the effects of reduced RNase P function on the maturation and accumulation levels of plastid and mitochondrial tRNAs, a series of northern blot experiments with tRNA-specific probes was performed (Fig. 5). Interestingly, many of the tRNAs showed little, if any, changes in abundance of the mature tRNA species. Most blots needed to be strongly overexposed to visualize the unprocessed precursor RNAs. When this was done (Fig. 5A), some overaccumulation of precursor molecules was detectable in the RNAi lines for many of the plastid tRNAs (which, due to the larger volume of the chloroplast compartment, are generally much more abundant than mitochondrial tRNAs and, therefore, detected at higher sensitivity). As far as the plastid tRNAs are concerned, only two of the investigated tRNA species showed significant reductions in the levels of the mature tRNAs. tRNA-Arg(ACG) was reduced in the strongest RNAi line (RNAi-2; Fig. 5A) and tRNA-Phe(GAA) was reduced to barely detectable levels in the two strongest RNAi lines (RNAi-2 and RNAi-5). In both cases, this reduction in mature tRNA molecules was accompanied by the overaccumulation of precursors (Fig. 5A).

In the whole study population, Δ25(OH)D was significantly correlated with the following anthropometric variables: ΔBMI (r = 0.425) and ΔWC (r = 0.338). When considering biochemical parameters, a significant, linear correlation was found between Δ25(OH)D and the following: total cholesterol (r = 0.065), low-density lipoprotein (LDL)-cholesterol (r = 0.104), triglycerides (r = 0.056), HOMA (r = 0.312), and hsCRP (r = 0.171), while an inverse relationship was found with high-density lipoprotein (HDL)-cholesterol (r = −0.175). Regarding hemodynamic parameters, only diastolic blood pressure (DBP) reached statistical significance (r = 0.219).

Jorge Lôbo, in 1930 , reported a new human “blastomycosis,” restricted to subcutaneous tissue and different from the one described 20 years earlier by Adolfo Lutz , causing systemic infections in South American patients, which later became known as Paracoccidioides brasiliensis . Later, Jorge Lôbo published a detailed description of his finding but did not name the etiologic agent. The patient was a 48-year-old Brazilian man that first noted a small nodule on the lumbosacral anatomical region after a trip to the Amazonas, Brazil. The patient referred that the lesions appeared after he was bitten by a snake. Several months later, a small skin lesion appeared at the bite location. The small lesion was highly pruritic and slowly increased in size; thus, it was surgically removed. However, few months later, the lesion reappeared. When the patient came to Lôbo’s attention in Recife, Brazil, he had carried the infection for the last 19 years. The patient was described as a businessperson, but details on other occupational habits were not identified. Histopathological preparation of the infected tissues showed the presence of numerous uniformly in size yeast-like cells in chains, connected by small bridges, different from the yeast cells developed by P. brasiliensis in infected tissues. Based on this finding, he concluded that it was a new clinical entity, a notion reviewed later in his thesis to become Professor at the Department of Dermatology, Faculty of Medicine Recife, Brazil and in subsequent reviews on the subject . Jorge Lôbo inoculated several animals with the yeast-like cells extracted from one of the nodules, without success. He also used P. brasiliensis antigens in a skin test and in complement fixation assay with negative results. These results confirmed that he was facing a new morbidity . Although Jorge Lôbo inoculated culture media with the yeast-like cells extracted from the lesion in the original patient, he was not able to recover the pathogen in culture . Therefore, he remitted his patient to the Institute Oswaldo Cruz, Rio de Janeiro, Brazil.

The proposed hypothesis depends upon restriction of posterior fossa growth as a cause of neural injury with females having a smaller, genetically-determined, average posterior fossa size and cisterna magna CSF space than males. Posterior fossa size will be normally distributed. The genders represented separately will form overlapping curves with males to the right. If genetic or environmental factors that restrict growth of the posterior fossa interact with a normal variation in posterior fossa CSF space, and if the pathogenesis of spina bifida is related to hindbrain compression due to posterior fossa hypoplasia, there will tend to be a difference in severity of lesions between the sexes. Anencephaly will predominate in females, with lower spinal lesions being more common in males. This concept is represented in Fig. 6, and accords with observations on differences between lesion prevalence between the genders . This hypothesis allows speculation that smaller CSF spaces in the female are part of a regulatory mechanism leading to smaller head size. With similar fluctuations in spinal venous volume a more spacious posterior fossa in the male may facilitate greater pressure wave transmission into the head resulting in larger fetal head size .

We compared binding affinities for HA‐NEDD4 between the WT and K88R FLAG‐PIP5Kα. The K88R mutant maintained a binding affinity for NEDD4 as strong as the WT (Figure 5D). Moreover, we repeated the pull‐down assay with full‐length GST‐fusion proteins of PIP5Kα WT and K88R. Consistently, the NEDD4‐binding abilities of the GST‐PIP5Kα K88R were similar to those of the GST‐PIP5Kα WT (Figure 5E), suggesting that the non‐degradable PIP5Kα K88R mutant against NEDD4 is likely due to a defect in ubiquitination rather than in binding. WT or K88R FLAG‐PIP5Kα‐cotransfected cells with Tubby‐R332H‐YFP were examined for PIP2 levels by monitoring YFP localization. Confocal images showed that the plasma membrane targeting of the PIP2‐specific fluorescent probe was more robust in the K88R mutant‐expressing cells than in the WT‐expressing cells (Figure 5F), indicating a relatively high level of PIP2 in the K88R mutant. Collectively, these data support that K88 is one of the main degradative ubiquitination sites of PIP5Kα by NEDD4.

The cytoplasmic surface of a single-membraned vesicle is topologically uniform. Thus, all viral replication on that surface will be exposed to the cytoplasm. As the vesicle invaginates and fuses to form the double-membraned vesicle, a portion of what was once the outer membrane will now face the interior of the vesicle. This event explains how the synthesis of viral particles may take place in both environments. Accordingly, when PV-infected cells are examined by electron microscopy (EM) at 6 hours post-infection, viral particles are observed both free in the cytoplasm and trapped within double-membraned vesicles .

[...] Gli alunni riescono ad apprendere più facilmente se il calcolo, il ragionamento, si svolge alla loro presenza: il software Mathematica mi consente di scrivere la procedura in modo chiaro, senza l’ausilio della tavoletta grafica. Insomma speriamo che me la cavo.]

Dental occlusal trauma plays an important role in alveolar bone remodeling and its effects includes many cytokines and signaling pathways. However, the exact mechanism of the traumatic stimulus for alveolar bone remodeling is still unclear (Wan et al., 2012). Changes in mechanical stimulation as a result of dental extraction can lead to changes in bone tissue. Traumatic occlusal forces are responsible for altering the expression of osteoblasts and osteoclasts genes, and thus may cause bone resorption (Walker et al., 2008).

Untill now, scientists have found different techniques for DCS with comb-tooth resolution. A first one is based on the so called virtually imaged phased array (VIPA), that is a side-entrance etalon disperser providing resolution better than 1 GHz (ref. 19). The VIPAs are employed in free-space set-ups that hardly can be integrated in portable devices. This technique allows one to observe up to ∼2,000 separate comb lines (typically 0.2–10 THz bandwidth, depending on comb line spacing) in a single measurement taking a few milliseconds and has been demonstrated in various spectral regions202122. A similar approach is based on substituting the VIPA with a scanning Fabry–Perot (FP) cavity operating according to a Vernier2324. This approach has demonstrated near-parallel acquisition of ∼4,000 comb lines (4-THz bandwidth) in a time of 10 ms. A second technique for DCS is called dual-comb spectroscopy, and uses two OFCs with slightly detuned252627 comb-line spacings. This approach has the advantage of useing a single point detector, however, it requires two OFC sources. Dual-comb set-up based on free-running OFCs can only reach resolution of few GHz, that are typically not sufficient for observation of single comb lines25. Indeed, pushing the resolution of dual-comb spectroscopy to the comb-tooth level requires complicated set-up to overcome the relative drifts between the two OFCs2829; nonetheless, state-of-the-art systems have been shown to resolve ∼120,000 comb lines over 12 THz with acquisition times of 2.7 s (ref. 30). This technique has also been applied to probe two-photon transitions of Rb with Doppler-limited resolution31. A third technique, Fourier-Transform Infrared (FTIR) spectroscopy coupled to OFC sources, has become a powerful combination enabling the measurement of broadband spectra with comb-tooth level resolution32. As FTIR spectroscopy is based on a Michelson interferometer with a scanning delay line on one arm, reaching comb-tooth resolution requires a sufficiently long delay line (up to 10 m for comb line spacing of 100 MHz), which implies correspondingly long measurement times and extended optical layouts sensitive to vibrations.

