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1.
Ann Vasc Surg ; 91: 168-175, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36563846

RESUMO

BACKGROUND: Stenosis severity has been the indication for carotid endarterectomy (CEA) for 4 decades, but the annual stroke risk in asymptomatic carotid stenosis >70% is under 2%. Atherosclerotic volume has emerged as a risk factor for future stroke, but needs to be measured noninvasively. Tomographic ultrasound (tUS) is a novel technology that assembles 3D images in seconds. We evaluated accuracy of measuring Carotid Plaque Volume (CPV) with tUS in patients undergoing CEA. METHOD: Consecutive patients were imaged immediately before CEA by tUS and contrast-enhanced tUS (CEtUS). CPV was measured using tUS, CEtUS, and a fused images incorporating both tUS and CEtUS by trained vascular scientists. Precise volume of the endarterectomy specimen was measured using Archimedes technique. RESULTS: Mean ± sd (range) CPV in 129 endarterectomy specimens was 0.75 ± 0.43 cm3 (0.10-2.47 cm3). Mean ± sd CPV measured by tUS (n = 114) was 0.87 ± 0.51 cm3, CEtUS (n = 104) was 0.75 ± 0.45 cm3 and with fusion (n = 95) was 0.83 ± 0.49 cm3. Differences between specimen volume and CPV measured by tUS (0.13 ± 0.24 cm3), CEtUS (-0.01 ± 0.21 cm3) or fusion (-0.08 ± 0.20) were clinically insignificant. Intra-/interobserver differences were minimal. CONCLUSIONS: tUS accurately measures CPV with excellent intra-/interobserver agreement. CEtUS improves accuracy if precise CPV measurement is needed for research but tUS alone would be sufficient for population screening.


Assuntos
Estenose das Carótidas , Endarterectomia das Carótidas , Placa Aterosclerótica , Acidente Vascular Cerebral , Humanos , Estudos de Viabilidade , Resultado do Tratamento , Artérias Carótidas , Ultrassonografia/métodos , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/cirurgia , Estenose das Carótidas/complicações , Endarterectomia das Carótidas/efeitos adversos , Placa Aterosclerótica/complicações , Acidente Vascular Cerebral/etiologia , Meios de Contraste
2.
BMC Med Educ ; 23(1): 626, 2023 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-37661272

RESUMO

BACKGROUND: The Aboriginal and Torres Strait Islander Health Curriculum Framework helps higher education providers to deliver safe and well-informed cultural humility education. However, there is currently a scarcity of evidence surrounding the efficacy and impact of cultural humility education. This study will use qualitative and quantitative research methods to evaluate learning outcomes from an Indigenous health educational webinar aimed at Australian medical students. METHODS: A pilot study was conducted following a group of Australian medical students who attended an educational Indigenous health (IH) culturally responsive webinar. Recruitment was conducted via the webinar hosts' social media pages. Quantitative methods involved sending one pre- and two post-webinar questionnaires to attendees. To assess participants' retention of information, one post-webinar survey was sent out immediately after the webinar and another three months after the webinar. These questionnaires were designed to reflect pre-determined learning objectives for the webinar. Qualitative methods involved a focus group discussion to identify common themes from participant feedback. RESULTS: Twenty-six participants were included in the final quantitative analysis. Most of the participants were clinical students between 18 and 24 years old who did not identify as Aboriginal and/or Torres Strait Islander. There was a significant increase (p = 0.007) between pre-intervention (M = 0.35, SD = 0.26) and post-webinar knowledge for the learning outcome exploring the links between health and education (M = 047, SD = 0.25). No results were obtained from the three months post-intervention questionnaire. The qualitative analysis synthesized feedback from three participants and identified presenter delivery style as an important mediator of webinar effectiveness. CONCLUSIONS: There was a significant increase in knowledge and understanding for the learning outcome that explored the links between health and education. We attribute this partly to the engaging and conversational delivery style of the webinar presenters. The importance of Indigenous facilitators that encourage reflective teaching should not be understated. Our results suggest that cultural humility webinars can have a positive impact on medical students' understanding of the Aboriginal and/or Torres Strait Islander health landscape. This pilot study warrants further research on a larger population.