After the activity is ceased, another trial is started by (a) rewiring the network according to the rules described in last section and in the Supplementary Material; (b) resetting the state of the neurons; and (c) flashing the same square stimulus to the network. This procedure is repeated many times for each E and L. Therefore, the averages and variances presented in this section are calculated over these several trials of the network quenched disorder in the connections between neurons. The disorder of the system creates rare region fluctuation effects on the size NR of the percolation cluster for a finite range of the E parameter. The system then presents a GP in such interval262728. Fig. 2A shows the temporal profile of activity A(t) (the sum of every soma spike in the network for a given time step) for a single trial of the network with L = 99 and four different E.

MET基因是肝细胞生长因子受体蛋白（hepatocyte growth factor receptor, HGFR）的编码基因。MET信号通路的异常激活可由多种形式导致，如基因突变、基因扩增、蛋白的过表达等[50, 51]。它的异常激活，可以作为原发驱动基因，也是EGFR-TKIs获得性耐药的重要机制之一。克唑替尼Ⅰ期临床试验PROFILE 1001的MET扩增队列中，克唑替尼单药显示出一定的临床疗效，但ORR仅33%。2016年ASCO报告Capmatinib（INC280）的Ⅰ期临床数据，在免疫组化3+的患者中ORR为29%，基因拷贝数≥5的患者中ORR为63%。最值得期待的疗效预测因子可能是MET基因14外显子跳跃突变：2015年，Paik等报告小分子MET抑制剂（克唑替尼、卡博替尼）在MET 14外显子跳跃突变的NSCLC患者中可能疗效卓越。2016年ASCO会议中，PROFILE 1001研究报告了MET 14外显子跳跃突变队列应用克唑替尼治疗的初步结果，截至报告为止，15例可评价疗效的患者中10例患者达到PR。从以上结果看来，MET基因的扩增、过表达及突变似乎均可作为MET抑制剂的疗效预测因子，其中以14外显子突变的疗效预测意义最为显著。基因扩增、过表达及突变作为疗效预测因子是否具有内在逻辑的相关性值得进一步探索。

迄今为止，晚期NSCLC及大多数癌症的治疗策略仍主要以经验为依据。近年来，正如2007年ASCO指南中所述，对于身体状况良好的患者，可推荐采用基于铂类的双药方案作为一线化疗，即顺铂或卡铂联合另一种药(经验性地在包括吉西他滨、多西紫杉醇、紫杉醇、培美曲塞和长春瑞滨的这一组药物中选择) 。最近，对于适合使用贝伐单抗的患者(主要是非鳞癌类型和之前没有咳血的患者)，这一血管表皮生长因子(VEGF)靶向药物联合化疗可作为一种选择。另外，刚刚公布的FLEX(First-Line Erbitux in Lung Cancer)试验显示了西妥昔单抗联合化疗的获益，尽管这一表皮生长因子受体(EGFR)靶向单克隆抗体尚未被批准用于NSCLC。在使用4-6个周期之后，基于铂类的化疗一般即会被终止，而且患者治疗结束，并采取“观察和等待”的策略。直到现在，这一治疗策略唯一值得注意的例外是那些采用贝伐单抗作为一线化疗的患者，贝伐单抗通常可作为单药继续使用直至疾病进展。

Life expectancy in patients with MFS is mainly determined by cardiovascular complications. Progressive dilatation of the proximal aorta is an important manifestation, rendering these patients at risk of aortic dissection or fatal rupture . Although the aortic sinus is most commonly affected, aneurysms and dissections in more distal aortic regions and in extra-aortic arteries can also occur . The reported prevalence of aortic root dilatation is slightly lower in children compared to adults (approx. 80% vs. 90%) . Furthermore, data from the Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) registry indicate that adult males are more likely than females to have aortic root dilatation (92% vs. 84%), aortic regurgitation (55% vs. 36%), and to have undergone prophylactic aortic root replacement (47% vs. 24%) . Increased awareness, early detection, careful follow-up, life-style adjustments, pharmacological treatment and prophylactic surgery are currently established as the cornerstones of treatment in MFS. Implementation of these aspects in the treatment strategy has shown to substantially reduce the risk of type A dissection . In patients with known (or suspected) MFS, echocardiography plays a central role in the identification, severity assessment and follow-up of cardiovascular abnormalities .

To perform MVF lying in the scanner, an acrylic platform (Figures 1A,Ba) with a mirror (Figures 1A,Bb) on the top table was prepared. The platform was placed over the body of the participants while they were lying in the MR scanner. The left and right hands were placed at the front and back of the mirror, respectively. They could observe the reflection of the left hand on the platform in another mirror (Figure 1Ac) attached on the top of the head coil, while the right hand was hidden behind the mirror on the platform (Figure 1B). The position, height, and angle of the mirror on the platform were adjusted individually such that the reflection of the left hand appeared to be the right hand. The position of both hands was also adjusted at the beginning of every run. Visual cues were presented on a flat monitor placed 5 m from the entrance of the bore of the scanner. Participants could observe the cues in the mirror on the head coil. The horizontal and vertical visual angle of the mirror was 36.2 and 25.0 degrees, respectively. All participants could observe the visual cues in their entirety and the mirror reflection of the left hand on the platform through the mirror. The oral responses of participants were recorded by a voice-capture system for MRI experiments (FOMRITM II, Optoacoustics Ltd., Or Yehuda, Israel) via a microphone attached to the head coil (Figure 1Ad).

Por otro lado, partiendo de los preceptos de la política exterior del Gobierno Nacional y de la creciente relevancia de la salud en la agenda internacional, especialmente en los procesos de consolidación de los ODS, se estrechó la comunicación y la relación institucional entre el MSP y el Ministerio de Relaciones Exteriores y Movilidad Humana, lo cual ha favorecido la posición de Ecuador en materia de salud a escala internacional. Del mismo modo, y en virtud de la preponderancia de las políticas sociales, la coordinación y las interrelaciones con el Ministerio Coordinador de Desarrollo Social también han desempeñado un papel clave para la consolidación de las estrategias de posicionamiento internacional en materia sanitaria (10).

MMP-1 and MMP-3 are elevated in the amniotic fluid and lower uterus of GB37-inoculated NHP. At Cesarean section, amniotic fluid and a tissue segment from the lower uterus were collected from each animal, and each sample was analyzed for MMP-1 (A) and MMP-3 (B) levels by Luminex. Data from GB37 and GB37ΔhylB were compared using a Mann-Whitney test. Although P values between 0.055 and 0.1 are noted due to the small sample size of this nonhuman primate study, P values of <0.05 were considered significant. GB37ΔhylB#5 is designated by an open square.

Wearable robotic devices (WRD) to assist, support, or augment human functions and activities are gaining popularity and practicability. A great diversity from fully wearable and soft, to stationary and rigid devices has been developed over the past decades, showing promising ranges of functionalities [1–3]. Nonetheless, the number of WRD in daily use is still very low due to missing availability on the market, as well as technology acceptance limitations [1, 4, 5]. More specifically, the usability—defined as “extent to which a system, product or service can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction in a specified context of use” —appears to be a key factor limiting the market translation and technology acceptance of WRD. Particularly, devices for medical applications such as robot-aided therapy or advanced assistive technologies often struggle to comply with the complex contexts of use, as users with health issues have more specific and personalized needs [7–10].