Assuntos
Assistência à Saúde Culturalmente Competente , Educação de Graduação em Medicina , Estudantes de Medicina , Adolescente , Adulto , Humanos , Adulto Jovem , Austrália , Povos Aborígenes Australianos e Ilhéus do Estreito de Torres , Projetos Piloto , Faculdades de Medicina , Educação de Graduação em Medicina/métodos
3.
Reprod Domest Anim ; 53(3): 644-654, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29450923

RESUMO

Trace minerals feeding had significant effects on sperm production and fertility with better absorption and proper utilization within the body for optimum reproductive function. Several studies have shown that more influenced trace elements in the diets of animals are copper (Cu) and zinc (Zn). Bucks showing deficiency of this mineral might affect the quality of semen production which in turn would affect the fertility. This experiment was thus designed to test the effects of organic Cu and Zn supplementation on antioxidants enzyme activities and sperm functional attributes in fresh semen of bucks. Forty bucks (n = 40, Aged 5 months) were assigned to ten groups of four animals in each group, supplemented (for a period of 8 months) with different levels of organic Zn: 20 mg (T2), 40 mg (T3) and 60 mg (T4), organic Cu: 12.5 mg (T5), 25 mg (T6), 37.5 mg (T7) and combined organic Zn and Cu: 20 + 12.5 mg (T8), 40 + 25 mg (T9), 60 + 37.5 mg (T10), respectively, per kg dry matter and no additional mineral diet (control; T1). One hundred and sixty semen samples were collected through electro-ejaculator and analysed for sperm quantity, quality, acrosome intactness and plasma membrane integrity and correlated with the catalase, superoxide dismutase, glutathione peroxidase and glutathione reductase enzyme activities in seminal plasma. The results indicated organic Cu and zinc supplemented bucks produced more sperm cells, had higher sperm concentrations, maintained higher (p < .01) sperm livability, plasma membrane and acrosome integrities, more motility and velocity. The increased antioxidant enzyme activities, reduced oxidative stress and lowered lipid peroxidation were positively correlated (p < .05) with the sperm functional attributes. In conclusion, organic Cu and Zn supplement to male goats showed protective roles against oxidative damage and maintained better fresh semen characteristics.


Assuntos
Cobre/farmacologia , Cabras/fisiologia , Espermatozoides/efeitos dos fármacos , Zinco/farmacologia , Acrossomo , Fenômenos Fisiológicos da Nutrição Animal , Animais , Antioxidantes , Membrana Celular , Cobre/administração & dosagem , Suplementos Nutricionais , Masculino , Sêmen/enzimologia , Análise do Sêmen/veterinária , Motilidade dos Espermatozoides/efeitos dos fármacos , Espermatozoides/citologia , Espermatozoides/fisiologia , Zinco/administração & dosagem
4.
J Anim Physiol Anim Nutr (Berl) ; 102(2): 591-595, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28990230

RESUMO

An experiment was conducted to determine the effect of in ovo administration of different forms of zinc with respect to hatchability and performance of commercial broiler chicken. In trial 1, the fertile eggs on day 18 were divided into six treatment groups: Group I as control without any supplementation of zinc, group II to IV were supplemented with 0.5 mg zinc per egg as zinc sulphate, zinc methionine or nano zinc, respectively, and Group V with nano zinc at 0.25 mg zinc per egg. Sixth group received 0.5 ml citric acid per egg as sham control. The results of the first trial indicated that in ovo administration of nano zinc at both levels and zinc methionine resulted in complete failure of hatchability. A second trial to validate the result of trial 1 consisted of Group I control (no administration). Group II and Group III were supplemented with zinc sulphate and zinc methionine, respectively, at 0.5 mg zinc per egg. Group IV and Group V were supplemented with nano zinc at 0.04 and 0.08 mg per egg. In the second trial, again there was a similar pattern for zinc sulphate and zinc methionine. Administration of Zn by nano form had around 80% hatchability on fertile eggs in comparison with the unadministered control eggs (92%). There was no difference (p > .05) in body weight gain, feed intake and FCR. No difference (p > .05) was observed between treatments for cell-mediated immune response and humoral immune response. Nano Zn-administered group showed a non-significant downregulation of MUC2 gene. It could be concluded that in ovo administration of higher levels of zinc has to be with caution for the developing embryo of commercial broiler chicken.