En cuanto al sexo, la frecuencia de anticuerpos contra Rickettsia spp. fue levemente mayor en los hombres (69,7 %) que en las mujeres; además, el 72,4 % de los pacientes positivos procedían de la zona urbana. Otros factores de riesgo analizados, como el tipo de construcción, la tenencia de mascotas, el contacto con bovinos o equinos, las picaduras de pulga, el contacto con garrapatas, y la presencia de zarigüeyas y roedores, se asociaron con gran frecuencia a muestras positivas (títulos mayores o iguales a 64) para IgG en la fase aguda, aunque sin significación estadística (cuadro 2).

RNA Isolation and Quantitative Real‐Time Polymerase Chain Reaction: qRT‐PCR was used to quantify the mRNA expression levels of HDAC1, HDAC2, HDAC3, and HAT1 relative to the reference gene for GAPDH. RNA was isolated from hMSCs on ≈1520 mm2 substrate 3, 6 (reversible condition), or 20 d (irreversible condition) after seeding onto the hydrogels using the RNeasy Micro Kit (Qiagen, Cat. No. 74004). RNA quantity and purity were measured via spectrophotometry (ND‐1000; NanoDrop). cDNA was synthesized from total RNA using the iScript Synthesis kit (Bio‐Rad, Cat. No. 1708841) and relative mRNA expression levels were measured via qRT‐PCR using SYBR Green reagents (Bio‐Rad, Cat. No. 1708884) on an iCycler (Bio‐Rad) and normalized to GAPDH for three technical replicates per condition. Primer sequences are listed in Table 1 .

Malgré les progrès réalisés, le traitement prothétique total ou partiel du genou reste toujours insuffisant pour supporter durablement une activité importante chez des patients jeunes et actifs. Sur des bases biomécaniques, les ostéotomies étaient proposées pour une population jeune, valide et active . Elles s'inscrivent dans le cadre des traitements conservateurs qui visent à ralentir l'évolution de la gonarthrose. Les ostéotomies pour déformation en valgus sont beaucoup moins fréquentes que celles pour déformation en varus comme en témoignent les séries de la littérature qui sont moins nombreuses [4, 5].

Effective and safe acute pain management following major colorectal surgery is a challenge. Opioid drugs continue to make up the major component of multimodal analgesia, but are associated with significant side effects—in particular, contributing to postoperative ileus. The search for safe and effective alternatives and or adjuncts continues, and there has been a recent resurgence of interest in the use of intravenous lidocaine infusions. Studies to date have shown most success in patients undergoing major colorectal surgery, which may be due to both improved pain control but also reduction of ileus (Weibel et al. 2018; Ventham et al. 2015; Eipe et al. 2016; Rimback et al. 1990). However, questions remain regarding the details of mode of action and the optimal dosing schedule.

Sensory transduction in the inner ear relies on the mechanoelectrical capabilities of hair cells, the sensory receptors in auditory and vestibular organs. Hair cells contain two differentiated compartments with distinct physiological roles: the mechanosensitive hair bundle and the basolateral membrane that includes specialized synaptic zones. The hair bundle is responsible for translating a mechanical vibratory input into an electrical current that, coupled with the basolateral complement of voltage and calcium activated ion channels, creates a receptor potential. The receptor potential drives synaptic output from ribbon synapses. Ribbons are vesicle-associated structures implicated in the modulation of trafficking and fusion of synaptic vesicles at presynaptic terminals (Heidelberger et al., 2002; Frank et al., 2010; Snellman et al., 2011). Ribbons are also postulated to be important for creating a large pool of primed vesicles and even perhaps recycling endosomes into reusable synaptic vesicles (Kantardzhieva et al., 2013). Calcium ions play critical but distinct roles in mechanotransduction, receptor potential modulation and synaptic transmission. Whereas Ca2+ defines the open probability of apical mechanotransduction channels in hair bundles (Farris et al., 2006; Johnson et al., 2011; Peng et al., 2013) and regulates basolateral membrane channels (Art and Fettiplace, 2006), Ca2+ levels allow the trafficking and exocytosis of neurotransmitter-containing synaptic vesicles at ribbon synapses (Moser et al., 2006). Evoked synaptic transmission is mediated by Ca2+ influx through voltage-dependent Ca2+ channels and is additionally modulated by release of Ca2+ from intracellular stores. In this review, we will discuss the potential contribution of intracellular stores and Ca2+-induced Ca2+ release (CICR) to synaptic transmission in central, retinal and hair-cell ribbon synapses. The potential role of CICR in the recruitment of vesicles to releasable pools in hair-cell ribbon synapses will also be addressed.

Eine besonders relevante Erkenntnis aus dieser Ausbruchsuntersuchung war, dass Übertragungen auch ohne „typische“ Symptomatik, wie z. B. Fieber oder Husten, sowie auch präsymptomatisch erfolgen konnten. Das war zu diesem Zeitpunkt noch nicht bekannt. In mehreren Fällen war die Inkubationszeit sehr kurz. So wurden sehr früh wichtige Eigenschaften des Erregers deutlich, die vor allem nicht mit denen übereinstimmten, die vom SARS-CoV-1-Erreger von 2003 bekannt waren. Dessen im Krankheitsverlauf späte Infektiosität hatte die Eradikation durch klassische Public-Health-Maßnahmen erheblich begünstigt. In Deutschland wurde aufgrund dieser Erkenntnisse ab dem Auftreten der ersten SARS-CoV-2-Fälle empfohlen, Kontaktpersonen bereits ab dem zweiten Tag vor Erkrankungsbeginn des Primärfalles zu ermitteln.

PBMCs not only rely on glucose as energy source, as glutamine utilization in these cells can be even greater than that of glucose . In our study glutaminase activity was significantly reduced following the meal, in line with its increased activity in lymphocytes from starved rats . The fact that the AspAT activity followed the same profile than the glutaminase, further confirms that this enzyme rather than GDH is mainly responsible of the glutamate to α-ketoglutarate conversion in PBMCs. However, PBMCs do not only use glutamine for energy purposes, as the production of non-essential amino acids (such as alanine and aspartate) via the transaminases for biosynthetic purposes is of great importance for this kind of highly proliferating cell . Following the meal, when circulating amino acid levels increase, PBMCs would rather rely on them for biosynthesis processes, reducing the demand from transaminases and resulting in an increase in the glutamate channelling through the GDH reaction , explaining the increased GDH activity in our study. Finally, the fact that the glucose utilisation was enhanced in response to the meal, whereas glutamine utilisation was reduced, strongly suggests that during the fasted-to-fed transition a metabolic shift allows PBMC to switch from glutamine to glucose utilisation .

In 2018, 4798 questing ticks (704 adults, 4094 nymphs) were collected by flagging the low vegetation at five different sampling sites located at two distinct areas in Lower Saxony, namely “Rauher Busch” (N52°34′; E8°48′) and “Barsinghausen/Mooshuette” (N52°19′; E9°23′). Both locations had been associated with humans that showed clinical TBE disease and/or were seropositive for TBEV. Ticks were pooled according to stage and sampling site and stored at 4 °C for a maximum of 7 days until further processing. Each of the analyzed pools contained 5 to 10 adults or 10 to 20 nymph ticks. Pools were homogenized using steel beads in 500 µL cell culture medium (Leibowitz’s L-15 or MEM Eagle, Thermo Scientific, Waltham, MA, USA) and TissueLyser II (Qiagen, Hilden, Germany). The homogenates were clarified by centrifugation and total RNA was extracted from the homogenates using the NucleoSpin® RNA Virus kit (Macherey-Nagel, Dueren, Germany) or MagNA Pure96 Viral RNA Small Volume Kit (Roche, Mannheim, Germany) according to the manufacturer’s instructions. The extracted RNA was re-suspended in RNase-free water and screened for TBEV-RNA by quantitative reverse transcription-PCR (RT-qPCR) following the protocol developed by Schwaiger and Cassinotti . TBEV-RNA of the Austrian Neudoerfl strain (U27495.1) was used as a positive control, while RNase-free water served as negative control. Furthermore, the quality of RNA extraction was tested in randomly selected samples (10% of all pools) using a RT-qPCR targeting the 16S ribosomal RNA (rRNA) of I. ricinus (Schwaiger and Cassinotti ).