Assuntos
Embrião de Galinha/efeitos dos fármacos , Galinhas/imunologia , Metionina/análogos & derivados , Compostos Organometálicos/administração & dosagem , Óxido de Zinco/administração & dosagem , Sulfato de Zinco/administração & dosagem , Animais , Injeções/veterinária , Metionina/administração & dosagem , Metionina/farmacologia , Compostos Organometálicos/farmacologia , Óvulo/fisiologia , Óxido de Zinco/farmacologia , Sulfato de Zinco/farmacologia
5.
J Public Health (Oxf) ; 39(2): 297-303, 2017 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-27160859

RESUMO

Background: Research on the impact of psychosocial stressors on child and adolescent lung function is uncommon, and has primarily relied either on parents' own stress measures or parent-reported stressors the child experienced, which may be a poor proxy for perceived stress in older children and adolescents. Methods: We performed multivariate linear regression of spirometry measures (FVC, FEV1 and FEF25-75) and psychosocial stressors in 584 adolescents in the Los Angeles Family and Neighborhood Survey. We examined family conflict, unsafe neighborhood or school, and the absence of a father in models stratified by gender, adjusting for PM2.5 and potential confounders. Results: We observed reductions in lung function in males related to the absence of a father in the house (FEV1: -176.2 ml, 95% CI -322.7, -29.7) and family conflict (FEV1: -156.2 ml, 95% CI -327.8, 15.5); associations were stronger in older males ages 15-17 years for each stressor (P for interaction of age and sex was 0.009 and 0.06, respectively). Conclusions: This research informs a very small literature on psychosocial stressors and lung function in adolescents. Our finding of differential vulnerability by age and gender warrants further exploration of adolescent psychosocial stressor response on lung function.


Assuntos
Conflito Familiar/psicologia , Pneumopatias/etiologia , Relações Pais-Filho , Determinantes Sociais da Saúde/estatística & dados numéricos , Estresse Psicológico/complicações , Adolescente , Adulto , Fatores Etários , Criança , Feminino , Humanos , Los Angeles/epidemiologia , Pneumopatias/epidemiologia , Pneumopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários
6.
Eur J Vasc Endovasc Surg ; 52(4): 466-474, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27436173

RESUMO

Three-dimensional (3D) ultrasound is an evolving modality that may have numerous applications in the management of abdominal aortic aneurysms. Many vascular specialists will not be familiar with the different ways in which 3D vascular ultrasound data can be acquired nor how potential applications are being explored by researchers. Most of the current literature consists of small series and single-centre experience, although clinical themes such as measurement of abdominal aortic aneurysm volume and surveillance following endovascular repair are emerging. The aim of this topical review is to introduce clinicians to the current concepts of 3D ultrasound, review the current literature, and highlight avenues for further research in this new and exciting field of vascular imaging.


Assuntos
Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Imageamento Tridimensional/métodos , Ultrassonografia/métodos , Aorta Abdominal/diagnóstico por imagem , Procedimentos Endovasculares/métodos , Humanos , Complicações Pós-Operatórias/diagnóstico por imagem
7.
Phys Rev Lett ; 115(19): 193602, 2015 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-26588380

RESUMO

In this work we present a simple method to reconstruct the complex spectral wave function of a biphoton, and hence gain complete information about the spectral and temporal properties of a photon pair. The technique, which relies on quantum interference, is applicable to biphoton states produced with a monochromatic pump when a shift of the pump frequency produces a shift in the relative frequencies contributing to the biphoton. We demonstrate an example of such a situation in type-II parametric down conversion allowing arbitrary paraxial spatial pump and detection modes. Moreover, our test cases demonstrate the possibility to shape the spectral wave function. This is achieved by choosing the spatial mode of the pump and of the detection modes, and takes advantage of spatiotemporal correlations.