Armutsbekämpfung sollte auf sämtlichen Ebenen des föderalen Systems (Bund, Länder und Kommunen) sowie allen dafür geeigneten Politikfeldern ansetzen, wiewohl nur ausgewählte behandelt werden konnten. Bloß durch eine konzertierte Aktion im Bereich der Wirtschafts‑, Steuer- und Finanzpolitik, der Arbeitsmarkt- und Beschäftigungspolitik, der Sozial- und Gesundheitspolitik, der Familienpolitik, der Bildungspolitik sowie der Wohnungs‑, Wohnungsbau- und Stadtentwicklungspolitik sind dauerhafte Erfolge möglich. Dabei müssen auch Landes- und Kommunalpolitik mehr Verantwortung übernehmen (vgl. dazu: Gintzel et al. 2008; Lutz 2010). Je umfassender die Maßnahmen zur Verringerung bestehender und/oder zur Verhinderung der Entstehung neuer Kinderarmut angelegt und je besser sie aufeinander abgestimmt sind, desto eher ist dem Problem beizukommen.

Zusammenfassend zeigen die hier präsentierten Studien und Ausführungen, dass eine jahrzehntelange kompetente zahnmedizinische Betreuung bei Menschen mit Behinderung erforderlich ist, um bei ihnen die Zahn- und Mundgesundheit im Verlauf des Lebens zu erhalten. Diese Bemühungen werden immer noch durch zahlreiche Barrieren erschwert, auch wenn in den letzten Jahren wichtige Schritte in die richtige Richtung unternommen wurden.

a–c) Schematic illustration of design of patterning in PNIPAm microgels and phase contrast images of each microgel in water at 20 °C. The 2D‐patterning denotes thick line pattern (h = 5 µm) cross‐linked from top to bottom of microdisc by 20 mW of laser power like conventional 2D lithography (2D patterning). The gradient 2D patterning has stiffness gradient by changing laser power 20 to 40 mW. The 3D positioning denotes thin line pattern (h = 500 nm) cross‐linked only the top part with stiffness gradient. d) Comparison of the area of microgels from top of view when the radius of each microgel at 32 °C was set to 1. Pure PNIPAm microgels (dot), 2D patterning (dot and line), gradient 2D patterning (blue line), gradient 3D patterning (red line), and microgel at 34 °C (black line). Scale bars, 50 µm.

Figure 2Box-plots show median, quartile, and extreme values of bone thickness ( in millimeters ). Boxes include 50% of values; the horizontal lines inside the box indicate the medians, and the vertical lines extend to 1.5 of the inter-quartile range. Circles depict outliers.

Zunächst braucht es eine Anwendung, die eine Kommunikation zwischen Betreuenden und Teilnehmenden ermöglicht und ähnlich wie ein Hörsaal funktionieren kann. Aufgrund des vielfältigen Angebots an Kommunikationsplattformen erfolgte zunächst ein Test, mit welcher Software die benötigten Funktionen realisierbar sind. Hierzu zählten die Möglichkeiten, Präsentationen zu teilen, Sprach- und Textchat, Screensharing, Erstellung von Gruppenräumen, Kompatibilität und Verfügbarkeit. An der Westsächsischen Hochschule Zwickau (WHZ) wurden zum Ist-Stand drei Anwendungen verwendet: Big Blue Button, Zoom und Microsoft Teams. Alle drei Plattformen erfüllen im Wesentlichen die notwendigen Voraussetzungen. Die Entscheidung fiel aufgrund vorher durchgeführter Tests mit kleinen Studierendengruppen auf Microsoft Teams, da sowohl die Handhabung als auch die Performance überzeugten.

To clarify the chromosome assignment of this gene, the cloned genomic sequence was subjected to alignment with the chromosome-based draft sequence of the common wheat (Chinese Spring) genome (http://www.wheatgenome.org/) (IWGSC). The alignment result displayed that this gene sequence shared 95.33%, 95.42%, and 100% identities with the matched sequences of the TGACv1_scaffold_195106_3AL, TGACv1_scaffold_220646_3B, and TGACv1_scaffold_249256_3DL, respectively. The data suggested that the gene should locate on the long arm of the wheat chromosome 3D. To verify this alignment on the chromosomal localization, genomic DNAs extracted from Chinese Spring Nulli-tetrasomic lines (NTs) were used as template of PCR using the gene-specific primers to confirm the chromosome location of the gene. The results proved that the gene was indeed located on the long arm of chromosome 3D (3DL) (Fig. 1B). Blast search against the nucleotide acid sequence database in the National Center for Biotechnology Information (NCBI) indicated that the gene sequence is homologous to COMT. Thus, this gene cloned from CI12633 was designated as TaCOMT-3D.

Die WHO teilt die Rehabilitation in 4 Phasen.Phase I entspricht der Mobilisation im Krankenhaus.Die Phase II kann als Anschlussheilverfahren entweder ambulant oder stationär erfolgen.Die Phase III ist eine Anschlussrehabilitation, die ambulant erfolgt, um die Nachhaltigkeit der Phase II Rehabilitation zu verbessern und die Situation bei schwereren Verläufen zu stabilisieren.Die Phase IV bedeutet eine „Verstetigung“ in dem Sinne, als die Patientin/der Patient das Erlernte ein Leben lang weiterführen sollte.

Ten patient plans (4 Head & Neck and 6 Prostate) were selected for this IMRT plan‐to‐film registration study. IMRT dose measurements were obtained in both axial and coronal planes using radiographic and radiochromic film. The calculated and measured dose distributions were registered with one another using the RIT113 dosimetry software. Manual registration was performed by visual selection of four points in common on the dose and film images. Fiducial‐based registration was performed using the “Template” tool in RIT113 and marks placed on the films prior to irradiation.

La comunicación de riesgo5 es esencial en salud pública, especialmente durante las emergencias sanitarias. La OMS recomienda que la comunicación de riesgo sea transparente, oportuna, fácil de entender, que reconozca la incertidumbre en la información y que se divulgue a través de diferentes plataformas. Estas recomendaciones son amplias, pero resultan poco concretas para los tomadores de decisiones y las autoridades encargadas de comunicar el riesgo (3). Por ello, la OMS y las Naciones Unidas publicaron una guía para la recuperación pos-COVID-19, en la que se destaca la necesidad de fortalecer los canales de comunicación e incluir las tecnologías digitales (4). No obstante, las recomendaciones continúan siendo generales y en ellas no se considera la importancia de la alfabetización estadística y su influencia positiva en la comprensión y el uso de la información para la correcta toma de decisiones por parte de las autoridades sanitarias y la población general.

Aerobic exercise can induce physiological myocardial hypertrophy, increase the expression of some myocardial energy metabolism proteins, stimulate myocardial energy metabolism, and enhance myocardial contractility and pumping function30. For example, 8 weeks of aerobic exercise decreased body weight and increased HWI in rats31, while rats exposed to swimming training for 12 weeks had decreased body weights and increased heart weight and HWI32. Supplementation with MOTS-c induces hypoglycemia and a reduction in lipid levels33–35. We reported that exercised rats reduced body weights and increased HWI, consistent with other reports that aerobic exercise induced myocardial hypertrophy. Exercised rats treated MOTS-c had similar body weights and HWI compared to untreated exercised rats, suggesting that there may be an synergetic effects between MOTS-c and aerobic exercise to promote physiological myocardial hypertrophy.