8.
Eur J Vasc Endovasc Surg ; 50(2): 148-56, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26109428

RESUMO

INTRODUCTION: Carotid artery dissection is a leading cause of stroke in younger patients, with an associated prevalence of 2.6-3.0 per 100,000 population. This meta-analysis aims to determine whether in patients managed medically, treatment with anticoagulants or antiplatelet agents was associated with a better outcome with respect to mortality, ischaemic stroke, and major bleeding episodes. PATIENTS AND METHODS: A comprehensive search strategy was employed of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (January 1966 to March 2015), and EMBASE (January 1980 to March 2015) databases. Primary outcomes were death (all causes) or disability. Secondary outcomes were ischaemic stroke, symptomatic intracranial haemorrhage, and major extracranial haemorrhage during the reported follow-up period. RESULTS: No completed randomized trials were found. Comparing antiplatelets with anticoagulants across 38 studies (1,398 patients), there were no significant differences in the odds of death (effects size, ES, -0.007, p = .871), nor in the death and disability comparison or across any secondary outcomes. CONCLUSION: There were no randomised trials comparing either anticoagulants or antiplatelets with control, thus there is no level 1 evidence to support their routine use for the treatment of carotid artery dissection. Also, there were no randomised trials that directly compared anticoagulants with antiplatelet drugs, and the reported non-randomised studies did not show any evidence of a significant difference between the two.


Assuntos
Anticoagulantes/uso terapêutico , Dissecção Aórtica/tratamento farmacológico , Doenças das Artérias Carótidas/tratamento farmacológico , Fibrinolíticos/uso terapêutico , Inibidores da Agregação Plaquetária/uso terapêutico , Dissecção Aórtica/complicações , Dissecção Aórtica/diagnóstico , Dissecção Aórtica/mortalidade , Anticoagulantes/efeitos adversos , Doenças das Artérias Carótidas/complicações , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/mortalidade , Fibrinolíticos/efeitos adversos , Humanos , Hemorragias Intracranianas/induzido quimicamente , Razão de Chances , Inibidores da Agregação Plaquetária/efeitos adversos , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Resultado do Tratamento
9.
Trop Gastroenterol ; 36(4): 244-50, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-27509702

RESUMO

BACKGROUND: Solitary rectal ulcer syndrome (SRUS) is a chronic, benign defecation disorder often related to excessive straining. SRUS is diagnosed on the basis of clinical symptoms, endoscopic and histological findings. METHODS: All patients diagnosed with SRUS by colonoscopy and confirmed by histopathology from October 2012 to August 2014 in the Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, India, were included in the study. Out of 92 patients, thirty-four patients underwent anorectal manometry. Twenty age-matched healthy volunteers were also studied with anorectal manometry to serve as controls. RESULTS: Mean age of the group was 41 ± 19 years with age range of 10-82 years; males were 58 (63%) with male to female ratio of 1.7:1. Bleeding per rectum was present in 83%, constipation in 46.7%, abdominal pain in 27.2%, and diarrhea in 25% of the patients. On endoscopy, ulcerative lesions were seen in 83% patients of whom solitary and multiple lesions were present in 44% and 39%, respectively. Polypoidal lesions were reported in 17.4% whilst rectal polyps and erythematous mucosa were found in 5.4% and 2.2%, respectively. Histological examination revealed fibromuscular obliteration in 100% of patients, surface ulceration in 70.6% and crypt distortion in 20.65% of patients. Anal relaxation and balloon expulsion test was significantly abnormal in SRUS patients compared to healthy controls (53% vs. 20%, p < 0.01). CONCLUSION: Rectal bleeding was the most common symptom and ulcerative lesions the most common endoscopic finding. Fecal evaluation disorder was more prevalent inpatients with SRUS.


Assuntos
Canal Anal/patologia , Doenças Retais/patologia , Úlcera/patologia , Dor Abdominal/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canal Anal/fisiopatologia , Criança , Colonoscopia , Constipação Intestinal/etiologia , Diarreia/etiologia , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Índia , Masculino , Manometria , Pessoa de Meia-Idade , Doenças Retais/complicações , Doenças Retais/fisiopatologia , Reto/patologia , Reto/fisiopatologia , Síndrome , Úlcera/complicações , Úlcera/fisiopatologia , Adulto Jovem
10.
Eur J Neurol ; 21(7): 1011-20, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24698360

RESUMO

BACKGROUND AND PURPOSE: Migraine pathophysiology involves a complex interplay of processes wherein the hormonal, neurotransmitter and inflammatory pathways interact to influence the migraine phenotype. However, all studies pertaining to the role of genetic variants in migraine have been restricted to a specific pathway and none of the studies has looked into inter-pathway genetic analysis. Our aim was to combine all the genetic variants from our previously reported studies to conduct higher order gene-gene interaction analysis using different multi-analytical approaches. METHODS: The study group included 324 migraine patients and 134 healthy controls. The study included 20 polymorphisms from hormonal, neurotransmitter, inflammatory and genome-wide associated variants from our published reports. Univariate and multivariate analyses were carried out by logistic regression. Classification and regression tree (CART) analysis was performed to build a decision tree via recursive partitioning. The high order genetic interactions associated with migraine risk were analyzed using multifactor dimensionality reduction (MDR). RESULTS: Univariate analysis revealed significant associations of polymorphisms in CYP19A1, ESR1, TNFA and PRDM16 genes with migraine susceptibility. Multiple regression analysis found significant results for four markers in CYP19A1, TNFA, ESR1 and LRP1 genes. In CART, the most prominent splitting variable was CYP19A1 polymorphism followed by TNFA, ESR1 and PRDM16 markers. The MDR analysis identified markers of CYP19A1, CYP19A1- TNFA, CYP19A1- ESR1- TNFA and CYP19A1- ESR1- TRPM8- PRDM16 as best models for one, two, three and four factors, respectively. CONCLUSIONS: The present study suggests interactions amongst hormonal, inflammatory and genome-wide associated variants but not with neurotransmitter pathway variants in migraine susceptibility.


Assuntos
Estudo de Associação Genômica Ampla , Transtornos de Enxaqueca/genética , Polimorfismo Genético/genética , Transdução de Sinais/genética , Predisposição Genética para Doença/genética , Hormônios/genética , Humanos , Neurotransmissores/genética , Fatores de Necrose Tumoral/genética
11.
Eur J Vasc Endovasc Surg ; 47(5): 487-92, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24618331

RESUMO

OBJECTIVE: CT angiography (CTA) for endovascular aneurysm repair (EVAR) surveillance involves irradiation and nephrotoxic X-ray contrast agents. Three-dimensional contrast enhanced ultrasound (3D CEUS) is a novel imaging technique that may be more sensitive to blood flow detection than CTA or 2D CEUS. 3D CEUS utilises positional information from magnetic field emitters to assemble all ultrasound reflections into a high-definition image. We compared 3D CEUS with CTA for the detection of endoleak and aneurysm expansion following EVAR. METHODS: 3D CEUS (Curefab), 2D CEUS (Philips IU22), and CTA were compared in 30-paired images from 23 patients. Sensitivity, specificity, positive, and negative predictive value were calculated for 2D and 3D CEUS against CTA as the 'gold standard'. Pearson correlation was used to compare aneurysm sac diameter. Data were analysed using SPSS version 19.0. RESULTS: 30 paired 3D CEUS and CTA images were analysed from 23 patients. Endoleaks were detected in 17 images with CTA, 18 on 2D CEUS, and 18 on 3D CEUS. The sensitivity, specificity, positive, and negative predictive values of 3D CEUS to detect endoleak were 100%, 92%, 94%, and 100%, respectively. There was excellent correlation (r=0.935; p≤.0001) between CTA and 3D CEUS for AAA sac diameter. Only 3D CEUS detected the inflow and outflow arteries in all 18 scans with endoleak. 2D CEUS detected the inflow in 16 (88.8%) and CTA on 12 (66.6%) of the images. CONCLUSION: 3D CEUS may be more sensitive to endoleak following EVAR than either 2D CEUS or CTA.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Meios de Contraste , Endoleak/diagnóstico por imagem , Procedimentos Endovasculares/efeitos adversos , Imageamento Tridimensional/métodos , Ultrassonografia Doppler em Cores/métodos , Idoso , Aortografia , Endoleak/etiologia , Procedimentos Endovasculares/métodos , Feminino , Seguimentos , Humanos , Masculino , Projetos Piloto , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
12.
Rheumatol Int ; 33(4): 1075-7, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21152923

RESUMO

A subset of patients with lupus erythematosus develops erythema multiforme-like skin lesions with speckled pattern of antinuclear antibodies, positive rheumatoid factor, anti-Ro (SS-A), and anti-La antibodies (SS-B), which known as Rowell's syndrome. We report an adolescent boy presented with erythema multiforme-like skin lesions and pericardial effusion; he fulfilled criteria of both Rowell's syndrome and systemic lupus erythematosus (SLE). Such initial presentation of SLE is rarely reported in literature.