Colonoscopy is a secondary prevention method that is generally offered to populations with increased age, family history of CRC syndromes, and chronic inflammatory bowel diseases . Unlike other cancer screening methods aiming for early diagnosis to improve patients’ outcomes, colonoscopy additionally allows removing precancerous lesions during the examination . In Germany, statutory health insurance (SHI) has offered fully covered colonoscopies to people aged 55 years and above since 2002, as an alternative to the fecal occult blood test, which has been offered since 1977 . In 2019, Germany lowered the recommended age for screening colonoscopies for men to 50 years, while it remained unchanged for women .

Here, we note a number of limitations that accompany our studies and offer counterarguments that may mitigate these concerns. Although arguably more ecologically valid than experiments in which choice history is decoupled from reward availability, our task could still be limited in its ecological validity. This issue could be remedied by employing more naturalistic foraging fields and by affording greater degrees of motoric freedom when foraging. A number of studies in rodents and humans have explored more ecologically realistic scenarios with innovative task designs [11, 37, 38]. However, the benefit of the more artificial experimental setup of the VI task is the precise control of reward probabilities, while also controlling energetic costs and motoric uncertainties. Estimating the cost of travel or time in foraging animals is difficult, which makes it challenging to compare the performance of animals with that of the optimal agent models. Here, we chose to focus on a simple and straightforward behavioral task design and used the model derivation to generalize to ecologically relevant contexts. One further concern that could be raised is whether the VI task is really a foraging task. The term “foraging” has been used by some authors to describe decisions between an explicit foreground option against background reward rate of the habitat [39–41]. According to this definition of foraging tasks, an agent typically estimates the average reward rate of the habitat using the R-learning model [10, 19, 37] or follows rules imposed by the marginal value theorem (MVT). Whilst it is true that major theories of foraging posit this as a central problem the animal is attempting to solve, it does not mean that other tasks cannot be defined as foraging tasks. The more broad definition of foraging is simply searching for food sources and making decisions among available alternative options [41–44]. Under this definition, we think that the VI task fits as a foraging task.

The genetic similarities (GS) among 86 accessions were estimated by Jaccard coefficient based on gliadin markers. The GS for the 86 accessions ranged from 0.108 to 0.952 with a mean of 0.382. The lowest value of GS was 0.108, which was observed between accession PI598800 (Russia) and 205124 (Sichuan, China), while the highest GS (0.952) was found between accession PI372696 and PI348916, both collected from Alaska, USA. The average of GS among North America accessions was 0.859, while it was 0.636, 0.494, 0.418 and 0.391 for Mongolia, Kazakhstan, Russia and China. In the China group, the highest average of GS (0.555) was found among accessions from Qinghai, followed by Inner Mongolia (0.554), Xinjiang (0.514), Tibet (0.483), Gansu (0.454) and Sichuan (0.452).

1) As it currently reads (subsection “YcbB-mediated β-lactam resistance”, first paragraph), it appears that selection for both resistance to 500 μg/ml IPTG induction and resistance to 32 μg/ml ampicillin were performed simultaneously. Is this correct? If so, the rationale as well as rate of mutation should be better explained and documented, as this is central to the manuscript.

Verbatim transcripts of the narratives were analyzed using Linguistic Inquiry and Word Count [LIWC, (39)], an extensively validated computerized text-analysis tool. LIWC analyses texts by calculating the percentage of words in a given text that fall into a set of pre-defined psychological and grammatical categories. Based on prior research and cognitive PTSD theory, we limited our analysis to the categories cognitive processes (e.g., “cause,” “know,” “ought”) as an index of elaboration and cognitive processing, death-related words (e.g., “dead,” “kill,” “grave”) as an index of mental defeat and death salience, negative emotions (e.g., “angry,” “sad,” “cry”), as an index of negative emotionality, and first person singular pronouns (e.g., “I,” “me,” “my”) as an index of self-immersed processing. To address the question of process specificity, we computed separate word-use variables for the trauma and negative event narratives. Sample excerpts illustrating these four language variables in both types of narratives are provided in the Appendix.

Aufgrund der gesundheitlichen Gefahren der Verbreitung des neuartigen SARS-CoV-2-Virus und den damit einhergehenden Empfehlungen zur Kontaktreduktion greifen viele Unternehmen auf die Möglichkeit zurück, ihre Mitarbeiter/innen im Homeoffice zu beschäftigen.

Researchers observed and tracked animal carcasses during multiple stages of the slaughter process. These carcasses included both those from animals individually marked and from other animals that were present on the selected trucks. To maintain the identity of the animals that had been identified and individually marked at unloading and track their carcasses, researchers added uniquely identifying tags at multiple processing stages.

where Xi is the individual maximal accuracy rate in the ith subject, N is the total number of subjects, and Z is the standard normal distribution with a significance level α. Typically, α is 0.1, 0.05, or 0.01. In this study, because the number of subjects was 104, the upper values of the two confidence levels at α 0.05 or α 0.01 were obtained as 0.594 and 0.658, respectively. Second, based on these criteria, we divided all subjects into three types according to BCI performance. The high-performance group was above 0.658, the intermediate-performance group was between 0.594 and 0.658, and the low-performance group was below 0.594. Finally, after the discrimination of BCI performance groups, we used the value of subsequent BCI performance as the kappa (ϰ) values, which were converted from the maximum accuracy rates according to Eq. 12, because the kappa values were normalized from 0 (chance level) to 1 (perfect classification). For the linear correlation or regression with individual EEG features in the prior states, the converted kappa values would limit the output values by preventing unnecessary bias.

Household locations within the 12 HFCAs were aggregated to 115 village-sized clusters using a k-means algorithm, restricting clusters to reside within HFCAs (Fig 1). The number of clusters in each HFCA, k¸ was selected such that increasing k by one yielded a less than 10% improvement in within-cluster sum of squares. The population in each simulation cluster averaged a few hundred people (S1 Fig) and varied from round to round due to inter-cluster migration and cycling from births and deaths. Birth and death rates were fixed at 45 per thousand per year in all simulations.

The repeated administration of α4β2 nAChRs agents in colitic mice elicited weak effects on most of the analyzed inflammatory parameters. Only DAI was significantly reduced on day 4 by both the agonist TC-2403 and the antagonist DBE, when administered at the highest tested dose (Figure 1A); at the same dose, DBE was able to attenuate also colonic MPO activity (Figure 1E).

To further characterise this reduction, we marked the forming muscles with MyoD and co-stained with N-Cadherin. As expected, a strong reduction is observed in the cells ensheathing the muscles (Fig. 5E,F). Western blots from wild-type and Tbx5 mutant limbs using N-Cadherin and β-Catenin antibodies confirmed a decrease in the levels of both proteins in the mutant (Fig. 5G). Expression levels of another mesenchymally-expressed Cadherin, Cadherin 11, are unaffected however (not shown) suggesting that there is not a general Cadherin downregulation and that the response to the loss of β-Catenin in MCT may be limited to N-Cadherin.

Patients were asked to document their experience of WB‐MRI using a 26‐item scale modified from an instrument developed to assess experience of colonoscopy.22 The scale has previously been adapted to better capture experience of diagnostic imaging scans23 and for the current study was modified further to include items deemed relevant by the researchers to WB‐MRI, based on interview data from initial patients recruited. The scale had three domains: scan discomfort (13 items), worry (6 items) and satisfaction (7 items). Response options were on a 1 to 7 scale, anchored at both ends, with participants asked to indicate experience by ticking along the scale. An example discomfort item was 1=’claustrophobic’ to 7= ‘not claustrophobic’. Questionnaire content and results from the current study cohort has been reported previously.10

Le virus semble transmis principalement par les gouttelettes . Le port du masque dans les espaces clos et en extérieur dans certains lieux est devenu obligatoire en Tunisie avec une nouvelle saturation du système hospitalier et une augmentation des décès. Dans notre étude, un contact avec un cas suspect ou confirmé de COVID-19 était identifié chez 6 patientes. Il s´agissait d´un membre de la famille dans quatre cas. Malgré les moyens de protection (Le masque de protection respiratoire individuelle de type FFP2, visière, gants et blouse jetables pour tous les soins) six patientes parmi les 11 seraient responsables de la contamination de 12 personnes travaillant au service. Les données de la littérature suggèrent que la période d´incubation serait d´environ 5 jours (entre 2 et 14 jours) . La période de contagiosité pourrait précéder les symptômes . Dans notre étude, la durée moyenne d´incubation du virus était de 5.89 jours. Zhu et al. ont rapporté rétrospectivement le suivi de neuf mères dans cinq hôpitaux du Hubei . Quatre ont présenté des symptômes dans les quatre jours avant l´accouchement, deux le jour de l´accouchement et trois par la suite. Dans la littérature, la majorité des personnes (80%) infectées par le SARS-CoV-2 et présentant des symptômes n´ont eu qu´une légère rhinite ou un syndrome grippal léger ou modéré. Des symptômes plus graves ont également été décrits (16 à 32%), présents chez les patients présentant une immunodépression ou des comorbidités et les femmes enceintes .

Despite great innovations in the development of drugs and biologics for the clinical management of pediatric diseases, regulatory bottlenecks threaten to deny or delay children’s access to life-saving therapeutics. As human health researchers and as members of the biopharmaceutical community, we have a voice in this regulatory system, and an obligation to help improve it. We encourage the communities of pediatric health researchers, biopharmaceutical industry, and regulatory firms to come together and share ideas, concepts, and models toward facilitating a more efficient commercial review process for pediatric drugs and biologics.

Urinecytologie heeft een matige voorspellende waarde voor gradering en invasiviteit van UTUC. Bij patiënten met maligne cytologie was in 40% van de gevallen sprake van een laaggradig UTUC en in 33% van niet-spierinvasief UTUC. Tumorgrootte was geassocieerd met tumorgradering, maar niet met tumorstadiëring. Met de huidige criteria van de European Association of Urology worden mogelijk kansen gemist om meer patiënten niersparend te behandelen. Deze data kan een argument zijn om in selecte gevallen toch te kiezen voor niersparende behandeling, ondanks de aanwezigheid van hooggradige cytologie of een tumor > 2 cm.

Se debe mencionar que hay otras dimensiones de desigualdades relevantes para el análisis de cobertura de las intervenciones, por ejemplo, la escolaridad de las madres, grupo étnico y más, que no se abordaron en el presente análisis ya que se utilizó el “índice de riqueza”, que cubre otras dimensiones de desigualdades (27,28).

Em revisão para avaliar as propriedades de medida e estudos de intervenção com a PIPP, verificou-se que o instrumento continua a ser uma medida confiável e válida para avaliar a dor aguda em crianças. A confiabilidade interclasse foi excelente (>0.89) e a confiabilidade intra-examinadores foi de 0.95.49 Outro estudo de revisão, com a mesma escala de dor em RN termo e RNPT, obteve uma excelente confiabilidade interobservador, de 0.93 a 0.96, e intraobservador, de 0.94 a 0.98.17

The consequence of the observed rapid LD decay is that genetic mapping in the cultivated grapevine will not follow other organisms' paths towards genome-wide mapping studies. To date, the path towards GWA and GS has begun with genotyping microarrays that carry tag SNPs, SNPs that effectively capture neighboring variants through LD . The grapevine, however, has such low LD that most functional alleles would not be tagged by a genotyped marker from an array-based assay. Thus, we anticipate that whole-genome sequencing will be required for well-powered genome-wide approaches in the grapevine. There are two other reasons why this is a reasonable way to move forward. First, we found that the quality scores from the Vitis9KSNP array are influenced by the number of SNPs present in the probe sequence (Figure S2). This observation suggests that it may be difficult to obtain high-quality genotype data using genotyping microarrays on high-diversity plant species. Second, because the grape is a long-lived perennial that generally produces fruit 3 years after planting, the focus should now be on establishing a mapping population that effectively captures the diversity within the grapevine, paying careful attention to experimental design (e.g. number of replicates, number of environments, etc.). It is likely that by the time sufficient phenotype data is collected from such a mapping population, the sequencing costs will be minimal compared to the costs of establishing and phenotyping the population. Thus, we argue that it is most effective to now concentrate on establishing grapevine mapping populations that will allow for well-powered genetic mapping studies in the future and to exploit the anticipated low future costs of whole-genome sequencing.

Interessanterweise bewegte sich das Verhältnis von Dosisreduktionen zu Dosissteigerungen in unserer Untersuchung in einer ähnlichen Größenordnung wie das oben beschriebene Verhältnis von Medikamente absetzen zu Medikamente (wieder)ansetzen. Insgesamt konnten 75 % mehr Dosisreduktionen als -steigerungen vorgenommen werden. Werden Antihypertensiva zu hoch dosiert, kann es bei geriatrischen Patienten zu gefährlichen Hypotonien kommen , wodurch sich die Sturz- und Frakturgefahr dramatisch erhöht. Daher sind die in den jeweiligen Fachinformationen angegebenen Tageshöchstdosen unbedingt zu beachten. Bei gleichzeitiger Anwendung von Amlodipin und Simvastatin kann es zu einer klinisch relevanten Medikamenteninteraktion kommen . Die Hemmung des Cytochrom-P450(CYP) -Isoenzyms 3A4 durch Amlodipin führt zu einer Erhöhung der Plasmakonzentration des CYP3A4-Substrats Simvastatin mit der Gefahr einer Myopathie bis hin zur Rhabdomyolyse. Unter Komedikation mit Amlodipin sollte die maximale Simvastatintagesdosis daher 20 mg nicht überschreiten .

Extended data Figure ‎6: DCDC2 co-localised with microtubules and clustered in primary cilia and mitotic spindles. (A) The immunofluorescence of DCDC2 demonstrated the cellular distribution and co-localisation with microtubules, primary cilia, and mitotic spindles in proliferating hWT-IR podocytes. (B) DCDC2 shows a slight overlap with the insulin receptor that does not change with insulin stimulation. (40x magnification).

Cette étude sur la tuberculose dans la zone de santé de Lubumbashi, nous a permis de noter que l'incidence de cette maladie est de 530 cas de tuberculose pour 100 000 habitants et que le sexe masculin est le plus concerné. La localisation pleurale a été la forme la plus rencontrée parmi les formes extrapulmonaire et la forme pulmonaire à microscopie positive reste celle qui a le taux de mortalité le plus élevé. Nous estimons que le système de santé pour la prise en charge des patients tuberculeux est encore à améliorer dans l'ensemble de cette portion de la ville de Lubumbashi pour espérer une réduction de la morbi-mortalité liée à la tuberculose.

Die beiden Gruppen, konnten rein statistisch betrachtet, trotz unterschiedlicher Gruppengröße, miteinander verglichen werden, da gemäß der Effektstärke nach Cohen die Stichprobengröße ausreichend ist, um einen mittleren Effekt beim Unterschied der ordinalskalierten Variablen statistisch belegen zu können.

We agree with the Reviewer this would be interesting to test and we are actually also very interested in this question given that SOX2 has been implicated in mouse research to be important for bronchiolar lineage formation (Ochieng et al., 2014; Que et al., 2009). However, as mentioned above, further optimisation of the basal cell differentiation protocol is required for our organoid cells, so we feel this is beyond the scope of this technically-focused manuscript.

Currently, there are no formal or specific treatments. The only antiviral drug authorized by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for the treatment of SARS-CoV-2 is remdesivir, an adenosine nucleotide analog that interferes with RNA polymerization .

В зерне твердой пшеницы представлен широкий набор каротиноидных пигментов: лютеин, β-каротин, зеаксантин, β-криптоксантин, β-апокаротенал, антраксантин, тараксантин (лютеин-5,6-эпоксид), авоксантин и тритикоксантин. Каротины α и β в основном находятся в за- родыше, превалирующий в зерне среди каротиноидов лютеин (86–94 %) одинаково распределен по слоям и частям зерновки (Digesù et al., 2009). Его доля в семолине при размоле зерна твердой пшеницы составляет 83 %, во фракциях отрубей – 75 % (Fu et al., 2017). Установлено, что характер распределения желтых пигментов по фракциям, выделяемым в процессе размола, варьирует, в зависимо- сти от генотипа. Концентрация лютеина в эндосперме сорта Navigator была выше, чем в отрубях, в то же время у сорта Strongfield наблюдалась обратная закономерность (Fu et al., 2017). В процессе помола и получения крупки (семолины) концентрация большинства каротиноидных пигментов уменьшается, что связано с увеличением кон- такта измельченных частиц зерна с кислородом воздуха и активностью ферментов. Лютеин и зеаксантин имеют более высокую стабильность при помоле и изготовлении конечных продуктов, по сравнению с другими каротиноидами (Kean et al., 2011).