Assuntos
Eritema Multiforme/patologia , Lúpus Eritematoso Sistêmico/patologia , Derrame Pericárdico/patologia , Pele/patologia , Anticorpos Antinucleares , Criança , Eritema Multiforme/imunologia , Humanos , Lúpus Eritematoso Sistêmico/imunologia , Masculino , Derrame Pericárdico/imunologia , Síndrome
13.
Natl Med J India ; 26(2): 79-81, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24093980

RESUMO

BACKGROUND: We prospectively studied the prevalence, type and causes of anaemia in newly diagnosed patients with lymphoid malignancies. METHODS: Between January 2007 and June 2008, a total of 316 newly diagnosed, consecutive patients (aged 15 years or above) of Hodgkin lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia with anaemia (haemoglobin <11 g/dl), were analysed to determine the prevalence and a subgroup of 46 patients was analysed for the cause of anaemia. RESULTS: Hodgkin lymphoma, non-Hodgkin lymphoma and chronic lymphocytic leukaemia were the diagnoses in 81 (25.8%), 203 (64.7%) and 30 (9.6%) patients, respectively. Anaemia was present in 134 patients (42.4%). Anaemia of chronic disease was present in 33/46 (71.7%) and iron deficiency in 18/46 (39.1%) patients. Vitamin B12 and/or folate deficiency was detected in 10/46 (21.7%) patients (B12 deficiency alone in 7, folate deficiency alone in 1 and combined B12 and folate deficiency in 2). Autoimmune haemolytic anaemia was detected in 5/46 (10.9%) although direct Coombs test was positive in 17/46 (37%) patients. Among patients with Hodgkin lymphoma and non-Hodgkin lymphoma, anaemia due to bone marrow involvement was present in 16/40 (40%). In most patients with bone marrow involvement, anaemia was due to other causes. In only 3 patients, anaemia was attributable to bone marrow involvement alone. Anaemia was multifactorial in 18/46 (39.1%) patients. Nutritional deficiency alone or in combination was present in 22/46 (47.8%) patients. CONCLUSION: Anaemia is common in lymphoid malignancies at initial presentation. Besides managing anaemia of chronic disease and bone marrow involvement, nutritional and autoimmune causes should be ruled out.


Assuntos
Anemia/epidemiologia , Anemia/etiologia , Doença de Hodgkin/complicações , Leucemia Linfocítica Crônica de Células B/complicações , Linfoma não Hodgkin/complicações , Adolescente , Adulto , Anemia Hemolítica Autoimune/epidemiologia , Anemia Hemolítica Autoimune/etiologia , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/etiologia , Medula Óssea/patologia , Feminino , Deficiência de Ácido Fólico/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Deficiência de Vitamina B 12/complicações , Adulto Jovem
14.
Sci Rep ; 13(1): 16087, 2023 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-37752170

RESUMO

We present experimental results of the trace argon impurity puffing in the ohmic plasmas of Aditya-U tokamak performed to study the argon transport behaviour. Argon line emissions in visible and Vacuum Ultra Violet (VUV) spectral ranges arising from the plasma edge and core respectively are measured simultaneously. During the experiments, space resolved brightness profile of Ar1+ line emissions at 472.69 nm (3p44s 2P3/2-3p44p 2D3/2), 473.59 nm (3p44s 4P5/2-3p44p 4P3/2), 476.49 nm (3p44s 2P1/2-3p44p 2P3/2), 480.60 nm (3p44s 4P5/2-3p44p 4P5/2) are recorded using a high resolution visible spectrometer. Also, a VUV spectrometer has been used to simultaneously observe Ar13+ line emission at 18.79 nm (2s22p 2P3/2-2s2p2 2P3/2) and Ar14+ line emission at 22.11 nm (2s2 1S0-2s2p 1P1). The diffusivity and convective velocity of Ar are obtained by comparing the measured radial emissivity profile of Ar1+ emission and the line intensity ratio of Ar13+ and Ar14+ ions, with those simulated using the impurity transport code, STRAHL. Argon diffusivities ~ 12 m2/s and ~ 0.3 m2/s have been observed in the edge (ρ > 0.85) and core region of the Aditya-U, respectively. The diffusivity values both in the edge and core region are found to be higher than the neo-classical values suggesting that the argon impurity transport is mainly anomalous in the Aditya-U tokamak. Also, an inward pinch of ~ 10 m/s mainly driven by Ware pinch is required to match the measured and simulated data. The measured peaked profile of Ar density suggests impurity accumulation in these discharges.

16.
Kathmandu Univ Med J (KUMJ) ; 10(40): 12-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23575045

RESUMO

BACKGROUND: No comparative study has been conducted in India considering different anthropometrically derived adiposity measures to study the association with Type 2 Diabetes. OBJECTIVE: This study aims to examine the association of different adiposity measures and to find out the best adiposity measure in assessing Type 2 Diabetes. METHOD: On 187 adult males aged 25-67 years, fasting and two hours postload glucose levels were assessed. Height, weight, hip circumference, and waist circumference at two anatomical sites, one at the level of the greatest anterior extension of the abdomen i.e. abdominal circumference and the other one at the narrowest part of the torso i.e. minimum waist circumference were measured. Waist hip ratio, body mass index, waist height ratio and conicity index were calculated subsequently. RESULTS: The prevalence of Type 2 Diabetes was 12.3%. Abdominal circumference revealed the highest odds ratio (OR 2.75; 95% CI 1.45-5.23) for Type 2 Diabetes, followed by waist height ratio (OR 1.86; 95% CI 1.05-3.32) and minimum waist circumference (OR 1.83; 95%CI 1.03-3.26). The area under the receiver operating characteristic curve of abdominal circumference was also larger (68%; 95%CI: 0.57-0.79) compared to other adiposity measures in assessing Type 2 Diabetes. CONCLUSION: Waist circumference measured at the level of greatest anterior extension of the abdomen was the best central adiposity measurement in predicting and assessing Type 2 Diabetes.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Programas de Rastreamento/métodos , Circunferência da Cintura , Adulto , Glicemia , Índice de Massa Corporal , Pesos e Medidas Corporais , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Prevalência , Curva ROC , Sensibilidade e Especificidade
17.
ESMO Open ; 7(5): 100558, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36007449

RESUMO

BACKGROUND: We synthesize the efficacy and toxicity of poly(ADP-ribose) polymerase inhibitors (PARPis) in patients with newly diagnosed advanced ovarian cancer. PATIENTS AND METHODS: We manually extracted individual patient data (IPD) for progression-free survival (PFS) from published survival curves of randomized controlled trials (RCTs) that compared PARPi versus placebo as maintenance therapy in first-line treatment, for whole study populations and subgroups, based on BRCA1/BRCA2 mutation (germline and/or somatic) and homologous recombination deficiency (HRD) status, using WebPlotDigitizer software. The respective PFS curves for each study and combined population were reconstructed from extracted IPD. The primary outcome was PFS in combined whole population and subgroups. RESULTS: In IPD analysis of combined population from three RCTs, with 2296 patients and 1287 events, PFS was significantly longer in PARPi versus placebo [median 20.4 (95% confidence interval (CI) 18.6-21.9) versus 14.9 (95% CI 13.9-16.5) months, respectively; hazard ratio (HR) 0.67, 95% CI 0.60-0.75; P < 0.001]. In IPD subgroup analyses from four eligible RCTs (2687 patients and 1485 events), median PFS was significantly longer in PARPi versus placebo arm, in the BRCA-mutated (45.7 versus 17.7 months, respectively; HR 0.38, 95% CI 0.32-0.46; P < 0.001), HRD-positive including BRCA-mutated (34.7 versus 17.9 months, respectively; HR 0.45, 95% CI 0.38-0.54; P < 0.001), and HRD positive excluding BRCA-mutated (22.3 versus 13.1 months, respectively; HR 0.47, 95% CI 0.34-0.65; P < 0.001) subgroups, but not in the HRD-negative (15.0 versus 11.3 months, respectively; HR 0.90, 95% CI 0.76-1.05; P = 0.75) subgroup. Results of trial-level meta-analysis were concordant with IPD analysis in whole population and subgroups. CONCLUSIONS: Among newly diagnosed ovarian cancer patients, PARPi maintenance therapy significantly improves PFS in those with germline and/or somatic BRCA mutation and/or HRD-positive tumor but not in those with HRD-negative tumor.