In heterogeneous tumours, both phenotype subpopulations had down‐regulated oxidative phosphorylation (Figure 4d,e, and Figure S4a,b), suggesting a change in metabolic activity compatible with enhanced tumour growth. Individual contributions of the two phenotypes in “heterogeneous” tumours resulted in major changes in cell–cell junctions and ECM interactions with increased expression of FN1, TNC and matrix re‐modellers, and alterations in the repertoire of collagens and adhesion receptors (Figure 4f and Tables S1–S3).

Mme L.L âgée de 30 ans sans antécédents pathologiques particuliers, ayant consulté pour une tuméfaction cervicale antérieure augmentant progressivement de taille depuis l'enfance sans signes de compression mais devenant gênante sur le plan esthétique. L'examen clinique trouvait une patiente en bon état général avec une masse cervicale médiane ad-hyoïdienne, de consistance ferme, indolore, mesurant 2cm sur 2 cm, ascensionnant à la déglutition et à la protraction de la langue. Il y'avait pas de signes inflammatoires ni d'adénopathies cervicales. L'échographie montrait une masse cervicale antérieure mesurant 21 mm de diamètre, d'échostructure hétérogène renferment des débris hyperéchogènes faisant suspecter un KTT. La glande thyroïde était d'aspect normal sans adénopathies cervicales détectables. La patiente était opérée selon la technique de Sistrunk emportant en bloc le kyste, son cordon, le corps de l'os hyoïde et une collerette musculaire basilinguale. L'examen histopathologique de la pièce opératoire a révélé un microcarcinome papillaire sur KTT. Le taux de la thyroglobuline et de la TSH étaient normaux. Après une discussion multidisciplinaire, la patiente a bénéficié d'une thyroïdectomie totale (Figure 1), l'étude histopathologique a révélé un microcarcinome papillaire thyroïdien. Un balayage isotopique corps entier à l'iode 131 a révélé des résidus tumoraux thyroïdiens. Une ira thérapie a été prescrite, avec une hormonothérapie à dose freinatrice, l'évolution était favorable : absence de récidive après un recul quatre ans.

Высокопроизводительное генотипирование ячменя впервые апробировано в 2005 г. (Rostoks et al., 2005) на основе технологии Illumina GoldenGate (Fan et al., 2003). Первые коммерчески доступные чипы для генотипирования ячменя появились в 2009 г. (Close et al., 2009). Для его создания было выбрано и протестировано 4596 SNP на 576 ДНК-образцах для двух пилотных чипов ОРА, РОРА1 и РОРА2, и на 480 ДНК-образцах для третьего пилотного чипа – РОРА3. Далее было выбрано 3072 SNP, которые прошли качественный контроль и были генетически информативны. Они составили две производные OPA – BOPA1 и BOPA2, которые планировалось использовать для дальнейших исследований генофонда ячменя. Из 3072 SNP, выбранных для изучения, 2279 были получены из библиотек EST, а 793 – путем секвенирования ПЦРампликонов. В результате в платформу для генотипирования, содержащую 3072 маркера, вошли два чипа, BOPA1 и BOPA2, каждый из которых содержал по 1536 маркеров SNP, и они имели различные дизайны генотипирования (Close et al., 2009). Следующий чип был разработан Illumina Infinium iSelect 9К Custom Genotyping BeadChip (Comadran et al., 2012) и включал в себя 2832 маркера, разработанных для предыдущей технологии GoldenGate, и 5010 дополнительных маркеров, основанных на обнаружении маркеров SNP в данных Illumina RNA-seq из 10 элитных сортов Великобритании (Bayer et al., 2017).

TM helices depicted in green circles (black outline). Green circles with red outline, Blue circles with black outline and Purple color circles represents the conserved residues for all class A GPCRs, conserved motifs of class A GPCRs and helix 8 implemented in 7-TM helices of hsβADR1, respectively.

Le paragangliome (PG) est une tumeur endocrinienne développée aux dépens des cellules chromaffines extra surrénaliennes. Les formes rétro péritonéales sont moins fréquentes que les autres localisations [1, 2]. Nous rapportons une observation d'un paragangliome rétro péritonéal avec des particularités révélatrices du diagnostic, et de prise en charge périopératoire.

In the next step in the simulation, prevalence is no longer used and incidence is used instead. The incidence was obtained from the baseline model using prevalence. Both the prevalence and the incidence parameters have a roughly exponential trend concerning age; see Figure 1. It is noticeable that in the case of incidence, there is an artefact for the cohort of 100-year-olds due to merging the people older than 100 from the Eurostat data into one group. Nevertheless, this artefact does not play a role in the simulation, as it is a very small group of patients who also “die” in the next step.

各研究结果的不一致可能受入组病例数、化疗方案、基因型检测方法等因素影响，也与不同种族基因型频率分布显著不同有关。ERCC1基因多态性影响晚期NSCLC患者铂类化疗疗效及生存期的机制尚未完全阐明，如果将ERCC1 mRNA以及蛋白表达共同融合到ERCC1 C8092A、118密码子基因多态性研究中，探讨其相互影响的机制，可能有助于阐明ERCC1多态性对基因转录和蛋白质翻译的作用。ERCC1基因多态性能否为个体化治疗提供选择药物的依据，还需要进行更大样本更严谨的临床研究来明确RCC1基因多态性对晚期NSCLC患者含铂化疗疗效及生存的作用。

Martelli and colleagues firstly demonstrated that erucin, the isothiocyanate deriving from arugula (Eruca sativa Mill. belonging to Brassicaceae family) is a smart H2S-donor, which releases the gasotransmitter only in presence of thiol-groups, or in biological environment. Moreover, erucin showed hyperpolarizing activity on human aortic smooth muscle cells and vasoactive effects in ex vivo models; furthermore, in spontaneously hypertensive rats, erucin promoted anti-hypertensive effects . Furthermore, previous studies reported that 4-month oral treatment with sulforaphane (SFN), which is another natural isothiocyanate, reduced blood pressure values in spontaneously hypertensive rats and increased glutathione levels in aortic smooth muscle cells , .

Our study was performed on a population of 529 asymptomatic patients, aged between 25 and 87 years old (62 yrs ± 12.79) at baseline, divided in 257 male patients and 272 females, who were attending twenty years ago our “Centre for the Early Diagnosis of Preclinical and Multifocal Atherosclerosis and for the Cardiovascular Prevention”, in Palermo, Italy. We identified 529 asymptomatic subjects at baseline from our registry of more than 9000 patients referred from 1985 to 1991 and in follow-up in our centre. From this registry we selected the population evaluated in the present study with MetS, according to the document of Scientific International Societies - International Diabetes Federation (IDF), National Heart, Lung, and Blood Institute (NHLBI), World Hearth Federation, International Atherosclerosis Society e American Heart Association (AHA) – published in 2009 , which defined MetS as an alteration in 3 or more of the following 5 components: abdominal obesity, triglycerides, high-density lipoprotein (HDL) cholesterol, blood pressure (BP), and fasting plasma glucose. The following cut-off values were used to define alterations: waist circumference >102 cm for men and >88 cm for women for abdominal obesity, triglycerides ≥150 mg/dL (1.69 mmol/L), HDL-cholesterol <40 mg/dL (1.04 mmol/L) for men and < 50 mg/dL (1.29 mmol/L) for women, BP ≥ 130/≥85 mm Hg and fasting glucose ≥ 100 mg/dL. The choice of cutoff values for waist circumference was done according to the recent published consensus, taking into consideration the geographic distribution . The most common CV risk factors (lifestyle, dietary habits, smoking, family and personal history of CV disease) were investigated. Moreover we evaluated the anthropometric parameters (weight, height, and waist circumference) and the laboratory ones (fasting triglycerides, HDL-c, fasting glucose and fasting insulin), as well as blood pressure. Figure 1 shows the prevalence of the mean cardiovascular risk factors in the population evaluated.