Assuntos
Antineoplásicos , Neoplasias Ovarianas , Feminino , Humanos , Inibidores de Poli(ADP-Ribose) Polimerases/farmacologia , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico , Carcinoma Epitelial do Ovário/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/genética , Antineoplásicos/uso terapêutico , Intervalo Livre de Progressão
18.
Rev Sci Instrum ; 93(11): 113552, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36461425

RESUMO

Spectroscopy in vacuum ultraviolet (VUV) and visible ranges plays an important role in the investigation and diagnosis of tokamak plasmas. However, under harsh environmental conditions of fusion grade devices, such as ITER, VUV-visible systems encounter many issues due to the degradation of optical components used in such systems. Here, near-infrared (NIR) spectroscopy has become an effective tool in understanding the edge plasma dynamics. Considering its importance, a NIR spectroscopic diagnostic has been developed and installed on the ADITYA-U tokamak. The system consists of a 0.5 m spectrometer having three gratings with different groove densities, and it is coupled with a linear InGaAs photodiode array. Radiation from the ADITYA-U edge plasma has been collected using a collimating lens and optical fiber combination and transported to the spectrometer. The spectrum in the NIR range from the ADITYA-U plasma has been recorded using this system, in which Paß and Paγ along with many spectral lines from neutral and singly ionized impurities have been observed. The influxes of H and C have been estimated from measurements. The H influx value is found to be 2.8 × 1016 and 1.9 × 1016 particles cm-2 s-1 from neutral hydrogen lines Hα and Paß, respectively, and the C influx value is found to be 3.5 × 1015 and 2.9 × 1015 particles cm-2 s-1 from the neutral carbon and singly ionized carbon, respectively. A good agreement is seen between these results and the results obtained by using a routine photomultiplier tube based diagnostic.

19.
Rev Sci Instrum ; 93(11): 113529, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36461525

RESUMO

Nascent observations about the influence of kinetic instabilities on electron cyclotron emission (ECE) from runaway electrons (REs) have been detected and explored at the Aditya-Upgrade (Aditya-U) tokamak. The developed broadband ECE radiometer system offers wideband measurements by integrating several radio frequency units with a fixed intermediate frequency receiver with multiple channels, which is a novel approach to meet the needs of the localized measurements at various toroidal fields and extend the system dynamic range. The low density (ne ≤ 1 × 10-19 m-3) plasma discharges at Aditya-U are consistently accompanied by a 20%-40% increase in the ECE radiometer signal amplitude within 100 µs and sporadic step-like modulations. The Pitch Angle Scattering (PAS) of REs induced by kinetic instabilities is a potential candidate for their occurrence. This steep jump in the radiometer signals was detected due to its high temporal resolution of 10 µs. A "PREDICT" code that employs the relativistic test particle model validates these experimental findings of the radiometer diagnostic for the first time for Aditya-U tokamak. Preliminary observations of the ECE radiometer signals also show that additional gas puffs can be used to vary the trigger timings of such PAS events or even lead to their complete avoidance.

20.
Rev Sci Instrum ; 93(9): 093512, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36182481

RESUMO

Runaway electrons (REs) are passively studied by hard x-ray (HX) emissions generated by REs. A LaBr3(Ce) detector-based HX spectroscopic diagnostic (operational within ∼75 keV to 3.5 MeV) has been set up on the ADITYA-U. The diagnostic acquisition software utility is upgraded to obtain the temporal evolution of the HX spectrum to understand the RE energy distribution in plasma during its various phases. The peak position moves to lower energy for Ohmically heated discharges (200-80 keV), indicating a relative increase in the thermal particle content in the plasma. The peak position of RE energy shows a decreasing tendency with increasing ne with Ne gas puffing and termination of the electron cyclotron resonance pulse.

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