I think there’s aspects of the role that are really frustrating, such as being on bank staff is really hard sometimes … having a group cancelled just feels crap sometimes … because I’m a co-facilitator, if my co-worker is on leave and the group is cancelled, I don’t work, which means I have less money. (London Peer Worker)

Network approaches have been used in predicting and identifying the disease genes in multiple studies and some of the results have been verified26,27. It is suggested that, in the viewpoint of network biology, drug targets tend to locate at the transition area from the essential hubs, e.g. proteins interacting with more partner proteins, to redundant peripheral nodes28, e.g. proteins interacting with fewer partner proteins. The rationale behind this is a balance of toxicity and efficacy regarding the potential influence of the targets on cellular function.

As of 2018, ST1478 has been identified in 19 of 62 CNISP participating hospitals in 6 provinces. Of the 19 hospitals, 12 were from western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba), 6 from central Canada (Ontario and Quebec), and 1 from eastern Canada (Newfoundland and Labrador, Prince Edward Island, New Brunswick, and Nova Scotia). Regionally, ST1478 represented 23.7% (65/274) of isolates tested from western Canada, 14.8% (49/332) of isolates tested from central Canada, and 50% (1/2) of isolates tested from eastern Canada during 2013–2018. Furthermore, among the VRE BSI identified in western Canada, a significantly higher proportion were ST1478 (56.5%, 65/115) compared with non-ST1478 (42.4%, 209/493; p = 0.006).

A 19-month-old girl presented at our hospital with a history of recurrent fever and cough for 2 weeks. She was diagnosed with pneumia by a local hospital and had received azithromycin, ceftriaxone, and methylprednisolone treatment. However, her fever and cough persisted. Upon admission at our hospital, her respiratory rate was 70 breaths/min and body temperature was 39.7oC. Her eyelids were swollen and she had a needle-like rash over her entire body. Chest examination revealed crackles in two lung fields. Laboratory examinations revealed WBC count of 2.5 × 109/L, normocytic anemia (hemoglobin of 10.1 g/dL), thrombocytosis (platelet count of 75 × 109/L), and elevated CRP of 28 mg/L. CT demonstrated inflammation in the lungs and pleural effusion. We suspected infection by a drug-resistant microorganism and administered imipenem and methylprednisolone therapy. On day 9, her condition deteriorated and her respiratory rate increased with frequent cyanosis. The patient subsequently received tracheal intubation and mechanical ventilation. Because we could not exclude the possibility of methicillin-resistant S. aureus (MRSA) infection, vancomycin was administered. However, her oxygen saturation was only about 80%. X-ray showed interstitial emphysema, mediastinal emphysema, and subcutaneous emphysema in the lungs. She then received extracorporeal membrane oxygenation for 5 days. On day 22, bronchoscopy was performed, which revealed substantial purulent secretion and necrotic areas throughout the tracheal mucosa (Figure 2C1). Her condition improved and her tracheal tube was removed. Histologic evaluation showed inflammatory necrotic tissue and Aspergillus fumigatus infection (Figure 3C). Repeat CT showed local stenosis of right main bronchus (Figure 4C) and a cavity formed near the pleura in the right lower lung. She subsequently received voriconazole, caspofungin, and amphotericin B treatment. Bronchoscopy was performed seven times to remove the pseudomembrane. The last bronchoscopic examination during hospitalization showed tracheal stenosis and granulation (Figure 2C2). On day 44, she was discharged from our hospital and received oral voriconazole for 6 months. The last bronchoscopic examination showed persistence of some mucosal irregularities. CT taken 1 year after discharge showed almost complete absence of lung inflammation.

Examen: sur les 249 certificats étudiés l'évaluation psychologique a été faite (100%) avec 21 victimes présentant un choc psychologique (8,4%). Nous trouvions 147 cas où le nombre de lésions (Figure 3) était compris entre 1 à 2 lésions (59%) et 76 victimes présentant entre 3 à 5 lésions (30,6%) et 20 victimes présentant plus de 5 lésions (8%). Les lésions étaient le plus souvent mixtes pour 138 victimes (55,4%). Lorsqu'elles étaient uniques, nous comptions 56 plaies (22,4%), 28 contusions (11,2%), 10 fractures (4%), 5 luxations (2%), 4 érosions (1,6%), 3 entorses (1,2%) et 2 morsures (0,8%). La description précise des lésions figurait sur les 246 certificats où la nature des lésions a été donnée et était absente sur 3 certificats correspondant aux certificats où aucune lésion n'a été trouvée. Ces lésions étaient décrites dans leur aspect, leur forme, leur taille précise et les lésions en forme notamment les morsures étaient soulignées dans la description initiale. Sur 227 cas les lésions étaient récentes (91,2%) et 19 victimes présentant des lésions anciennes (7,6%). La localisation des lésions figurait sur 244 certificats (98%) avec 55 lésions (22,1%) localisées au niveau du massif crânio-facial et du cou, 6 lésions du thorax (2,4%), 2 lésions de l'abdomen, 10 lésions du rachis et du bassin (4%), 68 lésions des membres (27,3%) dont (54 cas soit 21,7% pour les membres supérieurs et 14 cas soit 5,6% des cas pour les membres inférieurs) et 103 cas où la localisation des lésions était mixte (41,4%). Cette localisation était établie par rapport à des repères anatomiques fixes, dans les différents plans de l'espace.

L'inconvénient majeur est le prélèvement de la greffe de fascia-lata qui entraîne une large cicatrice sur la cuisse; le retentissement fonctionnel de cette prise de greffe sur la fonction du membre inférieur n'est pas évalué dans les différentes études . Galano et al. rapportent une récupération complète de la mobilité active chez 9 malades sur 11. Une amélioration significative de l'antépulsion moyenne (158,2°- 164,5°), des scores fonctionnels ASES (American Shoulder and Elbow Surgeons Shoulder) (de 53,3 à 63,8), et des échelles visuelles analogiques (de 5.0 à 2.9), étaient notées chez l'ensemble des patients. Le suivi a objectivé un lâchage du transfert dans un cas, 6 mois après l'intervention suite à un traumatisme. Les complications rapportées sont à type d'infections du site opératoire dans deux cas, ainsi qu'une asymétrie inesthétique des seins chez une patiente.

Another noteworthy issue was identifying how to deliver healthcare services in a ‘culturally-sensitive’ manner without creating a sense of ‘discrimination’ or ‘racism’. An obvious instance was depicted by Manirankunda et al. in Flanders, Belgium. The study was centred on provider-initiated HIV testing and counselling (PITC) for Sub-Saharan African migrants (SAMs). Though PITC was deliberately initiated to tackle high prevalence of HIV/AIDS amongst the SAMs population, physicians were reluctant to encourage their patients to undertake HIV/AIDS testing (unless patients themselves requested) owing to a fear of being accused of racism. A survey of the opinions of health experts in Greece failed to reach a consensus on whether or not establishing a separate ward for migrants would increase the efficiency of healthcare service delivery, this resulted from fears that it might emphasise the perception of racial inequity . This is something Worth et al. called the ‘fear of making cultural blunder’ in health practitioners. In occupational health, even though racism is not expressed explicitly, Meershoek et al. observed that Dutch doctors assigned a stereotype of ‘problematic’ patients to migrants more often than to Dutch patients. This bias explained why Dutch occupational physicians occasionally failed to fine tune their coaching activities to meet the needs of migrants, and this, in turn, made some migrants more likely to suffer from conditions that prevented them from working than general Dutch patients.